With Vioxx in the news right and left for its deadly effects, I guess it really shouldn't come as any surprise that the risks of other common painkillers are coming under scrutiny.
Such is the case with acetaminophen, known best by the brand name Tylenol. In the last weeks of last year, this ubiquitous over-the-counter medicine, the nation's leading pain reliever, in fact, was found by recent research to be the nation's leading cause of acute liver failure as well.
According to a recent Associated Press article, research conducted by scientists from two leading American medical facilities (the University of Texas Southwestern Medical Center and the University of Washington Medical Center) concludes that NEARLY HALF of all cases of acute liver failures in 662 patients from 22 liver transplant centers over a 6-year span were caused by acetaminophen poisoning.
What's even more disturbing is the upward trend in the incidence of acetaminophen poisoning this research revealed. In 1998, only 28% of the study's liver poisonings could be blamed on acetaminophen by 2003, that number had ballooned to 51%. More than 7 out of ten of these victims died as a result. Also remarkable is the fact that 48% of these cases were from UNINTENTIONAL OVERDOSES, while only 44% were from suicide attempts (OTC painkillers are common approaches to self-offing).
That's right, significantly more people in the study were killed by accidental overuse of acetaminophen than intentional over-ingestion! If this trend holds true nationwide, the number of acetaminophen-related deaths could add up to quite a scary number indeed. In fact, the FDA itself estimated 2 years ago that 56,000 emergency hospital visits per year are due to acetaminophen poisoning.
The study's architects also point out (and I concur) that if taken correctly and not abused, acetaminophen and other OTC drugs are safe.
The problem, they say, is the typical American tendency to overdo things. The idea that if 8 tablets of Tylenol a day are good for pain relief, then 12 or 16 must be even better. According to at least one of the principal authors of the study, even doubling the dose in this manner can kill.
Are You Double Dosing, Knowingly Or Not?
When you get a headache or low-grade fever, do you pop 3 or 4 Tylenol (or Motrin, Advil, aspirin, or whatever) when the label calls for only 1 or 2? Do you think that you'll get better or faster relief by taking just a little bit more? So many folks do.
Then, after a day of double dosing, do you drown yourself with acetaminophen-laced NyQuil Cold-n-Flu or similar liquid at bedtime? Or do you think you're being good by taking only the label-recommended dose of Excedrin or Tylenol for that headache, but on top of the daily mega-milligram blast of arthritis-strength acetaminophen you're taking for joint pain? All these things can cause major liver toxicity, and land you in the hospital or the morgue.
My advice, Take no more acetaminophen (or any other OTC painkiller, for that matter) per day than what is advised by the label on the bottle and take it only when you're in need of pain relief, not just for general painlessness. ("Perks me up, relaxes me and, besides, It's good for my arteries." People will believe almost anything they are told, except the truth. With the advent of TV, my rule has become, "Believe only half of what you hear and nothing you see.)
Oh, and make sure to factor into your calculations the acetaminophen, acetylsalicylic acid, ibuprofen or other common pain medicine that any prescription meds you may be taking might contain some, like narcotics Vicodin and Percoset, contain as much as 750 mg of this painkiller per pill.
William Campbell Douglass II, MD
Remember a couple of years ago, when an aspirin a day was thought to be a heart tonic? Popping a "harmless" white pill each day for thinner blood and a healthier heart was all the rage, and many doctors still recommend it. Not this one, though.
In fact, more than 2 years ago (Daily Dose, 4/29/03), I sounded the alarm about the deadly risks of "aspirin therapy," citing a University of Maryland Medical Center study in which blood platelet clumping, which can lead to heart attacks, was noted in 64% of daily aspirin-takers whose blood cholesterol levels were considered by modern medical standards as too high (LDL over 130, which leaves out relatively few Americans.)
To recap, my angle in that earlier Daily Dose piece was that if this University of Maryland study is correct, a daily aspirin INCREASES the risk of coronary events in people with healthy (and normal) LDL cholesterol levels of 180, 200, or more.
