Should You Ever Take Tylenol?

Last September, Johnson & Johnson CEO William Weldon testified before the House Committee on Oversight and Government Reform, apologizing for the numerous recalls the company had in recent months.

This included:

• May 2010: Recall of Children's Tylenol and Motrin
• September 2009: Recall of 21 children's Tylenol products
• 2009: A "phantom recall" involving more than 80,000 Motrin tablets. (Rather than announcing the recall and having stores remove the product from shelves, Johnson & Johnson allegedly sent in undercover agents disguised as regular shoppers to buy up the remaining stock.)

Since then, more recalls have taken place, including a January 2011 recall of Tylenol 8 Hour, Tylenol Arthritis Pain, and Tylenol upper respiratory products, and, most recently, a June 2011 recall of nearly 70,000 bottles of Tylenol Extra Strength Caplets. This does not include the famous Tylenol CN (cyanide) recall that occurred when I was doing my family practice residency in 1982.

Can You Trust Tylenol Products?

There have been enough recalls to make even the most brand-loyal consumers raise their eyebrows, and as USA Today reported many are questioning whether it's safe to pick up another bottle of Tylenol. And rightly so, considering that Tylenol's manufacturer Johnson & Johnson, in my opinion, is a company with questionable integrity.  Johnson & Johnson was named by AllBusiness.com as one of the "Top 100 Corporate Criminals of the 1990s!" for deliberately destroying documents related to a criminal investigation case on one its products.

In January 2010, the U.S. Department of Justice also accused Johnson & Johnson of paying tens of millions of dollars in kickbacks to Omnicare Inc to buy and recommend Johnson & Johnson drugs – a matter that is the subject of a federal lawsuit that has 18 states suing not just Omnicare, but 14 other major drug companies, alleging that they ran this scheme together.

And then in May 2010, a J&J subsidiary pleaded guilty to illegally promoting its epilepsy drug Topamax for psychiatric purposes and submitting alleged false claims to Medicare, and in so doing, settled a civil lawsuit in the case for $75 million.

A few months later in October 2010, the government of British Columbia, Canada filed a lawsuit against J&J, which claims they aggressively marketed the "Ortho Evra" contraception patch without disclosing serious side effects like blood clots, pulmonary emboli, strokes, heart attacks and deep vein thrombosis. The suit claims J&J did not provide adequate warnings on labels, conduct long-term use risk studies or provide Health Canada with accurate risk information.  When you take this information and couple it with the recent spate of product recalls, I think consumers have good reason to question the quality of Johnson & Johnson products -- but even if you take all of that out of the equation, there's still reason to question whether a Tylenol tablet should ever pass by your lips.

What's the Number One Cause of Acute Liver Failure in the United States?

If you guessed acetaminophen (Tylenol type products), you're absolutely right. But many people are completely unaware that Tylenol can be toxic to your liver, even at recommended doses such as eight extra-strength Tylenol tablets daily for a couple of weeks. Taking too much acetaminophen can lead to liver failure, liver transplant and death, which is why the U.S. Food and Drug Administration (FDA) announced earlier this year that it is asking manufacturers of prescription acetaminophen combination products (such as painkillers Vicodin and Percocet, which contain acetaminophen) to limit the maximum amount of acetaminophen in these products to 325 mg per tablet.

But over-the-counter acetaminophen products can be problematic too, partly because it is so widely used in cold and flu and other medications. When many people have a cold, headache or other ache or pain, they don't just take two Tylenol and leave it at that. Many people double or triple-up, taking multiple OTC medications, all of which may contain acetaminophen.

So it's actually very easy to overdose on acetaminophen, and thereby cause serious liver damage or liver failure.

Additionally, a recent study found that chronic acetaminophen users had nearly twice the risk of developing blood cancer, and separate research has linked it to higher rates of asthma and chronic obstructive pulmonary disease (COPD), as well as reduced lung function. Long-term Tylenol use has also been linked to brain damage and increased blood pressure -- so it is not the "harmless" pill that many people consider it to be.

