Tylenol vs. Ibuprofen: A Liver Doctor’s Take

[@tsukikage]

I hate when doctors say "avoid ibuprofen" when they mean "avoid NSAIDs". (This has actually happened to me, where I didn't know I was supposed to avoid NSAIDs because the doctor just said to avoid ibuprofen. Not a problem - I keep 500 mg naproxen at home! So that's what I was taking instead.)

[@A---ti3zz]

Got diagnosed with a DVT and put on a blood thinner...no one told me to avoid NSAIDs. I literally have a prescription for two different NSAIDs so the pharmacist knew I was taking NSAIDs.

[@lokipokey]

Yipes!

[@waffles3629]

Yep, so many docs do not say what they mean. I had a doctor tell me to stop drinking coffee. Which was impossible, because you can't stop doing something you don't do, but he actually meant caffeine. Which I don't do because it annoys my migraine. But I could totally see someone who was having problems from drinking coffee due to caffeine switching to energy drinks.

[@limiv5272]

Yes, doctors often feel the need to dumb things down to the level that they're giving confusing or false information which ultimately can cause a lot of damage, all for the greater purpose of saving time and effort for themselves

[@its_mil_4816]

@@limiv5272"dumbing things down" doesn't save them any time. it takes time to try to explain things to people that aren't educated on the matter and all doctors do that. naturally, though, thorough explanations can take time, so they take shortcuts, which can lead to issues

[@kathleenstoin671]

Years ago when I was working in a hospital, we had a 14-year-old patient who had swallowed a bottle of Tylenol after becoming hysterical during an argument with her mother. She didn't tell her mother about the Tylenol, until she started getting jaundiced. She destroyed her liver with Tylenol and died in our care. A very, very, sad case.

[@justaguy5770]

That's one of the sadder sides of Tylenol abuse, by the time the damage is done often times the person has already calmed down and is thinking more clearly but it's too late

[@Number6_]

If you allow your self to become hysterical, this will happen.. more people are killed by emotional reactions then anything else!

[@kathleenstoin671]

She was 14. Expecting someone of that age to govern their emotions is unrealistic.

[@Number6_]

@@kathleenstoin671 you have just grown unrealistic. I did, and I have see teenage girls do it too. Responsible parents produce rational children.

[@kathleenstoin671]

@@Number6_ Oh, if only. It's just not that simple! At my age of 78, I've seen many examples of children of good parents who acted irrationally. And vice versa. There are no guarantees when bringing up children. We do our best as parents, and we hope for the best.

[@Snow_Whyte]

As a chronic pain patient since 2010, I’ve been treated with literally every pain medication on the market- both OTC & Rx at some point. At times when I was prescribed hydrocodone/oxycodone, it was ALWAYS a mixture including acetaminophen. This always made me feel uneasy, knowing the rising doubts about Tylenol, especially when taken on a regular basis. Only recently was I prescribed one without acetaminophen- 14 years into my disease. I was really grateful to my dr for showing concern for *BOTH* my pain (aka my quality of life), AND my body. I’m so used to Drs focusing immovably on one or the other. But he proved that it’s possible- and not very difficult- to show thorough concern for both. ❤️‍🔥

[@palmbeachcitizen]

May I ask, what did he prescribe? I have McCune-Albright Syndrome and I could use a change myself.

[@George-sc3wo]

I live with chronic pain and because of the crackdown on controlled pain medications I had to stop taking everything…. Frustrating can’t find a doc who can or wants to help so I just live in a constant state of pain.

[@jooleebilly]

@@George-sc3wo Yeah, it sucks. There are only a few doctors who are allowed to prescribe it, and they get a printout FROM THE DEA every month showing how many people they prescribed it to, and the amount. One month they go a little over the limit and they can be cut off from prescribing it. Just to keep 'em overcautious, because who wants to go to jail just for taking someone's pain seriously? Also, apparently vicodin/norco have been linked to increased suicidality, and they can get blamed for that, too. I take 2400mg ibuprofen and 1000mg tylenol per day. And that just keeps my pain down to a "dull roar." Without it, I wouldn't be able to function. With it, I'm risking both my liver and kidneys. I've been referred to a "pain clinic" where they do things I've already done for years (PT, meditation, psychology. But I'm trying to get back surgery for the now severe arthritic changes in L5-S1 causing spinal stenosis. Like, I can't even walk for 5 minutes. I can't sit for more than 15 minutes. I can't stand more than 10 minutes. My length of sleep is determined by when my back pain wakes me up. And now the spine doctor, after making me get a bunch of tests is saying he doesn't even want to send me to an MD (anaesthesiologist) on the other side of the pain clinic. He's pushing back and saying "Cortisone only works for a few weeks," and "What pain do you think your back is causing?" B*tch, I already told you!! But that's just the start of it, so maybe some of the other things caused by hEDS can be helped by the sort-of pain clinic.

[@localroger]

This is a time-honored practice called denaturing. You can see it in its original habitat at the hardware store, where you buy a can of fuel alcohol and it's "denatured." This is ethyl alcohol, the same stuff as in 151 rum, but the "denatured" part means that it has been mixed with just enough wood alcohol to poison you if you ingest it. The purpose of denaturing nearly all opioid pain meds with Tylenol is quite simple, it's to kill you if you abuse the opioid, because we all know that's an absolutely fair and just punishment for violating drug laws. If it had any other purpose you would see rows of opioids mixed with other non opioid pain meds like ibuprofen. It is, after all, cheap enough to supply a bottle of Tylenol along with whatever prescription you really need.

[@roberthastings5550]

For pain, I use kratom as well as suboxone. There are some sympathetic MDs who will Rx suboxone to get you off kratom. That way, you don't need to the hassle of scoring heroin from the cartel to get the Rx. Despite the admonitions of some "spiritual" and ideological nut jobs, pain degrades - it never edifies. As always, don't believe some internet rando, do your own research, start small, listen to your body. Good luck.

[@AshGreen359]

The difference for me is that Tylenol never works.

[@100dollartissues]

Me neither, and I have no idea why. My mom is the same way

[@Jsuarez6]

Taken from another comment: "As i understand it ibuprofen is therapeutic, meaning it can help reduce inflammation that causes pain, whereas Tylenol is simply palliative, has no therapeutic action like reducing inflammation but only works by blocking pain signals. This may explain why ibuprofen often works when Tylenol doesn't. Ibu works to reduce what causes pain, Tylenol only blocks pain signals but doesn't make anything better."

