By Dr. Mercola
If you use acetaminophen-containing products (such as Tylenol) for minor aches and pains, or prescription drugs like Vicodin (which also contain it), please be very careful about the dose.
As new research confirms, even a very slight overdose over the course of several days could be deadly.
In fact, a new study, led by Dr. Kenneth Simpson of the University of Edinburgh in Scotland, found that you’re more likely to die from a “staggered overdose” (taking just a little bit too much for several days or weeks) of Tylenol than from a single large overdose.
Among the people who took a staggered overdose of Tylenol, 37 percent died, compared to 28 percent of those who took one large overdose.
Given the fact that Tylenol is one of the most common drugs in the world, with billions of doses purchased in the United States each year, you might be surprised to learn that taking just a bit too much, on a regular basis, could be deadly — but it’s a very real, and very significant, risk.
Acetaminophen is the Number One Cause of Acute Liver Failure in the United States
Yes … you read that correctly, the number one cause!
But because Tylenol and related products are familiar household items, many people are completely unaware that these drugs can be toxic to your liver, even at recommended doses such as eight extra-strength Tylenol tablets daily for a couple of weeks.
It’s surprisingly easy to take too much acetaminophen, especially for those who are struggling with chronic pain or multiple conditions, such as headache, toothache and/or backache. Many people would not think twice about upping their dose “just a little bit” to help take the edge off the pain — but this can turn into an unintentional “staggered overdose,” which can lead to liver failure, liver transplant and even death.
What makes the danger so insidious is that many users will not equate the initial overdose symptoms of nausea, vomiting and abdominal pain with the Tylenol they took hours or days before. Many will not even mention it to their physician or in the emergency room, and even if a physician were to suspect acetaminophen as a culprit, tests would not likely reveal high enough levels in the patient’s system to indicate a problem.
This frequently delays treatment, which is available in the form of N-acetyl cysteine (NAC) (more on this shortly) – a move that can be deadly because the sooner NAC is given, the more effective it is at preventing liver damage.
The previously mentioned study, in fact, found that getting medical help more than 24 hours after an overdose increased the risk of death or the need for a liver transplant, compared to those who got help sooner.
Medications You Might Not Expect Contain Acetaminophen
Adding to the problem is the fact that acetaminophen is not only in products labeled as “Tylenol.” It’s also widely used in cold and flu and other over-the-counter medications.
Of course, when many people have a cold, headache or other ache or pain, they don’t just take two Tylenol and leave it at that. Many people double or triple-up, taking multiple OTC medications, all of which may contain acetaminophen.
Prescription painkillers like Vicodin and Percocet also contain acetaminophen, so it’s actually very easy to overdose unintentionally, and thereby cause serious liver damage, liver failure or even death.
This was precisely the reason why the U.S. Food and Drug Administration (FDA) asked manufacturers of prescription acetaminophen combination products in early 2011 to limit the maximum amount of acetaminophen in these products to 325 mg per dose, as well as required manufacturers to update labels of all such products to warn of the potential risk for severe liver injury.
There are over-the-counter Tylenol products, however, that currently contain well over 325 milligrams of acetaminophen. These will not be included in this new limit, even though they’re easier to obtain, and so you will have to watch out for this risk yourself.
There are other serious health risks associated with acetaminophen use, and they’re significant enough, even without the risk of liver damage, that I do not recommend taking this drug for minor aches and pains. Some of these include:
If You Take Tylenol, Be Sure toTake NAC With It
While I do not believe acetaminophen-containing drugs are appropriate for minor aches and pains, given their significant risks, they are sometimes necessary to suppress severe pain, such as while you are recovering from an injury or surgery, or while you are seeking to address the underlying cause of your pain.
For those instances, make sure you are also taking N-acetyl cysteine (NAC), which is the rate-limiting nutrient for the formation of the intracellular antioxidant glutathione.
It’s thought that Tylenol causes its damage by depleting glutathione, an antioxidant that protects cells from toxins such as free radicals. If you keep your glutathione levels up, the damage from the acetaminophen may be largely preventable. This is why anyone who overdoses on Tylenol receives large doses of NAC in the emergency room.
So whether you are taking Tylenol in prescription or over-the-counter form, I strongly suggest taking NAC along with it.
Safe Tips for Relieving Pain Naturally
It’s completely understandable to want to eliminate pain, and doing so can make an immense difference in your quality of life. However, please understand that there are many safe and effective alternatives to prescription and over-the-counter painkillers, though they may require some patience.
Among the best are:
- Start taking a high-quality, animal-based omega-3 fat like krill oil. Omega-3 fats are precursors to mediators of inflammation called prostaglandins. (In fact, that is how anti-inflammatory painkillers work, they positivelyik influence prostaglandins.) The omega-3 fats EPA and DHA contained in krill oil have also been found in many animal and clinical studies to have anti-inflammatory properties.
- Eliminate or radically reduce most grains and sugars (including fructose) from your diet. Avoiding grains and sugars will lower your insulin and leptin levels. Elevated insulin and leptin levels are one of the most profound stimulators of inflammatory prostaglandin production.. That is why eliminating sugar and grains is so important to controlling your pain and other types of chronic illnesses.
- Optimize your production of vitamin D by getting regular, appropriate sun exposure, which will work through a variety of different mechanisms to reduce your pain.
In the meantime, you don’t need to suffer unnecessarily. The following options provide excellent pain relief without any of the health hazards that acetaminophen and other pain relievers carry:
- Astaxanthin: One of the most effective oil-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than many NSAIDs. Higher doses are typically required and one may need 8 mg or more per day to achieve this benefit.
- Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
- Curcumin: Curcumin is the primary therapeutic compound identified in the spice turmeric. In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility. In fact, curcumin has been shown in over 50 clinical studies to have potent anti-inflammatory activity, as well as demonstrating the ability in four studies to reduce Tylenol-associated adverse health effects.
- Boswellia: Also known as boswellin or “Indian frankincense,” this herb contains powerful anti-inflammatory properties which have been prized for thousands of years. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
- Bromelain: This protein-digesting enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form, but eating fresh pineapple may also be helpful.
- Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a “joint lubricant” and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.
- Evening Primrose, Black Currant and Borage Oils: These contain the fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
- Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body’s supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
- Therapeutic modalities such as yoga, acupuncture, meditation, hot and cold packs, and even holding hands can also result in astonishing pain relief without any drugs.