NSAIDs and Stem Cells: Naprosyn Messes Up Cartilage - Regenexx®

NSAIDs and Stem Cells: Naprosyn Messes Up Cartilage

nsaids and stem cells
I highlighted a study recently that suggested that taking NSAID drugs long-term could cause more arthritis. However, the question is how that could happen. Now another recent study sheds light on a possible mechanism for how that could work—NSAIDs cause abnormal cartilage to be manufactured because of the interaction of NSAIDs and Stem Cells.

NSAIDs in the Water Supply

It’s amazing that every single guideline for treating an acute injury involves taking NSAID drugs. These are anti-inflammatory medications that include drugs like Motrin. Aleve, ibuprofen, Advil, Naprosyn, Celebrex, celecoxib, Mobic, and meloxicam (just to name a few). Doctors and the public seem to be under the bizarre illusion that these drugs are safe, when in fact they’re the most dangerous medications you can buy over the counter. Not only can they cause nasty stomach ulcers, but, more importantly, all NSAIDs increase your risk of having a fatal stroke or sudden-death heart attack. The lowest risk is Naprosyn, which more than doubles your risk of a stroke or heart attack, and the worst is Voltaren, which almost quintuples it!

We’ve told patients for years to get off NSAID drugs prior to a stem cell procedure, which can sometimes be quite difficult as many middle-aged and elderly patients take this stuff just to function normally. They begin to get aches and pains in middle age, and rather than managing them with diet, exercise, and natural supplements, like high-dose fish oil, curcumin, or glucosamine/chondroitin, they begin to pop Motrin pills like they’re scarfing M&M’s. The problem is the relationship between NSAIDs and Stem Cells as these little pills will mess up your stem cells. Let’s look at how that works…

How Cartilage Is Made

New cartilage is made in your joints all the time. When you go for a run or even a walk, many cartilage cells and little bits of the matrix they produce are lost. This needs to be replaced, and that happens by local stem cells differentiating into cartilage cells to replace the dead ones. The new cartilage cells then lay down the stuff where they live, known as extracellular matrix, or ECM. In a joint, the cartilage cells plus the ECM are what we call “cartilage.”

The composition of the ECM is critical so it can resist force. In order for it to be strong enough, the right type of collagen has to be produced. Collagen is the stuff that makes up our skin, hair, bones, and many other tissues. It comes in many different flavors or types. Each organ or body part can be engineered to have certain properties, like more or less stretch or more or less firmness, just by altering the composition of the different collagen types. One of the things we know about bad cartilage (like the type found in arthritis) is that it has more collagen X (ten). This makes it too soft and unable to withstand normal forces.

The Dangerous Interaction Between NSAIDs and Stem Cells

The recent study looked at Naprosyn, also known as Aleve, as well as other NSAID drugs. The authors had found in a prior study that Naprosyn (but not other NSAID drugs) altered gene expression in stem cells for type-10 collagen (caused the cellular machinery that makes this protein to be stuck in overdrive). This study looked at stem cells from normal healthy patients and from patients with arthritis. The cells were then exposed to Naprosyn or not and then given clues to become cartilage cells. The cells exposed to Naprosyn made too much collagen X. Interestingly, this was happening because one of the inflammatory pathways that Naprosyn and other NSAIDs doesn’t block was also placed into overdrive. Also very interesting is that there are supplements, like high-dose fish oil and curcumin, that we know block this other inflammatory pathway (lipoxygenase).

So is Naprosyn the only bad actor? Not in the least. Here’s another study showing that Voltaren causes stem cells to turn into fatty pieces rather than turning into normal tendon cells. Other studies have shown that NSAIDs also mess with new bone formation and healing (although pharma has been working overtime to produce research reviews to block this one as this messes with orthopedic surgeons prescribing NSAIDs for postop patients).

The upshot? Normal inflammation is how we heal. So just from a 30,000-foot view, blocking it in a patient trying to heal or undergoing a treatment like stem cell therapy, where healing is the primary aim, just seems ill-advised. Now we have multiple studies that show that the interaction between NSAIDs and stem cells will mess with stem cells at multiple levels and through multiple mechanisms. So if you’re seeing a doctor who wants to perform a stem cell treatment, and he or she doesn’t provide advice to get off the NSAID sauce, find a new doctor!


