Ibuprofen, along with paracetamol, is generally considered very safe. All over the world they are prescribed for any kind of pain, fever, inflammation or discomfort. Of course, there are some known side effects, but they are generally considered minor.
Does it make sense that a virus would evolve to favour these conditions? Or is it just an unfortunate coincidence? I guess it depends on whether the virus being "worse" means it helps spread faster, or just compromises the host faster - after all, the virus doesn't gain from killing its host. Also, animals don't get treated with NSAIDs to the same degree, so if nCovid-19 came from a non-human host that's another argument for it being coincidence.
Paracetamol (acetaminophen) isn't all that safe. Too high a dose can quickly and irreversibly damage your liver. Many people have died this way.
If you're intending to take paracetamol long term, you can do worse than to reduce the stated maximum daily dose on the bottle by 1/4 or 1/2. You'll be less comfortable, sure. But it's called a "liver" because you need one to live. So it's worth a little extra discomfort to avoid the risk of breaking yours.
Paracetamol is probably as safe as it gets when it comes to drugs in its class. Overdosing is not all that simple and the numbers are high because of the availability and popularity of Paracetamol as a pain-killer and its silent use as a side ingredient in many products. Paracetamol is not as good as Ibuprofen when it comes to killing pain (IMHO), so maybe this causes a tendency to overdose in people who have built a tolerance to the drug.
To get liver damage, you have to exceed the daily recommended maximum of 4g of Paracetamol. Wiki says paracetomol toxicity is likely if your consumption exceeds 7g in a day [1]. Assuming you are a consuming Paracetamol in the form of OTC pills, say the super strength ones which are 500mg, you have to consume like 15 pills in a day. Overdosing from a combination of drugs containing paracetamol is much more likely. Most people don't realize the presence of the other ingredient.
For short term use, Ibuprofen is said to have a similar safety profile to Paracetamol, though its classification as an NSAID lends to its perception as a slightly less safe drug. Long term, it causes stomach and kidney damage.[2]
Anecdotally, Ibuprofen is much better at killing my pain, but I also have some negative reactions like increased reflux. Technically, Paracetamol also increases acidity but I tolerate it much better. I've mostly stopped using NSAIDs but I realize this is not possible for a lot of people.
I have GERD (Gastroesophageal reflux disease) along with mild asthma, and NSAIDs are a big no-no for me. When I was in the Army, the docs handed out bottles of 800mg Ibuprofen tablets like candy for virtually any complaint - I took them because I was young and invincible back then.
These days, I rarely take anything for headaches. If it's bad enough, I'll take the occasional Tylenol (usually after my wife orders me to take something because the pain is making me cranky). Body aches get ice and/or bengay.
If you want to manage your GERD, diet is a big driver. Ever since I lost weight and changed my eating habits, I haven't had a single GERD episode and it's been two years.
In my weight loss journey I went through keto, then paleo, now I'm doing 40 days of high carb vegan (for lent) — macro composition doesn't matter that much, what I think mattered was the weight loss itself and eating whole foods.
It's interesting because I used to get GERD episodes from kidney beans or bananas and nowadays I eat impressive amounts with no GERD in sight. I figured that if I am to survive this month on veganism, I have to eat a lot of beans, lentils, etc. I am no longer drinking carbonated beverages, no beer or sodas, so that might have something to do with it. The general idea being that some trigger foods might not be a problem in the context of a healthy diet and a body weight that's close to normal.
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I have allergic asthma and while it's been under control for years, with me requiring no treatment, when I was in my twenties I went through really rough periods, with me ending up in ICUs with difficulty breathing.
I also heard that extensive use of Ibuprofen can worsen asthma episodes and this is what happened in my twenties, however my asthma is nowadays under control, my immune system seems to be working normally and even when catching a cold, I seem to tolerate Ibuprofen quite well.
Just so we are clear, I'm now 37 and my tolerance of Ibuprofen and similar improved a lot since my twenties, so it can go in the other direction.
