top of page


Updated: Jan 20

Many drugs can cause liver damage, liver failure, and death. Yet, acetaminophen prompts the most calls to poison control centers—more than 100,000 per year.

Paracetamol, also known as Acetaminophen is a very common over the counter painkiller - it is most commonly known as Tylenol, among other household brand names.

Acetaminophen alone is the leading cause of acute liver failure in the United States. It accounts for over 100,000 calls to poison control centers every year.

And is that wasn't troublesome enough, over the counter painkillers are responsible for about 56,000 emergency room visits and 26,ooo hospitalizations every year in America.

How is it that a seemingly inoffensive and commonly used over the counter painkiller do this?

Whether you are a daily or an occasional Tylenol consumer, you are going to want to hear this:

There is a fine line between what a safe and what a dangerous dose of Acetaminophen is given that doses slightly above the suggested dose of 4/g a day can cause some serious liver damage.

The way it works has to do with the fact that Acetaminophen is a dose - dependent liver toxin and even at standard doses, metabolizing this compound releases small amounts of a toxic substance called N-acetyl-benzoquinoneimine (or NAPQI). The higher the dosage you take, a much larger amount of this toxin is released into your liver.

Acetaminophen is particularly toxic when taken on an empty stomach given that when fasted, the levels of glutathione (the body's own antioxidant and detoxifier) that are needed to safely metabolize acetaminophen, are at its lowest. The less glutathione in your body = the more risk of acetaminophen toxicity.

This is a list of some of the most frequently prescribed painkillers that contain acetaminophen. This list is by no means exhaustive as there are many other over the counter pills that contain this toxic compound.

  • Tylenol® No.2, Tylenol® No.3, Tylenol® No.4: acetaminophen and codeine

  • Vicodin®, Lorcet®, Lortab®,

  • Maxidone®, Zydone®: acetaminophen and hydrocodone

  • Percocet®, Roxicet®: acetaminophen and oxycodone

  • Fioricet®: acetaminophen, butalbital, and caffeine

  • Darvocet-N®, Wygesic®: acetaminophen and propoxyphene

Do the benefits outweigh the serious health conditions associated with daily acetaminophen use?

Over the counter painkillers have been marketed to normalize acute chronic pain in a way that neglects to target the root cause of pain in the first place. Moreover, these painkillers have been found to not also cause extreme stress on the liver but also destroy the stomach lining, have a dangerous blood thinning effect and can even alter your brain chemistry in the long run.

In summary - no, I do not believe the temporary painkilling effects of acetaminophen outweigh the long term serious health conditions it causes.

What if there was a better option?


These botanical ingredients have been known and used for centuries by Ayurvedic practitioners and many others in the field of functional medicine.

When combined, these components are 8.5 times more effective than Acetaminophen at relieving acute pain and reducing the emotional distress associated with pain without causing liver damage, damage of the stomach lining, blood thinning, among other side effects.

Turmeric (Curcuma longa)

Turmeric has gained popularity as one of the most effective natural pain medicines. You can check our blog post on the benefits of Turmeric & ginger tea