October is “liver awareness month” according to the American Liver Foundation. Unless you work in a health related field or you or a loved one have liver disease, such as a hepatitis B or C infection, you’re probably not often thinking about what the human liver does. In short, the liver is a chemical factory. It synthesizes, converts, filters, and stores all sorts of important biochemicals.
One of the major function of this chemical factory is ridding your body of the chemical poisons that it encounters. Paint fumes, alcohol, and medicines are among the poisons that it filters out of the body every day. The liver and kidney are the main organs responsible for detoxifying your body. Perhaps surprisingly, there are some common toxins that people actually put into their bodies in hopes of improving their well-being that severely disrupt the detoxification abilities of these organs. People sometimes are hospitalized or even die as a result. Among the worst of these offenders are common nonprescription painkillers that many think are so safe they feed them to their children.
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Tylenol: A Common Deadly Poison
While it’s obvious that sniffing paint, doing vodka shots until you’re drunk, and chemotherapy are all hard on your liver, what you may not realize is that there are some very common medicines that nearly everybody has sitting in their medicine cabinets that can completely destroy your liver. Even when they are used according to directions, they may very well hospitalize or even kill you. At the top of my list of such seemingly safe but deadly dangerous drugs is the painkiller Tylenol, also known as acetaminophen or paracetamol.
Johnson & Johnson and their nonprescription drug unit McNeil Products and other big-name vendors spend millions every year encouraging you to wrongly believe that this drug is so safe that it’s even OK for little kids. This is extremely dangerous misinformation. That’s because even properly manufactured Tylenol, without contamination leading to the recalls, is a severe risk to liver health. Along with the painkiller effect, the drug causes rapid and severe depletion of the critical antioxidants glutathione and S-adenosyl-L-methionine (SAMe). The effect is probably the most severe in the liver, but also clearly affects the kidney, another important detoxification organ. In a person who is already ill or has been taking Tylenol chronically, the body’s glutathione levels are already very likely low and the risk of even a standard dose of the drug is significant.
You may suspect that this is a new problem. After all, Tylenol has been around for years and recent news has featured so many stories about poor quality control that has caused the FDA to demand repeated massive Tylenol recalls in the last year. The McNeil Products division of Johnson & Johnson is facing a criminal investigation for its irresponsible and deception actions. People are buying much less of the product, likely because of all the bad news:
Consumers are clearly wary of the company’s recent recall record. Sales of Children’s Tylenol are down 96 percent, and adult Tylenol and Motrin sales are down 56 percent from last year.
The drop in sales has been a drag on Johnson & Johnson’s stock price, which closed down today at 60.54. It had been over 66 in April.
But the deadly nature of Tylenol is not new. It is intrinsic to the drug and has been well-known for many decades. It has nothing to do with bits of contaminants leading to recent recalls. Personally, I hope that Tylenol sales never recover unless the company is willing to address the intrinsic flaws in the product that can make people who use it deathly ill.
A 25-year-old, healthy Swedish man developed gastroenteritis while on holiday in Turkey. For a day and a half before flying home, the man experienced nausea and vomiting, and he was unable to keep food or liquid down. Noticeably ill during the flight, upon landing he was taken directly to a hospital. As his condition worsened, he was diagnosed with liver failure and transferred to await a liver transplant. Information from his brother, who had been with him in Turkey, indicated that the patient had taken 500 mg to 1,000 mg of acetaminophen two to three times each day, with a maximum total intake of 5,000-6,000 mg over two days. Unexpectedly, the patient’s condition began to improve, liver transplantation was canceled, and he was discharged ten days later.1
What had the Swedish man done wrong to develop liver failure? Nothing. His use of acetaminophen was within the recommended dosage range. The maximum recommended dosage of acetaminophen is 4,000 mg/day. The man took only 2,000 or 3,000 mg/day. He took acetaminophen merely to ease the pain of acute gastroenteritis, as do thousands of people each day. He followed the rules but nearly died.
Tylenol Leads to Less Reye’s Syndrome, More Liver Failure
Tylenol became rapidly popular in part after the word got out that using aspirin in children who suffer flu-like or other viral illnesses can cause Reye’s Syndrome, a potentially fatal reaction causing hypoglycemia (low blood sugar) and damage to the brain, liver, and other organs. At its peak, over 500 children per year in the US were afflicted with this illness. Today, it’s only a handful each year.
The makers of Tylenol and chemically related drugs would probably like you to believe that their drugs somehow have saved lives. Actually, they are the number one cause for acute liver failure worldwide. They are also a major culprit in other liver diseases as well as kidney cancer. As they are included in many drugs without the Tylenol name, including many nonprescription cold and cough medicines, you may be consuming this dangerous chemical without even being aware of it.
Found in more than 100 OTC preparations, including Sudafed®, Theraflu®, and Tylenol®, acetaminophen is used to reduce pain and fever. It has been available in the United States since 1960. Unlike NSAIDs, acetaminophen does not reduce inflammation or blood clotting or cause gastric complications (Roberts LJ et al 2001).
Nevertheless, acetaminophen overdose is one the most common causes of OTC drug poisoning in the United States and Britain. More than 30,000 cases per year of acetaminophen overdose are reported to the American Association of Poison Control Centers (Bartlett D 2004). It is a leading cause of liver failure in the Western world and the leading cause of drug-induced liver failure in the United States (Bartlett D 2004).
