Most of us lift weights to gain strength and to boost the amount of muscle we carry on our frames. Even if you don’t want muscle definition, you need resistance training to reduce the natural loss of muscle that comes with aging. So, you work hard to optimize your diet and your training, but could common non-prescription analgesic medications, probably already in your medicine cabinet, interfere with your muscle hypertrophy gains?
The medications under scrutiny are analgesics, drugs you can buy at any pharmacy to relieve pain and muscle soreness. The two main groups of over-the-counter analgesics are ibuprofen and acetaminophen. People take these medications for everything from fever to menstrual cramps. Serious bodybuilders and athletes are no stranger to these medications either. Athletes take them to ease the pain of strains and injuries, and people who weigh train often pop one or two to ease delayed-onset muscle soreness or DOMS.
These medications offer temporary relief from aches and pains, but could they interfere with muscle gains?
Ibuprofen and Muscle Protein Synthesis
Ibuprofen is the preferred choice of people who weight train as it is more effective at relieving muscle aches and pains than acetaminophen. Ibuprofen and other NSAIDs work by blocking the enzyme called cyclooxygenase inhibitors, also known as COX enzymes. These enzymes boost the production of inflammatory chemicals called prostanoids. By blocking prostanoid with ibuprofen and other NSAIDs, you feel less pain and experience less inflammation until the medication wears off.
Blocking inflammation sounds like a good thing, but some studies show that inflammation plays a role in muscle hypertrophy. In fact, prostanoids seem to stimulate anabolic pathways that build muscle by acting as signaling molecules. Without prostanoids, muscle protein synthesis is hampered. Most of the evidence to support this is in rats. Studies in humans have been inconsistent. One showed that taking NSAIDs after eccentric training reduced muscle protein synthesis by more than half. However, other studies show no interference with muscle protein synthesis and one even found that NSAIDs increased it.
Why are these findings so inconsistent? There are many factors–animal vs. human subjects, intensity, and type of training, and whether the study used trained or untrained individuals. Age is a factor too. Older individuals often have baseline low-grade inflammation that a younger person doesn’t have. So, it is possible that NSAIDs have differing effects on younger individuals and those who are untrained as opposed to older people and highly trained ones.
Acetaminophen
Acetaminophen is another popular analgesic available without a prescription. Many people use it to treat aches and pains and to lower fever. However, some studies suggest that it may decrease muscle protein synthesis. In one study, young, healthy volunteers took either 4,000 milligrams of acetaminophen, 1200 milligrams of ibuprofen, or a placebo after completing sets of eccentric leg extensions. A day later, the participants underwent a muscle biopsy. It showed a reduction in muscle protein synthesis in both the acetaminophen and the ibuprofen group but not the placebo.
Timing and duration of use may be important too, as a 3-month study of elderly people found those who took analgesics daily experienced an increase in muscle size and strength relative to the placebo, as confirmed by muscle biopsy. So, the matter is far from settled. Differences in age and the dose of analgesics used in the two studies may explain the discrepancy in findings. Plus, one study was short term, and the other lasted three months.
Why You Should Avoid Over-the-Counter Analgesics
Taking occasional acetaminophen or ibuprofen for a headache or achy muscles probably won’t interfere with muscle growth, but both medications have potentially serious side effects if you take them for long periods of time or take above the recommended dosage.
Ibuprofen can cause stomach irritation and bleeding from the intestinal tract. In people who are sensitive, even one dose can cause bleeding. In addition, some drugs, particularly ACE inhibitors, lower blood pressure by their action on the kidneys. Ibuprofen also has an impact on the kidneys, and ACE inhibitors and ibuprofen often don’t get along, especially in people who are mildly dehydrated. In fact, the combination of ibuprofen, ACE inhibitors, and dehydration can cause kidney damage and a rise in blood pressure. Finally, studies now show that NSAID use is linked with a higher risk of heart attack, especially in people who are already at high risk.
Acetaminophen has drawbacks and risks too. It’s processed by the liver and has a narrow therapeutic range, meaning there’s a fine line between the amount that relieves symptoms and the amount that’s toxic. Although it’s usually safe as long as you don’t take more than the recommended dosage, drinking alcohol can affect its metabolism and increase the risk of toxicity. In fact, people who drink a lot of alcohol need to adjust the dose they take to be safe. Also, people with liver disease of any type are at higher risk of serious side effects from acetaminophen.
Just because it’s available without a prescription doesn’t guarantee its safety! Achy muscles might be uncomfortable, but it’s safest to try alternative strategies for pain relief, including massage, stretching, heat, ice, etc., as opposed to taking analgesics with side effects. There’s preliminary evidence that some foods and supplements, including tart cherry juice, turmeric, ginger, and omega-3s reduce inflammation and may help with the pain. If you have to take analgesics, do it for the shortest time possible and stick to the recommended dose. Be sure to stay hydrated too!
The Bottom Line
The impact analgesics have on muscle hypertrophy isn’t clear. Some studies suggest that they interfere with muscle protein synthesis and a few imply that they might boost muscle growth. How’s that for conflicting information? Also, just because something interferes with muscle protein synthesis doesn’t necessarily mean it impeded muscle growth since other factors play a role too. But when you combine these studies with the other potential side effects of taking analgesics on a frequent basis, it’s better to limit how frequently you take them.
References:
· American Journal of Physiology, Regulatory, Integrative and Comparative Physiology. 292: R2241-R2248, 2007.
· Sports Med. 2012 Dec 1;42(12):1017-28.
· Pharmacy Times. “Acetaminophen, Ibuprofen, or Neither?”
· Am J Physiol Endocrinol Metab. 2002 Mar;282(3):E551-6.
· Am J Physiol Regul Integr Comp Physiol. 2011 Mar;300(3):R655-62.
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