WARNING!
This is an older article that may not reflect Dr. Mercola’s current view on this topic. Use our search engine to find Dr. Mercola’s latest position on any health topic.
By Dr. Mercola
Many view over-the-counter (OTC) drugs as safe because they don't require a prescription. Nothing could be further from the truth. In fact, many OTC drugs were previously carefully monitored prescription drugs.
OTC drugs are still chemicals that in no way, shape, or form treat the cause of your problem, and can lead to complications that can seriously injure and even kill. The pain reliever and fever reducer acetaminophen is one such example.
Most people will take this medication without thinking twice about it, which is probably why acetaminophen overdose is the leading cause for calls to Poison Control Centers across the US every year. Acetaminophen is also responsible for more than 56,000 emergency room visits, 2,600 hospitalizations, and an estimated 458 deaths due to acute liver failure1 each year.
The US Food and Drug Administration (FDA) finally added warnings about liver damage to the drug's label in 2009. This action came 32 years after a panel of experts advised the agency it was "obligatory" to do so...
Then, on January 14 this year, the FDA issued a statement2, 3 urging health professionals to discontinue prescribing and dispensing prescription combination drug products that contain more than 325 milligrams (mg) of acetaminophen per tablet, capsule, or other dosage unit, to limit the risk of serious side effects.
Keep in mind that certain prescription painkillers, such as Vicodin and Percocet, also contain acetaminophen and should therefore not be mixed with other acetaminophen-containing medications.
Acetaminophen During Pregnancy May Promote ADHD in Children
Now, a team of researchers are raising questions about the use of acetaminophen during pregnancy, as it may raise the risk of behavior problems in your child later on. The study, published in the journal JAMA Pediatrics,4 notes that "[r]esearch data suggest that acetaminophen is a hormone disruptor, and abnormal hormonal exposures in pregnancy may influence fetal brain development."
While they say it's too early to make any definitive recommendations to the public, a "heads-up" warning is certainly warranted. As reported by Forbes:5
"...since the results do suggest that prenatal use may as much as double the risk of behavior disorders in the child, pregnant women may want to take the study into consideration, or talk with their doctors."
The study included data from more than 64,000 mothers and children in the Danish National Birth Cohort. Over 50 percent of the women reported taking acetaminophen while pregnant, which was found to be linked to:
- A 30 percent increased risk for ADHD in the child during the first seven years of life
- 37 percent increased risk of being diagnosed with hyperkinetic disorder (HKD), a severe form of ADHD
Behavioral effects appeared to be dose dependent. The more frequent the use of acetaminophen during pregnancy, the higher the offspring's chances of being diagnosed with ADHD-related problems.
Children of women who used the drug for 20 or more weeks during pregnancy had nearly double the risk of getting an HKD diagnosis. They also had a 50 percent greater chance of being prescribed an ADHD medication. According to the featured article:6
"Acetaminophen can cross the placenta, making its way to the fetus and its delicate developing nervous system. The drug is a known endocrine (hormone) disrupter, and has previously been linked to undescended testes in male infants.
Since the maternal hormone environment plays a critical role in the development of the fetus, the authors say that it's 'possible that acetaminophen may interrupt brain development by interfering with maternal hormones or via neurotoxicity such as the induction of oxidative stress that can cause neuronal death.'"
ADHD on the Rise
I believe it's imperative to be aware of, and abstain from, as many potential neurotoxins as possible during pregnancy to protect the health of your child. Our environment is saturated with such a wide variety of toxins, and you may not be able to defend yourself against each and every one of them, but you do have a great degree of control within your own immediate household.
The food and drinks you ingest, and the household, personal care, and medical products you opt to use during pregnancy can have a distinct impact on your child's development and long-term health. Behavioral problems such as ADHD have skyrocketed over the past few decades, signaling that something is awry. Our environment is becoming overly toxic, and children are paying the price for our chemical-laden lifestyles.
According to a 2010 US government survey, 1 in 10 American children now has attention-deficit hyperactivity disorder (ADHD)—a 22 percent increase from 2003. ADHD makes it hard for children to pay attention and control impulsive behavior, and about two-thirds of the children diagnosed with ADHD are on some form of prescription medication. Such medications, in turn, are poisoning the kids even further. Potential side effects of ADHD drugs include:
According to data released by the Substance Abuse and Mental Health Services Administration7 (SAMHSA) last year, ADHD drugs such as Ritalin, Vyvanse, Strattera, and Adderall (and their generic equivalents) were responsible for nearly 23,000 emergency room visits in 2011. This is a greater than 400 percent increase in ER visits due to adverse reactions to such drugs in a mere six years! Other reports show a dramatic spike in ADHD drug abuse. For example, data from IMS Health8 showed that prescriptions for ADHD drugs rose 39 percent between 2007 and 2011, with a whopping 48.4 million prescriptions issued in 2011.
We really need to nip these trends in the bud before an entire generation is permanently damaged. To do so, we must pay greater attention to shielding pregnant women from any and all toxic exposures, as there's no telling which one may be the proverbial straw that broke the camel's back... With that in mind, I recommend avoiding medications of all kinds during pregnancy if at all possible, including OTC drugs like acetaminophen.
