The other day I asked my EP which NSAIDs would be less harmful. He replied that since I am not on anticoagulants NSAIDs are not contraindicated for me. I said nothing. I didn't have the heart to say I had more confidence in my wonderful UK Afib forum than in his pronouncement.
At some point, however, it would be good to point to the evidence. Are there studies, or is it just watching many cases closely over time, which this forum does so well?
Same with muscle relaxants -- my family is becoming frustrated that I won't take them. They want to see a doctor say it, or some hefty other evidence.
Thanks so much for any thoughts.
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I couldn’t find any recent research - this study is 2013-14 but please note the privisos at the end of the article ncbi.nlm.nih.gov/pmc/articl... the nunmbers do not take into consideration participants who obtained NSAIDs OTC.
From what I have read elsewhere the risks of NSAIDs causing AF is small, but statistically significant. Statistics however are just numbers and everyone will react very differently. I have had the odd NSAID and it didn’t spark my heart to misbehave but I personally wouldn’t chance taking them on a regular/daily basis.
For your information, in many European countries such as Spain, you cannot obtain NSAIDs without prescription. I lived in Spain for 6 months and found it very irritating as I used them for headaches - this was prior to AF. Needless to say as soon as I was aware of the connection - I stopped taking them and found alternative solutions - mostly natural.
Your decision and remember that any Doctor’s advice is based on their experience and interest of the subject and there is always controversy. My view is you need to consider which is lesser of two evils and can you live with the AF if the meds trigger you?
A non-steroidal anti-inflammatory like Motrin or Aleve. There are also prescription NSAIDs in the States as well, but Motrin and Aleve are sold over the counter.
well I am a study of one. I took Celebrex a prescribed NSAID and went into AF for the first time after the second tablet. I googled it from my trolley and in SOME people it interferes with the potassium channels in the heart and sends them into AF . If by muscle relaxants you mean benzodiazepines I would not touch those with a barge pole . I won’t take tablets but then the trade off is I can’t really moan about my aches and pains when I refuse the “solution “
I recently had acupuncture for pain in hands, feet and knees from Osteoarthritis. I have to say it seems to have worked, expensive but effective for the pain. It’s not instant and I had 6 treatments but told that will see me through for about 12-14 weeks.
Spanish docs are crap dish out benzodiazapans and nsaids like sweets and do nothing about checking if a patient has afib I challenged my Spanish doctor about this and prescribing strong benzodiazapans and risk of falls with elderly patients age she replied that's how we are trained
This is only my experience of course but I have paroxysmal AF and recently was in excruciating pain due to a herniated disc in my neck. To try to reduce the inflammation I took ibuprofen regularly for at least a week or more (mainly slow release long lasting). I didn’t take them out of choice but necessity as I was desperate and I stopped my anticoagulants as I know they are contraindicated (though my pharmacist says just the odd few ibuprofen won’t hurt).
Anyway I had no AF episodes at all. Sadly I have just had two episodes of AF (fingers crossed no more!) but it was a few weeks after the ibuprofen so I don’t think it was connected.
My neurosurgeon just gave me a few days of muscle relaxants and they have made a huge difference in reducing the muscle spasm that was mainly causing all the pain allowing me to move more freely which then reduces the spasm too.
As I say this is not advice just my recent experience…..
Spot on Sunnyday about the muscle spasms often causing more pain than the original problem. That’s why I sit with a heat pad on my lower back after a couple of hours in the garden. Very effective for pain relief.
Thank you for sharing -- I am glad ibuprofen helped without issue, and that the muscle relaxant did its job. Many people think they are terrifically useful
Yes indeed, and there are definitely country by country differences in which way to lean. I am wondering what is prescribed in the UK or other places (or suggested, if it is non-drug) for seized up muscles. In the US it would be flexeril (muscle relaxant) or motrin (NSAID). Afib is not really on the radar for these decisions here, as far as I can tell
Are those tablets? It seems a pity that there is nothing topical available to apply rather than having to take them orally. I am sure that would be safer and probably quite effective too.
If anyone in the UK has heard of/used a topical muscle relaxant please let me know. Just one day off the diazepam and I can feel my neck and shoulders seizing up again 🤦♀️
Yes, they are tablets. There is topical magnesium available, as well as nonprescription products like IcyHot, but I don't have personal experience with them. Many find them helpful apparently.
If I wasn't taking an anticoagulant, I most certainly would have recently taken an NSAID for my recent back pain. Bear in mind that all NSAID drugs carry the risk of causing haemorrhages. Even a single dose has been shown to cause erosion of the intestinal wall, I recall reading.
