There are some food and drink combinations you know you’re going to have to pay for later. If you’re prone to heartburn, you know a meal of hot wings and beer is probably going to keep you up later. If you stop by Starbucks for a cake pop and a Frappuccino, you know that sugar high is going to lead to a major drop in blood sugar, taking all your energy along with it.
Even if you’re used to thinking about how different combinations could impact your digestive system or blood sugar, you probably don’t think too much about how what you consume will impact your liver. After all, the liver quietly does its job (or more aptly, jobs; it does more for the body than you probably realize) without us even thinking about it.
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Everything you eat, drink or swallow impacts the liver. It’s the liver’s job to process blood into nutrients and filter out toxins, which are excreted in the form of urine or stool. Again, all of this happens without us even realizing it. But when the liver is overtaxed, your health can take a turn for the worse quickly, and sometimes it’s even life-threatening.
There’s one combination that you may not realize can damage the liver. Here, hepatologists explain what it is and why it’s so dangerous.
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Tylenol is a go-to medication for headaches, menstrual cramps, body aches and more. There’s a good chance you have a bottle in your bathroom right now. It’s popular because it works. Pop a couple of Tylenols, and you’re ready to go about your life. While Tylenol is generally considered safe, Parade talked to three doctors and they all said that there is one common mistake people make when taking Tylenol: combining it with alcohol. “Both Tylenol (acetaminophen) and alcohol are processed by the liver, and together they create a toxic storm that most people have no idea is happening,” says Dr. Susan Kais, MD, a gastroenterologist and assistant professor of clinical at UC Health.
Dr. Seth Sclair, MD, a hepatologist and assistant professor of medicine at Case Western Reserve University, explains that Tylenol has a toxic metabolite called NAPQI that accumulates in the liver and is neutralized by an antioxidant called glutathione in the liver. He says that when too much Tylenol is taken over the course of a few hours, the liver’s protective stores of glutathione are depleted, and then the toxic breakdown product from Tylenol accumulates. This is already dangerous enough, but drinking alcohol taxes the liver even more, making it worse.
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According to Dr. Sinclair, this is especially dangerous for habitual alcohol drinkers, who often have lower levels of glutathione, making them more susceptible to the toxic effects of Tylenol.
Dr. Neha Jakhete, MD, a gastroenterologist and hepatologist with the University of Maryland Medical System, echoes this, saying that the risks of combining Tylenol and alcohol are greatest for people with cirrhosis because their glutathione levels are already lower. (If you have cirrhosis, Dr. Jakhete recommends taking only half of the recommended Tylenol dose to avoid overtaxing the liver.)
But Dr. Kais warns against anyone mixing Tylenol and alcohol. “The risks are serious and should not be underestimated. The liver is the body's primary detoxification organ, responsible for processing Tylenol, alcohol, medications and environmental toxins. When both are present at the same time, the liver becomes overwhelmed. The toxic byproduct that Tylenol naturally produces builds up faster than the liver can clear it, which can cause significant liver cell damage,” she tells Parade.
The impact is most dangerous when Tylenol and alcohol are combined regularly. “Over time or in high doses, [the effects] can escalate to severe liver inflammation and an increased risk of acute liver failure. What makes this combination particularly dangerous is how common both substances are. Tylenol is one of the most widely used over-the-counter pain relievers, and alcohol is one of the most common stress relievers, so the combination happens far more often than people realize,” Dr. Kais says.
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Another Common Mistake People Make When Taking Tylenol
Besides combining Tylenol and alcohol, Dr. Jakhete says that one common mistake people make is taking more than one medication with acetaminophen in it, something that happens way more frequently than people realize.
“Someone could be taking Tylenol for pain, but also taking a cold medication, which also could have acetaminophen in it, for example,” she explains. To avoid accidentally doubling up on acetaminophen, Dr. Jakhete suggests always reading the ingredients list on any medications you’re taking together.
Acetaminophen toxicity is the second most common reason for liver transplants and the most common cause of acute liver failure in the U.S. Roughly half of these cases stem from unknowingly consuming more than one medication with acetaminophen in it or misinterpreting the directions. This speaks to just how easy it is to double up on acetaminophen without even realizing it.
What’s especially dangerous about taking too much Tylenol or combining it with alcohol is that there typically aren’t any symptoms at first, even though the liver is being damaged. “After a Tylenol overdose, most individuals will not have symptoms for the first several hours. Symptoms include nausea or vomiting, sweating, stomach pains, especially in the right upper abdomen where the liver resides, fatigue, weakness, yellowing of the eyes or skin and confusion or drowsiness in severe cases,” Dr. Kais says.
She emphasizes that early symptoms may be very mild, even when liver damage is occurring, explaining, “It is crucial to seek medical attention immediately if you suspect Tylenol toxicity."
If you do go to the hospital because you took too much Tylenol or you combined it with alcohol and the liver has been negatively impacted, it will be treated by giving the liver more glutathione through an infusion. “This is most effective within the first eight hours of the liver being impacted,” Dr. Jakhete says.
In very rare cases where too much time has passed or the liver is worsening, a liver transplant may be required.
It’s easy to take your liver for granted. It’s also easy to downplay the impact that over-the-counter medications like Tylenol can have when they’re misused. Always read the label on your medications to make sure you aren’t doubling up on the same ingredients. And save that alcoholic drink for when you’re feeling better.
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Sources:
Dr. Susan Kais, MD, gastroenterologist and assistant professor of clinical at UC Health.Dr. Seth Sclair, MD, hepatologist and assistant professor of medicine at Case Western Reserve University.Moyer, A. M., Fridley, B. L., Jenkins, G. D., et al. (2010). Acetaminophen-NAPQI Hepatoxicity: A Cell Line Model System Genome-Wide Association Study.Toxicological Sciences. 120(1):33-41.Dr. Neha Jakhete, MD, gastroenterologist and hepatologist with the University of Maryland Medical System.Acetaminophen Toxicity. StatPearls.Hence then, the article about 3 hepatologists are begging people to stop combining this one thing with tylenol was published today ( ) and is available on Parade ( Saudi Arabia ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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