Acetaminophen Toxicity, Elevated Liver Enzymes & Liver Damage
~ by Jo Jordan
The Journal of the American Medical Association (JAMA) reports that when given the maximum approved daily dosage of acetaminophen – a substance present in a range of common medications including Tavist Allergy/Sinus/Headache Caplets, Vicks DayQuil Multi-symptom Cold/Flu Relief Liquid, and Tylenol – test subjects developed early signs of possible liver damage.1
In the JAMA study published July 5, 2006, lead researcher Dr. Paul Watkins of the University of North Carolina reported that between thirty-one and forty-four percent of the 145 volunteers he tested experienced maximum ALT levels (the enzyme known as alanine transaminase) – more than three times the upper limit of normal – as a result of recommended daily doses of acetaminophen.
Significantly, none of the volunteers in the study who received a placebo (did not receive acetaminophen) had ALT elevations of this level.2
Acetaminophen’s effect on the liver
So what does all this mean for people who are concerned about their health, and who want to protect their liver?
Well, ALT is an enzyme that helps metabolize protein. When the liver is damaged, ALT is released in the bloodstream, increasing ALT levels, and indicating a host of potential liver problems. The fact that so many of the volunteers in Dr. Watkins’ study had extremely high ALT levels is clear evidence that acetaminophen causes damage to the liver.
The human liver contains thousands of enzymes, special types of protein cells that help necessary chemical reactions to take place. Enzymes trigger activity in the body’s cells, speeding up and facilitating naturally occurring biochemical reactions, and maintaining various metabolic processes within the liver.
The liver performs many important functions to keep us healthy. It makes enzymes and bile that help digest food; it converts food into substances needed for life and growth; and it removes harmful material from the blood. From circulation to digestion, the liver continuously processes the blood used by the rest of the body.
While the liver is capable of regenerating itself, its capacity to repair itself can be seriously impaired by repeated or extensive damage, such as that perpetrated by the negative affects of the supposedly safe, recommended daily amount of acetaminophen.
Protect your liver from toxic damage?
According to the Harvard Women’s Health Watch, 56,000 emergency room visits and approximately 458 deaths from acute liver failure each year are attributable to acetaminophen overdose. And acetaminophen-related liver failure seems to be increasing.3
The results of Dr. Watkins’ study indicate that even the recommended daily allowance of acetaminophen can cause an overdose, resulting in liver damage. With this in mind, the obvious solution to avoiding becoming a statistic would be to stop using acetaminophen.
However, this is not an option for everyone, and since there are a myriad of other potentially liver-damaging toxics being ingested by people everyday, it makes sense to implement a multi-pronged health regimen aimed at detoxifying not only the liver, but the rest of your body as well. But first, here are a few tips for practicing safe acetaminophen use.
Tips for avoiding acetaminophen toxicity
- Read the label: The maximum recommended adult dosage is 4,000 milligrams per day (i.e. twelve regular or eight extra-strength acetaminophen tablets). Always use the lowest dosage first, and proceed from there without exceeding the daily maximum.4a
- Use caution with combinations: Many over-the-counter combination medicines and prescription painkillers contain acetaminophen. Make sure you are not exceeding the recommended intake when taking a variety of medications.4b
- Take alternate painkillers: If the recommended daily dose of acetaminophen doesn’t control pain, talk to your health care provider about alternating acetaminophen with a non-steroidal anti-inflammatory drug, such as ibuprofen or aspirin.4c
- Be careful with alcohol: Most labels warn against using acetaminophen if you have three or more alcoholic drinks each day. Remember that everyone metabolizes alcohol differently, so it’s safer to avoid alcohol while taking acetaminophen.4d
- Be careful with caffeine: Large amounts of caffeine may boost the risk of liver dysfunction caused by acetaminophen.5 Monitor caffeine intake carefully when taking acetaminophen.
And always remember, just because a drug is sold at a pharmacy does not mean that it is completely safe for everyone.
