♪ Bob and Brad ♪ ♪ The two most famous
physical therapists ♪ ♪ On the internet ♪ - Hi folks, Brad Heineck,
physical therapist. - Bob, physical therapist,
obviously not here. Chris is here, the pharmacist,
to help us with this video. Bob is on vacation this week,
taking some well-deserved R&R. The title of today's video
is ibuprofen versus Aleve versus turmeric versus Tylenol and we're updating this video, we did this video about three years ago and by popular demand,
we're gonna add aspirin. A lot of people were
asking what about aspirin? So we're gonna include that this time and Chris has got some updated research and things that may come
up, new that wasn't known back three years ago. Before we go any farther, I do need to get a little business out of the way. Here we go. How does this go again? Bob does this all the
time, I'm a little slow. Join us at BobandBrad.com, we do have a giveaway again this week. It is the Knee Glide, which is a device great for range
of motion of the knee before or after surgeries,
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shorter versions there, if you don't wanna put up with our lengthy 10 minute version. Okay, Chris, again these medications, very popular. Probably everyone across
the nation, I would say and maybe worldwide, has
taken a form of these for their aches, their
pains, whatever it may be but so many people, do I take ibuprofen? Do I take Tylenol? Do I take acetaminophen? What's the difference? So that's what we're gonna talk about. So Chris, let's start with
what we missed last time and so many people were
interested in, aspirin. It's been around for a
long time, hasn't it? - It's been around for thousands of years. Aspirin is the granddaddy of them all, so I mean, we've been using
it for thousands of years, it actually was-- - We don't have aspirin here but we're just gonna talk about it. - We're just gonna talk about it but basically, aspirin, mostly
extracted from willow bark. It was just a natural-- - What? - Willow bark. - Willow bark? - Yeah, just from the tree. So basically, they would,
Native Americans would chew on it and it would
reduce inflammation and fever, it was remarkable and then
over the years we decided to try and make it a
little bit more scientific and Dr Bayer in Germany,
the make Bayer Aspirin. - Sure. - He was the one that got
the patent in the 1890s and so it's been around as a patented drug for well over a century now. - Well, I know when I was
a child back in the 60s, that's all you heard about was aspirin. You need an aspirin, you can get aspirin and not so much anymore. - No, not so much anymore. I mean, aspirin does
have its share of risks and basically, most commonly
for most people it can be a bleed risk, which for
a lot of us would be the other type od stroke,
not the clotting stroke but the bleeding stroke,
the more dangerous one. - The blood thinner-- - Blood thinner aspects of it and also for people, a lot of
ulceration or tummy problems. So we have to be kind of careful. Those are the two major ones
that most people will fall into and it's fallen out of favor
as a fever reducer in children because of Reye's Syndrome,
so it can be a rough-- - Reye's? - Reye's Syndrome. - R-Y-- - R-Y-E-S, I believe and
so it's just something that we just don't give
to kids with fever. - Okay. - So that's what Tylenol came around for. - And I know my mother
had baby aspirin for her, just a maintenance thing, for
a blood thinner I understand. - Yep as a blood thinner, yep. - And actually last year,
the doctor said no more, they're not doing that any more
because of hazards or risks. - Bleed risks again, so. - Bleed? - Yep, so basically
what happens is you have two types of strokes, you
have the clotting stroke where something clots up and
blocks the flow of blood. - So in your brain? - In your brain. - The blood flow can give us that stroke. - And then the other type of
stroke is the bleeding risk, which is actually more
rare but more serious and that's where a capillary
or something would burst and then blood would
leak into the brain area and then very dangerous
devastating things would occur. - Right, so that's the hemorrhagic stroke. - Hemorrhagic stroke, 100% correct. - Okay, so again, that is no longer, or the doctor, it's up to the doctor if it's-- - Yeah you wanna check with
your doctor if aspirin is appropriate for you for
that particular reason. They've changed a lot of the guidelines over the last couple of years. We used to have everybody taking aspirin for blood thinning purposes, even if you were healthy. Now we find that that's not the case, again because of the bleed risk. - So if you cut yourself
and you're on aspirin, are you gonna bleed more? - Little more, little more. - It's not like you're gonna bleed out? - You're not gonna bleed
out, you're not gonna get exsanguinated or anything like that. You'll clot up but it just