How to Limit Some of Acetaminophen's Potential Damage

Please understand that I do not recommend taking Tylenol or similar products for minor aches or pains, and I will detail some natural pain relief options you can use instead below. However, I do realize that acetaminophen-containing drugs are sometimes necessary to suppress pain, such as while you are recovering from an injury or surgery, or while you are seeking to address the underlying cause of your pain.

For those instances, make sure you are also taking N-acetyl cysteine (NAC), which is the rate-limiting nutrient for the formation of the intracellular antioxidant glutathione.

It's thought that Tylenol causes its damage by depleting glutathione, an antioxidant that protects cells from toxins such as free radicals. If you keep your glutathione levels up, the damage from the Tylenol may be largely preventable. This is why anyone who overdoses on Tylenol receives large doses of NAC in the emergency room.  So whether you are taking Tylenol in prescription or over-the-counter form, I strongly suggest taking N-acetyl cysteine (NAC) along with it.

11 Natural Pain-Relief Options

I don't recommend simply swapping out your Tylenol for another pain medication, like non-steroidal anti-inflammatories (NSAIDs), as they carry their own set of risks and side effects. Plus, all medications only provide symptomatic relief and in no way, shape or form treat the underlying cause of the pain. If you are suffering from pain, I suggest you work with a knowledgeable health care practitioner to determine what's really triggering your pain, and then address the underlying cause.

In the meantime, you don't need to suffer unnecessarily. The following options provide excellent pain relief without any of the health hazards that acetaminophen and other pain relievers carry:

1. Emotional Freedom Technique (EFT), which is currently being used by more than 15,000 psychologists, is a drug-free approach for pain management of all kinds. EFT borrows from the principles of acupuncture, in that it helps you balance out your subtle energy system.
   
   It helps resolve underlying, often subconscious, negative emotions that may be exacerbating your physical pain. By stimulating (tapping) well-established acupuncture points with your fingertips, you re-balance your energy system, which tends to dissipate pain.
2. Astaxanthin: One of the most effective oil-soluble antioxidants known. It has very potent anti-inflammatory properties and in many cases works far more effectively than many NSAIDs. Higher doses are typically required and one may need 8 mg or more per day to achieve this benefit.
3. Ginger: This herb is anti-inflammatory and offers pain relief and stomach-settling properties. Fresh ginger works well steeped in boiling water as a tea or grated into vegetable juice.
4. Curcumin: In a study of osteoarthritis patients, those who added 200 mg of curcumin a day to their treatment plan had reduced pain and increased mobility.
   
   A past study also found that a turmeric extract composed of curcuminoids (plant-based nutrients that contain powerful antioxidant properties) blocked inflammatory pathways, effectively preventing the launch of a protein that triggers swelling and pain.
5. Boswellia: Also known as boswellin or "Indian frankincense," this herb contains specific active anti-inflammatory ingredients. This is one of my personal favorites as I have seen it work well with many rheumatoid arthritis patients.
6. Krill Oil: The omega-3 fats EPA and DHA contained in krill oil have been found by many animal and clinical studies to have anti-inflammatory properties.
7. Bromelain: This enzyme, found in pineapples, is a natural anti-inflammatory. It can be taken in supplement form but eating fresh pineapple may also be helpful.
8. Cetyl Myristoleate (CMO): This oil, found in fish and dairy butter, acts as a "joint lubricant" and an anti-inflammatory. I have used this for myself to relieve ganglion cysts and a mild annoying carpal tunnel syndrome that pops up when I type too much on non-ergonomic keyboards. I used a topical preparation for this.
9. Evening Primrose, Black Currant and Borage Oils: These contain the essential fatty acid gamma linolenic acid (GLA), which is useful for treating arthritic pain.
10. Cayenne Cream: Also called capsaicin cream, this spice comes from dried hot peppers. It alleviates pain by depleting the body's supply of substance P, a chemical component of nerve cells that transmits pain signals to your brain.
11. Methods such as yoga, acupuncture, meditation, hot and cold packs, and even holding hands can also result in astonishing pain relief without any drugs.