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It's probably worth mentioning that this drug is called Acetaminophen in the US, and is the active ingredient in Tylenol and other over the counter medicines.
maybe should add (tylenol) to the article subject?
Basically, paracetamol turns out to be mildly contraceptive, by meddling with cell division cycle.
I wonder if it might also slow healing of wounds, or wherever else intense cell division happens.
The authors touch on potential wider implications in the abstract:
> These results suggest that APAP should be used with caution by women attempting to conceive. Given that cell division is fundamental to all development, further investigation is now warranted to substantiate these findings and to elucidate possible implications for other developmental processes, such as gonadal and brain differentiation.
NSAIDs reduce inflammation. Since inflammation is part of healing, they can slow recovery, but they’re useful when inflammation itself is a problem.
Unsure if this is related, but I’ve heard that taking painkillers for delayed onset muscle soreness will reduce muscle gains.
I think rapid cell division might occur during embryo development. Not a biologist. Just a guess.
The vaccine-autism smoking gun that Andrew Wakefield and RFK Jr. heroically tried to find has, so far, failed to turn up. But there was a study recently that showed that autism is correlated with the mother taking acetaminophen during pregnancy.
I live in Brazil. We have broad access to non-steroidal anti-inflammatory drugs. Even the best-known medicines have unexpected and unknown adverse effects: in general and specifically in people with unexpected genetic, enzymatic, and protein variations. This has no solution. The medicine acts differently in each body, which is subtly diverse from the others. I see a lot of research criticizing any "old" general medicine and introducing the "new" one. I don't know if this is the case. Every medicine has its rush, half-life, and side effects, and its actions are not fully mapped. My preference for long-term treatments is: dipyrone. Short term: ibuprofen. Lymphatic pain: paracetamol. It may not make sense, but that's how I use it.
Interesting how you put metamizole at #1 for long-term treatment. As far as my experience goes, many doctors do the same in Germany. On the other hand, I've heard that the medication is banned in many other countries.
I guess the safest way is to take up the treatment in a hospital, to check for immediate bad reactions.
On the other hand, like with many medications, severe allergies and individual sensibilities causing side effects often don't show up often in the short term, but rather suddenly after many dose intakes.
So I'm back where I started. Not disagreeing with what you say. It seems like these non-steroidal pain relief medications are poorly understood regarding their interaction with the whole body though.
Many OTC medications and even some prescribed ones (especially psychiatric medications) suffer from a very poor understanding and apparent lack of effort in improving the understanding of their mechanisms of action.
I've always had an (unreasonable?) dislike of Paracetamol/Tylenol ever since I found out it was the #1 cause of acute liver failure in the US. Liver failure is scary.
The UK started requiring that Tylenol always be sold in blister packs instead of convenient-to-kill-yourself-with whole bottles of pills.
Results: "Suicidal deaths from paracetamol and salicylates were reduced by 22% (95% confidence interval 11% to 32%) in the year after the change in legislation on 16 September 1998, and this reduction persisted in the next two years. Liver unit admissions and liver transplants for paracetamol induced hepatotoxicity were reduced by around 30% in the four years after the legislation. Numbers of paracetamol and salicylate tablets in non-fatal overdoses were reduced in the three years after the legislation. Large overdoses were reduced by 20% (9% to 29%) for paracetamol and by 39% (14% to 57%) for salicylates in the second and third years after the legislation. Ibuprofen overdoses increased after the legislation, but with little or no effect on deaths."[1]
Most, if not all, medication would carry a poisonous symbol, if it were not taken out of regulation for that. Mostly, you kill organs by any overdose.
Roughly:
- Paracetamol overdose can cause severe liver damage and may be fatal.
- Ibuprofen in high doses can lead to kidney injury and stomach bleeding.
- Aspirin overdose may result in salicylate poisoning, causing ringing in the ears, confusion, and metabolic acidosis.
It's not just that it causes liver failure: it's that the difference between the therapeutic dosing range for pain relief it's prescribed for is dangerously close to the toxicity level.
Other drugs like theophylline have ceased to be prescribed for a similar reason alternatives were available, but due to drug marketing, acetaminophen is touted as the "safe" pain reliever.
As with all things, the poison is in the dose. A tonne of incredibly useful medicine can kill you if dosed incorrectly.
Tylenol is unusual among OTC medications in that you can get liver damage from as little as double the recommended dosage. It doesn't play well with alcohol, either. I wonder how many of those liver failures are the result of people drinking and taking too much of the drug either because the alcohol causes them to lose track, or from the alcohol interaction itself.
Also extra damage if the liver is already busy with alcohol. So not good to take for a hangover.
This is why Ibuprofen is perhaps the better default painkiller.
I'm finding all the 'liver failure' comments on this post fascinating. The dose is on the back on the packet, as is the time interval between doses and the maximum number of pills per day. To overdose you need to ignore that. Given all the mention of 'Tylenol' I'm assuming most of the commenters are American - is this a thing in the US where you just take a random number of pills and ignore the labelling or treat it as a guide? Is it a consequence of the fact you can buy these in bottles by the hundred?
It is scary, but I assume caution improves your chances of avoiding an overdose considerably.
This send me into a whole rabbit hole. Mostly children get paracetamol overdose. Then I learned that in US/UK kids get paracetamol in liquid form with all kinds of flavours. Which is much harder to dose correctly when the kid spits or drools it out.
Total culture shock for me, as in Europe the default for children is rectal ingestion (which is probably a culture shock as well for Americans). Any how, with pills it is much easier to avoid overdose.
> "Smoking and alcohol are established risk factors for spontaneous abortion, underscoring the importance of the chemical environment during embryonic development."
Both of my parents are/were heavy smokers drinkers from their teenage years. Mom died of lung cancer from smoking. Kind of wild to think that the odds were really stacked against my birth.