[@safiremorningstar]

Before Tylenol came out when I was still a kid I can tell you that aspirin never worked for me and it was also sometimes more of a problem than anything else because it used to bother my stomach a lot, it was thought that when Tylenol came out that people like me who had problems with Aspirin would find Tylenol and it would or better than playing aspirin and would in fact be better for pain relief for me but it never did never worked but then again a lot of things don't work for me most pain relievers don't work at all for me at 4 works mostly for reducing swelling not really so much for pain relief but it's better than if they say nothing, unless you consider the fact that I'm always in pain and have been for most of my life in which case you understand why I avoid taking any painkillers at all and just live with the pain for the most part. And there's also the fact that anesthetics don't seem to work at all for me either. The amount of times that I had friends who took marijuana and even gave me some and it didn't work and I just used to wish it wouldjust so I could be without pain for a little while I can tell you that it didn't work and it has never worked in fact I've never understood how so many people could get high on it I just I didn't understand it as a teenager and I still don't understand why it is that apparently I don't respond to any form of anesthesia, or any kind of aesthetic that most people have fun with I'm talking the legal stuff as well like you know getting drunk some people can get drunk I can't. So you are not alone when you say that Tylenol has no effect you're right the majority of people in my family are that way it has no effect.

[@dougberrett8094]

I prefer m & m’s to Tylenol. They work just as well, but taste better!

[@100dollartissues]

@@dougberrett8094 That’s basically what my mom says. “I could drink a glass of water and it would have the same effect!” Though hydrating could help with pain too, depending

[@erikaquatsch2190]

Retired RN here. I see what appears to be a urine sample cup with dark urine at Dr Schmidt's YT plaque over his right shoulder. I once told some young CNA's that I had been in nursing so long that to find out if a patient was diabetic we would taste the urine for sweetness, while I lifted a urine sample cup to my lips and took a sip of apple juice.

[@macmcleod1188]

Classic trick from a movie too!

[@rockspyder3970]

😂😂😂

[@fredericapanon207]

Hehehe, my father used to tease my mother by saying that was how pharmacists would diagnose diabetes as well. My mother was a pharmacist.

[@squoctopus]

Oooh that's mean!😂

[@redjoker365]

That was a very ancient way of diagnosing it, but also back then the only real treatment was a near starvation diet

[@mikemillson9572]

You are a fast talker and having to listen several times to get this in my head. But great information.

[@archibaldy1929]

You can slow down the speed if you need to-Just click on the gear in the upper right corner of the video…you’ll find the control there.

[@mikemillson9572]

@@archibaldy1929 thanks

[@safaiaryu12]

​@@archibaldy1929 Yes! There are a few channels on KZbin that I do this for, it's very helpful.

[@mrcryptozoic817]

This was quick. (Nice!) So there's time enough to listen more than once...if it's important to you.

[@mikemillson9572]

@mrcryptozoic817 my comment said, "Great information" and that I listened to it several times. Thanks.

[@Debbie338]

Veterinarian here. One single dose of Tylenol will kill a ferret or a cat. Notice I said it WILL kill, not can kill. A dog might live if the dose is small for its body weight. But, acetaminophen is all-around bad news in Vet Med.

[@alexp2915]

Thanks for sharing that! How about ibuprofen?

[@Debbie338]

@@alexp2915 It’s a little less toxic, but still dangerous. It has such a narrow margin of safety, even a small overdose can cause serious symptoms in dogs. The only human NSAID that’s safe for dogs is meloxicam, but that has to be used carefully, too. Cats are a whole different ball game. NSAIDS are just not well-tolerated. Even a few consecutive doses can put a cat into liver or kidney failure. Same goes for ferrets. (Edited to add) And yet, meloxicam is well-tolerated by rabbits and Guinea Pigs. We use it all the time on those guys. Vet Med is crazy like that sometimes.

[@DH-gk8vh]

Thank God I'm not a dog or cat. I have spinal stenosis that my neurosurgeon wants to do surgery on. Just waiting to get through physical therapy because if insurance. I've had it for years and then this past February was in a car accident that wasn't my fault. I was wearing seat belts. I'm greatful for them, but a car cut a left turn in front of me on a highway and I couldn't stop in time throwing my entire body forward. My pain is worse now. I went by ambulance to the ER where they did a full body scan. Now I can barely walk around or lay down to sleep without taking Tylenol. The doctor has put me on less than 4,000 mg in a 24 hr period. I'm very careful to keep it around 3,500 in 24 hours, but I don't want to keep taking it at this level. It does help. I have one kidney because I donated my left kidney to my son in 2001. The nephrolgist told me no ibuprofen ever. I stretch my doses out 10 hrs or more. I hope I don't end up damaging my liver.

[@Debbie338]

@@DH-gk8vh I hope not, too. 3500 mg every 24 hours would scare me; but, then again, that’s mostly because I see what it does in animals, so I tend to stay away from it. I hope you get better soon!

[@oogba71]

Well, we're not talking about cats, right? Also, what's a raw onion do to a dog? My grandpa used to eat them like apples.

[@theriseabovecoach]

From someone with chronic pain, this is really informative. Thanks for the post!

[@aaro96live]

I like how he's now called a "Liver fellow" (bc he's doing a fellowship focused on the hepatobiliary system). Other than that, great vid!!

[@limiv5272]

No, it's obviously because he's a member of the Fellowship of the Liver. I wonder which volcano they're taking it to

[@grondhero]

Well, as long as he's not secretly a cannibal. 😉

[@Plasmod1um]

During my respiratory therapy internship in pediatrics, we actually intubated someone following a suicide attempt by Tylenol overdose. Went into liver failure, and altered mental state followed soon after. Crazy how precarious drug doses can be. Thanks for the video, Doc!

[@bigedslobotomy]

I’m a retired respiratory therapist and I’ve seen similar situations. Dying from liver failure is not a good way to go! People think Tylenol is benign, when it’s not.

[@saltiestsiren]

It's a go-to for kids attempting suicide; in the psych ward (as a teenage patient multiple times) it was a common anecdote from fellow patients

[@bobbobertson7568]

As a pretty heavy drinker over the years myself, I always found it amazing people can do much more damage to their liver in a day or two of taking tylenol than 30 years of heavy drinking.

[@PhilipOgelby-ft8go]

I've been a light drinker, start drinking when it's light. Went for routine blood test recently but the sample evaporated..

[@hotrodray6802]

George Burns smoked for 90 years and never got lung cancer.

[@lynnebucher6537]

My father was a heavy and daily drinker for a good 70 years and it hasn't killed him. His liver and kidney function were impaired, yet after 5 years in a nursing home with no booze, his organ function has improved and that tough old bird is still kicking at 92.

[@jessicaolson490]

Well that's because it's chronic stress versus a toxin that starts killing your liver at relatively low doses. The only reason Tylenol is over the counter is because it has existed for so long. If it was a brand new medication it would be one of the high risk medications that would be prescription only and probably would require double sign off when given in the hospital. (Highest risk medications typically will have that as a safety measure for the RNs). Most medications won't kill you if you take five times the dose that's helpful. (Tylenol can start to kill you at x2).

[@tommywolfe2706]

Been a daily heavy drinker for over 20 years and I only have problems when I take Tylenol. Usually, the only time I let up on my drinking is when I get sick and have to take it. I I am afraid of the damage that both will do. On the flip side, when I broke a couple ribs, I didnt want vicoden, so I got prescription Ibuprofen instead. 800mg per pill, take two of them three times a day. That is the same as taking 24 regular ones. Because of that, when I had pain, I would pop 4 and not think anything of it. I didnt look it up because my doctor acted like twice that was ok. Ignorance sucks, these comments are invaluable. I have known about it for a while....the toxicity of those things, but never realized until reading these comments how bad they truly are.

