Paracetamol, also known as acetaminophen, is the panacea of our time. From joint sprains to toothache, and even labor pains, everything can be used. It ranks among the three tiered pain relief methods recommended by the World Health Organization (WHO) for cancer. We feed it to feverish children; As adults, we also swallow a few tablets to relieve headaches or menstrual cramps; As we enter middle and old age, doctors may prescribe some medication to alleviate the torment of arthritis or back pain. In the United States alone, 27 billion doses of paracetamol are sold annually, and over 600 drugs contain this ingredient.

Because paracetamol is ubiquitous, you may think it is safe and effective, at least at the recommended dosage. Therefore, we rely more on paracetamol than aspirin and ibuprofen, which can stimulate the gastric mucosa and cause gastric bleeding. However, the backbone of this medicine cabinet is not as gentle and reliable as you imagine.
Paracetamol was discovered in the late 19th century, but due to its strange side effects, it seems to cause some people's bodies to turn blue (i.e. cyanosis), leading to its almost immediate abandonment upon discovery. This side effect may be caused by contamination from another drug, but paracetamol remained on the bench for many years until further testing in the 1940s confirmed its good fever reducing effect. Later, research also found that it is a fairly effective analgesic. Paracetamol truly began to shine in the 1960s, when people began to worry about the side effects of long-term use of aspirin and other non steroidal anti-inflammatory drugs. Among arthritis patients alone, there are currently approximately 16500 deaths annually in the United States, related to nonsteroidal anti-inflammatory drugs.
We believe that paracetamol is relatively safe. Of course, if you eat too much, it will definitely cause serious damage to the liver, but if you only recommend the dosage, there is no problem. Isn't that right?
This view is facing challenges. Research has shown that prolonged use of paracetamol may cause serious damage to the stomach, similar to non steroidal anti-inflammatory drugs. If it can indeed relieve pain, the cost seems to be worth it. However, for most people taking medication, the effect of paracetamol is almost indistinguishable from placebo.