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Prachi Shah

Two of the most common medications for alleviation of pain, acetaminophen (Tylenol) and ibuprofen (Advil), are used daily by many people with pain from arthritis, tendinopathy, back pain, and other persistent conditions, but is it safe to use these drugs daily? 

Ibuprofen acts in the body by directly preventing the conversion of arachidonic acid to prostaglandin H-5– an important signal to the brain indicating that there may be damage to the body. Since your brain stops receiving the message indicating damage, you stop feeling pain. Aspirin has a slightly different effect on a molecular level, but the same result. Since prostaglandins play a role in blood coagulation and protecting the digestive tract lining, the regular use of ibuprofen or aspirin can cause irritation of the digestive tract and an increased risk of bleeding. Some people get gastrointestinal symptoms with just one or two doses of ibuprofen or aspirin, but that might not be an indication of damage. 

Acetaminophen is thought to work somewhere in the central nervous system,  interrupting the “pain message”’ closer to the brain, but no exact mechanism has been determined yet. Acetaminophen is digested in the liver, and although the majority of it is digested and excreted normally, a small amount is converted to a toxic byproduct. So, if too much acetaminophen is administered too quickly, the toxic byproduct can build to dangerous levels. There are numerous stories of people inadvertently overdosing on acetaminophen, which can damage the liver to the point that it no longer functions. This also means that acetaminophen in combination with other things that harm the liver, such as excessive alcohol, can be dangerous.

While the use of high doses of ibuprofen and acetaminophen can cause liver and kidney damage, the risk of this is small. These are some of the most widely used and safest medications known. Most pills contain only a fraction of the dose needed to cause damage. For example, a standard ibuprofen tablet contains roughly 200 mg of ibuprofen. A dangerous level in an average adult is upwards of 3,200 mg (or 16 pills) in one day or 800 mg (four pills) at once. 

All medicines merit caution. Experts recommend the following tips for safe pain alleviation:

1. Make sure to know all the possible sources of acetaminophen ingested in one day. It is a common ingredient in many over-the-counter remedies and has multiple brand names, so it’s important to check the ingredient list before taking multiple medications.
2. Take  as little as possible, and make sure to check the recommended dosage. The maximum amount of medication that is safe varies by factors such as size, sex, and medical conditions. 
3. Avoid mixing medications/substances. This includes drinking alcohol while taking these medications, as well as asking a health provider about which over-the-counter medications are safe to take along with prescribed medications. 

Over-the-counter pain relievers, such as acetaminophen, ibuprofen, and aspirin, can be available and affordable treatments to help alleviate simple aches and pains. They can be taken on a daily basis if one is careful. 

https://tuftsjournal.tufts.edu/2008/04/professor/01/

https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/How-Do-Pain-Relievers-Work

https://www.youtube.com/watch?v=9mcuIc5O-DE

https://www.health.harvard.edu/pain/acetaminophen-safety-be-cautious-but-not-afraid

https://www.webmd.com/a-to-z-guides/tylenol-acetaminophen-poisoning#1

https://www.news-medical.net/health/Ibuprofen-Mechanism.aspx

https://adf.org.au/drug-facts/ibuprofen/

https://www.ucihealth.org/blog/2018/03/acetaminophen-liver-failure#:~:text=%E2%80%9CSevere%20damage%20could%20occur%20if,cause%20problems%2C%E2%80%9D%20he%20adds

https://www.healthline.com/health/can-you-overdose-on-ibuprofen#dosage

Photo from FDA

Inki Lee

Decades of hesitancy about vaccines have lowered vaccination rates leading to a recent resurgence in measles.  Measles is a highly contagious disease. In 2000 it was declared eliminated from the United States because none of the 86 diagnosed cases documented resulted in transmission.  While the early history of vaccination was a bit spotty, it’s modern application represents one of the most successful public health interventions in history.  

Hesitancy regarding vaccines is undoing this good work. A common concern is exposure to mercury from the use of thimerosal, which is a preservative. Studies have found that ethylmercury, which is the mercury source in thimerosal, is broken down and excreted from the body very quickly. There are no credible links between thimerosal and harm. Nevertheless, to assuage concerns, there are now thimerosal-free vaccine options.

Formaldehyde is used to inactivate the virus and neutralize bacterial toxins so that vaccines don’t cause sickness. Formaldehyde can cause cancer when there is exposure to large quantities over a long period of time. Formaldehyde is a normal human metabolite and is naturally present in the human body in small amounts. The amount of formaldehyde present in vaccines is unlikely to affect natural formaldehyde levels.

Aluminum is added to vaccines to make them more effective in smaller doses. Some people wonder if  long-term exposure to aluminum may result in disease. Aluminum is ever-present. It is in the food and water we consume. Aluminum has been used safely in a wide variety of products for a long time. It seems unlikely that the relatively small amount of aluminum used in vaccines will have much influence on health.

There are concerns that the use of antibiotics and gelatin in vaccines could trigger an allergic response. Since antibiotics are removed during the vaccine purification process, there are only trace amounts left after production; too little to cause an allergic reaction. 

The amount of gelatin in vaccines varies with each vaccine, from 0.0015 mg on the low end to 14.5 mg on the high end. If gelatin allergies are a concern, alternatives and exemptions are available.  The rate of severe allergic reaction to gelatin in a vaccine is estimated to be fewer than one in every two million vaccinations.  

The odds of a severe allergic reaction to antibiotics in vaccine are estimated at one in a million. For context, the odds of being struck by lightning in one lifetime is 1 in 3,000.

Vaccines are safer than many of the products that we use or consume on a daily basis. The risk of harm from the diseases these vaccines limit or prevent outweighs all known risks including possible exposure to chemicals.

https://www.verywellhealth.com/vaccine-additives-and-preservatives-2633691

https://www.publichealth.org/public-awareness/understanding-vaccines/goes-vaccine/

https://www.healthline.com/health/vaccinations/opposition#results