Am I ruining my liver?

Submitted ⁨⁨6⁩ ⁨months⁩ ago⁩ by ⁨dysprosium@lemmy.dbzer0.com⁩ to ⁨[deleted]⁩

I often take painkillers (acetaminophen aka paracetamol), but I’ve noticed that it’s much more effective if I take them TOGETHER with my ADHD medication (ritalin aka methylphenidate) + my morning coffee. If I don’t take them AT the same time, the painkiller is far less effective.

I do not exceed the maximum dosage of painkiller (1gram per intake, mornings), but alone this would barely suffice to kill my morning headache.

My hypothesis is that since the LIVER has to convert all three, I am effectively overdosing on either substance (painkiller or ADHD meds), and damaging my liver in the process.

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Wahots@pawb.social ⁨6⁩ ⁨months⁩ ago
Talk to your doctor, do not get medical advice from the internet, it is too risky.

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- Iheartcheese@lemmy.world ⁨6⁩ ⁨months⁩ ago
  Counterpoint: Do more drugs the internet says so.
  
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- CuttingBoard@sopuli.xyz ⁨6⁩ ⁨months⁩ ago
  Half a pack of cigarettes will make the headache go away. Make sure to sprinkle them with turmeric.
  
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tiredofsametab@kbin.run ⁨6⁩ ⁨months⁩ ago
Wrong question, I would argue. If you have a morning headache, you should really find the root of that and try to resolve it making the medication unnecessary.

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  I know, but I’ve headaches since I was about 10 (now almost ~30), and the only causes for this that I can seriously come up with is: being sensitive af in general, which then leads to being (subconsciously) easily stressed, which then, results in headache. This happens during the day, but I also (more) frequently wake up with a headache for no reason. This even happens in the summer, when I’m not doing ANYthing (no school, university, work). I am generally perfectly healthy. I am hydrated, eat healthy, etc. I don’t exercise an awful lot, but when I do (for months), I barely notice any difference.
  
  Being “sensitive” (whatever that means exactly) is the only weird but plausible explanation. Reading the other comments, though, like sleep apnea, I’m curious if that’s anything…
  
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  - MrBobDobalina@lemmy.ml ⁨6⁩ ⁨months⁩ ago
    If you have the option, I would suggest going to a Dr before assuming anything is the only plausible explanation.
    
    Personally, I found out about my neck / posture issues (even though outwardly I have decent looking posture so I never assumed it would be that), got some excercises from a physio and a completely different pillow, and that combo drastically reduced my headaches
    
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  - liam070@sopuli.xyz ⁨6⁩ ⁨months⁩ ago
    But did you talk about it with a medical trained person ? In the end its just a damaged nerve in your neck or sonething that can be easily fixed with proper care.
    
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  - tiredofsametab@kbin.run ⁨6⁩ ⁨months⁩ ago
    I have some chronic pain issues as well, some of which were solved and some are managed. I'm sorry you're going through this. Have you tried getting a second opinion or maybe a different type of medical provider? I had headaches as well that turned out to be largely brought on by stress and also some bad posture. I did get an MRI+MRA just to be sure nothing was actually wrong in the brain itself, but techniques to reduce the causes were helpful to me. Good luck!
    
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  - Today@lemmy.world ⁨6⁩ ⁨months⁩ ago
    CBG can be really helpful for headaches. I use it for migraines and a lot of times i can wait until i get home to take prescription meds that make me feel weird. Lots of people use it as a preventative with about half the frequency/severity. Helps with migraine nausea too.
    
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  - hayreddin@lemmy.world ⁨6⁩ ⁨months⁩ ago
    Another hypothesis is bruxism (teeth grinding). Some people have it during the day, others (like me) have it during sleep. Stress and anxiety makes it worse. I only discovered I had it because people heard me biting my teeth against each other while asleep. I went to a dentist, she made me a mouth guard that I use every night before going to sleep, and the morning headaches stopped since then.
    
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  - volvoxvsmarla@lemm.ee ⁨6⁩ ⁨months⁩ ago
    Ok, follow up question. If you don’t take a painkiller in the morning, how does the headache progress?
    
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  - RBWells@lemmy.world ⁨6⁩ ⁨months⁩ ago
    Migraines come during sleep like that, but if Paracetamol works no way is it a migraine. That stuff literally does nothing for any pain I’ve had, ever.
    