takes a little bit longer, a little more pressure,
probably a band-aid. - So it's still a good thing you can buy, you can buy it off the
shelf, you can use it but again, it seems like these
are more popular nowadays. - More popular, I mean
aspirin back in the day, it's a great anti-inflammatory,
so it's good for arthritis. It's still good for arthritis and it's still good for
fevers if you're sick, if you're an adult or over the age of 12. Again, if you have questions,
check with your doctor but we've moved on to
other items like ibuprofen but again, basically it's just kind of a chemical modification on what aspirin's structure is and for a lot of us, I think it's probably a little bit
better anti-inflammatory 'cause it's a little bit less GI upset and stomach irritation but it still can, so we always want to take
this with a little bit of food to protect the tummy. - And didn't you say, I
think you've told me milk, if nothing else, is a good base for it? - Yep, milk's a little bit of a buffer 'cause it's not like water
where everything's transparent, milk has a little bit to it,
so with all the other nutrients that are in milk, so it slows it down and protects it and buffers
the stomach a little bit. - So if you've got a sprained
ankle, something swelling up, that's that inflammatory
process, that would be a good reason you might wanna take this? - Yeah it's a great reason to take it. - How 'bout a headache? - Headache is a great reason to take it. - And everyone kind of perform or responds differently
to these, I understand? So which one do you wanna take? - Yeah usually my go-to, as a pharmacist, I recommend ibuprofen not
exclusively because it depends. I'll ask a couple of
questions of a patient to see what's best for them
but really ibuprofen's my go-to for a lot of the patients
that I try and help but for a headache, I think it's great but there's reasons to go
with acetaminophen or Tylenol, there's reasons that
some people like Aleve because it lasts longer, so we have advantages on all products
for different reasons. - Sure, okay. How many do you take, if
two's good, is six better? - No, no, no! We don't, more is good, some is good, more is
better, definitely not. So we want to go to the regular directions that the manufacturer throws out there, which is one or two tablets, up to every four to six hours apart. So when you read the fine print-- - Is that written on here? I can't read it. - You can't read without your glasses, my contacts are in, so
I can actually read it but it's one or two, every four to six hours apart as needed but no more than eight in a day. So eight is your hard line in the sand. - And isn't there something
about this, ibuprofen, being hard on your kidneys
or your heart possibly? Or is that rare? - No it's not, it's not common but it's definitely
something that doctors are gonna be really aware of. So if you're on certain
blood pressure medications, if you have certain kidney problems, we do have to be extra
cautious with these guys and turmeric to a degree as well. So again, that's what the
acetaminophen is in here for, so we'll kind of work our way down to that but the reality of it is,
always check with your doctor to make sure it's appropriate for you or check with your pharmacist
to make sure it's appropriate. - Right, right, okay. Very good, anything else on ibuprofen? - No ibuprofen, again-- - I know it's like, we talk
about as you and I are active, I exercise a lot, we injure
ourself, over-exercise, those kinds of things. - Oh yeah. - Is this something that the
athlete or the weekend athlete, the person who's running the marathons, is it gonna be good for
their aches and pains to get to pulled muscles et cetera? - Yeah I think so, I think the advantages of anti-inflammatories and there's two schools of thought but fighting the
inflammation fights the pain, so if we're uncomfortable, it's gonna allow us to train further, so it'll get you back
out there, participating. There are some schools of
thought, more modern science is saying some of that inflammation
actually is a good thing, so we have to have a fine balance
but I guess in your world, if you've got a joint
that's not working properly, usually rest is probably
the added measure of caution from that standpoint. Sometimes we don't listen
very well ourselves, as we've done on our
Saturday morning expeditions. - I've got a five mile
run and if it hurts, I'll take some of these
and I'll get through it but that's probably not the idea. Shall we go on to Aleve? - Yeah, Aleve or Naproxen sodium. - Aleve's not an anti-inflammatory? - It is an anti-inflammatory. - But it's not... - It's another cousin of
ibuprofen, so it behaves the same. I don't wanna say as similar
as Coke and Pepsi per se and I don't wanna advocate sugar but that said, it's just a close analogy but this is another type
of anti-inflammatory, if you were to actually
