My gf is the same way but it's the opposite for me. Ibuprofen doesn't do anything and acetaminophen (generic version of Tylenol, I don't use Tylenol brand) works wonders.
My gf is the same way but it's the opposite for me.
Ibuprofen doesn't do anything and acetaminophen (generic version of Tylenol, I don't use Tylenol brand) works wonders.
It's the same for my partner. Tylenol is her preferred headache medicine, but it doesn't work for me. I rarely get headaches but when I do ibuprofen works great for me. Neither touch pain like...
It's the same for my partner. Tylenol is her preferred headache medicine, but it doesn't work for me. I rarely get headaches but when I do ibuprofen works great for me.
It's funny this would come up today - I get periodic headaches I haven't been able to pin down. I used to take aspirin but for the last few months been using ibuprofen as it always seemed like a...
It's funny this would come up today - I get periodic headaches I haven't been able to pin down. I used to take aspirin but for the last few months been using ibuprofen as it always seemed like a dice roll whether or not it would do anything - haven't had any extra luck with ibuprofen.
I woke up with the same headache today and was researching whether or not I should take paracetamol instead - the general consensus is that ibuprofen is better for bruising/inflammation and paracetamol works best for headaches/fevers.
The findings say
Although acetaminophen has some efficacy in treating the pain from tension headaches, the relative risk (RR) of 1.3 is probably too low to be significant (moderate quality evidence).
I'm sure everyone reacts differently. Maybe it's the cup of tea and the lie down I have that sorts me out, maybe it's stepping away from work for a bit, maybe it's something I'll never quite understand.
If you get frequent headaches that are bad enough you want to lay down, there's a good chance they're migraines, which over the counter anti-inflammatories aren't going to do much for. There are...
If you get frequent headaches that are bad enough you want to lay down, there's a good chance they're migraines, which over the counter anti-inflammatories aren't going to do much for. There are many prescription options now, though, which are worth looking into. After dealing with moderate or severe migraines for years, I talked to a doctor about it and have had a major improvement.
I've had decent luck with rizatriptan (Maxalt). If I take it early on, it can stop it in 15-30 minutes.
My understanding is migraines are quite sharp pains usually isolated on one side of the head. I've definitely experienced that before, but only once or twice. This is moreso a mild, sometimes...
My understanding is migraines are quite sharp pains usually isolated on one side of the head. I've definitely experienced that before, but only once or twice.
This is moreso a mild, sometimes moderate, dull pain behind the eyes, no worse on either side. It's possibly eye-strain, but seems to be more connected to poor sleep, particularly oversleeping. As such I'm usually tired, photo-sensitive, and find it hard to concentrate - makes laying down in the dark an appealing option.
Sorry to hear you've had migraines - I hear they can be really debilitating. It's good to know there's options, I've not heard of rizatriptan, but I'll give it a look.
Migraines present in a variety of ways, I would advise reading up on them instead of relying on secondhand information. I challenged someone's assumptions on them recently and they soon realized...
Migraines present in a variety of ways, I would advise reading up on them instead of relying on secondhand information. I challenged someone's assumptions on them recently and they soon realized that they had essentially been dealing with an essentially 24/7 migraine for months.
If you don't already utilize caffeine, I have to say that it's by far the most effective remedy for those sorts of headaches in my experience. If you do, then maybe try yerba mate, which has a mix...
If you don't already utilize caffeine, I have to say that it's by far the most effective remedy for those sorts of headaches in my experience. If you do, then maybe try yerba mate, which has a mix of xanthines (the class of chemicals that caffeine typifies) that can work together (by contrasting mechanisms of action, particularly vasoconstriction vs dilation) to really clear fatigue headaches out. It has some (generally non-lifethreatening, think nausea or anxiety, but always good to be safe) drug interactions, so if you take meds, check those out before drinking a bunch.
They tend to present, for me, as a dull, pounding pain that often comes with some photosensitivity and frequently nausea. More severe ones will slowly "ramp up" to a sharper pain, but not always....
They tend to present, for me, as a dull, pounding pain that often comes with some photosensitivity and frequently nausea. More severe ones will slowly "ramp up" to a sharper pain, but not always. They're most frequently concentrated behind or to the side of one eye, but can sometimes be between-and-slightly-above. (They also tend to present less frequently when I have better sleep quality and lower stress.)
I've also noticed that barometric pressure has a strong effect. Since moving to an area with more frequent/more severe rain storms, I've noticed that I tend to get them (even mildly) in the lead up to rain.
There's a whole spectrum of migraine symptoms and suspected triggers. I spent most of my life assuming they were normal, or that people with migraines must be worse off than whatever I had until a doctor set it straight. So, I guess what I'm getting at is it's always worth looking into, because they could be avoidable.
My migraines usually start behind my eyes for what it's worth. I had a prescription for them for years. I've found Excedrin migraine with sleep and a damp cloth is the best fix.
My migraines usually start behind my eyes for what it's worth. I had a prescription for them for years.
I've found Excedrin migraine with sleep and a damp cloth is the best fix.
