this post was submitted on 06 Jun 2024
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I often take painkillers (acetaminophen aka paracetamol), but I've noticed that it's much more effective if I take them TOGETHER with my ADHD medication (ritalin aka methylphenidate) + my morning coffee. If I don't take them AT the same time, the painkiller is far less effective.

I do not exceed the maximum dosage of painkiller (1gram per intake, mornings), but alone this would barely suffice to kill my morning headache.

My hypothesis is that since the LIVER has to convert all three, I am effectively overdosing on either substance (painkiller or ADHD meds), and damaging my liver in the process.

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[–] [email protected] 90 points 5 months ago (2 children)

Talk to your doctor, do not get medical advice from the internet, it is too risky.

[–] [email protected] 12 points 5 months ago

Counterpoint: Do more drugs the internet says so.

[–] [email protected] 3 points 5 months ago

Half a pack of cigarettes will make the headache go away. Make sure to sprinkle them with turmeric.

[–] [email protected] 63 points 5 months ago (1 children)

Wrong question, I would argue. If you have a morning headache, you should really find the root of that and try to resolve it making the medication unnecessary.

[–] [email protected] 10 points 5 months ago (10 children)

I know, but I've headaches since I was about 10 (now almost ~30), and the only causes for this that I can seriously come up with is: being sensitive af in general, which then leads to being (subconsciously) easily stressed, which then, results in headache. This happens during the day, but I also (more) frequently wake up with a headache for no reason. This even happens in the summer, when I'm not doing ANYthing (no school, university, work). I am generally perfectly healthy. I am hydrated, eat healthy, etc. I don't exercise an awful lot, but when I do (for months), I barely notice any difference.

Being "sensitive" (whatever that means exactly) is the only weird but plausible explanation. Reading the other comments, though, like sleep apnea, I'm curious if that's anything...

[–] [email protected] 26 points 5 months ago

If you have the option, I would suggest going to a Dr before assuming anything is the only plausible explanation.

Personally, I found out about my neck / posture issues (even though outwardly I have decent looking posture so I never assumed it would be that), got some excercises from a physio and a completely different pillow, and that combo drastically reduced my headaches

[–] [email protected] 9 points 5 months ago (1 children)

But did you talk about it with a medical trained person ? In the end its just a damaged nerve in your neck or sonething that can be easily fixed with proper care.

[–] [email protected] 7 points 5 months ago (2 children)

I did many times but most of the time I was just advised to "try eating and sleeping better" which I kind of already did, but improving those did not make a difference whatsoever. I also went to many physiotherapists and one manual orthopedic doctor. Nothing was ever improved.

Except one time when I went to a acupuncturist who also added some spiritual woo, and that actually remedied a part of it.

[–] [email protected] 8 points 5 months ago (6 children)

That combined with what you mentioned about cannabis triggering your headache sounds like the issue might be your trigeminal nerve (my guess mylohyoid) or similar nerve branch in the neck area. Sleeping likely causes it because there's constant pressure on it at night as you sleep.

An orthopedic pillow might help, something such as this for example: https://www.amazon.com/Osteo-Cervical-Odorless-Adjustable-Orthopedic/dp/B09964WTF5?th=1&psc=1

Alternative hypothesis would be it's blood pressure related, perhaps orthostatic hypotension or fluctuating hypertension - you can test this by getting a good blood pressure machine and checking in the morning before you get up from bed without moving much, immediately after sitting up, immediately after standing, and then stay standing still for 1 minute and take again.

Probably don't need the coffee by the way considering the medicine you take (Ritalin)

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[–] [email protected] 2 points 5 months ago

Find another doctor, and another one after that...

Unfortunately, most doctors SUCK, if you have even a slightly complicated or unusual problem.

[–] [email protected] 4 points 5 months ago

I have some chronic pain issues as well, some of which were solved and some are managed. I'm sorry you're going through this. Have you tried getting a second opinion or maybe a different type of medical provider? I had headaches as well that turned out to be largely brought on by stress and also some bad posture. I did get an MRI+MRA just to be sure nothing was actually wrong in the brain itself, but techniques to reduce the causes were helpful to me. Good luck!

[–] [email protected] 2 points 5 months ago (1 children)

Ok, follow up question. If you don't take a painkiller in the morning, how does the headache progress?

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[–] [email protected] 2 points 5 months ago (1 children)

Another hypothesis is bruxism (teeth grinding). Some people have it during the day, others (like me) have it during sleep. Stress and anxiety makes it worse. I only discovered I had it because people heard me biting my teeth against each other while asleep. I went to a dentist, she made me a mouth guard that I use every night before going to sleep, and the morning headaches stopped since then.

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[–] [email protected] 53 points 5 months ago (2 children)

Many countries have lowered the max dosage of Paracetamol from 1000mg since there's indeed a worry that it will cause liver damage. I'm in one of the countries that still go with 1000 (Sweden) and my suggestion would be to use 500mg Paracetamol and 400mg Ibuprofen taken together instead. That's what the medical professionals themselves do.

