Misc So I am almost certain I have damaged my liver. Wat do?

[Naggers]

Just after a quick bit of advice.

Took 5g of paracetamol/tylenol in a single dose about 36 hours ago. First time doing this without a CWE, I am aware it was a bad idea but I had reasons that sounded good enough at the time (it was about pain relief not getting high). I know that this is just about a threshold dose for hepatotoxicity, yet my past 2 number 2's have been quite pale... brief searching states this is a sign of hepatotoxicity and to seek medical treatment immediately. However I believe it is too late for treatment with N-acetylcysteine, so if I do go to the hospital I will merely be monitored, and also have to explain why I took 5g of APAP.

Basically I'm asking for a consensus on whether pale poop is enough evidence of damage for me to seek medical attention, and have to go through the whole palava of being in hospital. I really can't imagine 5g of apap has done much damage, but I have been drinking a lot of alcohol over the past week, and it is obvious I have affected bile production in some way.

What do you think?

Edit: I have not been eating any particularly fatty foods recently, so that would not account for the pale poop.

 

[someone12345]

I think you will be fine. The FDA's maximum recommended daily limit is actually 4,000mg so I do not think 5,000mg would be a travesty. Unless you have some other pre existing conditions I think you should be fine. I really hope so anyways because I am in a very similar boat where I took 6,000mg~ over the course of 12 hours. I felt alright 24 hours later but I did notice pale poop as well. I was not aware this was a symptom. I didn't notice any other symptoms (liver pain, nausea, etc)

 

[Naggers]

Hey, thanks for the reply!

Yeah considering the FDA's daily limit I wasn't worried, until I saw the poop! Apparently the paleness is excess fat, which is making an appearance because the liver is not producing enough bile to allow it to be properly digested. There are other things which can cause this, but considering our paracetamol consumption it is very likely to be caused by liver damage. Like you say I doubt it will cause any serious harm in the long term given the doses involved, but the fact that we have caused some actual damage to our body, to affect it's functioning in this way, especially to the liver which is very poor at healing itself (hepatic cell division takes around 1 year if I remember correctly) is very unnerving, for me at least. Definitely learned my lesson here.

Hope you are OK, all the best

 

[Somberlain]

[...] especially to the liver which is very poor at healing itself [...]

Where the fuck did you get that from? The liver is just awesome when it comes to this. I can't think of any other organ that is so forgiving. I recently experienced this myself. After treating my liver like shit for a while, the blood test came back with frightening results and my liver also looked pretty unhealthy when they did an ultrasonography. Two months later all enzymes are perfectly normal and it's even starting to look healthier, but of course that part takes a lot longer... getting rid of the fat cells and repairing the damage takes time and that's perfectly normal. The point is, that the liver is just awesome and especially as a drug user you should appreciate that. And it's always a good idea to give this wonderful organ a break and maybe give it some support. For my liver, all it took was me staying away from the really hepatoxic stuff like alcohol, paracetamol etc. and some milk thistle + green tea.

Ok, I think I made my point. Reads like I worship my liver... maybe I do. Maybe I should? Anyway... pale stool can be a symptom, but it can also be completely unrelated. I had pale stool at times where my liver was completely healthy according to blood tests. Could be something you ate or could be stress. Of course it's also possible you really did put to much stress on your liver and it needs a break. What i want to say is that for me, this wouldn't be concerning enough to go to the hospital, but it would be a good idea to get a blood test done. Based on the results you can decide what you should do next.

 

[pasha]

Go see a doctor, express your concerns, they'll most likely give you a liver function test which is fast and easy.

 

[TrYpTiCaL]

Where the fuck did you get that from? The liver is just awesome when it comes to this. I can't think of any other organ that is so forgiving. I recently experienced this myself. After treating my liver like shit for a while, the blood test came back with frightening results and my liver also looked pretty unhealthy when they did an ultrasonography. Two months later all enzymes are perfectly normal and it's even starting to look healthier, but of course that part takes a lot longer... getting rid of the fat cells and repairing the damage takes time and that's perfectly normal. The point is, that the liver is just awesome and especially as a drug user you should appreciate that. And it's always a good idea to give this wonderful organ a break and maybe give it some support. For my liver, all it took was me staying away from the really hepatoxic stuff like alcohol, paracetamol etc. and some milk thistle + green tea.

