Do you react badly to paracetamol/tylenol?

[Countrygirl]

Is intolerance to paracetamol/tylenol a common problem in ME?

Both my mother was (she is deceased) and I, since developing ME and maybe before, are intolerant to paracetamol. When I asked the GP not to give it to Mum for pain control because it made her ill, the doctor said she had never heard of someone being made unwell as a result of paracetamol.

Now, I have just read this on my news feed: (Bear in mind that autism is claimed to be biochemically similar to ME):

Acetaminophen (Tylenol) (paracetamol) use after measles-mumps-rubella vaccination was **significantly associated** with autistic disorder when considering children 5 years of age or less.
(Tyelenol lowers glutathione levels, which are needed to eliminate toxicities...be sure to share this with your friends who are rushing out to get their kids the MMR vaccine.)http://www.ncbi.nlm.nih.gov/pubmed/18445737

Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination, and autistic disorder: the results of a parent survey.
Schultz ST1, Klonoff-Cohen HS, Wingard DL, Akshoomoff NA, Macera CA, Ji M.
Author information

Abstract
The present study was performed to determine whether acetaminophen (paracetamol) use after the measles-mumps-rubella vaccination could be associated with autistic disorder. This case-control study used the results of an online parental survey conducted from 16 July 2005 to 30 January 2006, consisting of 83 children with autistic disorder and 80 control children. Acetaminophen use after measles-mumps-rubella vaccination was significantly associated with autistic disorder when considering children 5 years of age or less (OR 6.11, 95% CI 1.42-26.3), after limiting cases to children with regression in development (OR 3.97, 95% CI 1.11-14.3), and when considering only children who had post-vaccination sequelae (OR 8.23, 95% CI 1.56-43.3), adjusting for age, gender, mother's ethnicity, and the presence of illness concurrent with measles-mumps-rubella vaccination. Ibuprofen use after measles-mumps-rubella vaccination was not associated with autistic disorder. This preliminary study found that acetaminophen use after measles-mumps-rubella vaccination was associated with autistic disorder.

Comment in

• A response to the article on the association between paracetamol/acetaminophen: use and autism by Stephen T. Schultz. [Autism. 2009]

PMID:

18445737

[PubMed - indexed for MEDLINE]

Could the lowering of glutathione be responsible for the adverse reaction and, if so, shouldn't this be found to be a common problem with people with ME?


Just curious...................................

 

[Sushi]

Could the lowering of glutathione be responsible for the adverse reaction and, if so, shouldn't this be found to be a common problem with people with ME?

Yes, it does lower glutathione which would affect the methylation cycle. Even main stream doctors seem to know that it lowers glutathione as that is the treatment given for acetaminophen overdoses in hospitals.

The biggest problem I know of with acetaminophen is the tiny margin between a safe dose and a toxic dose. It is hard on the liver. Perhaps some of us also have high liver enzymes for other reasons (medications?) and thus don't tolerate acetaminophen?

Sushi

 

[Countrygirl]

Thanks for your response Sushi. The doctors here, however, knew nothing about the problems with paracetamol. Actually, your answer chills me. About three years ago, when I was calling my 91 year-old mother throughout the day to check on her, she told me one evening, in great distress and agitation, that the carer who had just walked out the door who had found that she had failed to take her medication over a 48 hour period, had stood over her, and with the permission of the care manager, forced her to catch-up with her medications by forcing her to take eight parcetamols, a number of metaclopramide (these exacerbate the action of paracetamol), a double-dose of high blood pressure tablets and various other medications. I wish I knew then what I know now about paracetamol. Perhaps it is just as well, as I would have rushed to the care manager's office and nailed him to the floorboards. How ill Mum must have felt from this abuse! On second thoughts............I wish I had known this. I SHOULD have nailed him to the floorboards!

 

[MeSci]

Is intolerance to paracetamol/tylenol a common problem in ME?

Both my mother was (she is deceased) and I, since developing ME and maybe before, are intolerant to paracetamol. When I asked the GP not to give it to Mum for pain control because it made her ill, the doctor said she had never heard of someone being made unwell as a result of paracetamol.

I'm fine with it, and it is very effective. Just one is usually enough, although my ME itself doesn't directly cause any significant pain, so it's not 'ME pain'.

 

[MeSci]

Thanks for your response Sushi. The doctors here, however, knew nothing about the problems with paracetamol. Actually, your answer chills me. About three years ago, when I was calling my 91 year-old mother throughout the day to check on her, she told me one evening, in great distress and agitation, that the carer who had just walked out the door who had found that she had failed to take her medication over a 48 hour period, had stood over her, and with the permission of the care manager, forced her to catch-up with her medications by forcing her to take eight parcetamols, a number of metaclopramide (these exacerbate the action of paracetamol), a double-dose of high blood pressure tablets and various other medications. I wish I knew then what I know now about paracetamol. Perhaps it is just as well, as I would have rushed to the care manager's office and nailed him to the floorboards. How ill Mum must have felt from this abuse! On second thoughts............I wish I had known this. I SHOULD have nailed him to the floorboards!

