Nsaids and Protein Synthesis

NSAIDs and Muscle Building

According to research published in the The Physician and Sports Medicine, since NSAIDs are over-the-counter (OTC) medications and aren't banned from competition by the World Anti-Doping Agency, "athletes often self-administer these medications to prevent pain and inflammation before it occurs. However, scientific evidence for this approach is currently lacking, and athletes should be aware of the potential risks in using NSAIDs as a prophylactic agent. These agents are not benign and can produce significant side effects, including gastrointestinal and cardiovascular conditions as well as musculoskeletal and renal side effects.

But that's not all: there are also performance side effects for the weightlifter to consider. Drugs such as ibuprofen are classified as COX inhibitors, and since COX (cyclooxygenase) activity is a critical component of muscular hypertrophy, there's a clear link: Ibuprofen can inhibit muscular hypertrophy.

In fact, previous research suggests that treatment with ibuprofen can reduce muscle hypertrophy by almost 50 percent, which means that taking a COX inhibitor may very well be counterproductive for muscle gains.

While these are intriguing findings, we must keep in mind that these studies were conducted in rodent models. The research still needs to be scrutinized since a handful of studies have also been done on humans and have yielded conflicting results.

One of the first human studies to support the notion that NSAIDs may blunt protein synthesis was published in the American Journal of Physiology, Endocrinology, and Metabolism.4 Participants were given the maximal over-the-counter dose for ibuprofen, acetaminophen, or a placebo following 10-14 sets of eccentric knee extensors.

Researchers found that rates of protein synthesis were suppressed in groups taking the NSAIDs. Results from this study support the earlier findings that NSAIDs may negatively influence protein metabolism in skeletal muscle.

Research suggests that treatment with ibuprofen can reduce muscle hypertrophy by almost 50 percent.

However, more recent research on human subjects has demonstrated that NSAIDs do not necessarily impact muscle protein synthesis as much as previously thought. In fact, there are several studies that have found chronic supplementation (12 weeks) actually improved muscle strength and size.

The problem with these studies, however, is that each have their own limitations we must consider. For example, a majority of the research on NSAIDs as it relates to muscle protein synthesis has been done in untrained individuals; hence, the results might yield a different outcome on athletes who are already active and have a larger degree of muscle mass than an untrained person.

Some of the research also looked at only older subjects with osteoarthritis; thus, these results might not be indicative of results for healthy, active individuals. Finally, some of these studies only looked at the effects of NSAIDs on the acute changes in muscular hypertrophy, and these findings may not reflect the long-term adaptations to muscular hypertrophy with prolonged use of NSAIDs.

While there's certainly a time and place to utilize NSAIDs, the key takeaway is that they should be used with caution, in relatively moderate dosages, and for short periods of time.

An article published in the Critical Journal of Sport Medicine discussed the practical management of NSAIDs in athletic injuries and concluded that NSAIDs are not recommended in the treatment of completed fractures, stress fractures at higher risk of nonunion, or in chronic muscle injuries.

While the authors of the article recommended NSAIDs for the management of acute ligament strains, muscle strains, tendinitis, and eccentric muscle injury, they cautioned that the prescription of the NSAID should be judicious and the length of treatment should be kept as short as possible.

NSAIDS can help with short-term pain management, but their use should be minimized not only because of their potential long-term side effects, but also the impact they may have on making substantial gains in muscle mass.

Even with some conflicting research, this much is clear: Don't reach for a bottle of ibuprofen every time you have a slight bout of DOMS. Recognize that the inflammation you're experiencing is part of the muscle-building process, and save NSAIDs for when you really need them.

In a nutshell, we need to keep anti-inflammatory to a minimum to keep protein synthesis as high as possible to accumulate maximum tissue in the shortest time possible.