Are your habits causing inflammation? Plus 5 reasons to think before popping the ibuprofen

Many of us don’t think twice about chucking that economy-sized bottle of ibuprofen into our shopping carts right along with a head of lettuce and a jug of protein powder. Indeed, “Vitamin I” has become a staple strategy for reducing America’s pain and inflammation. Headache? Menstrual cramp? Backache? Overzealous-workout-induced muscle aches? Sure, ibuprofen can ease your discomfort. And I shouldn’t be picking on ibuprofen here—there are a plethora of other, so-called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) out there. Drugs like aspirin, naproxen, and prescription-only agents like meloxicam and celecoxib (aka Celebrex) are quite fashionable as well.

Here’s a crazy stat for your next cocktail party (or not): each year, we Americans collectively pop a whoppin’ 30 BILLION doses of NSAIDs like ibuprofen and naproxen. I don’t think Costco makes a bottle THAT big….yet.

As a pharmacist, I don’t think there’s too much harm in the occasional use of drugs like ibuprofen or naproxen by people who have a healthy heart and blood pressure, good kidney and liver function, and a fortified gastrointestinal tract. But, I see that many people aren’t aware of the risks of frequent or chronic use of even over-the-counter (OTC) NSAIDs like ibuprofen and naproxen (aka Advil, Motrin, Aleve).

Let me break it down for ya:

  • Roughly 1 of every 4 people who chronically use NSAIDs will develop an ulcer
  • Risk of a gastrointestinal bleed or perforation (YIKES!) is about 4 times higher in people who use NSAIDs compared to those who don’t
  • NSAIDs reduce blood flow to the kidneys and can result in kidney damage—especially if used frequently by people with high blood pressure, heart failure, or diabetes.
  • About 1 in every 10 cases of drug-induced liver damage is due to NSAIDs
  • If you take low-dose aspirin for cardiovascular health, some NSAIDs actually reduce the heart benefit of that aspirin

Back to the gut for a sec: scientists who want to better understand how NSAIDs (like OTC ibuprofen, naproxen, and regular-strength aspirin) cause ulcers have actually shown that they profoundly change the composition of the gut microbiome, and not for the better (if you missed my last post that espoused the magic of the microbiome, you can read it here). In other words, when we take NSAIDs, we are risking hostile takeover of our gut microbiomes by not-so-friendly bugs. And that could negatively affect our physical, mental, and emotional health as outlined in my previous post.

For all of the fitness enthusiasts out there, how often do you turn to OTC or prescription NSAIDs to ease joint or muscle aches? I’m hearing more and more that people in the athletic / fitness community are popping NSAIDs to keep injuries from “flaring up” or to reduce DOMS (delayed-onset muscle soreness) after workouts and training sessions. In addition to the stats on potential NSAID-induced adverse effects listed above, here’s another reason to pause before you pop that pill: researchers have shown (for decades) that NSAIDs actually impede the building and repair of muscle. And while the human data are more ambiguous than the dramatic effects seen in animal studies, the totality of evidence has convinced most experts to recommend against long-term use, especially of prescription doses of NSAIDs. The general consensus from a recently published review article in the journal Connective Tissue Research is that NSAIDs inhibit the healing process of connective tissue and the stimulating effect of exercise on connective tissue protein synthesis.

Interestingly, at least one study has shown that 400mg of ibuprofen (a standard OTC dose) had no more effect on post-exercise muscle soreness than placebo.

Healthy ways to quash inflammation

How can you continue your exercise / training routine while reducing the use of drugs like ibuprofen, naproxen, etc? What if you have chronic aches and pains?

Below I’ve included 5 non-NSAID strategies that can help reduce the amount of inflammation in the body and shift you back toward a healthy balance of inflammation. Remember that inflammation isn’t all bad! When we’re injured or have an infection, for examples, inflammation is crucial to the healing process—it’s how the body fights back and repairs damage. BUT, it’s important to consider that inflammation is not necessarily just an acute response to injury. More and more, researchers across multiple specialties—from the brain to the heart to the liver to the gut—are all finding that “silent”, chronic inflammation is a key underlying commonality of diseases like diabetes, heart disease, depression, ADHD, Alzheimer’s disease, liver disease and even cancer.

These 5 strategies below aren’t quick fixes—more like habits to be incorporated into your lifestyle.

