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to. But what of exercise’s impact on medicine? It’s a topic researchers recently focused with interesting results, concluding that “a drug’s dosage may need to be personalised for athletic individuals to ensure they remain effective and nontoxic”. The reasons for this are to do with both short-term physiological changes and long-term fitness adaptations. The former include diversion of blood away from the liver, reduced plasma volume and blunted drug-metabolising activity, all of which can change a drug’s blood concentration. Long term, changes in body composition, a more resilient gastrointestinal tract, greater bile production and enhanced enzyme activity can change how a drug is absorbed and metabolised. What does this mean for you, the athlete? The researchers aren’t clear but suggest it “poses lots of questions about drug efficacy”. It does, however, support the notion that drugs like ibuprofen should be avoided when training or racing.
