…Continued from p.64
raced professionally for almost twenty years, I would be on the “extreme” scale of lifetime endurance activity. Caffeine intake and alcohol consumption are also triggers. However, a study in Denmark showed that patients using NSAIDS for two to four weeks were at a 76 per cent higher risk of developing AF compared to those not taking them. For me, that is a flag as I had been treating myself with NSAIDs regularly in the two weeks prior to my incident. It could be for athletes, particularly Ironman athletes who are older than 40, the risk of using NSAIDS is not worth the benefit of some short-term pain relief.
Victoria’s Dr. Vanessa Young, a sport medicine and family physician, warns of further risks of NSAIDs: “Drugs like Advil [ibuprofen], aspirin, Aleve [naproxen], and even topical Voltaren [diclofenac] carry well-known risks, including gastrointestinal bleeding, hypertension, fluid retention and kidney toxicity.”
These drugs are also listed as risky for people with existing heart disease. Think of the advertisements for drugs with the comical list of side effects worse than the ailment being treated – why do we readily self-medicate with these products?
Atrial fibrillation can happen at any age, but individuals have different thresholds over which they can end up in AF. University kids can get it after a night of heavy drinking. Older people can be in AF permanently. It is not life threatening, but AF can increase the risk of a stroke. Things that are thought to lower the threshold include alcohol, caffeine, age and stress. There is also some suggestion that nervous system fatigue can contribute to heart rhythm abnormality.
Knowing NSAIDs are linked to episodes of AF is a red flag for endurance athletes. Many Ironman athletes are older, have years of endurance training and subject themselves to high levels of stress. Drinking alcohol and using caffeine further lowers the threshold for an episode of AF. Controlling the triggers during big blocks of training is a measure of prevention, but I would add eliminating NSAIDs to that list. I haven’t had an episode since 2017, despite resuming 100 per cent of my previous training schedule. However, knowing the risk of alcohol, caffeine, nervous system fatigue and now NSAIDs, my habits have changed. I can’t be sure that NSAIDs put me into AF, but it’s not worth compounding the risk.
Melanie McQuaid is a three-time Xterra world champion and coaches MelRad Racing. She won the 2011 and 2017 ITU Cross Triathlon World Championship.