I know you already got a couple replies, but I wanted to first commiserate on the oversleeping trigger. I get (usually milder) migraines or mixed-tension migraines, and oddly catching up on sleep...
I know you already got a couple replies, but I wanted to first commiserate on the oversleeping trigger. I get (usually milder) migraines or mixed-tension migraines, and oddly catching up on sleep after days of sleeping poorly is one of my triggers.
The second point was: when i first started getting headaches, i assumed they were tension headaches (what my md at the time suggested). It sort of, but not quite, fit.
Many years later, I mentioned my confusing, inconsistent symptomes to my newer md, who suggested a mixed tension-migraine. Whatever the ultimate classification might be it describes my experience much better.
Just another anecdote to maybe help you contextualize your experience :)
Oh that's good to know! I've been suffering from migraines since my teens and only recently discovered Sumatriptan and Naproxen. Taken together (I do this super sparingly) they can stop most...
Oh that's good to know! I've been suffering from migraines since my teens and only recently discovered Sumatriptan and Naproxen. Taken together (I do this super sparingly) they can stop most migraines in their track
Have you ever bought one of those "migraine relief" pills (Excedrin's the biggest brand name but there's lots of generics)? They combine aspirin and paracetamol/acetaminophen along with some...
Have you ever bought one of those "migraine relief" pills (Excedrin's the biggest brand name but there's lots of generics)? They combine aspirin and paracetamol/acetaminophen along with some caffeine. It definitely depends on the source of the headache for me (if it's due to not drinking enough water obvs this is less effective than a glass of water, etc.) but when I had proper migraines there was nothing better than this plus a caffeinated drink.
Of course, it's possible/probable it was really the aspirin and/or caffeine rather than the paracetamol, but with migraines I feel like the "throwing everything at the wall" approach feels justified in the moment.
Combining two anti-inflammatories that act on different systems can help to augment their effects Tylenol alone sucks, but Tylenol combined with ibuprofen has demonstrated similar efficacy to...
Combining two anti-inflammatories that act on different systems can help to augment their effects
Tylenol alone sucks, but Tylenol combined with ibuprofen has demonstrated similar efficacy to opioids for pain control
APAP/IBUP is my go to combo for my headaches. If that doesn’t completely do it, I have a little bit of Coca Cola. It gives me the caffeine and helps with nausea.
APAP/IBUP is my go to combo for my headaches. If that doesn’t completely do it, I have a little bit of Coca Cola. It gives me the caffeine and helps with nausea.
Really?! I've had headaches for decades and ibuprofen never managed to touch it (even very high doses) but when I started taking Excedrin (acetaminophen, aspirin, coffee) it really helps ~50-60%...
Really?! I've had headaches for decades and ibuprofen never managed to touch it (even very high doses) but when I started taking Excedrin (acetaminophen, aspirin, coffee) it really helps ~50-60% of the time
Neither acetaminophen (Tylenol) nor ibuprofin do much for me. However, paracetamol works very well for my headaches. For aches and cramps, I have had the best luck with naproxen sodium, but I...
Neither acetaminophen (Tylenol) nor ibuprofin do much for me. However, paracetamol works very well for my headaches.
For aches and cramps, I have had the best luck with naproxen sodium, but I still wouldn't say it's super effective.
In 2017 I did an extensive search of Cochrane Reviews that addressed the efficacy (lack, really) of Tylenol (acetaminophen) in controlling pain. With few exceptions, it did little or nothing. In...
In 2017 I did an extensive search of Cochrane Reviews that addressed the efficacy (lack, really) of Tylenol (acetaminophen) in controlling pain. With few exceptions, it did little or nothing. In the six ensuing years, there have been more published on the efficacy of the drug. And the message is the same.
I remember reading somewhere Tylenol( I think?)lhad this odd psychological effect where it made you take more risks. If I'm recalling the drug this study was associated with correctly, I could...
I remember reading somewhere Tylenol( I think?)lhad this odd psychological effect where it made you take more risks. If I'm recalling the drug this study was associated with correctly, I could believe the "pain relief" is actually the medicine telling your body to "saddle up and keep going"
A couple years ago I probably would have nodded along, but having an infant I've seen the effect Tylenol has had on her when we've used it and I find it pretty hard to believe it was just a...
A couple years ago I probably would have nodded along, but having an infant I've seen the effect Tylenol has had on her when we've used it and I find it pretty hard to believe it was just a placebo effect when she didn't even know what medicine was.
Yes, there is absolutely no doubt here. It may be crap for pain relief, but Tylenol is absolutely wondrous in bringing down fevers in young kids. 10/10, would not stock a child's medicine cabinet...
Yes, there is absolutely no doubt here. It may be crap for pain relief, but Tylenol is absolutely wondrous in bringing down fevers in young kids. 10/10, would not stock a child's medicine cabinet without it.
In the article (or maybe it was the comments afterwards) you mentioned that Tylenol is useful at fever reduction. Aside from that, anything else that showed efficacy?
In the article (or maybe it was the comments afterwards) you mentioned that Tylenol is useful at fever reduction. Aside from that, anything else that showed efficacy?
And still, both my wife and I think Tylenol is a godsend. It's the only thing that works against period pains. Before Tylenol there was just aspirin, which did nothing whatsoever.