  1. Cut down on sugar and processed food. Better yet, eliminate them. Sugar has been shown to trigger the release of chemical messengers in the body that promote inflammation. Processed foods in general ain’t doin’ you any favors.
  2. Choose fats that are rich in anti-inflammatory omega-3 fatty acids. Many food products in the aptly-acronymed SAD (standard American diet) are relatively heavy in pro-inflammatory omega-6 fatty acids. We do need omega-6 fatty acids, but the SAD tilts the scale waaaay to much in favor of omega-6—like about 20x too much! Many oils found in abundance in processed foods are high in omega-6, such as corn, peanut, vegetable, safflower and sunflower oils. And trans fats (hydrogenated oils) are also known to promote inflammation. In addition, grain-fed meats from factory farms are rich in omega-6. On the flip side, foods like avocados, olives, walnuts, almonds, flax seeds, chia seeds, pumpkin seeds, coconut, coconut oil & milk, grass-fed beef, pastured chicken (and eggs), grass-fed butter, and ghee (clarified butter) are all rich in omega-3 fatty acids.
  3. Get enough good sleep. Sleep is when our bodies repair. And the vast majority of us are not getting enough restorative, uninterrupted sleep. The American Academy of Sleep Medicine recently stated that sleeping fewer than 7 hours per night is associated with weight gain, diabetes, depression, heart disease, impaired immune function, increased pain, and impaired performance—lots of the same issues that are related to too much inflammation.
  4. Consider supplementing with omega 3 fatty acids. I personally take a tablespoon daily of Barlean’s Ultra High Potency Omega Swirl. It tastes great (my uber-picky 4-year old thinks it’s a treat to get a teaspoon after dinner), with NO burping / indigestion issues that people often complain about with capsules. By the way, one of the main reasons those fish capsules may be giving you the burps is because the oil is rancid. YUCK is right. To avoid this, be picky when buying fish oil—get one that is “molecularly distilled” which means that the oil has been purified enough to remove contaminants that promote rancidity. (Note that Barlean’s Omega Swirl does not say “molecularly distilled” on the bottle, but I checked the company’s website FAQ’s and their fish oils are ultra-purified through molecular distillation). Also, choose a fish oil with roughly 1000mg EPA and 500mg DHA (2 key types of omega-3)—don’t just look at the total milligrams of omega 3’s.
  5. If you have joint pain or other inflammation-related conditions, consider taking curcumin. This is a key component of turmeric, the yellow spice that gives curry its bright color! This substance has been studied for MANY types of inflammatory conditions ranging from diabetes to dementia, and is currently the subject of much ongoing research. Here are some VERY important considerations before you start taking a curcumin (or turmeric) supplement:
    1. Not a good idea to start curcumin if you are currently taking warfarin (Coumadin) or clopidogrel (Plavix). Curcumin can increase the anti-clotting effects of these drugs.
    2. Pick a supplement that contains a specific type of curcumin known as “BCM-95”. This specific formulation is much better absorbed. Turmeric capsules are very poorly absorbed, meaning that very little of it will actually get into your system. Several companies now make BCM-95 formulations. I have no ties / relationships with any of them. I personally take a brand called CuraMed (made by Terry Naturally), one 750mg capsule daily, and have had none of the GI distress that has been reported with other turmeric supplements.

My short take on all this:

There’s A LOT we can do to tamper inflammation that doesn’t involve medications that come with potentially counterproductive or even dangerous side effects. What we choose to do on a daily basis has a ginornmous impact on our levels of disease markers, including inflammation—both the kind that we feel as pain and the “silent” inflammation now recognized as a component of many chronic diseases. Our food choices, physical activity, and sleep are so important to our health. You may hear this advice all the time, but are you really checking into gauge your food, movement, and sleep habits? And if they aren’t so healthful, are you ready to make changes for the better?

Please share any questions you have about inflammation and treatment options, and I will do my best to provide answers!


Lanza FL, Chan FKL, Quigley EMM, et al. Prevention of NSAID-related ulcer complications. Am J Gastroenterol 2009; 104:728–738.

Dideriksen K. Muscle and tendon connective tissue adaptation to unloading, exercise and NSAID. Connect Tissue Res. 2014;55:61-70.

Krentz JR, Quest B, Farthling JP, Quest DW, Chilibeck PD. The effects of ibuprofen on muscle hypertrophy, strength, and soreness during resistance training. Appl Physiol Nutr Metab. 2008;33:470-475.

Rutters F, Nieuwenhuizen AG, Lemmens SG, Born JM, Westerterp-Plantenga MS. Acute stress-related changes in eating in the absence of hunger. Obesity (Silver Spring). 2009;17:72-77.

What’s brewin’ in your belly? The role of your microbiome

What’s brewin’ in your belly? The role of your microbiome

by Amy Beausang, PharmD and certified health coach

Ever notice that many common expressions contain the word “gut”? Phrases like “trust your gut”, “gut instinct”, and “gut feeling” connote that sometimes you just KNOW something is right, even if you don’t know WHY. It’s almost like your gut is some kind of brain or something.

Not almost. Your gut actually is a kind of “brain”. In fact, scientists often refer to the gut as “the second brain”. And the impacts of this second brain on everything from digestion to dementia are becoming vividly clear and largely dependent on…wait for it:

GUT BUGS. Yep, turns out your second brain contains some 100 TRILLION microbes, mostly bacteria. And you didn’t think anything could make our national debt look small—ha! What’s more, these gut bugs—now fashionably referred to as “the microbiome”—play a big role in your ability to:

  • Lose weight and keep it off
  • Fight infection
  • Digest food and absorb nutrients
  • Control inflammation, a major culprit in many chronic diseases
  • Be happier and handle stress

But I have some bad news. Our belly bugs tend to be all out of whack, thanks in part to massive overuse of antibiotics. Antibiotics—even when they are appropriately prescribed—may eradicate the bugs that are making us sick, but also lots of the good guys, too. Ever gotten a yeast infection after a round of antibiotics? This pleasantry occurs because antibiotics don’t discriminate—the good guys die, too, and those non-susceptible nasties shout “PARTY IN DA HOUSE!” and just proliferate like crazy.

But antibiotics aren’t entirely responsible for our imbalanced bellies. The standard American diet (SAD) of low-fiber, high sugar, highly-processed food is feeding our highest obesity rates in history while paradoxically starving our microbiomes. Why is this and why should you care?

In his latest awesome book, Brain Maker: The Power of Gut Microbes to Heal and Protect Your Brain—For Life, board-certified neurologist Dr David Perlmutter tells us (and repeats it because it’s IMPORTANT, people!) that “Diet has the dominant role in shaping our gut microbiota, and changing key populations may transform healthy gut microbiota into a disease-inducing entity.

Ahem. In normal, non-doctor speak: “Those belly bugs you got brewin’ up in there are largely a result of what you put in your mouth, so when you eat or drink sugar, refined carbs, and highly-processed food, you give the bad bugs license to thrive.” Why is this a big deal? Becuase an imbalanced microbiome is now linked to a host of maladies including obesity, type 2 diabetes, depression, anxiety, Alzheimer’s, autism spectrum disorder, eczema, asthma, multiple sclerosis, rheumatoid arthritis, Crohn’s disease, ulcerative colitis, and atherosclerosis.

On the flip side, enjoying a variety of high-fiber veggies, healthy fats (avocados, olives, nuts, chia seeds, pumpkin seeds to name a few), and fermented foods (such as live-cultured yogurt, kefir, tempeh, kimchi, sauerkraut, and kombucha) can help your probiotics flourish. The good bugs love this stuff, and incorporating these foods into your everyday life will give you love in return. If you need a little extra help in the happy bug department, supplementing with probiotics is a widely available option. To ensure a smart purchase, Dr Perlmutter recommends checking with a reputable store and choosing supplements that contain at least the following probiotic species:

  • Lactobacillus plantarum (immunity and inflammation regulator)
  • Lactobacillus acidophilus (also found in yogurt, yeast infection fighter and healthy cholesterol maintainer)
  • Lactobacillus brevis (brain bug extraordinaire)
  • Bifidobacterium lactis (aka animalis; digestive comforter and immune booster)
  • Bifidobacterium longum (antioxidant, free radical scavenger, anxiety reducer) 

I would be remiss in my duty if I didn’t mention prebiotics. Prebiotics are “fuels” that promote probiotic growth. Dandelion greens, garlic, leeks, onions, and asparagus are great sources. AND, you can also use a prebiotic supplement daily to nurture your microbiome. I settled on a product made from acacia fiber that easily mixes with water. I purposely avoided psyllium fiber because it can cause bloating, cramping, and gas. Got no time for that.

So, if you’re a reverse reader, here’s the 5-point summary:

What’s brewin’ in your belly? The role of your microbiome

Wishing you happy bellies,