Im taking 1000 mgs of Acetaminophen 3x a day, with Tramadol, per my internist, in an effort to stay ahead of the constant pain I have from fibromyalgia and arthritis. My rheumatologist adamantly disagrees with the amount of Acetaminophen. He says it can affect my liver at some point at that dosage. They are both great doctors, I trust them implicitly, the rheumatologist is world-renown, but I think I need another opinion.  My blood tests come back normal, nothing unusual. Blood pressure, heart rate are fine.My biggest concern is amount of Acetaminophen Im taking, is it too much for my liver?I wont be seeing my nephrologist until Sept. He usually agrees with my internist....HELP.Thanks for your time and knowledge.AAAAA
Hello, The toxic dose of acetaminophen is variable. The recommended usual dose of acetaminophen is 4 GMS a day and as such seems to be quite safe for you, but definitely there can be some concern if you use acetaminophen constantly although in a recommended dose of just 3 GMS a day. The problem with acetaminophen is actually not the acetaminophen itself, but its metabolite in the liver called as NAP QI. Although NAP QI is cleared easily by liver but in people who are deficient in glutathione or in people suffering from malnutrition deficiencies or people who are taking alcohol regularly, then dangerous levels of NAP QI can be built in liver and cause liver damage. Although this may be far-fetched, but your doctor has pointed in this direction only. If left on me, I would also hesitate in prescribing ACETAMINOPHEN to my patient indefinitely at dose of 3 GMS a day. Thanks