And still, both my wife and I think Tylenol is a godsend. It's the only thing that works against period pains. Before Tylenol there was just aspirin, which did nothing whatsoever.
I'd like to offer a caution on using American Council on Science and Health as a source, since it's well-known to have pro-industry biases. That being said, it's also well-known that...
That being said, it's also well-known that acetaminophen/paracetamol is not an ideal medicine for over-the-counter use, because the effective dose is closer to the toxicity threshold than for most medicines. Toxic effects appear at about 2x the maximum daily dose, and are potentiated by alcohol consumption and other common medications.
Combine that with minimal effectiveness for pain control, and there's not much justification for Tylenol. It's still a favorite of surgeons, dentists, and emergency rooms because it's not anticoagulant, unlike most NSAIDS.
[I'm one of those that gets zero pain relief from Tylenol - naproxen + low-dose THC/CBD works for arthritis flare days.]
Also isn't it especially difficult to handle a Tylenol OD because it cannot get pumped out or flushed easily? I may toss out the ones I have at home and get a Costco advil.
Also isn't it especially difficult to handle a Tylenol OD because it cannot get pumped out or flushed easily?
I may toss out the ones I have at home and get a Costco advil.
The big problem is that liver damage has already occurred by the time someone with an acetaminophen overdose starts showing symptoms. And an "overdose" can be chronic - older people, those who...
The big problem is that liver damage has already occurred by the time someone with an acetaminophen overdose starts showing symptoms. And an "overdose" can be chronic - older people, those who already have liver compromise from alcohol, viral infections (not just hepatitis), medications, etc. are at risk even from OTC doses taken for extended periods. With acute overdose, the ER can treat to minimize damage from still-circulating toxin, but they can only provide supportive care (and eventually, liver transplant...) for the liver injury.
IANAD, just someone who's had some toxicology and public health statistics training, but I personally will take the risk trade-offs for chronic use of NSAIDS (lots of risks, but decent pain control) vs. Tylenol (crap pain control with a side of gradual liver damage).
Footnote: NSAIDS, particularly strong COX-2 inhibitors, also come with varying degrees of cardiovascular risk. It's hard to quantify since inflammation also raises CVD risk... Aspirin has a different mechanism of action, with less CVD risk than naproxen, ibuprofen, celecoxib, etc., but much higher gastric injury and bleeding risks. Choose your poison carefully...
For me, topical diclofenac (Voltaren gel) works well on smaller joints and tendon inflammation, so I can avoid some of the systemic risks of high-dose oral NSAIDS.
If you've got something hurting enough that you need pain relief for more than a few days, it's a good idea to see an actual doctor about it.
I was wondering why the premise of the article seems so strange (cherry-picking systematic reviews and presenting it as doing honest science) and goes straight against WHO-guidelines regarding...
I was wondering why the premise of the article seems so strange (cherry-picking systematic reviews and presenting it as doing honest science) and goes straight against WHO-guidelines regarding pain management. Then I noticed @patience_limited remark about the bias of ACSH and a quick google search revealed that it is basically a pro-industry lobby organization.
It’s all politics and optics baby. Of course people that are unhappy with the standard practices and don’t have good experiences with paracetamol will agree with the sentiment presented by the ACSH. Science says it doesn’t work, and did you know you’ll damage your liver? Is taking too much Tylenol unsafe? Sure, but so is eating too much salt or drinking too much water. And the acute effects are less endangering than overdosing on a NSAID or opioid. There’s no opioid crisis in Ba Sing Se. But the billion dollar question is of course: Does it generate money?
I am glad I am not a GP. But these articles make it even harder to convince patients to take medicine that have a good chance of working, when taken adequately for a period of time. (Yeah 1 Tylenol does nothing for your headache right this second, neither does taking 10 all at once). And of course different types of pain need different types of thinking about the most useful approach. It means jumping to an opioid as step 1 when necessary, sometimes advising to exercise more, but also give the angry patient the same advice as every Thursday: Take Tylenol 3 times a day for the coming five days and then rate your pain again. (Spoiler: He won’t do it and gets some CBD drops instead). The industry just loves to paint doctors as these idiots who only can write their own name (illegibly) and need the industry to decide on which Rx those hieroglyphs are to be written down on.
You don’t have to believe me. Just ask your GP. But somehow, we trust some fancy titled blogger on the web (did you know he invented an antibiotic?) more than the guy or gall who will one day put their fingers up our behind and asks us to cough.
The long and short of it is, there is an enormous quantity of pain and inflammation control research, of highly variable quality (limited study population sizes, poor study design, uncontrolled...
The long and short of it is, there is an enormous quantity of pain and inflammation control research, of highly variable quality (limited study population sizes, poor study design, uncontrolled major variables, industry biases, occasional fake data...). The research can be cherry-picked and spun and sensationalized. Even gold standard Cochrane analyses can't reveal absolute truth about safety/efficacy of a drug or treatment for 100% of patients.