[@Zelmel]

Genuinely useful information that I'm sure is basically unheard of outside of your specialty (to the harm of some, I'm sure)!

[@pastpatour]

Please talk about aspirin and blood related complications. My country is going through an epidemic of dengue fever right now and I feel like we're not sufficiently informed about aspirin in those cases.

[@supercalafra]

Dengue is awful, sorry you're going through that!

[@M_SC]

Oh yes I’d be interested

[@nancydemarco7421]

Aspirin is an NSAID. Sorry you are going through this!!

[@SmallSpoonBrigade]

@@nancydemarco7421 It is and IIRC, the main issues with aspirin have to do with what it does to the stomach and it's tendency to reduce the blood's ability to clot. But, at least it works to reduce fevers and kill pain.

[@saltiestsiren]

Aspirin is another good example of a "safe" drug that can quickly become dangerous, especially in kids

[@sebastianheine378]

excellent video explain the nuanced differences between Tylenol vs. NSAIDs in a clear way. Thank you

[@honeybrew5063]

ER Nurse here. That really helped me understand it better. Thanks doc.

[@Ranstone]

WHY DOES AN ER NURSE NOT ALLREADY KNOW THIS?!?!?!

[@sfactor7]

​@@Ranstone😂

[@johnmccarthy727]

@@Ranstone LMAO it is the practice of medicine smartass.....and smart people are aware of what they don't know and appreciate continual learning. Idiots never lose an opportunity to sound smart at the expense of others even though they are idiots

[@thekinginyellow1744]

@@Ranstone Because ER nurses don't prescribe medicine!

[@diyeana]

You're right. I had the opposite opinion for the liver. Very interesting, doc. Thanks!

[@AmaraJordanMusic]

I developed chronic pain when I was 12 and my dad was an ER doc turned pain management specialist (mom and I were both sick and he wanted to understand better, and he saw how badly we were treated). I remember telling my teacher, “Oh, Tylenol is still not completely safe; it’s metabolized 70% by the liver and when stacked with my other meds, even a little dose has risks. 🙂” She was so nonplussed.

[@annclinkscales8222]

Of course! Some people just DON'T GET IT!! Thank you for explaining the differences and what can male your medical issues worse!! ❤❤ Doctor Schmidt❤❤❤❤

[@spvillano]

That's the bear of it, balancing insult vs therapeutic effects. In general, drugs basically come in two flavors, kidney insulting or liver insulting, to super-Goober things by a lot. Balancing things out, hell, I know of physicians that call specialists just for that, things can get that tangled. And when one wants to let doctor know they're in for some fun, one need only mention the cytochrome P450 enzyme systems... ;) Something higher levels in the liver, but ubiquitous, as it's pretty much mandatory for survival.

[@patrickstonetree1]

A+ for using nonplussed properly.

[@poonyaTara]

As a PMDD sufferer I hate it when doctors warn me about the dangers of taking ibuprofen to the liver. This is because ibuprofen is one of the last drugs developed by a scientist who was experimenting on himself--and was a raging alcoholic. He just dismissed the side effect of cognitive impairment as part of his alcoholism. Liver doctors, if you keep warning PMDD sufferers about cirrhosis we're going to keep dismissing your warnings about the snake in the room because you don't realize that the room is an escape room that's on fire. We can't care about the snake because we're focused on the bigger problems. If you really care, then persuade a pharmacist to compound the isomer of ibuprofen that takes effect in ten minutes instead of thirty--we're willing to pay for it. It'll give us fifteen days a year back, making it possible for us to hold down a good-paying job.

[@Happybidr]

Excellent comment.

[@bryant475]

Please look into Whole Food Plant Based Nutrition, and Dr. Neal Barnard's book "Your body in balance"!

[@carlyle8969]

Please get help

[@LGrian]

⁠@@bryant475buddy that doesn’t fix people who produce excess prostaglandins and whose own hormones make them sick. I’ve eaten perfectly most of my life according to books like that. It doesn’t matter. There are genetic and environmental factors out of our control, and you can’t simply “health food” your way out of it. Life style is important but meds are simply necessary to make many reproductive disorders tolerable

[@bryant475]

@@LGrian Regardless, it's still best to eat this way, win wins all around. No animal foods or processed foods, is optimal.

[@michaellowe3665]

I have used Ibuprofen for knee inflammation and it works. It actually fixes the problem. Once the inflammation is gone I stop taking it to avoid side effects. Interestingly, I have been prescribed Meloxicam to replace the Ibuprofen because the doctor said it does the same thing, but with less risk of stomach problems. My question is that if it does the same thing with less risk, why doe it need a prescription when Ibuprofen doesn't?

[@Aracuss]

I believe It has something to do with heart and blood pressure and Meloxicam vs Ibuprofen

[@shannonlanghart346]

Ibuprofen's patent expired in 1984 and became an OTC drug with a limit of the dosage by the FDA. It can still be prescribed at higher dosages by doctor's.

[@spvillano]

One of the few that remember to mention, "taken on a consistent basis". Far too often, we get a first year resident's take, "You have kidney damage, avoid NSAIDs". First year, as the only damage is some mild protein leakage, secondary to a heat stroke in 2009, zero progression, zero other issues in the lab values. Or we get the first year's other mistake, "Oh, you drink ethanol, avoid acetaminophen", I've gotten both, despite my liver function being well above normal, to my own mystification, as it appears to be pretty much the only organ system that's still operating optimally. ;) Still, you did give medical advice and of all medical advice, the best medical advice - talk to your doctor. Oddly, I've noticed some changes with age. Back when I was young and fire had just been invented, APAP didn't really work well as an analgesic at all for me, but ibuprofen did (and still does). Now that I'm older than a fair number of hills that were mountains in my youth, both are fairly effective analgesics, with APAP preferred for things like when my wisdom teeth started making my life a misery, ibuprofen for my lumbar/SI issues. Both taken on a highly inconsistent basis, as I hate taking pills nearly as much as I hate taking opioids or opiates (massive MAST cell dumping in me, literally makes me feel like I'm dying), which all are about on par with the notion of self-gratification utilizing a cheese grater. Don't get me started on antihypertensives, thyroid blocker, proton pump inhibitor, etc. So, adding even one more pill, well, that's nearly as welcome as using a durian fruit as a suppository.

[@adamloepker8057]

Is that a cup of pee sitting on your shelf by the youtube plaque behind you?

[@Doc_Schmidt]

Maybe

[@Queezbo]

Oh my gosh. I hadn't noticed. There is nothing else in the world that looks like except a sample cup. Green lid and everything. I peed in one of those two days ago.

[@upyoursassmonkey]

Let's just say its organic fertilizer for his garden.

[@sallywerkmeister5192]

😂

[@CM-is4ug]

😂😂😂

[@rhucks]

A small trade off of living to see all three of my sons graduate from high school and college and seeing one of them get married thanks to a liver transplant is not having ibuprofen as a pain management alternative. It's a price I'm happy to pay.

