Topical NSAIDS

[Martha]

Can topical NSAIDS set off an MC flare?

I've had a pain in my right shoulder since September. It started off mild, and has gotten worse. It only hurts with certain movements of my arm.

I had planned to see my doctor about it when it got bad enough that it was bothersome, but then the pandemic came, and so I didn't see her.

Last TuesdayI had my yearly physical, by teleconference, and she, much to her credit, told me that due to my MC, she wouldn't prescribe oral NSAIDS, which would be the usual treatment. Instead she prescribed Diclofenac Sodium Topical Gel, 1%. I didn't know that it was an NSAID until I read the insert.

I use 2 grams morning and evening. I started it on Thursday. It has helped the pain, but then I began having more bowel movements, and then some diarrhea.

On the food side, I did eat some cherries on Saturday and Sunday, which might have caused the diarrhea.

I stopped both the cherries and the topical gel on Monday (Sunday being the last day for both), and will see how things go. Then I can restart the gel and see if things deteriorate again. I haven't had any D so far, but did take a whole Imodium on Sunday. I usually only take half if I have D.

But for general knowledge, is it likely that a topical NSAID, in what seems like a very low dose, would cause diarrhea that quickly?

Martha

[TXBrenda]

I have used this quite a bit in the past. Don't need to use it much now. Also don't remember it causing D for me.

FWIW, saw a commercial the other day for Volteran gel as an OTC item.

[tex]

Hi Martha,

Here are my thoughts:

Some of us (but not all of us) can successfully use topical NSAIDs. So I'm guessing that the gel might not work for you. But that's just a guess, based on the evidence, so I could certainly be wrong.

Based on my own experience, I'm wondering if the shoulder pain might be due to calcium deposits. Here's why: Even if we're taking a magnesium supplement, over the long-term, we can easily become magnesium deficient if we also take vitamin D. Vitamin D will tend to increase our ability to absorb the calcium in our diet. Even though I've never taken a calcium supplement, I've had problems with calcium deposits in joints, when my vitamin D level is relatively high (70–80 ng/ml) or higher. In fact, when I allowed my vitamin D level to rise to above 90 ng/ml, I had problems with a couple of kidney stones, for the only time in my life.

The reason why this happens is (in my opinion) because higher calcium levels in our blood, deplete magnesium. The body uses magnesium to help insulin transport calcium to our bones and other cells, and it uses magnesium to properly purge the excess calcium as it automatically regulates the calcium level in the blood. Since calcium is an electrolyte, the blood level must be carefully regulated, so the body does this automatically. If insufficient magnesium is available, the body improperly deposits some of the excess calcium at random, in joints and muscles, in order to limit the blood level of calcium.

So the takeaway message (in my opinion) is:

• 1. If we take supplemental vitamin D, we should also take supplemental magnesium.
  
  2. The more vitamin D we take (the higher our blood level of vitamin D becomes), the more magnesium we need to take.
  
  3. The more calcium in our diet, the more magnesium we need to take.
  
  4, This is probably irrelevant in the short-term, but in the long-term, it can become a significant issue.

Since we're all different, in different situations, this may or may not apply to you or anyone else. And since this is just my opinion, it might have some merit, or it might be way out in left field.

Tex

[LydiaS]

Perhaps we should also consider taking Vitamin K2 (MK-4 and MK-7) to ensure that Calcium is properly utilized by the body. i.e. that it goes into the bones and teeth rather than the arteries and tissues.