Table 3a. Symptoms and diseases associated with analgesic use in sport (excluding musculoskeletal system).
| Organ system | Symptoms/diseases | Sources | Remarks |
| Blood | Anemia | 9, 22, 23, 40 | Especially with ASA use: „sports anemia“ common in endurance athletes; anemia increased by hematuria and hematochezia; bone marrow suppression described |
| Bleeding diathesis | 6, 7, 20, 22, 33, e3, e11 | Especially with ASA use: increased bleeding on injury, increased risk of compartment syndrome, delays in necessary surgery | |
| Thrombembolism | 37, 40 | Mechanical stress on platelets; increased elimination in spleen might lead to formation of larger platelets | |
| Electrolytes | E.g. hyponatremia | 6, 7, 24, 30, 32, 33, 35, 38, e1, e3, e5–e7, e9, e11, e23 | Risk of electrolyte imbalance, local muscle cramping, seizures, and cardiac arrhythmias |
| Skin | Urticaria, angioedema | 18, 26 | |
| Cardiovascular | Cardiovascular problems | 10, 24, 28, 33, 34, 38, 39, 40, e7, e9, e23 | No further details of symptoms in the literature cited |
| Hyper-/hypotension | 9, 20, 24, 34, e1, e11 | Pathogenesis via the kidneys is discussed | |
| Arrhythmias | 6, 22, e18 | More common in the presence of electrolyte imbalance (among other things) | |
| Heart failure | 37, e17 | ||
| Myocardial infarction | 7, 37, 38, e23 | ||
| Liver | Liver damage | 25, 33, 39, 40, e11, e14 | Because of its limited duration and strength of action, paracetamol is often overdosed |
| Lungs | Asthma/ bronchospasm | 18, 24, 26, 33, 40, e3, e8, e11, e20 | Bronchospasm and asthma attacks often triggered by ASA in particular, especially in athletes due of the increased prevalence of asthma |
| Gastrointestinal | GI symptoms | 10, 18–20, 23, 26, 28, 30, 32, 34, 37, 38, e1, e4, e6, e7, e9, e11, e12, e20, e22, e23 | No further details of symptoms in the literature cited |
| Nausea, vomiting | 33, 39, 40, e7 | Reduced perfusion due to redistribution during sport Prostaglandins reduced by analgesics Mechanical stress and NSAIDs lead to reduced barrier function and increased permeability (toxic bacterial products, loss of fluids/electrolytes/blood) |
|
| Diarrhea | 19, 33, 40, e7 | ||
| Stomach ache, gastritis | 9, 19, 30, 33, 38–40, e7, e17, e18, e23, e24 | ||
| GI bleeding | 6, 8, 10, 22, 23, 33, 38–40, e2, e5, e7, e9, e17, e18, e23 | ||
| Ulcer | 25, 33, 39, 40 | ||
| Kidneys | Altered renal function | 9, 10, 18–21, 26, 28, 30, 34, 35, 38, 39, e9, e11, e12, e24 | Reduced kidney perfusion due to redistribution during physical activity and prostaglandins reduced by NSAIDs Kidneys stressed by i ncreased accumulation of metabolites with frequent fluid deficit (sweating, losses via GI tract, reduced fluid intake) |
| Hematuria | 6, 22, 23, 38, 40, e2, e18 | ||
| Chronic kidney failure | 18, 23, 25, 33, e1, e4, e14 | ||
| Acute kidney failure | 6, 20, 22, 24, 26, 32, 33, 35, 37, 40, e3, e5, e7, e9 | ||
| Central nervouse system | Fatigue | 18, 19 | |
| Dizziness | 18, 19, 39, 40 |
ASA, acetylsalicylic acid; GI, gastrointestinal; NSAIDs, nonsteroidal anti-inflammatory drugs