Killing Pain or Killing Your Workout?

There are over 900 studies documenting the adverse effects of statin drugs designed to protect the heart by reducing cholesterol levels. Conversely, there have been reports that the statin statin-medicationsdrug Lipitor causes diabetes in women. However, more alarming for the millions of resistance training and fitness minded individuals, a new study appearing in the Journal of the American College of Cardiologyrevealed that statin drugs reduce mitochondrial efficiency by its destruction of CoQ10, the major energy molecule in the heart. Researchers now know that exercise promotes mitochondrial biogenesis, which is the creation of fresh new cells where energy is manufactured. This study revealed that a negative feed-back process kicks in because of this alteration in heart muscle bioenergetics causing the aerobic benefits of workouts that protect and strengthen the heart to be possibly cancelled out. While not publicized enough, the fact is 90% of the body’s physiological energy needs are dependent on CoQ10, as it allows the mitochondria to convert food metabolites (byproducts of metabolism) into ATP (adenosine-tri-phosphate), the energy molecule that sustains the body’s biological activities.

 Parallel Studies of NSAID Use

 Despite these unsettling proclamations medical and sports medicine professionals are voicing more concerns about the number of men and women having serious health complications up to and including death as a result of  prescribed non-steroidal inflammatory drugs (NSAID’s) and over-the counter ( OTC) painkillers like ibuprofen, diclofenac, naproxen and Tylenol. To put this disaster into NSAID_labelproper perspective, consider the fact that the number one cause of liver failure here in the US is acetaminophen poisoning.  Nonetheless research has shown that with women’s increased participation in athletics and fitness endeavors, this has pushed their usage of NSAID’s to a new high outside the realm of normal everyday aches and pains. The surprising thing here according to Dr. Tom Freiden, MD, Director of The US Centers For Disease Control is that women are taking more NSAID’s than males. More startling is the collective data indicating that since 1999 the percentage increase in death due to NSAID poisoning was actually higher among women than men (400% in women vs. 265% in men). Overall, prescription painkillers killed nearly 48,000 women between 1999 and 2010 with more than 6,600 women, or 18 every day dying from a prescription painkiller overdose. Additionally, there were more than 200,000 emergency department visits for negative pain killer events among women, about 1 every 3 minutes, validating the real danger of this seemingly harmless medication.

A Puzzling Problem

For reasons unknown research has shown that women are more likely to have more chronic pain, be prescribed prescription painkillers, be given higher doses, and use them for longer periods than men. The higher doses needed by women according to Dr. Frieden is not well understood because on average, women weigh less than men, but at the same or slightly higher dose, they are more likely to have an adverse event.

Unintentional Over Prescribing: A Common Trend

Dr. Jay S. Cohen, M.D., an associate professor of Preventive Medicine and Psychiatry at the University of California, states that nearly half of the people who overdose on acetaminophen do so unintentionally. Dr. Frieden contents that this is a societal problem. As a point of clarification here, societal here refers to the fact that NSAID’s are being over prescribed in hospitals, in private office setting, and over-used to combat minor aches and pain. This was recently voiced by Dr. Carl Orr MD of the Royal College of Surgeons in Ireland in a recent editorial in Medical Medscape, stating that use of NSAID’s is out of control. To make matters worst, Dr. Joseph Mercola, D.O. a well-known alternative medicine physician in Hoffman Estates, IL reminds us that we use acetaminophen based products like Tylenol as quick remedies for toothaches, headaches, backaches, colds and flu. It is this unintentional a little dab here and there that is extremely volatile as cited by Dr. Kenneth Simpson of the University of Edinburgh in Scotland.

Medical researchers refer to this as a staggered overdose which elicits more damage like liver failure and need for liver transplant versus one single large dose. However, what is most alarming within this chaos is a study in the American Journal of Emergency Medicine that revealed when doctors prescribed narcotic-acetaminophen combination pain medications to patients, they don’t warn patients about other medications containing acetaminophen that they should reduce or discontinue.

 The Problem with NSAID’s

While there exist a misconception that NSAID’s are only cautioned in patients with existing heart disease, researchers at the , Department of Cardiology at the Copenhagen University Hospital in Denmark state that even short-term treatment with most NSAID’s  is associated with increased risk of death. Additionally, many doctors already exercise caution when considering NSAID’s for the relief of chronic pain because these drugs increase the risk of ulcers and serious bleeding in the stomach and gastrointestinal tract. Furthermore, researchers at the Duke University Medical Center recently reported that even in healthy individuals, use of commonly available NSAID’s like ibuprofen, diclofenac, and naproxen are linked with increased risk of stroke. From a fitness perspective, researchers contend that many athletes and fitness enthusiasts take NSAID’s before every workout or competition.

