Wednesday, November 23, 2011

Tylenol Deadly? Not according to this study!

I find it very interesting that there is such ranting against one of the safer medications available, like Tylenol, and very little against meds like Cerebrex, or the statin drugs and ibuprofen - both of which are much more taxing on the liver than tylenol.

The latest study found that (as the headline on MSNBC read) "Even a tiny overdose of tylenol can be deadly".
Doing the math on this one.... The single dose of 27 grams was equal to 27,000 MG! That much of anything can be deadly!

From Google's calculator: 1 gram = 1000 mg. Extra Strength tylenol = 0.75 grams per pill, not even a gram.

Now if those folks took 24 grams of tylenol over "several days" (how many days "several days" meant isn't mentioned) but say they mean 14 days so that's 24/14 = 1.7 grams a day or 1700 mg so... if they broke it up into 4 doses, that would be 425 mg per dose.

It's true that this is a tiny over dose - your liver can only handle 325 mg at a time.

But then, do we know what other drugs these folks had been taking? They could have been taking statin drugs which are very hard on the liver. Marajuana, medical or not, is hard on the liver. Splenda and Nutrasweet really tax the liver as does Alcohol - which can be a liver killer - did they sequester these folks and give them two weeks of a healthy diet to make sure their livers were "clean"? Seems not.
"Staggered overdose patients may have fared less well because they did not receive the appropriate treatment soon enough, or because they had been drinking alcohol along with acetaminophen, he said."
Looking at the study, we find that they took 663 patients over a 17 year period having liver problems. Then somehow accessed how much tylenol they'd been taking (probably from hospital records which would be what the people self reported and people tend to understate what meds especially OTC's they are taking).

Then, looked at how many died.

But one may ask, how do they know it was the tylenol which caused the damage since there are so many other medications and substances people use which also cause liver damage?
Epidemiological studies are notoriously inaccurate because they never have sufficient amount of information on the cohort to make a good analysis.

A good example of this is the deviation in the results of the epidemiological studies on low dose birth control (for hormone replacement therapy) which found that birth control hormones greatly lowered the risk for heart attack and stroke, and the clinical studies on birth control hormones for HRT which found that these hormones greatly raised the risk for heart attack, stroke and thrombosis as well as significantly raised the risk for breast cancer.

Epidemiological studies can be misleading in other ways - they often can be manipulated to conclusions desired by those funding the studies. For example if they asked how many of those folks rode bicycles when they were kids, they would likely find that most or all of them did. Using the logic of the study they could then, reason that riding a bicycle when you are a kid burns your liver as an adult! No wonder Phillip Johnson a doctor of law, quipped that if lawyers used the same logic as scientists, they'd be laughed out of court! :)

A couple of months ago, a friend of mine collapsed with a heart attack from the medication she was taking. She didn't tell me what it was but I suspect something like Celebrex which raises the risk for heart attack. She was fine and then, suddenly, she keeled over. Of course, she's 78 years old so she could have had a heart attack anyway even without the medications. Hard to tell. If we don't get something else, we will get a heart attack sooner or later. Age 78 is pretty close to the expected lifespan of women in the USA and she also has had a lot of stress in her life since she was forced to move several times etc.

My spiritual advisor, a Jesuit priest, on Warfarin, was found in a pool of blood - brain bleed. He died in the hospital 2 hours later. The reason he was on Warfarin was because 2 years before I met him, in his mid 70's, he had been put on Vioxx. After two weeks of no arthritis pain, he keeled over suddenly, with a heart attack. A fit, active man who rode his bicycle at least once a week or so, he didn't expect a heart attack and attributed it to the drug, but again, it could have been that the occasional exercise he got, wasn't enough to really protect his heart, plus the extreme stress he was under, trying to keep working and being forced to retire because of his age.

It's true the warfarin saved him from another heart attack. He died of a brain bleed instead. I remember his arms being a sort of purplish from the obvious internal bleeding going on. Warfarin is also still used as "rat poison". We must ask if it is compartimentalizing too much to say that we should give one drug which works well for what it's specified but produces side effects which can be equal or worse than that from while the person is being "saved".

Nancy Rogers, MD, in her book, NO MORE HEARTBURN, observed that medicine seems to all too often treat one thing which is broken in the body by breaking something else.
Epidemiological studies are advantageous for making good news headlines as they use large numbers of people in the cohort and most folks don't question how the study was constructed so being published all over the world in the news media can open the door for large grants for the the researching scientists. One scientist told me "of course epidemiological studies are baloney sausage, but if they come out with a result we like, then we use them." :( As ex-NASA climatologist reminded, "Scientists are human too!" (Roy Spencer, PhD, CLIMATE CONFUSION, NY 2008)
I like this recommendation in the article:
"Acetaminophen also appears in combination with other drugs in certain prescription products. In January the Food and Drug Administration asked all manufacturers of acetaminophen to lower the dose in a single tablet to 325 mg. Even at this dose, patients who took two tablets every four hours for 24 hours would be at risk for a staggered overdose, Lenchus said."
I hope this goes through. Lately I've only been able to find Tylenol Regular, 325 mg a pill in house brand. I agree here. 1 pill, 4 times a day is about all a person wants to take. Of the pain meds, Tylenol in the proper quantities is about the safest and a whole lot safer than aspirin (which to me, is like playing Russian Roulette because if you do get a brain bleed from aspirin, you have only a 20% chance of surviving). Not withstanding aspirin can also cause a severe gastrointestinal bleed (1 in 1000 says the Bayer company) and microbleeds in the brain (one UK study found that a large percentage of those who took the daily aspirin got these).

I think more than tylenol, that ibuprofen, statin drugs, alcohol and aspartame are what is a huge factor in the increased incidence of liver damage we are seeing. As for this study, it sounds rather poorly designed to me!

But it did make a good news story! Which is of course, the bottom line.