Experts warn this habit may harm your liver faster than drinking

Experts explain how this common practice can damage your liver.

Key Points

• Acetaminophen (Tylenol) is safe when used correctly but can harm the liver in high doses.
• Taking multiple medications with acetaminophen can lead to accidental overdose.
• Speak with a health care professional to learn what dose is safe for you.

Your liver plays many different important roles in the body, from processing nutrients and removing toxins from the blood to metabolizing medications. While the liver does a lot to keep you healthy, it has its limits. 

By now, you’ve probably heard plenty of warnings about alcohol and liver health. It’s well known that excessive alcohol use—either over a long period of time or through occasional heavy drinking—can be hard on your liver. But there’s another common habit that can harm your liver that many people are unaware of: overusing acetaminophen, an over-the-counter painkiller that’s sold under brand names including Tylenol, and is present in combination medications such as NyQuil and Dayquil.

It may not seem like a simple over-the-counter medication could do much damage, but it can—especially in high doses or when taken too frequently. In fact, it’s the leading cause of sudden liver failure in the United States.

To understand why this habit is so harmful and how to lower your risk of liver injury, we spoke with health experts to break it down.

How Painkillers Can Damage Your Liver

People regularly take over-the-counter medications like acetaminophen for many reasons, such as managing pain or reducing a fever. While acetaminophen is safe in certain doses, it can cause problems when taken in excess. Liver damage can occur if you take high doses of acetaminophen for multiple days in a row or take too much at once. In some cases, acute liver failure is even possible.

“When acetaminophen is used in doses greater than recommended, it can overload the processes in our body that are responsible for metabolizing the medication,” says Laura Heath, Pharm.D. “If that happens, severe liver damage can occur.”

The majority of acetaminophen is safely metabolized through normal liver pathways, explains Farrah Tavakoli, Pharm.D. “A small amount of acetaminophen is converted to a substance called NAPQI, a toxic metabolite that can be harmful when it builds up.” Under normal conditions, the body can neutralize NAPQI with an antioxidant called glutathione, but if too much builds up, it can damage the liver.

How Much Acetaminophen Is Too Much?

According to the American College of Gastroenterology, healthy adults shouldn’t take more than 1,000 milligrams of acetaminophen at a time or more than 4,000 mg per day. Additionally, avoid taking 3,000 mg per day for more than three to five consecutive days.

“The maximum dose of acetaminophen for most adults is 4,000 milligrams per day from all sources,” Tavakoli says.

To keep your acetaminophen intake within safe limits, it’s important to remember that acetaminophen isn’t just in pain medications. It’s found in many over-the-counter and prescription products, including those used to treat allergies, colds, flu and migraines, as well as pain relievers and fever reducers. Health experts caution against taking more than one product containing acetaminophen at the same time.

“If you realize that you are taking multiple different medications that have acetaminophen, it’s important to contact your health care provider,” says Rucha Shah, M.D. “If you start to notice any jaundice or abdominal pain or have accidentally ingested too much, it’s important to tell your doctor right away—sometimes people need to be admitted to the hospital for a workup.”

It’s always a good idea to ask your health care provider or a pharmacist what a safe dose of acetaminophen looks like for you. “This may vary for each person based on their medical history, liver function, renal function and other genetic factors,” explains Heath. 

Other Considerations

• Talk to Your Health Care Provider. It’s important to speak with your health care provider before taking multiple medications at once. “Consult a pharmacist or a health care provider when combining medications to ensure that there are no interactions or duplications of the same medication,” says Tavakoli.
• Always Read the Label. Check the label of your over-the-counter medication to see if it contains acetaminophen. More than 600 over-the-counter and prescription medicines contain acetaminophen, and it’s important not to take two at once.
• Know Your Safe Dose. If you have liver disease, check with your health care provider about what dose of acetaminophen is safe for you to take. A patient with known liver disease may be advised to minimize or avoid using acetaminophen, notes Heath.
• Don’t Mix with Alcohol. Avoid combining over-the-counter pain medications with alcohol. “Combining alcohol and acetaminophen increases the risk of liver injury, even when acetaminophen is taken within the recommended limits,” warns Tavakoli.

Our Expert Take

The over-the-counter pain medication acetaminophen is safe for most adults when used as directed—but taking too much can harm the liver. Acetaminophen is found in many different over-the-counter and prescription medications, meaning it can be easy to exceed the recommended dose without realizing it. Always read medication labels and check with your doctor or a pharmacist to make sure you’re staying within safe limits.

Read the original article on EatingWell