Ibuprofen for altitude sickness

Vitamin I delivers again? This looks interesting...

"(Health.com) Ibuprofen has been used for decades to treat pain. Now, research suggests the drug's anti-inflammatory properties also may help prevent the piercing headaches and other symptoms of altitude sickness.

A small new study, published this week in the Annals of Emergency Medicine, found that people who took four 600-milligram doses of ibuprofen over a 24-hour period in which they ascended to 12,570 feet above sea level were less likely to experience altitude sickness than people taking a placebo.

Sixty-nine percent of the participants who took placebo during the ascent developed the headaches, nausea, dizziness, and fatigue that characterize altitude sickness, also known as acute mountain sickness. By contrast, just 43 percent of people who took ibuprofen developed the condition.

The prospect of using an over-the-counter pain reliever to stave off altitude sickness is appealing, the researchers say, because the only two drugs currently approved to prevent and treat the condition, acetazolamide and dexamethasone, are prescription-only and carry a risk of side effects.
..."

More here: cbsnews.com/8301-504763_162…

I generally carry about 10-15 Advil/Ibuprofen for a week in the mountains, and rarely use it all. I might start being more conscientious about my consumption of "I" now.

The prior wisdom was to avoid taking ibuprofen to avoid masking headache and other symptoms of altitude sickness. I generally take it because, after having my knee rebuilt twice, it really keeps the inflammation down. It may aid in acclimating, but I've never really had much a problem with that anyways. Maybe I was getting a little help all along?

Now are we sure we arent just masking the symptoms and not treating the problem at all? I would be worried about people pushing higher harder and faster and now developing worse AMS problems(HACE, HAPE, etc)

Good points about potentially inviting more trouble by masking symptoms. I'm not sure if that's what is happening though - will have to wait for the paper to actually be published before we get more details.

Correction: Ibuprofen helps alleviate your throbbing head ache from Viagra (also a alt. drug), just a joke. Viagra is supposed to help people with Raynaud’s or bad circulation. Personally I’ve only taken 81mg of Aspirin a day to help with headaches and thin the blood to prevent cold injuries at high altitude. Just acclimate smart and slow.

You could not pay me to take it. Ibuprofen is a non-selective cyclooxygenase inhibitor and not only inhibits Cox-2 (inflammatory), but Cox-1 (necessary for repair, especially joint and intestinal tissue). People who take it for their aches and pains after a hard day of exercise, or being at high altitude, are inhibiting their body's ability to heal, in addition to adding to electrolyte imbalance.

There are better natural alternatives. This article/study is aimed at selling more ibuprofen to sedentary people planning their staycations to high-altitude states this summer.

JohnJ80302 wrote:This article/study is aimed at selling more ibuprofen to sedentary people planning their staycations to high-altitude states this summer.

Yop!

The study used 86 participants and did not specify race and age. Race and age consideration make a huge difference when analyzing pharmacological evidence. Additionally, reduction in severity of symptoms was not statistically significant. Therefore, the conclusions which can be drawn from the data are little more than speculation.

This link is better med.stanford.edu/ism/2012/m…

A key point - The authors say that taking more than 600 mg of ibuprofen might “provide more robust prevention,” but that the theoretical benefit of such a move would have to weighed against a possibly increased risk of gastrointestinal and kidney problems in people who may be dehydrated.

If anyone can find it, I would love to read a formal results and discussion from this experiment.

-Jonathan

419 wrote:If anyone can find it, I would love to read a formal results and discussion from this experiment. -Jonathan

http://www.annemergmed.com/webfiles/images/journals/ymem/FA-gslipman.pdf

JohnJ80302 wrote:This article/study is aimed at selling more ibuprofen to sedentary people planning their staycations to high-altitude states this summer.

Actually the research was sponsored by the Stanford University School of Medicine and the American Alpine Club, not by some drug company. The whole point of the article was that ibuprofen could be used an alternative to acetazolamide (Diamox), which is a whole lot more expensive and less convenient than ibuprofen since it requires a doctor's visit to obtain a prescription and a pharmacist's dispensing fee.

The study is way too small to draw any conclusions, plus as the paper states the study failed to show much statistical significance in the results. Another contribution to the classic "ulcers vs. headache" dilemma.

doligo wrote:the study failed to show much statistical significance in the results.

There was a statistically significant decline in the incidence of AMS (43% vs 69%). But for those who reported AMS there wasn't a significant decline in the severity of symptoms between the two groups.