That is incredibly shocking.

 

[Countrygirl]

Perhaps some of us also have high liver enzymes for other reasons (medications?) and thus don't tolerate acetaminophen?

Sushi

I understand that our phase II detoxication pathway is compromised, so could this result in an inability to cope with paracetamol? I recall that the local hospital (before they were advised that ME was a figment of our over-heated imagination) used a dose of buspirone to discover if a person had ME. If the patient reacted badly within 20 minutes they gave a diagnosis of ME. The pathway that detoxifies buspirone is responsible for a huge number of drugs and it is these, I believe, to which we are intolerant. Maybe paracetamol is one of these. (I have the list buried away in a pile of one zillion ME papers in my box room.

Is it related to Gilbert's syndrome with which a comparatively large number of us are diagnosed, I wonder? Probably, not as this just results, I think, in chronic low level jaundice.

 

[Gondwanaland]

she had never heard of someone being made unwell as a result of paracetamol.

Just every dr I saw knows that paracetamol can cause drug-induced hepatitis - and I saw pretty useless drs. My husband had it. Of course it depends on how often you take it.

 

[eafw]

Is intolerance to paracetamol/tylenol a common problem in ME?

Makes me feel poisoned and hungover, but then most meds have a bad effect so it's hard to tell whether the paracetemol is any different to the sensitivity I have to drugs in general.

 

[Sushi]

I wish I had known this. I SHOULD have nailed him to the floorboards!

Yes, he should have been nailed to the floor! There is a warning on the bottles in the US, though it is way too small:

Taking more than the recommended dose may cause liver damage. In case of overdose , get medical help or contact a Poison Control Center. (number given) right away. Quick medical attention is critical for adults as well as for children even if you do not notice any signs or symptoms.

Sushi

 

[Sidereal]

Yes, people with Gilbert's syndrome don't tolerate paracetamol well, as well as a host of other meds. Yet another area of medical ignorance claiming that Gilbert's syndrome is asymptomatic.

 

[Countrygirl]

That is incredibly shocking.

Yes, it was a nightmare, to be honest. At the same time, one (I think more) of the carers was stealing Mum's pension and Attendance Allowance. This continued for at least a year and she so controlled Mum that she was totally dependent upon her. The carer even boasted to me that she was persuading Mum to make a will. She had already acquired three other properties from her clients. I learnt a challenging lesson. Just as a paedophile grooms a child so these corrupt carers groom the elderly until they utterly believe them and disbelieve their next-of-kin. Mum even tipped her off as to where the CID had placed the cameras. The care manager appeared before County Hall and the police on a charge of attempted murder and after an 18 month period of laying traps and facing Mum's ire as I pursued her carer I finally landed her in the County Court. Poor Mum who never left her home found her story in the national dailies and the front pages three weeks running. Never, never would I ever use carers again. They are a dreadful hassle and more trouble than they are worth.

 

[Countrygirl]

Yes, people with Gilbert's syndrome don't tolerate paracetamol well, as well as a host of other meds. Yet another area of medical ignorance claiming that Gilbert's syndrome is asymptomatic.

Thank you for that! My family and I have Gilbert's syndrome. Is there any link, please, to this so that I can inform my doctor?

 

[Sidereal]

Thank you for that! My family and I have Gilbert's syndrome. Is there any link, please, to this so that I can inform my doctor?

I am not aware of any good scientific information that you can show to your doctor. I heard about this intolerance of various substances that are metabolised via glucuronidation from other people with Gilbert's who post online. If you read their symptom list it sounds a lot like CFS to me. According to mainstream medicine this syndrome doesn't cause any symptoms so instead of fighting a futile battle with doctors, why not just switch to a safer painkiller instead? Paracetamol is very taxing on the liver anyway.

Eur J Drug Metab Pharmacokinet. 1999 Jan-Mar;24(1):9-13.
Heterogeneity of paracetamol metabolism in Gilbert's syndrome.
Esteban A1, Pérez-Mateo M.
Author information

