
Ibuprofen alters human testicular physiology - tokai
http://www.pnas.org/content/early/2018/01/03/1715035115.full
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fencepost
Okay, so ibuprofen impacts testicular function, acetaminophen/paracetamol
causes muting of emotional response (along with the liver toxicity), many
other painkillers are related to ibuprofen, and opiates are Right Out.

Is aspirin at least reasonably safe as long as the blood thinning isn't a
problem?

~~~
manyxcxi
I can’t take Ibuprofen (or any typical NSAIDS including aspirin) because of a
medical condition, which has sucked over the last decade because acetaminophen
really doesn’t help me at all when I’m excruciatingly sore for whatever
reason.

In Oregon and Washington, where I’ve lived for pretty much my entire life,
legal marijuana has been amazingly helpful, at least since I finally got
around to trying it.

The various products out that are high in CBD and low in psychoactive
ingredients have been really good at even my worst muscle aches and really
painful, but not super serious, injuries like sprained ankles and such.

My surgeon after hip surgery even blessed the notion of using the opiates I
was prescribed for as short as possible and then using high CBD edibles to
cover the gap between excruciating post-op pain subsiding but still being in a
lot of pain. In fact, he didn’t just bless the idea, he practically endorsed
it as a “still emerging but very likely positive course of treatment” in his
words.

I don’t use CBD like someone might (even if maybe they shouldn’t) pop
ibuprofen, but it’s great to have an option between acetomenaphin and opiates.

~~~
darpa_escapee
I use CBD infrequently for pain.

Chronic high CBD usage will result in withdrawal upon cessation.

The 5HT1A agonism aspect of CBD makes for a particularly bleak and anxiety
ridden withdrawal.

~~~
dzhiurgis
Not sure if it's CBD or THC, but coming off pot makes you realise how madly
your REM sleep was disturbed (or basically non existent).

Part of smoking pot I enjoy initially is amazingly deep sleep, but that can't
be good in the long term.

~~~
Toast_25
Actually, you don't get REM when you smoke. That's why you don't dream and
it's why it comes back full-swing when you stop. I occasionally smoke and
drink (alcohol also disturbs REM quite a bit), but I try and do it early in
the day so I can get quality sleep.

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ardit33
If you hang around bodybuilding forums you will hear to avoid Ibuprofens as
they hurt your ‘gains’ Perhaps bro-science was right in this case

~~~
bluedevil2k
Bodybuilders tend to not rely on their testes for testosterone production
though

~~~
Toast_25
Not all bodybuilders juice, and even when they do, there's a wide variety of
ways to increase your gains without straight up shooting testosterone.

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MollyR
It would be mind boggling if pain killers were connected to dropping male
fertility.

It might even explain why so many cultures had rites to male adulthood
involving extreme pain.

~~~
kinkrtyavimoodh
I sometimes imagine, with horror, what would happen if after 500 years of
progress, humanity were to realize that almost all cultural practices they
painfully, one by one, undid, were all sensible to begin with for reasons that
humanity didn't previously understand.

~~~
acchow
“If the stars should appear one night in a thousand years, how would men
believe and adore; and preserve for many generations the remembrance of the
city of God”

~~~
deadmetheny
Or, alternatively, you'll be driven mad by the sight and your entire
civilization will collapse.

[http://www.astro.sunysb.edu/fwalter/AST389/TEXTS/Nightfall.h...](http://www.astro.sunysb.edu/fwalter/AST389/TEXTS/Nightfall.htm)

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Alex3917
At 1200mg/d, I feel like destroying your reproductive system would be the
least of your concerns.

~~~
koolba
Is the /d per day? If so that's well within what I've seen "normal" people
take.

A regular Advil is 200mg. The usual dose is two pills, so 400mg. If your
larger it's common to take three or four pills. Multiply by a dose ever six
hours and it's quite easy to get to 3200mg per day.

~~~
rconti
Yup; after seeing my mom be recommended 3-4 pills every 6 hours as needed for
knee pain, I sure don't bother with just 2 pills as a 200# male if I "need"
ibuprofen. I either take 3, or I take nothing.

Fortunately I have no chronic issues, rarely need ibuprofen (in fact I'm
paranoid about taking it for muscle aches as I've always felt it must harm
muscle development, which seems to be catching traction as a theory), and
generally avoid medications altogether, but it seems like if you're taking it,
might as well take a dose that will do something.

~~~
randallsquared
TIL that my pain is weak and mild, even when I think I'm in a lot of pain. I'm
well over 200 lbs (still), but 200mg of ibuprofen usually eradicates whatever
pain I have. If it's _really_ _bad_ pain, then I take 400mg.

~~~
saurik
TIL I have only experienced pain a few times in my life, and this apparently
doesn't even include when I have had extensive dental work done as I don't let
them give me any novocaine and don't mind them drilling into my teeth or cord
packing my gums.

I am really hoping that it isn't just that you all are like, five years older
than I am, and so I have to expect that I am going to just end up in pain a
lot soon :/.

~~~
Toast_25
I think it depends on the person, a friend of mine would act out WWE type
stunts: jumping on a trampoline full of tacks, getting hit with a chair in the
head and bleeding all over... He says the pain tolerance has stayed with him
through the years.