[@M_SC]

I swear he just said Tylenol was worse for kidneys

[@TheVivi13]

@@M_SC Sounds like you should rewatch the video

[@CanItAlready]

​@@M_SCListen to what he says at 1:50

[@mirandacoulter888]

When I was first diagnosed with end-stage liver disease, that was one of the first things I was told. Tylenol only. I’m 10 years post-transplant as of yesterday (and after the kidney damage caused by my liver failure) and it’s even more true now.

[@rhucks]

@@mirandacoulter888 Whoo hoo! 10 years! Congrats! I'm blessed to be 14 years post transplant. I'm right there with you on the kidney damage but I'm so happy to still be above ground!

[@dlarsen325]

Will you talk about basic bowel management and your preferences for constipation? Senna? Miralax? Thank you!

[@Call-me-Al]

Senna like that dangerous "dieting" tea?? Just get more water and fiber into your diet, fiber without more water will just make constipation worse. Psyllium husk / metamucil is a classic. Edit: Some benefit from a little more healthy oils in their diet too for both better health and better poops.

[@herrbrahms]

Soluble fiber is the key. It turns into a gel that lubricates your colon. I eat peas every day, though almost any legume will do.

[@bryant475]

Stick to Whole Food Plant Based Nutrition!

[@davidb2206]

Eat prunes. If that doesn't work, get some Mexican food from a street cart. Natural methods only.

[@cyn4476]

Ibuprofen caused my while GI tract to bleed. I developed Crohn's disease and my first two doctors never mentioned the effect of ibuprofen on my intestines, but knew I was taking both Ibuprofen and aspirin. Third Dr was shocked that I wasn't warned and immediately took me off of all drugs, put me on a low fodmap regimen and antibiotics for sibo. My digestion has been so much better, no more bleeding, no more ulcerations, a lot fewer symptoms. I am on GI meds that work, too.

[@billyz5088]

the thing about Tylenol is that so many OTC products contain it - and many treat different symptoms - so some people may not realize they're getting too much of it in their bodies in too short a time frame - then you could get some prescription which might also contain it - then you could be far above safe levels ..

[@tabby73]

That's why people should always read the info on the package.

[@queenbunnyfoofoo6112]

Fortunately I rarely need painkillers, but if I do I always go with ibuprofen. Like many others have commented, Tylenol doesn't touch pain for me. I might as well be popping a tic tac.

[@kingofthedots3835]

I worked in an ER in the eighties ....teenagers were committing suicide with Tylenol ......taking a huge dose to produce liver failure and permanent coma or brain death ....count me out 😮

[@SmallSpoonBrigade]

@@kingofthedots3835 Tylenol is particularly egregious as there's little science to back it addressing any sort of pain. IIRC, it can be useful for children in reducing fever, but there isn't really any reason to take it as a pain reliever as the science just isn't there.

[@laurag7295]

Tylenol does nothing for me either. I dislocated my wrist and was in a cast. My hand and fingers were swollen badly. They told me to take Tylenol for the pain, so yook some, nothing. I took ibuprofen for the inflammation, which was causing the pain!!!

[@lynnebucher6537]

Tylenol doesn't work for me either. Never has. Ibuprofen is a miracle drug.

[@Senbatorii]

Military medicine has taught me that Ibuprofen cures all ailments.

[@falconerd343]

Get your daily dose of Vitamin I

[@paulwheeless1080]

seemingly always in giant 800mg tablets

[@johnsyler8580]

800mg and return to duty!

[@shellcracker18]

@@johnsyler8580don’t forget the monster energy drink

[@fegolem]

My brother has a long story about too much ibuprofen and then later too much tylenol. The first one tore up his stomach then the other scarred his liver. All in the effort to remain functional.

[@funkijote]

Geez, that’s tough, I hope he gets some relief

[@infinitejest441]

Doctors went from prescribing enough opioids to kill an army, to prescribing suckitup and take an aspirin. Liability is the main reason.

[@BlackSeranna]

This is why oxycodone is useful - it doesn’t affect either organ. The only down side is, you want to make sure that you don’t have an addictive gene, and you also make sure you stick to the label, never taking more. A little goes a long way!

[@safaiaryu12]

There's a problem with medical professionals not taking pain seriously. It's definitely a liability concern, I get that, but if a person's pain is affecting their functionality, maybe they actually do need the meds??

[@katendress6142]

@@safaiaryu12 It's turned into a moral panic. I'm lucky that I only need Norco to handle breakthrough pain so my doctor is still willing to prescribe it to me. I have a follow-up colonoscopy next month to find out if the damage to my stomach lining from too much ibuprofen has healed, so I have to be careful about that too. There's research that shows that one of the causes of chronic pain is untreated or undertreated acute pain.

[@itamarsalhov]

one thing ibuprofen has over paracetamol is that it sometimes reduces pain.

[@SarahMaywalt]

This is a science fact.

[@drumset09]

I asked my doctor why it was okay to take the recommended dose of both acetaminophen and ibuprofen for pain. If you took that many pills of either one, it wouldn't be good, but why is it okay to take both. This video helped explain that to me. That's something I've been wondering for about 5 years now.

[@philbenson6041]

They both are different medications and work differently in the body

[@Sashazur]

@@philbenson6041and harm different parts of the body if too much is taken

[@johnlindskog6413]

Why not just take Aspirin?

[@mattglennie9644]

Aspirin is a nsaids type medication and affects bleeding/coagulation

[@CarrieMK]

Thank you! This video did so much to put my mind at ease. I was always very anxious when taking my doctor prescribed dose of Tylenol (1g every 8-12 hours). I knew that Tylenol could damage my liver, but no one talks about how much is actually safe.

[@supercalafra]

Generally, doses less than 2g per day in healthy patients does not cause acute damage. That's not to say it can't, nor that it doesn't cause cumulative damage: it does. However, taking 2 500mg tylenol pills for a migraine is not going to immediately do your liver in. Taking it every day, or taking more than 2g per day can. It's a lot like drinking alcohol in that way.

[@ShyGuy1066]

Having liver and kidney problems is a tenuous situation at best.. Chronic use of medication (daily over years) will eventually cause significant loss of liver and kidney function. People who chronically take analgesics aren't doing so because they like the taste. It's a tough job for the doctor to balance all of this to maintain quality of life.

