How long after APAP dose are you in the clear?

[Adamantine]

Hi, I'm new here, and I'm terribly sorry if this isn't posted in the correct area. It seemed the mostly likely area for it to fit.

Firstly, I will say that I realize that taking a large amount of acetaminophen is one day is very stupid. I will never, EVER do it again. I wasn't even trying to get high, though I have taken oxy/hydro for that purpose. I just wanted pain relief for my back, and docs around here just refuse to give anything. I have a high tolerance to pain meds. I was given an Rx for 20 Vicodin. I took ten of them the following morning, around 10 am (5000mg acetaminophen). Gave one to my husband for his headache. Took the other 9 at 11 pm that night, after tossing around for two hours trying to sleep. (4500mg acetaminophen). That last dose was taken 48 hrs ago.

My hopefully simple question is, when will I be in the clear, when can I stop checking my eyes for jaundice, jumping at every abdominal pain, examining my own urine? I know it's stupid, but I'm so scared to go to the doctor about this. It's already a fight to get pain relief at all around here, and I have both chronic back pain and chronic pancreatitis. I NEED pain meds in the future. Things like this get you a big fat sticker and you can't get a prescription ever again. I don't buy pills illegally.

If it matters, I am quite overweight, and in this case maybe that will actually be helpful to me. I weigh 253 lbs. I am a 28 yr old female.

I am not a drinker, can't remember the last time I drank. I had not taken any acetaminophen for at least a week before this incident.

Any help would be appreciated. There is so much conflicting information. So many reports of people taking ridiculously huge amounts and being fine, and others taking far less and needing liver transplants.

 

[Foreigner]

The effects of an APAP overdose are usually seen within 72 hours, and usually within the first 24 hours. If you have not had any major symptoms like nausea, vomitting, jaundice, sweating, and pain, then you are likely going to be fine.

However, you should know that even if you present no symptoms, you still could have done liver damage which would affect liver function. For this, you will need to get your blood work done to determine the damage.

Also keep in mind that the window for treating APAP overdose and preventing the damage from progressing is 3-5 days. This means that even if you aren't in imminent danger, you still have the choice to see your doctor and maybe keep your liver in better health than it otherwise would be.

I've read that one method that EMS would use to help clear your body of the acetaminophen metabolites is to supply glutathione. Foods that contain glutathione or its precursors include beets, broccoli, and cabbage.

IMO you should still see your doctor to make sure your health hasn't been impacted, but if you really wish to avoid it then proceed cautiously.

 

[Adamantine]

The effects of an APAP overdose are usually seen within 72 hours, and usually within the first 24 hours. If you have not had any major symptoms like nausea, vomitting, jaundice, sweating, and pain, then you are likely going to be fine.

However, you should know that even if you present no symptoms, you still could have done liver damage which would affect liver function. For this, you will need to get your blood work done to determine the damage.

Also keep in mind that the window for treating APAP overdose and preventing the damage from progressing is 3-5 days. This means that even if you aren't in imminent danger, you still have the choice to see your doctor and maybe keep your liver in better health than it otherwise would be.

I've read that one method that EMS would use to help clear your body of the acetaminophen metabolites is to supply glutathione. Foods that contain glutathione or its precursors include beets, broccoli, and cabbage.

IMO you should still see your doctor to make sure your health hasn't been impacted, but if you really wish to avoid it then proceed cautiously.

Ah, thank you for the response. I eat tons of broccoli and cabbage as it is, maybe that has helped as well. I feel so stupid about the whole thing. Well, because I *was* stupid about the whole thing. It was already so late, and I'd never done a CWE, plus read that they could take SO long. I have to be up early. I just wanted some relief.

For right now, I just plan to avoid acetaminophen and alcohol completely, for quite a long time. I only hope that it is enough.

EDIT: I forgot the whole reason I even posted it here in this section of the forum:

What can I do to help my liver get healthy again, or if it has miraculously not been damaged, what can I do to keep it healthy, other than avoiding excess of the above-mentioned things? If my liver has NOT been damaged, and I take supplements like NAC, can that actually harm me somehow? Or are those okay to take on a "just in case" kind of basis?