Being your own physician is hazardous in this information environment. If you have an acute or chronic condition, talk to a doctor. Ask questions, reveal all the details of the medications you're taking (including dietary behavior, OTC drugs, supplements, and controlled substances). If the doctor's advice isn't working, go back and let them know ASAP. If at all possible, build a relationship with your GP so that they know when you've had a concerning change in health status which requires specialist care. Persist and be your own best health advocate to medical professionals, but don't give up and let Dr. Google be your only guide.
[I live in the U.S., with the benefit of what passes for good insurance coverage, and this has still been a difficult, expensive process. It's completely understandable why people attempt to self-treat with non-prescription medications, or go outside of medical advice to resolve issues without seeing a doctor again. Nonetheless, doing so raises the odds of a worse outcome for conditions that are treatable, of neglecting serious diseases, and of doing harm through inappropriate, cumulatively toxic, or otherwise inadequate self-treatments.]
The only time, and I do mean the ONLY time I've taken Tylenol and had good results was when I combined it with ibuprofen. Three ibuprofen and an extra strength Tylenol helped with gall bladder...
The only time, and I do mean the ONLY time I've taken Tylenol and had good results was when I combined it with ibuprofen. Three ibuprofen and an extra strength Tylenol helped with gall bladder pain. This combination is touched on in your article.
I don't typically take Tylenol or Ibuprofen for pain. Usually just for fever reduction. But I have tried tylenol + ibruprofen post wisdom teeth removal and that worked surprisingly well. I also...
I don't typically take Tylenol or Ibuprofen for pain. Usually just for fever reduction.
But I have tried tylenol + ibruprofen post wisdom teeth removal and that worked surprisingly well. I also had Vicodin, but I was curious to see this would work since the oral surgeon also recommended it if I didn't want to take the Vicodin (I mainly took the Vicodin). I thought it actually worked better than the opioid, with basically none of the side effects.
Lately, I've been hearing of people told to alternate/stack Ibuprofen and Tylenol for pain relief that I would previously have expected them to receive opioid painkillers for. So I think there...
Lately, I've been hearing of people told to alternate/stack Ibuprofen and Tylenol for pain relief that I would previously have expected them to receive opioid painkillers for. So I think there must be something to the stacking.
Side note: I get why doctors are prescribing fewer opioids, and I think it's a good thing overall. But when I had a kidney stone, I was very, very glad for them.
Many years ago upon leaving the hospital after a C-Section, I was told to take Tylenol (Acetaminophen) and Advil (Ibuprofen) together and the combination worked for me. Did a Google search and...
Many years ago upon leaving the hospital after a C-Section, I was told to take Tylenol (Acetaminophen) and Advil (Ibuprofen) together and the combination worked for me.
They’re not kidding when they say the time for a conversation about this had been long past. I have known that acetaminophen was practically useless compared to the risks that are involved. For...
They’re not kidding when they say the time for a conversation about this had been long past. I have known that acetaminophen was practically useless compared to the risks that are involved.
For the longest time, I have thought it was unethical to mix acetaminophen with opioid drugs. The idea was that it was supposed to discourage people from abusing it, but in effect it was done by poisoning it. That’s just insane.
When I was addicted to opiates, I got up to 200mg (or more) of oxycodone per day. But 10 or 12 hydrocodone was enough to get some relief from the withdrawals when I needed it. Problem being, it...
When I was addicted to opiates, I got up to 200mg (or more) of oxycodone per day. But 10 or 12 hydrocodone was enough to get some relief from the withdrawals when I needed it.
Problem being, it was too much Tylenol if you did that once or twice per day. What we did was "cold water wash" the pills. Dissolve them in cold water and then strain through a coffee filter into some orange juice.
My point is this - it's really messed up that they poisoned these pills. The only people they hurt were the people who weren't educated on the fact that they could kill you or cause permanent damage. Anyone who was smart enough to know about the anti-abuse mechanisms was smart enough to Google how to defeat them.
No different than how we used to suck on the time-released pills to defeat the slow-release mechanism. It was all for show so they could keep peddling dope.
Their real sin was making it harder to get after getting everyone hooked. That was when we all went to heroin. Evil.
APAP is definitely added in quantities meant mainly for toxicity, but it does help cut down on a lot of the discomfort that opioids can cause people, like the hot flashes and headaches. Hell,...
APAP is definitely added in quantities meant mainly for toxicity, but it does help cut down on a lot of the discomfort that opioids can cause people, like the hot flashes and headaches. Hell, given its weirder effects and MoA, it might help with the nausea, though I can't find any evidence with a quick search. There's just a huge difference between 150-300 mg added to 10 mg oxycodone and 1000 mg added to 5 mg oxy.
Some of those combinations are pretty old, and the idea at the time was that both of these meds are quite risky, so combining the two together means you can give lower doses of both of them and...
The idea was that it was supposed to discourage people from abusing it,
Some of those combinations are pretty old, and the idea at the time was that both of these meds are quite risky, so combining the two together means you can give lower doses of both of them and get synergistic effects. Turns out that doesn't work and the science at the time wasn't great at running trials so we didn't know it didn't work until years later. And because pain is a complex phenomena people develop a strong preference for the meds they're on if they think those meds work.