be really scientific and pop it under a microscope and look at all the, an
electron microscope to look at the structure, they're
very very similar skeletons. The advantage of Aleve over
ibuprofen in some cases is it lasts a lot longer and when you were bringing
up that heart disease issue, some studies suggest that
Naproxen sodium might be a little bit better for
our blood pressure patients and people that have some kidney problems, so it's something that could
be a slightly safer alternative but again, check with a
doctor to be on the safe side. - It sounds like if you've
got some co-morbidities, other problems and medications,
these over the counter ones, you really probably should check to make sure it's gonna fit your-- - It's always good to ask questions. The only question that's a bad question is the one that's never asked. So always check with your
pharmacist and your doctor, again, but the nice thing with
Aleve, with Naproxen sodium, specifically is it might
work a little bit better on soft tissue injuries, so
if you've got a muscle ache, a tear, a pull, it might
do a little bit better job than even ibuprofen, at
least some of the older and some more modern studies have shown. - But as far as joint pain
or headaches, it only? - No, it'll work for those too. Again, just as you and I
are different, we respond to different medications across
the board differently too. So it kind of comes down to a
little bit of trial and error and making sure it's appropriate for you. - Typically with this, I
believe, I was dealing with this with my mother, she could
only take one in the morning, one at night and no more because
there's potential to have some problems if she was taking too much. - Yep, again, stomach ulceration, probably a little bit worse
with this than the ibuprofen. So we have to be careful,
so food or a glass of milk but food probably a little
bit better with the Naproxen insofar as that also still
has the same bleed risk, so if you're on blood
thinners, so again, ibuprofen, aspirin and Aleve and
when we get to turmeric, we're gonna have to be
careful with that too. - Okay. All right, shall we go to? Now this is something, a lot of people, we did spell it wrong on the last video, apologize for that and the pronunciation, we need an English major on our staff but anyway, turmeric, it's a spice. It's used, I understand, for mustard and it's got some healing
values, benefits to it. So you wanna talk about that? - Yep, turmeric basically, most of the research that's out there that's best and has
most scientific basis is for an anti-inflammatory, so
it's gonna behave like aspirin, ibuprofen and Naproxen sodium. So it's gonna help, so with aches or pains and anywhere, you wanna make
sure it's turmeric curcumin, it's the curcumins, that's the scientific, that's the thing that
actually makes it yellow but it's also the business end, it's what makes this an anti-inflammatory. - Gives this medical benefits. - So that's where the
benefits are coming from and you wanna make sure that
the product that you choose, in a lot of cases you're
not gonna just take a spoonful of turmeric
from the grocery store, you're probably gonna wanna buy something that's a standardized extract, you wanna make sure it's 95% pure. If you can find the symbol USP, it stands for United States Pharmacopeia, it means that it's been lab-reviewed and independently tested. So it's gonna ensure that
what's in that capsule is in that capsule. - So using this, this is mine from home and I use it to spice my food. Is just putting it on your
food gonna be a benefit or is it? - It's gonna be a
benefit but it's gonna be really hard for you to really get the anti-inflammatory aspects of it. Turmeric, when it hits the
stomach acid, dissolves quickly, so you really don't absorb a lot of it, so it makes everything taste great but a lot of the medicinal
effects are not there. All right, so yeah, so
Piperazine or it comes from black pepper extract and so with that, basically what we found is that seems to piggyback on to the turmeric and allow it to absorb better in the gut and there are some other
companies that are getting really fancy and using enteric coating, so they make a special
coating on the capsule, so it doesn't dissolve in
the gut or in the stomach but it dissolves in the intestines and absorbs there a little bit better. - Sure. - And so they use kind of some
fancy science to create that and then what happens
is, as you're delivering more turmeric to the system and the dose that you're looking for is probably about 500 to 1000 milligrams, so it's a little bit different
then when I delivered-- - Per day? - Well, per dose, so you can-- - And this is from a study or something? - Multiple studies and
usually 500 milligrams to 1000 milligrams up to per day or even a couple of times a day, depending upon what
you're going for for pain and inflammation management and most of the studies suggest
