Tylenol vs Advil - for exercise, and also for parents

Sports & Exercise
1

This started as an exercise post, but I think this topic may be useful for anyone with not only exercise, but also for anyone who is working hard outside in the hot weather. And also for parents choosing between Advil or Tylenol for their children.

I will start with the exercise part and then move on to the other stuff, hang with it…

For exercise

For a shorter run, I think either Advil or Tylenol are fine. I don’t take either one very much, but if I am sore and I have a hard run on the plate, I will take Advil before a short run.

But for long runs or long periods of exercise, Tylenol is better!

Advil (Ibuprofen) can block certain prostaglandins - which are hormones that help dilate the blood vessels that lead to the kidneys. Blocking prostaglandins can cause a decreased blood flow to the kidneys, which is not a good thing to do during a long run when you may become dehydrated!

Tylenol (Acetaminophen) is metabolized almost totally by the liver, so your kidneys are not affected by it.

So a general rule for long runs or long periods of exercise (or any hard work where you may become dehydrated) - if you need a pain reliever, take Tylenol (Acetaminophen) instead of Advil (Ibuprofen).

Once you have re-hydrated after your exercise, Advil is fine.

For parents

As a great example of how sports science plays so importantly with other real-world issues, related to the same thing with dehydration, here is a guideline for parents giving pain relievers to their children…

Dehydration plays an important role in triggering renal damage by NSAIDs. Indeed, ibuprofen (Advil) should not be given to children with profuse diarrhea and vomiting, with or without fever.
Working Towards an Appropriate Use of Ibuprofen in Children: An Evidence-Based Appraisal - PMC

I know the option sucks there, because Tylenol is the one that causes issues with the G5 (but not the G6), so if you switch to Tylenol you have a different potential issue…

Taking medications with acetaminophen (such as Tylenol) while wearing the sensor may falsely raise your sensor glucose readings.
CGM Safety Information | Dexcom | Dexcom

@LarissaW, I think you have some info to add having to do with the effect on the heart also, right?

2 Likes
2

Not related to intense exercise, but worth mentioning re: choosing between NSAIDs: most of my decision between the two is about whether I want to target inflammation (then I use ibuprofen (Advil) or naproxen (Aleve)) as well as pain, or if it’s just pain, in which case I tend to find acetaminophen (Tylenol) most effective. For the worst pain, I use a combo of both. If my goal is primarily to reduce inflammation without much need for pain management, I almost always go with naproxen, because 2x day dosing is easier, as it lasts 12 hours supposedly. I find the pain relief it offers tapers off around 9-10 hours though, so prefer ibuprofen for daytime if pain is a major factor.

I use a Dexcom G5 and find the effect of acetaminophen not that bad—raises readings slightly, so I check with my meter more when using it, but it doesn’t render my Dex inoperable or not useful.

5 Likes
3

Interesting! I didn’t realize Advil could be a problem pre-exercise.

I only take Advil before bed to help me sleep through the pain. I hope that poses no problems! Advil works much better than Tylenol for my issues (lupus related) but I still try to restrict its use as much as I can!

2 Likes
4

I avoid acetaminophen due to its known adverse liver effects. Don’t need any more stress on that organ.

1 Like
5

The nsaids don’t seem to do anything for me, so I don’t take any, save for baby aspirin daily. I started that about 12 years ago since the endo at that time said all diabetics should be taking aspirin. BTW:if you start on daily aspirin therapy, don’t stop… It’s a bad deal

2 Likes
6

I’ve been given different advice re baby aspirin ranging from:

I consider it the standard of care for diabetics

To

It’s not a bad idea to take 2-3 times / week

To

No. Maybe when you’re older.

Don’t know what to think honestly.

1 Like
7

I think the general consensus now is that there no strong evidence for using aspirin preventatively in the general population of healthy adults. In a rehab population of people with prior cardiac or stroke events, it’s still recommended as further prevention. Don’t see any reason a reasonably healthy adult would start it though. Personally, I don’t see my T1 as putting me into the rehab category when I have no indicators of cardiac disease whatsoever, though I imagine some may say that alone is sufficient risk, which is why some suggest it for diabetics.

Do what you’re comfortable with, but for whatever it’s worth, acetaminophen used occasionally, without combining with alcohol, is not a big deal re: the liver. It’s mostly a concern when combined with alcohol (do not drink while on it) and/or when overused, the latter happening mostly because of opiates being packaged with acetaminophen, so people take dangerous doses of acetaminophen in order to get high. On its own, for a healthy person, used infrequently and dosed properly, it shouldn’t be of particular concern, unless you are otherwise so avoidant of liver stress that you also wouldn’t drink alcohol. But on that front, none of the NSAIDs are great taken super regularly—ibuprofen and naproxen strain kidneys and wear on the stomach lining.

4 Likes
8

I used to have a major problem with tension headaches when I was younger. Swimming regularly really helped strengthen and maybe loosen muscles in my back? Anyway, I would try taking Tylenol, but it never did anything. Ibuprofen would help a ton. I suspect it is the anti-inflammatory effect.

I don’t get these headaches very often anymore, but when I do only ibuprofen will help. Even sleeping it off doesn’t work. I just wake up with a worse headache than the one I had when I went to sleep, and it may progress into a headache with migraine-like symptoms (vomitting, light sensitivity, etc) if I don’t take ibuprofen. As I said, rarely happens now. Very thankful for Ibuprofen though.

Tylenol doesn’t seem to have any effect at all. I know it helps other people, but it seems completely pointless to me.

2 Likes
9

I just have a couple of comments about the choices in the Tylenol vs. Advil.

With the use of NSIADs. In a recent discussion with my Internist, she had pointed out that as Eric mentioned above the NSAIDs restrict blood flow to the kidneys. My Internist also said that with the reduced blood flow to the kidneys that my BG could run lower because the insulin would be staying active in my bloodstream longer. If you run into problems with low BG during or after exercise, taking an NSAID may not be the best thing.

In the same discussion with my Internist, she also mentioned that Tylenol was the only pain reliever that did not reduce blood flow to the kidneys.

I haven’t done enough research into this yet, so I can’t say for sure, but after combing through BG logs for the last ten years, I think there might be something to this (at least in me).

I hope this helps with some of the decision making, and may prevent some low BG.

3 Likes
10

I think there’s a fair bit of individual differences in response to NSAIDs. Some of the pain specialists I know claim one or the other tends to work best for any given person—I don’t really buy that as both work for me, just differently, but I definitely think some are ineffective for some people in general and/or some pain types more specifically. For example none of the NSAIDs, nor opiates, tend to work well on nerve pain unfortunately (gabapentin helped me when recovering from some nerve damage and is one of the go-tos for that), and none of the NSAIDs touch my more generalized pain symptoms when that gets activated (whereas amitriptyline is fairly effective at keeping that at bay for me).