[@langreeves6419]

I've never had tylenol reduce my pain at all Not even like a one percent reduction of pain So I never take it It feels like the story of the emperor's new clothes And there have been some recent studies to show that this is true for a lot of people Don't really like taking ibuprofen because to get the good effect of ibuprofen I have to take a rather high dose My favorite pain reliever is alleve Because it last twelve hours But I still think the most effective pain reliever.I've ever taken is aspirin Well, that is, if we're talking non.Opioid

[@Hi_Im_Akward]

I'm not sure exactly what the studies say about this, but acetaminophen (Tylenol) helps me the most for head pain if taken early with early signs. I have migraines regularly, so if I take it early enough I can stop them from disabling me. If I take it too late, it won't matter. Ibuprofen helps me the most with anything associated with inflammation, i.e. joint pain, muscle issues and period related pain. Similarly, the earlier I take it, the more effective it is, so if I know I'm going to be getting my period, I'll take it before the cramps get really bad. If I take it later, I feel less effectiveness and I have to end up taking a higher dose. Something like aspirin helps me more with nerve pain, and naproxen (Aleve) helps me the most with chronic injury type pains. And it is safe to take acetaminophen (at normal dose) with ibuprofen (at normal dose), which I have done on multiple occasions but I don't do it regularly. Something else I've heard is that name brand can be more effective. I used to think it was BS but learned that the filler ingredients sometimes have a purpose for delivery method, can effect delivery method and absorption or people can have reactions to those ingredients. Since the non medically significant ingredients don't need to be regulated like the main active ingredients do, it can vary a lot depending on the drug. I'm not a name brandist, but it's something worth considering. Of course do research about all of this. I have known how to take OTC meds mostly from my parents who are in the medical field, and generally know how to read labels, compare drugs and what is ok to mix or not mix but it's all tertiary information.

[@ComfyChaos]

I try to avoid both as I generally have a high pain tolerance. However, I recently had to have endometriosis excision surgery and my surgeon put me on a short course of both 600mg ibuprofen and 500mg acetaminophen. Both worked very well in combination for the post op pain! I don’t have any liver issues though NASH runs in my family so I am always keeping it in the back of my mind.

[@supercalafra]

Similar experience. I had acute appendicitis and 1000mg of tylenol alone brought the pain down to nearly zero.

[@ConstantlyDamaged]

There is a local (to Australia) brand of ibuprofen that has 500mg of paracetamol already in the tablet, that's generally the strongest over the counter painkiller here. I normally avoid ibuprofen (I'm hypertensive) but my doc told me that if I keep to the dosage limits, for a short time, I should have some (following some surgery on my thumb, somehow got a wart growing under the nail and had to have said nail half removed).

[@waffles3629]

Yep. Well I don't specifically avoid it, but due to chronic pain very often by the time pain is bothering me OTC meds won't help most of the time. So I just don't take it much.

[@BillDyszel]

Added concern: Many OTC cough remedies include acetaminophen, even though it doesn't help a cough. I wish they'd leave that out. If I need Tylenol I'll take some. Otherwise I'd rather only take it when needed.

[@zamis21]

I have been taking 800mg Ibuprofen as need for over 40 years. I get tested every year to check all my liver and Kidney functions.

[@M_SC]

Ive been taking ibuprofen nearly every day for about 15 years

[@kimr3755]

Tylenol does not work for me. Doesn't work for fever or for pain.

[@karldavis7392]

I have that same story with ibuprofen and usually choose aspirin. It's very individual with medicine.

[@duxdawg]

@kimr3755 Interesting since Tylenol works better for me than any of the others.

[@chellann]

My adult son almost died from taking too much Tylenol for a bad toothache, he has a very high tolerance for pain, and this was unbearable for him. Even after the dentist alerted us to him needing to go to the ER immediately it took both morphine and haldol before he was able to calm down. I have never seen him react that way to pain. Thankfully, we had a nurse both in the ER and ICU that had experience and empathy for the fact that he is on the spectrum even though it is hard to tell and this has led to some really bad treatment by both nurses and doctors. The point of my story is that my parents would often tell us to take a double dose or more when in severe pain because this was how many people approached medicines and it as far as they knew it had never killed anyone. So I didn't even think to ask just how much he had taken until I'm sitting in the ICU replaying the doctors telling us that had that dentist not taken the actions he did my son could have died from liver failure at the age of 25 because of a toothache. Now, our entire family is more careful and aware that it is very easy with severe pain to cross that line between more than the bottle says, and being in the ICU for Tylenol toxicity and doctors telling us that we won't really know if the medicine is working until he has been given enough by IV for them to test if the level in his blood is decreasing with tratment.

[@st.haborym]

As someone with really shitty teeth and way too much dental work, in my experience ibuprofen works a lot better for toothaches cause of it's anti-inflammatory properties. Two extra strength ought to do the trick.

[@Call-me-Al]

​​@@st.haborym Seconding: I got prescribed 800mg ibuprofen pills alongside the antibiotic treatment when I had a tooth abscess with severe pain. It worked great. Also, I used to rotate between aspirin, ibuprofen, and paracetamol (tylenol iirc) for my severe period pains back when I had them (rotate so I could take more painkillers within the same 24 h than just the max dose of one type) because otherwise I wasn't able to function the first two days of my period. Ibuprofen worked the best. Naproxen felt like a less strong but more long lasting ibuprofen. So that wasn't useful to take instead of ibuprofen for me, since I needed maximum pain relief. Once, diclofenac gave relief for the extreme pain of a sinus infection none of my three usuals touched. I rarely have to take pain killers these days in comparison to the past, when I do it's ibuprofen for headache or similar pain, or sumatripran for migraines.

[@komikbookgeek]

It's because nsaids are older while Tylenol is newer - and the toxic level is way way way less than ibuprofen or other nsaids for otherwise healthy people. So to many people, it's not as dangerous as it is.

[@5H4D0W.]

@@komikbookgeek Tylenol as you americans call it, is just paracetamol, which was available in the US from 1960. Ibuprofen for example, available in the US from 1974. These substances where synthesized much earlier ( still, paracetamol was known earlier than NSAIDs) . Paracetamol/acetaminophen is metabolized by the liver and forms a toxic metabolite known as NAPQI which is responsible for liver toxicity. NSAID's are metabolized by the liver aswell , like most of the drugs are , but they DO NOT form toxic metabolites. They do however cause damage to kidneys when overdosed (as literally anything) . Don't spread false information about medication when you clearly have no idea what are you talking about

[@5H4D0W.]

When a weak analgesic like Tylenol does not work, you don't increase the dosage multiple times. You change the active substance and switch to more potent analgesic like Naproxen, Nimesulide, Diclofenac or Tramadol. Morphine is total overkill.

[@kathybuffington4883]

You’re right. As a liver nurse we told patients to take Tylenol up to 2 grams a day(not long term) for pain. Not ibuprofen. Had a lot of patients argue as their pcp told them not to take Tylenol. Explained we are the liver experts and we say to take Tylenol for a headache.

[@The93ssfd]

Liver nurse?

[@M_SC]

Life sucks without ibuprofen though. Tylenol rarely works for me. I’ll tell a doctor eventually

[@dianeviviana9830]

I agree! Tylenol has never worked for me. I started taking Ibuprofen when my gynecologist told me to take it instead of aspirinfor cramps. I consider it a wonder drug.

[@alsaunders7805]

Tylenol works good as a fever reducer for me, it does absolutely nothing for pain, never has. I always wondered why people even took it. 🤔🤓🍻

[@Tser]

Studies have repeatedly shown it really doesn't work for a lot of kinds of pain, you're not alone. It does reduce fever, though.