Some of limitations of the study are (i) they didn't go very high (12,500') and (ii) they didn't do a direct comparison between ibuprofen and acetazolamide - only between ibuprofen and a placebo.

johnL wrote: For an article on some relatively benign effects on a relatively common practice already to be an industry funded conspiracy is a bit of a stretch no?

Nothing was said about any industry funded conspiracies; it's just another attempt to find novel uses, and new profits, for an incredibly ineffective and dangerous OTC drug. And the fact that it's a 'common practice' only speaks to how ubiquitous the misinformation really is. I know people who swear by 'Vitamin I', and they've obviously swallowed the Kool-Aid.

Personally, I'd take co-dergocrine mesylate (Hydergine), which has more research, at higher altitudes, and has shown more efficacy. It actually attenuates hypoxia and prevents cellular damage at altitude. Hydergine was discovered by Albert Hoffman when he worked for Sandoz, and is a prescription in the USA. It is another medication he derived from ergot alkaloids, a natural source. One can order it online and import it legally for personal use.

ncbi.nlm.nih.gov/pubmed/136…

ncbi.nlm.nih.gov/pubmed/153…

ncbi.nlm.nih.gov/pubmed/208…

If you take ibuprofen its a good idea to make sure you stay well hydrated, since it can effect kidney function. I avoid it before and during exercise, as renal blood flow is reduced during exercise. I figure afterwards I can take it while hydrating. I am going to Cirque of the Towers in July, as a flatlander I will be bringing some ibuprofen along.

JohnJ80302 wrote:it's just another attempt to find novel uses, and new profits, for an incredibly ineffective and dangerous OTC drug... Personally, I'd take co-dergocrine mesylate (Hydergine)

Generic ibuprofen 200mg costs about a penny a tablet if purchased in bulk. I don't think anyone's going to be making much in the way of profits by promoting ibuprofren for AMS prevention.

I'm sure you're sincere in your views about Hydergine, and I agree that the ibuprofen study has many shortcomings, but it's ironic that you think that this study was motivated by profits yet you prefer an alternative that costs over 100 times as much.

Wait, whats all this jibber jabber about Ibu being a devil drug? Ibu is my go to pain reliever, and I haven't had any bad side effects. I find it works much better for me than Tylenol does, and I've been taking it for years, including in prescription form when I broke my back. So what's the scoop?

Hmm, I'd have to disagree-- the scoop is that ibuprofen causes a fair number of serious GI bleeds, kidney failure (usually reversible if you stop the drug) and there's some literature that it hinders healing of soft tissue injuries (like ligaments and tendons.)

I take it rarely, but then I avoid medicine when I can.

As for the study itself, I'm unconvinced. They failed to show a significant change in AMS score (albeit with a trend towards a minor improvement,) and I suspect the only reason the difference in AMS frequency reached significance is that most of the patients in both treatment arms are very near 3 points on the Lake Louise Questionaire, so that minor changes in AMS score are magnified when converted to the yes/no, AMS or not result of the Questionaire.
It's interesting that the biggest improvement in symptoms for the patients who took ibuprofen was in GI complaints rather than headache.
I wonder how tyelenol would stack up in a similar study.

Mark

lmao

Taylor Ogden wrote:Wait, whats all this jibber jabber about Ibu being a devil drug? Ibu is my go to pain reliever, and I haven't had any bad side effects. I find it works much better for me than Tylenol does, and I've been taking it for years, including in prescription form when I broke my back. So what's the scoop?

It will shut your kidneys down if you take it chronically. Acute Kidney Injury isn't really a path you want to go down. If you are using it as directed and not for weeks straight at a time, you are probably going to be alright.

edit: Oh yeah, and GI bleeds like Mark was saying above. In short: when you've got blood in your crap and can't piss, you've probably taken too much Vitamin I ;).

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Taylor Ogden wrote:Wait, whats all this jibber jabber about Ibu being a devil drug? Ibu is my go to pain reliever, and I haven't had any bad side effects. I find it works much better for me than Tylenol does, and I've been taking it for years, including in prescription form when I broke my back. So what's the scoop?

The other problem with Ibuprofen is that it accumulates in your body and takes a long time to be eliminated. Kidney damage can be insiduous, you may not know that you have a problem until there has been a lot of damage.

Football pro Kenny Easley lost his kidneys because of ibupron.
en.wikipedia.org/wiki/Kenny…

In place of ibuprofen for inflammation try bromelain-an enzyme from pineapples that is a very effective antiinflammatory if taken on an empty stomach. Also, try Arniflora Gel-an arnica gel applied topically that works incredibly and doesn't stink like some of the other topical gels.