8 ms·

> But if acetaminophen is safer, then why don’t official sources tell you that? Guess it depends on country. Here in Norway official sources[1][2] do say aceta

> But if acetaminophen is safer, then why don’t official sources tell you that? Guess it depends on country. Here in Norway official sources[1][2] do say acetaminophen (paracetamol here) should be the default for treating fever and pain in kids, adults, pregnant women and elderly, and have for some time. Ibuprofen they say should be used with caution. [1]: https://www.dmp.no/nyheter/behov-for-smertestillende-slik-velger-du-riktig https://www.dmp.no/nyheter/behov-for-smertestillende-slik-ve... [2]: https://nhi.no/for-helsepersonell/nytt-om-legemidler/arkiv-2022/paracetamol-nye-doseringsanbefalinger https://nhi.no/for-helsepersonell/nytt-om-legemidler/arkiv-2...

socalgal2 6mo ago
Here in my body, it tells me acetaminophen does absolutely nothing for pain where as ibuprofen does. I wouldn't take ibuprofen for fever
- bluGill 6mo ago
  I once got it to make a small difference for pain - but I was in the hospital (surgery recovery) where the doctors were giving me more than the daily maximum.
- criddell 6mo ago
  This might sound like woo, but sometimes I'll find a quiet place and just sit there and focus on the pain. I try to really understand the sensation that's being registered as pain by trying to notice all the properties of it (is it throbbing, burning, etc...). Occasionally I'll find that the more I try to identify specific features of the sensation, the harder it gets to do so and the pain sensation fades away.
  - vjvjvjvjghv 6mo ago
    I do that too. But at least if you are a meditator on my level, there are limits. I sometimes get migraines and focusing on the pain while you are shivering, sweating and close to throwing up at the same time just doesn’t work for me.
schnitzelstoat 6mo ago
It’s the same in the UK - paracetamol is the default. Ibuprofen is better for reducing swelling, inflammation etc.
- rustyhancock 6mo ago
  Ibuprofen is better are reducing fever and managing headaches. Paracetamol is the safer version Phenacetin. You used to be able to buy aspirin, phenacetin and caffeine..but phenacetin with withdrawn. APC when it was marketed was very popular but soon you were told to never give children aspirin for a fever so we used Paracetamol. Then Phenacetin was withdrawn and paracetamol became part of APC (like Alka selzta XS , or just the popular caffeine paracetamol combos) Paracetamol came in as safer but similar, yet no where near effective. It captured bith the market feeling of its pros and cons. So we interpreted it as safer than alternatives (especially aspirin for children due to Reye syndrome). But also dangerous which might be why OPs view was that ibuprofen is safer. The NNT (number of people you'd need to take it) to be headache free after 2 hours is about 12-20 for paracetamol. But only 7-10 for ibuprofen. It's quite surprising that paracetamol became the defacto analgesic given it performs so poorly but it was historical inertia. And plenty of people argue that if we were to start over we would not make paracetamol OTC.
  - sixeyes 6mo ago
    Wiki for phenacetin says it's mechanism of action is being metabolized into paracetamol. IDK about your "nowhere as effective". It was withdrawn for sometimes being metabolized into another, toxic and carcenogenic, molecule.
    - rustyhancock 6mo ago
      Here is a summary of COCHRANE evidence on Paracetamol "widely used and ineffective"[0]. It's a paradox no? Paracetamol is only the presumed only active metabolite, and that is why paracetamol rapidly replaced phenacetin. There is a quirk though, phenacetin actually delivers paracetamol to your brain and spine (where it primarily reduces pain) faster than an oral dose of paracetamol. Similarly IV paracetamol is far more effective that oral paracetamol. Phenacetin was also considered mildly addictive, and induced a gentle euphoria and then sedation.(We still see sedation after paracetamol in children and the elderly). But general use we don't see these effects in paracetamol, why did phenacetin do this more effectively? Probably the higher peak levels around nerve endings. These effects are both wanting of an explanation of phenacetin is just paracetamol and directly analegisic. [0] https://web.archive.org/web/20240721144157/http://www.evidentlycochrane.net/paracetamol-widely-used-ineffective/ https://web.archive.org/web/20240721144157/http://www.eviden...
watwut 6mo ago
The only issue with treating pain with paracetamol is that it does not work at all against the pain. It works against fewer or maybe mild inflammation and what not ... but it does absolutely nothing with actual pain. It is placebo at best.
- sitharus 6mo ago
  > but it does absolutely nothing with actual pain Neither paracetamol nor ibuprofen work by blocking pain. Depending on the type of pain and your physiology it can range from really effective to not at all. I only take paracetamol, it works better than both ibuprofen and opioids for me. I know other people who have the exact opposite experience. There’s no absolute here.
  - omnimus 6mo ago
    Yeah paracetamol does absolutely nothing to me with pain. I thought its mainly fever medicine.
    - cassianoleal 6mo ago
      Same here. Paracetamol also gives me pretty strong stomach aches whereas ibuprofen rarely has a gastric effect and when it does it's mild at best. I've been told by many people that the opposite should be true but oh well. I wish they dipyrone was sold here, but alas I can only get it when I travel abroad.