Yes, you read that right: In case you didn't already know this, I've long maintained obviously, in sharp divergence with the mainstream that anyone with an LDL cholesterol number LOWER than 200 risks serious heart problems. In fact, I don't caution anyone to worry about cholesterol at all until their LDL hits 300 or more. (Doctors should look for the real cause of the problem and stop chasing the cholesterol level. Cholesterol is a marker, and a protective mechanism, not a disease.)
As if this isn't bad enough news for those who've been duped by their doctors or the media into taking an aspirin every day for their tickers, consider this: As dangerous as this evidence suggests it is for most Americans with normal blood cholesterol to take aspirin every day, a newer study points to an immediate and grave risk of STOPPING aspirin therapy once you've begun.
According to a May 2004 study rolled out to the American College of Chest Physicians, people who STOP taking daily aspirin once they've been doing it for a while risk serious heart problems at an alarmingly high rate. The research analyzed the medical records of 1,236 people hospitalized for heart attacks and other acute coronary events. Their findings: That more than 10% of people taking daily aspirin for heart reasons were hospitalized within one week of stopping the therapy. The patient's likely interpretation: "Gee, the aspirin was protecting me; I shouldn't have quit." However NONE of these patients had been hospitalized for heart-related events before they stopped taking their daily aspirin. Keep reading
It means you're damned if you do and damned if you don't, basically. If you take daily aspirin for heart health and your cholesterol's anywhere near the modern American norm, you could be risking a heart attack. And if you stop, you could as well.
It doesn't seem too fair, does it? Just like a lot of things in mainstream medicine.
Seriously, folks, I don't know what to tell you here. If you are unfortunate enough to be one of the millions of Americans taking a daily aspirin for heart health on the advice of your doctor, I think you should ask him about ways to safely wean yourself off the blood-thinner without shocking your system into a heart attack.
And from now on, only take ANY painkillers, aspirin, acetaminophen, Cox-2s, whatever, when you NEED them. Never forget that these are powerful drugs, & should be treated with respect & not overused (or overdosed on).
Loaded for Bayer and shootin' you square,
William Campbell Douglass II, MD
For Information About A Safe Painkiller: William Campbell Douglass II 2/4/2003 - Cocaine For Back Pain
Acetaminophen Information: Dr. Ben Kim 11/9/2006 - Acetaminophen Generic Acetaminophen Tainted
Acetaminophen Information: Dr. Ben Kim 5/11/2010 - Understanding Pain Killers And Inflammation
Acetaminophen Information: Natural News 11/25/2009 - Acetaminophen Linked To Asthma
Acetaminophen Information: Natural News 3/9/2010 - Common Painkiller Acetaminophen Linked To Asthma
Acetaminophen Information: Natural News 8/17/2010 - More Than Doubles Risk Of Asthma In Young People
Acetaminophen Information: Natural News 10/7/2010 - Acetaminophen Linked To Asthma
Acetaminophen Information: Natural News 5/16/2011 - Study: Tylenol, Acetaminophen Linked To Causing Blood Cancer
Acetaminophen Information: World Health 9/23/2008 - linked to asthma in adults and children
Acetaminophen Information: Dr. Mercola 12/17/2000 - Anti-Fever Drugs Prolong Flu
Acetaminophen Information: Dr. Mercola 8/4/2004 - Toxicity
Acetaminophen Information: Dr. Mercola 5/4/2005 - Painkillers
Acetaminophen Information: Dr. Mercola 7/20/2006 - Tylenol And Liver Damage
Acetaminophen Information: Dr. Mercola 1/2/2007 - Stronger Health Warnings
Acetaminophen Information: Dr. Mercola 7/15/2009 - FDA Is Getting Serious With Tylenol Risks To Your Health
Acetaminophen Information: Dr. Mercola 7/21/2009 - FDA Changes Tylenol Warnings
Acetaminophen Information: Dr. Mercola 5/25/2011 - This Common OTC Painkiller Found Linked To Cancer
Acetaminophen Information: Dr. Mercola 12/15/2011 - Taking Just A Little Too Much Tylenol Can Be Deadly