TYLENOL® poisoning, more common than we think

Acetaminophen (paracetamol in Europe) has long been known to cause liver failure. But now researchers reveal why its the number one cause of acute liver failure.  And even more troubling, many people don’t realize they are overdosing on this common medication.

 

What does the liver do?

The liver filters and detoxifies blood.  Additionally it breaks down and stores cholesterol and lipids and produces proteins. The liver also produces bile that gets stored in the gall bladder to help digest food after eating.  It is one of the few organs in the body that can regenerate itself when tissue is damaged.  So its troubled scientists how drug toxicity could irreversibly damage the liver to the same degree hepatitis, cirrhosis and cancer do.   Researchers from the University of Edinburgh studied human and mouse liver cells and now know why.

What is liver failure?

In order for the liver cell to work, it needs to work in concert with the cells surrounding it but work in separate groupings, each with a different function.  Excessive acetaminophen (the main ingredient in Tylenol) disrupts these cell connections, called “tight junctions”, hence the cells don’t function properly.  “Failure” of an organ, such as “liver failure”, “heart failure”, and “renal failure” occur when the cells of the organ aren’t healthy enough to allow the organ to function.

Signs and symptoms of liver failure include:  jaundice (yellow color to skin and eyes), fatigue, weakness, easy bleeding, nausea, diarrhea, confusion to name a few.

Knowing the mechanism of injury to the hepatocytes, liver cells, may allow scientists to create a means to repair liver cells that can’t be repaired themselves.  Or design a pain reliever that doesn’t damage the liver.

How much acetaminophen is toxic?

Taking more than 4 grams a day could be considered and “overdose” and toxic.  Frighteningly, this level is commonly consumed on a daily basis.  Over the counter an “extra strength” dose contains 500 mg of acetaminophen.  So if a person takes 1-2 pills every 4-6 hours, they can easily take 4 grams a day. Add a pain medication such as Vicodin or Percocet which contain acetaminophen, or a cough and cold remedy, or even an over the counter sleeping aid which may contain it as well, and its no surprise so many end up in the emergency room.

 

The following is a list of over the counter medications that may contain acetaminophen (provided by knowyourdose.org)

Some Common Over-the-Counter Brand Name Drugs That Contain Acetaminophen

Actifed®
Alka-Seltzer Plus®
Anacin®
Cepacol®
Contac®
Coricidin®
Dayquil®
Dimetapp®
Dristan®
Excedrin®
Feverall®
Formula 44®
Goody’s® Powders
Liquiprin®
Midol®
Mucinex®
Nyquil®
Panadol®
Robitussin®
Saint Joseph® Aspirin-Free
Singlet®
Sinutab®
Sudafed®
Theraflu®
Triaminic®
TYLENOL® Brand Products
Vanquish®
Vicks®
*And store brands

Some Common Prescription Drugs That Contain Acetaminophen (or APAP)

Butalbital®
Endocet®
Fioricet®
Hycotab®
Hydrocet®
Hydrocodone Bitartrate®
Lortab®
MIDRIN®
NORCO®
Oxycodone®
Percocet®
Phenaphen®
ROXICET ™
Sedapap®
Tapanol®
Tramadol
TYLENOL® with Codeine
Tylox®
Ultracet®
Vicodin®
Zydone®
*And generic drugs

*Many OTC and Rx medicines have store-brand or generic versions. For example, there are many store-brand products that are similar to brands like TYLENOL®, NyQuil®, and Robitussin®. Prescription medicines that come in generic form may list the ingredients in place of a drug name. For example, the generic version of “Vicodin” has “hydrocodone and acetaminophen” written on its label. Your prescription label may list the ingredients, the brand name, or both. Always read and follow the label and ask your healthcare provider if you have questions about the ingredients in your medicine.

 

We recommend discussing all your medication, especially over the counter, with your medical provider, and to not assume just because its available without a prescription, its safe in any dose.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

A third of our fast food products may contain toxic chemicals

image from Live Science

A report published this week in the Journal of Environmental Science & Technology Letters suggests chemicals used in fast food packaging is leaking into our fast food.  These chemicals help prevent grease and drippy tomatoes from sogging up the wrapper or box. They also are non-stick and stain proof so a wrapped burger is easier to take out of the packaging looks more aesthetic.

The chemicals of concern are called PFAS’s, pre- or polyfluoroalkyl substances.  According to the CDC, PFAS and her sister chemicals Perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorohexane sulfonate (PFHxS), and perfluorononanoic acid (PFNA) have been shown to cause liver, kidney, pancreas and endocrine issues. They can cause fertility issues, increase cholesterol, affect the learning potential and behavior of a fetus and are even carcinogenic.   Not only are these substances widely used in the restaurant industry but are they are also used in upholstery, carpeting, Teflon, clothing, cosmetics and metal plating.

Study author, Laurel Schaider, a research scientist at the Silent Spring Institute said, “These studies have found that the extent of migration depends on the temperature of the food, the type of food and how long the food is in contact with the paper.”  The study did not quantify how much of the chemical leaked, however.

The good news is not all samples collected for this study tested positive for PFAS.  When they tested for fluorine, paper cups and “non-contact” paper were clear.  The sandwich wrapping, however, was positive for fluorine 46% of the time, followed by the cardboard-like sandwich holders, where 20% tested positive.  Beverage cups were at 16% percent.

But these results imply that not all packaging contained fluorine, so alternatives may be used that are not leaking chemicals.  Moving forward, although making your own lunch sounds safer, I’ll just ask the fast food server to, in a gloved hand, pass me the burger and throw the fries into my purse.  I’m not ready to give up fast food just yet.

 

                                                                                                         LearnHealthSpanish.com

                                                                                                         Medical Spanish made easy

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician