Nutrition
Free Radicals, Crossfit, and Supercompensation
I eat paleo a few times year. Typically for about a month at a spell. The rest of the year I follow what Zach Filer of Old Country Iron Club calls Spartan Diet. This way of eating suits me because it has a few more food options than paleo does and I respond well to paleo no-no’s such as yogurt.
The Spartan Diet is essentially The Mediterranean Diet tweaked to deliver calorie dense nutrition for athletes. The need for this nutritional plan came in response to meet the recovery needs of athletes undergoing six week long waves of progressive barbell training called Caliber Cycles.
The details on how to follow The Spartan Diet will be the topic of future posts but some basic foundational principals include:
- High white meat intake
- High vegetable intake
- High olive oil intake
- Moderate red wine intake
- Low red meat intake
- Limited grain intake
- Yogurt with berries daily- see as follows.
This is a performance diet. Will you lean out? Yes, but that is not the point. There are dozens of weight loss diets out there to choose from if that is what you are looking for. This nutrition gives you your best shot at recovering from a heavy 5,5,5+ on Monday in time to do it again on Wednesday without over training.
If you google search “oxidative stress” with “Exercise” or “Crossfit” you will likely come across alarming blogs and studies that demonstrate that “extreme” exercise releases FREE RADICALS! For example: P90X and Crossfit Athletes Beware
The relationship between increased free radical production (RONS) and exercise was first demonstrated by the early work of Dillard and his colleagues in 1978. Since that time there have been nearly 300 original studies published exploring this relationship and how to mitigate it. Wellman and Bloomer’s Acute Exercise and Oxidative Stress: A 30 Year History is a comprehensive summary of that work and is worth a read. The main points are summarized below.
This post began as a research project on which anti-oxidant supplements would be most effective for blunting the spike in Free Radical (RONS) production associated with high intensity exercise. My research pointed me in another direction though. Free Radicals are not the villains they appear to be.
- RONS are produced by high intensity exercise
- Conditioned athletes only produce spikes in RONS with higher intensity training
- Free radicals are agents of cellular damage and aging
- Anti-oxidants can act as “mops” that soak up or neutralize free radicals
- For decades researchers have attempted to isolate the perfect combination of anti-oxidant supplementation to minimize the post exercise spike of RONS.
- These studies were rarely successful
- When the proper dosage and timing of vit. C, E, Co Q10 etc. was isolated, the results were surprising
- Those test subjects who experienced a successfully blunted RONS production also experienced a blunted training effect.
- They did not exhibit the typical positive results of exercise such as increased insulin sensitivity, strength gains, increased production of superoxide dismutase etc. (1,2)
- RONS appear to play a role as messenger to stimulate a compensation response that causes the health benefits of exercise.
- As with all stimulation, there appears to be an ideal volume of RONS production which stimulates an acute anti-oxidant response (4) and adaptation or supercompensation. Below that volume, the body does not respond. Above that volume tissues are damaged. (5)
- Anti-oxidant supplementation for the purpose of mitigating exercise induced RONS production is only recommended when training beyond your fitness level in the case of an unusual event that exceeds your body’s capacity to respond such as a 50 rep max, marathon, competition, etc.
For normal training I recommend low volumes of whole food sources of anti-oxidants in the form of blue berries, cherries, raspberries etc. The anti-oxidants found in these whole food sources evolved over millions of years to withstand the oxidation of constant sun exposure. The relative volume of anti-oxidants present in this whole food sources is low but diverse and has been shown to improve anti-oxidant response following acute training bouts of training. (6)
Conclusion:
Yes free radicals cause cell damage which causes aging and yes intense exercise causes an acute spike in free radicals but please don’t throw the baby out with the bath water. Those regular spikes in ROS free radicals cause your body’s adaptive reactions that make you a fitter athlete and person. It makes your body more resilient to normal daily free radical deluge that your body endures every time you consume food and every time you are exposed to sunlight. The best way to manage your ROS balance is to have a fit oxidative response. High intensity exercise is how your body gets it’s oxidative swole on.
1) Wellman and Bloomer’s
2) Gomez-Cabrera
J Physiol. 2005 Aug 15;567(Pt 1):113-20. Epub 2005 Jun 2.
5) SCOTT K. POWERS and MALCOLM J. JACKSON
6) TraustadĂłttir, Davies
Rhodiola and Adrenal Fatigue
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Being a Viking can be stressful.
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| Freedom hating is demanding on the adrenals. |

 A life well lived can be pretty stressful. Most of the people that I know like to drink lots of coffee, lift heavy things, and procreate. All of these activities are demanding on your adrenal system. When your lifestyle demands more stress hormone then your adrenal glands are able to provide, you run at a deficit which manifests in the symptoms of Adrenal Fatigue.
