Is Ibuprofen Bad For You? The Truth About NSAIDs and Your Gut Health

On a recent “ask me anything” episode of The Art of Being Well, one of the questions I had from a listener was: how bad is ibuprofen really?

This is a question I hear a lot in my telehealth functional medicine practice.

Often, someone has heard that ibuprofen and other NSAIDs might be bad for their gut health or overall health, but they want to know if it’s okay to take just one or two here and there for a headache, cramps, or occasional pain.

This is such a good question and there are a few key points to consider, so I decided to write you this guide that really breaks it all down.

I’ll also share a list of some of the most effective natural pain relievers, how to choose a cleaner NSAID if and when you need one, and quick questions to ask yourself if you’re not sure about taking an ibuprofen.

An Overview of Ibuprofen and NSAIDs

Let’s start with a quick primer on what ibuprofen and NSAIDs are, and how they actually work in the body.

NSAIDs stands for nonsteroidal anti-inflammatory drugs— medications that are developed to work like corticosteroids to reduce inflammation and pain, but without the side effects of steroids (though of course they come with their own possible side effects, which we’ll get to later).

Common drugs that fall into this category include:

• Ibuprofen (sold under the brand names Advil, Motrin, and others)
• Naproxen (sold under the brand name Aleve and others)
• Aspirin (sold under the brand names Excedrin, Bufferin, and others)

How Do NSAIDs Like Ibuprofen Work?

NSAIDs, including ibuprofen, work by blocking specific kinds of enzymes (cox-1 and cox-2) that produce hormone-like substances called prostaglandins.

Among other things, prostaglandins are known to produce inflammation, swelling, and pain. By blocking the enzymes that facilitate the production of prostaglandins, NSAIDs are able to reduce inflammation and pain.

Ibuprofen, Prostaglandins, and Your Gut Health

So how might ibuprofen negatively impact your gut and overall health? Let’s go back to prostaglandins for a minute.

As I mentioned above, prostaglandins produce inflammation and swelling. This might make them sound like bad guys, but keep in mind that inflammation is a natural, necessary, and protective function in many cases.

And prostaglandins do other things, too. Some of their functions include:

• Protecting the stomach lining from damage
• Reducing excess stomach acid
• Stimulating the production of gut-protective mucous
• Helping to regulate kidney function
• Improving blood flow to the liver

So by blocking the production of prostaglandins, we’re not just stopping the process of inflammation and pain, we’re blocking all of these other functions, including those that support and protect the gut.

This is how and why ibuprofen and other NSAIDs can negatively affect your gut health.

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Potential Side Effects of NSAIDs

In addition to overall disruption of gut health, NSAIDs have been linked to several different kinds of short term and long term side effects.

Acute or short term side effects may include: 

• Stomach or abdominal pain
• Nausea or stomach upset
• Indigestion
• Constipation
• Headache
• Dizziness
• Drowsiness
• Fatigue
• Tinnitus
• Fluid retention

Long term side effects may include: 

• Chronic stomach pain, heartburn, or nausea
• Increased risk of gastrointestinal bleeding
• Small bowel inflammation
• Increased risk of stomach ulcers
• Increased risk of heart disease and cardiovascular events including heart attack, stroke, and heart failure
• Increased risk of kidney disease or kidney failure

Neither of these are complete lists, and some people may be at a higher risk of experiencing serious side effects.

This includes those with existing stomach, heart, or kidney problems, high blood pressure, liver disease, or those using certain other kinds of medications including blood thinners.

Seek medical care right away if you experience chest pain, blurred vision, shortness of breath, slurred speech, or a sudden or severe headache after taking ibuprofen.

Is It Okay To Take Ibuprofen Occasionally?

Now that we know a bit more about how ibuprofen works and how it can affect your body, we can get to the practical question— is it okay to take ibuprofen sometimes?

It depends— let me explain.

The more ibuprofen you take and the more frequently you take it, the more likely you are to experience gut issues and other side effects. But even occasional use of ibuprofen can, for some people, cause issues in the gut.

This is especially true if you already have a gut health imbalance, digestive issue, or inflammatory condition. In these cases, your baseline ability to tolerate the occasional gut-disruptive NSAID is likely to be lower.

This doesn’t necessarily mean you should absolutely never take an ibuprofen, but it’s a reason to be more conscious of your use and the effects it may have on your system.

On the flipside, there are times when the benefits of reducing pain with ibuprofen likely outweigh the risks. You’ll want to weigh the pros and cons for your own situation.

When Ibuprofen Makes Sense

For example, if taking ibuprofen once a month for menstrual cramps is the only thing that helps you get through that day, I don’t want you to be afraid to take one.

Another example is the occasional headache or acute pain that’s interfering with your ability to sleep. Sleep is essential and incredibly restorative, and the benefits of getting a good night’s rest (for your gut health and in general) probably outweigh the risks in this case.

It’s all about balance. I’ll also add that stress is known to disrupt gut and hormonal health— and this includes things like worrying about taking an Advil. Being aware of the risks and aiming to limit your use is great, but don’t panic if once in a while you need to take one.

If you do take the occasional ibuprofen or another painkiller, aim to find the most infrequent use and the lowest dose that works for you. In many cases the minimal effective dose of ibuprofen is actually lower than what the label recommends, but it all depends on the individual.

Of course, it’s always best to speak with a healthcare professional if you’re unsure about the safety of ibuprofen in your case.

Natural Anti-Inflammatory Options For Pain Relief

Here’s some good news: there are a ton of great natural compounds and supplements that can help to reduce inflammation and pain without the gut irritation and side effects of ibuprofen.

Especially if you typically use ibuprofen more regularly, I would highly recommend testing out some of these other options to see if you can find a natural alternative that works for you. Again, make sure to speak with your doctor especially if they have recommended NSAIDs for you.

Here are a few of my favorite natural anti-inflammatories and pain relievers: 

• Curcumin: Curcumin, the active ingredient in turmeric, is one of the most powerful natural anti-inflammatory remedies and has been shown to help decrease pain and inflammation in several studies. My supplement The Curcumin is one of my top go-to options that I use with my patients.
• Boswellia (frankincense): Boswellia has been used for centuries in herbal medicine. Among other benefits, it can help to reduce joint pain, improve joint function, and reduce inflammation.
• CBD: Early studies have shown that CBD can help to reduce chronic pain and inflammation.
• White willow bark: White willow bark contains salicin, which gets converted in the body to salicylic acid, the primary metabolite of aspirin. It’s been used for centuries to reduce pain and inflammation, without the side effects of over-the-counter medications.
• Magnesium: One of the most common causes of chronic headaches and other kinds of chronic pain that we see in our telehealth practice is magnesium deficiency. Supplementing with magnesium can help to address this underlying cause and reduce (and prevent) headaches, muscle cramps, and pain. You can check out my magnesium formulation here.