That said, something in your life is causing you to have morning headaches and it's a better idea to fix that. Regular painkiller usage is one of the things that causes it (!). Other possibilities can be waking up during the wrong sleep cycle (deep vs light), sleep apnea causing bad sleep in general, overdosing on caffeine causing withdrawal symptoms in the morning etc.

/Not a medical professional

[–] [email protected] 11 points 5 months ago (1 children)

It's shockingly easy to OD on acetaminophen. I don't think you are; i just think it's interesting how a few Tylenol plus a couple doses of cold medicine can be serious.

[–] [email protected] 18 points 5 months ago (2 children)

Also a fatal dose of acetaminophen/paracetamol is one of the worst ways to die. If you don’t get treatment within like, eight hours of taking it, you will slowly die of liver failure over the next few days and there’s nothing anyone can do about it. So you painfully waste away in the hospital.

Stories of people who attempted suicide by downing a whole bottle of Tylenol are horrific, because MANY people who attempt suicide regret it after the attempt (as is reported by people who survive attempts). This means that people who attempt suicide this way still die, slowly, painfully, regretting it but unable to do anything about it, over a few days. Having to face their loved ones, knowing how hurt those loved ones are by the action. The idea terrifies me.

Note, I am not a doctor, so take this with a grain of salt. But this is what I’ve read.

[–] [email protected] 5 points 5 months ago

Paramedic here who worked a lot with toxicology patients: You are entirely right.

It's always horrific.

[–] [email protected] 3 points 5 months ago

Yeah, that's what I've read, a day or two of feeling shitty, a day of feeling better and been dead.

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[–] [email protected] 35 points 5 months ago (1 children)

Long time headache adventurer here.

You are basically making a homemade Excedrin (acetaminophen + aspirin + caffeine). Stimulants cause your body to metabolize the pain reliever more quickly.

As for if you're ruining your liver, I can't say, other than you should probably go see you doctor and ask for a blood panel/ liver function test. Even if your liver values are normal, you'll know for sure, and have a baseline to compare future tests against. Plus your doctor may have some thoughts on why you're having a headache everyday.

For me it turned out that while i had acceptable blood pressure, it was high "for me", and a beta blocker took care of the most frequent headaches. But we didn't figure that out until we had ruled out a whole bunch of other things.

It was a frustrating journey to be sure. I wish you luck in yours.

[–] [email protected] 2 points 4 months ago

Perhaps you're hitting the nail on the head. My blood pressure is apparently normal (at least during the day). But perhaps it is indeed too high for me. It feels plausible but idk what that is worth. I'm going to ask my doctor to test this idea. Not sure yet which med for lowering blood pressure is good. I thought that Beta blockers were specifically for headache patients. Perhaps this is why... Also, apparently ACE inhibitors and ARBs are also blood pressure lowering agents. Any experience with those...?

[–] [email protected] 27 points 5 months ago (1 children)

Two things:

  1. Generally when you take medicine with high acidity food, like coffee, it will break down your medicine prematurely - you won't get as strong as an effect. I had to stop taking my Vyvanse with orange juice because it basically nullified the medicine.

  2. Talk to your doctor. I had chronic headaches that I found out were related to low blood pressure and dehydration. Drinking water instead of diuretics, like coffee, immensely helped me.

[–] [email protected] 5 points 5 months ago

Fuckkkkkkkkkkkkkkkkkkkk........... Point 1....no wonder.....

[–] [email protected] 14 points 5 months ago (2 children)

Why do you have morning headaches? That's not supposed to be a thing. Sleep apnea? Dehydrated? Other valid medical reasons? Sorry I can't answer you initial question, but it seems easier to treat the underlying cause (yeah I've watched house 8) )

I got diagnosed with sleep apnea couple of years ago and everybody asked me if I had headaches in the morning. It's easy to test for.

[–] [email protected] 5 points 5 months ago

Probably a lupus. (Would suck it turned out to be the case xD)

[–] [email protected] 4 points 5 months ago (1 children)

Sleep apnea very sounds interesting, I haven't thought about that. Perhaps worth testing for, thanks for the suggestion. I do not have any other medical issues, nor can it be any withdrawal symptom since I did not take any other medication before my adhd or coffee habit. So did you have headaches in the morning? Is that solved now?

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[–] [email protected] 13 points 5 months ago (2 children)

It's best to talk to a doctor instead of asking random people on the Internet.

But since you asked, weed helps to mitigate headaches better than paracetamol and doesn't affect your liver.

[–] [email protected] 13 points 5 months ago (2 children)
[–] [email protected] 6 points 5 months ago (1 children)

Well, there's your problem, then.

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[–] [email protected] 3 points 5 months ago (1 children)

Another thing to talk to your doctor about.