Symptoms include:
Mid line weight gain, fatigue, difficulty sleeping, difficulty concentrating, reduced sex drive and other upleasantries.
They used adaptogens such as Rhodiola that’s how:
“Rhodiola has long been used in traditional medicine, primarily in Russia and Scandinavia. The Vikings used rhodiola to enhance physical strength and endurance, and it was commonly used by many Northern peoples to treat fatigue, poor physical endurance, nervous system disorders, and infections, and to enhance fertility.”(1)
USES:
Rhodiola has been shown in studies to improve cardiovascular performance by reducing perceived exhaustion and by improving the cardioprotective capacity of lung tissues in hypoxic environments.(2,3) Decrease lactate levels and skeletal muscle damage due to prolonged exercise(4,5.) Rhodiola has long been used for treating the perceived effects of stress and anxiety as well. This is not the sort of supplement that I have used on a maintenance basis as I do fish oil or vitamin D. An early study showed decreasing cardiovascular returns with prolonged use but more recent long-term trials have showed continued benefits with chronic use. (4,5)
WHEN TO USE IT
You don’t have to wait until you suffer overt symptoms before you supplement. I start to consider this supplement when I’m training hard and I start to wake up at 2am.
HOW TO USE IT
Rhodiola has a more stimulating effect at lower amounts, and a more sedating effect at higher amounts. In medical treatment, the usual amounts taken are 200 to 600 mg per day of a standardized extract to at least 3% rosavins and 0.8 to 1% salidroside. The nonstandardized amount would be 1 gram three times daily of the root, the amount for the alcoholic extract (40% alcohol) is 5 to 40 drops two to three times per day (with a weight to volume ratio of 1:1 to 1:5 ). Rhodiola is usually taken before meals.
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| Golden Root, Rhodiola rosea, Roseroot |
Thrive Under Pressure: Recover Rapidly.
This posting is designed to help a group athletes out of Crossfit West Seattle in their upcoming Caliber Cycle. These recommendations are general and are applicable to supporting recovery from any high intensity training cycle. This is the 4th Cycle that Zach at CFWS has run this year and we’ve learned a lot about how to get the most out of our efforts. Most importantly: Recover rapidly, Don’t get hurt, and Don’t get sick.
Everyone will have their own goals for the end of this cycle but the key is recovery and the path there is the same:
- Fuel Recovery
- Control Inflammation
- Prevent Injury
- Don’t Get Sick
Whether you hope to gain or lose weight in this cycle it is important that you increase your caloric intake. If you wish to lose weight then you are in the right program. Adding a few pounds of skeletal muscle over the following 6 weeks will increase your metabolism. Remember that calories are a measurement of energy. You are planning on expending a lot of energy and you plan to recover quickly, so it is wise to plan on consuming a lot of quality calories. The calories you consume will not cause you to grow. They will pass through the following hierarchy:
- Fuel Your Efforts in the Gym
- Fuel the Recovery From Your Efforts
- Fuel Adaptation/ Strength Gains
- Fuel Growth
Many people who are afraid of “getting too big” only satisfy the first requirement and risk injury because they lack sufficient energy to recover and continue training without injury. A simple way to increase your calories is to add something with a high caloric density such as nuts, avocados, olive oil, or a post-workout concoction of milk and protein powder. For those of you who wish to add an alarming amount of volume to your stature, it won’t be easy. You’ll have to eat in a way that is extreme and uncomfortable. A wise man named Scotty once told me “The meals should be harder than the wods.”
2- Control Inflammation/ Advil is not a vitamin.
Inflammation is not the enemy. Inflammation is the initial step in the healing process. It would be a mistake to rely on NSAIDs to suppress the pain of inflammation. NSAIDs weaken your joints leaving you susceptible to injury. Chronic consumption of NSAIDs often leads to serious gastric and kidney problems.
Instead relying on NSAIDs, control inflammation with:
Fish oil– That’s right. Lots of it too. The guidelines in this link are extreme but if you are ever in your life going to take a high volume of fish oil, now is the time. Buy it. Then drink it.
Contrast Therapy- Several minutes in barely tolerable heat and going right into shockingly cold water. The occasional rest day at Banya 5 or the Y are easy ways to get this done. After a series of particularly heavy training days make your tub into an Ice Bath and submerge your whole body to your chin for 5 minutes. This constricts your capillaries and hastens recovery. Its also strong immune support. For a convenient alternative simply alternate your shower hot 2 min/cold 2min for three cycles.
NSAID alternatives- When you’re looking from the relief that you typically get from NSAIDs, try proteolytic and digestive enzymes. They speed the inflammation and healing process instead of suppress it.
