Tylenol for pain

I already take 325 mg aspirin for my Afib (plus beta blocker and digoxin). Yesterday I aggravated the arthritis in my right thumb joint so badly (by weeding) that the pain is excruciating. Is it true we can take Tylenol for this kind of pain (as opposed to other types of analgesics)?

Andrea, the thing i take for arthritic type pains is a very good anti-inflammatory [sold by Hans' vitamin store at a price $10 cheaper than the same stuff sold by my local health food store] called Zyflamend.

Tylenol is ok i guess though i have never found it to be very good as a pain reliever. Also, tylenol is a liver poison. Take too much of it and big trouble can ensue. It has a synergistic action with alcohol, too. With that combination, 2+2 does not make 4, but something like 6 or 8. People have had to have liver transplants from that combination. Personally i do not feel safe in drinking any alcohol if i have taken tylenol within 24 hours. But i do not use tylenol these days since trying the zyflamend. It is good for all the aches and pains that my old body is prone to. Its main ingredient is turmeric, the same as the kitchen spice. Has other helpful stuff in there too. Nothing harmful at all in there. I highly recommend it from personal experience with it. I have tried taking turmeric in capsules, and it is helpful, but the zyflamend does a better job.

Sometimes i get what i call knee episodes. Like last week, i was perfectly comfortable when i sat down in my own rocking chair to chat with a visiting friend, and when i stood up that knee felt like it had broken glass in it. I got somebody to take me up to the healthfood store and purchased a bottle of zyflamend [for $30 instead of the $17 plus change that i would have paid online], took 2 capsules immediately and 2 more a little while later, and by morning i was able to walk without my cane. The knee was still a little sore, but nothing i could not handle. I have stayed with the zyflamend, and that knee does not hurt me any more. This was maybe 4-5 days ago max. In the past these episodes have had me using crutches for several weeks, with no more provocation than what i just described. I truly despise using crutches, but if it hurts too badly i am glad i still have them. Ever try going down stairs when on crutches? A teetery, unsafe kind of experience. I can do it, but not easily. Did not have to do that this time. Try it, i think you will like it.
PeggyM

Thanks Peggy. Are you on either aspirin or coumadin (and how much)?

Andrea, the doctor does want me to be on coumadin and i did take it for some months but one day on my way to my weekly coumadin check somebody kindly offered me a drink. I politely accepted, drank it down, and got into a cab to go to the doctor's office. i did not know that alcohol on top of coumadin will put your INR number all the way up to patent pending on their scale, but i found that out when the nurse came back all hysterical about the number. That was a tuesday morning, and she told me not to take any more coumadin til Friday when she could test me again.

Just as background to this, i had a small stroke in April 2009, last year. I was able to walk and talk, but my short term memory was harmed to the extent that i could not do the simple arithmetic required to keep my checkbook in order, i had to get somebody to do it for me.

Well, wednesday morning i found that without the coumadin i could add and subtract once more, and also i could remember to take 3 doses of a medication in a day, which i had not been able to do since the stroke. On Friday i went back, but i refused to take any more coumadin at all. I started using nattokinase, 3 caps a day for a total of 6000fu's a day. My doctor was not happy about it but the choice i gave her was nattokinase or nothing, and she reluctantly consented. She and the coumadin nurse were certain that coumadin does not affect people that way, but it sure did me. I have not taken any more of it and do not plan to.

Am i being unreasonable? I hope not but if i am it is just too bad. I do not enjoy being a mental cripple at my age. [68] Maybe it was not the coumadin doing that but if not then it is a real big coincidence that the brainfog lifted just as soon as the coumadin wore off. Too big a coincidence to really be a coincidence is what i think.

If you are curious about nattokinase, Jackie did a really lot of research on it and she has presented that information in 2 Conference Room Proceedings sessions,#'S 39 and 40, Which you can and should read.