Anecdotally Tylenol does nothing for my headaches, but when I had muscle/knee/leg inflammation, it provided very noticeable and necessary moderate relief when timing the doses between doses of...
Anecdotally Tylenol does nothing for my headaches, but when I had muscle/knee/leg inflammation, it provided very noticeable and necessary moderate relief when timing the doses between doses of strong naproxen to help carry over the relief (since naproxen's effect would wear off long before another dose could be taken). Disclaimer: this dosing schedule was reviewed / discussed with medical staff to ensure a reasonable/tolerable level of safety.
I can only take tylenol because of other medicines I am on. I get headaches a lot. It works for me though it's not "super" effective. If I take two extra-strength tablets it will usually reduce my...
I can only take tylenol because of other medicines I am on. I get headaches a lot. It works for me though it's not "super" effective. If I take two extra-strength tablets it will usually reduce my headache pain about 80 or 90 percent in 30 minutes, but that only lasts for an hour or two.
I'm in a similar position - allergic to aspirin and a stomach condition makes me unable to tolerate ibuprofen except extremely sparingly. The Tylenol does help vs doing nothing for headaches....
I'm in a similar position - allergic to aspirin and a stomach condition makes me unable to tolerate ibuprofen except extremely sparingly. The Tylenol does help vs doing nothing for headaches. However, I don't even bother for physical pain (injury/overwork/etc). It does nothing for that kind of inflammation, and back before I had the stomach troubles I far preferred ibuprofen.
Have you looked at extended release arthritis tylenol? It's like two regular strength but in a delay release 8 hour format. I usually use those unless the headache is just pounding.
Agreed 100%. Acetaminophen works well for headaches and fever reduction. But I would never bother using it for pain in muscles, skin, or anything below my neck really.
Agreed 100%. Acetaminophen works well for headaches and fever reduction. But I would never bother using it for pain in muscles, skin, or anything below my neck really.
Here in Singapore paracetamol is the very first go-to antipyretic and/or analgesic. NSAIDs like ibuprofen and naproxen are the next line. Having said that doctors here are much, much more unlikely...
Here in Singapore paracetamol is the very first go-to antipyretic and/or analgesic. NSAIDs like ibuprofen and naproxen are the next line. Having said that doctors here are much, much more unlikely to prescribe opiods than in the US (vicodin is almost unheard of, for example).
@mainmeister is there any particular reason you submitted a twit.social post linking to an article, instead of the actual article itself? AFAICT it adds nothing significant, and the author of the...
@mainmeister is there any particular reason you submitted a twit.social post linking to an article, instead of the actual article itself? AFAICT it adds nothing significant, and the author of the twit.social post is not the article author. So for now, I have changed the link to the article, and modified the tags to reflect that. But if there was a legitimate reason for linking to twit.social, let me know, and I can undo the change.
p.s. Please label this comment offtopic so it doesn't detract from the on-topic discussion.
I mean, this is super anecdotal but I have to agree. Ibuprofen knocks out my headaches but I've never seen Tylenol have a real effect.
My gf is the same way but it's the opposite for me.
Ibuprofen doesn't do anything and acetaminophen (generic version of Tylenol, I don't use Tylenol brand) works wonders.
It's the same for my partner. Tylenol is her preferred headache medicine, but it doesn't work for me. I rarely get headaches but when I do ibuprofen works great for me.
Neither touch pain like alcohol though...
It's funny this would come up today - I get periodic headaches I haven't been able to pin down. I used to take aspirin but for the last few months been using ibuprofen as it always seemed like a dice roll whether or not it would do anything - haven't had any extra luck with ibuprofen.
I woke up with the same headache today and was researching whether or not I should take paracetamol instead - the general consensus is that ibuprofen is better for bruising/inflammation and paracetamol works best for headaches/fevers.
The findings say
I'm sure everyone reacts differently. Maybe it's the cup of tea and the lie down I have that sorts me out, maybe it's stepping away from work for a bit, maybe it's something I'll never quite understand.
If you get frequent headaches that are bad enough you want to lay down, there's a good chance they're migraines, which over the counter anti-inflammatories aren't going to do much for. There are many prescription options now, though, which are worth looking into. After dealing with moderate or severe migraines for years, I talked to a doctor about it and have had a major improvement.
I've had decent luck with rizatriptan (Maxalt). If I take it early on, it can stop it in 15-30 minutes.
My understanding is migraines are quite sharp pains usually isolated on one side of the head. I've definitely experienced that before, but only once or twice.
This is moreso a mild, sometimes moderate, dull pain behind the eyes, no worse on either side. It's possibly eye-strain, but seems to be more connected to poor sleep, particularly oversleeping. As such I'm usually tired, photo-sensitive, and find it hard to concentrate - makes laying down in the dark an appealing option.
Sorry to hear you've had migraines - I hear they can be really debilitating. It's good to know there's options, I've not heard of rizatriptan, but I'll give it a look.
Migraines present in a variety of ways, I would advise reading up on them instead of relying on secondhand information. I challenged someone's assumptions on them recently and they soon realized that they had essentially been dealing with an essentially 24/7 migraine for months.