Don’t Get Sick and While You’re Up, Don’t Get Hurt
It is well documented that the immune system can be suppressed during periods of high stress and intense training. There is evidence that supplementing Vitamin C with bioflavinoids during periods of intense training decreases the frequency of upper respiratory tract infection. A gram/ day of Vit C is enough to keep you well. Make sure a that your supplement contains at least 500 mg bioflavinoids though. Without this important co-factor, your vitamin C levels may actually drop due to poor binding and competitive inhibition of your food based Vitamin C intake.
There is some evidence to support the claim that supplementing the minerals Zinc and Magnesium during intense training cycles prevents hormonal imbalances and the resultant over training symptoms of fatigue and malaise. The dose used in this study was 3mg/kg body weight/day. Zinc is an excellent supplement for preventing and fighting upper respiratory infections anyway which makes it a quality supplement to use anytime you feel you may be close to your training threshold. Just be sure to have something to eat first. Zinc supplements on an empty stomach deliver a “rowdy tequila bender” level of nausea.
4- Prevent Injury
Everyone will experience some physical discomfort during this cycle. It is normal for muscles to get sore after a hard workout. It’s not always necessary to “listen to your body” because your brain will often misinterpret terrible and glorious things like Fran and 400m sprints. “Help. Stop. Take a break. You are killing me.” It is an important skill to filter these false alarms and recognize true warnings of impending injury.
Now is the time to get proactive about the weak links in your kinetic chain. You know your spots: shoulder, elbow, wrist, back, hip, knee, ankle- address your weaknesses. Mobility issues in any of these joints will be exposed in the basic olympic lifts. Make it a priority to get to class early and spend 5-10 minutes improving your range of motion. The MWOD has dozens of quality mobilities for the major movements that we’ll be implementing. Supplemental therapies such as ART and Graston are sometimes necessary to make progress in areas with a history of injury.
Summary: There you have it. It is easy to thrive under pressure: Recover quickly, don’t get hurt, and don’t get sick. Contact me with any specific questions regarding recovery and supplementation. Have a great cycle.
GOMAD Part II
There is only one week left in the GOMAD Project. Here is an update.
The Plan: Drink One Gallon of Cheap Whole Milk in Addition Other Foods Daily For One Month or Until I gain 13 pounds. Whichever happens first.
Background:
I did not invent the GOMAD (Gallon Of Milk A Day) diet. It is a common choice among young men in a pinch to put on pounds fast. The reason why GOMAD works is simple. For one thing there are two thousand five hundred and sixty calories in a gallon of whole milk. In addition to that caloric push, milk has unique hormonal attributes including IGF-1 that drive growth. Dairy products also drive a strong insulin response that is out of proportion with its modest volume of sugar.
This is my third consecutive intervention experiment: July= Paleo, August= Vegan, September=Milk
This is a good way to contrast the acute effects on strength, energy, body composition, beard growth etc.
Results so Far:
Beard? Luxurious. Energy? Down. Strength? Up. Handsomeness? Down. Markedly. (Friends tell me I’m beginning to resemble Vince Vaughn. Not his charm or his height. His trademark puffy eyes and his pasty swollen party face.)
Body Composition:
My numbers have plateaued. I was initially gaining weight at an alarming rate. A full pound every other day going from 192.6 on 9/11/10 to 196.2 on 9/17/10. That is just 6 days. Imagine what that looks like after 6 months?! As I told my wife “imagine how great it will be when there is twice as much of me!” A surprising thing happened after that. I plateaued and then lost weight leveling out for the last ten days at 194.4 pounds. I am today only 3 pounds heavier than I was when I was a vegan nearly a month ago. This doesn’t seem reasonable.
The 3 Phases of Acceptance-
1) Confrontation:
The scale doesn’t lie. I came across some facts about the dairy industry that made cheap milk an unacceptable option. If you would like to continue to enjoy the simple pleasure of cheap milk then do not follow this link. You can’t unring the bell. It made me question why on earth I was doing this to my body and I made the switch to organic milk.
2) Blame:
There is something wrong with this milk. It clearly doesn’t work. I wish I could take it back but is too late. What kind of dwarven pygmy cattle are they milking at Horizon? I blame the cows. Maybe I should have stuck to my guns and stayed on the cheap milk.
3) Acceptance:
I Blame Myself.
I became complacent. I depended too often on the Moo Juice to supply all that I needed. I’d occasionally pull down half a gallon after my morning workout then charge off to the clinic without breakfast.
With only a week to go the question is what to do now? I’ll complete the task but I’ve been told to switch to chocolate milk if I want to get past this weight plateau. Interesting. I’ll let you know how it goes next week. Moo.
