Excessive use of anti-inflammatories can have negative consequences. In addition to disrupting homeostasis, it can compromise the defense against infections.
New studies that expand knowledge about the importance of inflammation in the body’s defence, tissue repair, brain function and many other vital processes, as Estadão showed on Saturday, are also generating concern. discussion of the risks of drug abuse.
“The abuse of anti-inflammatories can have two negative consequences. In addition to disrupting homeostasis (the maintenance of the body’s physiological balance), it can compromise the defense against infections and even against certain types of tumors,” immunologist Ruslan Medzhitov, a professor at Yale University (USA), told Estadão. In a special issue on the role of inflammation, recently published by the journal Science, he offers a broader view of the subject.
According to Medzhitov, recent studies have shown that nonsteroidal anti-inflammatory drugs (such as acetylsalicylic acid and ibuprofen) can cause ulcers in the intestine and even reduce the positive effect of physical exercise, if they are used in high doses and for long periods. Self-medication, a common practice in Brazil, compounds the problem.
In January this year, 26 million boxes of anti-inflammatories were sold in pharmacies across the country. If each consumer had taken only one box, the quantity sold this month would be enough to reach 12% of the Brazilian population. Between 2020 and 2021, sales increased by 3%: from 217 million to 224 million boxes.
The survey commissioned by Estadão by the consulting firm IQVIA, a company that monitors information from the pharmaceutical sector, only considers the category of anti-inflammatories used to treat the musculoskeletal system, such as pain in the leg, arm, shoulder, hip and spine, among others.
Such pains are well known in the dance world. Júlia Pontes dos Santos, 19, from São Paulo, trained in professional classical ballet, put on her first shoes at the age of two and spent her childhood training at the bar and rehearsing choreographies for long hours.
She was under 12 when she suffered a spinal injury. “I took anti-inflammatories, muscle relaxants and opioids to avoid physical therapy and keep dancing,” says Júlia. “Sometimes I was stuck in bed for two days. I started using these remedies like water. My mother hid the boxes, but I took them without her knowing.
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Like so many girls who want to go through the difficult selection of the big dance companies, Júlia wanted to be discovered in São Miguel Paulista, east of São Paulo, and shine abroad. More mature, she studies physiotherapy and continues to practice four hours of dance (classical ballet, heel dance and belly dance) a day, three times a week. Júlia intends to work with the physical preparation of the dancers. “I didn’t give up on my dream, but I opened my mind.”
To follow this new path, she is inspired by the example of Tamires Reis, a personal trainer specializing in the physical preparation of dancers. A graduate in physical education from the Federal University of São Paulo (Unifesp) and a professional dancer, she created an online injury prevention program. He is a consultant for major dance companies and is well versed in the culture of drug abuse.
“Dancers think it’s normal to feel pain and take anti-inflammatories themselves. One indicates the remedies to the other. I went through it myself and made that mistake,” he says. “While they think it’s a weakness to show they’re unwell, many teachers insist that long hours of dancing are enough to prepare the body to perform the moves,” says Tamires. . “That’s not true. Dancers need muscle work to prevent injuries, just like footballers and other athletes,” he adds.
Ana Caetano Faria, president of the Brazilian Society of Immunology, points out that anti-inflammatories are extremely important when used at the right time. In situations where the person cannot cope with exacerbated infection or inflammation, in an autoimmune or allergic disease. “The person needs this medicine, but it has to be done very carefully so as not to inhibit other beneficial substances,” he says.
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For immunologist Luiz Vicente Rizzo, director-superintendent of research at the Israelita Albert Einstein Hospital, the abuse of anti-inflammatories harms the homeostatic balance. “It’s one of the most widely used classes of drugs in Brazil and around the world, but about 10% of people have side effects,” he says.
He explains that, in most cases, it’s because our receptors understand that the drug is an attempt to block a natural process. “Of course, anti-inflammatories are important in cases where, for example, a person has rheumatoid arthritis that needs to be controlled, but they are not over-the-counter drugs, as many do.”
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