Understanding the Dangers of Over-The-Counter Painkillers

Essential Takeaways

  • Casually popping OTC painkillers can actually delay your pain relief, trouble your stomach, and cause problems for your health.
  • NSAIDs include medications like diclofenac, ibuprofen, aspirin, and naproxen.
  • Taken over long periods, NSAIDs have potentially dangerous side effects.

What do you usually do when your cramps arrive? Unless you’ve discovered the power of plant-based healing, you probably pop an over-the-counter (OTC) painkiller and pray for the pain to stop. It works for a few hours, then you pop another. Same thing the next day(s)—your cycle has you going in circles. What you might not know is that you are actually trapped in a very dangerous cycle.

Read more: Painful Periods: When to See a Doctor

According to Dr. Kimberly Sackheim, DO, a pain management specialist at NYU Langone’s Rusk Rehabilitation, casually popping OTC painkillers can actually delay your pain relief, trouble your stomach, and cause problems for your health. Additionally, Dr. Sackheim says, “Because over-the-counter painkillers are easy to get, they’re easy to abuse, and that makes them dangerous.”

As Dr. Sackheim said, the dangers of OTC painkillers are real, and we believe you have the right to be equipped with the information to decide whether OTC painkillers are the right choice for you. Below, we outline the two types of OTC painkillers (NSAIDs and acetaminophen) and the very real dangers associated with their continuous use.


There are many types of NSAIDs (nonsteroidal anti-inflammatory drugs), which are some of the most commonly used drugs worldwide. 70 million prescriptions and 30 billion over-the-counter doses are sold every year in the US. NSAIDs include medications like diclofenac, ibuprofen, aspirin, and naproxen. They work by stopping prostaglandin production (this reduces inflammation and can help relieve period pain).

But there’s a problem here - prostaglandin does more than create inflammation. It also protects the stomach and intestines by building up their lining. If this lining breaks down, you can experience an upset stomach; at the extreme, you can develop an ulcer. Yikes.

NSAIDs can not only create said problem, but they can also make it worse by making it difficult for your body to clot and stop the bleeding of a serious stomach ulcer. “It’s a double whammy,” says Nitin Sekhri, medical director of pain management at Westchester Medical Center in Valhalla, N.Y. “It’s eating away at the lining of the stomach and exposing blood vessels.”

You may wonder if NSAIDs work well enough to be worth the side effects. Researchers at the Cochrane Collaboration explored 80 clinical studies with over 5,800 girls and women between the ages of 12 and 47 to determine how effective NSAIDs are and how well they’re tolerated. The takeaway: painkillers relieved pain in only 31 out of 100 girls and women. Additionally, 51 out of 100 girls and women who took NSAIDs still had severe pain after a few hours. These studies also showed NSAIDs caused side effects such as:

  • Stomach problems
  • Nausea
  • Headaches
  • Drowsiness

Need more convincing? Taken over long periods, NSAIDs have potentially dangerous side effects. Let’s explore the very real side effects of two of the most common NSAIDs - ibuprofen and aspirin:


Cardiovascular risks - In 2017, a study published in European Heart Journal – Cardiovascular Pharmacotherapy linked ibuprofen use with a 31 percent increased risk of cardiac arrest. Several other studies link ibuprofen to the following:

  • Non-fatal myocardial infarction
  • Congestive heart failure
  • High blood pressure

GI problems - Ibuprofen harms the GI tract by reducing beneficial prostanoid (aka what maintains the integrity of the gastric tissue and intestinal barrier). This means GI complications are incredibly common—so common, in fact, that 60 to 70 percent of individuals who take NSAIDs long-term develop things like:

  • Intestinal inflammation
  • Increased intestinal permeability
  • Mucosal damage
  • Gastric ulcers
  • Diverticulitis
  • Blood loss and anemia
  • Nutrient malabsorption

Liver harm - Ibuprofen damages the liver by raising levels of the enzymes AST, ALT, ALF, and bilirubin. These are the primary markers in liver function testing. Currently, researchers are searching to understand how ibuprofen causes damage to the liver, and they believe it could be one of two things:

  1. An immune reaction to the drug
  2. The body’s response to toxic byproducts produced when it attempts to metabolize ibuprofen

Kidney Damage - Ibuprofen also damages the kidneys and interferes with immune function. That's because the drug reduces glomerular filtration (aka the process in which the kidneys filter excess fluid and waste products into your urine).  By reducing glomerular filtration, it strains the kidneys. Ibuprofen also weakens the immune response, which suppresses the body’s ability to target and destroy viral infections.


As you may have heard, public health authorities have long recommended low-dose aspirin therapy to help prevent cardiovascular disease. However, recent research has cast serious doubt on the validity of this habit. Additionally, a large 2018 study found aspirin use has no beneficial effects on a “healthy lifespan” (or a life free of dementia or persistent physical disability in older adults). Long story short - aspirin has no real benefits for healthy adults and may only exert protective effects in people with pre-existing cardiovascular conditions.

So, you have to weigh your pros and cons. Risks associated with aspirin use include:

  • Stroke caused by a burst blood vessel - Daily aspirin use can prevent a clot from forming. Ipso facto, it prevents a clot-related stroke but also increases the risk of bleeding.
  • Gastrointestinal bleeding - Daily aspirin use can increase the risk of developing a stomach ulcer. It also can increase the risk of bleeding from an ulcer that is already present.
  • Tinnitus or ringing in the ears and hearing loss - Too much aspirin causes tinnitus which over time can lead to permanent hearing loss in some individuals.
  • Liver injury - Liver injury can occur with overdoses of aspirin.

