Hepatic Hideaway.

May 29, 2009 2:10 PM

Please tell me I didn't destroy my liver! Details within

I got very drunk 2 weeks ago, which is quite rare for me. I usually drink maybe 3-4 drinks a week, if that. Although I've been ramping it up lately. But still well under 7 drinks a week.

Anyway, between 4 of us I think we emptied 2 bottles of Jamesons. I was really drunk and was worried about being hung over. I drank (I believe) 4 pint glasses of water. In the past I would have taken aspirin but in my friends medicine cabinet there was only tylenol (i think that's what it was).

I know at this point this was insanely stupid, but I took 4 tylenol. The next day I was normally hung over, got up in the morning and went home, not feeling great but not too bad. Through the day I was very weary (we were up till 3 I believe). By the next day I was just tired, no more hangover.

I'm just worried that I might have done some permanent damage to my liver. No jaundice, no nausea or anything else. I am very stressed out lately and feeling anxious but I think that's more due to circumstances than anything (just started a school program).

Anyway. I know you are not my doctor, etc. Should I get a liver test? Or is the fact that I'm feeling pretty ok a good enough sign that I got lucky?

posted by sully75 to health & fitness (23 comments total)

I'm pretty sure it takes more chronic abuse than this to harm your liver. Otherwise I would have had to have a couple transplants just to get through grad school.
posted by scody at 2:18 PM on May 29 [2 favorites]

It's hard to imagine that 4 tylenol would do liver damage, if that's what you're worried about. The National Library of Medicine site says don't take more than 4000 mg per day, and that over 7000 mg could lead to a severe overdose. Regular strength tylenol is 325 mg, and extra strength doses are 500 mg. If you took 4 pills, at worst you took 2000 mg, which is well below what the NLM says to be worried about.

If you're looking for something to be concerned about, might I suggest you see if you can cut back your drinking?
posted by jasper411 at 2:18 PM on May 29

You're fine.
posted by samthemander at 2:19 PM on May 29 [2 favorites]

Jasper411 my drinking is minimal. The issue is the combination of tylenol and alcohol which apparently can be toxic and fatal.
posted by sully75 at 2:21 PM on May 29

The issue is the combination of tylenol and alcohol which apparently can be toxic and fatal.

Toxic and fatal in large amounts. Seriously, if people could die or screw up their livers by taking 4 Tylenol on top of a night of heavy drinking, it would be banned.
posted by scody at 2:23 PM on May 29 [4 favorites]

The liver can regenerate after toxic injury (indirect cite). Personally, after two weeks, I wouldn't worry about it.
posted by exogenous at 2:24 PM on May 29

This was 2 weeks ago? If you haven't died, you're fine. Acetaminophen overdose basically runs its course in 3-5 days, with liver and kidney function returning to normal in a few weeks.

So you know, 4 Tylenol, whether regular or extra strength, is above the therapeutic maximum for an adult, which is about 1000mg at once or 4000mg per day. In the future, take less, and don't combine it with alcohol. If you continue to drink more and more (i.e., more than 3 drinks per day), you should stop using acetaminophen-based pain relievers.
posted by jedicus at 2:25 PM on May 29

You may be interested in this article, which discusses the questionable clinical evidence behind the idea that acetaminophen (paracetamol) interacts badly with alcohol or alcoholics, and also mentions evidence that ethanol has a protective effect against the liver-damaging effects of acetaminophen.

Anecdotally, I've known people who took more acetaminophen than you did and drank about as much, and they turned out fine, but everyone's different. See a physician if you develop any symptoms, etc.
posted by Maximian at 2:25 PM on May 29

Jedicus, thanks. Just for the record, I've ramped up my drinking from 4 drinks a weeks to maybe 7. It's not likely to go higher than that.

In the past I usually took aspirin as a sort of hangover cure...it was pretty effective (seemingly anyway). But my stupidity here freaked me out. I think I'll stick with the water cure.

Thanks for the help.
posted by sully75 at 2:27 PM on May 29

It will get you smashed, but in my non-scientific, friends who drank a lot filled college days, 1/2 a bottle of Jameson typically wasn't even alcohol poisoning level. Just nice and drunk level. Hell, it wasn't all the uncommon to drink more than that on weekend evenings...not that I recommend it.
posted by jmd82 at 2:31 PM on May 29

I usually drink maybe 3-4 drinks a week, if that. Although I've been ramping it up lately. But still well under 7 drinks a week...Anyway, between 4 of us I think we emptied 2 bottles of Jamesons.

my drinking is minimal.

Calling 3-4 up to 7 drinks a week "minimal" is a stretch, IMO (not even mentioning half a bottle of Jamisons). Comparing yourself to others is not the point - there will always be people who drink more or less. You say you've been "ramping it up." If you're concerned about your liver health, try ramping it down.
posted by jasper411 at 2:31 PM on May 29 [2 favorites]

I'm a musician, and I'm in bars 6 or 7 nights a week. I've been drunk 1 time in the last year. I get all the free drinks I want, and I don't really want them. I'm not in general concerned about my liver health. This one particular situation scared me into thinking that I potentially might have done permanent damage.

I admit though, minimal was a poor choice of words.
posted by sully75 at 2:37 PM on May 29

You know, aspirin after a bender isn't such a great idea either, if you really want to get into it. If you combine alcohol with aspirin, you face an increased risk of gastrointestinal bleeding. And: Avoid drinking alcohol while you are taking this medication. Alcohol may increase your risk of stomach bleeding.
posted by otherwordlyglow at 2:42 PM on May 29

I assume drinking a crapload of water is still ok?
posted by sully75 at 3:10 PM on May 29

a crapload of water and a b vitamin before you go to bed, drinkin' things johansen.
posted by beefetish at 3:12 PM on May 29

Yes they are a bad comb, and yes 4 tylenol could be harmful when you're that drunk. However, permanent damage? No. Especially if you feel fine now and you aren't glowing yellow (jaundice), you're okay. Don't make it a habit.
posted by davidnc at 3:20 PM on May 29 [1 favorite]

Yes, please don't make the mistake of thinking that as long as you avoid Tylenol, you can take as much aspirin (or ibuprofen or naproxen sodium) as you like. Regular use of NSAIDS can cause gastrointestinal problems, whether you're taking them on top of Jameson's or not.
posted by scody at 3:39 PM on May 29

You did not destroy your liver.
posted by blink_left at 4:13 PM on May 29

I have a damaged liver. There's no mistaking the signs, beyond a certain point. At best you'll feel bloated, with a constant sense of vague discomfort. At the other end of the scale you'll be writhing on the floor in utter abject misery. My guess would be that you're okay, but it's a good thing that you're giving this some thought now. Scale back on the drinking as much as you can, and never mix it with Tylenol. Drink plenty of water.

Take care of yourself.
posted by metagnathous at 4:22 PM on May 29

A tangentially related previous AskMe about a potentially serious acetaminophen + hydrocodone overdose. It might help you put things into perspective.
posted by mrmojoflying at 4:27 PM on May 29

FWIW - Milk Thistle (Silymarin) supplements will help your liver regenerate itself.
posted by torquemaniac at 5:58 PM on May 29

You're fine, no ifs, ands or buts about it. Take two aspirin and quit faking being sick.
posted by christhelongtimelurker at 8:51 PM on May 29

you're fine. don't do that again.
posted by RedEmma at 10:26 AM on May 30