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Stumble It!What Every User of Acetaminophen Needs to Know
by DrLauraMarkham
Most parents think of Tylenol as a wonder drug -- harmless, readily available, and a miraculous cure for teething fussiness, ear infection pain, fevers and other childhood maladies. But when an old friend's son died recently from tylenol poisoning, I did some research. Call me naive, but I was shocked by what I learned.
Apparently, Tylenol/Acetaminophen is toxic to the human body. It causes liver poisoning. The analgesic effects derive from the liver's attempt to fight the tylenol by releasing enzymes to break it down. A liver that is not healthy or that is overwhelmed by other toxins (such as alcohol), or that has not been sufficiently fueled by food intake, can become overwhelmed and fail, leaving the poison in the body to cause organ damage and death.
The danger is that there isn't much difference between a safe, effective dose, and a toxic dose. Just a doubling of the maximum daily dose can be enough to kill, warns Dr. Anne Larson of the University of Washington Medical Center. The other problem is that if you have no food in your stomach, or if you have alcohol in your system, or worse yet, both, (not relevant for your kids unless they're teenagers, but think about that tylenol you took for your hangover last month), the regular dosage can be toxic because of the overload to the liver.
Acetaminophen (the active ingredient in tylenol) accounts for 100,000 calls to poison control centers, 56,000 emergency room visits, 26,000 hospitalizations, and 450 deaths annually.
A study published in the Journal of the American Medical Association found that even at recommended doses, acetaminophen can cause organ damage. Out of 106 patients in the study, 39% who took acetaminophen showed increases in liver enzymes to more than three times the normal upper limit, indicating potential liver damage. Another 25% of the patients had enzyme levels at five times the normal level, while 7% of the patients' enzyme levels increased to eight times the normal level! Their enzyme levels continued to increase for up to four days after the acetaminophen was stopped, and their enzyme levels did not return to normal for as long as 11 days, researchers said.
"This study shows that even taking the amount on the package can be a problem for some people," said Dr. William M. Lee of the University of Texas Southwestern Medical School, who was not involved in the study.
In another new study, in the Archives Of Internal Medicine, one in 10 women who took acetaminophen over an 11-year period experienced a 30 percent decline in kidney filtration function. The study showed that the more acetaminophen pills taken during a lifetime, the higher the risk of detrimental effects, indicating that the organ damage from even routine doses is cumulative.
If you choose to use acetaminophen in your household, follow common sense precautions to prevent poisoning:
1. Be certain you give the correct dosage. If you have both children's and infant's Tylenol in your house, be aware that the dosage is different. A teaspoon-full instead of a dropper-full of the wrong one can be lethal. Keep them in separate places so you don't mix them up at night.
2. Don't mix medicines. Be aware that most cold medicines contain acetaminophen. If you also give tylenol you are double dosing your child and risking liver failure.
3. Be sure all medicines are in child-safe containers, including that packet in your purse.
4. Be sure to educate any babysitters about tylenol safety.
5. Communicate with your spouse, babysitter, etc about any medicines given, and write down the time so the next dosage isn't given too soon.
6. Once your kids are old enough to self-medicate, educate! Don't let them be cavalier with tylenol or any medication. Make sure they know to consume tylenol with food, and not if they have been drinking. (My own view is that if a teen has a hangover, they should suffer the consequences. It's nature's way of curbing future excess.)
7. Be aware that many teen suicide attempts use tylenol as their method. "Acetaminophen has been a suicide drug of choice since the 1970s," says J. Ward Donovan, MD, FACMT, FACEP, medical toxicologist and emergency medicine specialist at Penn State Milton S. Hershey Medical Center, in the December 17 issue of Annals of Internal Medicine. "People can get it anywhere and use it without supervision in any amount they choose. And its biochemistry is such that is highly toxic at high doses."
The recommended dosage for a healthy adult is a maximum of four grams (4000 mg) in a 24 hour period. That's the equivalent of eight extra-strength tablets. If you suspect an overdose, do not hesitate to go to the emergency room.