Killing Healing Mechanisms Silently

Ironically, both alcohol consumption and fasting (due to illness, anorexia, or malnutrition) greatly increase the risk of liver injury due to acetaminophen. Fasting decreases levels of glutathione, the most abundant and powerful internal antioxidant that you naturally have. Glutathione helps the liver detoxify acetaminophen and in clinical trials has shown the ability to kill breast cancer cells. The key nutrient responsible for the production of glutathione is N-acetyl cysteine (NAC).  NSAID’s actually kill off your supply of NAC. This is why people who overdose on Tylenol are given large doses of NAC when they are brought to the emergency room. Dr. Mercola whom I spoke of earlier adamantly states that Acetaminophen-containing drugs should not be used for minor aches and pains and or exercise tolerance, but for severe pain, like recovering from surgery or an injury. However, if NSAID’s are warranted he suggest taking N-acetyl cysteine and for reasons just cited it is advisable not to take NSAID’s on a empty stomach. Incidentally, N-acetyl cysteine (NAC) is a protein supplement that can be purchase at your local vitamin store. Forward thinking medical professionals have petitioned the FDA to include an inset to alert NSAID users about the benefits of NAC, however to no avail.

Furthermore, studies indicate that consuming NSAID’s before a workout can increase the side-effects typically seen in heavy users. Apparently, an hour following ingestion of NSAID’s  they begin damaging  the intestines causing  alterations in a compound known as intestinal fatty acid  binding protein( I-FABP). This is how intestinal hemorrhages occur with repeated NSAID use.

NSAID’s Disrupt Recovery Efforts

As you know following a workout you need to have a cool down period, much like turning off your computer after a number of hours. Remember, your body is a network of multiple deeply interconnected systems, all of which get impacted to various degrees by training.  Rest and recovering from this ordeal, yes a painful one to the body is about more than just not taking berardi_study_exhaustionNSAID’s, it’s about giving your muscles, joints, your brain and internal communication system the time to heal as well as allowing your nervous system to calm down. This will help your body repair those tired aching muscles and keep those natural pain killers swarming within you on high alert. Unfortunately, when you take NSAID’s following a workout you reduce muscle satellite cell production. Satellite cells in skeletal muscle tissue in response to resistance training connect with existing muscle fibers forming new lean muscle tissue, and serve as key players in healing damaged muscle tissue. Also, according to Dr. Michael Loes, author of Healing Sports Injuries Naturally, 95% of sports injuries are due to minor trauma involving soft tissues like sprains, strains, contusions or bruising, resulting in inflammation and pain. Taking a NSAID inset like ibuprofen actually activates pro-inflammatory chemicals called prostaglandins which encourages sub-acute inflammation on top of the normal discomfort which  usually persisting longer than 3 or 4 weeks.

False Positives and Pain

To make recovery efforts worst Dr. Mellisa Stoppler M.D., Ph.D., who has served an Assistant Professor of Pathology at Georgetown University School of Medicine states that there is a wind-up phenomenon that causes untreated pain to get worse. Dr. Stoppler reminds us that nerve fibers like muscle tissue that gets stronger with exercise, become more efficient at transmitting signals to the brain, essentially amplifying pain signals even in cases of or slight injury. Consequently, the pain feels much worse, even though the injury is not worsening. At this point according to Dr. Stöppler, pain may be termed chronic and it is no longer helpful as a sign of injury. Conversely, a recent study appearing in Nature Reviews Neuroscience suggests that chronic pain affects the anatomy of the brain and impairs certain nerve pathways, leading to a negative feedback loop that prevents the brain from releasing its own painkillers. However, studies have found that this mishap can be reversed by employing the use of mind body healing techniques such as acupuncture, meditation and yoga. In fact, a new report coming out of Boston University revealed once-weekly yoga classes’ relieved pain, improved function, and reduced the need for pain medication.

Bottom line here, by focusing on just relieving pain before and after a workout without any emphasis placed on healing you are literally turning up pain signals that in some cases maybe false alarms.

Natural Freedom from Pain        

Dr. Carl Orr whom I mentioned earlier states that it is preferable to target the underlying cause of pain with pain-modifying anti-rheumatic drugs (DMARDs) than to prescribe NSAIDs. The most important aspect of these natural pain modifiers or DMARDs is there ability to promote healing. While this report can’t cover all of the natural pain relievers you have at your disposal, the synopsis below represents some of the most widely researched and utilized ones.

