While looking for something else, I came across something interesting that I had not recalled seeing before. In "Enter the Zone" (ETZ), chapter 12 discusses eicosanoids. On page 132, the first paragraph starts out by making a statement about NSAIDS knocking out all of the eicosanoids, assuming all eicosanoids are bad. However, since some eicosanoids are good to have, it got me to thinking about NSAIDS, and how big of a role taking an NSAID like Ibuprofen plays in eicosanoid balance.

I normally take an NSAID, usually Ibuprofen but at times I take Naproxen, at a fairly high dose to help with an old knee injury and a more acute problem--plantar fasciitis. I have been taking it for years, usually just in the morning, right along with my fish oil and calcium/vit D supplements, usually more of a preventative measure. I could probably do fine without it, not sure, never really tried to go without it.

During all of the time that I have been Zoning, I will admit that it is not always easy for me to get in or stay in the Zone, despite doing everything else just right with controlling the diet and the other elements that are under my control. This recent review of ETZ raised the question, is my daily intake of NSAIDs playing a big role in my eicosanoid balance? If it is altering the balance, then is it possible that I could improve my Zone outcomes by eliminating NSAIDs? Is the information that I was reading in ETZ (the oldest book in the Zone series) even relevant anymore? (must ask this question because there is some info in there that has been updated).

Any thoughts?

w2ow, thats a great question. i`m very interested in this too!

sarah

After I posted the question, I went to AIZ and ORxZ to read more. Both suggest the same thing regarding NSAIDs, although it is also suggested that NSAIDs can be used for acute pain, but overall suggesting that chronic use will decrease good as well as bad eicosanoids.

There is so much to learn about all of this, and I don't know why this never hit me as a relevant question before? I also did a search in the forums and discovered that there has been previous discussions on this topic, as well (I have even participated in those discussions, so it blows my mind that I had forgotten this important piece of the puzzle).

I have also had much assistance from other Zone experts to try to find MY missing piece of the puzzle, and this issue never came up. But, would anyone even think about asking about it? The issue is not covered in great detail, it did take a lot of searching to find it.

Here's my thought/questions to ponder... if I continue to take NSAIDs, am I just throwing money out of the window by taking fish oil? Am I undoing all that I thought I was doing? Is the elimination of NSAIDs going to be my key factor that will boost my reaching and staying in the Zone, having always had issues with hunger and carb sensitivity, and slower than expected fat loss? What about Zone foods? I trialed them, gave them a fair shot, and was not impressed by my results. Is it fair to assume that perhaps something else was in play, i.e. NSAIDs?

At this point, I am currently taking Ibuprofen due to the dog bite, I might be able to tolerate going without it, and just kick up the fish oil, since the pain is not really acute any longer, but rather a milder ongoing issue, and really has more to do with inflammation than the acute injury. (since I already took Ibuprofen today, will not take any more on this day and perhaps start some experimentation tomorrow-I imagine that there are some 1/2 life issues with regard to the ibuprofen as well as beefing up the fish oil, so any thoughts on how to bridge this gap would be helpful, too).

Most likely you could lower or maybe even eliminate your NSAID dose with stricter adherence to the Zone diet to further reduce inflammation and a switch to Omega Rx at the correct dose for your level of AA/EPA (you have mentioned here many times you are not the strictest with diet). I doubt your higher level of sensitivity to carbohydrate is related to NSAIDs.

I have been strict with diet, and I am taking the correct amount of fish oil. There have been times in the past and more currently that I have done EVERYTHING in the right way, but still had difficulty, still struggled. It is an ongoing issue, one that I have basically just lived with (because the alternative is much worse, turning away from the Zone is not where I should be going).

Lets take all of the subjectivity out of the question and ponder the original issue... what effect does an ongoing dosage of NSAIDs have on one's eicosanoid balance? Is it possible for one to truly achieve the Zone if he/she is taking a daily dose of NSAIDS for an extended time? (from what I have been reading recently, my gut says NO, it is not possible, but would really love to hear some objective and insightful discussion).

All Fish Oils are not credited equally. I would suggest you switch back to OmegaRX and add Polythenol XT and remove NSAIDS.

