Welcome toDear Julia,,A weekly column where readers can present questions about daily health about everything, from the science of hangovers to the mysteries of back pain.Julia Belluz will come through research and consult experts in the field to find out how science can help us lead happier and healthier life.
What is the difference between Tylenol, Advil and Aspirin?What is best to hurt?
I always took acetaminophen (usually indicated by his brand name, Tylenol) for incidental headache or painful muscles, especially because we used it in my house that grew up.Then any other type of freely available pain lighting, and I suppose the same is the case for many people.most popularOver-the-counter painkillers around the world.
So I was surprised when I discovered that there is a big gap between how pain scientists think of this medicine and how the public is more specific, every researcher I have contacted for this piece, a variation of whatAndrew Moore, a pain researcher told at the University of Oxford,: Tylenol does not actually work very well for pain.
Moore has carried out a number of systematic assessments of pain medicine about recipes and looks at all the available evidence to find out which works best for various problems.), Ibuprofen (as Advil) and Aspirin.
Like all well -based drugs, he was able to give a very practical answer: “If you are talking about aspirin in doses of 500 to 1,000 mg or two tablets, 30 percent of people get relief from acute pain.From 500 to 1,000 mg, around 40 percent have a success.
Now Moore referred to acute pain here that hit after a certain event, like asurgery, a cut or a burn, but his message was simple: ibuprofen seems to work best, followed by acetaminophen and then aspirin.
(Maridav/Shutterstock)
For running (or chronic) pain - a painful crucifix, says whether the type of degenerative arthritis that usually develops with age - Ibuprofen still surpasses acetaminophen.
"We thought that [Tylenol] is not effective on both pain and disability results for low back pain"IN2015 systematic reviewof high -quality evidence, published inBMJ, discovered that acetaminophen did not seem to help most people of chronic low back pain and that it hardly illuminates pain in people with osteoarthritis.Pain in the immediate and short term and is no clinically superior than placebo on both pain and disability results for osteoarthritis.
A limitation of the study is that the proof of acetaminophen was mainly for low back pain, but as from the University of LeedsPhilip ConaghanExplained: "There are very little data in the long term [about chronic back pain], and if a substance does not work in the acute problem, it does not seem unlikely that it works in the chronic phase-buoying back pain can be even more complicated endeestoarthritis pain."
The study also noted that patients on Acetaminophen "are almost four times more likely to have abnormal results on liver function tests compared to those who take oral placebo."
Other studies like thisWell -designed randomized control attemptsPeople with knee pain have similar conclusions: Acetaminophen does not work as well as ibuprofen and it is linked to higher liver problems.
It turns out that this is another fascinating problem for pain scientists.Either the results in studies are poorly defined, the studies have too few participants to say something concrete, or many people in the studies actually seem to have chronic headaches in contrast to the ordinary that the researchers reportedly study.
“Most people would say if you look at the data,Take an ibuprofenTablet, "said Moore." Acetaminophen is just not very good painkiller [pain relief], but it is go-to material because it is considered safe. "
And this is where things become even more interesting: acetaminophen is not really certain.
"We always thought that [acetaminophen] was safe, but there are more and more signs of unintended overdose in people who regularly use it for chronic pain and some liver toxicity," explainedCoreps, who hasstudied information about side effectsRelated to this popular medicine.
Between 1998 and 2003 was AcetaminophenImportant cause of acute liver failureIn the US there are also hundreds of associated deaths every year - although they remember that millions of people take drugs with acetaminophen, so these more extreme side effects are rare (especially if you only take them in small doses).-benefits benefits the risk may not be worth it.
"Don't think that just because something is freely available, it's certain," Conaghan added.on other medicines.)
"[Tylenol] is an old medicine, outdated and must be completely avoided"
Kay brune, a professor in pharmacology and toxicology at Friedrich-Alexander University in Germany, who also investigated the toxicity of painkillers, was even more direct in his mind about Acetaminophen: "It is an old medicine, outdated and must be completely avoided."
Aspirin is safer than acetaminophen, he said, but to be used as pain relief requires much higher doses - that can have side effects such as stomach disorders.Aaspirine also interferes with blood clotting in days after taking it."" If you take a gram.From Aspirin, "Brown explained," you run the risk of bleeding for another four days.
Ibuprofen does not have these two problems - it is less toxic than the other in the doses that people give pain relief.But it has other side effects.free of risk, "said Brown. Use of it in high doses also seems to increase blood pressure and increase the risk of heart attacks and strokes - one of the reasons for itFood and Drug Administration recently warnedPeople may only use ibuprofen (and other "non-steroidal anti-inflammatory drugs" or NSAIDs, such as naproxen) for short periods and in small quantities.
I asked Brown about what he would propose for incidental headache or painful muscles."Taking 400 mg of ibuprofen does not cause measurable damage," he replied..
Is acetaminophen good at something?
If the research community seems to have chosen the side of Ibuprofen for pain, is Acetaminophen good for something?
Yes.There are some groups of people with health complications that should not take Ibuprofen.
There is also any evidence that NSAIDs can increase the risk of psychosis and cognitive impairment in the elderly, so that doctors can prevent these drugs from being prescribed for older patients.Tylenol is generally considered saferThen Advil or Aspirin for pregnant women.
Fever is another area where acetaminophen can help, Moore said.Systematic revision,Acetaminophen seems to be safe to treat very young children with fever, and youCan give childrenAs young as 3 -month -old acetaminophen while you have to wait until the children are at least 6 months old to treat them safely with ibuprofen.
But a final warning here: if your child is older than 6 months, it isNot so clearThe Acetaminophen surpasses ibuprofen to reduce fever and the same is the sameWhere adults.So remember the next time you confront your medicine cabinet.
See: How Americans got stuck on endless drug advertisem*nts
(Maridav/Shutterstock)
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:no_upscale()/cdn.vox-cdn.com/uploads/chorus_asset/file/3975450/shutterstock_142335808.0.jpg "Do you have to take Tylenol, Advil or Aspirin for pain? (1)")