*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.
Read 27 Comments
  1. This is an interesting article and should open our eyes. The issue is what alternative we have for pain managment and pain relief in arthritis. Curcumin and Fish oil might be a good alterative but what high doses of fish oil one would need to have the same effect as 800 mg of ibuprofen does in decreasing pain and inflammation. When we get stem cells obviously there is a time of healing, so what pain medications are safe to use and will work effectively to manage healing (again after stem cell therapy).
    Dr. Cenntenno, can you please elaborate and provide solutions as well.
    Thank You

    1. Shahab,
      We put a year’s worth of lab research into determining what supplements in what ratio supported stem cells and chondrogenesis best and created the Advanced Stem Cell Support Formula, which is what we recommend to our patients. (ingredients shown) http://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/ Many people have found good alternatives in Curcumin and Fish Oil, which you’ll find there as well. http://www.regenexx.com/curcumin-for-knee-arthritis/ http://www.regenexx.com/nsaid-addict-can/ Unfortunately, treating arthritis with NSAIDs is alot like treating psorosis of the liver with vodka!

    2. i have arthritis all through my body. i would like to try curcumin, where can i get this and how much of fish oil=800mg of ibuprofen

      1. Shahab,

        Dr. Centeno explains what type and how much fish oil to take here: http://www.regenexx.com/how-much-fish-oil-should-you-take-for-your-arthritis-and-stem-cells/ It’s important to take good quality curcumin with bioperrine added for greater bio-availability. We’ve done the legwork and have one that we’ve researched and do quality control on, on the website here: http://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/ (fish oil as well) but if you will be purchasing it in a store, look for those ingredients in a good quality healthfood store. Please see: http://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/ and this is what types of things to avoid: http://www.regenexx.com/stem-cell-supplements/

  2. That’s really good to know as I just had stem cells injected in my shoulder and hip. This the third time for stem cells for me and each time I was told not to take NSAIDs each time. So far I have had good success with this therapy. Thanks to Dr Schultz for all your work. Dr Stiene has done great work for me again.

  3. Got off of Aleve a few months before extraction of SC’s in Cayman and never to use again almost two years ago. Do these NSAIDs do permanent damage or can our bodies repair the harm they’ve done? My SC’s were not as “healthy” as they could have been and I blamed the Aleve.

  4. I quit using Celebrex during the bone marrow stem cells injections , basically you’re saying not to use the Celebrex afterwards ?

    1. William,
      This is something to discuss with the Doctor who did your procedure, as each case is unique and they are the expert on your case. However in general, to maximize the potential of the procedure and to make sure those stem cells get to produce good cartilage, NSAIDs should be avoided. The Advanced Stem Cell Support formula was based on a year’s worth of research to find the supplements and in what ratios actually support stem cells and chondrogenesis. http://www.regenexx.com/regenexx-advanced-stem-cell-support-formula/ Long term, many people have found fish oil and curcumin have controlled pain and inflammation well.

      1. Thank you for being so prompt and I am using the fish oil, curcumin ,Black seeds oil and what is the best glucosamine & chondroitin. Bayer aspirin ok?

        Best regards

        1. Bill,

          We know the quality of the Glucosamine and Chondroitin in The Advanced Stem Cell Support Formula which also has, curcumin, bioperrine, bittermelon and resveratrol, which has been found to protect cartilage:http://www.regenexx.com/supplement-for-cartilage-protection/ But any quality brand from a trusted Health Food store will work, providing it does not use shark cartilage as it’s source. For Glucosamine, take 500mg twice a day of a brand that has both the sulfate and HCL forms of this natural compound. For Chondroitin, it’s 1,200 mg a day, usually taken 600mg twice. http://www.regenexx.com/shark-cartilage-side-effects/ Aspirin, though it doesn’t have the cardiac risk, is technically an NSAID. I will inquire if creates the same problem for cartilage…

    1. Tommy,

      Cannaboids can encourage stem cells to produce bone rather than cartilage which is not what we want, so they should be avoided for 6-12 weeks after a stem cell procedure.

  5. I would like to stop using diclofenac, can you recommend an over the ctn fish oil and Curcumin that would be equal to the relief I am getting from the diclofenac

  6. I just had umbilical cord stem cell injections in both knees 5 days ago. Last night I took excedrin migraine for a headache out of habit and realized after it has 250mg of aspirin in it. I obviously will never do this again. How serious of a mistake have I made. I’m very upset I did this. I’m trying to do everything right for this procedure to work.

    1. You’re fine as you were scammed. There is no such thing as an umbilical cord stem cell injection. These are all regulated by the FDA to be dead cell, non-viable products. Hence, you got no live stem cells injected in your knees.

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