Why? The liver converts acetaminophen into N-acetyl-p-benzoquinone imine (NAPQI) in an attempt to get rid of it. (“N-acetyl what??” Don’t worry about pronouncing it, there will be no test at the end of this blog). The problem is that NAPQI requires huge amounts of a really important endogenous (body-made) antioxidant called glutathione in order to make it less toxic. Glutathione is responsible for scavenging all the free radicals produced all over the body by various (often normal!) metabolic processes. NAPQI chews up glutathione in massive quantities, leaving excess free radicals to burn and cause DNA and cellular damage all over the body. The liver then has to deal with not only the lack of glutathione, but the highly toxic NAPQI. Hepatocellular (liver cell) damage, necrosis (ugly cell death), and liver failure follows.
Okay, so you’ve taken Tylenol in the past and you didn’t die, so no harm, no foul, right? Sort of. The liver is an incredibly resilient organ, so in most normal people it takes the hit, waits until the acetaminophen passes, restores glutathione (if you eat right) and then rebuilds liver cells. BUT, in small children, in anyone with liver damage, or in large doses it can lead to liver failure.
Acetaminophen has a much lower maximum daily dose than almost any other over the counter medication. Adults should take NO MORE than 3,000 mg per day. That is six 500-mg pills per day. Children’s dose is at maximum 80 mg/kg per day. Most people have no idea what that means, which is why pediatricians give you a dosing chart. Do NOT exceed that dose!! The problem is that acetaminophen is in many combination products, including over the counter cough syrups, Nyquil, pain formulas and more. Read the labels carefully!
I have more reasons to loathe acetaminophen, including the implications of depleting glutathione in developing children. Here is that follow-up blog post again: Just say “NO” to Tylenol: Acetaminophen causes autism?
Until then, here’s your review:
1. It’s not the degree of fever, but how your child looks that matters.
2. Avoid acetaminophen whenever possible. When you do use it, read the label carefully and never exceed the recommended amount. Check all your pain, flu and fever combination products for their active ingredients, and never combine Tylenol with other over-the-counter formulas.
Don’t believe me? Here’s a great article from Seattle Children’s Hospital about the Myths of Fever.
And here is another great post, written by my colleague, about how to overcome your Fever Phobia.
The super rad chemical structure and how it is converted in the body (for all you nerds out there). Paracetamol is just another name for acetaminophen. GSH in an abbreviation for glutathione (the purple arrow). The blue arrows show other pathways the liver can use for detoxification too.
Okay, so you’ve taken Tylenol in the past and you didn’t die, so no harm, no foul, right? Sort of. The liver is an incredibly resilient organ, so in most normal people it takes the hit, waits until the acetaminophen passes, restores glutathione (if you eat right) and then rebuilds liver cells. BUT, in small children, in anyone with liver damage, or in large doses it can lead to liver failure.
Acetaminophen has a much lower maximum daily dose than almost any other over the counter medication. Adults should take NO MORE than 3,000 mg per day. That is six 500-mg pills per day. Children’s dose is at maximum 80 mg/kg per day. Most people have no idea what that means, which is why pediatricians give you a dosing chart. Do NOT exceed that dose!! The problem is that acetaminophen is in many combination products, including over the counter cough syrups, Nyquil, pain formulas and more. Read the labels carefully!
I have more reasons to loathe acetaminophen, including the implications of depleting glutathione in developing children. Here is that follow-up blog post again: Just say “NO” to Tylenol: Acetaminophen causes autism?
Until then, here’s your review:
1. It’s not the degree of fever, but how your child looks that matters.
2. Avoid acetaminophen whenever possible. When you do use it, read the label carefully and never exceed the recommended amount. Check all your pain, flu and fever combination products for their active ingredients, and never combine Tylenol with other over-the-counter formulas.
Don’t believe me? Here’s a great article from Seattle Children’s Hospital about the Myths of Fever.
And here is another great post, written by my colleague, about how to overcome your Fever Phobia.
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