PeggyM

Andrea: If you need to take Tylenol for your pain you might want to take some SMM with it. See below:

Gordon

Acetaminophen-Related Liver Damage May Be Prevented By Common Herbal Medicine
Main Category: Liver Disease / Hepatitis
Also Included In: Pain / Anesthetics; Nutrition / Diet; Genetics
Article Date: 18 Nov 2009 - 4:00 PDT

A well-known Eastern medicine supplement may help avoid the most common cause of liver transplantation, according to a study by researchers at the Stanford University School of Medicine. The finding came as a surprise to the scientists, who used a number of advanced genetic and genomic techniques in mice to identify a molecular pathway that counters acetaminophen toxicity, which leads to liver failure.

"I didn't know anything about the substance that was necessary for the pathway's function, so I had to look it up," said Gary Peltz, MD, PhD, professor of anesthesiology. "My postdoctoral fellow, whose parents and other family members in Asia were taking this compound in their supplements, started laughing. He recognized it immediately."

The molecule was S-methylmethionine, which had been marketed as an herbal medicine known as Vitamin U for treatment of the digestive system. It is highly abundant in many plants, including cabbage and wheat, and is routinely ingested by people. Coincidentally, Garnett Cheney, MD, at Stanford University performed a series of studies in the 1950s in which he used the compound to treat peptic ulcers.

Peltz is the senior author of the research, which will be published online Nov. 18 in Genome Research. The experiments were conducted in Peltz's laboratory at Roche Palo Alto in Palo Alto, Calif., where Peltz worked before coming to Stanford in July 2008. He is continuing the research at Stanford. The first author of the paper, Hong-Hsing Liu, MD, PhD, is now a postdoctoral scholar in Peltz's Stanford lab.

Acetaminophen is a pain reliever present in many over-the-counter cold and flu medicines. It is broken down, or metabolized, in the body into byproducts - one of which can be very toxic to the liver. At normal, therapeutic levels, this byproduct is easily deactivated when it binds to a naturally occurring, protective molecule called glutathione. But the body's glutathione stores are finite, and are quickly depleted when the recommended doses of acetaminophen are exceeded.

Unfortunately, the prevalence of acetaminophen makes it easy to accidentally exceed the recommended levels, which can occur by dosing more frequently than indicated or by combining two or more acetaminophen-containing products. However, severe liver damage can occur at even two to three times the recommended dose (the maximum adult dose is 4 grams per day; toxic daily levels range from 7 to 10 grams).

"It's a huge public health problem," said Peltz. "It's particularly difficult for parents, who may not realize that acetaminophen is in so many pediatric medicines." Acetaminophen overdose is the most common cause of liver transplantation in this country. The only effective antidote is an unpalatable compound called NAC that can induce nausea and vomiting, and must be administered as soon as possible after the overdose.

Peltz and his colleagues used 16 inbred strains of laboratory mice for their investigations. Most strains are susceptible to acetaminophen toxicity, but one is resistant. They compared how the drug is metabolized by the different strains and looked for variations in gene expression and changes in endogenous metabolites in response to acetaminophen administration. They identified 224 candidate genes that might explain the resistant strain's ability to ward off liver damage, and then plumbed computer databases to identify those involved in metabolizing acetaminophen's dangerous byproducts.

One, an enzyme called Bhmt2, fit the bill: It helped generate more glutathione, and its sequence varied between the resistant and non-resistant strains of mice. Bhmt2 works by converting the diet-derived molecule S-methylmethionine, or SMM, into methionine, which is subsequently converted in a series of steps into glutathione. The researchers confirmed the importance of the pathway by showing that SMM conferred protection against acetaminophen-induced liver toxicity only in strains of mice in which the Bhmt2 pathway was functional.

"By administering SMM, which is found in every flowering plant and vegetable, we were able to prevent a lot of the drug's toxic effect," said Peltz. He and his colleagues are now working to set up clinical trials at Stanford to see whether it will have a similar effect in humans. In the meantime, though, he cautions against assuming that dosing oneself with SMM will protect against acetaminophen overdose.

"There are many pathways involved in the metabolism of this drug, and individuals' genetic backgrounds are tremendously variable. This is just one piece of the puzzle; we don't have the full answer," he said. However, if subsequent studies are promising, Peltz envisions possibly a co-formulated drug containing both acetaminophen and SMM or using SMM as a routine dietary supplement.

