All the facts about acetaminophen

When I was a little girl I asked my mother, how does the Tylenol know to go to fix my headache? How does it know that the pain isn’t in my toe? She told me it was magic.

Apparently that’s not far from the truth. An article I read recently stated that it isn’t known how acetaminophen actually works, just that it does. And, many of us take it to relieve minor aches and pains and/or to reduce fever.

According to Harvard Medical School, there are over 600 drugs containing acetaminophen. “Billions of doses of acetaminophen are consumed safely every year, but deaths still occur from accidental overdoses and thousands of people end up in the emergency room,” HMS’ website says.

The most common warning is about damage to the liver. “The body breaks down most of the acetaminophen in a normal dose and eliminates it in the urine. But some of the drug is converted into a byproduct that is toxic to the liver. If you take too much, all at once or over a period of days, more toxin can build up than the body can handle,” HMS says.

So, the moral of the story is to make sure you’re not taking more than the recommended 4,000 milligrams each day for an average- to large-sized person, or less if you’re smaller (like 3,000 milligrams). Be sure to read labels of any drugs that may contain acetaminophen such as cold medicines or opioid pain meds and add up the milligrams carefully.

“Drinking alcohol causes the liver to convert more of the acetaminophen you take into toxic byproducts. Men should not have more than two standard drinks per day when taking acetaminophen (one drink per day for women),” Harvard says.

You probably know all this. What I found while researching this article is that there have been several studies conducted on side effects of acetaminophen that perhaps you haven’t heard about.

One is a study by the National Heart, Lung, and Blood Institute’s asthma network. It had been reported that children with asthma should not take acetaminophen because it worsens the condition. This study compared children taking acetaminophen with those taking ibuprofen and concluded that there were no significant differences in safety between the two drugs.

“The scientists did not detect any worsening of asthma in the children treated with acetaminophen compared with those receiving ibuprofen. This was measured by asthma exacerbation rate, the number of days of asthma control, the need for rescue mediations, and unscheduled medical visits for asthma.” The NIH report said.

The University of British Columbia researchers found that acetaminophen may also reduce the psychological effects of fear and anxiety over the human condition, or existential dread.

“Pain exists in many forms, including the distress that people feel when exposed to thoughts of existential uncertainty and death,” says lead author Daniel Randles, UBC Dept. of Psychology. “Our study suggests these anxieties may be processed as ‘pain’ by the brain – but Tylenol seems to inhibit the signal telling the brain that something is wrong.”

There have been several articles in national publications that claim that pregnant women who take acetaminophen are more likely to give birth to a child with ADHD or other behavioral problems. An article in MedPageToday says that these statements can be either misleading or simply wrong. And, FitPregnancy.com lists Tylenol, both regular and extra strength, as the safest drug to take during pregnancy.

The study I found most interesting is the one headlined “Does acetaminophen reduce empathy?” Published in Medical News Today, the article written by Tim Newman states:

“Researchers from The Ohio State University have found evidence that acetaminophen not only dulls physical pain, it also reduces our ability to predict pain in others and empathize. If the results are to be believed, this common drug might hamper our ability to imagine each other’s discomfort.”

If you have any questions about the safety of acetaminophen or its interaction with any drugs you’re taking, see your healthcare provider or talk to your pharmacist.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 264-4029 or kathyleehubbard@yahoo.com.