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For many people giving up on painkillers isn't an option. My wife gets migraines that are so bad it makes her puke.
I'm writing this to say that GERD and allergic asthma are many times manageable with the proper treatment and a lifestyle change.
> Does it make sense that a virus would evolve to favour these conditions?
I strongly doubt that COVID-19 has been exposed to NSAIDs long enough to result in evolution of any type. The paper suggests that NSAIDs make us more biocompatible, so it really is just a coincidence. Lots of medications have contra-indications.
> Ibuprofen, along with paracetamol, is generally considered very safe
NSAIDs are considerably more harmful than might be assumed from their availability and public perception. Over the past half decade, I've heard doctors recommending with increasing frequency against cessation of OTC NSAID use. Research available on Pubmed and NCBI seems to agree.
I'm also in a common but at-risk group for Covid-19 that should never use NSAIDs, but I think qualifications of their safety shouldn't be accepted outside of any but a very loose definition of 'generally'.
Ibuprofen is an anti-inflammation drug, which means it weakens somewhat your immune system (which is responsible for the inflammation in the first place). It makes sort of sense that taking such medication while infected with a virus for which there is no treatment can be dangerous.
In related news, there have been cases of "severe" forms of Covid-19 among young people with no antecedents, all of them having taken ibuprofen.
This is precisely the sort of comment that not only makes social networking a medium with nearly no real value, but actually dangerous.
The commentator comes here with some assumptions, perhaps some hearsay, and an emotional attachment to their position and make the statement as though it's fact.
In this comment, you know what's missing? Actual knowledge, actual reasoning, and actual facts to back up the his/her claims. Perhaps worse, there are some facts (Ibuprofen suppresses some immune system responses to infection) which are used to draw unsubstantiated conclusions about the commentator's opinions (Ibuprofen can cause severe forms of Covid-19 in young people).
From where did this "related news" come from? On what rational basis do you draw the conclusion that an across-the-board recommendation not to take Ibuprofen is warranted? How does that trump other factors that may be at play?
What I really worry about though is how many people will read the comment I'm responding to and go on to post elsewhere, "in related news...", with a similar air of self-certainly and casting of opinions as facts. In other contexts of high emotion, people get lynched because of this sort of social media posting, people may cause themselves harm because of this kind of posting.
By the way, the commentator may actually be right... but there is nothing in the comment to make me believe that his/her being right would be anything more than coincidence.
I'll leave with the personal observation that this community is suppose to be made up of "the smart ones"; which we ourselves so often confidently believe to be true that we all too frequently think we should be able to engineer society and solve all its ills. If there is any one ponder-able to take away from reading Hacker News on regular basis, it's how decidedly average even "the smart ones" can be on any given topic.
> But you don't have to believe me as I read and don't make bibliographies in all of my posts.
We certainly don't have to make them in all posts, but I think it's reasonable to request that we make them in what are hopefully a small number of posts wherein we offer medical advice.
No one should be accepting anything online as medical advice. It's like high finance, if you base every purchase on what you read on Yahoo finance you are going to lose your shirt. If you take health advice online you might die. Nobody is giving advice here. We are having a discussion.
Read not to contradict and confute; nor to believe and take for granted; nor to find talk and discourse; but to weigh and consider.
your link does not support what you wrote. You wrote
> "Ibuprofen is an anti-inflammation drug, which means it weakens somewhat your immune system"
The article says
> anti-inflammatory drugs are known to be a risk for those with infectious illnesses because they tend to diminish the response of the body’s immune system.
weakens the immune system != weakens the response of the immune system
The taking of anti-inflammatories [ibuprofen, cortisone … ] could be a factor in aggravating the infection. In case of fever, take paracetamol. If you are already taking anti-inflammatory drugs, ask your doctor’s advice.”
> In related news, there have been cases of "severe" forms of Covid-19 among young people with no antecedents, all of them having taken ibuprofen.
I'm not sure what you're trying to say here - are you claiming that all young people with severe cases of COVID-19 (including, for instance, 33-year-old Wenliang Li) took ibuprofen?
