A new warning label may soon be appearing in your medicine cabinet.
In September, an FDA advisory panel recommended that the agency require the manufacturers of all acetaminophen products to update their packaging to include a warning that an overdose may cause serious liver damage. More than any other brand, this requirement will affect Tylenol, which accounts for the lion’s share of acetaminophen production worldwide. Johnson & Johnson, the makers of Tylenol, has already agreed to add a new warning.
If you heard this news when it was reported by the major media outlets, you heard about Tylenol, the FDA, and some extreme examples of acetaminophen overdose. But the real news here is the health of your liver.
The liver is the Rodney Dangerfield of the body: it gets no respect – not compared to, for instance, the heart or the brain. But the liver is a workhorse of metabolism, performing more than 400 separate functions in an average day, all devoted to converting food into nutrients, storing nutrients for later use, and sorting out the toxins that require elimination. Obviously, a healthy liver is essential to the health of the entire body.
So if you take an occasional Tylenol now and then, how concerned should you be that you might be doing harm to your liver? It depends on who you talk to. Johnson & Johnson reps say that the incidence of overdose is rare – only a “handful” of cases each year. But an FDA review reports that there are more than 14,000 unintentional overdoses of acetaminophen every year, with about 100 of those cases resulting in death. (Can you imagine a natural supplement manufacturer trying to get away with dismissing 100 deaths per year as just a “handful”?)
The current guidelines recommend a maximum of 4 grams of acetaminophen per day – the equivalent of 8 extra strength tablets. But because acetaminophen products are considered mild, compared to so many other over-the-counter drugs, many users often exceed the recommended dosage. And while this may not result in immediate problems, over time, a constant intake of large amounts of acetaminophen can easily lead to a highly toxic situation.
A healthy liver can easily metabolize low amounts of acetaminophen. But when the demand to metabolize rises to a saturation point, immediate treatment is called for.
N-acetylcysteine (NAC) is an antidote for acetaminophen poisoning and is especially effective within 8 hours of ingestion of the overdose. In an e-Alert I sent you last month (“Storm of the Eye” 10/9/02), I told you about NAC, an invaluable amino acid that stimulates production of glutathione, one of the most potent antioxidant enzymes. This ability to infuse the liver with antioxidants, coupled with excellent anti-inflammatory properties, makes NAC an effective liver crisis treatment. Studies have shown that NAC treatments may significantly decrease the chance of mortality in patients suffering from acute liver damage.
Clearly, it’s important to take good care of your liver – even if you never take a single acetaminophen tablet. Fortunately there are a number of herbs and vitamin supplements you can take that help keep the liver functioning properly.
Milk thistle has been shown to stimulate the production of new liver cells, and is often used to help protect the liver from alcohol damage and to treat liver diseases. Turmeric root, like NAC, is reputed to have powerful antioxidant and anti-inflammatory effects that promote healthy liver function. And burdock helps to stimulate the liver’s ability to purify the blood.
The antioxidant qualities of vitamins C and E are also good for the liver, as are B vitamins, zinc and lecithin. And because the liver is a nutrient processor, it will come as no surprise that raw fruits and vegetables are just what the liver needs – for both its own healthy function and the proper function of the body as well.
By some estimates, more than 100 million people a year take acetaminophen. But there’s a good chance that number is even higher because acetaminophen can be found in almost 200 products other than Tylenol. This is one of the reasons why some people overdose: they simply don’t realize they’re getting acetaminophen from a variety of medications.
Fortunately there are alternatives to acetaminophen in treating headache, fever, muscle aches, menstrual cramps and toothaches. For instance, the herb white willow is an anti-inflammatory pain reliever that has compounds similar to aspirin. In fact, white willow’s salicylic acid is the parent compound of aspirin (acetylsalicylic acid). Salicylic acid, however, has the benefit of being less abrasive to the stomach and intestine. And a study published last year in the journal Rheumatology, showed an extract of willow tree bark to be as effective as a prescription drug in the treatment of lower back pain.
Other herbs that have been used to treat headache pain include meadowsweet, valerian, passionflower, skullcap, chamomile, and ginkgo. A standout among these is feverfew, which has been used with success to alleviate the effects of migraine headaches. As with white willow, feverfew has anti-inflammatory properties.
Another recent study, published in Phytomedicine, showed that an extract of the herb devil’s claw successfully treated hip, knee, and lower back pain. Researchers believe that further studies may also show that it slows the joint deterioration associated with arthritis. And once again, it’s the herb’s ability to curb inflammation that makes it effective.
Finally, there are some common nutrients that are useful in preventing headaches; calcium, magnesium and niacin may help relax muscles that often contribute to headaches. And supplements of omega-3 essential fatty acids and coenzyme Q10 both deliver antioxidants that can ease the stress of headache and muscle pains.
So, obviously, the story that you won’t see on Headline News is that you can beat a headache without putting your liver in harm’s way.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