GOMAD: Gallon Of Milk A Day
So what’s the best way to rebound from eating vegan for a month? Exactly. Drink a gallon of cheap whole milk every day and hope for the best.
I’ve been at it for a week now. My first day was rough. I started late in the day and tried to down the gallon during my lunch break. I think that physically I could have done it. What I failed to account for was the time needed for naps and long sour looks into the mirror. I came up one cup short of a gallon in 3 hours.
So to get you up to speed; eating vegan left me strong but battered. My body fat increased 33% in just 23 days taking me to a personal record of 13%. My muscle mass dropped by four pounds. Those are ominous figures if I was to stick it out for the long haul. After the first 5 days of this GOMAD experiment my numbers all rebounded: back down to 10% bf and the 4 pounds of muscle came back.
So far so good. The biggest challenge thus far has been one of storage. I’m keeping a jug at the clinic, one at Crossfit and a couple at home. I’m going with the cheap stuff because I’m looking for growth right? Why pass on the free growth hormone that conventional cattle are pumped full of? I should probably get a full blood panel at the end of this one.
Gandhi DLP Part II: Eat Like a Hippie/ Lift Like a Bull
The plan was to train for one month eating completely vegan to see if I could make a significant strength gain in the absence of meat based protein.
I stuck to this plan for the most part only having some egg in a birthday cake I had and an insignificant amount of soy. The training cycle had to be cut a week short not giving me much time to make an increase but I did the most I could with a 23 day cycle.
I went with a dead lift regimen designed by Zach at CFWS: 5×5 deficit lifts, single rep rack pulls, these terrible things called front squat 1 1/2’s, and some Crossfit Football WODs on off days. The plan was to grind me into a fine powder and see if my body could recover from these beatings while eating like a hippie.
I tried to do this without supplementing any processed protein: no hemp powder, no soy, nothing weird. I went at it like this:
I ate a lot of vegetables.
I ate a whole lot of quinoa.
I drank olive oil like it was my job.
Here is my first attempt at #455 after 23 days training vegan:
It is a little known fact that olive oil has a whopping 120 calories per tablespoon. That is nearly the same number of calories that you’ll find in an entire cup of 2% milk (130 cals.) Whole milk gives you 160/cup and causes spikes in insulin which may cause long-term health problems. I kept my caloric intake high by adding one to two salads per day with 1/2 cup one each = 1000-2000 salad cals per day.
I realize that this isn’t the typical vegan diet but it worked for me. I failed to wither away. I gained 1.5 lbs.
I came off of the Paleo Diet heading into this vegan experiment and the stark contrast of meat intake is not the biggest difference between the two diets. The biggest difference is the wide amount of options that you have as a vegan. When you eat Paleo you would have to go a long way out of your way to eat poorly.
Example: Eat nothing but celery and ham for 30 days.
You have to go a long way out of your way to be a healthy vegan. You can follow STRICT vegan and have a destructive lifestyle with crappy nutrition.
Example:
First tie-up your pleather shoes and walk to your favorite brunch spot.
Pancakes, mimosa, and bagels with soy spread for breakfast-
Red Vines and two American Spirit cigarettes, and a liter of diet Coke for a snack-
Engage in domestic violence then have a peanut butter and jelly sandwich and malt liquor for lunch-
Chips and salsa with a salad for dinner- Then kick an old man down some stairs.
You see- Destructive right?
The way I did vegan worked. The predetermined marker of success for this program was to pull #455 (a #15 gain) in a 23 day training cycle. I took on a ridiculous amount of volume training from Coach Z, recovered from each training session well and pulled a much bigger weight off the ground than I had hoped.
Here is the #475 pull: I changed my form a little and it turned out ugly.
I’d like to thank my friend Eric for inadvertently editing this cut. His shirt is better looking then that pull but it doesn’t have to be pretty to count. At the end of the day I went from #440 to #475 bringing me just over a 2.5 body weight DL after 23 days intensive pulling training. I gained 1.5 pounds but my body fat went up 3%!
Conclusions:
1) The body fat increase may have been due to the relatively high sugar intake.
2) Don’t believe the hype. Vegans can get strong.
3) Gandhi probably had a sick dead lift.
The Ghandi Deadlift Project
Many of you may already know that I grew up on a strict vegetarian diet. My parents have been eating vegetarian for the past forty years and meat was not really considered food in my childhood. This is not such a big deal now but back in the 80’s in rural Washington in a hot bed of meat, mullets, and musk it was a much bigger deal. It was a rare meal that I had without someone asking a brilliant question that warranted an answer such as:
“Well that’s a good question but no, turkeys are not effing vegetables so no, I don’t eat them.”
