Tylenol: to Take or Not to Take?
Picture this. Your daughter spiked a little fever (maybe 100.6) last night that was gone by morning, but you and Dad need to go to work. And you both missed time last week because your son had the flu. She seems to be acting okay. What do you do? Do you keep her home for that measly 100.6 temp last night? Do you send her and hope she doesn’t spike a fever? If day care calls you, you are looking at 2 days of missed work which totally would not make your bosses happy. What if you just give her a dose of Tylenol this morning and hope for the best? It wouldn’t be totally unwarranted. She does have the sniffles.
Fevers aren’t the enemy
I think most of us know that fevers aren’t the enemy, but it is sometimes hard to not act like fevers are inherently bad. Think of school and daycare guidelines- “the child can’t return until he is fever free for 24 hours.” Or talking to other parents- “I can’t come over. My daughter has a fever.” It is almost used synonymously with illness. And it doesn’t change as adults. Fever is the only acceptable reason to call out of work (that and the stomach bug because you know, vomit... no one wants to question that). When your friends question your illness, you have to justify it with how high your fever is. “Well, I was so sick last weekend. Running a 102 degree fever for 2 days!” That sounds a lot better than “I felt terrible last weekend, but my temp was only 99.”
But are you ready for the truth bomb? A fever doesn’t determine the severity of the illness, and lowering the temperature does not make someone better. Let that sink in. A child could be on the verge of death with a 100 degree fever, and another child could be completely better in a few hours with a 104 degree fever. I have seen this in real life. Promise.
So then what is a fever and why does it have such a bad rep? A fever is simply your body’s response to an infection. Your body has the ability to identify an attack (infection) and react to destroy it. One of the many ways it reacts is by elevating the core body temperature a few degrees. This slight elevation actually makes it more difficult for the infection to continue to multiply and basically have free reign over the body. The elevated temperature actually gives your body time to mount the big attack that involves a lot more of your immune system which we won’t discuss here. So biologically a temperature is actually helpful in getting rid of illness, even though you feel worse with it. This is partly why it has such a bad rep- it makes you feel bad. Also, an elevated temperature is a sign of an infection. This is why schools and day cares (and even doctors) make such a big deal about temperatures. It is a measurable criteria for the presence of infection. And infections are typically contagious and at the very best require a little more rest and fluids.
A little real life example of fevers. My daughter spikes fevers like crazy. I was so concerned when she was a toddler, I had blood work done. She still will spike fevers with just a cold, especially if she is tired. And these fevers will normally break in a few hours, usually after we have her rest. It is totally normal for her when she is sick to spike fevers up to 104. On the other hand, my older son rarely spikes a fever. When he is really sick, his fever tops out at 102. This is just a comparison of different immune systems at work. Everyone’s works a little differently.
So let’s wrap up all this talk about fevers. Basically fevers are just your body’s helpful response to infections. They show us the presence of infection- that is why people are so concerned about them.
Tylenol (Acetaminophen) and its history
It seems that the number one medicine for fevers is Tylenol. But it wasn’t always this way. Aspirin was the king until it was connected with Reye’s syndrome which affects kids. Then in the 80’s, Tylenol became popular, really popular. Its classification is an antipyretic analgesic (lowers fever and numbs pain). So it is the best when you are sick--lowers the fever and soothes headaches and body aches. But giving it around the clock (every 4 hours) is not best. I have even heard of friends taking it every 3 hours because they felt so bad. I get it, you want relief, but that isn’t safe. And you could be hindering your body’s ability to fight infection. I also know of parents who obsessively give it to their children whenever they have a sniffle, which also isn’t best. Again, I understand. Seeing your child sick is the worst. And sometimes you just can’t miss work, especially for a sick child. So you try to prevent day care from calling you and hope for the best. It’s real life, and there are gray areas. But medication should be seen for what it is and what it can do.
Tylenol overdose is a real and serious complication
Liver failure. Yes, you heard that right. Liver failure. And it is a pretty agonizing way to go. Tylenol overdose is the number one cause of acute liver failure. It became such a health concern that a few years ago, the recommended max dose of Tylenol was lowered to 3000 mg/day for adults and 75mg/kg/day (based on weight) for kids. That means if someone takes the recommended dose of Tylenol every 4 hours around the clock, he is taking more than the max per day. If this happens for awhile, we are looking at overdose then liver failure then death. But it’s not only just regular Tylenol. Did you know that Tylenol is found in other common medications? Such as Lortab, Percocet, Nyquil, Dayquil, and a whole host of generic cold medications. Keep an eye out for “acetaminophen” in the name. That is Tylenol’s generic name. Think of someone after surgery, in pain and developing a postop fever (a common complication). She might take that Percocet for pain and some Tylenol for fever, but now she is taking a huge dose Tylenol! And this can happen again and again if she doesn’t know that it’s a problem. Overdose then liver failure… It is something to be a little cautious with, especially in children.
So am I saying never take Tylenol? Never treat a fever? Avoid medicine at all costs? No, definitely not! People just need to be aware of the risks. We need to treat Tylenol like we do all medicines--take only when other remedies have failed. It should not be given to prevent fevers or pain. It should rarely be given around the clock. And it needs to be kept in a safe, kid proof area, because overdose is no joke.
Until Next Time,
P.S. Keep an eye out for further discussions about Melatonin and Benadryl. If you would like to hear my opinion on other medications, let me know. I would be glad to research those for you.
**I am not a physician. I do work in the medical field and have access to peer-reviewed research articles (which is not the same as what can be found on the internet). For any and all questions, please consult your personal physician.