[@bethsojourner6798]

​@@dianeviviana9830I'm the same way. The first time I took ibuprofen for my cramps I was sold. I couldn't believe how effective it was. I used to take midol or pamprin for cramps to no avail. Basically one was asprin with a diuretic and the other was Tylenol with a diuretic. Both were equally useless.

[@rncine]

Why not alternate the meds? What this doctor forget to say that his video is for patients that have chronic pain not acute.

[@VTPSTTU]

In 2015, I took Tylenol PM one night. At work the next day, I had chest pains shooting into my jaw. I soon fainted. They never figured out what happened. Everyone assumed a heart attack, but the ER found no heart attack symptoms. I don't believe that the the Tylenol had any causal effect, but I still can't bring myself to take Tylenol again. Typically, I use low-dose aspirin for pain relief, but even then, I rarely take anything.

[@TheVivi13]

Do you know much about Aspirin? That could be something to talk about next. I know it exists but I know next to nothing about it other than it's actually different from those 2. For the longest time I thought aspirin/advil were interchangeable names but obviously that's not the case.

[@stevepreskitt283]

Aspirin (acetylsalicylic acid) is an NSAID. It's not the same drug as ibuprofen, but it's in the same class of drugs with similar potential risks. "Aspirin" used to be a trademark for Bayer's version (just like "Heroin" was a trademark for Bayer's version of diamorphine), but over the years it became such a common term for acetylsalicylic acid that it lost trademark protection.

[@macmcleod1188]

It can also be a Willow Bark Tea or Willow Bark extract. Be *careful* in that form. One lady was taking the equivalent of 75 aspirin per day. Aspirin can be helpful to thin the blood for people with cardiac risk. Aspirin has a different affect for me. It's better for headaches but not as good for general body aches.

[@buzzallnight3605]

@@stevepreskitt283 Aspirin was first before anyone even though of NSAID which is just fake aspirin.

[@elizabethgerring130]

Thanks Doc, this video was very timely for me.I’ve been on large doses of Ibuprofen for going on seven weeks for a back problem. In between er and hospital visits I was given opioids. I was finally given a medication for nerve pain that is working but was told to take ibuprofen for breakthrough pain. I have had enough ibuprofen to kill a horse so I am now taking es Tylenol. This video really helped me! Thanks

[@ADeL-xp2hv]

Thank you for clearing that up for me! I have a sub category of NAFLD, stage 3 NASH, and the GI doc told me to only take Tylenol because nsaids were more harmful. A few months later and I happened to have kidney stones. I went to the ER because I was also pregnant at the time and I was worried it was something to do with the baby. After a few tests ER doc finds kidney stones and tries to prescribe ibuprofen for the pain but I told him I could only take Tylenol because of my liver. After some back and forth he gives me Tylenol but tells me my GI doc is wrong because Tylenol is worse but ok, take the Tylenol since you want to fight about it. Next time I’ll just show them this video, just in case.

[@lilannegirl03]

I'm surprised the ER doc tried to prescribe you ibuprofen while you were pregnant! 😮 I've always been told it's a no-go during pregnancy.

[@carlyle8969]

Dr. Schmidt, how do you deal with the unhinged doctor hate that these videos seem to always inspire? No matter what you’re talking about

[@thomasdalton1508]

Why do you say ibuprofen is similar to Motrin and Advil? Those are ibuprofen. They are brand names that ibuprofen is sold under. The excessive use of brand names for drugs in the US causes a lot of confusion (how many Americans actually know what Tylenol is?). Just call drugs by their correct names. People can then buy whatever brand of it they like.

[@TheVivi13]

Because calling them by commonly known names is easier to understand, most people don't know their chemical names lol

[@thomasdalton1508]

@@TheVivi13 If people used the correct names, those names would quickly become commonly known. I'm not talking about chemical names. I'm talking about the standard names of the drugs. Like "ibuprofen" or "paracetamol" (or "acetaminophen" if you prefer - I don't know why that one has two names, which is unhelpful in itself). I'm not expecting anyone to call ibuprofen "isobutylphenylpropionic acid".

[@TheVivi13]

@@thomasdalton1508 Yea I know what you meant, most people don't really know those. They know them by their trade names. You are correct that if we called them only by their drug names then the brand names would be less confusing, but that's not the world we live in lol. If I tell my parents that I need ibuprofen, they have no idea wtf I'm talking about. Same with acetaminophen.

[@thomasdalton1508]

@@TheVivi13 It is the world we live in. It just isn't the country you live in. Other countries call drugs by their names. Not doing so allows drug companies to rip you off - Advil costs much more than generic ibuprofen despite being exactly the same thing, but you can't buy generic ibuprofen because you don't know that's what it's called.

[@TheVivi13]

@@thomasdalton1508 I mean I feel like a lot of countries use trade names for it, so no not really.

[@AshGreen359]

I wonder if this is part of the reason so many people are on dialysis. It's insane how many there are. They have chains of dialysis clinics and they are everywhere, almost as common as Starbucks. In my area the two biggest chains are Davita dialysis and Satellite Healthcare

[@LynnTRoman]

But why does it seem like tylenol doesn't work? It hardly ever relieves my pain. Earlier in the week I was even taking oxycodone, tylenol, and ibuprofen. The only thing that helped was the ibuprofen. It was seriously tempting to take more oxy to help manage my pain, but instead I decided to take more ibuprofen.

[@nancydemarco7421]

Better off with small doses of your oxy

[@stellamarina4123]

I move up to Excedrin which does seem to work.

[@z10isguy]

So, Why wouldn't you take glutathion or NAC along with the tylenol?

[@SamSam-ke9zy]

One of the Tylenol theories is it DOES affect prostaglandins. And with how well it works preventing my migraines going from the blinding halo phase to the pain &vomiting phase it shows it does just that.

[@silverstorm3729]

I have been avoiding tylenol and ibuprofen even when in pain because I wasn't sure what amounts / how much use would cause damage, so this has been so helpful.

[@M_SC]

The packages come with a pamphlet, It has precise info about doses

[@TheVivi13]

All medicine comes with recommended dosages lol. If you have current issues then that's something to talk to your doctor about.

[@soyothedanny]

Meds tell you "do not take more than X amount in 24 hours" in the box. As for Tylenol, you can take 3000mg per day, definitely no more than 4000mg I believe.

[@RyanMartinez]

Thank you for this. Me and my dad were debating what was bad for what. Now I have a doctor's confirmation.

[@matdex]

Just noticed the cup of pee on the shelf.

[@SolitaryWolf]

Once I saw it, I can’t seem to take my eyes off it.

[@roomtogrowouthere]

Thank you for so much information. Very educationally important.

[@thehuntressdanni2972]

But Naproxen *IS* Aleve. And Aleve *IS* Naproxen. So many people have no clue that Naproxen is the drug name and Aleve is just the brand name. They honestly think they're two different things. And you saying both names, as if they're two different things, only helps to perpetuate that total misunderstanding of the drug. I think if people are going to mention both names, they should say it more like "And Naproxen, also better known by its brand name, Aleve." Or something to that effect. And I'm commenting this, more so the people who read this, that DIDN'T know they were the same thing, will now know they are the same. Just like Acetaminophen and Tylenol. Same thing.