This continued through undergrad where I played division I men’s rugby. It blew my mind how a person who I just literally spent an entire afternoon kicking around a field would inform me after that “you can’t grow muscle without meat.” Rage. Blind Rage.
Despite medical advice from authorities the vegetarian diet worked fine for me until my early 20’s when I met my beautiful, meat cooking wife Alicia. I now eat large pieces of flesh at every meal and I will admit that I am significantly stronger now then I was in my early 20’s (ten years ago.) I’m the same size and weight that I’ve always been but my training is more intense and focused on strength gains so to determine if it is the meat or the training that has me strong I am undergoing what I call:
4 weeks strict vegan (not vegetarian) diet
Intensive deadlift training similar to deadlift cycles I have done over the last several months.
Culminating in a deadlift single rep max attempt to beat my current record which stands at #440 on 5/1/10.
This lift was a #25 pound jump for me and was the result of a 6 week long deadlift strength program.
For this experiment to be a success and prove that Ghandi most likely had a SICK deadlift I will have to make a jump that big in only 4 weeks instead of 6 bringing me up to #465.
The project begins Monday, August 9th.
The max is on Monday September 6th. I’ll report back then.
Paleo Challenge Summer 2010
The official Challenge runs from July 12th through August 11th.
If you have to start late just run late and complete the 30 days.
To get started, email me at sk**********@gm***.com and I’ll send you a pdf of the food journal and schedule a time for you to get your body composition numbers for your before and after comparison.
There is a $10 buy-in for all participants and the money and prizes are divided among the winners. There is a point system to quantify compliance and a before and after body-composition test to reward your training efforts as well.
This will be a running posting throughout the month. Post your questions, recipes, and heart felt grievances to comments and I’ll post a reply. When you come across a novel solution to a Paleo-Problem: ie– “What on earth do I eat for breakfast when I am sick of eggs?” or “Where do I get macha?” or if you come across a good sale on meats at a local store please post that golden info to comments. This challenge can be difficult at first but it is a LOT easier when we share ideas and do our best to keep our diets diversified.
New Balance Paleo-Challenge
What is Paleo? What is Gluten, and why go through such an uncomfortable challenge?
Paleo is simple. It is eating in a way that is congruent to your genetic needs. You don’t have to hunt or gather. No raw meat or foraging for huckleberries. It is following a few simple rules:
New Balance Paleo-Challenge
Example day:
New Balance Paleo-Challenge
New Balance Paleo-Challenge
Carrot Banana Muffins- These look well worth the one salt point- or leave the salt out.
What to keep in your gym-bag after you realize that Advil is not a vitamin:
What to put in your cupboard after you clear out the NSAIDs? If you are the type who depends on Ibuprofen for sprains/strains and headaches, start with Proteolytic Enzymes or Pancreatic Enzymes such as Wobenzyme N (which you can find at Pharmaca), or Intenzyme Forte by Biotics Research Corp. This company is not open to the general population. I can place an order on your behalf at your request. These products are combonations of digestive enzymes such as amylase, lipase, protease, trypsin, chymotrypsin and bromelain. Some people use these enzymes to help boost their body’s digestive potency when taken with food but this posting is focused on the ability of these enzymes to combat inflammation in an acute setting when taken on an empty stomach.
Bromelain’s theraputic properties include: (1) interference with growth of malignant cells; (2) inhibition of platelet aggregation; (3) fibrinolytic activity; (4) anti-inflammatory action; (5) skin debridement properties. (J Ethnopharmacol. 1988 Feb-Mar;22(2):191-203.)
Bromelain has been shown in a recent 2008 study to decrease neutrophil migration to sites of acute inflammation. What that means is that this is what you want to have in your gym bag when you injure yourself training or at an event and you want to give yourself your best chance at rapid recovery. The 2002 review article by Maurer does a great job of explaining the biochemistry of proteolytic enzymatic activity anti-tumor and anti-inflammatory effects.
Toxicity and Contraindications
Allergy to pineapple
Proteolytic/Pancreatic Enzymes have a potential anti-coagulant effect so they are not advised if you are having surgery or if you are already taking an anti-coagulant medication
Dosage and Administration
Bromelain can be used in isolation and has a dose-dependent effect. Doses as small as 200mg per day have been demonstrated in a study by Walker et al to be effective treatment of osteoarthritis. Acute inflammation responds well to doses as large as 400mg taken 3 times throughout a day. Most products are a polyenzyme preparations consisting of pancreatin, bromelain, papain amylase, trypsin etc. and dosage is determined by product. (Vasquez, Integrative Rheumatology)
Additional Information
Some studies have shown Proteolytic Enzymes to have enhanced effect when taken with 500mg Citrus Bioflavinoids. The research on these alternatives is not performed as often as with mainstream drugs but I recommend these as your first line of defense for life’s aches and pains because they are an effective, safe alternative to NSAIDs that help you to feel better but often at the expense of your own long-term health and strength.
