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The safety of paracetamol used on a regular basis

Aches and pains happen……………..

But, for some, they become an institution. One of the go to medications, that can provide relief is paracetamol.

Paracetamol, also know as acetinomorphen, is the pharmacological name for household pain relieving meds, you will know the product by their brand names, which include Panado®, Tylenol® etc.

The GP’s choice

The plus about paracetamol, you don’t need a doctor’s script to access it, in fact, in most countries, you can buy it at the local supermarket.

It’s accessibility, plus years of being told…………..

It’s the GP’s choice for kids

means, most people see it as being extremely safe.

But it does have a down side.

The downside of paracetamol

And that downside, can manifest when you take paracetamol on a routine basis, for extended periods of time.

Most of the time, when we think about medicine, we think of what it does.  But what  goes in, must come out, and it’s getting paracetamol “out”, that is it’s Achilles heal.

Now don’t get me wrong, the body is quite capable of removing paracetamol.

But, it is hard work.

Paracetamol toxicity

And, if there is TOO MUCH paracetamol, which can happen in cases of an overdose, the system fails.

This failure manifests with liver failure.

Brought on by the accumulation of a particularly nasty metabolite, called NAPQI.

It does happen.

But, if you stick with the recommended dosages, it’s not something to worry about.

The reason………

The NAPQI and other paracetamol metabolites are rendered quite harmless, by the body’s detoxification system.

Getting rid of paracetamol

The molecule at the centre of this detoxification system is sulphur.  The sulphur get’s slapped onto the paracetamol, in one form or another.   Once this happens, the paracetamol is marked for elimination.

And when these “sulphated” paracetamol complexes pass through the kidney, as part of the standard blood filtration process, the kidney “knows”, they are unwanted……….

So it holds on to them.

Bye bye paracetamol

This means they are flushed out, alongside the body’s own waste products.  The system is pretty efficient.

In fact, it takes somewhere between 7 to 14 hours, to remove ALL the paracetamol  from your system.  This is why, the pain comes back……… and you need to take ANOTHER PILL.

NOTE :  Exactly how long it takes, depends on how efficient your detoxification system is, this is primarily determined by genetics, but can be influenced by other things. 

The power of sulphur

So it takes sulphur to remove paracetamol.

So what ?

Sulphur is pretty common.  In fact, it is considered to be the fourth most common element on the planet.

But not all sulphur is created equal.

Cysteine the eradicator

It turns out, a sulphur containing amino acid, called cysteine is particularly important in getting rid of paracetamol.   It is responsible for processing between 30 to 40 % of the paracetamol.

Now cysteine is a very busy amino acid.

And if a chunk of cysteine is being used, to rid your body of paracetamol, this means less is available of other things.

Cysteine supplies

Now, if you are eating a diet, with adequate amounts of protein, specifically animal protein, no worries.

Your supply will take care of the extra demand.

But, if you’re NOT.

Over time, you can run short of cysteine.

Muscles take strain

Among the  bits and pieces of you, that are “vulnerable”, when cysteine levels are compromised, are your muscles.   Shortages of cysteine, have been shown to cause

• loss of muscle mass,
• muscle strength and
• muscle quality.

Now muscle loss,  is a normal part of the aging process, but accelerated muscle loss, as seen with cysteine shortages, is a crisis.

It causes a condition  known as sarcopenia  i.e. flesh poverty.

So muscle loss is a BIG DEAL.

And protecting your muscle health is something that needs to be on your radar ……

The paracetamol threat

Swallowing a paracetamol pill, a couple of times a week, could inadvertently, compromise your muscle health………….. so you need to be extra vigilant.

Ensure you are getting enough protein, especially animal protein.

Many plants, are sulphur rich, but they only have trace amounts of cysteine.

Current guidelines, recommend older folks, consume 1-1.5g of protein / kg.    Translated, that means if you weigh 70 kg, you should be eating at least 70 g of protein every day.

Getting enough cysteine

I know for older folks, getting this much protein, can be a challenge.

A lack of appetite, cost and teeth, are all potential issues.

If you’re struggling, remember, eggs are a good source of cysteine containing protein, they’re relatively inexpensive and easy to eat.

And they won’t cause a heart attack !

NOTE : If you don’t see your way to increasing animal protein intake, you can purchase an N-acetyl cysteine (NAC) supplement, to enhance cysteine availability, but it is probably better to meet your cysteine requirements by eating REAL FOOD.

Further reading

 

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