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Meds and Multisports: OTC Danger

Today’s post is brought to you by TriSports Champ Greg Vanichkachorn, MD.

Triathletes are an assorted bunch.  Our swim styles are as uniform as the weather at St. George.  Our choice in bikes is as predictable as the Kona lottery. We do, however, share one common trait: we love to punish our bodies. Back aches, ITB pain, and anything-tendonitis: these are common maladies for the masochistic multi-sporter. The constant barrage on our bodies can take its toll, and it’s easy to reach for a pill when the pains persist.

As a physician, I have seen the unfortunate ramifications of equating “over the counter” with a notion of “not a real medicine.” Over the counter drugs, with their dangers hidden beneath familiarity, are most certainly real medications that can have significant side effects, even when used properly. Here are a few tips that can keep meds from being a prescription for disaster.

Nothing new on race day

One of the wisest adages of triathlon is that nothing new should be tried on race day. No matter how enticing those new wheels are at the expo, you don’t change your bike setup the day before an Ironman. The same philosophy should go for medications.

I know the feeling. That moment when you’re standing in Target, buying that travel toothbrush with that cap as a handle before leaving for Ironman, when you see it – the brand-spanking-new, clinically proven pill that cures aches, prevents sunburns, raises your power output, and unites North and South Korea. The shiny and new can be difficult to resist, but you must persevere.

Race day is not the time to realize that new med also causes explosive diarrhea. If you have medication requirements on race day, stick to what you know works for your body. Also, make sure you get your medications filled in a timely manner. You don’t want to show up on race morning without your blood pressure medicine. All the training won’t matter if you suffer a stroke.

NSAIDS, Exercise, and Gastritis Oh My!

Some of the most common medications used by athletes are non-steroidal anti-inflammatory drugs, such as Advil and Aleve. While they are effective pain relievers, they can have several significant side effects, one of the most serious being irritation of the GI tract. This irritation can be so severe that it may result in bleeding or even perforation.  The risk is even greater with the extra sensitivity of the GI tract during strenuous exercise. Gastritis is not a fun way to recovery post race!

You can help avoid the bathroom podium finish first by practicing moderation: only use NSAIDS, especially before a really tough workout, if you really need it. If you do have to pop a few tablets, stick to the instructions on the bottle or your doctor’s orders. Unlike bicycles in the garage, more pills are not necessarily better! Also, take the medicine with food and allow plenty of time for it to settle in, say an hour, before pounding the pavement. If you do have post-workout GI issues from taking NSAIDS, speak with your medical provider to make sure nothing more serious is amiss.

Allergic to Being Awake

While we cherish the spring blooming of flowers (or the July thawing of lakes here in Montana), all of that glorious pollen blowing in our faces at 20 mph can have less than ideal results. The sore throat, itchy eyes, and runny nose of seasonal allergies can turn the most perfect of days into mucous mayhem.

“I love spring rides”

Fortunately, there are plenty of medications available to help prevent you from turning into a snot rocket. However, while some of the newer medications, such as Loratadine, are relatively safe, there are a couple out there that you should be wary of.

Benadryl, or diphenhydramine HCL, can definitely stop allergy symptoms in their tracks. The only problem is that Benadryl can also stop a horse in its tracks due to its sedative side effects. The drowsiness potential should not be underestimated; sometimes Benadryl is prescribed purely to help with sleep and anxiety. It is also one of the most commonly abused and impairing medications used in the work place. If Benadryl can make photocopying in the office dangerous, it’s the last thing you want in your system while descending at Coeur d’Alene or using a porta-potty.

Another allergy medicine that deserves special caution is good old Sudafed, or pseudoephedrine. Sudafed is a powerful nasal decongestant, and it works by constricting blood vessels in the nasal passages. The problem is that the medicine works like the TriSports Team; it gets the job done everywhere. The widespread vasoconstriction through out the body can lead to increased blood pressure, dry mouth, reduced sweat ability, and troubles urinating. These are the exact things you would like to avoid on the way to the Energy Lab in Kona.

Stay safe

In a time when there is a pill or supplement for everything, it is tempting to take a visit to the local drugstore for the next great cure when aches and pains arise. The indiscriminate use of meds, however, may do more harm for your triathlon career than a bottle of EPO in your fridge. Careful consideration and planning well ahead of race day will keep your medications a prescription for safety and success.