The research on bromelain’s effect on headaches is sparse. There were some studies that looked promising for the treatment of acute sinusitis but they were performed in the 60’s with little follow-up. Will pancreatic enzymes knock-out a headache like an Advil liquid-gel? Usually not, but what do you have to lose by treating proteolytic enzymes as your first line of defense? At a minimum you are decreasing your systemic inflammation, improving your digestion and possibly decreasing your chances of tumor growth. You can’t say that about liquid-gels.
NSAIDs Kill Tens of Thousands of People Per Year and Weaken the Joints They are Meant to Protect.
A wise man once said that as much as of 50% of what we call “fitness” may be pain tolerance. This may be true. In life it is sometimes necessary to continue on long after we exceed our comfort zone in order to do what we must. Whether you are a working person (kids or job) or an athlete we all have times that we do not “listen to our bodies.” We have those critical moments when we tell our bodies to shut their yaps and do as they are told. Anyone who has run 400 meters for time or has risen for a 5th time in the night to care for the needs of a child knows what I am saying. Whenever you push your body beyond its previous limits, it sounds the alarm. That sensation that your blood is on fire or that you are so tired that you feel stuck to the bottom of the ocean- that is your body panicking, having a tantrum: “STOP. YOU ARE CRAZY. YOU ARE GOING TO KILL US.” With training and experience we become familiar with this warning and decipher true alarms from the pangs of exertion.
The point to all of this is that we all bite off more than we can chew at times and in order to cope with the pain of injury or growth we do what we must to continue on with life. Most people reach without thinking for a bottle of NSAIDs to ease the pain. What do you reach for when you are in pain?
Disclaimer: I am not a pharmacist or a medical doctor. I do not prescribe drugs nor do I recommend changes to prescriptions that I don’t make. If you are self medicating with NSAIDs I’m about to give you some good reasons to stop. If they were prescribed to you, I’m going to give you some good reasons to discuss the necessity and safety of that prescription with your physician.
NSAID stands for nonsteroidal anti-inflammatory drugs. The most common over the counter versions that many of us have in our cupboards are Ibuprofen, Aspirin, Aleve, Motrin etc. These drugs act by counteracting the Cycloxygenase (COX) enzyme that produces prostaglandins that begin the body’s inflammation cycle which is the first stage of injury repair. Most people self-medicate common aches and pains or mild fevers with NSAIDs but they are also prescribed for cardio-protective and anti-inflammatory purposes. The intended effects of NSAID use are decreased pain and swelling.
The less desirable effects include:
Promotion of bone necrosis, cartilage destruction, and prolonged tissue healing time:
This is the horrible and ironic byproduct of NSAID use. The very joints that these drugs are effective at relieving the pain of inflammation in the short-term are degraded and weakened in the long-term. The mechanism of action is the interference by NSAIDs on chondrocyte function and thus cartilage formation within synovial joints.(7,3) This is likely the reason why NSAID use slows tissue healing time in athletes with severe muscle strains.(6) Think that over the next time you have a sore muscle. You can have relief from the bottle in the cabinet but it is relief on credit. It is relief that makes you weak and vulnerable to future injuries.
Gastric Ulceration and gastrointestinal bleeding: Nearly all NSAIDs promote gastric ulceration and gastrointestinal bleeding. Endoscopic studies indicate that among people who chronically use NSAIDs, up to 30% will develope gastroduodenal ulceration.(3,4) Conservative calculation estimates that approximately 107,000 patients are hospitalized annually for NSAID-related gastrointestinal (GI) complications. According to a research review article by Singh (5) 16,500 NSAID related deaths occur annually among arthritis patients alone.(3) There are no reliable warning signals for impending serious GI complications. – >80% of patients with serious GI complications had no prior GI symptoms and currently, limiting NSAID use is the only way to decrease the risk of NSAID-related GI events. (5)- These effects are compounded by the co-administration of or chronic use of alchohol.
Increased intestinal permeability due to damaged mucosa- “Leaky Gut” contributes to many rheumatic and musculoskeletal disorders by promoting the formation of immune complexes that are deposited into synovial tissues causing local inflammatory responses within the joints. (2,3) Anyone familiar with the Paleo Diet and the adverse effects of gluten on the small intestine is well aware of the importance of a patent intestine. For more information see my posting titled The New Balance Paleo Challenge: 30 Uncomfortable Days to Define Your Optimal Nutrition.
