Read this if you take ibuprofen, naproxen sodium, aspirin, or acetaminophen
There's so much we don't know, so make sure these common medications actually meet your expectations.
Happy Thursday, health heroes.
Today we’re talking about something much more common and less glamorous than GLP-1’s, weed for health conditions, or rice water for weight loss. And although I know this is not a trendy topic per se, but I can’t help but think that we need to be reminded of what we take for granted and rethink how we approach our health.
We all use Advil, Motrin, Aleve, and Tylenol. They’re ’ no-brainer’ medications baked into our daily lives — you probably have some or all of them in your medicine cabinet or first aid kit right now!
These medications are so common that they’re often overlooked. So, let’s put our curiosity into practice and take a closer look. Here's why I think these medications need to be discussed more in the context of safety and use.
Ibuprofen and acetaminophen are so common that they’ve become household names. Walk into any drugstore, and you'll see shelves lined with familiar brands like Advil and Motrin (ibuprofen), Aleve (naproxen sodium), or Tylenol (acetaminophen).
These medications are the go-to solution for headaches, muscle aches, fevers, and more. Americans spend billions each year on over-the-counter (OTC) pain relievers, with ibuprofen and acetaminophen being the most popular choices.
We take these medications without thinking much about it. Surveys show that many people don’t know what’s in their painkiller medication — do you?
How much do we really know about these medications? And how can we take them intentionally so they do what we expect of them? Let’s find out.
Why Do We Use Them?
Let me tell you how many of us are being offered these medications as a healthcare solution so you can see the practical problem first-hand. Before I had my knee replacement surgery, my orthopedic doctor recommended I take naproxen sodium to help with my knee pain as a long-term solution. When I asked how long I should take it, he said that I could use it literally forever without any negative impact. He was utterly unconcerned about its long-term use. That made me think – is this really a good idea for my overall health? What about my poor kidneys? Could they take the increased workload for the rest of my life?
I decided thoughtfully (using the same methods I provide in my articles), and ultimately, my conclusion was no—taking Alleve for the rest of my life wasn’t a good long-term strategy for me. So, I decided to opt for knee replacement surgery instead. It also had its down-sides, but I was willing to take on those rather than stay on medication for the rest of my life.
Think about this. It wasn’t until recently that these medications were prescription only and not available over the counter (OTC).
Tylenol (acetaminophen): Originally available by prescription, acetaminophen was approved for over-the-counter use in the U.S. in 1955. Its widespread availability as an OTC pain reliever and fever reducer helped it become a popular household medication. It is now a popular OTC pain reliever and fever reducer helped it become a popular household medication.
Ibuprofen: Initially marketed as a prescription-only medication when it was approved in 1969, ibuprofen became available over the counter in 1984. It is used for pain relief, fever reduction, and as an anti-inflammatory.
Naproxen sodium: Marketed under the prescription brand name Naprosyn, naproxen was approved for prescription use in 1976. In 1994, the FDA approved its over-the-counter version as Aleve, allowing it to be sold without a prescription for pain and inflammation relief. The patent for Aleve originally developed by Syntex and later marketed by Bayer, expired in 2005. After this, generic versions of naproxen sodium became widely available. The expiration of the patent allowed multiple pharmaceutical companies to produce and sell generic versions of the drug, making it more affordable and accessible to consumers.
Aspirin was originally a prescription drug when it was first introduced in the late 19th century. It was developed by Bayer and became available as a prescription pain reliever in 1899. It wasn't until 1915 that aspirin was approved for over-the-counter (OTC) sales, making it widely available without a prescription. Initially, aspirin was a revolutionary treatment for pain and inflammation. Still, as its safety and efficacy became better understood, it transitioned to OTC status much earlier than other similar drugs like ibuprofen or naproxen. Today, aspirin is widely used for pain relief and fever reduction, and, in low doses, for reducing the risk of heart attacks and strokes due to its blood-thinning properties that ibuprofen and naproxen sodium do not have.
Ibuprofen, aspirin, and naproxen are all nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce inflammation and alleviate pain from things like muscle strains, menstrual cramps, and arthritis. They are mainly used for headaches. Acetaminophen is a pain reliever and fever reducer but lacks anti-inflammatory properties, making it effective for headaches and minor transient aches.
These medications are so easily accessible that we forget how fortunate we are to have access to them. They really do help us feel better by managing symptoms. But what they do NOT do is just as important - they don’t cure the underlying problem. That’s one of the biggest misconceptions - these medications speed recovery. They reduce inflammation (ibuprofen and naproxen sodium) or block pain signals (acetaminophen), but they don’t address the root cause of your pain, nor do they speed recovery. More on this in a minute.
How Do They Work on the Cellular Level?