Or simply that there exists a small group of people such that all people in that group took ibuprofen, and there are also other young people with severe cases who did not?
Given that standard advice for young people (who are expected not to have severe cases) is to take fever-reducing medication like ibuprofen, I feel like we need a lot more information here before we can turn this correlation into causation.
I don't know what happened to Wenliang Li. What I know is that there have been reports of severe cases among young people without antecedents or pre-existing pathologies where I live and the common thread was that they took ibuprofen. In parallel, there are papers/preprints popping left and right suggesting that ibuprofen's side effects may worsen the symptoms of covid-19. Just google things, it's not hard to find.
>Given that standard advice for young people (who are expected not to have severe cases) is to take fever-reducing medication like ibuprofen, I feel like we need a lot more information here before we can turn this correlation into causation.
There's other fever-reducing medication that doesn't involve anti-inflammation action. Paracetamol is fine.
Inflammatory response is not the immune system. Both are intertwined but this should not be misread to say they are the same thing. Although I don’t disagree with your statement. There is possible reason against and no evidence that it (or paracetamol for that matter) improves outcomes.
What makes you feel qualified to give medical advice on an Internet forum?
There might be negatives to taking ibuprofen in relation to COVID-19, but so far no official guidelines exist. Only internet stories. Responsible institutes have not handed out such advice, nowhere.
It's already considered unsafe to take NSAIDs when suffering from influenza. In fact it's even been hypothesized that the Spanish flu pandemic was so bad because of widespread use of (the new) aspirin.
>What makes you feel qualified to give medical advice on an Internet forum?
Because of where I work I have been given "primary sources", but of course you are free to not believe me. This is my own sentiment, feel free to look things up yourself.
> no official guidelines exist. Only internet stories.
Not in the US, maybe, but such guidelines definitely exist where I live. Again, you do you
It's unclear if English is your first language or not, but in case there is confusion resulting from this, quotation marks around a word is sometimes used to indicate sarcasm.
In this context, it could be read that you don't believe that Covid-19 is at all serious - that the effects are "no worse than the flu".
I don't know if you believe that, or if that is your intention, but there are some that are claiming this pandemic is a 'media hoax'. As you can imagine, that is a very emotionally expensive viewpoint to have to fight, especially when it's an at-risk loved one who is making that claim.
If you're a medical professional and you've seen numerous papers or reports coming in that ibuprofen is a factor in the severity of Covid-19, why do you need to use a throw away account? Why can't you say where this information has come from?
I've seen this topic shot down by doctors on Twitter - a throw away account quoting "primary sources" is unlikely to convince many of us! Can you expand with something a bit more concrete? For example, where are these guidelines that are saying not to us ibuprofen?
If any official source, regardless of country, recommends to abstain from ibuprofen I would simply like to know. I neither live in the US nor think that scientists and medical personnel in other country are less educated or trained.
I think it's about distinguishing important information from stuff people randomly write online because a non-peer reviewed study made a hypothesis.
The goal is for everyone around the globe to be as safe as possible and misinformation in the context of medical advice is not helpful.
Of course it's better not to take ibuprofen, in any case. But some people may rely on it or other NSAIDs.
The reason it's headline news at the moment is because some minister tweeted about the lancet letter this thread is talking about. It's a letter that's not gone through peer review which definitely shouldn't be taken as an official source! Numerous doctors on Twitter have come out and said we shouldn't listen to it too.
I'd strongly argue a minister tweeting, even when it is the health minister, isn't official advice in the sense of national guidelines.
I actually think he was incredibly stupid for tweeting that - he should know better than to write what would obviously cause a media stir based on an open non-reviewed letter.
Does it make sense that a virus would evolve to favour these conditions? Or is it just an unfortunate coincidence? I guess it depends on whether the virus being "worse" means it helps spread faster, or just compromises the host faster - after all, the virus doesn't gain from killing its host. Also, animals don't get treated with NSAIDs to the same degree, so if nCovid-19 came from a non-human host that's another argument for it being coincidence.