Ok, I think I made my point. Reads like I worship my liver... maybe I do. Maybe I should? Anyway... pale stool can be a symptom, but it can also be completely unrelated. I had pale stool at times where my liver was completely healthy according to blood tests. Could be something you ate or could be stress. Of course it's also possible you really did put to much stress on your liver and it needs a break. What i want to say is that for me, this wouldn't be concerning enough to go to the hospital, but it would be a good idea to get a blood test done. Based on the results you can decide what you should do next.

Personally I was expecting something along the lines of a sonnet or two....an ode to my liver. LOL

 

[XoxoMaryJane]

OP the only true way to know for certain will be to have your Liver enzymes checked. A doc can order simple blood tests to check once they get the results they go from there.

 

[someone12345]

Hey,

Just to follow up on my last post,

I should note that before the 6,000mg dose I took I had actually been nonchalantly popping 5/325s (probably about 8 total) in addition to about six 5/500s. This was about 24 hours before my 6,000mg dose; you do the math - I had a fair amount. All while drinking (Had maybe 8-10 beers)

I woke up this morning with pretty intense nausea (didn't vomit) and mild upper right quadrant pain. I drank a liter or so of water and headed to the emergency room. They gave me some NAC and had me drink some activated charcoal. After this they took some blood and ran some basic liver function tests. Enzymes were elevated but I wasn't in any immediate danger. I was told I would have more than likely been fine without medical attention but to obviously not make a habit of this irresponsible behavior.

If you are anything like me (young, no pre-existing conditions) then I think you'll be fine

 

[alcoholic333]

I am 25 and on countless occasions took 5grams apap even more on a couple occasions. I was also sure my liver was done for but recently had tests done and apparently am perfectly fine

 

[Artificial Emotion]

When I was 13 I took 16g of paracetamol before I knew how to do a CWE, had no medical attention and my liver is now fine. I wouldn't have thought that would be possible but unless I was hallucinating it definitely did happen. How I survived and didn't damage my liver beyond repair is beyond me, but it just goes to show what sort of abuse your body can take. I'm not condoning this sort of reckless behavior but I'm just trying to reassure you, you won't necessarily have done any damage. Get a liver enzyme test from the doc and start taking milk thistle religiously.

 

[lenses]

Try dosing some < 2 gs of taurine for a few days, it's a great liver function booster and according to research (http://www.ncbi.nlm.nih.gov/pubmed/11352821) it also will prevent/improve liver injury. You are not too late for some big doses of NAC too.

Don't get too worried. I have done much worse to my liver and am still around. It is an organ that responds very well to supplementation and can rejuvenate and repair itself if you nourish it.

Milk thistle (silymarin) is great too, but the only form I recommend is silyphos (brand name) which gets absorbed by the body 10x more than regular silymarin. Silymarin will protect the liver from some crazy things! I take it when I get worried about taxing my liver and it seems to help.

-lenses

 

[Foreigner]

OP: Pale, chalky poop is a sign that bile is not being excreted, as you already said. If there's no blockage to the bile duct then it means your liver probably can't metabolize the drug you are taking, and it has disrupted liver functions. I would just not take it anymore.

I second milk thistle. It has been proven to regenerate the liver.

 

[sekio]

As far as I can tell, APAP toxicity is pretty obvious when it happens because it causes symptoms like intolerable abdominal pain, nausea, dizziness etc. Also, single doses of under about 10-15 gm are very unlikely to cause long-lasting damage.

The color of your craps alone is not enough of a diagnostic for liver function, unless you eat oatmeal three meals a day, 7 days a week. It's easily influenced by dietary intake.

 

[someone12345]

As far as I can tell, APAP toxicity is pretty obvious when it happens because it causes symptoms like intolerable abdominal pain, nausea, dizziness etc. Also, single doses of under about 10-15 gm are very unlikely to cause long-lasting damage.

The color of your craps alone is not enough of a diagnostic for liver function, unless you eat oatmeal three meals a day, 7 days a week. It's easily influenced by dietary intake.

This is pretty much along the lines of what I was told at the ER. I just find it interesting because it is contrary to what now seems to be misinformation regarding acetaminophen poisoning. All over these boards you will find users hellbent on advising CWE (for obviously good reason) and insisting that any intake over 5 grams requires a visit to the ER.