[@waffles3629]

Yep, so many people don't know the drug name for meds they take. It's kinda scary. I had someone tell me ibuprofen is useless and I should be taking Motrin, and then called me a slur when I said that's the same thing.

[@macmcleod1188]

One interesting point on Ibuprofen. There are 11 distinct molecular varieties and 3 of them work slightly differently. Discovered this by accident after buying Ibuprofen and a ski resort and it felt really different for the same dosage than Kirkland brand i usually used. Plus Ibuprofen is affected by the binders with different binders letting it hit your system at different rates.

[@kdw75]

Since I was a teenager I have had frequent headaches. The best conclussion to why is a neck issue. That means that my entire life I have been taking pain relievers about half the days. I have never exceeded that maximum dosage, but years ago took a lot of Tylenol for a week and got elevated liver enzymes. After that I took mostly Ibuprofen and haven't had any issues since.

[@chrisdaigle5410]

I try to avoid pain killers of any kind. But Tylenol typically gives me zero relief

[@JamesTheManiac]

Having been in nursing school it kinda bothers me how you're naming Tylenol/acetaminophen by brand name, but naming Advil/Ibuprofen by it's generic name, loll.

[@KebabEater]

What bothers me is that the USA & Japan uses the word acetaminophen instead of Paracetamol 🙃

[@7piecebucket]

I bet Lasix vs spironolactone would bother you the same way! 😁

[@Zelmel]

In the US, Tylenol has become a generic name but Advil hasn't, it's that simple. Much like Jello is generic for gelatin but Yoplait isn't for yogurt.

[@joeystroud]

New grad?

[@HavalinaSSUSMC]

What bothers me is that you are comfortable critiquing a Doctor, when you should be studying for the nclex rn. What would Florence Nightingale say?

[@ggtjr4]

Man talks fast and says big words. I should listen to him.

[@MatthewTheWanderer]

What if I have kidney disease? What pain meds can I take? Doctors say ibuprofen is bad but Tylenol is good. Also, aspirin seems to be allowed. Unfortunately, Tylenol and aspirin don't make the pain go away at all.

[@marshagaffin7593]

How about aspirin?

[@LGrian]

NSAID. Sorry this is rude, but did you not even bother with a google search before you typed this?

[@miowacity]

Ibuprofen was developed under more modern FDA rules you can take the whole bottle (like 30 pills) and end up with just a sore stomach. Tylenol will kill you. Tylenol would not be approved if it applied for today. Granted some people might be better with one or the other, but I think much of the reason doctors have been recommending Tylenol is due to Johnson and Johnson sales reps. Now that the FDA has cut on some of that activity (no more free trips for prescriptions as an example) all of a sudden maybe in the past 5 years (unlike the previous 50) are now recommending Ibuprofin to me or even Naproxin Sodium instead of the constant use Tylenol mantra.

[@chantellenew2331]

I almost died from diverticulitis. A couple transfusions saved me. For a discussion I would like to know what foods or drugs I must avoid.

[@neen42]

Talk to YOUR doctor.

[@Zelmel]

Yeah, this isn't something to come to youtube or social media about, you need to speak to your doctor 100%.

[@chantellenew2331]

I have but this info is changing all the time and my doctor is just a family doctor.

[@belgadog99]

@@chantellenew2331 I know, you need a gastroenterologist for sure ! Who is treating your diverticulitis(gastro dr ?) Also, do you have issues with blood clotting ?(taking any blood thinners?)

[@Zelmel]

@@chantellenew2331 Then ask for a referral. The general internet is literally one of the worst places to ask.

[@pascalcrt]

This was extremely informative, thank you.

[@JamesSmith-uc8tk]

Advil works. Tylenol doesn't. 🤷

[@ericnyysti1920]

I used to like taking Aleve because like you said it works. Now I have stage 3 kidney disease and Aleve will get me to kidney failure a lot faster! I can’t take any pain killers that work otc, I told my doctor I’m in constant pain and she told me to get used to it 🤬

[@danielelkadi3499]

@@ericnyysti1920sorry you have to go through this. Get another opinion

[@seektruth8662]

Zoom out.That's a blanket statement opinion that applies to you but not everybody else. Tylenol works well for me and ibuprofen only upsets my stomach and makes me break out with hives.

[@bladewiper]

0.75 speed works better for me to understand what you said. Thanks for the video.

[@sct4040]

I am a NYer and understand him fine.

[@prjndigo]

Yes there is a simple answer. Aspirin.

[@8evanesse]

Aspirin is also an NSAID like ibuprofen.

[@LGrian]

This video clearly failed in its goal of improving medical literacy 😅

[@LGrian]

@@8evanesseit’s kinda sad how many people apparently watched this video and commented about aspirin without even bothering to check to see if it was an NSAID.

[@buzzallnight3605]

@@8evanesse no it is not it is much better!!!!!!!!!!!!!!

[@buzzallnight3605]

@@LGrian NSAID doesn't really have any meaning at all, it just means it is not a steroid.

[@ODX_Animation]

Great video! Would love an expansion of the video to include gastric disorders (ulcers, acid reflux, GERD, IBS, IBD, etc) as I've always been told that NSAIDs should be avoided in the presence of a gastric disorder as it may cause/worsen bleeding/inflammation.

[@YamIa3gypsy]

Going to pass on both! Unreal

[@daphnekivinen9482]

Why does Ibuprofen take my pain away but Tylenol doesn’t?

[@rondaadams2537]

So just dying pain cuz Tylenol is like eating candy and when you go to the dentist for a bad tooth they won't give you any painkillers because people in the United States eat painkillers like candy so don't take ibuprofen just take Tylenol which again is like taking candy come up with something

[@dragondancer1814]

Not a problem here-Tylenol hasn’t worked as a pain reliever since I was TWELVE. Ibuprofen, on the other hand, kicks pain’s ass for me-it even takes on pain when Vicodin didn’t do squat (wisdom teeth removal), and it made a great painkiller after gallbladder surgery!

[@dannnns20]

Why this title, naming one brand and not the other? It could have been Acetaminophen vs Ibuprofen or Tylenol vs Advil.

[@ryanreedgibson]

I don't have liver or kidney problems, but I do take 1000MG of Tylenol and 800MG of Advil once a day. I do it to avoid having to take opioids. This gives me something to think about.

[@m.r.jarrell3725]

As a pain patient I have had to deal with this issue for years. Neither NSAID's or Acetaminophen do squat for me. And I've been on the edge of fatty liver disease for a decade or two. I have yet to find any pharmacological solution for it. From gapapentin across the list. They either did nothing or made me ill and affected me mentally. Thankfully there is one thing that's helped. Cannabis. And it's easy on the liver and kidneys!

[@awaspow]

I’ve run into issues with my liver with no alcohol or tylenol, and i take medication that requires me to avoid ibuprofen. Using that weird perspective, i luckily got the answer right. Really interesting effects that people dont think about

[@andrewwasson6153]

Yeah, it sucks having to take medication. I was taking Azathioprine for about 4 years. It wasn’t really fixing the problem it was supposed to and it caused all kinds of issues. It raised my Gamma Gt levels substantially. Then one day they just shot into orbit without alcohol, Ibuprofen or Tylenol. Fortunately, I was getting blood tests every month so they detected it and moved me onto something else. It took about a year and a half for my liver enzymes to return to normal.

