12 ms·

"Ibuprofen and hypogonadism — bench to bedside to misinterpreted hype?" at https://www.nature.com/articles/nrurol.2018.26 https://www.nature.com/articles/nrurol

• michaco33 8y ago
  Sounds like the industry responding with "we cant really know guys, right?" I'm throwing away my Advil right now. Screw that.
  • gonyea 8y ago
    I get what you're saying, but ibuprofen and acetaminophen save lives. The problem is the western (American?) tendency to self-medicate and to over medicate with really potent stuff. That shouldn't be as normal as it is.
    • scjr 8y ago
      I am not aware of any common uses of Ibuprofen and Acetominophen that saves lives?
      • an_account_name 8y ago
        Fevers kill. Ibuprofen and acetaminophen reduce fevers.
        • potiuper 8y ago
          Fevers do not kill. Fever is a symptom, which is subjective, not a cause of death.
          • deleted 8y ago
            [deleted]
          • sandworm101 8y ago
            Fever can indeed kill. Raise the body temp a few degrees, no matter the cause, and things start going wrong very quickly. Google hyperthermia. In fact, i cannot think of any disease that literally kills. Even with the big stuff like cancer or aids, it is always the symptoms that get you. They damage body systems and the decline of those systems (aka symptoms) eventually causes the cardiac arrest or internal bleeds that shut off nutrients to the brain. Those symptoms are just as lethal no matter thier cause. A massive fever that stops normal body chemistry, whether caused by flu or ebola, will kill you just the same.
            • lgregg 8y ago
              I can confirm a fever can kill, saw and heard about it in SE Asia.
            • potiuper 8y ago
              Hyperthermia differs from fever in that the body's temperature set point remains unchanged. https://en.wikipedia.org/wiki/Hyperthermia https://en.wikipedia.org/wiki/Hyperthermia
              • sandworm101 8y ago
                Yes but the extra heat in the body causes the same cascade of chemical changes that will eventually kill. Initial treatment is different, to a point. If a fever is too high it will suddenly need the same treatment as hyperthermia: direct cooling.
          • anyfoo 8y ago
            Not a doctor: Isn’t fever (objectively, it seems) defined as a rise in body temperature? From what I’ve learned about protein denaturalization in high school, that doesn’t sound good if excessive.
          • richardknop 8y ago
        • robbiep 8y ago
          Not necessarily. Fevers can cause seizures and they can have detrimental effects in paediatric patients. For the bulk of the general population, these painkillers/anti inflammatories are simply symptom relief. For those talking about hyperthermia killing, yes but in almost all those cases the cause is not an infection. In fact, I would say that paracetamol kills a hell of a lot more patients than it actually ‘saves’. A study I have taken to heart is that permissive hyperthermia (up to 40 deg c) in ICU patients has a greater survival than those where fever is treated aggressively. Physiologically, this resonates because high temperatures activate the immune system and raised temperatures are non-optimal for bacterial proliferation; so the immune system is primed by fever; suppressing it can dull immune system response. In fact, malaria was used as a treatment for syphillis in the early parts of the 20th century because high temperatures kill spirochetes. There are also a decent number of case reports of cancers going into remission following fever. However in my quick mobile google then I could only see the following study that demonstrated no advantage for either control of permissive hyperthermia group in ICU patients; so perhaps I was relying on a study that has been superceeded. https://www.nejm.org/doi/pdf/10.1056/NEJMoa1508375 https://www.nejm.org/doi/pdf/10.1056/NEJMoa1508375
        • Valmar 8y ago
          Fevers are used by the body in an attempt to weaken invading bacteria and viruses, and make it easier for the body to heal. You don't want to stop a fever ~ just keep it within the safe zone where it's healing, but not dangerous.
          • Fjolsvith 8y ago
            I use my hot tub at 105 degrees to give me fever benefits without the bodily energy expenditure.
      • bitL 8y ago
        Ibuprofen is anti-inflammatory medication.
        • docbrown 8y ago
          >Ibuprofen is anti-inflammatory medication. And an acetaminophen tablet is a painkiller. While your statement is in fact true, ibuprofen is still a better choice for a fever. The latter is also generally considered a safer alternative, especially in long-term use — even though alternating the two would be ideal.
          • jrowley 8y ago
            If you have a fever, why not both (as long as you’re hydrated)?
          • donatj 8y ago
            Acetaminophen is actually a pretty dangerous drug that is pretty easy to overdose on. It’s been said if it were discovered today it would be a prescription drug. On top of that numerous recent studies have shown many potential problems. https://www.webmd.com/drug-medication/news/20150302/does-long-term-acetaminophen-use-raise-health-risks#1 https://www.webmd.com/drug-medication/news/20150302/does-lon... > Heavy use of acetaminophen is associated with kidney disease and bleeding in the digestive tract, the paper reports. The medication also has been linked to increased risk of heart attack, stroke and high blood pressure, the study authors noted. > One cited study even showed that overuse of acetaminophen can increase a person's risk of early death as much as 60 percent, the study authors found.
