Volume 11, Issue 96 October 29, 2014
Are painkillers actually making
your arthritis worse?
Ibuprofen is one of my favorite drugs. Now that might seem a little strange to hear from an alternative doctor, but let's face it, every now and then most people could use a pain medicine. And of all the pain meds out there, I like ibuprofen the most in terms of efficacy and safety. That said, should you use it every day?

A new study gives us some remarkable evidence that all of the drugs like ibuprofen and other NSAIDs can deplete vitamins – especially vitamin B6. And, as you will see, this can be a very significant problem.

The authors of the study start by pointing out that low blood levels of vitamin B6 are commonly seen in inflammatory diseases like rheumatoid arthritis. They wondered whether it was because of the inflammation itself or possibly from the medications these patients take for the inflammation. So they studied 150 rheumatoid arthritis patients. Some of them were regularly taking NSAIDs and some were not. As predicted, they found out that the ones taking the drugs had significantly lower blood levels of B6 than the NSAID-free patients. But that's not all they discovered.

In order for B vitamins to work in your body, your liver must convert them to their active form. For B6, the active form is called pyridoxal-5-phosphate, or P5P for short. The researchers discovered that using either celecoxib (Celebrex) or naprosyn (Aleve) for more than six months impairs the conversion of B6 to P5P. This renders it useless. That means that much of the B6 that is in your diet is wasted if you are regularly taking these drugs. And that's extremely important because B6 is critical for just about any reaction that occurs in the body. Then they found even more evidence.

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They gave a group of mice either celecoxib or naprosyn every day for six months in a dose equivalent to what humans routinely take. Then they examined the livers of these mice and found out that, sure enough, their livers were deficient in P5P. That's a big deal. Here's why: If I were to list for you all the reactions that occur in the liver that require B6, you would be reading the list a long time. This is what the authors of the study had to say after analyzing their data. "This study further raises concerns about the long-term clinical use of anti-inflammatory NSAIDs in humans." But the story gets even more interesting.

In the 1960s, a Texas physician by the name of Dr. John Ellis discovered that a deficiency of a certain B vitamin was one of the causes of arthritis, particularly arthritis of the hands. And what was that B-vitamin? You guessed it – B6. Dr. Ellis also discovered that taking a vitamin B6 supplement often eliminates carpal tunnel syndrome and trigger finger. Makes you wonder how many people out there are perpetuating their arthritis or carpal tunnel syndrome by taking the very drugs they think they need for the symptoms. So what should someone do who has been prescribed these drugs on a regular basis?

Of course, if you have to take the drugs, one good idea would be to take a B6 supplement. But not any supplement would work. It would have to be B6 in the form of P5P. And even that is not the perfect guarantee. Because if NSAIDs inhibit B6 activity they might also inhibit the activity of some or all of the other B vitamins. So my goal for a patient who regularly depends on NSAID medications would be to find alternatives for their pain. Depending on where the arthritis is and what the cause, there are many ways to do just that. Ironically, one of them is B6 supplementation! You can find B6 and P5P at most health food stores and online. Take 100-150 mg daily.

Yours for better health,

REF: Chang HY, Tang FY, Chen DY, et al. Clinical use of cyclooxygenase inhibitors impairs vitamin B-6 metabolism. Am J Clin Nutr. 2013, Dec;98(6):1440-9.

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