The research was partially funded by the Institute of General Medical Sciences and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health and by Roche. Peltz and Liu are the co-inventors on a patent filed on the use of SMM to prevent acetaminophen toxicity in humans. SandHill Bio, a drug discovery startup co-founded by Peltz, is further investigating the potential therapeutic applications of the finding.

Source: Krista Conger
Stanford University Medical Center

I'm kind of surprised no one else among us Afibbers has had this question of what to take for muscle or joint type pain considering interaction with blood thinners and any other heart meds. I wound up just taking 2 Tylenols today and then going to the health food store for turmeric and the grocery store for Arthricream rub and Tiger Balm patches.

Andrea, why not just increase the aspirin dosage and take it more often? You know the aspirin does not harm you, and it is an effective anti-inflammatory.
PeggyM

Wow, how do you get that aspirin doesn't harm you? It's well known to cause GI bleed and of course liver damage. I already take 325 mg and increasing it also would cause more blood thinning. I did end up buying turmeric capsules yesterday though plus some Tiger Balm patches and something called Arthricream rub.

Maybe i am a real tough customer, but aspirin has never harmed me, and i have taken a lot of it over a long and checkered lifetime. I always take it with a big glass of water, and if i am taking it on an empty stomach, i drink the glass of water first and draw another one to take the aspirin with, and drink all of that one too. The idea is for the pills to land in a nice big pool of water, not on the delicate stomach lining. Perhaps i am mistaken, but the threat of liver damage from the tylenol seems greater to me than any possible harm to the stomach. You must of course make up your own mind about this. I already did, some time ago. Good luck with it whatever you decide to do.

About the turmeric, it is available in capsules, or else one can purchase empty capsules and insert whatever one wishes, turmeric or whatever. It has an effect when taken this way, but i found the zyflamend to be better.
PeggyM

Andrea,

Here is coming at the pain from a tangential direction.

See this post on trigger point therapy. In your case, I'm not referring the "arrhythmia trigger point" referenced in this post. <[www.afibbers.org];

In your case, I'm thinking of trigger points for:

Base of thumb & Radial Hand Pain
Specfically looking for and resolving trigger points in these muscles using massage:

Supinator
Scaleni
Brachialis
Infraspinatus
Extensor carpi radialis longus
Brachioradialis
Opponens pollicis
Adductor pollicis
Subclavius
First dorsal interosseus
Fleror pollicis longus

See: [www.triggerpoints.net] choose Forearm and Hand Pain then click on the specific muscle. In this example for the Supinator muscle [triggerpoints.net], the red areas are where the referred pain can be, the X is a general location as to where to look for trigger points.

How to Self Massage for Trigger Points [saveyourself.ca]


More references:

The best lay persons reference by Davies: [www.triggerpointbook.com]

[saveyourself.ca]

Here is an online guide - [triggerpointproducts.com] it may be of use, though Davies' book is really needed to get a lot out of it.

Here is another online PDF - again not the best, but it is available on line.

[api.ning.com]

My experience is that much pain has a muscle origin (perhaps 80-85%). What is missed by many is that these trigger points can refer pain elsewhere, and the active trigger points do not hurt until you go looking for them (i.e. massage). In general, I use about 15-20 pounds of pressure to look for trigger points on the body, 6-9 pounds pressure on the face and 35-40 pounds on the buttocks. You can press on a bathroom scale to see how much force is required. Trigger points will be say 4 times more painful than the surrounding tissue with the same amount of pressure.

George

Andrea: If it's stomach upset you're worried about with aspirin you might consider taking an enteric coated one that doesn't dissolve in the stomach.

Also of interest to me since it's the first I've seen of it is the last paragraph saying that other NSAID's interfere with aspirin's clotting ability.