Other Harmful Effects Associated with Acetaminophen Use
Besides liver damage, acetaminophen has also been linked to other serious side effects, including kidney dysfunction when taken with alcohol, and potentially lethal skin reactions: Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TENS), and acute generalized exanthematous pustulosis (AGEP). (For more information about these potentially lethal skin reactions, please see my previous article on this topic.)
The FDA added a warning about potential skin reactions to prescription acetaminophen product labels last year. There's no way to predict who might be at increased risk for such side effects, so please heed the FDA's recommendation9 and do NOT take acetaminophen again if you've ever had a skin reaction when taking it.
Research published in the past few years have also linked chronic, high use of acetaminophen to an increased risk for blood cancers. The definition of "high" use was using acetaminophen at least four times a week for at least four years -- an amount that many Americans could easily exceed without even realizing it.
Little-known research from 2009 suggests acetaminophen might also render vaccinations less effective when administered together. According to this study,10 infants who received acetaminophen right after getting a vaccination experienced lowered immune response, developing significantly fewer antibodies against the disease they were vaccinated against. The vaccines used in the study were for pneumococcal disease, Haemophilus influenzae type b (Hib), diphtheria, tetanus, whooping cough, hepatitis B, polio, and rotavirus. (No flu vaccines were included. However, it's likely the effect might still be the same.) The authors concluded that:
"Although febrile reactions significantly decreased, prophylactic administration of antipyretic drugs at the time of vaccination should not be routinely recommended since antibody responses to several vaccine antigens were reduced."
If You MUST Use Acetaminophen, NAC May Counteract Hazards
Given their health risks, I generally do not recommend using acetaminophen-containing drugs for minor aches and pains. There are many other ways to address acute and chronic pain that do not involve taking a medication. For a long list of pain-relieving alternatives, please see this previous article. That said, pain relieving drugs like acetaminophen do have their place. Post-surgical pain, for example, or other severe pain may warrant its temporary use. For those instances, I recommend taking it along with N-acetyl cysteine (NAC), which is the rate-limiting nutrient for the formation of the intracellular antioxidant glutathione.
It is believed that the liver damage acetaminophen causes is largely due to the fact that it can deplete glutathione, an antioxidant compound secreted by your liver in response to toxic exposure. Glutathione also helps protect your cells from free radical damage. NAC is the standard of care in cases of acetaminophen overdose,11 approved in 1985 by the FDA as an antidote for acetaminophen toxicity.12 Mortality due to acetaminophen toxicity has been shown to be virtually eliminated when NAC is promptly administered in cases of acetaminophen overdose.
Here, I can't help but note the irony of the situation, as a nutritional supplement—NAC—is prescribed as the antidote to a pharmaceutical drug... This is just one of many examples where a supplement can be a lifesaver after conventional medicine has inflicted harm. Another example is CoQ10, which is crucial if you want to slow down the more debilitating side effects caused by statin drugs.
I mention this here as a side note because if Senator Durbin and the drug industry get their way, lifesaving supplements like NAC and CoQ10 would have to go through extensive and extremely costly drug testing, which might make them unavailable—at least temporarily, and if they were available, their selling price would undoubtedly skyrocket.
Suggestions for a More Toxin-Free Pregnancy
While you may not be able to avoid every single instance of toxic exposure, it is important to at least take whatever measures you can to reduce your toxic burden, especially before and during pregnancy. Avoiding any and all unnecessary drugs and vaccinations is one aspect you have a large degree of control over. Below are several more. Rather than compile an endless list of what you should avoid, it's far easier to focus on what you should do to lead a healthy lifestyle with as minimal a chemical exposure as possible. This includes:
1. As much as you're able, buy and eat organic produce and free-range, organic foods to reduce your exposure to agricultural chemicals like glyphosate. Steer clear of processed, prepackaged foods of all kinds. This way you automatically avoid pesticides, artificial food additives, dangerous artificial sweeteners, food coloring, MSG, and unlabeled genetically engineered ingredients.
2. Rather than eating conventional or farm-raised fish, which are often heavily contaminated with PCBs and mercury, supplement with a high-quality purified krill oil, or eat fish that is wild-caught and lab tested for purity. Wild-caught Alaskan salmon is one of the very few fish I still recommend eating.
3. Store your food and beverages in glass rather than plastic, and avoid using plastic wrap and canned foods (which are often lined with BPA-containing liners).
4. Have your tap water tested and, if contaminants are found, install an appropriate water filter on all your faucets (even those in your shower or bath).
5. Only use natural cleaning products in your home.
6. Switch over to natural brands of toiletries such as shampoo, toothpaste, antiperspirants, and cosmetics. The Environmental Working Group has a great database13 to help you find safer personal care products. I also offer one of the highest quality organic skin care lines, shampoo, and conditioner, and body butter that are completely natural and safe.
7. Avoid using artificial air fresheners, dryer sheets, fabric softeners, or other synthetic fragrances. Relinquish the idea that fragrance equals "clean." It doesn't. Clean laundry need not smell like anything at all.
8. Replace your non-stick pots and pans with ceramic or glass cookware.
9. When redoing your home, look for "green," toxin-free alternatives in lieu of regular paint and vinyl floor coverings.
10. Replace your vinyl shower curtain with one made of fabric or install a glass shower door. Most all flexible plastics, like shower curtains, contain dangerous plasticizers like phthalates.
11. Avoid spraying pesticides around your home or insect repellants that contain DEET on your body. There are safe, effective and natural alternatives out there.