In addition to my previous suggestions and those Tech posted, I'd also suggest eating as close to a vegan version of the Zone as you can and add Sea Health Plus. A vegan diet will further reduce omega 6 fat and AA intake, which will reduce your levels of inflammation. SHP contains anti-inflammatory polyphenols (not all polyphenols are ant-inflammatory). It has a synergistic effect when taken together with Omega RX, and because you reduce carbohydrate intake. Keep in mind that because you reduce your carbohydrate intake by 1/3, due of your carbohydrate sensitivity, you are short on polyphenol intake as compared to Zone recommendations.

On a related topic, and an interesting note to add, very small amounts of an NSAID (1/2 baby aspirin) have been found beneficial when taken with fish oil. You can read more about it in Zone books (AIZ, I think it's in). Look for the passage explaining about the discovery of aspirin triggered epi-lipoxins.

this is a very interesting thread.

Thank you for the suggestions on what to do. It didn't really answer the question that I asked, but it does confirm what I was thinking about my approach.

I am not able to afford the higher cost of SHP, let alone the higher cost of the fish oil. I don't want to write it off as a possibility, though.

I am, however, thinking about the possibility of doing an omega-3 test. Since I have already been taking fish oil, and have questions on the effect of the NSAIDs, I am considering taking a blood test NOW to see where I currently am. Then, make some changes and do another test to see what impact the changes have had.

I am not going to write down my entire food diary, but will give you a sampling of what I am currently eating.
My proteins consist mainly of chicken and fish/seafood. Sometimes egg whites in an omelet, fat free cottage cheese, plain fat free yogurt.
My carbs come from veggies, I usually eat a loaded salad every day (romaine lettuce plus enough veggies to overwhelm the heartiest appetite). Berries about 1-2 blocks per day, and usually a veggie-based cooked dish for dinner. I rarely eat any unfavorable carbs, and I have not been adding anything that is of higher density carb (like beans).
My fats are primarily from olive oil and nuts (almonds), sometimes some avocado in the salad.

Here are my thoughts on how to approach it, feel free to add any suggestions on my approach:
1. baseline blood test to establish where I am now, I feel that this would be a valuable tool, as I have already been established on a fish oil dosage for a long time. It might actually rewrite my entire plan, depending on what the results are. If it comes out great, then maybe the whole theory about the eicosanoid balance is out the door.

2. based on the results, this might change, but my next move would potentially be to stop the NSAID and increase the fish oil by 4 caps daily. I am not sure really how to do this without potentially going through some discomfort while not on the NSAID and while waiting for the fish oil to reach a therapeutic level. But, if one counteracts the other, I suppose there is no choice here.

3. after a month or 2, will repeat the blood test to see what impact these changes have had. Depending on results, I could then make further changes, if required.


I am on a limited budget right now, and so the thought of doing the blood test right now is not pleasing to me, nor is it pleasing to be repeating the test and increasing the fish oil dose. All of this is much more costly than a bottle of Ibuprofen. However, there is value in doing it this way, in terms of health. And, I really want to be able to see how each change impacts my overall profile.

Thoughts?

Lets take a look at your theory of expense ? Is it worth 1.32 a day to feel great, be certain of the purity and get the the levels and ratio of EPA and DHA that Dr Sears recommends per day ?

Lets experiment.... What do you pay now for your Fish Oil ? How mauch EPA and DHA per capsule? Does your product have test results which shows the Purity ? How much are you spending on your NSAIDS per month ?

QUOTE (Tech): Lets experiment.... What do you pay now for your Fish Oil ? How mauch EPA and DHA per capsule? Does your product have test results which shows the Purity ? END QUOTE
.
$16.00 for 120 soft gel capsules
400:200 per capsule
Yes

Techie,

Expense is an issue, but I am willing to look beyond it for my health, while keeping things realistic.



Ibuprofen is cheap, depends on where I get it and whether I go with name brand (Motrin) or generic store brand. Usually less than $5 per bottle.
I have also been taking Naproxen (Aleve). more expensive, especially name brand (Aleve), but usually spend about less than $5 per bottle, lasts me 2 weeks (about).

I would like to stick to the topic that I posted about, regarding the effects of NSAIDs on one's eicosanoid profile. I would really like to hear more about how big/small the effect is.

However, I would appreciate anyone's thoughts as to whether or not I am spending wisely vs. unwisely regarding the testing plan that I have laid out. Would you agree that I should do a baseline test now? And, how long after making adjustments should I wait before retesting? If I retest too soon, I imagine that would be a waste of money, as well!

