By Dr. Mercola
Given the fact that acetaminophen (sold under the brand name
Tylenol, among others) is one of the most widely used drugs
in the world, you might be surprised to learn that taking just a
bit too much, on a regular basis, or taking it in combination
with alcohol, can have rather significant health risks.
The drug can have adverse effects on your liver and kidneys,
and acetaminophen-containing prescription drugs must now carry a
warning about the potential for serious and potentially lethal
skin disorders.
Acetaminophen can be toxic to your liver, even at recommended
doses, when taken daily for just a couple of weeks.1
Research2
has also shown that taking just a little more than the
recommended dose over the course of several days or weeks
(referred to as “staggered overdosing”) is far more risky than
taking one large overdose.
Unfortunately, familiarity with this drug and the false sense
of security it can bring puts many in harm’s way. When suffering
with a cold, headache or other pain, many end up doubling or
even tripling the maximum recommended dose by taking multiple
OTC medications, all of which may contain acetaminophen at
varying amounts.
Certain prescription painkillers, such as Vicodin and
Percocet, also contain acetaminophen and should therefore not be
mixed with other acetaminophen-containing medications.
Failing to heed this warning can easily lead to an overdose,
which can cause serious liver damage or liver failure.
Acetaminophen is actually the number one cause of acute
liver failure in the US.
Tylenol + Alcohol = 123 Percent Increased Risk of Kidney Damage
Recent research3
suggests that acetaminophen also significantly increases your
risk of kidney dysfunction if taken with alcohol—even if the
amount of alcohol is small. The findings were presented at the
141st annual American Public Health Association meeting in
Boston, Massachusetts.
4
The risk is worrisome enough that the researchers advise
doctors who recommend acetaminophen for pain management to
educate their patients about the risks of mixing it with
alcohol. Besides alcoholics,5
young adults are particularly at risk as they’re more likely to
consume both.
The video above specifically addresses the potential hazards
of using Tylenol to treat a hangover.
When you consider that both excessive alcohol consumption and
regular use of acetaminophen can promote kidney toxicity and/or
damage,6,
7 it’s not a major stretch to imagine that combining
them might heighten such risks.
Data from more than 10,000 participants was analyzed for the
featured study. In all, 2.6 percent of participants reported
using acetaminophen together with small to moderate amounts of
alcohol, and 1.2 percent of those who did so had impaired kidney
function.
While that might not sound like much of a worry, the
researchers found that the combination of alcohol with
acetaminophen raised the risk of kidney damage by 123
percent, compared to either of them taken individually.
According to the authors:
"Although individually it may not be harmful to
ingest therapeutic dose of acetaminophen and a
light/moderate amount of alcohol, combining the two may be
potentially hazardous.”
Acetaminophen May Reduce Immune Function
When a medication is sold without a prescription and used
with such frequency as acetaminophen, it’s easy to forget that
every drug carries the potential for causing adverse
effects—especially if used in combination with other drugs.
Interestingly, little-known research from 2009 suggests
acetaminophen might render vaccinations less effective when
administered together.
Since vaccine-induced immunity is already inferior to
naturally acquired immunity, it certainly doesn’t make sense to
take something that might reduce whatever meager effectiveness a
vaccine might offer.
According to this Czechoslovakian study,8
infants who received acetaminophen right after getting a
vaccination experienced lowered immune response, developing
significantly fewer antibodies against the disease they were
vaccinated against.
The vaccines used in the study were for pneumococcal disease,
Haemophilus influenzae type b (Hib), diphtheria, tetanus,
whooping cough, hepatitis B, polio and rotavirus. (No flu
vaccines were included. However, it’s likely the effect might
still be the same.) The authors concluded that:
“Although febrile reactions significantly decreased,
prophylactic administration of antipyretic drugs at the time
of vaccination should not be routinely recommended since
antibody responses to several vaccine antigens were
reduced.”
The researchers suggested that the acetaminophen’s
anti-inflammatory activity might interfere with your body’s
immune system antibody response, which could explain why the
vaccines were rendered less effective. It’s worth noting that a
lowered immune response also means you're more susceptible to
develop other infections.