            • diydsp 8y ago
              how true would rate wikipedia's current claim that "how it works is not entirely clear" ?
      • gamma-male 8y ago
        That was what I used (nothing else) when I got H1N1. I thought I was going to die but I made it.
    • acct1771 8y ago
      And acetaminophen reduces empathy, according to some convincing research. What's wrong with cannabis-derived solutions, again?
      • tejasmanohar 8y ago
        What about it reduces empathy? My uneducated guess would be that it's unrelated to _which_ pain medicine you choose. Also, FWIW, in the past, I tried both CBD and THC without any luck where Ibuprofen helped so it's certainly not 1:1
        • acct1771 8y ago
          See other response. What forms did you try? What brands? Were they lab tested? Like any "new" drug - there's a lot of nonsense floating around. Please don't simply buy CBD capsules from Walmart, and say "this shit doesn't work for me".
      • SubiculumCode 8y ago
        For those downvoting parent please see https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5015806/ And others. True or not, parent wasn't just making up the empathy-painkiller association.
        • snibss 8y ago
          The point being: it's a psychological study, in relation to behavior and emotion, which cannot be measured with NEARLY the same degree of ease or precision as sex-related endocrine effects. It's behavior, and thus potentially non-replicable. It's soft science at best. Is someone being a jerk? Is it some strange long term NSAID side-effect? Why are they being so cold and callous? Is this just an artifact of social biases that have existed since time immemorial? Is it the drug? Good luck with that one. Have fun p-value hacking it. Meanwhile, is this person on the effeminate side for a male? Immediately apparent in many cases. Does there seem to be a lot more of this gender dysphoria business going around ever since the 80's when Ibuprofen went OTC? Why yes! Is it the drug? Well, we can introduce a protocol, and study it, and know conclusively in perhaps 10 years. But, between then and now...
    • rixrax 8y ago
      This. Just had friends visiting. Their teenage son had had his wisdom tooth pulled last week. Dentist had then given him (as a standard practice?) prescription for Ibuprofen (800mg tabs?) AND some opioid based pain killer! Needless to say, latter they said went directly to trash after they realized what it contained and for ibuprofen they halved the dosage. To me and his parents this was pain management gone way over dose! But we’re not medical experts and should not be doing clinical decisions since at one end of this rabbit hole you will find anti-vaccination and other nut jobs. So what to do?
      • adrianN 8y ago
        Move to Europe where we don't get as many drugs prescribed? I think the only time you get opioids is after major surgery. Personally I don't know anybody who had to take them.
        • phil21 8y ago
          No opioids after my wisdom teeth extraction would have resulted in potentially suicide. The pain was unbearable, and 3-4 days of hydrocodone was absolutely proscribed. There is nothing wrong with opiates being used for acute pain relief. They are a modern miracle when put to such uses. The problem comes when you start using them for long-term pain relief - a use-case in which they are neither appropriate or effective. A typical 2-3 day prescription after major dental (or other) work is not remotely a problem, and I really have no idea why this is where the focus is. It's always been long-term abuse as the actual problem - the weird overreaction over a few days use for acute pain is utterly absurd and only hurts people in some bizzare way for folks to feel they are "helping" fix the abuse problem.
        • mindcrime 8y ago
          Definitely varies by individual, and by the nature of the situation. My personal experience, as somebody who considers himself to have a pretty high threshold of pain tolerance, is that I never needed any of the Vicodin I was prescribed after wisdom tooth removal... but I can't imagine how I would have survived without Oxycodone in the first week after rotator cuff surgery.
  • sergiotapia 8y ago
    Same just did that. >resulted in the clinical condition named "compensated hypogonadism," a condition prevalent among elderly men and associated with reproductive and physical disorders. In the men, luteinizing hormone (LH) and ibuprofen plasma levels were positively correlated, and the testosterone/LH ratio decreased. Fuck that. I wonder what I should give my kids when they have fevers though
    • logicchains 8y ago
      >I wonder what I should give my kids when they have fevers though You don't have to give them anything. Ibuprofen doesn't make the underlying infection causing the fever go away any quicker, it just alleviates the symptoms. It's a trade off between reducing short-term suffering and risking long-term defects. Personally my parents never gave me painkillers for fever and I'm grateful for it: fever pain is just a temporary feeling, but some of the uncommon side effects of painkillers are much longer-lasting. *Edit: To whomever downvoted, I'm curious what part of what I said you disagree with.