Carnberry.

I would think testing is a good idea for you. You can get the test for free from us (150.00 value) with the purchase of 6 bottles of OmegaRX..

If you subtract the amount of the test from the amount of the fish oil.... the savings are extreme. That will give you an opportunity to use Dr Sears OmegaRX and see the results for your self while saving money.

Looking into if I can get more information on the topic.

A reasonable AA/EPA retest timeframe is 30 days after increasing fish oil diss. It takes only 30 days at any given dose to obtain the full benefit of that dose.

Thank you both for the added info. I was thinking the same thing, 30 days should be enough time, just wanted to be sure on that.

As for the free test, would have to crunch some numbers, it might make it more economical initially to get the testing done, but overall the cost of the Zone fish oil is twice as much as what I am getting. So, in the longterm, it would be much more economical to use what I am using now.

I do have an old omega-3 report that I can reference, my previous test was done while taking OmegaRx, so it will be interesting to see the changes. I don't recall if I was taking a daily dose of NSAID at that time, although I am thinking that I probably was.

A tip, you may not be able to do a valid comparison of AA/EPA if you're looking at 2 different types of AA/EPA tests (depends on both type of blood draw and the difference in the techniques used to perform the actual tests).

Also Cranberry ..... Maybe the forum page of the fish oil product that you use would be helpful.

vegan diet meaning what exactly?

i eat grass-fed chicken. is that an issue if I eat a lot of it?

sarah

[quote]
Posted By Sarah on 10 Jul 2012 02:28 PM
vegan diet meaning what exactly?

i eat grass-fed chicken. is that an issue if I eat a lot of it?

sarah
[/quote]


Vegan means consuming no animal products of any kind, no meat, poultry/fowl, fish, dairy products or eggs.

sarah

The best option if eating meat is grass fed !

So if, like, I eat a lot of grass fed chicken, does that mean I'm still getting a higher degree of omega-6s than I should?

Also what about pistactics? where do we stand on that one as compared to, say, almonds?

Sarah

Sarah, you can look up AA content on nutritiondata.com. It is also useful to compare nuts.

You are doing a good job eating chicken, stick to the breast for the least amount. I would assume it is even better eating grass fed.

Well, in order to look up AA content, you need to know the code name for AA,

C20:4n6

This is so helpful!

I'll look grass-fed chicken and pistactics up. :-)

By the way. It seems like grass-fed chicken tastes better ... anyone else notice this?

Sarah the carb-sensitive :-)

Hi Cranberry - I've been using Nutritiondata for quite a while but don't know how to look up AA with the code you mentioned. Any tips?

There is a tab on the fats table that you can click on, and the table will expand out so you can see the detailed info.

CranberryCat

Corticosteroids are the most powerful pain relievers knocking out all eicosanoids, “good” and “bad.” Aspirin and other NSAID’s affects a more limited number of eicosanoids (only prostaglandins and thromboxanes) knocking out the bad eicosanoids at a faster rate than it knocks out the good.
Low dose aspirin (81mg.) will not have a negative effect on eicosanoids . Dr. Sears has suggested that 1/2 of a baby aspirin approx. 40mg. daily with fish oil creates a new group of beneficial eicosanoids called resolvins. To learn more please search www.drsears.com using the key word "resolvins." Here’s one link - http://www.drsears.com/SearchResult...=resolvins
Of course keeping your AA/EPA within the ideal range (http://www.drsears.com/ArticlePrevi...ault.aspx) with your diet is ideal. However, as inexpensive insurance one may supplement with ½ a baby aspirin along with their omega 3’s.

Thanks for the reply, but it doesn't really answer the question...

My question focused on NSAIDS, not on corticosteroids or aspirin. It seems that the literature sets aspirin apart from other NSAIDS (like Ibuprofen). So, am I destroying all of my eicosanoids (good and bad) by taking Ibuprofen daily (longterm)? Exactly how dramatic of an effect is it? If it isn't a huge effect, then should I be worried about this at all?

I agree, the omega-3 blood testing would probably be helpful... funding for the test to be done is the issue, as my DH is out of a job currently, and my cash is slim due to the unexpected expenses from my recent dog bite (hoping to be reimbursed for that, but it won't happen tomorrow).

