Do nsaids affect muscle growth? Learn about the effects of ibuprofen on muscle growth and how it may impact your workout routine.
DO NSAIDS AFFECT MUSCLE GROWTH? SUMMARY
- NSAIDS don’t kill your gains, as a new study found no differences in muscle growth.
- Long-term NSAID use should not be a crutch to overcome continued training. Adjust your training so that you are not dependent on NSAIDs.
Introduction
Athletes are known to self-medicate to improve performance and improve muscle mass. It is not uncommon for lifters to take Advil before a workout or pop ibuprofen for soreness. You may have heard the rumors that taking non-steroidal anti-inflammatory drugs (NSAIDs such as aspirin, Advil, naproxen, Aleve, ibuprofen, and Tylenol) during weight training will kill your gains, but is there any truth to this? Does Ibuprofen kill muscle growth or does ibuprofen help muscle growth? A previous article on Evidence Based Muscle discussed how low dosages of ibuprofen do not reduce growth in young lifters, but a maximal dosage does.
Some studies suggested that ibuprofen reduces hypertrophy, while others found no such effects, and some found beneficial effects. This likely depends on the dose, age, and type of resistance training used in the study. This article will discuss the newest research on ibuprofen and hypertrophy, focusing on whether NSAIDs will kill your gains.
Understanding NSAIDs, Acetaminophen, and PainKillers: Do They Help Sore Muscles?
Elite athletes and recreational athletes often use pain pills like ibuprofen to manage headaches, pain, and inflammation. However, it’s important to understand the potential risks associated with these medications. NSAIDs work by blocking cox enzymes COX-1 and COX-2, which play a role in inflammation and pain. By blocking these enzymes, NSAIDs can reduce pain and inflammation but can also cause side effects such as stomach ulcers, delayed tendon healing, kidney damage, and increased risk of heart attack or stroke.
While some studies suggest that NSAIDs may hinder growth and recovery after exercise, the scientific evidence is inconclusive. First, It’s important to understand why you use pain inhibitors. Is it for an acute reason, or have you been using NSAIDs as a crutch to continue training?
What are the Risks of Using Anti-Inflammatories for Muscle Soreness?
Reducing soreness after a strenuous workout is important for many active individuals, and NSAIDs like ibuprofen are commonly used. However, it’s essential to understand the potential risks of using NSAIDs for muscle soreness. Studies have shown that long-term use of NSAIDs can cause gastrointestinal issues and kidney damage.
Additionally, these drugs can interfere with the body’s natural inflammatory response, vital for muscle repair and growth. While NSAIDs may temporarily relieve muscle soreness, they may inhibit muscle growth and recovery. Hence, athletes should always weigh the benefits and risks before taking medication or supplements to handle muscle pain and soreness.
Is Ibuprofen Bad for Muscle Growth?
Acute Studies on Ibuprofen
The controversy regarding NSAIDs and muscle growth stems from a 2002 study in which two commonly consumed over-the-counter analgesics, ibuprofen, and acetaminophen, were used during a high-intensity eccentric resistance exercise known to induce extreme soreness. The study found that the maximal over-the-counter dose of ibuprofen (1,200 mg/day) reduced protein synthesis after a bout of resistance exercise. Thus, long-term use of NSAIDs can reduce muscle growth. (Trappe et al., 2002)
The inhibitory effects on protein synthesis by NSAIDs may be due to their ability to inhibit the cyclooxygenase (COX) enzyme, which is involved in the production of prostaglandins. Prostaglandins play a role in protein synthesis by stimulating the production of insulin-like growth factor-1 (IGF-1), which is important for growth and repair. Therefore, the inhibition of prostaglandin production by NSAIDs may reduce the production of IGF-1 and inhibit protein synthesis.
According to the research results, there is conflicting evidence on whether ibuprofen slows the healing process. Some studies have found no detrimental effects, whereas others have found negative effects of NSAIDs, such as inhibited satellite cell responses that may reduce hypertrophy. (Mikkelsen et al., 2009)
Does Ibuprofen help Muscle Growth?
A 2011 study examined the long-term use of NSAIDs and resistance exercise in older adults (60-85 years old) and found that maximal dosages of acetaminophen and ibuprofen did not negatively impact growth in older adults, contrary to the researcher’s hypothesis the older adults had greater increases in growth compared to the placebo. However, this may be due to older adults starting with higher levels of inflammation which could have yielded beneficial effects. (Trappe et al., 2011) The researchers suggested that NSAIDs may be useful for the treatment of sarcopenia and other inflammatory disorders.