 The Natural Pain Reducing Alternatives

 Dr. Michael Loes, M.D. who also directs the Arizona Pain Institute at the University of Arizona, states that oral systemic enzymes like Wobenzym N are approved by all sports governing bodies, and has been used by many of Europe’s greatest Olympic and professional athletes. Dr.  Lowes in his research discovered that by adding proteases (enzymes that breakdown protein) such as bromelain, (derived from pineapple) and papain (derived from the papaya plant) following a workout accelerated muscle recover and greatly reduced inflammatory chemical that cause pain and swelling. In fact, in a recent study appearing in the Journal of Strength Conditioning and Research. Bromelain and papaya restored muscle power shortly after exercise, quickly re-establishing that portion of muscle strength it had lost.

Pain and Inflammation Control Naturally

Ironically, enzymes first seek out food particles to digest, but for sports injuries when taken on a empty stomach these guys immediately begin reversing exercised induced damage to tissues, much like little pac men devouring and breaking down all sorts of nasty chemical that cause pain and inflammation. For this reason sports medicine researchers and body building icons like Lee Labrada the author of Winning with the Enzymatic Edge recommend taking a multiple enzyme before and after workouts.

From his research, Dr. Merocola  recommends these natural pain relief products: Astaxanthin (a potent anti-inflammatory), Cetyl Myristoleate ( acts as an anti-inflammatory and lubricates the joints), Curcumin (  potent anti-inflammatory and can reduce Tylenol-associated adverse health events), Ginger( an anti-inflammatory, this herb offers pain relief and stomach-settling properties) , Evening Primrose, Black Currant and Borage Oils ( fatty acids that reduces arthritic pain) and Cayenne(capsaicin)  the active compound found in hot peppers, which reduces pain signals by down-regulating the body’s production of substance P, a chemical component of nerve cells that carry pain signals to your brain.

Natural Morphine Production

Moreover, the protein DLPA (DL-phenylalanine) is known to neutralize enzymes that inhibit release of endorphins known as the body’s natural morphine. White Willow Bark like aspirin, both contain the pain-killing compound salicylic acid, however chemically white willow doesn’t cause the gastrointestinal distress like aspirin, while Glucosamine and Chondroitin sulfate and Hyaluronic acid promote joint repair and Omega 3 Fish Oils termed by Dr. Joseph Maroon, M.D., Chairman of the Department of Neurological Surgery at the University of   Pittsburgh School of Medicine, as nature’s safest and most effective anti-inflammatory.

Explore and Incorporate a New Pain Reduction Technique

While not top of the list discussions around the gym or workout facilities, there are a number of non-medical protocols that definitively reduce pain, however in many cases unfortunately are mere afterthoughts. For example, simple stress reduction techniques like acupuncture, hypnosis, meditation, music therapy, relaxation therapy, and yoga and guided imagery. Furthermore, aromatherapy, bio-feedback, Epsom salt baths, deep tissue bodywork as well as hot and cold packs, massage therapy and magnet therapy can help. Last but not least give your self sometime to recover. You should have some on and off day’s in-between your workouts and get some sleep. Dr. Dawn Marcus M.D. a Neurologist and Professor at the University of Pittsburgh reminds us that studies show people who only sleep 4hrs a night, their pain threshold drops significantly. Pain management expert Dr. Harris H. McIlwain, MD, board-certified in rheumatology tells us that when the brain chemical serotonin is depleted from lack of sleep this causes an increase in sensitivity to pain and malaise (a general feeling of illness) to develop.


Pain is an important signal that lets you known something is wrong.  However, in the world of bodybuilding and fitness enthusiasts, the goal is to reduce body fat, become stronger and ultimately improve health. However, in the process you shouldn’t confuse pain relief with rebuilding and regeneration because this is what will allow you to keep reaching that next fitness, growth or strength plateau. Lastly, and most important for whatever reason you have to take NSAID’s be aware of how much and how often you are staggering your intake with other OTC products that contain acetaminophen. There is a clear and present danger here to both men and women. Finally, consider adding NAC to offset the negative effects of NSAID’s.


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George L. Redmon, Ph.D.

Dr. Redmon has been associated with the vitamin and health industry for over 25years, having served as The National Product and Education Director for one of the country’s largest retailers of nutritional supplements. He has been widely published in many major bodybuilding, fitness and alternative medicine publications. He is the author of

Natural Born Fat Burners, Managing and Preventing Arthritis: The Natural Alternatives, Energy for Life and is a member of The National Academy of Sports Medicine and The International Society of Sports Nutrition.