💥 Ibuprofen, aspirin, and naproxen block the production of chemicals called prostaglandins (COX-1 and COX-1 enzymes (enzyme cyclooxygenase) lead to the production of prostaglandins, and NSAIDS block these enzymes), which play a key role in inflammation and pain. Aspirin’s blood-thinning effect is unique because it irreversibly inhibits the COX-1 enzyme in platelets.
💢 Acetaminophen works on the brain to reduce pain perception but doesn't reduce inflammation.
Both effectively provide relief in their own way, but it’s essential to understand that they are managers of symptoms, not solutions.
Common Misconceptions
Many people believe that taking ibuprofen or acetaminophen speeds up recovery, but this isn’t true. Ibuprofen and acetaminophen do not heal; they mask symptoms, allowing us to function. Again, they don’t facilitate actual healing.
This can be problematic with long-term use, especially in chronic pain situations. You might feel better but risk ignoring underlying issues that may require deeper investigation.
In Western culture, we tend to focus on treating symptoms rather than addressing the root cause of discomfort. However, other cultures, like traditional Chinese medicine, emphasize balance and investigate the deeper cause of the problem.
The U.S. healthcare approach is often treatment-centered, not healing-centered, which distances us from understanding our health fully. Think in terms of avoiding repeating the need for medications FIRST. Then decide if medication is needed.
The Side Effects – Yes, There Are Some
Like any medication, ibuprofen and acetaminophen do come with side effects. This is one reason why they were all prescription medications at one point. Now it’s up to us to remind ourselves that these medications have potential side-effects like:
⛑️ Ibuprofen: Can cause stomach irritation, ulcers, and even gastrointestinal bleeding if overused. It may also raise blood pressure and negatively affect kidney function.
🔈 Aspirin: While generally safe when taken as directed, it can also cause stomach irritation, gastrointestinal bleeding, bruising and bleeding, and ringing in the ears.
💊 Acetaminophen: While gentler on the stomach, excessive use can lead to liver damage, especially when combined with alcohol. Many OTC cold or flu medications contain acetaminophen, so it’s easy to exceed the recommended daily dose.
🏥 Naproxen Sodium: The main difference between naproxen and ibuprofen is that naproxen generally lasts longer than ibuprofen. A single dose can relieve up to 12 hours, compared to 4-6 hours with ibuprofen, making it a good option for more sustained pain relief. Naproxen is often recommended for conditions that require longer-lasting relief, like arthritis and muscle pain. However, just like ibuprofen, naproxen comes with side effects, including stomach irritation, gastrointestinal bleeding, and potential impacts on kidney function with long-term use. Just how long these adverse effects take place is not known. Naproxen can also increase the risk of heart problems in people with preexisting cardiovascular conditions, so caution is needed.
Whenever you’re combining these or any other medications, be sure to consult your pharmacist or doctor. Mixing medications should not be taken lightly. Certain medications, like blood thinners or other NSAIDs, can interact dangerously with ibuprofen, and taking acetaminophen in large amounts can harm your liver. But there might be interactions with vitamins and supplements - do your homework before you start popping the pain relievers.
An important note: When you take medications like Tylenol, ibuprofen, aspirin, or Aleve, they don't just target the specific area where you're feeling pain or inflammation—they affect your whole body. That's because these meds get absorbed into your bloodstream and travel everywhere - not just to the hurting area. NSAIDS, which I mentioned before, block COX-1 and COX-2 enzymes. The COX-1 enzyme helps protect the stomach lining - this is why the medication can cause stomach irritation. But these enzymes are also found in the kidneys, blood cells (aspirin in particular, impacts blood cells because platelets do not have a nucleus and cannot produce new enzymes to replace the inhibited ones, which means that the blood-thinning effect lasts for the lifespan of the platelet - around 7-10 days), blood vessels, reproductive system, and even the brain. Could taking NSAIDS impact our brain? COX-2 plays a role in neurotransmission and brain development. Yes! But is it positive or negative? The research is not clear.
So, even though they help with pain, they can also impact your stomach, kidneys, or even your heart (and who knows what else).
This is why side effects, like stomach irritation or kidney issues, can happen, especially if you use them often. If you’re taking aspirin, you may not want to take additional supplements, like fish oil and Vitamins E or K, since they also have blood-thinning properties. Knowing this is important because it helps you understand why you must be careful with how much and how often you take them.
Stress and Pain: A Hidden Connection
Another key factor that exacerbates pain and inflammation is stress—whether it’s emotional, physical, or nutritional. Stress increases the release of cortisol, a hormone that, when elevated over time, can worsen inflammation and amplify pain. Whether it’s emotional stress from a hectic lifestyle, physical stress from overexertion, or poor dietary choices that stress the body nutritionally, it all contributes to the cycle of pain.