And, as we now know, in the case of the flu for example, it
is secondary infections such as bacterial staph
infections that turn out to be deadly -- not the flu virus in
and of itself. From that perspective, it may be worth
reconsidering your use of acetaminophen when you feel like
you’re “coming down with something.” You just might be better
off skipping the pain reliever, and taking steps to
boost your immune system instead, such as boosting your
vitamin D levels.
Beware of Fatal Skin Reactions
The potential hazards of this medicine cabinet staple don’t
end at liver and kidney damage. After reviewing data from the
FDA Adverse Event Reporting System (FAERS), the FDA found 107
cases of serious skin reactions linked to acetaminophen products
from 1969 to 2012. Sixty-seven of them required hospitalization;
12 died. The data, coupled with several cases documented in
medical literature, has prompted the FDA to require a warning
about potential skin reactions be added to prescription
acetaminophen products.9
The skin reactions linked to acetaminophen include:
- Stevens-Johnson Syndrome (SJS): This
reaction begins with flu-like symptoms that progress into a
painful purple or red rash that blisters and causes the top
layer of your skin to slough off. This can lead to serious
infections, blindness, damage to internal organs, permanent
skin damage and even death.
- Toxic Epidermal Necrolysis (TENS): TENS
also typically begins with flu-like symptoms (cough,
headache, aches, fever) and progresses into a blistering
rash. Layers of the skin may peel away in sheets, and hair
and nails may fall out. TENS is often fatal, typically as a
result of infection.
- Acute Generalized Exanthematous Pustulosis
(AGEP): This skin eruption causes numerous pustules
to appear on the skin, often accompanied by fever. This
condition typically resolves within two weeks once the
acetaminophen is stopped.
While the main cause of SJS, TENS and AGEP is the consumption
of certain acetaminophen-containing medications, no one knows
exactly why it occurs, or what makes certain people more at
risk. What is particularly alarming is that it can occur at any
time, even if you’ve taken the medication in the past without
issue. According to the FDA:10
“A serious skin reaction can occur at any time, even
if you've taken acetaminophen previously without a problem.
There is currently no way of predicting who might be at
higher risk. If you've ever had a skin reaction when
taking acetaminophen, don't take the drug again…“
[Emphasis mine]
Boosting Your Glutathione Levels May Help Counteract
Acetaminophen Hazards
While I generally do not recommend using
acetaminophen-containing drugs for minor aches and pains, given
their health risks, they are sometimes necessary to temporarily
suppress severe pain, such as post-surgical pain. For those
instances, I recommend taking it along with N-acetyl cysteine
(NAC), which is the rate-limiting nutrient for the formation of
the intracellular antioxidant glutathione. It is believed that
the liver damage acetaminophen causes is largely due to the fact
that it can deplete glutathione, an antioxidant compound
secreted by your liver in response to toxic exposure.
Glutathione also helps protect your cells from free radical
damage.
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. Bear in mind that while this may help prevent
liver damage from occurring, I’m not aware of any evidence
supporting its use for the prevention of kidney toxicity and/or
potential skin reactions.
Foundational Strategies to Address Chronic Pain
Chronic pain is perhaps one of the most common ailments there
is. And while different diseases and conditions may benefit from
specific pain-relieving strategies, I believe the following
guidelines are foundational basics for the treatment of most if
not all painful conditions.
- Get sufficient high-quality, animal-based
omega-3 fats. Omega-3 fats are precursors to
mediators of inflammation called prostaglandins. One of the
best sources of omega-3s is krill oil supplement. The
omega-3 fats EPA and DHA contained in krill oil have been
found in many animal and clinical studies to have
anti-inflammatory properties. Unlike fish oil, krill oil
does not pose any toxicity and rancidity to your body, which
may only damage your health. It is also far lower on the
food chain, making it far less likely to accumulate
environmental chemicals and toxins.
- Eliminate or radically reduce your intake of
grains and sugars, especially fructose. Excessive
intake of grains and sugars will elevate your insulin and
leptin levels primarily through causing your body to be
resistant to them, resulting in increased inflammation in
your body.