About the Author
Dr. Laura Markham, the Dear Abby of Parenting, is a clinical psychologist who hosts the popular advice column "Ask Dr. Laura" at the parenting web site YourParentingSolutions.com, The Good Dr. answers questions from parents of infants through teens, offering parent-tested solutions you can use every day to connect with your kids and create a richer family life. Her work appears regularly on a dozen parenting sites and in print, and she frequently speaks with groups of parents, both online and in person, about transforming their parenting. Dr. Laura lives in New York with her husband, son and daughter.
Apparently, Tylenol/Acetaminophen is toxic to the human body. It causes liver poisoning. The analgesic effects derive from the liver's attempt to fight the tylenol by releasing enzymes to break it down. A liver that is not healthy or that is overwhelmed by other toxins (such as alcohol), or that has not been sufficiently fueled by food intake, can become overwhelmed and fail, leaving the poison in the body to cause organ damage and death.
The danger is that there isn't much difference between a safe, effective dose, and a toxic dose. Just a doubling of the maximum daily dose can be enough to kill, warns Dr. Anne Larson of the University of Washington Medical Center. The other problem is that if you have no food in your stomach, or if you have alcohol in your system, or worse yet, both, (not relevant for your kids unless they're teenagers, but think about that tylenol you took for your hangover last month), the regular dosage can be toxic because of the overload to the liver.
Acetaminophen (the active ingredient in tylenol) accounts for 100,000 calls to poison control centers, 56,000 emergency room visits, 26,000 hospitalizations, and 450 deaths annually.
A study published in the Journal of the American Medical Association found that even at recommended doses, acetaminophen can cause organ damage. Out of 106 patients in the study, 39% who took acetaminophen showed increases in liver enzymes to more than three times the normal upper limit, indicating potential liver damage. Another 25% of the patients had enzyme levels at five times the normal level, while 7% of the patients' enzyme levels increased to eight times the normal level! Their enzyme levels continued to increase for up to four days after the acetaminophen was stopped, and their enzyme levels did not return to normal for as long as 11 days, researchers said.
"This study shows that even taking the amount on the package can be a problem for some people," said Dr. William M. Lee of the University of Texas Southwestern Medical School, who was not involved in the study.
In another new study, in the Archives Of Internal Medicine, one in 10 women who took acetaminophen over an 11-year period experienced a 30 percent decline in kidney filtration function. The study showed that the more acetaminophen pills taken during a lifetime, the higher the risk of detrimental effects, indicating that the organ damage from even routine doses is cumulative.
If you choose to use acetaminophen in your household, follow common sense precautions to prevent poisoning:
1. Be certain you give the correct dosage. If you have both children's and infant's Tylenol in your house, be aware that the dosage is different. A teaspoon-full instead of a dropper-full of the wrong one can be lethal. Keep them in separate places so you don't mix them up at night.
2. Don't mix medicines. Be aware that most cold medicines contain acetaminophen. If you also give tylenol you are double dosing your child and risking liver failure.
3. Be sure all medicines are in child-safe containers, including that packet in your purse.
4. Be sure to educate any babysitters about tylenol safety.
5. Communicate with your spouse, babysitter, etc about any medicines given, and write down the time so the next dosage isn't given too soon.
6. Once your kids are old enough to self-medicate, educate! Don't let them be cavalier with tylenol or any medication. Make sure they know to consume tylenol with food, and not if they have been drinking. (My own view is that if a teen has a hangover, they should suffer the consequences. It's nature's way of curbing future excess.)
7. Be aware that many teen suicide attempts use tylenol as their method. "Acetaminophen has been a suicide drug of choice since the 1970s," says J. Ward Donovan, MD, FACMT, FACEP, medical toxicologist and emergency medicine specialist at Penn State Milton S. Hershey Medical Center, in the December 17 issue of Annals of Internal Medicine. "People can get it anywhere and use it without supervision in any amount they choose. And its biochemistry is such that is highly toxic at high doses."
