Beware of the Risks of Acetaminophen Overdose

Would you be surprised to learn that excessive use of over-the-counter painkillers like acetaminophen (found in Tylenol and other generic brands) “causes more than 80,000 emergency room visits each year because people often aren’t aware they’re taking too much”?[1] And did you know that acetaminophen is actually included in over 600 different drugs: cold and allergy medications, fever reducers and sleeping pills, among others? So, when you think you’re just popping a few extra-strength Tylenol, and then you take cold medicine or a sleeping pill, you could actually be taking a major health risk.

Interestingly, “Acetaminophen overdose is the leading cause for calls to Poison Control Centers across the US—more than 100,000 instances per year—and acetaminophen poisoning is responsible for nearly half of all acute liver failure cases in the US.”[2] You’ve probably been taught from an early age that acetaminophen is safe when taken as recommended. But the problem is that there’s very little difference between a safe dose and a potentially lethal one.

If you take 25% more than the daily recommended dose, which equates to just two extra-strength pills a day, within just a couple of weeks of daily use you could be causing liver damage.[3] As strange as it may sound, research has proven that taking just slightly more than the recommended dose of acetaminophen over several days or weeks (which is called “staggered overdosing”) can actually be riskier than overdosing all at once.[4]

Fortunately, the FDA recently urged doctors and others in the health field to stop prescribing combination drug products (the type that you may take without knowing they contain acetaminophen) that have more than 325 mg of acetaminophen per tablet, capsule, etc.[5] Still, despite this action, there are prescriptions containing more than the recommended dose on the market, so remember to add up all the sources of acetaminophen you’re consuming. Also, beware of the fact that the dosing advice on these medicines is sometimes quite unclear and there are various recommendations for how much you can take per day.

As far as my practice goes, there was a recent study conducted that compared patients who took acetaminophen for back pain versus those who were given a placebo. It found that, “there was almost no difference in the number of days required to recover between the two groups; the median time to recovery was 17 days in the regular…group, 17 days in the as-needed…group, and 16 days in the placebo group.”[6] Since about 25-30% of people struggle with persistent or chronic back pain throughout their lives, it’s important to know these facts so that you don’t reach for ineffective treatments like acetaminophen the next time you’re in pain. Instead, seek other methods of pain relief, as I’ve discussed in previous blogs, or come see me for an adjustment!

A few more important notes to keep in mind:[7]

·      Don’t take more than one regular strength (325 mg) acetaminophen when combined with a narcotic analgesic like codeine or hydrocodone.

·      Don’t take more than the prescribed dose of a product that contains acetaminophen in a 24-hour period.

·      Don’t take more than one product containing acetaminophen at the same time. Read the list of ingredients on any over-the-counter or prescription drug you take.

·      Don’t drink alcohol while taking acetaminophen, even if the amount of alcohol is small. The combination can increase your risk of kidney dysfunction.

I hope this post was informative and useful to you for your future pain relief needs. It is our job to stay informed and put these lessons into practice rather than depend on the FDA or other branches of the health industry to work in our best interests.

“Working to restore GOD’s perfect design in you!”

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[1] Time Magazine July 31, 2014; Mercola “Acetaminophen Overdose is Far Easier Than You Might Think,” August 14, 2014

[2] Hepatology 2004 Jul;40(1):6-9; Mercola Id.

[3] JAMA July 5, 2006: 296(1); 87-93; Mercola Id.

[4] British Journal of Clinical Pharmacology 2012 Feb; 73(2): 285-94; Mercola Id.

[5] FDA.gov January 14, 2014; NPR.org January 16, 2014; Mercola Id.

[6] Lancet July 24, 2014 [Epub ahead of print]; Fortune August 4, 2014; Mercola Id.

[7] Mercola Id.

5 Things to Know about Wearable Health Devices

 You’ve probably seen or heard about the latest and greatest fitness “wearables,” small devices that are used to track how many steps you take in a day, how many calories you’ve burned, how many hours you’ve slept, and the list goes on and on.

Some of these include best-selling products from Fitbit (http://www.fitbit.com/ ), Jawbone (https://jawbone.com/ ), Withings (http://www.withings.com/us/), LG (http://www.lg.com/us/fitness-activity-trackers ), Garmin (http://sites.garmin.com/vivo/ ),  and Misfit (http://www.misfitwearables.com/ ), not to mention the various free and paid apps available on smartphones.