What other common medications are processed through the liver, and/or what should I avoid for the next few months? I know that the liver can regenerate itself and heal damage on its own... I found this interesting:

http://www.sciencedaily.com/releases/2010/06/100607065856.htm

 

[Foreigner]

Just eat a wide range of vegetables regularly to build blood and detoxing factors. Since blood and the liver are very related (liver stores and detoxes blood), making sure your blood is high quality will help the liver.

Make sure liver friendly nutrients like B12, iron, and folic acid (B9) are accounted for in the diet. More intensively, you could eat actual liver, since it contains everything your liver would need. Calf's liver is better... and you'd only need it once every couple of weeks or so.

Milk thistle is a great herb for liver protection and restoration.

Every medication you take is processed by the liver, whether it's mild or not. It goes through the CYP450 group of liver enzymes, whose abilities are determined by each person's genetic makeup. Avoiding alcohol and regular medication if possible would help.

It'll just take time.

 

[Adamantine]

Just eat a wide range of vegetables regularly to build blood and detoxing factors. Since blood and the liver are very related (liver stores and detoxes blood), making sure your blood is high quality will help the liver.

Make sure liver friendly nutrients like B12, iron, and folic acid (B9) are accounted for in the diet. More intensively, you could eat actual liver, since it contains everything your liver would need. Calf's liver is better... and you'd only need it once every couple of weeks or so.

Milk thistle is a great herb for liver protection and restoration.

Every medication you take is processed by the liver, whether it's mild or not. It goes through the CYP450 group of liver enzymes, whose abilities are determined by each person's genetic makeup. Avoiding alcohol and regular medication if possible would help.

It'll just take time.

Thank you again for your insight.

Calf's liver (or calf's anything, heh) isn't something that I can stomach. I do eat a ton of veggies already, though - with my go-to choices being broccoli, brussels sprouts, cabbage, and salads with baby spinach. I will pick up some milk thistle and a multivitamin.

Unfortunately, I'm not so sure that my blood is in fabulous condition. I'm a type 1 diabetic, on an insulin pump. It's not yet tightly controlled. Also, I'm sure I won't be able to avoid regular medication. I gave up my fight with sleep at 4 this morning and went and soaked in a totally hot bath until the water went cold. It's the only thing, without meds, that gives my back any relief whatsoever. I can't even sleep with this pain. Heating pad is somewhat effective. With two kids ages 2.5 and 1.5, though, my time for soaks and rests with the heating pad (or resting my back at all) are very few.

If I could only find a doctor who would take the back pain seriously, maybe we could get to the bottom of it. This is a very small town, however, and "back pain" is probably the number one thing used by drug seekers to get an Rx. I told my doc that I didn't want pain meds, I just wanted the pain GONE, and I'd rub bacon grease on my feet if that would do the trick. Instead, he gave me a very weak pain med, a list of back exercises, and said we'd wait six weeks and see what happened. Of course he wanted to start with conservative treatments, but I only went to him after my pain had been progressing for three full months. Ah well...

 

[Adamantine]

Sorry for the TMI, but... I had pale (clay-colored) stool this morning. Now I'm worried all over again. In your opinion, is that alone enough to warrant going in somewhere - to doctor or hospital? It's been something like 80+ hours since I last took acetaminophen. I have taken a couple doses of ibuprofen since, and one dose each of my meloxicam and baclofen. I didn't know, when I took them, that they are also processed by the liver.

 

[Foreigner]

Clay-coloured stool that is even gray means your bile ducts are blocked, your body isn't absorbing fat, or your liver isn't producing bile. If the latter, it could mean your liver has been damaged.

I would get to a doctor a.s.a.p.

 

[Adamantine]

Forgot to check back here yesterday. It was only the one time... two BMs since were totally normal. I am still going to schedule an appointment, though.

 

[Foreigner]

I'm glad you are choosing to see a doctor. It's the only way to be 100% sure.

I'm going to close this because I feel your question has been satisfactorally answered. Good luck!