People who have liver disorders or who consume large amounts of alcohol are advised to avoid acetaminophen, which can damage both the kidneys and the liver, even at therapeutic doses (Bromer MQ et al 2003). People who use acetaminophen on a regular basis double their risk of kidney cancer (Kaye JA et al 2001; Gago-Dominguez M et al 1999; Derby LE et al 1996).
Using Tylenol Safely
If you must use a painkiller, there are several steps you can take to vastly reduce the risk of Tylenol.
Never, ever mix Tylenol, acetaminophen, or paracetamol or products containing them with alcohol. Both of them put a severe detox load on the liver, combined they are far more likely to result in severe health effects.
Pay close attention to the ingredients in all drugs you are using. Codeine, Vicodin, and cough and cold medicines are all common places to find large doses of acetaminophen. For instance, you may pop a few codeine tablets per day after your major dental surgery, being careful to not go over the listed dosage, and think you can get a little more pain relief with an extra Tylenol tablet here and there. That’s very likely to put you into danger territory, greatly exceeding the safe limits for acetaminophen for even healthy people.
If you are having trouble holding down fluids and food or have been on a crash diet, avoid acetaminophen entirely. People in such conditions are far more likely to have impaired liver function that makes them far more susceptible to liver damage.
Finally, combine Tylenol with vitamin C and the inexpensive amino acid NAC (N-acetyl cysteine). The vitamin C helps keep the NAC from oxidizing in the body, and the NAC helps the liver pump out increased quantities of glutathione, thus protecting it and the whole body from the worst effects of the Tylenol.
Take somewhere around 600mg to 2400mg of NAC per day spread out in one to four doses of 600mg each along with a somewhat larger amount of vitamin C. NAC commonly comes in 600mg capsules, vitamin C often comes in 500mg or 1000mg tables or capsules. Both are cheap insurance to vastly lower the risk of liver damage from acetaminophen. Taking a 600mg NAC capsule with a 1000mg vitamin C tablet is a good balance of the two.
SAMe (S-adenosyl-L-methionine) is another supplement that is reputed to help boost the liver’s glutathione production. SAMe, however, is vastly more expensive than NAC. If cost is a concern and liver health is the main benefit desired, NAC is probably the better choice. SAMe has many other effects, however, particularly related to joint pain and depression, so don’t rule out its use simply because you’re using NAC. The two can be combined safely.
Some find that NAC has major benefits for immune system functioning — it’s often touted as a preventive supplement during flu season. I consider NAC a mainstay supplement given how research and practical medical experience shows it supports liver health and immune system functioning. Growing research has tied using larger doses of NAC, typically 1200mg to 3000mg per day or more, as a potential help for mental health conditions like obsessive-compulsive disorder and compulsive hair pulling, nail biting, and similar behaviors. I routinely take 600mg to 1200mg of NAC and around 4000mg of vitamin C most days, even though I rarely ever take Tylenol.
If you can find a source, the least expensive form of NAC may be NAC bulk powder that dissolves in water fairly easily but has a slight taste and smell of sulfur. It is often more convenient to use NAC in capsules, however. In capsule form, both NOW Foods and Swanson Health Products are priced competitively and now that some of my favorite sources for bulk NAC are no longer availabe, they might be the least expensive sources.
I’d not waste my money on “boutique brands” as NAC is a really simple amino acid, not anything that requires special research or processes to manufacture well. Companies like those two, as well as other GMP (Good Manufacturing Practice) certified supplement vendors, are perfectly well qualified to be making NAC capsules.
Don’t forget to take some vitamin C and plenty of water with the NAC for best effect. This improves how the NAC will work in the body both for increased glutathione production as well as helping to ensure it doesn’t cause a rare condition in which it crystalizes and acts somewhat like kidney stones.
Finally, to drive home the point of how useful NAC is for preventing the worst of the damage from Tylenol, consider that it is the treatment of choice for Tylenol poisoning used as a routine medical practice. It’s been pointed out that if Tylenol was reformulated to add NAC to the product, nearly all hospitalizations and deaths related to its usage could be eliminated.
(from Deadly FDA Neglect)
Since acetaminophen and N-acetyl cysteine are both sold over-the-counter, you might think that making a “safer” acetaminophen formula would not be difficult.
There is one problem. The FDA prohibits combining existing drugs and dietary supplements unless a New Drug Application is filed, tens of millions of dollars of clinical studies are performed, and the FDA agrees to allow the combination to be sold. The whole process can cost upwards of $100 million and take a decade to complete.
So by bureaucratic edict, a safer form of acetaminophen never made it to market.
The main obstacle to this simple cost-effective improvement is that the FDA isn’t actually focused on its stated job of protecting the public, it functions more as a profit-enabler agency for its big pharma friends to help them bring to market endless minor variations of common drugs. Such drugs often do little different from other similar drugs that have gone off patent and are available as inexpensive generics, but they do help line the bank accounts of big pharma companies with lucrative income streams and ensure that they will continue to direct billions of dollars in application fees to the FDA every year. The FDA would rather continue to participate in this scam as it lets generic drug approvals languish with inadequate staffing and funding, virtually ensuring that there will never be a safer form of Tylenol so long as the FDA has its way.
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