The final long run is in the books, every muscle in your body hurts from months of training, you’ve got a family waiting to get on with their day…a job for acetaminophen.
Race morning dawns and the injury you’ve been trying to keep at bay is wandering around in your mind causing doubts galore… a job for acetaminophen.
You can feel the germs your kids are spraying around with every cough coming your way, you feel a headache coming on… a job for acetaminophen.
Or is it? Are you inadvertently harming your body by taking too much?
I’m partnering with Know Your Dose to help ensure everyone, but especially runners, understand the potential harmful effects of getting more than you need, because acetaminophen is actually in more than 600 over-the-counter (OTC) and prescription products! It’s not just in the one’s you think of, it’s in your cold and flu medicine, allergy medicine, Alka-Seltzer Plus® and sleep aids too. 
Why Can Pain Relievers Be Issue for Runners?
Let’s start with what is acetaminophen? It’s the most common drug for pain relief and fever reduction, which is why you find it in things like Tylenol®, NyQuil® and 600 other products. We’re going to touch on two different things today: acetaminophen and NSAIDs).
A second type of common OTC pain relievers are nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, magnesium salicylate, and naproxen sodium.
Both acetaminophen and NSAIDs are safe and effective when used as directed. There are some important things you need to consider when taking either one.
For runners, there are two main issues with ingesting too much:
- Liver damage (related to acetaminophen) — acetaminophen overdose is actually the leading cause of acute liver failure!!
- Inflammation is part of how your body grows and adapts to training stimulus (related to NSAIDs)
I’d add that a third issue is simply caring for your entire family in a safe way.
According to the U.S. Food and Drug Administration (FDA), the recommended maximum daily dose of acetaminophen is 4,000 milligrams (mg) in a 24-hour period for adults. It’s super easy to exceed this by taking your next dose too soon, taking more than the label tells you to, or accidentally using multiple products with it. 
Especially as we are in the midst of cold and flu season, it’s important to take a minute to look at what you’re taking and ensure you aren’t overdoing it. Maybe you need far less. Or perhaps, as you’ll see below, you should skip it entirely!
Let’s dig in to the potential health issues.
What are the potential side effects?
I know, you’re a big guy, the amount on the label can’t be enough, right? You’ve been training so hard, what’s the big deal about taking something for over 10 days?
These are super common ideas and beliefs, which get us in to trouble! There can in fact be pretty serious liver problems and gastrointestinal side effects from frequent or heavy use of acetaminophen.
Liver Damage
Though total instances are rare in the context of the ingredient’s widespread use, acetaminophen overdose is the most common cause of acute liver failure in the United States, partly because it’s found in so many products. Runners exacerbate the issue when taking it prior to workouts because the toxicity is amplified as your push your body.
And don’t think you’re good to go after the race!! The combo of acetaminophen and alcohol amplifies the effects even more. If you’ll be enjoying the beer tent, you may want to consider holding off on the meds.
While that’s the major reason to avoid overdoing it with acetaminophen, we need to talk about all the NSAIDs you might be turning to for pain relief as well.
Think: Advil®, Aleve®, generic ibuprofen or aspirin. Treating symptoms when you have them is fine, but here’s what you might be doing if you accidentally take too much or take it before runs!
Runners Trots
Feel like you’re consistently struggling with this issue? It could be related to the medicines you’re taking. NSAIDs can block an enzyme called cyclooxygenase, which protect the stomach lining from digestive acids.
Without that enzyme, as you push your body through a race you might experience nausea, diarrhea, intestinal bleeding, and cramps.
Hyponatremia
It’s often thought of as over hydration, but it’s even more closely related to having flushed your body of all electrolytes, which is easier to do while sweating through say a long run. It’s easy enough to do this on any hot day when you’re dutifully drinking your water, but pain relievers block prostaglandins, which decreases blood flow to the kidney!
Whatever gains you think you’re making by taking something to avoid pain prior to a run might only be setting you up for a much larger problem.
Are you preventing gains from your workouts and damaging your body by running and taking over-the-counter pain relievers? Click To TweetInflammation is Good for Gains
Another often overlooked issue for runners is that constantly quelling inflammation might be hindering your progress, which is what NSAIDs are designed to do.
Inflammation isn’t entirely bad!
Immediately after a workout is the worst time to take anything for pain relief. In that moment, the inflammation is doing its job: helping your body to repair from the micro-trauma to become stronger, fitter, better able to handle that same workout the next time you attempt it.
If you don’t let your body work through this process, you’re actually mitigating your gains!
Of course, if you have an actual injury or are in the midst of the dreaded winter cold or flu symptoms, acetaminophen and NSAIDS can be WONDERFUL tools. But, just because they’re over-the-counter doesn’t mean you can ignore that they are still drugs.
Read your labels, know how they’re impacting your body, and don’t take them “just in case.”
If you’re in so much pain after most runs that you feel you need to take something, that’s a sign you need to build a better base and back off your workout intensity for a while.
Do you read your labels?
Did you know all of this about acetaminophen and NSAIDs?
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This post is sponsored by Know Your Dose.
Lex @ Flecks of Lex says
This is super helpful information! Thanks for writing this post.
Jenn says
Interesting information. I would bet that most people don’t think about these things when popping a few pills. So important to pay attention to these things!
Maria says
This is such a helpful post for avid runners! Knowing what your body can handle is so important.
Kelsey says
While I appreciate the message of this post and wholeheartedly agree that it’s incredibly important for people to know accurate dosing information and potential side effects for OTC painkilelrs, this post leaves a lot to be desired. There are multiple instances of misinformation and misleading statements. I would highly recommend having professional input on future posts like this from someone educated in the subject — PharmD, MD, PA, NP, etc. In addition, as someone who is not a medical professional, you really should add a disclaimer to this post saying that. Readers should only follow advice regarding medications, even OTC medications, from their own doctor or provider. This post is very disappointing.
amanda says
I appreciate the feedback. I actually did this in conjunction with Know Your Dose. I provided their information which was government and doctor approved, along with verified studies of information. I do point out dosing should follow the label.
Alisa Fleming says
This is very interesting. I remember in high school, after soccer tournaments I would be so insanely sore, and I couldn’t figure out why I was always this way since several of the other girls on my team seemed to be pretty okay. I found out later that they were all popping pain relievers – and a lot of them! At that age, I really didn’t even know pain relievers were a thing. I’ve avoided them most of my life, but sometimes you need one!
Lorie says
Ok, love the tip about not taking pain deliver right after a workout or training. Not something I knew was a bad thing!