Hi Tech Support - you mentioned that Corticosteroids knock out all eicosanoids, “good” and “bad.” What about a local cortisone shot? Since the inflammation/pain relief is limited to a local area, wouldn't the destruction of good eicosanoids also be limited and possibly not have a bad effect on the body, as a whole?

Larry

a local cortisone shot will be limited to that area and wouldn’t knock out as many good eicosanoids. It would have a minimal effect on eicosanoids.

So any updates for me?

nothing further at this time Cran.

Just keep me updated, even if there is nothing to report. Hearing something regarding the status of my question is better than hearing nothing at all :)

Cran.. The question was answered. (see earlier post from tech support)... Here is a bit more and this is all I have for you..

Aspirin and NSAIDs like Advil (an ibuprofen) don’t discriminate between the specific forms of the COX 1 & 2 enzymes and therefore side effects are associated with their long term use.
However, Ibuprofen is relatively mild and somewhat short-lived when compared with aspirin.
Always consult with your physician

Thanks--your previous post focused on Aspirin and other NSAIDS but then most of it talked about aspirin. Zone literature seems to separate aspirin as being a beneficial NSAID, as opposed to other NSAIDs which apparently have an effect on ALL eicosanoids, disrupting the good as well as the bad eicosanoids... that is why I asked the question...

Honestly, this answer does not support what is printed in the books... so I am still kind of "lost" here. Will go back and read the chapters, but looks like I may have to take this to a higher level.

OK knock yourself out. :-)

Well, I don't think I am going to knock myself out, but there just seems to be a discrepencey here between the Zone literature and what you are stating. It has been documented that this question has come up in the past, and has never been answered clearly. I'm kind of a "Nancy Drew" kind of person.

Here is the question again, as originally asked (thought I would post it again, just to refresh everyone exactly what my question is-and will keep everyone updated on what I hear back, if anything):

I normally take an NSAID, usually Ibuprofen but at times I take Naproxen, at a fairly high dose to help with an old knee injury and a more acute problem--plantar fasciitis. I have been taking it for years, usually just in the morning, right along with my fish oil and calcium/vit D supplements, usually more of a preventative measure. I could probably do fine without it, not sure, never really tried to go without it.

In "Enter the Zone" (ETZ), chapter 12 discusses eicosanoids. On page 132, the first paragraph starts out by making a statement about NSAIDS knocking out all of the eicosanoids, assuming all eicosanoids are bad. However, since some eicosanoids are good to have, it got me to thinking about NSAIDS, and how big of a role taking an NSAID like Ibuprofen plays in eicosanoid balance.

So my question, is my daily intake of NSAIDs playing a big role in my eicosanoid balance? If it is altering the balance, then is it possible that I could improve my Zone outcomes by eliminating NSAIDs?

Just doing my own research, I found this article on the Inflammation Research Foundation web page, which kind of addresses my question, but unfortunately it is not put in terms that I am able to understand. I need more of a layman's answer. But, here it is:

12. Pharmacological Targets for
Reducing Inflammation
12.1. Anti-Inflammatory Drug Targets. If the hypothesis is
correct that obesity is caused by silent inflammation, then
modulating molecular targets of anti-inflammatory drugs
would hold promise. Anti-inflammatory drugs remain the
foundation of medical treatment of pain caused by acute
inflammation. The relief of acute pain requires immediate
action with drugs. The more acute the pain, the more
powerful the anti-inflammatory drug that has to be used.
Unfortunately, the more powerful the anti-inflammatory
drug, the greater the side effects. Our working hypothesis is
that the obesity and the metabolic consequences of obesity
are caused by chronic low-level inflammation or silent
inflammation. Nonetheless the molecular targets of antiinflammatory
drugs are the same for anti-inflammatory
nutrition.
6 Journal of Obesity
The classical pathways of anti-inflammatory drugs have
been focused on the COX and LOX pathways of eicosanoid
production. Inhibitors of the COX enzymes, such as aspirin
and nonsteroidal anti-inflammatory drugs (NSAIDs), have
different targets. Aspirin is a suicide inhibitor of the
PGH2 synthase enzyme that is the rate-limiting step of
the formation of pro-inflammatory eicosanoids. NSAIDs,
on the other hand, are competitive inhibitors of various
enzymes involved in the generation of pro-inflammatory
prostaglandins. However, neither of these drugs has much
effect on the LOX pathways that generates leukotrienes.
Corticosteroids inhibit both the COX and LOX pathways by
inhibiting the release of AA from the phospholipids in the
cell’s membranes.