Another study examined the effects of high doses of anti-inflammatory drugs on strength and hypertrophic adaptations in young adults undergoing resistance training. The results indicated that high doses of anti-inflammatory drugs during resistance training inhibited strength and hypertrophic adaptations compared to a control group. (Lilja et al., 2018) Numerous studies have found that moderate dosages of NSAIDs do not impair muscle growth responses. (Krentz et al., 2008)
New Study: Ibuprofen Does Not Reduce Muscle Growth
As mentioned earlier, a study in young untrained adults found that a maximum dose of ibuprofen reduced muscle hypertrophy. However, hypertrophy was measured with magnetic resonance imaging (MRI). MRI is generally considered a reliable method for measuring hypertrophy; however, there may be some limitations to the accuracy of MRI measurements with fluid changes. Muscle biopsies involve taking a small sample of muscle tissue for analysis, directly assessing muscle fiber size and composition.
A new study published in The Journal of Applied Physiology titled “Limited effect of over-the-counter doses of ibuprofen on mechanisms regulating muscle hypertrophy during resistance training in young adults” was recently published. The study found that maximal strength ibuprofen taken for 8 weeks did not reduce muscle growth. This study took muscle biopsies, a more accurate measure of growth.(Lilja et al., 2023)
One interesting finding in the study was that the subjects’ average increase in muscle growth was ~5%. These were recreationally trained subjects, so this is on the low side for muscle growth, as studies have found that resistance exercise can increase muscle hypertrophy in 5-15% ranges. (Damas et al., 2015) A 5% increase in muscle growth is more likely in well-trained athletes, so the muscle growth response of ibuprofen was on the low side. (Schoenfeld et al., 2015)
Alternatives to NSAIDs for Muscle Soreness and Pain Relief
Athletes will often ask if there is the best pain reliever for sore muscles after a workout. Several alternatives to NSAIDs can help alleviate symptoms when managing soreness and pain. Natural remedies like turmeric and ginger contain anti-inflammatory properties that can help reduce inflammation and promote recovery. (Grzanna et al., 2005; Jurenka, 2009) Topical treatments such as menthol or capsaicin creams or balms can provide localized relief without the potential side effects of oral medications.(Higashi et al., 2010; Laslett & Jones, 2014)
Heat therapy is another effective non-pharmacological method for reducing soreness. Applying heat to the affected area can increase blood flow and promote healing. If you experience ongoing pain, it’s important to consult with a healthcare professional to determine the best treatment for your specific needs.
How to Make Informed Decisions About NSAID Use
Making informed decisions about NSAID use is crucial to use these medications safely and effectively. While NSAIDs can be a useful tool for managing pain and inflammation, it’s important to understand their potential impact on muscle growth and recovery. Before taking an NSAID regularly, please consult a healthcare professional to find the best treatment course for your specific needs.
The research suggests that ibuprofen will not completely kill your gains but may dampen the muscle growth process. Studies have also shown that ibuprofen can attenuate muscle protein synthesis after a bout of resistance exercise and interfere with the positive effects that resistance exercise training has on muscle growth and strength in younger adults.
Therefore, young individuals using resistance training to maximize muscle growth or strength should avoid excessive intake of anti-inflammatory drugs. However, a moderate dose of ibuprofen (400 mg/day) consumed daily after resistance training has been shown not to affect muscle hypertrophy and strength.
The Potential Risks of Chronic Ibuprofen Use
While the new study suggests that ibuprofen does not reduce muscle growth, it is still important to use it cautiously. Chronic use of ibuprofen can lead to side effects such as gastrointestinal problems, kidney damage (i.e., ibuprofen reduces blood flow to the kidneys), and an increased risk of cardiovascular events. Moreover, relying on ibuprofen for muscle soreness can mask underlying issues that must be addressed through training, nutrition, and recovery changes.
Therefore, young individuals using resistance training to maximize muscle growth or strength should avoid excessive intake of anti-inflammatory drugs. However, a moderate dose of ibuprofen (400 mg/day) consumed daily after resistance training has been shown not to affect muscle hypertrophy and strength.
