Hidden dangers with ibuprofin, Motrin and flu treatment

Thanks for the advice Andy! And you shouldn’t feel like a failure as a parent. It sounds to me like you love your daughter a lot, but you just didn’t know that Ibuprofin would have the effect it did.

Thanks, JG, for the extended information.  And I hope it’s okay that I’m linking here to the study you posted at Fark:

Study Links Heavy Use of a Pain Reliever to Kidney Failure

My interpretation is this is a warning for those who are chronic acetaminophen users. I think these are important paragraphs:

“The kidney study … found that averaging just one pill [of acetaminophen] a day for at least a year might double the risk of kidney failure. Despite the apparent hazard, however, researchers noted that both kidney and liver damage were rare, even for heavy users. For most people who take a pill or two occasionally for a headache, the medicine appears safe.”

And:

“In a second study, researchers found that when people took moderate amounts [of acetaminophen] after fasting, the drug could damage the liver.”

And:

“The risk of kidney failure increased about 40 percent in those who took acetaminophen from twice a week to once a day for at least a year, compared with those who used the drug less often.”

And:

“The risk was double in people who used [acetaminophen] an average of once or more a day for at least a year.”

I’m glad to hear that Ally has recovered. Cannot imagine how scary it must have been.

Hi rc,

You make good points. Allow me to respond and provide clarification:

Five days without food or water would be dangerous for any small child, Motrin or not.   I know of adults who have died in three days for flu induced hydration.

Water, yes. Food, no. That’s why (paraphrased) I said “no food and little water”. That freaked out my wife and I, but we were assured by multiple docs in the ICU that as long as she’s hydrated and kept the right electrolyte balance (and she was on an IV to do that very thing), people can go for a long time without food. Even at the 9-day point of no food, the docs didn’t feel that was a concern. For all its problems and evolutionary kludges, our bodies are capable of some amazing things!

I think you need to take Motrin off the hook here.  It has not shown to be a problem for those without chronic kidney disease or other complicating factors.   A high fever (which the Motrin treats)  is far more dangerous.  I see nothing in your story that would lead to such an extreme warning.

To best respond, I first called the specialist’s office and asked for clarification. I wanted to address your points honestly, and not be swayed by my own fear and lack of focus during the ordeal.

This is an office that handles only renal issues in children: pediatric nephrology, dialysis and transplantation. I submitted my questions to Ally’s kidney doctor, and got a call back from a dialysis specialist who related the doctor’s answer to me. (In an understandable coincidence, the specialist I spoke to was the same one who did Ally’s dialysis treatments in the ICU.)

She had these points I want to relate:

- Motrin was “definitely a contributing factor” in Ally’s situation. It was this combination of kidney-targeting problems (specifically flu / dehydration / Motrin) that caused the kidney failure.

- Even just one dose of Motrin can have bad effects on the kidneys. It doesn’t take much to cause a problem in children.

- Their office sees a lot of kids with kidney failure. And she said the majority (“almost everyone”, in her words) are young athletes: They exercise a lot, they get dehydrated, and they pop motrin for exercise-related pains and aches. Then boom, the kidneys fail. There are no underlying causes apart from exercise-related dehydration. For this specific office, that’s the most common type of renal failure. I say what I said originally: If you take Motrin, make sure you’re well-hydrated.

Sidenote: At the ICU, after we were just recovering and trying to relax, a doctor came into the room. He asked for our help in a situation that just happened. Apparently, another little girl came in the ER with symptoms almost exactly the same as Ally’s. She was the same age and also had just gotten a flu, and had also recently taken Motrin. He asked us a lot of questions, hoping to find correlation in order to better treat this girl. That’s just an anecdotal story to indicate that while Ally’s problem relied on a very specific combination of events, it may not be rare. However, I have no data to back up that guess.

Sidenote number two: At the ICU, Ally almost had a kidney biopsy. She never did, because soon after the dialysis she started recovering, and a biopsy simply wasn’t needed. However, the kidney doc said that if we had done the biopsy, we’d be able to tell not only if Motrin was a cause, but exactly how much of a cause it was. Getting the actual tissue gives them for more information. With Ally’s health and recovery taking priority, though, we never found that out.

In your paragraph I quoted above (“I think you need…”), your second sentence is true, but I still respectfully disagree with the first sentence. I still think the points I made are valid, but you’re right – complicating factors are also to blame, not just Motrin. At the least, even if you still think I’m taking this too far, I hope to show what factors make Motrin intake dangerous.