Very interesting, I have already received a reply from Dave Shreck on the NSAID question that I had (thanks Dave!). He actually said some similar things in his response that techie said, but in a way that related more to my situation and in a way that was understandable to a lay person. Some of the same information, but with explanation built into it. I have dealt with Dave in the past, and he has always been great at taking the science and bringing it down to earth. As I understand it, he and Barry Sears have been partners in the Zone for a long time. I respect him greatly.

I could copy the text of the email, but my mouse is not working at the present time (UGH) so will try to summarize it here. If I think of it, I will copy/paste it tomorrow if I am on a different laptop (someone remind me if you are interested).

First of all, acute pain is not an issue. Taking an NSAID for a few days won't have a longterm effect on eicosanoid balance, because it is short-term and one can restore eicosanoid balance quickly after discontinuing use (he didn't say this directly in the email, but this is my understanding of how acute versus chronic treatment differs, and the fact that Ibuprofen is short-lived).

He stated that Naproxen is a powerful NSAID. Corticosteroids are the most powerful, but my interpretation of what he said is the Naproxen is close behind. I have been taking Naproxen for probably 1-2 years! If NSAID use is required, it sounds like Ibuprofen is probably preferred due to the fact that it is short-acting and affects a more limited number of eicosanoids. And, of course, Aspirin does not have a negative impact on eicosanoid balance.

He stated that I am on the horns of a dilemma! Well, it is a good thing that I found this out now. I am going to stop using Naproxen and stick with Ibuprofen for pain relief, work on weaning off of it and upping my dose of fish oil to cover the chronic pain issues.

One good thing came out of my recent "dog bite" issue... I had the spare time to go searching for something and came up with this while looking for something else. Also, because of the dog bite, I have pampered my foot, the same one that has the plantar fasciitis. I have not felt any heel pain at all! So, basically, the dog bite cured my plantar fasciitis LOL! Now I just have to manage my knee problem, and then I will be all set.

Great summary. Thanks. I thought aspirin destroyed both the bad ecosanoids and the good, though, just like ibuprophen, etc. Except for the 1/2 baby aspirin taken with fish oil that produces special anti-inflammatory ecosanoids.

I will post the email as written later, the text is from Dave but apparently Barry's words.

Sure is nice to have a working mouse! LOL

Here is the actual response that I received via email from Dave Shreck:


Dr. Sears appreciates your email, here are his comments.

Taking NSAIDs on a daily basis may affect one’s hormonal balance. Too many “bad” eicosanoids may cause some of the symptoms listed on the eicosanoid status report (ESR). Icon link to the ESR is at: http://drsears.com/Resources/tabid/...fault.aspx

Naproxen is a powerful NSAID that is a prescription drug in most countries due to it risks and adverse effects.

Corticosteroids are the most powerful pain relievers knocking out all eicosanoids, “good” and “bad.” Aspirin and other NSAID’s (Ibuprofen) affect a more limited number of eicosanoids (prostaglandins and thromboxanes) knocking out the bad eicosanoids at a faster rate than it knocks out the good. However, Ibuprofen is relatively mild and somewhat short-lived compared with aspirin.

You may consider low dose aspirin (81mg.) which will not have a negative effect on eicosanoids . Dr. Sears has suggested that 1/2 of a baby aspirin approx. 40mg. daily with fish oil creates a new group of beneficial eicosanoids called resolvins. To learn more please search www.drsears.com using the key word "resolvins." Here’s one link - http://www.drsears.com/SearchResult...=resolvins

Of course keeping your AA/EPA within the ideal range (http://www.drsears.com/ArticlePrevi...ault.aspx) with your diet is important.

You are on the horns of a dilemma, take NSAIDs and compromise your health to relieve the pain or make other adjustments. Working with your physician consider adding in more omega 3’s while you cut back on the NSAIDs. Other suggestions that my provide relief; physical therapy, orthotics, stretching the plantar fascia and Achilles with a splint during the night, and mild electrical stimulation to hasten healing.

We hope you find this information helpful.

OKay, finally, a thorough response!
And one worth keeping for reference.

