The run started well enough, with me and my running group giggling, gossiping and soaking in the multi-million-dollar properties of the rich and famous on a cool, cloudless morning in one of the United States’ priciest ZIP codes. Even when the topography turned torturous and the sun started to scorch, the paradisiacal views and camaraderie made me grateful to live and train in San Diego.
Then about 90 minutes into it, things took a turn for the worse. On an isolated stretch of trail, I got the spins. I stopped, but the dizziness didn’t. How, I wondered as I tried to reach home base, did I get this sick this quickly? Then it dawned on me: I’d woken with the sniffles and taken one of those flu strips. That was followed by my typical regime before a two-hour-plus long run: two extra-strength Tylenol capsules, just in case an old injury flared up. The combined dosage was the culprit.
Thus, I learned that day that common pain relievers can spell big trouble.
Many runners manage the aches that accompany rigorous exercise with ice baths, frozen pea bags, rest, elevation, massage, special sticks, rolling pins and maybe a stiff drink, be it whiskey served neat or an extra shot in that latte. How often, though, do we consider the copious amounts of aspirin, Aleve, Advil and other analgesics that we consume to dull pain or even preempt it?
I searched among other running blogs and came up empty for experiences similar to mine. But this summer, a few months after my ordeal, the mainstream press was all over it. The topic was the dangers of taking too much Tylenol, the most common U.S. over-the-counter pain medication – and one promoted at a lot of road races. Newspapers like the Forth Worth Star-Telegram sounded warnings last month about Tylenol following a study published in a respected medical journal. Participants took the equivalent of eight extra-strength Tylenol tablets each day for two weeks, and tests then showed 40 percent suffered liver damage. The newspaper wrote that “excessive doses can overwhelm the liver, causing it to shift to an alternate breakdown route. This route produces a liver-toxic compound.” Physicians recommended not exceeding a daily dose of 4000 mg daily, which comes to eight regular-strength tablets in 24 hours.
That’s a decent amount but what most people don’t realize is that Tylenol’s active ingredient, acetaminophen, is in a lot of other medications, from the prescription drugs Darvocet and Vicodin to more than 200 drug store remedies, covering everything from headaches to hay fever.
Right now many runners are upping their mileage in preparation of half and full and ultra marathons this fall. As training intensifies, immune systems are more easily compromised if precautions aren’t taken. And when a cold or the flu hits, or when the tendons in knees, hips, ankles or feet feel tighter than usual, some of us will hit the medicine cabinet. To avoid ruining an otherwise excellent run, just remember: There are limitations to how much a body can take.