I hope this better explains my perspective and opinion. I originally was going to include much of this in the original article, but I didn’t want to make it too long. I guess I should’ve!

I am glad your daughter is feeling better!

Thank you! So are my wife and I. And so is Ally. Luckily, I think she’s already forgotten about the fear and the pain – she now talks about her hospital visit very casually and matter-of-fact. Sometimes it’s good to be young enough to forget. :)

Andy

Olivier,

I was wondering what you had in mind when you posted this episode.
What would you say is the take home message for the skeptical community?

I’d use a less specific version of the article title. Something like:

“Just because a drug is used all the time doesn’t mean it’s safe.”

Do you believe that one or both of them were unaware of anything you brought up here?

I don’t think so. I instead think they didn’t realize – or my wife and I didn’t make clear – the extent of my daughter’s flu/dehydration. It seems more likely this was an error of missing information, not a lack of knowledge.

Andy

I’m going to go on a limb here and say that I believe that most people know some dangers are associated with ibuprofen as well a acetaminophen. Granted, I didn’t know there existed contraindication in regards to children. But I don’t think anybody takes it for granted that a drug is safe because it is used all the time.
 
I understand that it is your right to publish what you wish to publish. That being said, I am not sure I fully appreciate the goal of this article. You have just responded to my message telling me that you believe that what happened to your daughter was caused by missing information… on your part. I  cannot seem to be able to link this back to the title of the article, or the alternative one you suggested in your response. How is the missing information about your daughter’s condition in anyway related to the “hidden dangers with ibuprofen [and] flu treatment”?
I don’t mean to sound harsh and if I appear to be I am sorry.

Olivier,

I believe that most people know some dangers are associated with ibuprofen as well a acetaminophen.

I had no idea about such dangers. Hopefully I’ve provided helpful information to someone.

How is the missing information about your daughter’s condition in anyway related to the “hidden dangers with ibuprofen [and] flu treatment”?

To me, they are connected. Here’s what I mean:

My wife and I subscribe to a couple “parent magazines”. These are sometimes helpful, since they talk about developmental stages for your children, give ideas for cheap or free activities, and review various kid toys and books. In each magazine, though, are what my wife and I call “I-almost-killed-my-kid-stories”. They’re stories sent in by parents whose children had an experience that almost turned dangerous or deadly. Some of these seemingly exist just to scare you: “My toddler almost strangled herself on a window shade cord.” Or “My son broke his arm in his crib.”

One thing that’s struck me as a young, first-time parent is the amount you have to know to simply keep your kid out of danger. Not the stuff you know intuitively, not being simply alarmist, but the stuff you’d never know without research or having others’ help. Like:

-Don’t give your kid peanuts or honey within the first year, since that increases the chances of food allergies.

-The baby’s immune system isn’t fully developed until three months or so, so take extra care not to expose her to germs.

-Put your baby on her back when she sleeps to decrease the chance of Sudden Infant Death Syndrome (SIDS).

- Keep pregnant women away from cats and cat poop, as exposure to certain feline parasites can cause miscarriage.

The article I wrote was meant to be one of these types of warnings, where you may not have known about this without someone telling you, where the information presented was contrary to what the “average person” might think, where you may not have acquired this information by the act of parenting.

This is my answer to your questioning the connection between topic and title. The title provides what I think is the popular assumption (there are no hidden dangers with flu treatment / ibuprofen). The article – and, increasingly, my followup comments! – are the detail why this is not the case.

I understand that it is your right to publish what you wish to publish.

Since I run the website, yes, this is true. And while I’ve rejected quite a few article ideas, you might be surprised: I’ve published many articles by others that I don’t agree with. If someone is a good writer, sincere, has a topic supported by at least some in the skeptical community, and supports their case with critical thinking, I might just publish it. Even if don’t agree with the conclusion. To me, the skeptical method of analysis is just as important as the facts of the article.

I don’t mean to sound harsh and if I appear to be I am sorry.

Not at all – Critique away! You are of course allowed to disagree with me. That’s one of the reasons I created DBS: “To provide a forum for people to share their articles and debate respectfully with others.“

Andy

Guggie,

Given in conjunction with vaccines, studies show it can cause mitochondrial dysfunction, predisposition to Autism and a lowered response to the vaccines themselves.

…can you give a citation for this?

Slightly off topic: how did your little one respond to a bit of flat soda?

She threw it up within an hour. That was one day before we went to the ER. Or possibly the day of the ER. The timeline is starting to blur.

Andy

Thanks, Sandy, for the kind words. I’m glad you’re doing better, too!