If you don't already utilize caffeine, I have to say that it's by far the most effective remedy for those sorts of headaches in my experience. If you do, then maybe try yerba mate, which has a mix of xanthines (the class of chemicals that caffeine typifies) that can work together (by contrasting mechanisms of action, particularly vasoconstriction vs dilation) to really clear fatigue headaches out. It has some (generally non-lifethreatening, think nausea or anxiety, but always good to be safe) drug interactions, so if you take meds, check those out before drinking a bunch.
They tend to present, for me, as a dull, pounding pain that often comes with some photosensitivity and frequently nausea. More severe ones will slowly "ramp up" to a sharper pain, but not always. They're most frequently concentrated behind or to the side of one eye, but can sometimes be between-and-slightly-above. (They also tend to present less frequently when I have better sleep quality and lower stress.)
I've also noticed that barometric pressure has a strong effect. Since moving to an area with more frequent/more severe rain storms, I've noticed that I tend to get them (even mildly) in the lead up to rain.
There's a whole spectrum of migraine symptoms and suspected triggers. I spent most of my life assuming they were normal, or that people with migraines must be worse off than whatever I had until a doctor set it straight. So, I guess what I'm getting at is it's always worth looking into, because they could be avoidable.
I get headaches from the change in barometric pressure as weather systems move in or out.
My migraines usually start behind my eyes for what it's worth. I had a prescription for them for years.
I've found Excedrin migraine with sleep and a damp cloth is the best fix.
I know you already got a couple replies, but I wanted to first commiserate on the oversleeping trigger. I get (usually milder) migraines or mixed-tension migraines, and oddly catching up on sleep after days of sleeping poorly is one of my triggers.
The second point was: when i first started getting headaches, i assumed they were tension headaches (what my md at the time suggested). It sort of, but not quite, fit.
Many years later, I mentioned my confusing, inconsistent symptomes to my newer md, who suggested a mixed tension-migraine. Whatever the ultimate classification might be it describes my experience much better.
Just another anecdote to maybe help you contextualize your experience :)
Oh that's good to know! I've been suffering from migraines since my teens and only recently discovered Sumatriptan and Naproxen. Taken together (I do this super sparingly) they can stop most migraines in their track
Have you ever bought one of those "migraine relief" pills (Excedrin's the biggest brand name but there's lots of generics)? They combine aspirin and paracetamol/acetaminophen along with some caffeine. It definitely depends on the source of the headache for me (if it's due to not drinking enough water obvs this is less effective than a glass of water, etc.) but when I had proper migraines there was nothing better than this plus a caffeinated drink.
Of course, it's possible/probable it was really the aspirin and/or caffeine rather than the paracetamol, but with migraines I feel like the "throwing everything at the wall" approach feels justified in the moment.
Combining two anti-inflammatories that act on different systems can help to augment their effects
Tylenol alone sucks, but Tylenol combined with ibuprofen has demonstrated similar efficacy to opioids for pain control
yeah its ability to be combined with NSAIDs (which you're famously not supposed to combine with each other) is a big plus there too I guess.
APAP/IBUP is my go to combo for my headaches. If that doesn’t completely do it, I have a little bit of Coca Cola. It gives me the caffeine and helps with nausea.
Really?! I've had headaches for decades and ibuprofen never managed to touch it (even very high doses) but when I started taking Excedrin (acetaminophen, aspirin, coffee) it really helps ~50-60% of the time
Neither acetaminophen (Tylenol) nor ibuprofin do much for me. However, paracetamol works very well for my headaches.
For aches and cramps, I have had the best luck with naproxen sodium, but I still wouldn't say it's super effective.
I’m confused by your comment… paracetamol is the same thing as acetaminophen
So it is! I'm not sure what's going on then; maybe different dosages under different brand names?
In 2017 I did an extensive search of Cochrane Reviews that addressed the efficacy (lack, really) of Tylenol (acetaminophen) in controlling pain. With few exceptions, it did little or nothing. In the six ensuing years, there have been more published on the efficacy of the drug. And the message is the same.
I remember reading somewhere Tylenol( I think?)lhad this odd psychological effect where it made you take more risks. If I'm recalling the drug this study was associated with correctly, I could believe the "pain relief" is actually the medicine telling your body to "saddle up and keep going"
A couple years ago I probably would have nodded along, but having an infant I've seen the effect Tylenol has had on her when we've used it and I find it pretty hard to believe it was just a placebo effect when she didn't even know what medicine was.
I agree, but I also used to "kiss it better" and that also seemed pretty effective.
I'm talking more specifically about tooth pain which could not be relieved enough through cool teething toys and such.
Yes, there is absolutely no doubt here. It may be crap for pain relief, but Tylenol is absolutely wondrous in bringing down fevers in young kids. 10/10, would not stock a child's medicine cabinet without it.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094994/#:~:text=The%20article%20entitled%20'Effects%20of,potentially%20by%20reducing%20perceived%20risk.
In the article (or maybe it was the comments afterwards) you mentioned that Tylenol is useful at fever reduction. Aside from that, anything else that showed efficacy?
And did they test it on period pains? Women are often left out of studies.