By "muscle relaxants" do you mean benzodiazepine drugs? If so, to my knowledge, these are safe with the newer anticoagulant medicines.
Benzodiazepines are effective muscle relaxants but do carry a dependency risk in maybe 30% long-term users. I'd never heard of Flexeril and see it's not available in the UK. It seems to have the potential for causing heart related side effects/
I have diazepam but it is addictive so the drs will only give a few at a time and even then reluctantly. I have been in severe pain since early June and wish they had given me diazepam straight away as it would have saved weeks and weeks of trauma!
It was the only drug that provided me with some real and welcome relief during my recent severe back trouble. I have read that it's not "addictive", technically but can create dependency in about a third of long-term users, hence the cautious approach to prescribing it. I must say that of the four or so people I have known who have used it, it was always said to be effective and safe. I use it rarely but find it helpful.
Some doctors are very cautious about prescribing it, but if it works safely for you and isn't taken long term, I would say it is a very useful drug. Looking at the patient reviews on the internet, many would agree. Only once did I take it for more than a week, and that was maybe fifteen years ago, and that was 10mg, too, and I had no problems at all with it.
Yes I had it prescribed for a severely slipped disc in my back a few years ago (had to have surgery in the end) and it worked well then too with no side effects after several weeks use.
The problem is trying to persuade the drs to prescribe it a and if the reluctance give in they only give for a few days. My problem is that if I use all of them and then the muscles completely seize up again I am stuck so I am trying to keep some in reserve…
You’re absolutely right, sadly. Luckily, my own GP is better informed and more pragmatic. The medical establishment has it in for these drugs it seems, despite the evidence that their side effects affect fewer than a third and that for many they work well.
Steve
NSAIDs are fine short term… but they increase erosion on gut mucosa and deplete kidney function over time.
Natural blood thinners like serrapeptase or nattokinase also reduce inflammatory responses…like nsaids but seem less damaging… a quick word about inflammation..
often the trigger can be over consumption of omega 6’s such as cooking oils and eating processed foods like biscuits and cakes.
The cure is increasing omega 3 such as fish oil but not the capsule form… use small bottles and check the dates…
I have read about some who have used nattokinase regularly for 15 years… they look well and healthy… the Japanese have very little Afib in their population.
Muscle relaxants… nothing better than magnesium…it’s what our body requires for healthy production of over 300 essential enzymes.. imagine what happens to your body when it cannot make enzymes.. health begins its decline….
Dr Sanjay Gupta.. York YouTube.. explains the benefits of magnesium taurate… on heart rhythm health… it really is a miracle mineral for a lot of reasons.
Yes magnesium on skin is equally effective but you cannot measure how much you absorb..if you live near the sea… walking in seawater works too… because it too contains magnesium… so consider adding magnesium flakes in your bath water….
If you take orally taurate is helpful because the highest content is found in the heart… people who received 3000 mg magnesium taurate via IV after a heart attack lived at least five years longer than those who didn’t in a study… just one infusion… extended lifespan by at least five years!
Yes.. I have.. the only thing to be aware of is the initial response.. go for a little less at first.. I am a man and went in at the deep end.. took 1000mg all at once… I know!.. it’s a man thing.
You will switch back on lots on enzymes reactions and may feel “odd” because there is a change to how things “work”
Think about it… our farming methods have stripped out magnesium in the soil.. which lowers levels in foods we eat… hence everybody just about has very low levels.. and non optimal health.. weak bones… and low energy .. poor sleep.
if you are only applying on the skin… then any of the magnesium group will work… if you itch.. you may be low on cortisol which controls histamine levels.
Did you get your thyroid checked? Thus can cause higher levels of calcium in the body which could be why you are unable to relax in the first place… women tend to suffer most.
Actually magnesium causes muscles to relax … it’s Calcium that causes muscles to contract…. Have you tried soaking a flannel or sponge in magnesium like Epsom salts.. then apply around spasm?
There are other things that may work better for you … lavender… Yang Yang.
Rhodiola… melatonin.
And use a hot water bottle… I use an electric one now … they are on sale through Amazon…it makes the body think there is inflammation so sends the immune system to work…this lessens inflammation.
A miracle mineral? Goodness - you have been lucky with it! I saw Dr Gupta's video and was left wondering about the scientific rationale but it's clear some people find it effective. You are one of the very lucky ones. I wish I were. Mind you I avoid over-processed food like the plague and eat lots of whole and fresh foods so will have a good natural supply of it.
Yes it is essential to the whole body… without it you would barely survive…
It’s the only mineral that performs the ATP switch to make energy for a reason… sodium and potassium switch places in each cell because of it.. people with low magnesium have low vitamin D… you really should research … try Dr Carolyn Dean she specialises in this mineral and has produced books on it.