Yes, definitely. It was amazing to me how many times this had been asked, and had never really been answered well. I am really glad to learn more about Naproxen, and even though it has worked well for my pain, it was probably not helping me much in terms of my eicosanoid balance.

What I understand now, is to use NSAIDS like Ibuprofen and Aspirin for acute pain, and work more on controlling chronic issues with fish oil dosing. The Aspirin is good as a daily dose, but the baby aspirin dosage size is probably not enough to control pain, but perhaps will see if the combination of that and the fish oil controls things better.

Since my heel pain is now gone, I really just have to work on the knee, which is a chronic issue for me.

And, if this all pans out the way that I think it will, getting in the Zone might be a whole lot easier if I am not unknowingly knocking out all of my eicosanoids!

Wow ! I just saw this.(read below) So thrilled to see our staff being consistent across our web-sites.

Tech-Support answer

Aspirin and NSAIDs like Advil (an ibuprofen) don’t discriminate between the specific forms of the COX 1 & 2 enzymes and therefore side effects are associated with their long term use.
However, Ibuprofen is relatively mild and somewhat short-lived when compared with aspirin.
Always consult with your physician

Corticosteroids are the most powerful pain relievers knocking out all eicosanoids, “good” and “bad.” Aspirin and other NSAID’s affects a more limited number of eicosanoids (only prostaglandins and thromboxanes) knocking out the bad eicosanoids at a faster rate than it knocks out the good.
Low dose aspirin (81mg.) will not have a negative effect on eicosanoids . Dr. Sears has suggested that 1/2 of a baby aspirin approx. 40mg. daily with fish oil creates a new group of beneficial eicosanoids called resolvins. To learn more please search www.drsears.com using the key word "resolvins." Here’s one link - http://www.drsears.com/SearchResult...=resolvins
Of course keeping your AA/EPA within the ideal range (http://www.drsears.com/ArticlePrevi...ault.aspx) with your diet is ideal. However, as inexpensive insurance one may supplement with ½ a baby aspirin along with their omega 3’s.





[quote]
Posted By cranberrycat on 27 Jul 2012 02:43 PM
Sure is nice to have a working mouse! LOL

Here is the actual response that I received via email from Dave Shreck:


Dr. Sears appreciates your email, here are his comments.

Taking NSAIDs on a daily basis may affect one’s hormonal balance. Too many “bad” eicosanoids may cause some of the symptoms listed on the eicosanoid status report (ESR). Icon link to the ESR is at: http://drsears.com/Resources/tabid/...fault.aspx

Naproxen is a powerful NSAID that is a prescription drug in most countries due to it risks and adverse effects.

Corticosteroids are the most powerful pain relievers knocking out all eicosanoids, “good” and “bad.” Aspirin and other NSAID’s (Ibuprofen) affect a more limited number of eicosanoids (prostaglandins and thromboxanes) knocking out the bad eicosanoids at a faster rate than it knocks out the good. However, Ibuprofen is relatively mild and somewhat short-lived compared with aspirin.

You may consider low dose aspirin (81mg.) which will not have a negative effect on eicosanoids . Dr. Sears has suggested that 1/2 of a baby aspirin approx. 40mg. daily with fish oil creates a new group of beneficial eicosanoids called resolvins. To learn more please search www.drsears.com using the key word "resolvins." Here’s one link - http://www.drsears.com/SearchResult...=resolvins

Of course keeping your AA/EPA within the ideal range (http://www.drsears.com/ArticlePrevi...ault.aspx) with your diet is important.

You are on the horns of a dilemma, take NSAIDs and compromise your health to relieve the pain or make other adjustments. Working with your physician consider adding in more omega 3’s while you cut back on the NSAIDs. Other suggestions that my provide relief; physical therapy, orthotics, stretching the plantar fascia and Achilles with a splint during the night, and mild electrical stimulation to hasten healing.

We hope you find this information helpful.

[/quote]

Perhaps consistent, but there were a few holes with regard to the info that was initially posted... and missing a piece of info specifically regarding Ibuprofen (techie's post focused on aspirin).

Since the posting of the email response, I did get some further individualized feedback with regard to my original question, without the obvious copy/pasting. :)

I am just happy that you got your answer in the form you needed too; to understand the information.. That is what is important

I am very happy with the end result, as well!

