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Tylenol And Glutathione: Does The Pain Reliever Deplete This Important Antioxidant?

Mar 23, 2023
Tylenol And Glutathione: Does The Pain Reliever Deplete This Important Antioxidant?

Glutathione is an antioxidant that protects body cells from oxidative stress and damage. Tylenol is the brand name for acetaminophen, an over-the-counter fever reducer and pain reliever used by over 60 million people each week.

Acetaminophen (Tylenol), also known as paracetamol, toxicity is the number one cause of hospital admissions for liver failure in the United States, according to Dr. David D. Moore, professor of molecular and cell biology at Baylor College of Medicine. Acetaminophen is found in over 600 different over-the-counter and prescription medications. Acetaminophen overdose is the leading cause for calls to Poison Control Centers and accounts for more than 56,000 emergency room visits and 2,600 hospitalizations. According to the U.S. Centers for Disease Control and Prevention, acetaminophen poisoning is responsible for about 300 deaths annually in the United States.1

Do Tylenol And Ibuprofen Deplete Glutathione?

When a person takes acetaminophen, the liver produces small amounts of a potentially harmful compound called NAPQI (N-acetyl-p-benzoquinone imine). As long as you have healthy amounts of glutathione in your liver, NAPQ1 will be neutralized.

In one study, researchers found that acetaminophen decreased glutathione levels in the body.2

Tylenol And Glutathione: Does The Pain Reliever Deplete This Important Antioxidant?

How Does Tylenol Cause Liver Damage?

When taken according to dosage guidelines, Tylenol is metabolized in the liver through sulfation and glucuronidation. A small percentage of your Tylenol dose is directly excreted in your urine. The cytochrome P-450 system oxidizes another small percentage into NAPQ1. NAPQ1 is detoxified by glutathione in your liver into a nontoxic acetaminophen-mercapturic compound, which is excreted in your urine.

If you take too much Tylenol or do not have enough glutathione in your liver, NAPQ1 builds up and damages liver cells, leading to liver failure.

A person holding his upper right side

What Are The Stages Of Tylenol Toxicity?

Tylenol toxicity has traditionally been divided into four stages.3

Stage 1

Stage one is characterized by nausea, vomiting, nonspecific right upper abdominal pain, and other nonspecific symptoms. These symptoms begin within a few minutes to hours after Tylenol consumption.

Stage 2

On days two to three, initial symptoms will begin to decrease, and liver symptoms may increase, including upper abdominal pain and increased liver enzymes, indicating liver cell damage.

Stage 3

By days three to four, peak liver injury occurs. Severe liver injury affects other body organs because toxins are not neutralized and excreted.

Symptoms include:

  • Brain dysfunction (encephalopathy)
  • Yellow color to eyes and skin (jaundice)
  • Inability to clot blood (coagulopathy)
  • Too much acid in the blood (metabolic acidosis)
  • Low blood glucose (hypoglycemia)

Stage 4

People who survive stage 3 will begin to recover.

How Do You Treat Tylenol Toxicity?

Acetaminophen (toxicity) is treated with N-acetylcysteine (NAC). NAC is a glutathione precursor that augments acetaminophen sulfation in the liver and restores glutathione stores. NAC scavenges free radicals, increases oxygen delivery to the liver, and has antioxidant effects. If you are treated within 8 hours of taking an excessive amount of Tylenol, your liver will be protected from hepatotoxicity (liver poisoning), though some people will develop acute liver failure.

antioxidants in food

How Do You Replenish Glutathione?

To protect your liver, stay within the dosage recommendations for Tylenol. Studies suggest that pain relief is not increased by taking larger doses.

If you take Tylenol and are concerned about your liver’s health, talk to your doctor about supplementing with glutathione. People low in glutathione seem to be more prone to acetaminophen toxicity. Glutathione is found in fruits and vegetables, and meats. Glutathione supplements also come in multiple forms, including nasal sprays, troches, injections, and rapidly dissolving tablets.

Do you have questions about glutathione and how it may benefit your health and protect your liver? Contact the treatment specialists at Invigor Medical to learn more about this product and others that can improve your overall health.

Looking to purchase and get a Glutathione prescription? Shop Invigor Medical today!

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

Tylenol And Glutathione: Does The Pain Reliever Deplete This Important Antioxidant?

Leann Poston, M.D.

Dr. Leann Poston is a licensed physician in the state of Ohio who holds an M.B.A. and an M. Ed. She is a full-time medical communications writer and educator who writes and researches for Invigor Medical. Dr. Poston lives in the Midwest with her family. She enjoys traveling and hiking. She is an avid technology aficionado and loves trying new things.


  • Dimova S, Hoet PH, Dinsdale D, Nemery B. Acetaminophen decreases intracellular glutathione levels and modulates cytokine production in human alveolar macrophages and type II pneumocytes in vitro. Int J Biochem Cell Biol. 2005 Aug;37(8):1727-37. doi: 10.1016/j.biocel.2005.03.005. Epub 2005 Apr 26. PMID: 15878691.
  • Lee WM. Acetaminophen and the U.S. Acute Liver Failure Study Group: lowering the risks of hepatic failure. Hepatology. 2004 Jul;40(1):6-9. doi: 10.1002/hep.20293. PMID: 15239078.
  • Fisher ES, Curry SC. Evaluation and treatment of acetaminophen toxicity. Adv Pharmacol. 2019;85:263-272. doi: 10.1016/bs.apha.2018.12.004. Epub 2019 Jan 22. PMID: 31307590.
  • McGill MR, Hinson JA. The development and hepatotoxicity of acetaminophen: reviewing over a century of progress. Drug Metab Rev. 2020 Nov;52(4):472-500. doi: 10.1080/03602532.2020.1832112. Epub 2020 Oct 14. PMID: 33103516; PMCID: PMC8427730.


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