And still, both my wife and I think Tylenol is a godsend. It's the only thing that works against period pains. Before Tylenol there was just aspirin, which did nothing whatsoever.
I'd like to offer a caution on using American Council on Science and Health as a source, since it's well-known to have pro-industry biases.
That being said, it's also well-known that acetaminophen/paracetamol is not an ideal medicine for over-the-counter use, because the effective dose is closer to the toxicity threshold than for most medicines. Toxic effects appear at about 2x the maximum daily dose, and are potentiated by alcohol consumption and other common medications.
Combine that with minimal effectiveness for pain control, and there's not much justification for Tylenol. It's still a favorite of surgeons, dentists, and emergency rooms because it's not anticoagulant, unlike most NSAIDS.
[I'm one of those that gets zero pain relief from Tylenol - naproxen + low-dose THC/CBD works for arthritis flare days.]
Also isn't it especially difficult to handle a Tylenol OD because it cannot get pumped out or flushed easily?
I may toss out the ones I have at home and get a Costco advil.
The big problem is that liver damage has already occurred by the time someone with an acetaminophen overdose starts showing symptoms. And an "overdose" can be chronic - older people, those who already have liver compromise from alcohol, viral infections (not just hepatitis), medications, etc. are at risk even from OTC doses taken for extended periods. With acute overdose, the ER can treat to minimize damage from still-circulating toxin, but they can only provide supportive care (and eventually, liver transplant...) for the liver injury.
IANAD, just someone who's had some toxicology and public health statistics training, but I personally will take the risk trade-offs for chronic use of NSAIDS (lots of risks, but decent pain control) vs. Tylenol (crap pain control with a side of gradual liver damage).
Footnote: NSAIDS, particularly strong COX-2 inhibitors, also come with varying degrees of cardiovascular risk. It's hard to quantify since inflammation also raises CVD risk... Aspirin has a different mechanism of action, with less CVD risk than naproxen, ibuprofen, celecoxib, etc., but much higher gastric injury and bleeding risks. Choose your poison carefully...
For me, topical diclofenac (Voltaren gel) works well on smaller joints and tendon inflammation, so I can avoid some of the systemic risks of high-dose oral NSAIDS.
If you've got something hurting enough that you need pain relief for more than a few days, it's a good idea to see an actual doctor about it.
I was wondering why the premise of the article seems so strange (cherry-picking systematic reviews and presenting it as doing honest science) and goes straight against WHO-guidelines regarding pain management. Then I noticed @patience_limited remark about the bias of ACSH and a quick google search revealed that it is basically a pro-industry lobby organization.
It’s all politics and optics baby. Of course people that are unhappy with the standard practices and don’t have good experiences with paracetamol will agree with the sentiment presented by the ACSH. Science says it doesn’t work, and did you know you’ll damage your liver? Is taking too much Tylenol unsafe? Sure, but so is eating too much salt or drinking too much water. And the acute effects are less endangering than overdosing on a NSAID or opioid. There’s no opioid crisis in Ba Sing Se. But the billion dollar question is of course: Does it generate money?
I am glad I am not a GP. But these articles make it even harder to convince patients to take medicine that have a good chance of working, when taken adequately for a period of time. (Yeah 1 Tylenol does nothing for your headache right this second, neither does taking 10 all at once). And of course different types of pain need different types of thinking about the most useful approach. It means jumping to an opioid as step 1 when necessary, sometimes advising to exercise more, but also give the angry patient the same advice as every Thursday: Take Tylenol 3 times a day for the coming five days and then rate your pain again. (Spoiler: He won’t do it and gets some CBD drops instead). The industry just loves to paint doctors as these idiots who only can write their own name (illegibly) and need the industry to decide on which Rx those hieroglyphs are to be written down on.
You don’t have to believe me. Just ask your GP. But somehow, we trust some fancy titled blogger on the web (did you know he invented an antibiotic?) more than the guy or gall who will one day put their fingers up our behind and asks us to cough.
The long and short of it is, there is an enormous quantity of pain and inflammation control research, of highly variable quality (limited study population sizes, poor study design, uncontrolled major variables, industry biases, occasional fake data...). The research can be cherry-picked and spun and sensationalized. Even gold standard Cochrane analyses can't reveal absolute truth about safety/efficacy of a drug or treatment for 100% of patients.
Being your own physician is hazardous in this information environment. If you have an acute or chronic condition, talk to a doctor. Ask questions, reveal all the details of the medications you're taking (including dietary behavior, OTC drugs, supplements, and controlled substances). If the doctor's advice isn't working, go back and let them know ASAP. If at all possible, build a relationship with your GP so that they know when you've had a concerning change in health status which requires specialist care. Persist and be your own best health advocate to medical professionals, but don't give up and let Dr. Google be your only guide.
[I live in the U.S., with the benefit of what passes for good insurance coverage, and this has still been a difficult, expensive process. It's completely understandable why people attempt to self-treat with non-prescription medications, or go outside of medical advice to resolve issues without seeing a doctor again. Nonetheless, doing so raises the odds of a worse outcome for conditions that are treatable, of neglecting serious diseases, and of doing harm through inappropriate, cumulatively toxic, or otherwise inadequate self-treatments.]