The key point is that although the study did not find ibuprofen reduced growth, it is not a good idea to use it chronically. You should adjust your training if you are sore and not rely on NSAIDs as a crutch.
Dr. Galpin, a leading expert in the field of hypertrophy, notes that individual differences in how people respond to NSAIDs and the effects on muscle growth might differ for each person. For some, NSAIDs might hurt muscle growth, while others might not experience any detrimental effects.
He advises against relying on NSAIDs for routine pain management after weight-training exercises and suggests using other recovery strategies, such as proper nutrition, hydration, and sleep, to promote optimal growth. He mentions that NSAIDs blunt the natural adaptation response to exercise during weight training exercises. The use of anti-inflammatory drugs to manage soreness and inflammation after exercise is not justified, and if you need to rely on nonsteroidal analgesic drugs consult a healthcare professional for personalized advice is a good idea.
References
Almekinders, L. C. (1999). Anti-Inflammatory Treatment of Muscular Injuries in Sport. Sports Medicine, 28(6), 383-388. https://doi.org/10.2165/00007256-199928060-00001
Damas, F., Phillips, S., Vechin, F. C., & Ugrinowitsch, C. (2015). A review of resistance training-induced changes in skeletal muscle protein synthesis and their contribution to hypertrophy. Sports Med, 45(6), 801-807. https://doi.org/10.1007/s40279-015-0320-0
Howatson, G., & van Someren, K. A. (2008). The Prevention and Treatment of Exercise-Induced Muscle Damage. Sports Medicine, 38(6), 483-503. https://doi.org/10.2165/00007256-200838060-00004
Krentz, J. R., Quest, B., Farthing, J. P., Quest, D. W., & Chilibeck, P. D. (2008). The effects of ibuprofen on muscle hypertrophy, strength, and soreness during resistance training. Appl Physiol Nutr Metab, 33(3), 470-475. https://doi.org/10.1139/h08-019
References
Lilja, M., Mandić, M., Apró, W., Melin, M., Olsson, K., Rosenborg, S., Gustafsson, T., & Lundberg, T. R. (2018). High doses of anti-inflammatory drugs compromise muscle strength and hypertrophic adaptations to resistance training in young adults. Acta Physiologica, 222(2), e12948. https://doi.org/https://doi.org/10.1111/apha.12948
Lilja, M., Moberg, M., Apró, W., Martínez-Aranda, L. M., Rundqvist, H., Langlet, B., Gustafsson, T., & Lundberg, T. R. (2023). Limited effect of over-the-counter doses of ibuprofen on mechanisms regulating muscle hypertrophy during resistance training in young adults. Journal of Applied Physiology, 134(3), 753-765. https://doi.org/10.1152/japplphysiol.00698.2022
Mikkelsen, U. R., Langberg, H., Helmark, I. C., Skovgaard, D., Andersen, L. L., Kjær, M., & Mackey, A. L. (2009). After eccentric exercise, local NSAID infusion inhibits satellite cell proliferation in human skeletal muscle. Journal of Applied Physiology, 107(5), 1600-1611. https://doi.org/10.1152/japplphysiol.00707.2009
Schoenfeld, B. J., Peterson, M. D., Ogborn, D., Contreras, B., & Sonmez, G. T. (2015). Effects of Low- vs. High-Load Resistance Training on Muscle Strength and Hypertrophy in Well-Trained Men. J Strength Cond Res, 29(10), 2954-2963. https://doi.org/10.1519/jsc.0000000000000958
References
Trappe, T. A., Carroll, C. C., Dickinson, J. M., LeMoine, J. K., Haus, J. M., Sullivan, B. E., Lee, J. D., Jemiolo, B., Weinheimer, E. M., & Hollon, C. J. (2011). Influence of acetaminophen and ibuprofen on skeletal muscle adaptations to resistance exercise in older adults. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 300(3), R655-R662. https://doi.org/10.1152/ajpregu.00611.2010
Trappe, T. A., White, F., Lambert, C. P., Cesar, D., Hellerstein, M., & Evans, W. J. (2002). Effect of ibuprofen and acetaminophen on postexercise muscle protein synthesis. American Journal of Physiology-Endocrinology and Metabolism, 282(3), E551-E556. https://doi.org/10.1152/ajpendo.00352.2001
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