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NSAIDs (nonsteroidal anti-inflammatory drugs) are generally the first-line drug for treating various symptoms, including muscle aches and pains to inflammation and flu-like symptoms. Most NSAIDs are available over-the-counter, but even so, they do require some special care when taking them. Here, we look at what these drugs are and what the current research suggests about the safety of using these drugs if you have a thyroid disease.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of medications that help relieve pain, fever, and inflammation. The most common over-the-counter NSAIDs are:
- Ibuprofen (Advil® and Motrin®)
- Aspirin (Bayer® or sometimes combined with other drugs in medications like Excedrin®)
- Naproxen sodium (Aleve®)
There are also prescription NSAIDs that some providers may recommend for treating chronic pain conditions like arthritis or for recovery after surgery.
These drugs work like corticosteroids but do not have the unwanted side effects of steroidal drugs. (Steroids are drugs that act like cortisone, a hormone the body produces that reduces inflammation.)
NSAIDs prevent the production of chemicals in the body that causes inflammation. Specifically, they block the enzyme cyclooxygenase (COX). The COX enzyme helps make prostaglandins essential for responding to tissue damage and illness by controlling inflammation, blood flow, and clotting.
The most common uses for this group of medications include treating muscle and joint pain, arthritis, headaches, cold and flu symptoms, fever, and menstrual cramps.
One of the reasons NSAIDs are a first-line treatment option for pain and inflammation is because they are generally safe and effective when taken correctly. However, when taken orally, the drug can affect all systems in your body and have serious side effects in specific individuals.
Because NSAIDs block prostaglandins which help the blood clot, these drugs can cause bleeding. Most notably, NSAIDs can cause gastrointestinal bleeding with consistent use or in high-risk individuals. In older adults, it may also cause heart attack and stroke. People with a history of kidney disease, liver disease, and heart failure generally are cautioned to avoid this class of medications.
Lesser side effects, such as stomach upset and headaches, can also occur. But for most people, there are few, if any, side effects.
The most common complaints include:
- Heartburn
- Gas
- Bloating
- Nausea
- Vomiting
- Diarrhea
- Constipation
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Digestive issues like bloating, constipation, or gas can be resolved or improved with simple lifestyle changes
Despite how common it is to use ibuprofen, studies on how it affects the thyroid gland are limited. However, because it is taken orally, it seems plausible that ibuprofen could have some effect on this small but mighty organ.
No known side effects suggest that ibuprofen affects thyroid hormone levels. One small study of 25 healthy participants taking various NSAIDs found that thyroid hormone levels remained unchanged in those who took ibuprofen. However, T4 temporarily decreased within eight hours in people taking aspirin, but those levels remained within the standard limit despite this slight decrease.
An even older study also confirms these findings, where 89 participants were evaluated similarly, and ibuprofen users did not see changes in their thyroid function. The study found that specific NSAIDs like salsalate and naproxen interfered with T4 and T3 binding to carrier proteins, but the participants still had thyroid hormone levels within normal limits.
To date, no studies have examined whether NSAIDs affect tissue in the thyroid gland.
Based on the few small studies we have, coupled with no significant anecdotal evidence to suggest thyroid problems with use, it appears that ibuprofen has no apparent impact on thyroid function. Therefore, ibuprofen is likely safe for many people who have an underactive thyroid. Additionally, it may help alleviate muscle and joint pain accompanying Hashimoto's disease, an autoimmune disease that can cause hypothyroidism.
However, because other NSAIDs like aspirin and naproxen may slightly lower serum T4 levels (although not below a normal threshold), it may be beneficial to consult your doctor if you have hypothyroidism. Thyroid function tests can help determine if your thyroid is functioning optimally while taking these drugs.
Furthermore, if you have other health conditions like heart disease or kidney disease or take blood thinners, you should avoid these medications or consult your doctor before using them.
- As a general rule of thumb, unless approved by a doctor, you should not use NSAIDs for pain relief for more than ten days or fever relief after three days of use. If you need these medications for longer than that time frame, you may need additional treatment for whatever is ailing you. You may also be at risk for a GI bleed with long-term use.
- Take the lowest dose possible for the shortest amount of time.
- Drink water to swallow the pill or capsule whole without crushing or chewing it.
- Avoid taking the medication on an empty stomach to avoid stomach upset.
- Taking too high a dose can lead to overdose and have severe health consequences. Follow the directions on the medication or your doctor's orders to avoid incorrect dosing and adverse reactions.
- NSAIDs can interact with other medications, including anti-depressants and blood thinners like warfarin. Be sure to consult your doctor before using NSAIDs while taking these medications.
- Pregnant women should consult their doctor before taking NSAIDS like ibuprofen. Some are considered safe in the first and second trimesters, but it is best to check with your doctor first.
- Suppose you are having surgery, including dental procedures. In that case, it is best to stop taking ibuprofen and other medications in the lead-up to your procedure unless otherwise directed by your health provider.
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A note from Paloma Health
Researchers haven't found much to be concerned about in the small studies to determine whether NSAIDs affect thyroid function. Taking an NSAID when needed shouldn't affect your thyroid, even if you have thyroid disease. Still, if you feel unsure or wonder which NSAID you should take, talk to your healthcare provider.
You can get comprehensive hypothyroidism care from Paloma Health's top thyroid doctors, who provide diagnosis through at-home blood tests, prescriptions for thyroid hormone replacement medication, and optimal treatment of hypothyroidism from the comfort of your home.
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