Since the original posting on this thread and the subsequent responses here and the emails that I received, I had decided to cut out NSAIDS for routine use entirely, and use Ibuprofen for acute pain only. I have also been entertaining the idea of starting the baby aspirin on a daily basis, but this would likely not be for pain control, but more for good eicosanoid balance. I had been using Naproxen on a daily basis, prior to the dog bite!!! Which, after reading the emails, seems like it was definitely NOT helping my Zone efforts.

My original strategy was to do a AA/EPA test before stopping the NSAIDS to see where I was at currently, but since finances were an issue, I just decided to go ahead with the plan and stop the NSAIDS. Going forward from here, I will eventually do a blood test, but will give it a month off of the NSAIDS and on my current dose of fish oil. Surprisingly, not having a daily dose of NSAIDs has not had a negative impact, my heel pain has not been an issue, and just the usual soreness in my knee (chronic pain from old injury). The way I feel now, I would not be compelled to make any major changes in fish oil dosing, unless the AA/EPA test comes back with results that indicate changes needed.

Still, since finances are an issue, I will be holding off on blood testing until I can afford it, and if the pain issues become more chronic, I may consider upping the fish oil, but hopefully I can hold off on that until I can establish where I am at right now.

Helpful thread. Just thought I'd add my experience as somehow who manages a congenitally bad hip. A long, long time ago I found that the strict adherence to the zone was much more beneficial for pain and function than NSAID's. Now I never ever take NSAID's, in spite of having quite a bit of pain, as I can really feel the negative effects they have on the "zone feeling" and soft tissue healing in general (many surgeons recommend not using them post surgery for this reason.)

If I have severe pain that interferes with sleep, I now prefer an agent that acts "centrally" (e.g., cyclobenzaprine, Tramadol) for very short-term use.

Another tidbut, I believe complications from long-term NSAID use is one of the leading causes of death in the U.S.--I would definitely stay away from them.

Also, it's striking how much of the information in the original zone book (which is what I still use as a reference) is valid and relevant today. (General public is just starting to accept idea that elevated insulin levels is behind obesity epidemic.)

P.s.,

This is the first I've ever heard of the "ESR." An alternative is going by "feel" and quality of stool. I can't remember where this came from, but 10 or 15 years ago, Dr. Sears gave following guidelines:

Overproduction of 'good' eicosanoids produces a very loose stool or diarrhea Overproduction of 'bad' eicosanoids produces a very dense stool or constipation. Optimal balance of 'good' and 'bad' eicosanoids produces a floating stool. (zone) If you are making too many ‘good’ eicosanoids, cut back your intake of EPA. (zone)
Any increase in grogginess upon waking is indicative of over-production of 'bad' eicosanoids Too many ‘bad’ eicosanoids, increase your intake of EPA and cut back your intake (no matter how limited) of GLA.

I agree, and I am really surprised that I allowed this to go so far, without thinking about it.

Part of the problem is with regard to how doctors handle it... mine was totally fine with me taking an NSAID longterm. And, I could get in the Zone, but it was just way to easy for me to become sidetracked, and was never able to really figure out why that was happening. I am already noticing the difference. I am actually not experiencing the heel pain that I was having for the past 2 years, and the knee pain that is more chronic is really no worse.

I do have an upcoming surgical procedure, though, which will probably sideline me again for a bit, but since Ibuprofen is one of the more mild NSAIDs, I will probably just use that for the short-term.

[quote]
Posted By Jonathan on 10 Aug 2012 09:15 AM
P.s.,

This is the first I've ever heard of the "ESR." An alternative is going by "feel" and quality of stool. I can't remember where this came from, but 10 or 15 years ago, Dr. Sears gave following guidelines:

Overproduction of 'good' eicosanoids produces a very loose stool or diarrhea Overproduction of 'bad' eicosanoids produces a very dense stool or constipation. Optimal balance of 'good' and 'bad' eicosanoids produces a floating stool. (zone) If you are making too many ‘good’ eicosanoids, cut back your intake of EPA. (zone)
Any increase in grogginess upon waking is indicative of over-production of 'bad' eicosanoids Too many ‘bad’ eicosanoids, increase your intake of EPA and cut back your intake (no matter how limited) of GLA.
[/quote]

This is info from Dr. Sears' books regarding how to interpret two of items in the ESR, stool density and grogginess upon waking.