    I agree with everyone here, this seems like a lifestyle thing - if your body is indeed sensitive to stress and relaxation, you are not doing it any favors with the paracetamol. Likely too stressed in day, too relaxed at night, the sudden change a trigger. Obviously you don’t want to fix that by being tense while asleep, so tackling the day stress responses make more sense. Do you exercise?
    
    What happens if you just have either coffee or the Adderall in the morning, without the painkiller drug?
    
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troed@fedia.io ⁨6⁩ ⁨months⁩ ago
Many countries have lowered the max dosage of Paracetamol from 1000mg since there's indeed a worry that it will cause liver damage. I'm in one of the countries that still go with 1000 (Sweden) and my suggestion would be to use 500mg Paracetamol and 400mg Ibuprofen taken together instead. That's what the medical professionals themselves do.

That said, something in your life is causing you to have morning headaches and it's a better idea to fix that. Regular painkiller usage is one of the things that causes it (!). Other possibilities can be waking up during the wrong sleep cycle (deep vs light), sleep apnea causing bad sleep in general, overdosing on caffeine causing withdrawal symptoms in the morning etc.

/Not a medical professional

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- Today@lemmy.world ⁨6⁩ ⁨months⁩ ago
  It’s shockingly easy to OD on acetaminophen. I don’t think you are; i just think it’s interesting how a few Tylenol plus a couple doses of cold medicine can be serious.
  
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  - TheRealKuni@lemmy.world ⁨6⁩ ⁨months⁩ ago
    Also a fatal dose of acetaminophen/paracetamol is one of the worst ways to die. If you don’t get treatment within like, eight hours of taking it, you will slowly die of liver failure over the next few days and there’s nothing anyone can do about it. So you painfully waste away in the hospital.
    
    Stories of people who attempted suicide by downing a whole bottle of Tylenol are horrific, because MANY people who attempt suicide regret it after the attempt (as is reported by people who survive attempts). This means that people who attempt suicide this way still die, slowly, painfully, regretting it but unable to do anything about it, over a few days. Having to face their loved ones, knowing how hurt those loved ones are by the action. The idea terrifies me.
    
    Note, I am not a doctor, so take this with a grain of salt. But this is what I’ve read.
    
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- Case@lemmynsfw.com ⁨6⁩ ⁨months⁩ ago
  In the US, you can get varying dosages based on a variety of commercial factors.
  
  That being said, 1000mg a dose not to exceed 4000mg in a 24 hour periods is the standard… well, was, its been a while since I was a pharmacy tech.
  
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KittenBiscuits@lemm.ee ⁨6⁩ ⁨months⁩ ago
Long time headache adventurer here.

You are basically making a homemade Excedrin (acetaminophen + aspirin + caffeine). Stimulants cause your body to metabolize the pain reliever more quickly.

As for if you’re ruining your liver, I can’t say, other than you should probably go see you doctor and ask for a blood panel/ liver function test. Even if your liver values are normal, you’ll know for sure, and have a baseline to compare future tests against. Plus your doctor may have some thoughts on why you’re having a headache everyday.

For me it turned out that while i had acceptable blood pressure, it was high “for me”, and a beta blocker took care of the most frequent headaches. But we didn’t figure that out until we had ruled out a whole bunch of other things.

It was a frustrating journey to be sure. I wish you luck in yours.

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  Perhaps you’re hitting the nail on the head. My blood pressure is apparently normal (at least during the day). But perhaps it is indeed too high for me. It feels plausible but idk what that is worth. I’m going to ask my doctor to test this idea. Not sure yet which med for lowering blood pressure is good. I thought that Beta blockers were specifically for headache patients. Perhaps this is why… Also, apparently ACE inhibitors and ARBs are also blood pressure lowering agents. Any experience with those…?
  
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011000010111001101110011@lemmynsfw.com ⁨6⁩ ⁨months⁩ ago
Two things:

Generally when you take medicine with high acidity food, like coffee, it will break down your medicine prematurely - you won’t get as strong as an effect. I had to stop taking my Vyvanse with orange juice because it basically nullified the medicine.

Talk to your doctor. I had chronic headaches that I found out were related to low blood pressure and dehydration. Drinking water instead of diuretics, like coffee, immensely helped me.
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- Codilingus@sh.itjust.works ⁨6⁩ ⁨months⁩ ago
  Fuckkkkkkkkkkkkkkkkkkkk… Point 1…no wonder…
  
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Blizzard@lemmy.zip ⁨6⁩ ⁨months⁩ ago
It’s best to talk to a doctor instead of asking random people on the Internet.