See article below from Johns Hopkins:

Gordon

Is enteric aspirin "safe” and "easier” on the stomach than uncoated aspirin? The jury is still out …

Aspirin has long been known as an effective painkiller, but it's become as important for preventing stroke and heart attack as it is for preventing pain. Low-dose aspirin therapy helps prevent heart attack and stroke by keeping blood platelets from clumping together and forming dangerous clots. But this wonder drug also can produce gastrointestinal (GI) side effects, including an upset stomach. Long-term use of aspirin can cause GI bleeding and ulcers.

Enter enteric aspirin. Enteric aspirin, sometimes called safety aspirin, is coated so that it doesn’t dissolve in the stomach but instead passes through to dissolve in the small intestine, preventing GI upset. Many people use enteric aspirin for aspirin therapy, because they believe that it protects the GI system while providing the same cardiovascular benefits as uncoated aspirin.

Recently, however, there’s been some controversy over whether enteric aspirin is as good at preventing blood clots as uncoated aspirin. A recent European study of 131 cardiovascular patients published in Stroke found that a daily 75-mg enteric aspirin was less likely to fully inhibit platelet clumping than uncoated aspirin. Fifty-four percent of subjects taking enteric aspirin experienced incomplete inhibition compared with 8% of subjects taking uncoated aspirin. Heavier people were less likely to respond to any type of aspirin, leaving them especially at risk for incomplete platelet inhibition.

However, other studies have come to different conclusions. A study published in the American Heart Journal pitted 81-mg enteric aspirin against 81- mg chewable aspirin in 50 volunteers and found no difference. In a small study published in the American Journal of Cardiology, people who took an 81-mg enteric aspirin each day took longer to achieve full platelet inhibition, but after seven days of therapy, inhibition was at the same level as that of subjects who took regular aspirin.

What’s the verdict? The jury is still out as to whether coated or uncoated pills are better for aspirin therapy. For starters, experts are still uncertain about the optimum dosage and how best to measure aspirin’s anticlotting ability. A typical recommended dosage can range from 75-165 mg daily. Researchers working on the European study recommend taking a 75-mg uncoated aspirin (the lowest dose available in Europe; the American low-dose equivalent is an 81- mg uncoated aspirin). If you’d like to try a lower aspirin dose, try 81-mg children’s chewable aspirin.

If you experience an upset stomach after taking uncoated aspirin, you can talk to your doctor about the appropriate dosage of enteric aspirin. Raising your dosage may help ensure that you’re fully protected against blood clots, but it could also increase your risk of GI side effects unrelated to immediate stomach upset.

Bottom-line advice: You might assume that because enteric aspirin is marketed as "safe” and “easier on the stomach,” you can take it without ever experiencing any GI side effects. That’s not true -- enteric aspirin does prevent immediate stomach upset, but it doesn’t protect against the bleeding and ulceration that can occur after frequent aspirin use. Aspirin -- enteric or not -- hinders the production of prostaglandins that protect the stomach lining. This occurs no matter where the aspirin dissolves in the body. Whether you use enteric aspirin for aspirin therapy or just to ease pain, keep this fact in mind.

A last caution for those who are on aspirin therapy, enteric or otherwise: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen products like Advil or Motrin, can interfere with aspirin’s anticlotting effect. People taking uncoated aspirin should avoid taking an NSAID for eight hours before and a half hour after taking their aspirin dose. It’s unclear how NSAIDs interact with enteric aspirin, but they may interfere more because enteric aspirin takes longer to be absorbed into the body, allowing no time for the body to absorb the drugs separately. If you must take other NSAIDs while you’re on aspirin therapy, ask your doctor about timing your doses of the two drugs.

Andrea,

You may be interested in this article:

[www.afibbers.org]

Hans

Andrea - do a google search on enteric coated aspirin intestinal damage.... even the 81 mg doses of enteric coated are known to cause intestinal injury.

NSAIDs are hard on the kidneys, too. I worked with a woman who took NSAIDs and aspirin for years and she ended up with about 30% kidney function.

Consider something like a natural antiinflammatory product like Zyflamend
or something like Kaprex from Metagenics.
[www.metaproteomicslabs.com]

Jackie