Updated: Jun 22
Many drugs can cause liver damage, liver failure, and death. Yet, acetaminophen prompts the most calls to poison control centers—more than 100,000 per year.
Paracetamol, also known as Acetaminophen is a very common over the counter painkiller - it is most commonly known as Tylenol, among other household brand names.
Acetaminophen alone is the leading cause of acute liver failure in the United States. It accounts for over 100,000 calls to poison control centers every year.
And is that wasn't troublesome enough, over the counter painkillers are responsible for about 56,000 emergency room visits and 26,000 hospitalizations every year in America.
How is it that a seemingly inoffensive and commonly used over the counter painkiller do this?
Whether you are a daily or an occasional Tylenol consumer, you are going to want to hear this:
There is a fine line between what a safe and what a dangerous dose of Acetaminophen is given that doses slightly above the suggested dose of 4/g a day can cause some serious liver damage.
The way it works has to do with the fact that Acetaminophen is a dose - dependent liver toxin and even at standard doses, metabolizing this compound releases small amounts of a toxic substance called N-acetyl-benzoquinoneimine (or NAPQI). The higher the dosage you take, a much larger amount of this toxin is released into your liver.
Acetaminophen is particularly toxic when taken on an empty stomach given that when fasted, the levels of glutathione (the body's own antioxidant and detoxifier) that are needed to safely metabolize acetaminophen, are at its lowest. The less glutathione in your body = the more risk of acetaminophen toxicity.
This is a list of some of the most frequently prescribed painkillers that contain acetaminophen. This list is by no means exhaustive as there are many other over the counter pills that contain this toxic compound.
Tylenol® No.2, Tylenol® No.3, Tylenol® No.4: acetaminophen and codeine
Vicodin®, Lorcet®, Lortab®,
Maxidone®, Zydone®: acetaminophen and hydrocodone
Percocet®, Roxicet®: acetaminophen and oxycodone
Fioricet®: acetaminophen, butalbital, and caffeine
Darvocet-N®, Wygesic®: acetaminophen and propoxyphene
Do the benefits outweigh the serious health conditions associated with daily acetaminophen use?
Over the counter painkillers have been marketed to normalize acute chronic pain in a way that neglects to target the root cause of pain in the first place. Moreover, these painkillers have been found to not also cause extreme stress on the liver but also destroy the stomach lining, have a dangerous blood thinning effect and can even alter your brain chemistry in the long run.
In summary - no, I do not believe the temporary painkilling effects of acetaminophen outweigh the long term serious health conditions it causes.
What if there was a better option?
TURMERIC, BOSWELLIA (Frankincense) & BLACK SESAME SEED OIL
These botanical ingredients have been known and used for centuries by Ayurvedic practitioners and many others in the field of functional medicine.
When combined, these components are 8.5 times more effective than Acetaminophen at relieving acute pain and reducing the emotional distress associated with pain without causing liver damage, damage of the stomach lining, blood thinning, among other side effects.
Turmeric (Curcuma longa)
Turmeric has gained popularity as one of the most effective natural pain medicines. You can check our blog post on the benefits of Turmeric & ginger tea here. This compound has been proven to decrease inflammation all throughout the body as well as getting rid of pain related to conditions ranging from muscle soreness to more serious conditions like osteoarthritis and rheumatoid arthritis. With turmeric, absorption is key.
Aim for turmeric as a spice, which is commonly sold at grocery stores in the spice section. Adding turmeric to bone broth, meat or poultry seasoning and even drinking it on tea are just a couple examples on how to increase your intake. As a pro tip, add some fresh ground black pepper given that it potentializes turmeric absorption in your body.
Boswellia (Boswellia serrata)
Although not commonly used in the Western diet, Boswellia (most commonly known as frankincense) is one of nature's most powerful anti-inflammatory medicines given its ability to inhibit 5-LOX - which is an enzyme that activates inflammation by inducing leukotrienes.
Given that non-steroidal anti-inflammatory drugs (NSAID) have worrisome effects on the gastrointestinal and cardiovascular systems, tests on Boswellia have been conducted to test its effectiveness. A placebo-controlled clinical study found that people had a higher pain threshold when regularly consuming Boswellia. It is also important to note that there is no over the counter painkiller that inhibits the 5-LOX inflammation pathway.
The most effective compound combination for a Boswellia supplement is Acetyl-11-keto-beta-boswellic acid (AKBA) which is a naturally occurring component from the stem of the tree and therefore is best absorbed by the body. These are two examples of clean supplements we recommend:
Black Sesame Seed Oil (sesaum indicum)
Although most seed oils have been found to be counterproductive to health and inflammation, black sesame seed oil contains compounds that have been found to have anti-inflammatory effects for synovial (joint) tissue in conditions like rheumatoid arthritis. It has been proven that Black sesame seed oil reduces TNF activity - which is a cytokine inflammatory compound responsible for much of the pain and inflammation perceived in all spectrums of arthritis and joint pain.
Sesamin, which is one of the main compounds, increases type II collagen and prostaglandins that prevent the breakdown of fatty acids that keep joints healthy.
Moreover, black sesame seed oil has also been found to control the ratio of omega-3 and omega-6 fatty acids which results in balanced cholesterol levels, immune system enhancement and cardiovascular system protection.
You CAN stop and entirely get rid of acute pain without risking your health
Finding pain relief that is fast and effective has been largely misguided towards synthetic components whose benefits are largely opaqued by their serious side effects. Today, there is a growing body of research proving the dangerous effects of over the counter medicines like Tylenol and their long term effect on brain chemistry.
In fact, some research points out that acetaminophen could also be impairing our social abilities to connect interpersonally with others. When you take into account the aforementioned health conditions associated with the use of this painkiller and the fact there is over 600 medicines that include this compound, it begs the question of whether acetaminophen is really an effective product or simply a very well marketed "solution".
As always, I urge you to be your own advocate and take what works best for your body and your specific needs. Our purpose is to bring informed opinion articles as well as awareness to products and practices that might enhance your daily life. Please feel free to reach out to our team with questions or just to let us know if you have tried and seen any benefits from our recommendations. We always love to hear from our community!
Below I will leave some interesting articles that informed and inspired this article.
Roberge R. Chronic acetaminophen toxicity. J Emerg Med. 2003 Nov;25(4):474.
Shahroor S, Shvil Y, Ohali M, Granot E. Acetaminophen toxicity in children as a “therapeutic misadventure”. Harefuah. 2000 Apr 16;138(8):654-7, 710.
Nourjah P, Ahmad SR, Karwoski C, Willy M. Estimates of acetaminop
hen (Paracetamol)-associated overdoses in the United States. Pharmacoepidemiol Drug Saf. 2006 Jun;15(6):398-405.
Tylenol® Extra Strength Acetaminophen. Warnings on package. McNeil Consumer Healthcare, 2006.