If you had a reaction … it was most likely the switching on of several dormant enzymes… magnesium actually helps over 300 enzymes to function…. If you think food can supply it .. yes… but eating 10 places of spinach a day is quite difficult… oxylates will damage your kidneys.
Measuring serum magnesium is difficult… only 1% circulates in the blood… 39% in tissue… and 60% in the bones… yes it stops bones breaking ..NOT calcium!
It also strengthens teeth and dissolves calcium in soft tissue… if you have plaque buildup on teeth… it’s due to low magnesium in your diet… twitching muscles …(Afib) … low magnesium… as we age it becomes harder to glean essential vitamins from food alone… hope you find this helpful.
Absolutely minimum for men 450mg a day women 350mg daily… bear in mind that not all magnesium is equal … it is not always absorbed in the body… even on the regime it can take months to get healthy levels … stress .. sugar…alcohol… illnesses..PPI’s all deplete magnesium..
Any excess taken is usually passed out .. best all rounder is glycinate .. avoid sulphate as this is for bowel issues…
Oxide is poorly absorbed.
The farmers stopped putting in back in soil… only nitrogen and phosphates hence foods grown by intensive farming lack what our ancestors enjoyed.
Thanks for all of that helpful information. I keep my levels checked annually, although I take your point on magnesium.
I think, in the case of that mineral, that unless there’s an actual absorption problem, the most easy to obtain form is from a good balanced diet. I try hard to eat well!
Just realised your avatar name suggests you are on PPI’s these interfere with the stomachs ability to make acid… which often prevents magnesium from being absorbed from food… you may not be getting enough Mg because of this alone.
Hi - yes, sadly, I do. I wish it were otherwise but I was told it was a very rare side effect by a GI specialist I asked. Despite his concrete assurances, I do keep a check on it.
Even worse news is that the PPI does this by blocking uptake of magnesium and calcium from the intestines, so taking a supplement has no effect at all. This means to absorb the nutrients the PPI has to be stopped, which isn’t something I look forward to having tried and failed once.
I wish you the best quitting the PPIs if that is what you want to do. They have side effects that aren't often pointed out. For example, for many they contribute to insomnia, which has its own problems.
I think from knowing a few that take them that generally they are very well tolerated and, goodness, they do work well if acid is a problem. The specialist I saw told me that they have saved countless risky ulcer operations and prevent erosion of the oesophagus and worse from happening.
Certainly that is true. Many things are a trade-off. The important thing is to know what is being traded off so that you can adjust for it. Best wishes to you
Yes the Danish studies have shown a statistical relationship between NSAIDS/Cox2 use and AF , with a marked raised incidence in AF/Flutter in new users as opposed to long term users. Is this a causal relationship or is it a case of chicken & egg?
In my case I have been in AF for ten years (96%) and been prescribed Diclofenac for chronic lower back and hand-joint pain. Following a small TIA three years ago I was urged to cease NSAIDS and or COX2 and tried all available alternatives; life became intolerable and I asked my cardiologist whether I could resume taking the Diclofenac and he said yes - take 75mg twice a day, and literally within a day I was pain free. Now I manage fine on 50mg instead (another Danish study recommended less that 150mg per day)
Remember that the 40-70% increase in cardiac events quoted in the 2011 study are changes in the tiny % chance of MACE, (major adverse cardiac events) and so are still small.
As taking the above and NSAIDS is definitely a no no unfortunately.
Post my last operation for removal of Johnson & Johnson kit Feb 22 I was given OXY-NORMAL and paracetimol. I took the former for 3 days only as I know they can become addictive.
But that leaves us with NO ANTI. INFLAMMATORY drugs.
We can do it via food Vit A, garlic, tumeric etc.
So the OXY-NORMAL like Codeine isfor pain.
My best anti was ifuprofen and 100mg would prevent or keep the inflammatory at bay.
Sorry no antis but if you are talking about relaxing the heart muscles BB Beta Blockers - adrenaline and CCB Calcium Channel Blocker-calcium will relax the heart.
It is definitely a fact , NSIAD’s are contraindicated when one is taken blood thinners. A steroid tablets are prescribed to relieve inflammation in place of NNSAD .Also muscle relaxants are contraindicated when taken anti arithmetic an exception is chlorozoxazone as prescribed by a doctor.
hi, a question, if you are on AFib why not on anticoagulants, my experience is you can't have one without the other. My experience with NSAID is they trigger my Afib. Also when in hospital after heart op the hospital didn't use them, it was paracetomol or morphine.
What muscle relaxants are you talking about and why?
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