Podium

…Con­tin­ued from p.64

Triathlon Magazine Canada - - Finish Line Reads -

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.

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