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Acetaminophen overdoses

Flick of the Wrist

In 1995, a 23 year-old Philadelphia man named Marcus Trunk began taking a prescription drug that contained acetaminophen to treat a sprained wrist. When his prescription ran out, he took an over-the-counter acetaminophen for another week. Within a few days he developed a fever and began vomiting. When he went to a hospital emergency room, doctors gave him further doses of acetaminophen.

Within a week, Marcus died of liver failure caused by acetaminophen overdose.

Adios, ephedra

Last year an FDA review estimated that there are more than 14,000 unintentional overdoses of acetaminophen every year, with about 100 of those cases resulting in death. This miserable track record is far worse than the approximately 100 TOTAL deaths that were reportedly caused by overdoses of ephedrine, the hyped-up, synthetic version of the herb ephedra.

Nevertheless, you can say goodbye to ephedra. At the December press conference that announced the upcoming ban of all ephedra products, FDA Commissioner Dr. Mark McClellan stated that the herb presents, “An unreasonable risk of illness or injury.”

Needless to say, no one is talking about a similar ban of acetaminophen. Nor should they. Like ephedra, no one makes you take acetaminophen. If you want to take it, that’s your right. And like ephedra, if you take acetaminophen as directed you’ll probably experience little or no harm. But if you take ephedra, acetaminophen, or any other herb or drug recklessly, you may pay a very high price.

Acetaminophen is the active ingredient in more than 200 over-the-counter pain-killers, fever-reducers and cold medicines, so it’s fairly easy to inadvertently take an overdose of the drug. But in spite of the dangers, I’ll bet that most of the people who use acetaminophen on a regular basis think of it as benign. They simply have no idea how easy it is for a healthy person to fatally damage their liver.

To the rescue

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.

Low amounts of acetaminophen can easily be assimilated by the liver. But when an overdose occurs, the demand to metabolize rises to a saturation point, the liver begins to malfunction, and immediate treatment is called for.

Studies have shown that N-acetylcysteine (NAC) is an effective antidote for acetaminophen poisoning and is especially effective within 8 hours of ingestion of the overdose.

In the e-Alert “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. Research also shows that NAC treatments may significantly decrease the chance of mortality in patients suffering from acute liver damage.

The liver’s best friends

Needless to say, it’s important to take good care of your liver – even if you never take a single acetaminophen tablet. And fortunately there are a number of herbs and vitamin supplements that may 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 potent antioxidant and anti-inflammatory effects that promote healthy liver function. Both of these natural agents are included in Liver C/S Plus, a liver-support formula created by John Burgstiner – a long-time member of the HSI network. (For more information, see the e-Alert “Always at Your Side” 10/6/03.)

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.

Knowledge is power

Marcus Trunk probably had no idea that he was abusing his acetaminophen dosage. And there’s a good chance that the Baltimore’s Orioles pitcher Steve Bechler was unaware that he was endangering his life last spring when he used ephedrine contrary to the manufacturer’s recommendations.

Still, neither of these treatments should be banned because of the missteps of their users. Marcus Trunk’s mother told an Associated Press reporter that she wonders, “If I’d been more educated to acetaminophen products, could I have steered him clear?”

To Your Good Health,
Jenny Thompson

Health Sciences Institute

Sources:

“Stronger Painkiller Warnings Possible” Lauran Neergaard, Associated Press, 9/20/02

“Clearer Liver Warning Urged for Painkillers” Adam Marcus, Health Scout News, 9/20/02

“Toxicity, Acetaminophen” Susan E. Farrell, M.D., Emedicine.com

“Improve Liver Function” Sandra Cabot, M.D., Health Advisory Service

“FDA Probes New Worry About Acetaminophen Overdose” Associated Press, 3/27/01

“Transcript of Press Conference Announcing the Ephedra Ban” Associated Press, 12/30/03, usatoday.com

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