Symptoms of liver toxicity
If you experience itchy skin, yellowing of your skin or the whites of your eyes, dark urine, upper right-sided abdominal tenderness, or unexplained flu-like symptoms, stop taking products containing acetaminophen. These symptoms are indications of potential liver toxicity, and you ought to contact your health care provider immediately.
Implementing a liver care regimen:
If you are not already doing so, you ought to consider a liver and colon cleansing detoxification program. Together, these programs can clear out many of the toxins we ingest on a daily basis, as well as provide adequate nutrients to enable your liver and colon to work as well as they can.
Everyone can benefit from a regular liver and colon cleansing regimen to help foster overall wellness. Your liver performs many vital functions...from purging the blood of environmental toxins, to manufacturing the enzymes and bile that aid digestion. A sluggish liver can lead to a host of problems, while a healthy liver will increase your energy, improve metabolism, help you burn excess fat, and put you on the road to optimum health.
Likewise, your colon is at the very core of your health; everything you eat passes through it. So if your digestive process is not working well, your entire body – including your liver – will feel the negative effects.
If you already have liver damage, strengthening your body nutritionally is of vital importance because malnutrition will contribute to further damage. A daily dose of Advanced Supplementation will ensure you are getting the vitamins and minerals your liver needs to regenerate, particularly vitamins B1, B2, B6, calcium, and iron.
Remember, organic foods are much higher in nutrients than non-organic foods, and are highly recommended for improving health, and helping people to avoid organ toxicity.
You may wish to consider a full-on liver cleansing diet, including a reduction of dietary fat. In the meantime, it is important to avoid foods that damage or slow down the liver. The fewer foods you ingest that contain chemical additives and preservatives or that have been processed, the better off you and your liver will be.
Fiber is also essential for a healthy liver. In fact, the importance of fiber to the liver cannot be overstated. When your liver wants to get rid of a toxin, it dumps it into the digestive tract. If there is enough fiber around, this toxin is taken out of your body with your next bowel movement; if not, these toxins can be reabsorbed into the blood stream and the liver has to deal with them again.
Sometimes our busy lifestyles make getting enough fiber nearly impossible. For the health of your liver, consider adding a dietary psyllium-based fiber supplement to help balance things out on those low fiber days.
Recover and regenerate your liver
The liver is one of the most active organs in the body. Unfortunately, our environment keeps the liver a little too busy dealing with toxins, including those perpetrated by seemingly harmless substances such as acetaminophen. According to the JAMA study cited above,
acetaminophen taken at the recommended dosages can cause liver damage, specifically increased ALT levels.
If there is one organ in your body that needs help, it’s your liver. You can lend your liver a hand by implementing a health regimen such as the one outlined above, which includes doing a liver and colon cleanse several times a year.
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1. Worst Pills Best Pills Newsletter: “New Study Links Signs of Possible Liver Damage to Lower Doses of Acetaminophen (TYLENOL), Supporting Previous Research,” http://www.worstpills.org/member/newsletter.cfm?n_id=439.
2. Paul B. Watkins, MD, et al, “Aminotransferase Elevations in Healthy Adults Receiving 4 Grams of Acetaminophen Daily,” Clinician’s Corner: The Journal of the American Medical Association, Vol. 296 No. 1, , http://jama.ama-assn.org/cgi/content/abstract/296/1/87.
3. Harvard Health Publications/Harvard Medical School, “Acetaminophen Overdose: How to avoid acetaminophen-related liver problems, from Harvard Women’s Health Watch,” http://www.health.harvard.edu/press_releases/acetaminophen_overdose.htm.
4. (4a-4d) Ibid.
5. Victoria Stagg Elliott, “Caffeine may boost acetaminophen risk to liver: High doses of both substances may be needed to cause such damage, but researchers are calling for greater caution,” American Medical News (AMA), http://www.ama-assn.org/amednews/2007/10/22/hlsd1022.htm.