One day on the pickleball court, the person next to me casually told me they take Tylenol (acetaminophen) as a preventive way to fight pain from playing pickleball every day. I didn’t know what to say. Didn’t they know how dangerous acetaminophen was for the liver? Reading the warning label, the directions are take no more than 1000 mg every 6 hours and do not exceed 6 capsules (500mg each) in 24 hours. Also, only take for 10 days!
This brings back the memory of one of my favorite people in high school, Bobby. He was quite the practically joker and I recall one time when I arrived at a party by the lake we lived by, I got out of my car and he ran over, picked me up and ran down a dock and jumped into the water with me still in his arms. I couldn’t be angry at him as I was soaking wet for the entire party. I just laughed at another Bobby antics. He was the kind of guy everybody liked. He was always smiling, smart and did well at school, and built his own house from the foundation up. It was there that it was the beginning of Bobby’s end. He was working one night by himself in the house he was constructing, when he pulled a stack of drywall that was leaning against the wall looking for a misplaced tool. The drywall came crashing down on Bobby’s leg trapping him for 12 hours before his brother came looking for him after Bobby was missing from work. He was rushed to the hospital almost losing his leg. For years I would glance at the terrible scar on his leg. He limped and was in constant pain. Tylenol was his go-to pain management drug. After years of taking Tylenol, the toxicity built up in his liver and sadly Bobby passed away from liver cancer last year. I was shocked when I read his obituary. He was just one of those guys that made the world a better place.
Acetaminophen can cause liver toxicity if taken over the maximum dose.
The drug is metabolized mainly by the liver and broken down into glucuronide and sulfate conjugates, but a minor percentage of the drug is converted into a highly toxic byproduct called N-acetyl-p-benzoquinone imine (NAPQI). NAPQI is typically detoxified in the liver if used safely and sparingly under the recommended guidelines, but too much acetaminophen over an extended period of time can overload the liver and cause toxins to build up. (https://www.tmc.edu/news/2020/05/does-acetaminophen-cause-cancer/)
What about Advil? (Ibuprofen) Is it just as toxic? Instead of being toxic on the liver, ibuprofen is tough on the kidneys. Again, I’m on the pickleball court when a nurse who works in the dialysis department tells me that many of the patients are on dialysis from taking too much Ibuprofen. What??!! I was stunned.
According to the National Kidney Foundation, as many as 3 percent to 5 percent of new cases of chronic kidney failure each year may be caused by the overuse of these painkillers. Once kidney disease occurs, continued use of the problem drug makes it worse.
Nonprescription pain medicines should not be used without your doctor’s permission if you know you have low kidney function. Also, even if your kidney function is good, long–term use with high doses of these pain drugs may harm the kidneys. Kidney damage happens because high doses of the drugs have a harmful effect on kidney tissue and structures. These drugs can also reduce the blood flow to the kidney. If you are older, your kidneys may have a stronger reaction to these medicines and you may need a smaller dose.
Kidney disease from pain medicines is often preventable. You can change your risk by how you take medicines. To avoid kidney problems, it is important to follow the instructions on the label. You should drink plenty of fluids and avoid becoming dehydrated when you use these medicines.
Even with normal kidney function, you should use pain medicines:
- Exactly as prescribed or as on the label
- At the lowest dose possible
- For the shortest period of time.
What are analgesics?
Analgesics are medicines that help to control pain and reduce fever, and some types also decrease inflammation. These are commonly used analgesics:
Acetaminophen. Although aspirin was most common analgesic for decades, today, the most commonly used over–the–counter pain medicine is acetaminophen. This drug is available under the brand name Tylenol® and as a generic (no brand name) with the word “acetaminophen” on the package. It is often effective for mild to moderate pain. Its safety depends on how it is used. People who take too much or take it too often risk side effects or worse. Acetaminophen is also found in combination with other ingredients in many cold, sinus, and cough medications. If you take these drugs together, the dose can add up.
Aspirin. This is one of the drugs grouped together under the name “nonsteroidal anti–inflammatory drugs” or NSAIDs. Nonsteroidal anti–inflammatory drugs (NSAIDs) are a specific group of pain relievers. Some NSAIDs are available over the counter. This includes different brands of aspirin, ibuprofen, naproxen sodium and ketoprofen.
Another warning on the Tylenol and Advil box is take no longer than 10 days! There are players on the court that take Tylenol like they are Tic Tacs. Why? Because it is an OTC drug, and people have the impression that they are harmless. Sadly, this is not true. Taken at a higher dose than recommended or using when you are also drinking cocktails at night, can be a deadly combination.
So, what can you do if you have constant pain? Well, the old story of the patient who goes to his doctor and says it hurts every time he bends his arm, and the doctor tells him to stop doing that, is true. If banging your knees on hard asphalt is causing pain, it may be time not to play as much.
Natural pain relievers like turmeric may give relief. https://www.healthline.com/health/pain-relief/surprising-natural-pain-killers#boswellia
Talking to your doctor about pain relief is a definite conversation to have with them. Discuss your concern with long-term OTC pain relief.
The takeaway to this blog is, taking OTC pain relief is serious and can cause damage to your liver and kidneys. Definitely stop taking Advil and Tylenol as a PREVENTATIVE pain solution for more than 10 days is not advised. Read the the back of the box or Google Tylenol risks. The next time you want to take an OTC pain reliever, you’ll give it a second thought.
Stay safe on the courts.
Pickleball Terry 941-400-0978
