Just Take a Tylenol

“Just take a Tylenol.”

This might as well be the American mantra. It reflects the perspective many of us have been taught to adopt: that the body is full of annoying symptoms, and the easiest response is to suppress them with drugs.

The main ingredient in Tylenol is acetaminophen, which has been used in the United States for more than 70 years. It is considered a benign over-the-counter medication, used reflexively for aches, pains, and fever, and is widely thought of as safe during pregnancy. About 23 percent of American adults, or roughly 52 million people, use a medicine containing acetaminophen each week. It is the most common drug ingredient in the United States and is found in more than 600 medicines. However, this “harmless” drug has been linked to more than 110,000 injuries and deaths per year.¹

So how can Tylenol, something handed out so casually, be harmful?

One surprising part of the conversation is that researchers still do not fully know exactly how acetaminophen works.² What is known is that the drug reaches the brain, and that matters because acetaminophen can deplete glutathione, an antioxidant that is especially important for brain health.³

Glutathione helps the body balance oxidative damage and inflammation. When a medication affects that system, it should at least make us think more carefully about how casually we use it.

This does not mean acetaminophen has no place. It means the phrase “just take a Tylenol” may be far too casual for a drug that affects important biological systems and is used so frequently.

The same broader concern applies to other common pain relievers, including NSAIDs. NSAIDs are often used for pain and inflammation, but they can injure the small intestine. In one study, 71 percent of chronic NSAID users showed visible small-intestinal damage, compared to 10 percent of nonusers.⁴

Damaged intestines can contribute to intestinal permeability, often called “leaky gut” or gut permeability. This matters because gut permeability has been linked with conditions such as depression, ADHD, and allergies. NSAIDs can induce gut permeability and may also harm the microbiome, the inner ecology of organisms that supports overall wellness.⁵

This is the larger problem with our reflexive approach to pain. We are often taught to see symptoms as inconveniences to silence rather than signals to understand. A headache, ache, pain, or fever may be uncomfortable, but discomfort is not automatically meaningless. It is often information.

When the first response is always suppression, we may miss the opportunity to ask why the symptom appeared in the first place.

That does not mean every headache needs deep investigation. It does not mean pain relievers should never be used. It means we should be more thoughtful about reaching for them automatically, especially when they are used often, casually, or without considering the broader effects they may have on the body.

Once we understand the potential concerns with Tylenol and other NSAIDs, the next question becomes obvious: what can someone use for headaches and other aches and pains?

One natural option worth discussing is turmeric, the yellow root found in curry powder. Turmeric contains curcumin, a compound with anti-inflammatory and pain-relieving properties. It has been used in Ayurvedic and Chinese medicine for centuries as a treatment for pain, digestive disorders, and wound healing.

Several studies have shown beneficial effects of curcumin. Research has found that curcumin may work as well as ibuprofen for pain related to knee osteoarthritis.⁶ Another study comparing ginger, mefenamic acid, and ibuprofen found benefit for pain in women with primary dysmenorrhea.⁷

So the next time you have a headache, it may be worth considering 1 to 2 grams of curcumin, or even a turmeric latte, depending on the situation.

The point is not that natural options are always better or that medications are always bad. The point is that “just take a Tylenol” should not be the only way we think about pain.

Pain is not always the enemy. Sometimes it is a message. The goal should not always be to silence the body as quickly as possible. The goal should be to understand what the body is saying, respond appropriately, and use any intervention, natural or pharmaceutical, with more awareness.

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References

1. T. Christian Miller and Jeff Gerth, “Behind the Numbers: We Explore the Data Behind Figures Showing How Many People Die from Overdosing on Acetaminophen, the Active Ingredient in Tylenol,” ProPublica, September 20, 2013. www.propublica.org/article/tylenol-mcneil-fda-behind-the-numbers

2. Carmen Drahl, “How Does Acetaminophen Work? Researchers Still Aren’t Sure,” Chemical and Engineering News 92, no. 29, July 21, 2014, 31–32. https://cen.acs.org/articles/92/i29/Does-Acetaminophen-Work-Researchers-Still.html

3. John T. Slattery et al., “Dose-Dependent Pharmacokinetics of Acetaminophen: Evidence of Glutathione Depletion in Humans,” Clinical Pharmacology and Therapeutics 41, no. 4, April 1987, 413–418. https://doi.org/10.1038/clpt.1987.50

4. D. Y. Graham et al., “Visible Small-Intestinal Mucosal Injury in Chronic NSAID Users,” Clinical Gastroenterology and Hepatology 3, no. 1, January 2005, 55–59. PMID: 15645405.

5. G. Sigthorsson et al., “Intestinal Permeability and Inflammation in Patients on NSAIDs,” Gut 43, no. 4, October 1998, 506–511. PMID: 9824578.

6. V. Kuptniratsaikul et al., “Efficacy and Safety of Curcuma domestica Extracts in Patients with Knee Osteoarthritis,” Journal of Alternative and Complementary Medicine 15, no. 8, August 2009, 891–897. https://doi.org/10.1089/acm.2008.0186

7. G. Ozgoli et al., “Comparison of Effects of Ginger, Mefenamic Acid, and Ibuprofen on Pain in Women with Primary Dysmenorrhea,” Journal of Alternative and Complementary Medicine 15, no. 2, February 2009, 129–132. https://doi.org/10.1089/acm.2008.0311