Little Known Dangers of Tylenol Acetaminophen and tylenol alternatives (Kids and Adults)
Acetaminophen, commonly know as Tylenol, is an incredibly commonly used medication, for both children and adults. Used for pain, fevers, headaches, menstrual cramps, I have had numerous patients over the years that they take 1-2 tylenol pills a day.. for years! Others only use it for a few days every month for headaches or menstrual cramps, but again, this pattern has been long standing as some dose the acetaminophen very highly during these times. I am not against the use of acetaminophen, when needed. Yes, I have felt the relief from pain medications and the value is undeniable. But the overuse of this medicine is causing problems and we need to talk about it.
Many drugs today can cause liver damage and liver failure. However acetaminophen is the number 1 reason people contact poison control in the United States, more than 100,000 calls are made yearly due to acetaminophen
Every year, acetaminophen is responsible for approximately 56,000 emergency room visits, 26,000 hospitalizations, and more than 450 deaths from liver failure.
Acetaminophen causes more cases of acute liver failure than all other medications combined!!
About 50% of tylenol overdoses are unintentional. Both fasting and consuming too much alcohol increases the risk of overdose.
Take this published story of an accidental overdose in a child given my well meaning parents:
"On the day of presentation, the patient had been given about 800 mg (200 mg/kg) of acetaminophen by his parents before circumcision. The parents had been instructed, by their physician, to give him 40 mg of acetaminophen before bringing him to the hospital for the procedure. The patient’s weight was 4.1 kg; thus, this was an intended dose of 10 mg/kg. The bottle of acetaminophen showed a concentration of 80 mg/mL, which was misinterpreted by the parents, in that they believed that the bottle contained 80 mg of acetaminophen in total. The child was given 10 mL, or about half of the bottle, with the intent of giving him 40 mg. The child underwent his circumcision, and, following the procedure, the physician instructed the parents to give him another dose of acetaminophen if he seemed uncomfortable. At that point, the mother commented that “it seemed like a lot of medicine,” and the error was discovered."
Why does acetaminophen affect the liver? Acetaminophen is a dose-dependent liver toxin. Even at regular doses, the metabolism of acetaminophen in humans causes the release small amounts of a toxic substance, N-acetyl-benzoquinoneimine (NAPQI). With very larger doses, higher amounts of this toxin is produced in the body. Used incorrectly and taken in excessive dose either accidentally or intentionally, acetaminophen is a toxic medication.
So what can you give your child instead of tylenol?
I always recommend checking with your doctor, as some fevers or ear infections may require tylenol or antibiotics
Alternatives to Tylenol for a Fever
Using tepid, luke-warm water (never using cold or ice water), I use a face cloth or sponge to pat down their face, arms and stomach. I make sure to focus on behind the neck and ears as well as the forehead.
Although there is no research linking dairy and cold or flu aggravation, I often find it helpful to remove dairy from the diet when my children are sick, especially if they have stuffy noses and increased mucous production. Instead, I provide warm chicken or beef bone broths and luke-warm teas. Catnip, chamomile and Lemon balm teas are herbal teas that are relaxing and also have been traditionally used for fevers. I keep the diet simple, offering fruits and other easy digest foods like applesauce and cooked oats. If the child has no appetite, I typically don't push food but ensure they are getting enough fluids (make sure they are still urinating throughout the day).
Homeopathic Medicines for Fever
Homeopathics are extremely diluted natural remedies that often come in the form of sugar pellets. There are a few common homeopathic remedies that may be helpful to gently lower a fever.
Used when the fever comes on suddenly and often recommended in the early stages of a fever
Used when the child has a very flushed hot face. Often generally recommended in the early stages of a fever.
Generally recommended for fevers that accompany teething in infants and toddlers.
4. Eupatorium (Boneset)
Used for fevers especially when accompanied with aches and pains, particularly if the child is complaining of bone pain.
Some children find ginger too strong and spicy, but others love the flavour especially if sweetened with a little honey. Ginger is antiviral and antibacterial and also helps to break up congestion and mucous. Ginger may also be helpful to soothe pain, and may help with the aches and pain associated with a mild fever.
