Posted by nkurz 3 days ago
> Acetaminophen has a scarily narrow therapeutic window. The instructions on the package say it's okay to take up to four grams per day. If you take eight grams, your liver could fail and you could die.
Gee I don't know, I think this is a wide enough window to not miss it. That difference is 8 500mg pills
> that for most people in most circumstances, acetaminophen is safer than ibuprofen, provided you use it as directed. I think most doctors agree with this.
Could be but I think a lot of doctors underestimate the dangers of paracetamol as well
All of the factors the author mentions about IBP are true. But it's all about the details. Safer? Safer in which condition?
"Dehydrated" ok take a glass of water. Active bleeding? Most NSAIDs interfere with that, and no you won't become a hemophiliac by taking one Ibuprofen
Also, some countries do add a notice for kidney problems for Paracetamol as well (e.g.) https://www.medicines.org.uk/emc/product/5164/pil
An as a conclusion, I find it "funny" that nobody considers how healty/safe it is to take paracetamol and have mild analgesia (translation - you're still in pain) and taking ibp and having better analgesia
On the other hand, if in the early 2000s you were to share those concerns with certain doctors, they would propose a more effective and non addictive alternative to morphine instead. Only the first part of what they would tell you was true.
Tylenol/acetaminophen is good for fever which NSAIDs won't help. Otherwise, take both and alternate their dosing times for better pain coverage.
A fever is not dangerous within normal parameters, except for being dangerous to the virus and bacteria that threaten the body. Your body runs a fever because it engages in a battle to the death with these microbes.
If you defeat the body's own defenses by lowering the fever, for example if you are a nervous mother who hates her baby's fussing, or if you're hospitalized and the nurses are laser-focused on "number go down" treatments, then you can expect to be ravaged by the contagion for much longer than expected.
Yes, ignorant consumers and physicians across the world.
You can't just 'vibe medicine' or 'vibe biology' - please don't comment if you don't know what you're talking about.
The vast majority of the time medicine can only ever help with (acute) symptoms and rarely the underlying cause unless it is something like vaccines or antibiotics.
Medicine has side effects because if there was a free lunch to be obtained from medicine, the human body would have synthesized the medicine directly. Hence medicine is always about making tradeoffs.
When it comes to general health, there is always a causal chain of cause -> primary symptom -> secondary symptom -> tertiary symptom -> ... and a lot of medicine tends to work on the secondary or tertiary symptom.
Pain evolved to be an accurate indicator of damage to encourage you to stop ruining your body and not a punishment.
Just imagine someone trying to lecture a network engineer about how really async bugs should really never be different than bugs you see single-threaded if you use a semaphore. I mean, that's why we have semaphores!
Anyway, the temperatures attained during fevers are at best bacteriostatic (read not helpful in actually treating an infection that would lead you to seek medical care). If you've got evidence-based arguments, happy to counter them. Just please don't evoke 'evolution' to explain your bias-du-jour.
Evolution didn't create the personal computer or build a skyscraper. We're firmly in uncharted territory wrt things our bodies were evolved to deal with. As a great example, human temperature has been going down over time—evolution tells us that must mean we're all more susceptible to getting sick!!! https://med.stanford.edu/news/all-news/2020/01/human-body-te...
I did a fevered research dive last time I had the flu and came to the conclusion that there wasn't really any good evidence that fever is helpful for flu, and I should have few compunctions about suppressing it. (And that most of the situations where fever is really valuable for are ones where in the modern world you should go to a hospital and in the case of a bacterial infection be given antibiotics)