Nature really, really, really wants you to have kids. It took us collectively as a species most of our existence to find genuinely effective methods to alter our biology sufficient to block this process, and we still have a hard time doing it without dramatically impacting the host organism.
This is probably one of those things where the risk is normally small, so small increases cause large changes in percentage.
For instance, if spontaneous abortion is normally 1% and smoking increases it to 2%, then that’s a 100% increase. Now, I don’t know the actual numbers, and smoking is just generally not good for one’s health, but I wouldn’t go as far to say things were stacked against you.
Smoking certainly isn't good, but it also isn't some super-poison like some people like to pretend. Nearly half of US smoked in the 40s and 50s and they had no problem having tons of kids.
Embryonic development is so sensitive, especially that if nervous system. I suggest to my patients total drug avoidance. Even peeling off the tomatoes.
It's interesting because my wife has been using Ibuprofen for headache relief, whereas I use Paracetamol. I usually got Paracetamol growing up but recent studies showing adverse effects of Ibuprofen on male fertility solidified my resolve and consistency in choosing Paracetamol. My wife's reason for using Ibuprofen was simply because it worked better for her. Now it's kind of surprising to learn that Paracetamol has negative effect on women's fertility... I guess this means that both drugs are harmful to a different gender? What a coincidence? We were both using the optimal one for ourselves for reasons beyond our understanding... Until more data comes out.
Anyway, I understand arguments for avoiding drugs, medicines and chemicals altogether. Clearly, everything is more complex than it seems and side effects can never be fully known or understood; especially on a case-by-base basis given that everyone's DNA is different and responds differently to chemicals. I only take Paracetamol if I have a migraine with visual aura which is quite rare. I don't take it for standard headaches.
Acetaminophen/Paracetamol is a cox3 inhibitor
it also messes with bone formation so be careful using it for any length of time
especially after athletic activity
“ APAP could contribute to early embryonic loss by impairing initial cell divisions. These results suggest that APAP should be used with caution by women attempting to conceive. Given that cell division is fundamental to all development, further investigation is now warranted”
By the same logic it would now be effective against cancer, no?
Isn't paracetamol forbidden in the US for pregnant women already? It is in other countries
As far as I can tell from my local health organisations, paracetamol is one of the safest painkillers for pregnant women.
That doesn't make it very safe, but NSAIDs carry well known risks during later stages of pregnancy, and opiods aren't exactly harmless either. Even aspirin carries risk (and aspirin doesn't even work as well compared to other drugs).
As far as I can tell paracetamol is still the first choice for painkillers while pregnant, but only because none of them are completely safe to use. It's probably fine for short term usage, but that also goes for non-pregnant people to be honest.
No it’s the only allowed pain reliever for pregnant women in the US. It’s also allowed in the UK and the EU from what I can tell. What countries are you talking abou?
You are probably thinking of ibuprofen which is considered non safe during pregnancy. Paracetamol is pretty much the only OTC pain relief medication that is recommended for pregnant women.
Can the effects of a drug on the body be reversed after a person stops taking it?
Sometimes yes, sometimes no.
Yes, in most cases. Or are you specifically asking about Paracetamol?
I won't take acetaminophen (usually) learning of the liver toxicity and low overdose potential. And I have a friend that destroyed his kidneys with ibuprofen and is on a transplant list.
But from what I understand acetaminophen also dulls emotional pain like from being fired or breaking up with a girlfriend which is interesting.
I still prefer to take neither if I can avoid it and I'll hurt a little bit instead. Hurt a lot and I'd probably change my mind though.
> And I have a friend that destroyed his kidneys with ibuprofen
Acetaminophen is not ibuprofen. But I also don't like planes because a friend of mine died in a car crash.
Expected in-depth discussions about the topic, but got pseudo-science medical advice instead. I guess HN _is_ a 'social media' after all.
This site is populated by mid-level code monkeys and “founders” of junk B2B startups. So, two groups that have an inflated sense of their own intelligence and believe everything that leaves their lips (or tips of their fingers) is on level of God’s word.
I'm sure an untreated infection might be more upsetting.
Except that paracetamol does not treat infections.
What scares me about this is that Tylenol is a drug that's been handed out to everyone, for everything, for decades. And if we could miss how dangerous this one is, what are the odds other drugs aren't just as risky?
Side note, here's a Scrubs clip from 2001 that shows just how ubiquitous Tylenol was.
https://www.youtube.com/watch?v=EcDWj7kZcRc
I know the anti-vax crowd is full of homeopaths, chiropractors, and tarot readers. But they're not wrong about one thing: drug companies make money by selling drugs. If we can't guarantee real oversight before those drugs hit the market, we're in deep trouble.
Anyone know what the long term side effects are?
I've been taking multiple paracetamol tablets for years now, almost out of habit now.
There is mounting talk of a link between Paracetamol/Acetaminophen/Tylenol and autism.
Some links:
https://hsph.harvard.edu/news/using-acetaminophen-during-pre...
https://jennifermargulis.substack.com/p/why-this-doctor-is-c...
I never took Tylenol/Paracetamol/acetaminophen, or anything containing it or given it to my children. We never reduce fever below 39.5/103.1 either - risks of febrile seizures are overstated and if you're a responsible parent, not a lazy one, you can see if things are going South, but there are other traditional means to lower fever. People are just too spoiled nowadays!
I tested positive with COVID-19 on Tuesday and had a pretty high fever (103) with a terrible headache, but I didn't take ibuprofen. First, because it could lower my fever, second, because its anti-inflammatory effect would compromise my immune system response to the pathogen. Most people I know immediately try to lower their fever to reduce their discomfort and would immediately take it for headaches, too.