using it for osteoarthritis, which is that wear and tear,
aches and pains that we all get as we age. Even for up to two months of regular use or even three months of regular use. - Okay. So is there really no risk
with this compared to this or is there some? - No there's still risk, it's still a natural anti-inflammatory, so it's gonna behave like your aspirin, behave like your ibuprofen and behave like your Naproxen sodium. So if you're on blood thinners,
we've gotta be careful. Talk to your doctor first, that's-- - But it's not gonna be a
problem just from your food? - Food amounts, probably
not unless you are really, I mean if you are really into the spice but and therapeutic
amounts, when you're taking a supplement, we have to be careful and also again, reflux,
stomach issues kinda rear their ugly head, same with
aspirin, same with ibuprofen, same with Naproxen sodium. - So if people wanna do this
and get the pill form online or at a box store or? - Yeah again, you can
go box store, online, all are good but again, you
wanna make sure you've got that stamp of approval, look for USP or a highly reputable company because again, just with
any supplement nature, you can have, it's the
wild wild west out there. So anybody can say, yeah
I've got turmeric in there and all of a sudden it's
crushed crab shells, so it's just something that
you wanna make sure that-- - Crushed crab shells? - Yep that's a different
subject all together, that's like glucosamine. - Is that a pharmaceutical-- - They use that for glucosamine but that's a whole different discussion, we'll do another video on that. - Okay. - [Cameraman] There's lots of
potential with neuroscience. - Yeah there's lots of
anecdotal studies out there that don't really-- - Now before we go on,
our cameraman just asked a good question about
the neuroscience of this with relation to Parkinson's and dementia? - Yeah it can be cognition and dementia. Some people feel that using
the substance turmeric may improve symptoms like that,
so more or less memory issues, dementia would be the ones
that I've seen most commonly but the studies have been small in scale, more anecdotal saying this worked. It's definitely safe enough, if you're not on any blood thinners, it's certainly something you could try but there needs to be a
lot more research done in that department. - But if someone wants to try
it and the doctor says fine, is it one of those things
that there's gonna be no harm to it, the worse
that'll happen is-- - Generally, well again, it's you know, I think that's one of the misconceptions with herbal type products is
that it's nature, so it's safe. I mean, yes for the most
part it's going to be safe, always check with the doctor first, check with your pharmacist, make sure there's nothing
in that profile of yours that would interact with
it, like the blood thinners or other, all of a sudden
they're taking aspirin or ibuprofen for their sore joints and they're piling on
turmeric because they want to try and help to improve
maybe some cognition it could cause some GI side
effects at the very least and it could go even further than that, so like a bleed risk, so
we have to be safe with it and smart with it. - Again, there's always some people, if this is good, maybe I
better throw this in there too and this and I'm gonna get better faster. - And we're gonna draw
the hard pass on that too because you don't wanna combine
them because you can have, you can combine them to get the benefits but you can combine them
and it can blow up on you. - Overload. - Exactly, so we do have
to be careful with that. - Okay, now we've got the next one, which evidently is a different family but we have it on the shelf,
people use it all the time, which is acetaminophen. - Yep, acetaminophen. - Aceto, aceta? - Acetaminophen. - Yeah, that's a good one. - There you go, otherwise known as-- - What is that, that's a family show. - Yeah so basically from this, the big difference from these guys are it's a great pain reliever but it doesn't carry the
bleed risks that these people plus the aspirin are going to have. So with this particular
medication, it's gonna allow you to lower fevers if you're
sick, it's gonna get rid of that headache, it's
gonna help those sore knees, it's gonna help those sore
elbows and it's not gonna run the bleed risk or that stroke risk that could possibly be potentiated by the other anti-inflammatories. - It sounds like this would
be the safer of all of them. - I think in a lot of cases you can probably look at it as
the safest of the bunch. It's not quite as
effective across the board because if, let's say,
you have a sprained ankle, to take our back example,
it's not gonna reduce the inflammation but it is gonna help you to at least get some pain relief. - And so you can take more
of that without a problem? - No absolutely not, Tylenol
actually, more than those in higher doses can be much more dangerous and a fatal dose of acetaminophen