Alternatives to Tylenol for an Ear Infection
Garlic Mullein Ear Drops
On the first sign of earache or infection I put a few drops of herbal ear oil into the affected ear every 3-4 hours. The classic mixture of natural ear drops contains garlic and mullein. Research has shown that garlic mullein ear drops provide pain relief, reduce inflammation in the ear and can help kill both viruses and bacteria in the ear. I always make sure to warm the bottle first by running it under warm water or rubbing the bottle in my hands. It is important to note that ear drops should not be used if you notice any fluid or liquid draining from the ear or if you suspect a ruptured ear drum (you would need to see your doctor if this is happening!). Some natural ear drop formulas may also contain calendula and/or st.johns wort, which may provide some added benefit.
As AOM often presents at the same time as a cold, using herbs that help fight off viruses and bacteria in the body can be helpful. Make sure to always check the label and dose the herbs based on your child's age and weight.
Elberberry, also known as Sambucus, has been shown to help fight bacteria and viruses that cause flu like symptoms and may help to shorten the duration of an illness. Elderberry can be found in a syrup or in dried berries that you can prepare in a tea. Most children like the sweet pleasant taste of elderberry.
My go to herb for cough and colds, echinacea is a tried and true remedy to help reduce the duration of an illness and fight off cold and flu. It can also be found in syrup, tinctures or teas. Make sure to always check the labels and echinacea can be paired with other herbs that may not be appropriate for children in some formulas. Echinacea is not as pleasant tasting as elderberry and often I mix this herb with a little honey (in children over 1) or maple syrup.
Other herbal teas (taken warm or cool) such as chamomile, lemon balm or peppermint may be soothing and relaxing to the child. Certain children find teas very calming and can be helpful when dealing with pain.
Homeopathy for Ear Infections
Certain homeopathic remedies for ear pain and earache may be helpful.
Ferrum Phosphoricum 9Ch or 30Ch may help reduce pain and targets the ear drum. This remedy is often best used on the very first sign of ear pain. This remedy is also historically used to treat mild fevers.
Belladonna 30Ch, used if Ferrum Phos does not work. Also used for sudden onset of ear pain with a fever and a hot, red face
Hepar Sulph 30Ch: typically used for "swimmers ear" however may also be helpful in AOM, used when the child is very sensitive to everything.
Arsenicum Album 30Ch used for burning ear pain, better with hot compresses.
Other Home Remedies for Ear Infection
Onion Ear Compresses
For centuries, onions have been used to help congestion, cold and earaches. Onions contain high amounts of sulphur compounds which may help to clear the infection and may aid in pain relief. An age old remedy is to apply onion right to the ear of the child and leave it in place for as long as possible while the child rests lying down. Many children (and adults alike) report this to be soothing.
•1 onion (I like purple onion as it is highest in sulphur)
•A hat or scarf to hold the onion in place.
•Compress cloth (a cheesecloth or thin sheet folded 8”x16”)
1.Cut up the onion into small pieces.
2.Warm the pieces in a little water- easiest is in a skillet.
3.Put the warm onion into the compress cloth making sure it is not too hot!
4.Fold it into a package and then use an elastic keep the onion in the cloth.
5.Put the onion compress over the ear and the bone behind the ear (mastoid bone)
6.Put a hat over the compress or wrap a scarf around the head to keep the compress in place.
7.Leave in place for as long as possible, ideally at least 20-30 minutes.
Hot water bottle (wrapped in a towel)
Making sure the hot water bottle is not too hot, let the child rest or sleep on a water bottle wrapped in a towel (to avoid burning the child). Do not fill the water bottle up too much as it will not be as comfortable for child compared to a partially full water bottle. Heating pads are not advisable .
In summary, a visit to your healthcare practitioner is always necessary if your babe is 3 months or under and may be necessary in older children depending on the circumstance. However, there are many things you can try at home if a visit isn't needed that may be helpful and also comforting to the child.
Nourjah P, Ahmad SR, Karwoski C, Willy M. Estimates of acetaminophen (Paracetamol)-associated overdoses in the United States. Pharmacoepidemiol Drug Saf. 2006 Jun;15(6):398-405.
Ogilvie JD, Rieder MJ, Lim R. Acetaminophen overdose in children. CMAJ. 2012 Sep 18;184(13):1492-6. doi: 10.1503/cmaj.111338. Epub 2012 Jun 4. PMID: 22664763; PMCID: PMC3447018.
Cohen, JS. "The Little Known Dangers of Acetaminophen" published in Life Extension Magazine. Accessed Jan 30 2023