Well made points but you are hardly comparing like with like.
Healthy, young weight trainers with sick/fasting people. There are risks to taking almost any medication long or short term. Acetominophen(paracetemol in europe) is very danerous in overdose and causes irriversible liver damage and your points about normal use are also true but adverse effects in people using it for headaches, hanovers, cold or flus are very, very rare. Not true. Many here in the US have needed liver transplants just using it for hangovers at recommened doses once or twice a week. This is exactly why there is a warning now on the label. Flu and cold remedies sell in the milions. and there are MANY deaths because of these drugs and not because of abuse. My arguement that saying a heavy cycle of orals compared to ordinary use of paracetemol is like sweets to your liver is crap. You are correct to highlight that paracetemol can be very danerous and shouldn't be taken excessively or routinely but you should not give the impression that someone using roids can relax safe in the knowledge that it's nothing compared to taking tylenol. That's exactly what I am saying. I have never known anyone who has needed a liver transplant because they took 50 mgs of dbol or 100mgs of drol for a few months. BTW, it's not just sick people who don't eat, it's also BB's who diet for shows. I wonder how many BB who are taking tylenol for aches and pains while contest dieting who may end up needing are liver tranplant and have it blamed on dbol?I am not very judgemental when it comes to roids. i have seen biochemical evidence of changes pre and post cycle. So have I and it is nearly impossible to get accurate readings on liver enzymes, CK levels and kidney due to the fact that these guys are breaking down muscle tissue to such a great degree. Millionds of people with chronic ill health use paracetemol regularily eg arthritis with almost zero side effect burden on patients or health service in terms of liver faiure. Statement of opinion not fact since there is no way to test liver enzymes on these millions of people. regards,
the Doc
Dear Disgusted,
My last post on this topic. Apologies for all my spelling errors. I'm tired. I was on call last night. Firstly, I'm not a scaremongering doc who thinks roids are evil responsible for all ill health. secondly I hhave no intention of insulting or trying to "own" you. The impact of anabolic steroid use on the health service in US/Europe is pretty much miniscule in the grand scheme of things. However there are risks involved and they shouldn't be dismissed as like taking candy compared to safe, recommended therapeutic doses of paracetamol eg less than 4 per day. Do you now that tyelenol is actually safe to use in low doses for fever/pain in patients WITH liver disease.(It's not metabolised as quickly so more time for liver to cope with the toxic metaboiltes. I can't exactly be accused of excessive medical jargon here.)
I'd say the young BB who used DBol for10 weeks and got huge and strong probably has normal LFT's. Your points about CK raised due to exercise and not roids are correct. Also i will repeat that you are correct to highlight the dangers of paracetemol. However I don't believe it's dangerous in therapeutic doses. People can get into trouble by accidently overdosing ie taking several products all containing paracetamol. In some retrospective studies paracetamol toxicitiy was the cause of failure in almost half of transplant patients but it was due to intentional or accidental overdose(which would include those takin too much flu/cold remedy.) In those cases doses taken were 7.5-10g per day while recommended dose is max 4g. There are isolated case reports of therapeutic doses causing liver failure although those patients had muscular dystrophy which may or not be relevant. Caution is needed in fasting pt's but paracetamol is often used in IV form intra and perioperatively in pt's taking nil by mouth on surgical wards.
So i will argue that paracetamol is a very usefull and safe drug when used properly. Unintentional is dangerous and people need to check what's in all there over the counter meds. D-Bol is probably safe if used responsibly but my whole arguement is basically that people should take that responsibility and I felt that comparing to paracetamol flippantly belittled that need. I don't believe responsible use of either will leave any significant no. of people on a transplant list. It's funny that rearding the safety of using d-bol we would probably not have much to argue over but the simple tyelenol has us divided!
I should clarify that when i mentioned paracetamol for hangovers i was refering to regular joe's after a fun night and not people with chronic alcohol misuse.(But alcohol is an arguement for another day)
"Millionds of people with chronic ill health use paracetamol regularily eg arthritis with almost zero side effect burden on patients or health service in terms of liver faiure.
Statement of opinion not fact since there is no way to test liver enzymes on these millions of people. regards,"
It's actually not just my opinion. I don't need to check their liver enzymes. These populations of patients are simply not cloging up liver clinics and transplant waiting lists.
"I wonder how many BB who are taking tylenol for aches and pains while contest dieting who may end up needing are liver tranplant and have it blamed on dbol?[/
I'd say approximately zero.You will have to look long and hard on the internet. I have included the abstract of a good article. Plenty of these patients were sick and fasting at times. I'm sure you could find plenty of ammo to throw back.
regards,
the Doc
Does Therapeutic Use of Acetaminophen Cause Acute Liver Failure?
Posted 10/15/2007
Richard C. Dart, M.D., Ph.D.; Elise Bailey, M.S.P.H.
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Abstract and Introduction
Abstract
Study Objective: To compare the reported occurrence of liver failure in subjects in prospective trials with that in patients in retrospective reports after repeated use of therapeutic dosages of acetaminophen.
Design: Systematic review of the medical literature.
Data Source: MEDLINE and EMBASE biomedical and pharmacologic databases.
Subjects: Adults who received repeated dosing of acetaminophen 4 g/day or lower for at least 24 hours.
Measurements and Main Results: Articles written in several languages were abstracted by trained personnel using a structured abstraction form. Data were categorized by methodology (prospective vs retrospective), acetaminophen dosage, and type of liver effect. A total of 791 articles were identified, which included 30,865 subjects in prospective studies and 9337 patients in retrospective reports. The prospective studies reported no cases of fulminant hepatic injury, liver transplantation, or death due to acetaminophen. Of the 30,865 subjects in these studies, 129 (0.4%) were identified who had a serum aminotransferase level that exceeded the upper limit of normal, including 61 subjects in randomized trials in which the proportion of serum aminotransferase level increase was the same as or less than that in the placebo group and 68 subjects in trials without a placebo group. In addition, 4263 (13.8%) received the maximum recommended therapeutic dosage (3.9–4 g/day). In the retrospective reports, 96 patients (1.0%) had a serum alanine aminotransferase level that exceeded the upper limit of normal, one (0.01%) underwent liver transplantation, and six (0.06%) died. Causality relationship of acetaminophen for each retrospective case was assessed with the Naranjo adverse drug reaction probability scale. The mean ± SD Naranjo score for all 103 retrospective cases was 3.2 ± 1.9, indicating a possible relationship between the increased aminotransferase levels and acetaminophen use. Some retrospective reports contained information suggesting that the patient had ingested an overdose despite a history of therapeutic use.
Conclusion: Prospective studies indicated that repeated use of a true therapeutic acetaminophen dosage may slightly increase the level of serum aminotransferase activity, but hepatic failure or death was not reported. Retrospective reports indicated a higher rate of increased serum aminotransferase levels, and several reported associated liver injury and death. The differing results and presence of evidence indicating inaccurate acetaminophen dosage information in some case reports suggests that these cases may be inadvertent overdoses, rather than true therapeutic dosages.