Kidney Disease: Chronic NSAID use is a critical risk factor in renal failure. (8,3)
Liver Disease: Liver disease is not as common in NSAIDs but is prevalent with Tylenol (Acetaminophen) this damage is especially likely when Tylenol is used with alcohol. The take home here is that Tylenol is not an acceptable solution for a hangover.
*All of the previously stated side-effects are compounded by the co-administration of alcohol or the chronic use of alcohol.
Inflammation is a necessary step in the tissue healing process- it is how broken materials are cleared out of the area before new tissues are laid down. That being said, the healing process is faster and more effective when this step is reigned in. In an on-line lecture Kelly Starette recently likened the degree of inflammation that the body mounts in a common injury to ripping a building down to its foundation to begin the process of fixing a small dent in one of the walls. This excessive and reactionary response was likely useful and necessary for our ancestors who had no access to sterile dressings or clean hot water to manage possible infection that often comes with tissue damage.
So what to do to reign in the inflammation process and speed healing time without the harmful and counterproductive effects of NSAIDs? Stay one step ahead of acute inflammation with an anti-inflammatory lifestyle that includes: Paleo Nutrion and regular supplementation of fish oil and glucosamine sulfate.
Prevention is key but sometimes sprains and strains happen. Then what?
The inflammatory phase of the tissue healing process lasts approximately 72 hours. For quicker healing times and stronger recovery from injury, follow a combination of these suggestions for the initial 3 Days post-injury:
1) Ice. Yes ice. It is almost too simple to take seriously, but seriously, take ice. You know the routine, now use it. That muscle that is sore after a workout/ game/ bout with lawn maintenance- ice it down through a towel for 20 minutes of every hour for the first 3 days following injury. If you are unwilling to make the time for icing try ice massage instead. It only takes 5 minutes of rubbing an ice cube directly into the injured area to achieve the effect of 20 minutes passive icing through a towel. While you’re at it, you may as well compress and elevate the area as well.
2) What to put in your cupboard after you clear out the NSAIDs? Start with Proteolytic Enzymes such as Bromelain. Bromelain has been shown in recent studies to have measurable anti-inflammatory effects for acute injury (9,10) and the only major side-effect for those without pineapple allergies is an anti-tumor and anti-cancer effect. (11,12)
There are several other well researched and well established herbal and natural anti-inflammatory products on the market but each deserves its own posting. Look out for future postings on Citrus Bioflavinoids, Boswellia, and Arnica etc. to guide you in the acquisition and administration of your own gym bag injury kit.
(1) Brandt KD. J Rheumatol Suppl. 1991 Feb;27:120-1. The mechanism of action of nonsteroidal antiinflammatory drugs.
(2)Inman RD. Antigens, the gastrointestinal tract, and arthritis. Gheum Dis Clin North Am. 1991 May; 17(2): 309-21
(3) Vasquez, Alex. Integrative Rheumatology 2007 :147
(4) Blower AL. Scand J Rheumatol Suppl. 1996;105:13-24; discussion 25-7. Considerations for nonsteroidal anti-inflammatory drug therapy: safety.
(5) Singh G. Am J Med. 1998 Jul 27;105(1B):31S-38S. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy.
(6) S Afr Med J. 1995 Jun;85(6):517-22. Non-steroidal anti-inflammatory drugs fail to enhance healing of acute hamstring injuries treated with physiotherapy.
(7) Brandt KD. Am J Med. 1987 Nov 20;83(5A):29-34. Effects of nonsteroidal anti-inflammatory drugs on chondrocyte metabolism in vitro and in vivo.
(8) Segasothy M Br J Rheumatol. 1995 Feb;34(2):162-5. Chronic nephrotoxicity of anti-inflammatory drugs used in the treatment of arthritis.
(9) Walker AF, Bundy R, Hicks SM, Middleton RW Phytomedicine. 2002 Dec;9(8):681-6. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults.
(10)Walker JA, Cerny FJ, Cotter JR, Burton HW. Med Sci Sports Exerc. 1992 Jan;24(1):20-5. Attenuation of contraction-induced skeletal muscle injury by bromelain.
(11) Chobotova K, Vernallis AB, Majid FA Bromelain’s activity and potential as an anti-cancer agent: Current evidence and perspectives. Cancer Lett. 2010 Apr 28;290(2):148-56. Epub 2009 Aug 22. Review.
(12) Bhui K, Prasad S, George J, Shukla Y. Bromelain inhibits COX-2 expression by blocking the activation of MAPK regulated NF-kappa B against skin tumor-initiation triggering mitochondrial death pathway.
Cancer Lett. 2009 Sep 18;282(2):167-76. Epub 2009 Mar 31.