The good thing about these devices is that they’re a step in the right direction. Many people actually want to be aware of their potentially unhealthy habits and are making an effort to change them. But while these devices aren’t bad, by any means, there are still some things to keep in mind before putting your faith in them completely.

Most of these are first-generation products and have limited capabilities—if you know this beforehand, you can have more realistic expectations if you purchase and wear one.

1. First, your device doesn’t know you or what activity level you’re participating in. For instance, a fitness tracker that measures movement will measure your steps the same way whether you’re running at a steep incline or walking along a flat sidewalk. Clearly, you’re going to be burning more calories and getting a more intense workout with the former. Additionally, activities with fluid motion like biking, rowing, and skiing will probably not be accurately tracked with these types of devices.

2. Some trackers are more accurate than others—and they’re not all the same. They vary widely in accuracy and measurements, so if you’re looking at your results from a tracker on a daily basis, you may not actually be getting a clear picture of reality.

3. Swimmers beware! Most activity trackers now claim that they’re water resistant up to a certain point. But, while an occasional splash of water won’t do any harm, sometimes swimming for an extended period of time can result in failure of the device. This clearly limits people who swim for regular exercise and would like to track their activity and progress.

4. Do your research to ensure that you’re wearing your wearable correctly. Different devices are meant to be worn on different areas of your body, and—believe it or not—your readings will actually vary depending on where the device is placed.  For example, some devices like Fitbit and the Misfit ankle accessory are recommended to be worn close to your ankle, while the CEO of LifeBeam (another device) thinks that you’ll have the greatest accuracy if you wear the monitor nearer to the core of your body.

5. Last but not least, be cautious when paying attention to sleep monitors. Many wearables made for sleep base their readings on nocturnal movement; if you’re not moving or fidgeting, they count this as deep sleep. As you can imagine, this leaves a lot of room for error and mis-readings. One woman pointed out that her Misfit device “just told me I had three hours of deep sleep last night—without any context about whether this is good or bad, or how you might be able to sleep better.”[1]

If you’re interested in purchasing and using a wearable fitness device, don’t let their less-than-perfect data dissuade you. As I said before, the benefits you can gain from just being aware of how much you’re moving each day (to a certain extent) can lead to making healthier choices—and that’s always a good thing!

“Working to restore GOD’s perfect design in you!”

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[1] Raskin. Everyday Health, August 12, 2014

Weather Not Connected to Back Pain After All?

If you’ve been worried about the return of your back pain in colder weather, don’t be. A recent study conducted in Australia and published in the Arthritis Care & Research Journal concluded that there’s not the connection between cold weather and back pain that was previously thought.[1]

In 2011 and 2012, researchers studied 993 cases of sudden, acute back pain in primary care clinics, and also gathered weather information.[2] They looked at the weather conditions that were occurring when patients first noticed back pain, and then compared it to conditions one week and one month before onset of the pain. 

After comparing all of their data, the researchers found “no association of temperature, relative humidity, barometric pressure or precipitation with episodes of pain.”[3] The only things that affected the risk of back pain—ever so slightly—were wind speed and gusts.

It’s important to note that back pain was the only type of pain looked at in this study, and their conclusions do not apply to arthritis, fibromyalgia, or other diseases.

Chris Maher, a professor at the George Institute for Global Health at the University of Sydney, suggests focusing on the aspects of pain you actually can control: carefully lifting objects, avoiding standing for too long a period of time, getting healthy amounts of physical activity and maintaining a healthy weight, and avoiding stress as much as possible. “Rather than worry about the weather,” Maher says, “worry about these other things, which you can change.”[4]

Also, remember that maintaining proper spinal alignment and structure through chiropractic care will lead to improved function, health, and wellness, as well as a decrease in pain.

“Working to restore GOD’s perfect design in you!”

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[1] Steffens D, Maher CG, Li Q, Ferreira ML, Pereira LSM, Koes BW, and Latimer J. “Weather does not affect back pain: Results from a case-crossover study.” Arthritis Care & Research 2014. DOI: 10.1002/acr.22378

[2] Bakalar N. “Weather May Not Affect Back Pain.” Well Blog, New York Times, July 16, 2014.

[3] Id.

[4] Id.