Abstract
Gilbert's syndrome (GS) is an inherited bilirubin UDP-glucuronosyl transferase deficiency. The object of this study was to investigate the possible effects of this disorder on the metabolism of a drug, such as paracetamol, which is basically eliminated by hepatic glucuronidation. We studied 32 healthy volunteers and 18 people with GS, all of whom were given 1.5 g of paracetamol orally. In the 24 h urine collected, we determined the elimination of free paracetamol, the conjugates (glucuronide, sulphate) and the oxidation products (cysteine, mercapturic acid) by high pressure liquid chromatography (HPLC). The results are given as a percentage of the total quantity of paracetamol eliminated. The patients with GS were divided into 2 subgroups (GS-I and GS-II) according to whether glucuronidation was more or less than 50%. The overall results of the GS group showed no significant difference in the urinary elimination of metabolites as compared to the control group. However, in subgroup GS-I, a reduction in glucuronidation (P = 0.0012) and an increase in oxidation (P = 0.0051) was seen, as compared with the other 2 groups. There was inverse correlation between the glucuronide produced by conjugation and the oxidation products (r = -0.8718; P<0.005). People with GS are a heterogeneous group with respect to the metabolism of paracetamol. In one subgroup this was normal. In the other subgroup there was a marked reduction in glucuronidation and an increase in oxidation. These changes could mean that people in this subgroup are more liable to liver damage after an overdose of paracetamol.

http://www.ncbi.nlm.nih.gov/pubmed/10412886

 

[lansbergen]

Is intolerance to paracetamol/tylenol a common problem in ME?

No problem for me.

 

[Countrygirl]

why not just switch to a safer painkiller instead? Paracetamol is very taxing on the liver anyway.

Actually, I stopped taking them because I am intolerant. I do need a pain killer for chronic neuropathic pain over my scalp and face, but even morphine had no impact, so I guess there is nothing to help.

 

[Sidereal]

Actually, I stopped taking them because I am intolerant. I do need a pain killer for chronic neuropathic pain over my scalp and face, but even morphine had no impact, so I guess there is nothing to help.

I'm sorry to hear that.

 

[peggy-sue]

Hiya Countrygirl!
I'm still lurking a bit, if not posting, but I do have some information about what constitutes paracetamol overdose, I managed to find and copy for my own use. It's this bit in blue.


Risk of severe liver damage (ie a peak ALT more than 1000 IU/L)

Based on the dose of paracetamol ingested (mg/kg body weight):

• Less than 150 mg/kg - unlikely.
• More than 250 mg/kg - likely.
• More than 12 g total - potentially fatal.

I've had sciatica for the last couple of years, and have been prescribed solpadol, (up to 8 a day) which is paracetamol with codeine. Paracetamol has never worked as a painkiller for me, (or for my brother and I know of loads of other folk too, who simply do not find that it works). It is touted as a painkiller, but there is not even a proposed pharmacological mechanism by which it might operate as an analgesic.

I'm small and don't weigh too much, and I'm aware that in the states, there are moves to make the most anyone can take in a day are 6, so I know never to take more than 6.
After a few months of up to 6 a day, my health started deteriorating. At first, we thought I simply hadn't managed to recover from a week's holiday with family in Eire, but I was going further and further downhill, my baseline activity level had been seriously curtailed. I went a year without being able to manage even a weekend away.

However, I needed the codeine for the pain. (My gp doesn't believe in ME, won't even give me a diagnosis, I've seen no "specialist"). Naturally, he won't give me codeine without paracetamol in it.

However, the biochemistry works out really neatly.

The antidote to paracetamol poisoning is NAC. (N-Acetyl-Cysteine)
NAC is the precursor to glutathione, one of our important energy chemicals.

Paracetamol uses up glutathione, so recently, I've been taking a couple of 600mg tabs of NAC along with my painkillers and it made a huge difference to my baseline. I went back to where I'd been before, without the compulsory poison.

It is costing a fortune, even though I do get the cheap stuff from H&B. Preferrably when it's on a special offer.

I would think if anybody with ME has to take paracetamol, it would be a good idea to take NAC along with it.

At one point it was considered that NAC should be included in every paracetamol tablet, because it would vastly reduce the munber of deaths from it, but that was deemed "too expensive".
So they put it in little blister packs of 12 and charge what they used to charge for 50 of the horrible things instead. Daft, because 12 could still easily kill. But an excuse to pump the price up.

 

[Countrygirl]

HORRAY...PEGGY-SUE IS BACK!!!!

I wondered where you were and why you had disappeared and hoped you were hanging together and not too poorly.

Thank you for the interesting information on parcetamol,but I wish I had known that when Mum was given an overdose. Next time a doctor implies that I am nuts for not being able to tolerate it I will know be able to wax eloquent about its effects on glutathione.

I hope you stay around Peggy-Sue.

C.G.
xx

Edited to say that I am so sorry that your GP is a ****!

 

[perchance dreamer]

I've read that Tylenol interferes with methylation. I've never found it effective as a pain reliever although on the rare occasions that I have a high fever, it brings it down quickly.

 

[MeSci]

Actually, I stopped taking them because I am intolerant. I do need a pain killer for chronic neuropathic pain over my scalp and face, but even morphine had no impact, so I guess there is nothing to help.

Have you tried cannabis or CBD oil? There are several threads talking about cannabis helping with pain, but I don't know if it works with neuropathic pain, or whether just the cannabidiol (CBD) oil does (I believe this is legal).

I have found that cannabis abolishes muscle pain and weakness within minutes.