Before You Reach for That Pain Pill...

About a year ago, I was skiing at Whistler Mountain in British Columbia with two British physicians. I had hurt my wrist in a fall, so I went into the lodge and emerged with a package of aspirin. The British doctors both glanced at the package, and before I could take two of them, as I normally would, they eagerly mentioned that the normal dose of aspirin given in a hospital in England is the same as what we tend to call baby aspirin in the United States.

That’s right. In other parts of the world, where medical outcomes tend to be better than in the United States, doctors prescribe a fourth of an aspirin to relieve pain — 81 milligrams. Of course, if you take two aspirin at once, as I used to do — they’re prescribing an eighth as much. Why? Because aspirin is a powerful blood thinner, and studies have shown you only need a little of it to relieve most inflammations and pain.

Aspirin causes tiny lesions in the gastric system every time you take it. The list of side effects of aspirin is numbing: It can create problems with your skin, kidneys, heart, nervous system, eyes, stomach and blood, among others things.

And now we are beginning to discover something else those Brits knew — we’re taking too much acetaminophen, which you may know by the brand name Tylenol. A year ago, the FDA told doctors not to prescribe medicines that contain, in combination, more than 325 milligrams of acetaminophen.

There are hundreds of prescription and over-the-counter drugs in this country that combine acetaminophen with other compounds. Taking too much acetaminophen is now the leading cause of liver failure in the United States. Many of the people on liver transplant lists took too much acetaminophen for too long.

A 2012 study of two hospitals in Boston shows that one of every 15 patients inadvertently received an overdose of acetaminophen.

The latest warnings come in a study published in the British medical journal BMJ. Researchers examining previous studies found that there is a higher risk than previously thought of taking acetaminophen, known as paracetamol in Britain, especially when taken at the higher levels of dosage recommended.

In the United States, the maximum recommended dosage in 24 hours is 4,000 milligrams for healthy adults from 12–64 years of age. Adults 65 and older should not take more than 3,000 milligrams a day. The recommended single dosage is 650–1,000 milligrams every four–six hours.

In Britain, the recommended dosage is the same, but patients are advised to never take acetaminophen more than four times in 24 hours.

My British doctor friends would tell you to skip over the boxes of pain relievers that say “extra strength” and take the smallest pill you could find (usually 325 milligrams) and see if one, not two, doesn’t do the trick.

By the way, you might be interested in seeing what Johnson & Johnson’s Extra Strength Tylenol contains beside 500 mg. of acetaminophen: carnauba wax*, castor oil*, corn starch, FD&C Red No. 40 Aluminum Lake, hypromellose, magnesium stearate, polyethylene glycol*, powdered cellulose, pre-gelatinized starch, propylene glycol, shellac, sodium starch glycolate and titanium dioxide.

*contains one or more of these ingredients. 

To a bright future,

Stephen Petranek
for The Daily Reckoning

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