[@Wranglerlaura]

Okay, so I didn't know NSAIDS were hard on the liver. Granted, I learned about the difference between Tylenol and Aspirin when Aspirin was more common than Ibuprofen. Thank you for the education.

[@dustyroads834]

I know everyone is different but I can say personally that Tylenol doesn’t do a thing for my muscle aches and pains. Ibuprofen works miracles

[@abeal49]

my liver doc advised me to avoid both NSAIDs and Acetaminophen. He told me to "use physical therapy" AKA heat, ice, massage, infrared light, electrophoresis, that sort of thing. When a migraine hit and I was away from home, I would go to a vending machine and buy two cans of Cola, one to use as an ice pack, the other to drink for the caffeine content. If I had access to a grocery store, a pack of frozen vegetables makes a better ice pack.

[@viningscircle]

As a chronic low back sufferer, with no known liver disease, I find that that Extra Strength Tylenol does not help me much at all, however, Aleve DOES provide relief enough to get through my work day. I also use cold compress, a cordless massager, and Volteran. Any other methods or products that you suggest?

[@OctupleThreat]

For Acute pain I think this is a very fair take, for chronic pain I think it gets muddy. There is an Oxford Table that compares various analgesic medications and the perceived reduction in pain, and surprisingly high doses of Naproxen and Celecoxib top the list even when compared with opioids and nerve pain meds, ie Lyrica and Gabapentin). Meanwhile Acetaminophen sat in the 40-60% of subjective effectiveness for pain relief. While this chart is based off of essentially a large-scale survey of hospitalized and chronic pain patients, it doesn't separate types of pain or the cause of pain if known, but I think that actually makes it less biased by nature of more randomness in the sample. Overall I think there is a hell of a lot of research to do regarding pain, pain meds, and long-term use of various medications, but if Naproxen provides subjectively better pain relief to >50% of the population, that is a very interesting result to me and while it is subjective, the numbers involved (IIRC ~10k patients just for the Naproxen part of the chart) make it a phenomenon worth studying all on its own.

[@DavidStevensMD]

As a med student about to begin IM residency, it pains me to admit I only really learned this on my 4th year GI elective. Counterintuitive, but have to avoid AKI/HRS for our patients with ESLD!

[@dianeviviana9830]

For those of us that are not trained medical professionals, could you please teach us what AKI/HRS and ESLD are? Thanks.

[@KeithCooper-Albuquerque]

Thanks for this useful info, Doc!

[@nsparacino]

Critical care doc in a major liver transplant center: this was awesome, man. 110% agree. Neither one are bad drugs, but I've seen WAAAAAAAAAY more nsaid problems than acetaminophen problems

[@Doc_Schmidt]

Appreciate it!

[@abradfordajb]

Tylenol (acetaminophen) works when combined with aspirin and caffeine - Excedrin. Another combo i use for moderate pain is two Ibuprofen's with two Excedrin's. Drink alot of water with them. If i have some pain before going to bed, i take two Ibuprofen's and sleep like a baby.

[@ronaldparvanian6949]

Am still using occasional aspirin. Heartened by new Italian study showing a 40% reduction in colorectal cancers with daily aspirin.

[@joeylawn36111]

My primary care doctor told me to stop taking ibuprofen because of problems with my kidneys (stones). I was taking it because of headaches, but he fixed those with blood pressure medicine (which was a little high)

[@MrsAshlee]

I knew what it is lol I’m 44 (will be 45) in July and my spine is broken in 8 places… I can NOT take NSAIDS at all and they won’t give me anything except over the counter Acetaminophen 8 hr Arthritis that helps absolutely NOTHING but to damage my liver because I have to take it every 4 hours instead of 8 just to be able to get out of bed and then I’m still in severe pain. Maybe liver doctors should look into to GPs/Primary docs that refuse to treat pain even under contract.

[@Captain_Sarcastic]

I think this should be required viewing in high school, Just knowing that there is the risk of liver damage or kidney damage is something people should be aware of at a young age. I was wondering why the Tylenol bottles said not to take over a certain dosage in a 24 hours period. Now I have a much better idea. Greatest "silly" video I have ever seen.

[@qienna6677]

As someone with reduced kidney function, thanks to damage done due to a rare kidney disease (Cystinuria), I can only have NSAIDs if my function on blood tests is good, so I try to save them for if I'm in the middle of passing a stone or something similar.

[@bryant475]

Please look into Whole Food Plant Based Nutrition, and Dr. Sean Hashmi!

[@albinoman13bt]

It was only a a couple months ago that a study released that showed that acetaminophen doesn't work for almost any pain, most especially back pain. Acetaminophen is a placebo.

[@kennethtodd5873]

KLT. This works for me. When I have pain, I take one Tylenol and let it dissolve in my mouth, then I wash it down. I do not take another one for one hour. It seems to take about 15 minutes for the pain relief so I can take one at a time and gauge it by the amount of pain that remains after an hour.

[@mikeflair6800]

Thank you. The most important thing I heard is use on short term basis, do not over take, and be aware especially to those who already have chronic liver or kidney problems. I rarely use either, but when I do, I combine them. This has a real knockout effect on the pain, so one extra strong dose, 2 tylenol, plus 2 advil, for me. Since both drugs work from different pathways, it is OK to combine them...hit it strong but short.

[@JimDixon55104]

Funny that you call Advil by its generic name (ibuprofen) but you don't do the same for Tylenol (acetaminophen or paracetamol).

[@CALIGRL888]

Super appreciate this video 👍 thanks Doc!

[@johnharris6655]

I was teaching 8th grade math, one of my female student's walked in not looking so good. Said she was having bad cramps. I asked if she wanted to see the nurse, and she said no she took some Motrin. Well when she said took some Motrin, she meant she took about 12 200 mg pills in a span of about 4 hours. I immediately called the school nurse. Luckily she turned out ok but passed out in the nurses office.

[@carolyngarrison10]

Unfortunately, Tylenol sucks. My husband only has one kidney, and cannot take ibuprofen. Tylenol does not help his arthritis at all. I was a nurse for many years, and knew very few patients who got any appreciable benefit from Tylenol, unless they were using it to reduce a fever.

[@hotrodray6802]

Proper diet eliminates arthritis.

[@user-vp1sc7tt4m]

Great information and well presented. Thank you!

[@CraftyVegan]

I don’t know if it’s true or not, but I was told by my science teacher that the active ingredient in Tylenol doesn’t cause liver damage, but they use a secondary component that **does** in order to keep people from overusing it. Could be false, but it was “common knowledge” when I was growing up. Side note: I know there are actual studies that show that Tylenol works source for pain than a placebo, and that it’s generally not recommended to take. Secondary side note: whenever I take any otc pain relievers, including aleve, get edema in my extremities.