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doi: 10.3390/ijms20184472 16 LuJLiuJLiA

Documented Long-Term Side Effects of NSAIDs Regular or long-term NSAID use has been associated with: Damage to the gut lining, increasing intestinal permeability (leaky gut) and immune activation (27,29,31) Reduced absorption of key nutrients, including iron, folate, and vitamin C (28,29) Delayed tissue repair , particularly in connective tissue where prostaglandins are required for healing (32) Kidney stress and electrolyte imbalance , especially during dehydration or endurance activity (30) Increased cardiovascular risk , particularly with higher doses or prolonged exposure (30) These effects help explain why NSAIDs may temporarily reduce pain while progressively impairing healing capacity, increasing systemic inflammation, and slowing long-term recovery