Glucosamine Sulfate and Chondroitin Sulfate: The Promotion of Cartilage Regeneration
Six years ago, for my 25th birthday my wife sent me on a ski trip with friends. A trip which I took as an opportunity to research the process of injury and recovery. After overshooting the landing on a tabletop and fracturing my right scaphoid and dislocating my lunate, I was left with two large pins stabilizing my wrist for the following four months.
Joints do not like to be immobilized. The hyaline cartilage that prevents bone on bone contact in synovial joints lacks any direct blood supply. It depends on regular compression and decompression to act as a pressure pump that draws blood from the surrounding chondrocytes. Because of this, even in ideal situations where the scaphoid heals well and the articulation with the lunate is restored, severe cartilaginous degeneration and resulting arthritis is a likely long-term outcome from this sort of trauma.
With my hobbies, goals, and livelihood I am well aware that it is worth the minimal investment to get the right nutrition and supplementation to give me my best opportunity to have wrists that are both mobile and pain free.
Glucosamine Sulfate is marketed for its promotion of cartilage regeneration. Glucosamine is not necessarily a building block for cartilage in your synovial joints but it along with Chondroitin stimulate the synthesis of glycosaminoglycan, proteoglycan and hyaluronic acid, which are the “building blocks” of joint cartilage. Recent studies have shown that glucosamine sulfate 500 mg TID (3 times per day) and/or Chondroitin Sulfate 1200mg are effective treatments for joint degeneration and pain seen in osteoarthritis.(1) They have also been shown to be as effective and safer than Ibuprofen in the treatment of knee pain.(2)
I have supplemented Glucosamine Sulphate and fish oil for the past several years and they seem to have helped my recovery. I now experience nearly full ranges of motion and my wrist causes me only minimal discomfort and only when I push it into full weight bearing extension during presses and handstands. That being said, as with all things nutrition I recommend you try for yourself and see if it works for you. If you have a demanding physical lifestyle and pain that localizes to a particular joint try 8 weeks of glucosamine/chondroitin supplementation. There is an anti-inflammatory effect that is useful in the short-term, but do not judge this product’s effect until you give it at least 8 weeks. That’s how long it will take to have an effect on cartilage regeneration.
Toxicity and Contraindications:
Glucosamine is derived from shellfish sources so beware if you have a known allergic reaction to shrimp, crab or lobster.
Dosage and Administration:
Glucosamine Sulfate: 1500 mg divided into 3 seperate 500mg doses (1500mg TID)
Chondroitin Sulfate: 1200 mg
Can be taken with or without food.
Additional Information:
Stay away from HCl. The cheaper products on the market are typically bound to HCl instead of Sulfate (Glucaosamine HCl/ Chondroitin HCl) It is cheaper to produce this way and the product MAY be just as effective but the above research and major studies that validate the use of Glucosamine /Chondroitin were done with Sulfate bound supplements.
Should I take Glucosamine alone or compounded with Chondroitin?
Some studies show that these two products have a cumulative effect. I have seen studies that show Glucosamine to be just as effective on its own. The important thing to remember when selecting the supplement is dosage; many compounded products will water down the amounts of each supplement to get more names on the label. If you find something that has both and they are both bound to sulfate, and the dosages add up, go for it. Otherwise keep it simple and stick with Glucosamine Sulfate alone.
(1)– Alex Vasquez, N.D., D.O.,D.C. Integrative Rheumatology Pg. 449
(2)– Muller-Fassbender H. Bach GL, HasseW, Osteoarthritis Cartliage. 1994 March;2 (1) 61-9
Paleo Frosty
The number one problem that people on the paleo challenge struggle with is getting that sweet tooth under control. I feel your pain. Three days into my first challenge I felt like I would rather eat my own shoes than eat another salad. Enter the Paleo Frosty. This is NOT a pre or post workout shake. This is what you turn to after dinner when you start to here the siren song of Cupcake Royale.
This thing is loaded with natural fats and sugars. Several sugar starved cave people have told me that it is the best shake they’ve ever had. Of coarse this is akin to having the best saltine of your life after not eating for 2 weeks. Just the same, it scratches the itch and keeps you from falling off the paleo-wagon and depending on how you are scoring your challenge, can cost zero points against your caveman cred.
The Paleo Frosty:
1 can coconut milk. (I prefer the regular milk but some can only handle the low fat)
2-3 whole pitted dates (all the sugar, none of the points!)
5 ice cubes
1.5 Tablespoons baking cocoa- the unsweetened bitter stuff
That is the base I add cashew butter sometimes and frozen fruits are solid too.
Put it all in a food processor or a burly blender and serve it in a champagne glass.