Thursday, March 3, 2011

Non-Steroidal Anti-Inflammatory Drugs Linked to Erectile Dysfunction

For the last few years, I have recommended only curcumin or enteric coated aspirin to my clients for pain relief - not ibuprofen, not acetaminophen, and not naproxin sodium, two of which may cause heart damage (despite what the article below says) and one destroys your liver (that would be acetaminophen).

Now it turns out these drugs cause ED (erectile dysfunction) in men, which is probably more likely to get men to stop taking them than mere health issues.

So it's curcumin, a cox-2 inhibitor with no side effects other than lower cholesterol, lower risk of neurodegenerative diseases (Alzheimer's Disease and others) and lower risk of several forms of cancer. Below the main article is some research info on curcumin for pain.

Here is the article reference:
Joseph M. Gleason, Jeffrey M. Slezak, Howard Jung, Kristi Reynolds, Stephen K. Van Den Eeden, Reina Haque, Virginia P. Quinn, Ronald K. Loo, Steven J. Jacobsen. Regular Nonsteroidal Anti-Inflammatory Drug Use and Erectile Dysfunction. The Journal of Urology, 2011; DOI: 10.1016/j.juro.2010.11.092

Non-Steroidal Anti-Inflammatory Drugs Linked to Increased Risk of Erectile Dysfunction

ScienceDaily (Mar. 2, 2011) — Men who take non-steroidal anti-inflammatory drugs three times a day for more than three months are 2.4 times more likely to have erectile dysfunction compared to men who do not take those drugs regularly, according to a Kaiser Permanente study published online in The Journal of Urology.

While previous research showed a trend toward this same finding, this observational study used electronic health records, an automated pharmacy database and self-reported questionnaire data to examine NSAID use and ED in an ethnically diverse population of 80,966 men aged 45 to 69 years throughout California.

After controlling for age, race, ethnicity, smoking status, diabetes, hypertension, heart disease, high cholesterol and body mass index, the researchers found that ED was 1.4 times more likely -- a modest risk -- among regular NSAID users compared to men who did not take the drugs regularly. This association was consistent across all age groups.

"This study is a great example of how we work to understand the safety and effectiveness of what we recommend for our patients. We went into this study thinking we would find the opposite effect: that NSAIDs would have a protective effect because they protect against heart disease, which is also linked to ED," said study senior author Steven J. Jacobsen, MD, PhD, an epidemiologist and director of research for Kaiser Permanente Southern California. "The next step is to dive a bit deeper to understand the underlying physiology of what might be happening with these drugs."

Erectile dysfunction is a common problem in many middle-aged and elderly men. According to the National Institutes of Health, approximately 5 percent of 40-year-old men and between 15 and 25 percent of 65-year-old men experience ED on a long-term basis.

However, the researchers caution that men should not stop taking NSAIDs based on this study.

"There are many proven benefits of non steroidals in preventing heart disease and for other conditions. People shouldn't stop taking them based on this observational study. However, if a man is taking this class of drugs and has ED, it's worth a discussion with his doctor," Jacobsen said.

Study authors included: Joseph M. Gleason, MD, and Howard Jung, MD, from the Kaiser Permanente Los Angeles Medical Center; Jeffrey M. Slezak, MS; Kristi Reynolds, PhD, MPH, Reina Haque, PhD, MPH, Virginia P. Quinn, PhD, MPH, and Steven J. Jacobsen, MD, PhD, with the Kaiser Permanente Southern California Department of Research & Evaluation; Ronald K. Loo, MD, Kaiser Permanente Downey Medical Center; and Stephen K. Van Den Eeden, PhD with the Kaiser Permanente Northern California Division of Research.

The following comes from a review article on various alternatives to NSAIDs, and it's a 2010 article, so the information is current. The article is open access, available by clicking on the doi link.

Article Reference:
Maroon, JC, Bost, JW, & Maroon, A. (2010, December). Natural anti-inflammatory agents for pain relief. Surgical Neurology International; 1: 80. doi: 10.4103/2152-7806.73804
Curcumin (turmeric)
Curcumin is a naturally occurring yellow pigment derived from turmeric (Curcuma longa), a flowering plant of the ginger family. It has traditionally been used as a coloring and flavoring spice in food products. Curcumin has long been used in both Ayurvedic and Chinese medicines as an anti-inflammatory agent, a treatment for digestive disorders, and to enhance wound healing. Several clinical trials have demonstrated curcumin’s antioxidant, anti-inflammatory, and antineoplastic effects. Results of a study by Zandi and Karin suggested that curcumin might be efficacious in the treatment of cystic fibrosis because of its anti-inflammatory effect.[121] Curcumin is known to inhibit inflammation by suppressing NF-kB, restricting various activators of NF-kB as well as stemming its expression.

Curcumin has also been suggested as a treatment for colitis, chronic neurodegenerative diseases, arthritis, and cancer. In addition, it regulates the activity of several enzymes and cytokines by inhibiting both COX-1 and COX-2. Most studies to date have been performed in animals, but given the centuries of use of curcumin, as well as its now demonstrated activity in the NF-kB, COX-1, and COX-2 inflammatory pathways, it may be considered a viable natural alternative to nonsteroidal agents for the treatment of inflammation.

The usual dosage of standardized turmeric powder is 400–600 mg taken three times per day.[13] Side effects are few, but with extended use, this agent can cause stomach upset, and in extreme cases gastric ulcers may occur at very high doses. Caution should be used if the patient is taking anticoagulant medications or high doses of nonsteroidal drugs. Studies have shown that curcumin may be used in combination with lower doses of nonsteroidal medications.[79,11,21,40,87,111,121]
Look for 95% pure extracts of curcumin, of at least 500 mg per capsule (up to 1000 mg per capsule). I take three caps a day, spaced out with meals. My knee arthritis rarely bothers me any more. A 64 year old client with severe arthritis in his fingers and hands has had similar results.

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