– Written by Dr. Meghan Birt
Many of us have heard of non-steroidal anti-inflammatory (NSAIDs) before. Actually most of us have probably used them at one time or another. They are one of the most commonly used over the counter drugs. The most common types are aspirin, ibuprofen, motrin, alieve, acetaminophen (Tylenol) and Celebrex. They are most commonly used for headaches, reducing fevers, inflammation, muscle injuries, joint pain, arthritis and menstrual cramps. What if there were natural alternatives and home remedies to NSAIDs? There are many herbs, homeopathic remedies, minerals, essential oils and lifestyle changes that have been shown to reduce pain and inflammation. I’m going to share with you my favorites a little later.
The definition of an NSAID is a “class of drugs that provides analgesic and antipyretic (fever-reducing) effects, and, in higher doses, anti-inflammatory effects. The term nonsteroidal distinguishes these drugs from steroids, which, among a broad range of other effects, have a similar eicosanoid-depressing, anti-inflammatory action. As analgesics, NSAIDs are unusual in that they are non-narcotic and thus are used as non-addictive alternatives to narcotics. “ –Wikipedia
How do they work?
Before I get into exactly how they work I want to explain a few scientific processes and give a few definitions.
- Prostaglandins: NSAIDs decrease the production of prostaglandins. A prostaglandin causes inflammation, fever and pain. It’s an enzyme that is produced by the body’s cells. COX enzymes produce prostaglandins and NSAIDs block the COX enzymes from being produced. There are two types of COX enzymes and they have very different functions. COX-1 and COX-2.
- COX-1 Enzyme: The COX-1 enzyme is responsible for producing prostaglandins that activate platelets and activate the stomach lining. COX-1 actually protects the stomach from becoming damaged by the stomach acid. COX-1 also helps the kidneys excrete water. This enzyme actually has very little to do with the inflammation and pain that we experience. The enzyme responsible for pain and inflammation is COX-2.
- COX-2 Enzyme: The COX-2 enzyme are found in the white blood cells and are responsible for the pain and inflammation that we feel. COX-2 is stimulated by an immune response and the production is stimulated by inflammatory cytokines. COX-2 contributes to swelling, pain and heat. Think about it this way… imagine you took a big bite out of an extremely spicy pepper. Your bite included the seeds and the ribs, all the heat containing parts! Think about what will happen to your body—you will start feeling really hot (maybe a bead or two of sweat will start to form on your brow), you will feel pain in your mouth and you will probably start to feel swelling on your lips because of the intense heat. That is what is going on inside of your body when COX-2 releases.
NSAIDs work by blocking the effects of both the COX-1 and COX-2 enzymes. If you block those enzymes you will block your body from producing the prostaglandins. That means you will not have as much pain and swelling. It is also able to reduce “heat” aka a fever.
A good example of how an NSAID works is to think about a house. This is a big house with many rooms. In one of the bedrooms upstairs there are 3 candles burning. One spills over and starts a piece of paper on the dresser on fire. You notice that happening and pick up the phone to call every fire truck in a 20-mile vicinity to put out this small fire in the home. They all come and start spraying the entire house with all of their fire hoses. Does this make sense? You may be thinking… that’s a little unnecessary. All you needed to do was walk to the candle and burning corner of the paper and blow out the flame. Why call the entire fire team? That’s exactly how an NSAID works. When you take one of those pills it sends the whole fire team into the scene and blocks all COX-1 and COX-2 enzymes. It can’t tell the difference between the two. By choosing a natural pain reliever you are in control of only isolating a specific flame. Or to use our example, blowing out a candle instead of spraying your whole house with water from fire hoses.
Blocking both COX-1 and COX-2 enzymes come with side effects. Whenever we take something that unnaturally blocks a process our body was created to do has side effects.
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