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seibelj
As much as possible, I believe we should all try to do everything in
moderation. Never be too extreme in medicine, exercise, drinking, drugs, food,
etc. Sometimes in life you can't avoid the situation, unfortunately.

~~~
carlmr
A friend of mine had some good wisdom from her mom. If you have to take
medication, take different ones, not always the same ones. If you eat premade
food, buy different kinds, not always the same ones.

It's basically portfolio risk diversification. You increase the risk of having
_some_ negative effects, by virtue of trying more things, but you hugely
decrease the risk of taking one thing excessively that does you a lot of harm
in the future.

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zengid
Not a doctor / scientist. Can anyone tell me if this is a pilot study or
reproduced results from other studies? Or in other words, should I take this
as a fact yet?

~~~
Shank
This is from PNAS early edition, and has no citations yet (meaning nobody has
used this work in subsequent studies). For the general topic, Google Scholar
([https://scholar.google.com/](https://scholar.google.com/)) is excellent at
finding journal articles on any topic (including testicular function as it
relates to ibuprofen). At first glance, this doesn't appear to be reproduction
of prior work either.

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diryawish
How sufficient is a sample size of 31 healthy white men?

~~~
3pt14159
It isn't. People talking about P values forget about p-hacking and selection
bias. Any scientific study with less than 200 participants should be discarded
and the failure to routinely do so has more to do with scientific laziness and
the pro-profit incentive most journals have than anything else.

~~~
sov
That's not entirely true and doesn't really convey the right message about
p-values or study size. P-hacking and selection bias are definite concerns,
but they're also concerns for studies with 200, or more, participants. Rather,
we should put more of an emphasis on the statistical power of the study. We're
not yet in the beautiful golden world of pre-registered studies, but even
high-n studies can have huge disparities due to bad statistical power (eg: The
Control Group is Out of Control).

~~~
3pt14159
I'm essentially right. Studies with less than 200 people are essentially
useless. It is more complicated than I originally let on, but not so much more
complicated to muck up the takeaway. Most of our junk science has to do with
these low population studies or with studies simultaneously studying high
numbers of attributes.

~~~
sov
Err, I don't quite agree with your description. The takeaway from your post
was that low-n is worthless and high-n is ineffable, full stop. The _size_ of
the trial has very little to do with whether or not we are to believe the
results insofar as it affects its statistical power. The fact that p-hacking
and selection bias exist doesn't immediately imply that low-n studies are
wrong. Those aren't problems unique to small sample size studies. For sure,
statistical power isn't the catch-all thing to examine either--rather, pre-
registration of studies would alleviate a great deal of falsities, but none of
any of this has to do strictly with low sample size trials as your post
implies.

Let's say the drug studied was a guaranteed 100% limb regenerative drug for
amputees. Would you really require a 200 person study to _prove_ that
Examplinol successfully regenerates limbs? I hope the answer to that is
"obviously not; it will be very clear whether or not it works with a low
sample size." Of course, how would we change the study if it wasn't supposed
to work in 100% of people? What if Sample Pharmaceuticals indicated that it
only worked for 50% of people? Or 10%? Or 1%? Would it suffice to use 200
people each trial?

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Pxtl
Is it callous of me not to worry about the testosterone levels of professional
athletes? Because they seem to generally have enough. I worry more about
people with RSI who often depend on overuse of anti-inflammatory meds and
_aren 't_ demonstrably professionally masculine.

~~~
anigbrowl
Professional athletes make for a good study population because they tend to
keep records of their training/performance/injury status. Also their behavior
influences painkiller consumption in the population at large through
endorsements or just interviews on their fitness regimen. If you like sports
and know your favorite athlete uses a certain class of product to deal with
cramps, you're likely to recall that when you're in the drugstore looking to
alleviate a similar problem.

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jensvdh
I'm suffering from Ankylosing Spondilytis (a non-cureable chronic disease
similar to Artritis). Let me tell you, the side effects are the least of my
concerns when I'm in chronic pain.

------
pfarnsworth
Shit, what does this mean for children and their development? Ibuprofen has
been our go-to analgesic since our kids were born.

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leeoniya
everything i read here refers to effects on testosterone levels. how does this
relate to actual fertility (that can be measured in a semen analysis)? would
lower testosterone levels affect count, motility, morphology, etc?

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ceejayoz
The URL seems to be hugged to death.

Media coverage: [https://www.theguardian.com/science/2018/jan/08/ibuprofen-
ma...](https://www.theguardian.com/science/2018/jan/08/ibuprofen-may-increase-
risk-of-fertility-issues-in-men-study-suggests)

~~~
IncRnd
You can visit [http://archive.is/vqFuM](http://archive.is/vqFuM) to view the
paper.

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blondie9x
I can't tell, is the impact irreversible and if so at what dose threshold?
Anyone know?

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mlloyd
I've taken entirely too much Ibuprofen - I've had a lot of babies. Since the
sample size of this study is 31 people, I say that my one case is significant
and this study is bunk.

That's why you can't rely on a study of 31 people.

~~~
WilliamSt
Of course. I'd much rather trust the anecdotes of a stranger on the internet

~~~
aeternus
mlloyd has a point, the P value is right on the edge of significance and the
study has only 31 people.

Take into account the bias that the negative result (no-correlation) would not
pass the bar for publication and you likely have noise.