The recommended dosage for a healthy adult is a maximum of four grams (4000 mg) in a 24 hour period. That's the equivalent of eight extra-strength tablets. If you suspect an overdose, do not hesitate to go to the emergency room.
About the Author
Dr. Laura Markham, the Dear Abby of Parenting, is a clinical psychologist who hosts the popular advice column "Ask Dr. Laura" at the parenting web site YourParentingSolutions.com, The Good Dr. answers questions from parents of infants through teens, offering parent-tested solutions you can use every day to connect with your kids and create a richer family life. Her work appears regularly on a dozen parenting sites and in print, and she frequently speaks with groups of parents, both online and in person, about transforming their parenting. Dr. Laura lives in New York with her husband, son and daughter.
Posted 7/3/2008 8:16:14 AM
About the Author
Dr. Laura Markham
View profile
New York, NY
About the Author
Dr. Laura Markham
View profile
New York, NY
Interests: Children and Families, Psychology, Being Human, Meditation, Yoga
This blog is written by an individual Wellness.com forum member and does not necessarily state the views of Wellness.com Incorporated or any of its affiliates.
Community Comments!
ben 7/8/2007 6:31:42 PM
Here's a scary story... we just got a 2AM call from my wife's Mother telling her that her sister (36 yrs old) was coughing up pints of blood all night and the doctors were afraid she might not make it to the morning. She was instructed to say her I love you's and goodbye's to her 3 kids, husband, sister, and parents while she went in for emergency surgery to determine the cause. The doctors found partially-undisolved acetaminophen tablets pasted to a couple nasty ulcers. They couldn't even operate because the ulcers were too bad and needed to heal a little first. She is not a drinker, but that night she had a couple margaritas too. Under a lot of stress, she developed these ulcers and managed the pain with acetaminophen. The result became deadly as she barely made it after splitting the lining of her stomach wide open. So, one of several morals of the story... don't use acetaminophen or other pain killers to "get by" when the next symptom you experience might be saying goodbye to your children. Pain is a warning signal that I suppose we have for a good reason. Acetaminophen does not appear to be a good pain killer for stomach issues as this almost killed her sister. Has anyone else experienced anything like this?
Ben
Ben
7/24/2007 1:29:02 PM
Ben-
what a story. I hope your wife's aunt recovers fully. Thanks for the precautions and the good advice.
Dr. Laura
Ben-
what a story. I hope your wife's aunt recovers fully. Thanks for the precautions and the good advice.
Dr. Laura
dfarrish 11/16/2007 10:53:39 AM
Patients who are thought to be at a high-risk or even only at a possible risk of developing acetaminophen liver injury are given the antidote, N-acetyl cystiene (Mucomyst) orally (or intravenously in Europe). This drug works by indirectly replenishing glutathione. The glutathione, detoxifies the toxic metabolite of the acetaminophen. The N-acetyl cystiene is most effective when administered within 12 to 16 hours after the acetaminophen was taken. Most physicians however, will administer N-acetyl cystiene even if the patient is first seen beyond this 16 hour period. Thus, a British study showed that patients already with liver failure who then received the N-acetyl cystiene were more likely to survive than patients who did not receive the antidote. Moreover, the survival occurred in these patients regardless of the time of initial administration of N-acetyl cystiene. Finally, people who recover from acetaminophen-induced liver damage are left, fortunately, with no residual or ongoing (chronic) liver disease.
Glutathione is found in every one of the trillions of cells in the body. It is most abundant in the liver and then the kidneys. These are the detoxifying organs. NAC N-acetyl cystiene is provided to patients in every hospital emergency situation in the USA for acetaminophen overdose. However NAC has many side effects to the health of the individual, but the alternative is certain death. So it is only administered in emergency room situations.
