In today's fast-moving world where alot of work are done in one sector or the other. Taking Pain-killers to relieve stress and discomfort have somewhat become inevitable. We talk about those with acute liver failure and affiliate the cause to drinking alcohol or an exposure to certain toxins. While these maybe true, recent studies have shown that taking pain killers can lead to liver damage.
An example of the popular Pain-killers like paracetamol, otherwise known as acetaminophen can lead to the death of liver cells due to either overdose or susceptible underlying liver diseases coupled with the drug intake.
According to Dr Leonard Nelson at Hepatology Laboratory and Institute for Bioengineering he stated that " Paracetamol is the world’s preferred pain remedy – it is cheap, and considered safe and effective at therapeutic dose. However, drug-induced liver damage remains an important clinical problem and a challenge for developing safer drugs. Our findings reinforce the need for vigilance in paracetamol use, and could help discover how harm caused by its adverse use might be prevented."
When you take paracetamol,it get absorbed by the intestine and goes into your blood stream where it's faced by the major metabolizing organ;THE LIVER. The liver is responsible for metabolizing drugs that are taken orally before reaching the targeted cell to cause a therapeutic effect. Hepatic enzymes like the CYP450(Cytochrome P450) in the liver metabolizes paracetamol to an active metabolite called NAPQI(N-acetyl-P-benzoquinone imine).
NAPQI are toxic metabolite produced by the CYP450 enzymes system in breaking of paracetamol. Its binds to the DNA and Important proteins in the liver cells and reduce the very important Glutathione,a natural antioxidant. Due to the depleted glutathione levels , the liver is left vulnerable to free radicals from other drugs and body metabolic processes which can lead to the liver cells death (Liver necrosis).
High dose of paracetamol (up to 15g) can lead to the accumulation of NAPQI causing acute liver damage. Sometimes,the average recommended dose can be fatal if the individual is exposed to other factors like alcohol and underlying liver conditions.
Some of the symptoms of liver toxicity caused by paracetamol intake include Jaundice (yellowing of skin and eyes), fatigue,and dark urine amongst many others indicating an impaired liver function.
The treatment of liver toxicity caused by paracetamol overdose is by the administration of NAC antidote (N -acetyl cysteine) . NAC antidote replenish the depleted glutathione levels in the liver. It's far better to know the prevention to avoid the cure.
Taking Pain-killers like paracetamol should be done moderately. The normal recommended adult dose is 4g(4000mg) per day. Avoid taking an overdose or combining multiple drugs with paracetamol which can harm the liver. The best thing to do is to be in touch with your doctor or pharmacist for safe use.
References:
• University of Edinburgh, research and innovation (paracetamol study shed light on liver damage): https://www.ed.ac.uk/research-innovation/animal-research/news/paracetamol-study-sheds-light-on-liver-damage
• A Research article at the national library of medicine:
https://pmc.ncbi.nlm.nih.gov/articles/PMC3150324/#:~:text=Paracetamol%20in%20high%20single%20doses,and%20therefore%20increase%20NAPQI%20synthesis Assessed and Endorsed by the MedReport Medical Review Board