But since you asked, weed helps to mitigate headaches better than paracetamol and doesn’t affect your liver.

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  I get headaches from weed
  
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  - zakobjoa@lemmy.world ⁨6⁩ ⁨months⁩ ago
    Well, there’s your problem, then.
    
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  - binomialchicken@lemmy.blahaj.zone ⁨6⁩ ⁨months⁩ ago
    Another thing to talk to your doctor about.
    
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- arvere@lemmy.world ⁨6⁩ ⁨months⁩ ago
  thc and cbd are metabolised in the liver
  
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abbadon420@lemm.ee ⁨6⁩ ⁨months⁩ ago
This thread sounds like a stackoverflow stereotype “How do I do X?.. You shouldn’t do X, you should do Y” except that the people in this thread are actually giving good advice (to find the root cause).

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- Tetsuo@jlai.lu ⁨6⁩ ⁨months⁩ ago
  Honestly, the only good advice is to consult a doctor.
  
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- perfectduck@lemmy.world ⁨6⁩ ⁨months⁩ ago
  Definitely can see this. Seeing a good family practice doctor or GP would be my advice, this kind of thing is their bread and butter. Sounds like there’s a few potential issues.
  
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- KISSmyOSFeddit@lemmy.world ⁨6⁩ ⁨months⁩ ago
  Most of those Stackoverflow answers telling you you’re going at your problem the wrong way are correct, too.
  
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Whorehoarder@lemmynsfw.com ⁨6⁩ ⁨months⁩ ago
Why do you have morning headaches? That’s not supposed to be a thing. Sleep apnea? Dehydrated? Other valid medical reasons? Sorry I can’t answer you initial question, but it seems easier to treat the underlying cause (yeah I’ve watched house 8) )

I got diagnosed with sleep apnea couple of years ago and everybody asked me if I had headaches in the morning. It’s easy to test for.

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  Sleep apnea very sounds interesting, I haven’t thought about that. Perhaps worth testing for, thanks for the suggestion. I do not have any other medical issues, nor can it be any withdrawal symptom since I did not take any other medication before my adhd or coffee habit. So did you have headaches in the morning? Is that solved now?
  
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  - Whorehoarder@lemmynsfw.com ⁨6⁩ ⁨months⁩ ago
    Well…no. I personally didn’t have headaches, but supposedly it’s very common, which is also why it flew under the radar for me. The tech kept asking, like it was almost a requirement. She also said I might feel fine now, but in 10 years I could develop heart problems, so the wearing the mask became an easy choice.
    
    Wrote a bunch more but the accidentally deleted it. No undo on Android so fuck it, have half a post :D
    
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- Xantar@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  Probably a lupus. (Would suck it turned out to be the case xD)
  
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KISSmyOSFeddit@lemmy.world ⁨6⁩ ⁨months⁩ ago
Here’s a question for you: Do you regularly drink anything that doesn’t have caffeine or alcohol in it, at all?

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  Yes. Don’t drink alcohol. I have had many long periods when I don’t drink any caffeine at all. No difference in experience/headaches
  
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Whorehoarder@lemmynsfw.com ⁨6⁩ ⁨months⁩ ago
Btw, we’re all gonna want an update if you figure it out. I’m invested now

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  I’ll try. Don’t think it will have a happy ending though
  
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Xantar@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
How come you have a headache every morning ? Sounds pretty worrying to me.

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  good question, I wish I knew… I am perfectly healthy as far as I can tell. Have had it since I was 10. Perhaps stress that I am incapable of getting rid of, even if don’t have ANY obligation. It’s like its an inherent part of me, never letting go of me…
  
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  - idiomaddict@feddit.de ⁨6⁩ ⁨months⁩ ago
    I have AuDHD, and… yeah, I sometimes get so tense that I get muscle aches because of stress that I create myself.
    
    That being said, I also suggest you talk to a doctor, because it would be way better if there was a way to fix it. If you can’t, then harm reduction in painkillers makes sense, but if there’s a simple solution (like nighttime stretching or going to bed earlier), you’ll save yourself a lot of worry and pain.
    
    Additionally, please don’t feel pressured to discuss this here (though I’m happy to talk to you further about it, I’m just not trying to pry), but something to consider: I tend to, as a result of my AuDHD, process really unpleasant personal situations somewhat subconsciously. What I mean is that I’m often not aware of negative emotions until I notice their psychosomatic effects on my body. I used to get headaches 3-5 days a week that would basically send me to bed after work. When my awful boyfriend broke up with me, they went away. I was incredibly unhappy with him and didn’t realize it, but I still carried a lot of tension that expressed itself physically.
    