The only time, and I do mean the ONLY time I've taken Tylenol and had good results was when I combined it with ibuprofen. Three ibuprofen and an extra strength Tylenol helped with gall bladder pain. This combination is touched on in your article.
I don't typically take Tylenol or Ibuprofen for pain. Usually just for fever reduction.
But I have tried tylenol + ibruprofen post wisdom teeth removal and that worked surprisingly well. I also had Vicodin, but I was curious to see this would work since the oral surgeon also recommended it if I didn't want to take the Vicodin (I mainly took the Vicodin). I thought it actually worked better than the opioid, with basically none of the side effects.
Lately, I've been hearing of people told to alternate/stack Ibuprofen and Tylenol for pain relief that I would previously have expected them to receive opioid painkillers for. So I think there must be something to the stacking.
Side note: I get why doctors are prescribing fewer opioids, and I think it's a good thing overall. But when I had a kidney stone, I was very, very glad for them.
Many years ago upon leaving the hospital after a C-Section, I was told to take Tylenol (Acetaminophen) and Advil (Ibuprofen) together and the combination worked for me.
Did a Google search and found this: How doctors are treating c-section pain without opioids
They’re not kidding when they say the time for a conversation about this had been long past. I have known that acetaminophen was practically useless compared to the risks that are involved.
For the longest time, I have thought it was unethical to mix acetaminophen with opioid drugs. The idea was that it was supposed to discourage people from abusing it, but in effect it was done by poisoning it. That’s just insane.
When I was addicted to opiates, I got up to 200mg (or more) of oxycodone per day. But 10 or 12 hydrocodone was enough to get some relief from the withdrawals when I needed it.
Problem being, it was too much Tylenol if you did that once or twice per day. What we did was "cold water wash" the pills. Dissolve them in cold water and then strain through a coffee filter into some orange juice.
My point is this - it's really messed up that they poisoned these pills. The only people they hurt were the people who weren't educated on the fact that they could kill you or cause permanent damage. Anyone who was smart enough to know about the anti-abuse mechanisms was smart enough to Google how to defeat them.
No different than how we used to suck on the time-released pills to defeat the slow-release mechanism. It was all for show so they could keep peddling dope.
Their real sin was making it harder to get after getting everyone hooked. That was when we all went to heroin. Evil.
APAP is definitely added in quantities meant mainly for toxicity, but it does help cut down on a lot of the discomfort that opioids can cause people, like the hot flashes and headaches. Hell, given its weirder effects and MoA, it might help with the nausea, though I can't find any evidence with a quick search. There's just a huge difference between 150-300 mg added to 10 mg oxycodone and 1000 mg added to 5 mg oxy.
Some of those combinations are pretty old, and the idea at the time was that both of these meds are quite risky, so combining the two together means you can give lower doses of both of them and get synergistic effects. Turns out that doesn't work and the science at the time wasn't great at running trials so we didn't know it didn't work until years later. And because pain is a complex phenomena people develop a strong preference for the meds they're on if they think those meds work.
Anecdotally Tylenol does nothing for my headaches, but when I had muscle/knee/leg inflammation, it provided very noticeable and necessary moderate relief when timing the doses between doses of strong naproxen to help carry over the relief (since naproxen's effect would wear off long before another dose could be taken). Disclaimer: this dosing schedule was reviewed / discussed with medical staff to ensure a reasonable/tolerable level of safety.
I can only take tylenol because of other medicines I am on. I get headaches a lot. It works for me though it's not "super" effective. If I take two extra-strength tablets it will usually reduce my headache pain about 80 or 90 percent in 30 minutes, but that only lasts for an hour or two.
I'm in a similar position - allergic to aspirin and a stomach condition makes me unable to tolerate ibuprofen except extremely sparingly. The Tylenol does help vs doing nothing for headaches. However, I don't even bother for physical pain (injury/overwork/etc). It does nothing for that kind of inflammation, and back before I had the stomach troubles I far preferred ibuprofen.
Have you looked at extended release arthritis tylenol? It's like two regular strength but in a delay release 8 hour format. I usually use those unless the headache is just pounding.
Agreed 100%. Acetaminophen works well for headaches and fever reduction. But I would never bother using it for pain in muscles, skin, or anything below my neck really.
I'll look into those, that sounds great, thanks!
My primary care doc tells me to stay away from Tylenol because it seems to raise my liver enzymes, even used as directed.
Here in Singapore paracetamol is the very first go-to antipyretic and/or analgesic. NSAIDs like ibuprofen and naproxen are the next line. Having said that doctors here are much, much more unlikely to prescribe opiods than in the US (vicodin is almost unheard of, for example).
@mainmeister is there any particular reason you submitted a twit.social post linking to an article, instead of the actual article itself? AFAICT it adds nothing significant, and the author of the twit.social post is not the article author. So for now, I have changed the link to the article, and modified the tags to reflect that. But if there was a legitimate reason for linking to twit.social, let me know, and I can undo the change.
p.s. Please label this comment offtopic so it doesn't detract from the on-topic discussion.