is much easier to achieve than say even doing something like this. It doesn't take long, the daily max that they recommend now is
actually 3000 milligrams, which would be six of these. - All at once or? - No, you have to spread
them out throughout the day, so the directions, when
you read this, this is a 500 milligram capsule. There's also regular strength,
325 milligram tablet. - Can we say who made that? - This is just a generic
form of acetaminophen, so every store, every box store, online, they're all gonna be acetaminophen. These are the quick release
gels, so they do absorb into the system a little faster. - I can't remember if we
can say the common name that everyone knows. - Tylenol. - Tylenol! - Tylenol is the name
that everybody knows it by and so from that standpoint, it doesn't matter where you
get it or how you get it, it's certainly something that you can use but you want to use it in
its controlled delivery, so you can do one or
two tablets or capsules, every four to six hours apart but if you're using the extra strength, which is what most people tend to purchase because stronger is better, you're gonna go to a
maximum of six capsules in divided doses throughout the day. - Sure and if you overdo
it, what can happen to you? - Well you can have lots of
trouble with the kidneys, lots of trouble with the liver
and a fatal dose is 15 grams and acetaminophen toxicity is something nobody wants to go through. - So that would, whatever that-- - It'd be a bottle. - Okay. (Brad laughs) Okay, all right, wow, very good. So there was one other thing
about this acetaminophen, is there anything that this will take care of that these won't? - Well no, generally speaking, no and a lot of times now, today
because of the opioid crisis, which is something that we
haven't got into at all, we will see people, as pain management, like dental pain, extractions,
they're gonna have you combine ibuprofen and Tylenol. - Oh really? - Yep, so you actually
get much better analgesia, which is pain relief. - Sure. - When you use the combination
of both ingredients together and it's safe. - It is? - Yep, in small amounts. So if you do one or two ibuprofen
and one or two of these, you can take them both together. So children, doctors have
been recommending them for lowering fevers in children
that are sick for years, also works for your bad
knee or tooth extraction or anything to that. - It sounds like maybe
we could have a video on that combination. - I could talk a long time on that. (Brad laughs) - 'Cause I'm, like you
said, I'm assuming there are some proper or-- - There are proper guidelines
and wrong ways too, so we do have to be very careful and again, something you want
to check with a physician, just to be on the safe side. - All right, well I would say,
any other questions, Tanner? Our cameraperson back there? But you know, I've been talking to Chris about these for years, I always ask 'cause I can never remember, so if you can't remember
all this information, just go back and review the video. (Brad laughs) - [Cameraman] Generally speaking though, these all typically have, are there gonna be some dangers with them? - Well we have to again,
you want to stick to-- - So all, they can't
hear, so the question was can you take acetaminophen with Aleve? Is that gonna be a good combination? Because we just mentioned a
different combination is better. - You can still do it, so
it's an excellent question. So again, Aleve, because it behaves like ibuprofen in controlled doses, you can take one of these twice a day, about every eight to 12 hours apart and you can take one or two of these, every four to six hours apart
in conjunction with the Aleve. So whether it's Aleve,
whether it's ibuprofen or even conceivably aspirin,
it's something that you could use to enhance pain relieving
aspects of it exclusively, or if you had a fever, same deal. It could help to lower that fever. So if you've got flu or maybe COVID and you're really uncomfortable
with a high fever, it certainly will help to reduce that. - Again, when you start
combining these things and maybe if you're already
on a couple other meds, definitely you need to consult. - Talk with your doctor,
talk with your pharmacist, can't stress that enough
because a little bit's okay but a lot can be very bad and
it can get bad in a hurry. - Wow, all right. I feel completely enthralled
with a lot of information, I've gotta digest it now. So once again Chris, appreciate you coming in, joining us. Bob will be back next week and again, we can fix just
about anything except for... - A broken heart. - And I don't think
these are gonna help that or am I wrong? - Well maybe the aspirin might help with the heart functioning. - Oh really? Well okay then, we got a start. We'll put that in a chapter. - There you go. - Enjoy the day. - Bye everyone. (upbeat tones)