Immunocal is a natural product that is clinically proven to raise and sustain Glutathione values at the cellular level. Immunocal is listed in the Drug Physican Desk Reference (PDR) and the Pharmacist Red Book. Glutathione plays 40 or 50 different roles in the body one of which is detoxification. In fact mercury is the second most harmfull chemical to the body. Glutathione is the only substance that can remove mercury from the body. Glutathione is all so an Anti-Oxidant. Anti-oxidants such as vitamin C & E are natural anti-oxidants but they are not natural to your body. We inroduce them to our bodies through foods and supplements. Doctors refer to Glutathione as the master anti-oxidant not because Glutathione is natural to our bodies. It's referred to as the master anti-oxidant because none of the anti-oxidants that the medical community is familar with would work were it not for the presence of Glutathione. Glutathione controls and regulates all anti-oxidants. Glutathione all so plays a significant role in the immune system. Your Glutathione goes low so will your immune system. By rasing your Glutathione levels will all so enhance your immune system.
Glutathione is A.I.D.
Anti-oxidant:The master Anti-oxidant.
Immune System:Glutathione is fuel for the immune system.
Detoxification:Glutathione detoxifies the body.
I would love to discuss this subject further.
dfarrish@starband.net
Glutathione is found in every one of the trillions of cells in the body. It is most abundant in the liver and then the kidneys. These are the detoxifying organs. NAC N-acetyl cystiene is provided to patients in every hospital emergency situation in the USA for acetaminophen overdose. However NAC has many side effects to the health of the individual, but the alternative is certain death. So it is only administered in emergency room situations.
Immunocal is a natural product that is clinically proven to raise and sustain Glutathione values at the cellular level. Immunocal is listed in the Drug Physican Desk Reference (PDR) and the Pharmacist Red Book. Glutathione plays 40 or 50 different roles in the body one of which is detoxification. In fact mercury is the second most harmfull chemical to the body. Glutathione is the only substance that can remove mercury from the body. Glutathione is all so an Anti-Oxidant. Anti-oxidants such as vitamin C & E are natural anti-oxidants but they are not natural to your body. We inroduce them to our bodies through foods and supplements. Doctors refer to Glutathione as the master anti-oxidant not because Glutathione is natural to our bodies. It's referred to as the master anti-oxidant because none of the anti-oxidants that the medical community is familar with would work were it not for the presence of Glutathione. Glutathione controls and regulates all anti-oxidants. Glutathione all so plays a significant role in the immune system. Your Glutathione goes low so will your immune system. By rasing your Glutathione levels will all so enhance your immune system.
Glutathione is A.I.D.
Anti-oxidant:The master Anti-oxidant.
Immune System:Glutathione is fuel for the immune system.
Detoxification:Glutathione detoxifies the body.
I would love to discuss this subject further.
dfarrish@starband.net
rk325 9/23/2008 9:30:27 AM
After reading this post, I am scared. I have a 5 years old girl with "growing pains". We tried massaging and keeping those legs warm in the evenings and when going to sleep, but what can I do when she wakes up at 11pm CRYING because of pain? By 11pm her tummy muts be empty; we finished dinner at 6pm.....we gave her children's tylenol on 2 occasions she woke up crying....what else can we do? Are there other alternatives to pain? Massages y reassurance....but she asks for a medication....please help me on this.
9/23/2008 12:59:33 PM
RK325-
I know how hard it is when your child is in pain. I strongly suggest that you call your doctor to ask about giving her tylenol given that she has an empty stomach. It may make a difference just to give it with a glass of milk, but your doctor is the best judge of that.
RK325-
I know how hard it is when your child is in pain. I strongly suggest that you call your doctor to ask about giving her tylenol given that she has an empty stomach. It may make a difference just to give it with a glass of milk, but your doctor is the best judge of that.
ben 9/29/2008 1:33:23 PM
Thanks... FYI, her sister made it through---barely, but what a scare. Do not mix stress, alchohol and asprin. It is not worth the risk.
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