Aspirin dangers aren’t limited to adults. Prenatal aspirin use is associated with an increased risk of fetal testicular dysfunction and cerebral palsy. The way aspirin creates these effects is similar to those mentioned with ibuprofen. Aspirin alters maternal hormone production, causes oxidative stress, and inappropriately stimulates the endocannabinoid system (the biological system that plays a pivotal role in the development and function of the brain).


Acetaminophen, the active ingredient in Tylenol, is not an NSAID but still comes with its own group of side effects. According to the Consumer Healthcare Products Association each week around 23 percent of U.S. adults, or 52 million Americans, consume acetaminophen. What they don’t necessarily know are the harmful effects of acetaminophen they’re susceptible to. We outline them below.

Liver toxicity - According to Sekhri, acetaminophen is to blame for about 50 percent of acute liver failures in the U.S. It is the leading reason behind calls to poison control and is to blame for more than 50,000 emergency room visits a year.

Gut Health and Microbial Drug Metabolism - Studies show chronic use of acetaminophen doses greater than 2,000 milligrams results in a 3.7 times increased risk of bleeding in the upper GI tract. Acetaminophen can also cause intestinal permeability, and overdosing on acetaminophen causes massive necrosis of the liver tissue.

Cardiovascular Health -  One study found that those taking opiates (some containing acetaminophen) were 95 percent more likely to be obese. They were also 63 percent more likely to have hypertension.

Kidney Disease - Studies associate heavy use of acetaminophen with an increased risk of kidney disease. In fact, one study found simultaneous use of acetaminophen and alcohol resulted in a 2.23 times increased risk of kidney dysfunction.

Cancer - Researchers have also found associations with acetaminophen and cancer. A 2013 meta-analysis of epidemiological studies associate acetaminophen with a significantly increased risk of kidney cancer. A 2011 study of more than 64,000 older men and women found that acetaminophen use was also associated with several different types of blood cancers.

Autism, ADHD, and Brain Health - Acetaminophen is currently marketed as safe during pregnancy. But acetaminophen use may have neurodevelopmental consequences for the fetus. To find out, a 2016 study followed more than 2,000 mother-child pairs from the first trimester of pregnancy. They performed several behavioral tests when the children were about five years old and exposed forty percent of the children to acetaminophen in utero.

The result: exposure to acetaminophen was associated with lower attention function and a greater risk for ADHD-like hyperactivity and impulsivity symptoms. In boys, acetaminophen exposure was also related to a greater number of autism spectrum symptoms.

Additionally, mothers who used acetaminophen more often had an even greater chance of having children with autistic-like behavior. The authors even ran the data again, excluding mothers that had a chronic illness, urinary tract infections, or fevers during pregnancy. They found the same results, suggesting that it was not the illness itself that contributed to the association.

Alternative solutions

At this point, you’re probably feeling pretty concerned about how you’re going to manage pain in the future. Not to worry - we’ve gathered some great, all-natural pain fighting solutions.


    In Ayurveda (an ancient Indian system of medicine), Boswellia is used to treat arthritic pain, reduce inflammation, and calm fevers. Skeptical? No need - modern science has spoken and deemed Boswellia as anti-inflammatory, antiarthritic, and confirms the analgesic properties of the plant. Try taking 800 to 1,200 mg three times a day for a therapeutic dosage.

    Tart Cherry Juice

    Sounds sour, but it can do some sweet things for pain. Tart cherry juice contains high levels of antioxidant and anti-inflammatory compounds that naturally reduce inflammation in the musculoskeletal system. It has proven benefits in treating arthritis, exercise-induced muscle pain, and fibromyalgia. In clinical trials, doses range from 2 to 12 ounces per day. We recommend starting at the low end (two ounces) and working your way up. Pro-tip: find a version without added sugars for maximum anti-inflammatory benefits.


    What’s the magic behind your golden latte? Turmeric does more than add a sweet bite. Containing the compound curcumin, turmeric is useful for alleviating arthritis pain. By itself, curcumin has low bioavailability, so make sure it’s complemented by piperine (commonly found in black pepper). Try taking a curcumin/piperine supplement containing 500 mg curcumin and 20 mg of piperine up to three times a day.

    CBD Oil

    Hailing from the Cannabis sativa plant, CBD oil is extracted from the resin of cannabis buds and flowers. Don’t trip - it doesn’t contain any THC. CBD produces pain-relieving effects, alleviating neuropathic, rheumatoid arthritis, and cancer pain by acting on the body’s endocannabinoid system. Our favorite? ZenChi CBD. Check it out here.

    Elix Cycle Balance

    We’d be remiss if we didn’t mention the power of Cycle Balance. Using Traditional Chinese Medicine (TCM), we formulate a healing botanical tincture catered to your flow. According to modern research, use of Chinese herbal medicine for dysmenorrhea (period pain) leads to significant improvements in pain relief, overall symptoms, and decreased use of additional medication when compared to the use of pharmaceutical drugs.

    Also, personalized herbal formulas showed these results held after three months of follow-up assessments—that's the power of natural healing.

    TCM has been used for centuries to help regulate our cycles, and studies now show that at an effectiveness rate of over 90%, these herbs do more than decrease period pains—they rebalance our hormones and heal our bodies from within.

    See how a Personal Herbal Healing Formula from Elix can help ease your cramping and PMS symptoms every month.


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    This article was reviewed by Dr. Liem Le.
    Dr. Liem Le is a Doctor of Chinese Medicine, Functional Medicine Practitioner, and Nutritionist Integrative Medicine Department at H. Lee Moffitt Cancer Center. He is a part of the teaching staff for the Masters program for the Functional Medicine and Human Nutrition program at University of Western States. Dr. Le is currently working on his fellowship in Integrative Medicine with the Academy of Integrative Health and Medicine via a scholarship from the White House to complete the initiative.

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