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[–] [email protected] 13 points 5 months ago (1 children)

Here's a question for you: Do you regularly drink anything that doesn't have caffeine or alcohol in it, at all?

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[–] [email protected] 11 points 5 months ago (3 children)

This thread sounds like a stackoverflow stereotype "How do I do X?... You shouldn't do X, you should do Y" except that the people in this thread are actually giving good advice (to find the root cause).

[–] [email protected] 4 points 5 months ago

Definitely can see this. Seeing a good family practice doctor or GP would be my advice, this kind of thing is their bread and butter. Sounds like there's a few potential issues.

[–] [email protected] 4 points 5 months ago

Most of those Stackoverflow answers telling you you're going at your problem the wrong way are correct, too.

[–] [email protected] 4 points 5 months ago

Honestly, the only good advice is to consult a doctor.

[–] [email protected] 9 points 5 months ago* (last edited 5 months ago) (1 children)

Talk do your doctor.

a) Paracetamol on it's own isn't healty for your liver if taken regularly. I don't know the specifics or if there is a safe dose.

b) Headache is one of the adverse drug effects of Paracetamol. Maybe you're getting part of your headaches from it in the first place.

[–] [email protected] 7 points 5 months ago (1 children)

I asked the doctor that prescribed the adhd meds, but he said it's no problem with paracetamol. However, I did not explicitly mention taking it at the exact same time. If I take them 5 minutes apart, the painkiller is already far less effective. All taken on an empty stomach.

Not taking paracetamol for many months did not lessen the headache whatsoever.

[–] [email protected] 6 points 5 months ago* (last edited 5 months ago)

Ah, alright. Yeah interaction of medication is a complicated thing. I'd advise you to ask your specific questions to a doctor. Is it okay to take them at the same time, is it okay on an empty stomach, is it okay for my liver to take that dose of paracetamol x-times in a month... Maybe they suggest an alternative to Paracetamol that works better and has less side-effects, thus being more appropriate for you, individually. And I think doctors have access to databases and general recommendations concerning drugs and reciprocity and (case) studies. They're probably more qualified to make a judgement and know about possible superior alternatives. (If there are any.)

They can also just test your blood and see if your liver is fine with what it's been subjected to.

Yeah, I'd say abstaining from the medication for months and still having the same headaches pretty much rules out it being the cause of that.

I hope you'll be granted an appropriate solution to your problem. Living with regular pain... isn't nice.

[–] [email protected] 8 points 5 months ago (1 children)

Btw, we're all gonna want an update if you figure it out. I'm invested now

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[–] [email protected] 8 points 5 months ago (1 children)

How come you have a headache every morning ? Sounds pretty worrying to me.

[–] [email protected] 2 points 5 months ago (3 children)

good question, I wish I knew... I am perfectly healthy as far as I can tell. Have had it since I was 10. Perhaps stress that I am incapable of getting rid of, even if don't have ANY obligation. It's like its an inherent part of me, never letting go of me...

[–] [email protected] 2 points 5 months ago* (last edited 5 months ago)

There is a plethora of causes for "headache", but you could maybe figure it out based on where and how it hurts. Get it checked.

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[–] [email protected] 6 points 5 months ago

Every morning headaches can be a sign of sleep apnea. Not saying you have it. Go to a doctor.

[–] [email protected] 6 points 5 months ago

Seriously talk it over with the doc that prescribed you the ADHD meds. 1 gram of ace is a lot!

Be clear about what you're doing and when.

In my personal experience that may differ from your own. The morning headache could simply be dehydration or minor withdrawal from the meds.

Generally speaking taking a 2 week break from the pain medication and caffeine may clear up your symptoms. But this is not professional advice, I'm not a medical professional. You should ask a doctor about this suggestion or any other remedies the good people of Lemmy suggest.

My doctor recommended strongly against having caffeine with the ADHD medications and could potentially indicate that your dosage needs adjusted. It's bad for your heart and eyeballs.

If you read the long piece of paper that comes with those medications there is a warning about not consuming them at the same time as other medications. There's a bunch of good reasons for this disclaimer.

[–] [email protected] 5 points 5 months ago (1 children)

They are not great for your liver. Especially long-term consistent use. You should be taking periodic liver function tests.

[–] [email protected] 5 points 5 months ago (4 children)

You should be taking periodic liver function tests.

That's not a bad idea......... :(

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[–] [email protected] 2 points 5 months ago

You take Ritalin with coffee? I have to space my Ritalin out from my morning coffee by at least an hour, or else I get horrible headaches which can last hours.

[–] [email protected] 2 points 5 months ago* (last edited 5 months ago)

Acetaminophen and caffeine are often included together in "extra strength" pain relievers as the caffeine enhances the effects of the acetaminophen. That part at least is perfectly fine. Half ibuprofen half acetaminophen plus caffeine works even better.

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