Chronic stress also impacts how you eat. Many people resort to unhealthy food choices when stressed, further increasing inflammation in the body. A diet rich in processed foods and sugars puts stress on the body and leads to heightened pain, compounding the effects of stress and poor health.
Reducing stress—through mindfulness, relaxation, better eating habits, and physical recovery—is a wise way to manage pain and inflammation naturally.
Natural Alternatives to NSAIDs and Acetaminophen
Several natural alternatives do exist to manage pain and reduce inflammation. Yet, they do not offer the same level of pain relief or will take more time and patience to achieve a consistent level of relief.
Some natural alternatives could be taken with NSAIDs or acetaminophen, but again, caution and professional advice are necessary to avoid interactions and overloading your system or creating a toxic combination of chemicals.
With that being said, here are some natural alternatives to consider in place of, or with, pain relievers.
Turmeric (Curcumin): A natural anti-inflammatory, helpful for arthritis and joint pain.
Ginger: Reduces inflammation and is useful for muscle soreness.
Omega-3 Fatty Acids: Found in fish oil, omega-3s reduce chronic inflammation.
Boswellia (Frankincense): Known for anti-inflammatory effects in conditions like arthritis.
Capsaicin: Found in chili peppers, effective in reducing pain topically.
Magnesium: Helps with muscle cramps and headaches.
CBD (Cannabidiol): A non-psychoactive compound that reduces inflammation and pain. Check out the article I wrote about CBD and its effectiveness.
Heat and cold therapy can be effective in managing pain. Cold therapy reduces inflammation, much like ibuprofen, while heat therapy relaxes muscles and improves circulation, helping with chronic pain.
Combining Therapies
You can alternate between ibuprofen and acetaminophen for short-term pain relief, as they work through different mechanisms and do not interact negatively when used correctly.
This approach can be effective for managing pain, as each medication targets different aspects: ibuprofen reduces inflammation and pain, while acetaminophen raises the pain threshold by acting on the brain.
A common alternating schedule might be taking ibuprofen first, followed by acetaminophen a few hours later, keeping the total dosage within recommended limits (no more than 3,000 mg of acetaminophen and 1,200 mg of ibuprofen per day for most adults). This helps maintain pain relief while reducing the risk of side effects from overuse of one medication. For instance, you could take ibuprofen at 8 a.m., acetaminophen at 12 p.m., and alternate as needed throughout the day.
If you want to try this, ensure you're following dosing guidelines and consulting your healthcare provider if you plan to alternate these medications, especially over a longer period, as excessive use can lead to side effects, including liver damage (from acetaminophen) and stomach irritation or ulcers (from ibuprofen).
A reminder: This article is not intended to be medical advice, it’s here for educational purposes. I want people to think about things before they act regarding their health! Do your homework and ask a professional before changing up your medication routine, especially if you take other medications that might interact. Do more research and decide what’s best for you. You are your own best health advocate.
In some cases, combining heat or cold therapy with medication may provide greater relief. For instance, you could use cold therapy immediately after an injury to control swelling, then take ibuprofen to reduce inflammation further and manage pain. Alternatively, for chronic stiffness, heat therapy paired with acetaminophen can help reduce discomfort while loosening tight muscles.
Overall, heat and cold therapy offer a more natural, localized approach to pain relief, whereas ibuprofen and acetaminophen offer broader symptom management. Using a combination of therapies found by exploration and curiosity about what works best for your body is a great way to manage pain thoughtfully!
When OTC Pain Reliever Medications Are the Right Choice
There are times when these medications are necessary. For example, ibuprofen can help after surgery to manage inflammation, or acetaminophen can reduce a dangerous fever.
The key is to use them intentionally. What are you hoping to gain from the medication? Are you masking pain, or are you addressing the root cause? Could lifestyle changes, like reducing stress or eating healthier, help?
It’s important to use medications like ibuprofen and acetaminophen as tools, not crutches. They can be part of a broader treatment plan, but relying on them without addressing the deeper causes of pain will only take you further from long-term health.
Remember, no medication is without its side-effects. Some effects we recover from quickly, some we don’t. Keep this in mind – is your body able to withstand the side-effects? It will largely depend on your health status.
The Call to Curiosity
I encourage you to approach your health with curiosity. Instead of masking symptoms, dig deeper. What’s causing your pain or inflammation? Could it be stress, poor diet, or an injury that hasn’t properly healed?
By being relentless in your pursuit of health—through logic, reason, and asking questions—you can go beyond symptom management and focus on healing.
That’s all for your Thursday letter this week, everyone. Have a great weekend and I’ll see you back here next Tuesday. Have any burning health questions? Anything to add to the chat? I’m always around in the comments section!
Dr. Alice
A little more about Dr. Alice Burron and The Health Navigator Group:
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