      • frostburg 8y ago
        Your parents probably aren't doctors. The issue isn't cut and clean... To a point a moderate fever usually helps your immune system (the response exists for a reason), but anything other than a moderate fever can be a lot more dangerous than long term issues stemming from sporadic usage of antipyretics.
      • babuskov 8y ago
        I didn't downvote you, but you seem to lack experience/knowledge on the topic if you think it's only a painkiller. Ibuprofen's main use is to help to keep the body temperature in check. When your body temperature goes too high you can lose consciousness and even die. I had a very high fever once and didn't want to take any medicine until I started to lose consciousness and I almost fell while waiting in a line in pharmacy. I was able to go through it only because I was adult. Children are more fragile. Fever is the reason people died so much before discovery of antibiotics. You are right that it alleviates the symptoms, and it's actually better not to use it when the temperature is moderate because high temp kills some germs. But if it goes too high, you have to stop it before it's too late.
  • drb91 8y ago
    OTOH acetaminophen is known to be toxic; is there an alternative here for non narcotic inflammation, fever, and pain relief that is shown NOT to have tradeoffs for use?
    • tchaffee 8y ago
      No tradeoffs? I don't think such a thing exists. Aspirin kills people every year. The only pain reliever I know of that has never killed anyone is cannabis. I don't think it does much for fever though?
      • sureaboutthis 8y ago
        Inhaling smoke into your lungs is never a good thing. Your lungs (cough) are trying to tell you something.
        • tchaffee 8y ago
          Where did I say anything about smoking? And I also didn't say cannabis has no tradeoffs either. But it won't kill you. That's a pretty strong pro in my book if you are looking for occasional pain relief.
          • sureaboutthis 8y ago
            You didn't say anything about not smoking it either.
        • deleted 8y ago
          [deleted]
    • arcticbull 8y ago
      Naproxen / Aleve?
      • sparn5 8y ago
        The naproxen molecule is very similar to ibuprofen, so I expect it would have similar effects.
  • tzjmetron 8y ago
    Ditto.
  • rsynnott 8y ago
    I doubt anyone is interested in protecting ibuprofen from a commercial point of view. Generic ibuprofen is extremely cheap; if anything the industry would probably like people to stop using it so that they could sell novel NSAIDs.
• lvs 8y ago
  Ironically, that title itself hypes the content of the perspective piece that follows. It does to not refute any finding in the PNAS paper. They simply question whether the observed effect on LH, which wasn't disputed, is clinically relevant or should result in modification of clinical recommendation, for which further work is needed. >Despite the excellent quality of the work, the main point to emphasize is the confusion that has arisen concerning the study conclusions versus the real-world relevance and application of its results.
• ricardobeat 8y ago
  In curious how can they make a statement such as “the study cannot be used to draw any conclusions” without providing any kind of reasoning, and get published in Nature?
  • raverbashing 8y ago
    Well, the reasons are probably explained in the text (which is not open), but I suppose Nature is peer-reviewed
  • Valmar 8y ago
    Whenever I see blanket statements like this in such studies ~ it's like they're trying to avoid pissing any powerful corporations that profit from whatever we're told to not draw any conclusions about. They don't want to potentially endanger their careers. Drug companies hate it when a cash-cow drug is threatened in any way. Anything that threatens those profits is a potential target in one way or another. Researchers studying these drugs know just how much power and influence these drug companies have, and so, are afraid of angering them. The reasoning is simple ~ make a vaguely disqualifying statement that hopefully keeps them in the good books.
    • skybrian 8y ago
      Well, except that it's also common that the people who did the study are often well aware of its limitations, and it's the media that's hyping it up to make a better story. Ignoring disclaimers is how the hype gets started. Understanding people's incentives will often result in reasons to be suspicious, but suspicions aren't evidence and it's not a shortcut for understanding the science.
    • pergadad 8y ago
      Ibuprofen is not really a cash cow though as it is now out of patent protection. So while you seem to desire maliciousness I'd venture to say.this is a rather prudent scientific approach. Should all men stop taking ibuprofen on the basis of this one study? No, obviously not.
  • appleflaxen 8y ago
• gameswithgo 8y ago
  >However, this study cannot be used to draw any clinical conclusions regarding effects of ibuprofen on male androgenic or reproductive health why not?
  • just_one_time_ 8y ago
    Because legal reasons.
  • zenexer 8y ago
    Their argument is that we have yet to determine the real-world consequences for the correlation observed in the experiment. In other words: yes, ibuprofen seems to affect something, but we don’t really know whether that effect is significant enough to warrant avoidance of ibuprofen. It might have no observable impact. (Not saying I agree—this is just their argument.)