Friday, May 29, 2015

Acetaminophen Risks Are Greater Than We Think

As our population ages, more and more people turn to over the counter medications for relief from osteaoarthritis and muscular pain.  The first recommended drug for the purpose is generally acetaminophen, best known as the brand name Tylenol.  Tylenol is commonly believed to be gentler on the stomach than any of the NSAID (non-steroidal antiinflammatory drugs) category of drugs, which includes aspirin, ibuprofen and others, making it more likely to be recommended for long-term use, but the drug may be neither as effective nor as harmless as people are led to believe.

A group of doctors in the United Kingdom did a review of previously published studies on the safety of acetaminophen, the active ingredient in Tylenol, also known as paracetamol in Britain.  Their findings were disturbing because they showed that taken together, the studies indicate that people who take the maximum recommended daily dosage of acetominophen are at increased risk for cardiovascular and gastrointestinal problems.

The findings were clearly dose related.  Non-users had the lowest rate of adverse effects, with low-dose users having a slightly elevated risk, and users who follow the instructions on the bottle for maximum dosage had significantly more adverse effects.

One of the difficulties in studying over the counter medications is that their use is under-reported.  People feel so safe taking them that when asked about medications, they may not even mention them.  An additional difficulty in measuring the amount of acetaminophen that people have taken is that it is often included in multi-symptom cold formulas, so people are taking it without even being aware of it.

If someone is sick and they are taking Tylenol for aches and pains or fever at the same time as a multi symptom cold relief formula, they may be exceeding the recommended dose of acetaminophen and putting themselves at risk for serious side effects.  The best way to avoid this is to avoid multi symptom formulas and take only what is needed.

Despite the popular perception that Tylenol is safe and gentle, it is the leading cause of liver failure in the United States.  Anyone who has any kind of liver problems would be best advised to avoid acetaminophen altogether.  The use of this drug accounts for over 100,000 calls to poison control centers, around 60,000 visits to emergency rooms and hundreds of deaths per year in the United States alone.

Perhaps the most frightening part is that the perception of acetaminophen as safe and effective results in its use for conditions for which it isn't even effective, like the pain of osteoarthritis.  Joint pain tends to be the result of inflammation, and acetaminophen has no anti-inflammatory action, making it not much better than a placebo for controlling this kind of pain.

Based on this information, you might think that using one of the NSAID's would be the solution.  They would be more effective at reducing inflammation, but they too come with their own risks and side effects, so they are not a great long term solution.

For many people, adequate pain relief can be attained with natural measures that are much less likely to cause dangerous and unpleasant side effects.  Manual manipulation of the spine or joint, which can be performed by a chiropractor or physical therapist, followed by strengthening exercises and training in the proper way to move to minimize pain has been shown to give superior relief without unwanted side effects.

Weight loss and increased activity, while it requires a commitment and willpower from the patient invariably reduces pain in the knees, ankles, feet, hips and back.  It will take time and effort, but it will pay off in increased mobility with reduced pain.

There are also several natural substances that have been shown to have an anti-inflammatory effect, such as the spices tumeric and ginger as well as green tea.  They can be used as part of your regular diet or taken as supplements, but one of the best ways I've seen to harness the natural healing power of food is by drinking the anti-inflammatory tea I recommend to my patients.

In my practice, I adjust limbs as well as spines, and have helped many patients recover from injuries to elbows, wrists, shoulders, hips, knees and ankles, in addition to performing spinal manipulation.  I help my patients achieve optimal health by advising them on exercise, nutrition and other lifestyle aspects.

If you would like to learn more about safe, natural pain relief through chiropractic and nutrition, or if you would like the recipe for anti-inflmmatory tea, visit our website at or call us at 516-783-0088 to make an appointment.