    For another example: I’m now in grad school and I’m a stereotype of an ADHD student (not everyone with ADHD is like this, but I definitely procrastinate until deadline stress can carry me through), so it’s very difficult. Since I started my master’s, I’ve also started vomiting, a lot. I’m getting checked out (tomorrow, actually) to see if there’s a physical cause, but I’m 90% sure it’s just stress. I’ll be done with my degree in February, but if it were a job instead of a temporary thing, I’d probably have to quit or develop some more effective coping skills.
    
    I just wanted to throw that out there and suggest that you might be physically reacting to a source of stress or tension in your life, and you might want to weigh whether that tension is worth the headaches or whether you can employ coping skills and assertively reduce that stress.
    
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  - Xantar@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
    There are a plethora of causes for “headache”, but you could maybe figure it out based on where and how it hurts. Get it checked.
    
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rufus@discuss.tchncs.de ⁨6⁩ ⁨months⁩ ago
Talk do your doctor.

a) Paracetamol on it’s own isn’t healty for your liver if take regularly.

b) Headache is one of the adverse drug effects of Paracetamol. Maybe you’re getting those headaches from it.

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  I asked the doctor that prescribed the adhd meds, but he said it’s no problem with paracetamol. However, I did not explicitly mention taking it at the exact same time. If I take them 5 minutes apart, the painkiller is already far less effective. All taken on an empty stomach.
  
  Not taking paracetamol for many months did not lessen the headache whatsoever.
  
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  - rufus@discuss.tchncs.de ⁨6⁩ ⁨months⁩ ago
    Ah, alright. Yeah interaction of medication is a complicated thing. I’d advise you to ask your specific questions to a doctor. Is it okay to take them at the same time, is it okay on an empty stomach, is it okay to take that dose of paracetamol x-times in a month… Maybe they suggest an alternative to Paracetamol that works better and has less side-effects, thus being more appropriate for you, individually. And I think doctors have access to databases and general recommendations concerning drugs and reciprocity and (case) studies. They’re probably more qualified to make a judgement and know about possible superior alternatives.
    
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Toes@ani.social ⁨6⁩ ⁨months⁩ ago
Seriously talk it over with the doc that prescribed you the ADHD meds. 1 gram of ace is a lot!

Be clear about what you’re doing and when.

In my personal experience that may differ from your own. The morning headache could simply be dehydration or minor withdrawal from the meds.

Generally speaking taking a 2 week break from the pain medication and caffeine may clear up your symptoms. But this is not professional advice, I’m not a medical professional. You should ask a doctor about this suggestion or any other remedies the good people of Lemmy suggest.

My doctor recommended strongly against having caffeine with the ADHD medications and could potentially indicate that your dosage needs adjusted. It’s bad for your heart and eyeballs.

If you read the long piece of paper that comes with those medications there is a warning about not consuming them at the same time as other medications. There’s a bunch of good reasons for this disclaimer.

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janNatan@lemmy.ml ⁨6⁩ ⁨months⁩ ago
Every morning headaches can be a sign of sleep apnea. Not saying you have it. Go to a doctor.

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ChonkyOwlbear@lemmy.world ⁨6⁩ ⁨months⁩ ago
Acetaminophen and caffeine are often included together in “extra strength” pain relievers as the caffeine enhances the effects of the acetaminophen. That part at least is perfectly fine.

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Tehdastehdas@lemmy.world ⁨6⁩ ⁨months⁩ ago
The liver has different enzymes to break different molecules, so those drugs might all use different ones, not slowing down the breakdown of others. I didn’t check.

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- dysprosium@lemmy.dbzer0.com ⁨6⁩ ⁨months⁩ ago
  Good point. I’ll check. Though I’m not sure if that is the only point of relevance. What if the overal ‘output’ of the liver is still exceeded? Aka it’s just working overtime producing those different enzymes.
  
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bionicjoey@lemmy.ca ⁨6⁩ ⁨months⁩ ago
You take Ritalin with coffee? I have to space my Ritalin out from my morning coffee by at least an hour, or else I get horrible headaches which can last hours.

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taaz@biglemmowski.win ⁨6⁩ ⁨months⁩ ago
Afaik constant use of paracetamol has most impact on stomach, it does something to the lining.
Or maybe that was ibuprofen?

Not a medical professional though

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