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Medical Forum / Diseases and Disorders / Hepatitis / July 2006Tylenol damaging the liver
http://www.foodconsumer.org/777/8/Tylenol_hurts_the_liver_even_at_recommended_do ses.shtml All over the news and many articles on google news. It appears Tylenol may be damaging the liver even at recommended doseages. This is not good news for those of us doing treatment who have liver disease and have been told by the medical profession that Tylenol at recommended doses is safe and is what we should be using to mange side effects. The more I learn about the medical profession, the less trust I have for them. Anyway, the question is, what should we be using for pain if Tylenol is dangerous? > http://www.foodconsumer.org/777/8/Tylenol_hurts_the_liver_even_at_recommended_do ses.shtml > [quoted text clipped - 9 lines] > Anyway, the question is, what should we be using for pain if Tylenol is > dangerous? Thanks for the post; the study is worth looking into, IMO. I'll be interested in reading what the actual "elevated" values for ALT were in the study, as well as other data. I note in the article you posted that Doc so-and-so implied the study indicates an adult should consume no more than 4 grams of Tylenol per day. But my understanding is that 3 grams is already set as the maxium safe consumption per day. My care provider for HCV Tx ordered that I consume no more than 2 grams per day -- that's 4 extra strength pills. I now take 500 mg Tylenol prior to each shot of interferon -- I've had too many rough episodes when going without to try that again. A modest amount seems to help a lot. I suppose if you rule out Tylenol, then as far as OTC analgesics go, you are limited to naproxen, aspirin, and ibuprofen. For deep muscle pain, ibuprofen works best for me. But Tylenol seems to do the trick best for low-grade fever and headache. I'll probably keep taking a 500 mg (extra strength) Tylenol before each interferon injection, and up to three of them per day when I want too.. My ALTs are coming down just fine, so I'm not too worried about it. It's no surprise that high or excessive doses of Tylenol cause some inflammation of the liver -- after all, an overdose, especially when mixed with alcohol, is a sure way to totally destroy the liver in a matter of hours. So I don't take high doses of Tylenol, nor any dosage of alcohol whatsoever, for that matter. >> http://www.foodconsumer.org/777/8/Tylenol_hurts_the_liver_even_at_recommended_do ses.shtml >> [quoted text clipped - 39 lines] >So I don't take high doses of Tylenol, nor any dosage of alcohol >whatsoever, for that matter. I haven't read any of the articles this morning yet, but on the network news last night they mentioned ALT elevations of "3X upper normal limit". Cheers /greyhackles Narcotics are probably the least damaging to the liver, but....they come with their own set of baggage. Pot smoke seems to be beneficial. :-) elmo http://community.webtv.net/elmoemerson/DocElmosHepFile http://community.webtv.net/elmoemerson/TheFamilyAlbum elmoemerson@webtv.net answered: > Narcotics are probably the least damaging to the liver, but....they come > with their own set of baggage. > Pot smoke seems to be beneficial. :-) > elmo I would have thought that pretty much everything went through the Liver. But my BCLD and then my GP confirming it, says Narcotics clear through the Kidneys, But then that EXCELLERATES the need for WATER WATER WATER..  Signature*..· ´¨¨)) ¸.·´ .·´¨¨)) ((¸¸.·´ .·´-:¦:-((¸¸.·´(º·.¸(¨*·.¸ ¸.·*¨)¸.·º) «.·°·. Michael .·°·-:¦:- >http://www.foodconsumer.org/777/8/Tylenol_hurts_the_liver_even_at_recommended_do ses.shtml > [quoted text clipped - 9 lines] >Anyway, the question is, what should we be using for pain if Tylenol is >dangerous? Tylenol. No more than 2 grams total per day. It's the least of multiple OTC evils, when taken in the context of anti-HCV meds, as it doesn't drop your plates (which are usually already under stress from the anti-HCV meds). I took a 500mg pill an hour before shot night, and often another first thing the next morning. hat was almost always all I needed to survive the weekend... Cheers /greyhackles >http://www.foodconsumer.org/777/8/Tylenol_hurts_the_liver_even_at_recommended_do ses.shtml > [quoted text clipped - 3 lines] >have been told by the medical profession that Tylenol at recommended >doses is safe and is what we should be using to mange side effects. Which you should continue to do. >The more I learn about the medical profession, the less trust I have >for them. And why is that, exactly? Because they actually check what they're doing and correct problems when they find them? >Anyway, the question is, what should we be using for pain if Tylenol is >dangerous? As usual, the news is alarmist and overhyped. Yes, they found elevated ALT levels in the study which had adults taking FOUR GRAMS of Tylenol EACH DAY FOR TWO WEEKS. This isn't that surprising at all. The recommended dose during treatment is TWO grams of Tylenol for no more than three days in a row. It's also unclear whether the study had participants abstain from alcohol use (Tylenol plus alcohol can be deadly even at the standard dose). The problem with Tylenol isn't that it's dangerous at any dose, but that the longer you take it, and the higher the dose, the higher the chance that the metabolites that result when the body can't completely get rid of any excess accumulate and indeed cause damage to the liver. If you avoid that by taking at least one or two "Tylenol-free" days per week, you greatly reduce chances of harm. And since the recommended dose already is half of the dose they used in the study, and most people don't even take that much for prolonged periods, there is no reason for alarm. Thomas SignatureTo reach me, complete my last name in the address. > >http://www.foodconsumer.org/777/8/Tylenol_hurts_the_liver_even_at_recommended_do ses.shtml > > [quoted text clipped - 36 lines] > -- > To reach me, complete my last name in the address. These studys are from people without hep-c. I wonder what the affect is on people with hep-c? They don't have a clue. Something to think about. Ron >These studys are from people without hep-c. I wonder what the affect >is on people with hep-c? They don't have a clue. Something to >think about. Hmmm... the following just showed up today. What's interesting is the placebo-controlled study that used the same dose and duration as the other one on people WITH liver disease and had only ONE instance of elevated enzymes. Makes you really wonder about the design of that other study. "The Paradox of Treating Liver Disease With Potentially Hepatotoxic Drugs" [...] Studies regarding safety of acetaminophen in patients with liver disease are scarce. A double-blind study evaluated the safety of short-term administration of acetaminophen (4 g/day for 13 days) vs placebo to 20 patients with stable chronic liver disease. One subject from the acetaminophen-group developed symptoms and increase of liver enzymes. However, it was believed to be a result of his underlying liver disease and not related to the drug.[99] There is a reduction in the total clearance of acetaminophen and consequently a prolongation of half-life of acetaminophen in patients with liver diseases compared with healthy volunteers.[100] A therapeutic misadventure can be dangerous in patients with underlying liver disease, although this has not been proven. Therefore, long-term therapy with acetaminophen at doses of 2 grams or less per day could be the preferred analgesic regimen for cirrhotic patients who are prone to gastrointestinal bleeding or bleeding diatheses that may be exacerbated by salicylates and/or nonsteriodal antiinflammatory drugs; however, there is a paucity of data supporting this strategy so vigilance is warranted when choosing this option. [...] Full text: http://clinicaloptions.com/Hepatitis/Annual%20Updates/2006%20Annual%20Update/Mod ules/Concha-Schiff/Pages/Page%201.aspx (Requires registration and entry through first page, text above is on page 9). Thomas SignatureTo reach me, complete my last name in the address. |
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