- Optimize your vitamin D levels through regular
and appropriate sun exposure. Combined with vitamin
K2, vitamin D can help prevent the softening of your bones
that can often lead to lower back pain.
Sun exposure also has pain-killing or analgesic
properties beyond vitamin D production. Research has shown
sun exposure can be quite beneficial for fibromyalgia pain
for example.
- Avoid aspartame and MSG, both of which
are notorious for causing headaches and triggering
migraines.
- Grounding. Walking barefoot;
grounding your body to the Earth, is a simple way to
reduce chronic inflammation and pain. When you're grounded,
there's a transfer of free electrons, which are among the
most potent antioxidants currently known, from the Earth
into your body. The effect is sufficient to maintain your
body at the same negatively charged electrical potential as
the Earth.
This results in a number of health benefits, including
calming your sympathetic nervous system which produces
beneficial changes in heart rate and blood pressure,
improved sleep, decreased levels of inflammation, reduced
pain, and an improved general state of well-being. It also
thins your blood and reduces your blood viscosity, resulting
in improved blood flow throughout your body.
Research has demonstrated it takes about 80 minutes for
the free electrons from the earth to reach your bloodstream
and transform your blood. A newer theory also proposes that
grounding may facilitate the formation of structured water
in your body, which may be critical for optimal health. To
learn more about this, please see m y interview with water
expert
Dr. Gerald Pollack.
Effective Pain-Relieving Modalities: Laser Therapy, EFT, and
More
I recently interviewed
Dr. Phil Harrington about the benefits of infrared laser
therapy for pain. Laser therapy treatment helps reduce pain and
inflammation and enhances tissue healing—both in hard and soft
tissues, including muscles, ligaments, and even bones. It
increases oxygenation of tissues and allows injured or damaged
cells to absorb photons of light, which speeds healing. While
there are a number of companies that manufacture lasers for
tissue healing,
K-Laser is currently the leading manufacturer of these types
of infrared laser tools. Examples of the types of painful
injuries that this kind of laser therapy can be helpful for
include:
- Acute injuries, such as strains, sprains, and shoulder
injuries
- Repetitive-use injuries such as carpal tunnel syndrome
- Traumatic injuries, such as post-motor vehicle accident
with cervical strain/sprain
- Chronic issues such as frozen shoulder and arthritis
To me, at this point in time, it would almost be medical
negligence bordering on medical malpractice not to try laser
treatment before prescribing drugs or surgery for conditions
such as these. Other
therapeutic mind-body modalities such as
Emotional Freedom Techniques (EFT), yoga, acupuncture,
meditation, hot and cold packs, and
Foundation Training can also result in astonishing pain
relief without any drugs. It’s worth noting that EFT is
effective against both acute and chronic pain.
Pain-Relieving Alternatives to Acetaminophen (and Other
Analgesic Drugs)
The following options can also provide excellent pain relief
without any of the health hazards associated with acetaminophen
and other pain killers.
- 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 a potent
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 study11
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 to have
potent anti-inflammatory activity, as well as demonstrating
the ability in four studies to reduce Tylenol-associated
adverse health effects.12
- 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.
- 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.
You Can Avoid the Painkiller Trap
Whether you’re trying to address acute or chronic pain, know
that there are many safe and effective alternatives to more
hazardous prescription and over-the-counter painkillers. K-Laser
therapy can be an excellent choice for many painful conditions,
including acute injuries.
For long-term relief, you'll want to start taking a
high-quality, animal-based omega-3 fat like krill oil, as
omega-3 fats are precursors to mediators of inflammation called
prostaglandins. Addressing your diet by eliminating or radically
reducing most grains and sugars (including fructose) is also
important, as 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.
I also recommend optimizing your production of
vitamin D by getting regular, appropriate sun exposure,
which will work through a variety of different mechanisms to
reduce your pain. Along with these strategies, be sure you are
also addressing any emotional elements. EFT is particularly
useful for this—whether your pain is chronic or acute. In both
instances, your level of stress, your anxiety and your
perceptions of pain all play a role in how you experience pain,
and addressing these elements can go a long way toward providing
effective pain relief.
© Copyright 1997-2013 Dr. Joseph Mercola. All Rights Reserved.