NSAIDs
| NSAIDs | |
|---|---|
| Formula | |
| Class | |
| Administration | Oral, topical, injectable |
| Solubility | |
| Legal status | OTC (most) to prescription only (stronger agents) |
| Brand names | Advil/Motrin (ibuprofen), Aleve (naproxen), Indocin (indomethacin), Feldene (piroxicam) |
| Bioavailability | |
| Recommended dose | |
| Upper limit | |
| LD50 | |
| Ray's verdict | Depends on context Share aspirin's cyclooxygenase-blocking mechanism but lack the protective salicylic-acid breakdown product that Peat credited to aspirin specifically |
NSAIDs (non-steroidal anti-inflammatory drugs) block cyclooxygenase enzymes to reduce prostaglandin production, lowering inflammation, pain, and fever. Aspirin, ibuprofen, naproxen, indomethacin, and piroxicam are all NSAIDs, differing mainly in potency, duration, and side-effect profile.
Aspirin as the outlier
[edit]Ray Peat treated aspirin as pharmacologically distinct from the rest of this class, not just another NSAID. Its breakdown product, salicylic acid, is itself protective to the stomach and other tissues, an effect the non-salicylate NSAIDs (ibuprofen, indomethacin, piroxicam, etc.) don't share:[1]
Salicylic acid is protective to the stomach and intestine, and other organs. When aspirin was compared with the other common anti-inflammatory drugs, it was found that the salicylic acid it releases protects against the damage done by another drug.
In a tumor-regression comparison Peat cited, aspirin performed comparably to indomethacin and piroxicam at far lower relative dosing (30% regression at 1 mg/day for aspirin versus 45% at 90 mg/day for indomethacin), suggesting the class shares real anti-inflammatory efficacy even where mechanisms diverge in detail.[1]
Anabolic effect in the elderly
[edit]Despite generally blunting exercise-induced muscle protein synthesis in younger adults, NSAIDs paired with resistance training have produced greater muscle growth and strength gains than training alone in elderly subjects in several studies, plausibly because they counteract the chronic low-grade inflammation common at older ages; among adults around 85, NSAID users had a substantially lower rate of sarcopenia.[3] The effect appears age- and context-dependent rather than universal, and is a separate question from aspirin's distinct salicylate-mediated benefits described above.
Practice
[edit]Non-aspirin NSAIDs carry the same GI-irritation and kidney-stress risks associated with the class generally, without aspirin's offsetting salicylate effect, and are not interchangeable with aspirin in Peat's framework even though they act on the same enzyme family.
See also
[edit]References
[edit]- ↑ 1.0 1.1 Ray Peat, "Aspirin," raypeat.com.
- ↑ Aspirin, brain, and cancer, Ray Peat newsletter
- ↑ Schoenfeld BJ. "Non-steroidal anti-inflammatory drugs may blunt more than pain," Acta Physiol (Oxf). 2018;222(3):e13007. Review discussing the age-dependent, sometimes anabolic effect of NSAIDs on muscle.