      - sitharus 6mo ago
        With medicine both can be true, the response depends on so many factors in your body. Same way that for some people, particularly those with ADHD, taking stimulants can make them sleepy.
  - tpm 6mo ago
    Yeah, for me paracetamol is worse in everything - fever, pain, etc. For mild stuff I use ibuprofen, if it gets worse, diclofenac works every time.
iamniels 6mo ago
In Western Europe too. > but it does absolutely nothing with actual pain. It is placebo at best. This is simply false.
- shlant 6mo ago
  you responded to the wrong comment. I assume this want mean for https://news.ycombinator.com/item?id=47860061 https://news.ycombinator.com/item?id=47860061
- watwut 6mo ago
  It is not false. It does nothing. Head hurts, you take paracetamol ... head still hurts. The belly hurts, you take paracetamol ... nothing change. When I took ibuprofen it did actually made an actual real change.
  - franga2000 6mo ago
    "I took it and it didn't work so it's a fake placebo drug" - wow, your scientific method is flawless, have you considered a career at the US Department of Health?
    - chintler 6mo ago
      Guideline #1 for comments- Be kind. Don't be snarky. Converse curiously; don't cross-examine. Edit out swipes.
    - maleldil 6mo ago
      That might be a good fit considering who's in charge today.
  - throw1234567891 6mo ago
    Maybe you had an inflammation-induced pain. That would explain why ibuprofen helped, and paracetamol did not.
  - rustyhancock 6mo ago
    You're partially right compared to placebo only about 5% of people are painfree over the effect of a placebo when taking paracetamol. Paracetamol got it's start as replacing the more effective but much more dangerous and withdrawn drug Phenacetin. Why don't people notice that it's such a small benefit over nothing? Well because placebo effect is quite good for pain and pain is usually transitory anywhere..if you have a tension headache you're probably going to aim to relax. Turn away from the screen or even have some caffeine and those are more effective than paracetamol!
gregoryyy 6mo ago
Yup - in the UK, paracetamol is usually recommended for general pain relief before Ibuprofen. Additionally, Ibuprofen and NSAIDs have a lot of interactions which can make them unsafe - SSRIs or blood thinners for example.
- lloydatkinson 6mo ago
  Where does Aspirin fit into this? I only use paracetemol and ibuprofen. The one time I tried asprin I got a stomach pain.
  - mrcrm9494 6mo ago
    aspirin is an NSAID, taking it modifies the prostaglandine levels (through its COX inhibition) and this influences the mucosa of your stomach. ibuprofen can still have the same side effects, because its belonging to the same class of drugs.
- mghackerlady 6mo ago
  Ibuprofen interacts with SSRIs? Anecdotally I've never had any problems with my Escitalopram and the Wikipedia page doesn't mention any interactions
  - magicalhippo 6mo ago
    The Norwegian pages I linked to states you should be careful with Ibuprofen and anti-depressants. I did a quick search and these[1][2] articles came up, suggesting increased risk of brain hemorrhaging and 10x increased gastrointestinal adverse effects due to the combination. [1]: https://www.cam.ac.uk/research/discussion/antidepressants-and-pain-killers-should-we-be-worried https://www.cam.ac.uk/research/discussion/antidepressants-an... [2]: https://pmc.ncbi.nlm.nih.gov/articles/PMC1884970/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1884970/
oulipo2 6mo ago
Same in France
apatheticonion 6mo ago
Really? I get headaches semi-frequently and my first line of defense is ibuprofen, I use acetaminophen sporadically as a last resort
- dncornholio 6mo ago
  Why? Does ibuprofen work better? It's bad for your stomach walls.
  - SkyeCA 6mo ago
    > Does ibuprofen work better? In my experience it works far better at managing headaches/migraines.
  - pixl97 6mo ago
    There seems to be some percentage of people that acetaminophen seems to do very little for. Ibuprofen has a much more pronounced effect, to the point that I take it at half it's recommended dosage.
  - amalcon 6mo ago
    For inflammatory pain (most headaches, most pain from injuries), ibuprofen absolutely works better. For migraines, neither works at all on its own -- though ibuprofen plus caffeine (I generally drink tea) does a little. For overexertion aches and cramps, or fevers, I think either is generally fine.
    - SirMaster 6mo ago
      >For inflammatory pain (most headaches, most pain from injuries), ibuprofen absolutely works better. Unfortunately, for me ibuprofen doesn't seme to help at all with any of these. Like I understand that my pain are often inflammatory based, and i try ibuprofen, but the pain doesn't dull at all even if I take 800mg etc... I take 1000mg acetaminophen and boom my pain is vastly reduced...
- sfn42 6mo ago
  I take both. 500-1000mg acetaminophen, 200-400mg ibuprofen. Usually helps for headaches which I get frequently. I only take them for the worst headaches though, so probably once every couple of weeks on average.
jcul 6mo ago
In Ireland you can buy acetaminophen in stores, gas stations etc. For ibuprofen you need to go to a pharmacy.
- lazzurs 6mo ago
  I couldn't get over this after moving here from the UK where you can pick up a pack for 10p in a supermarket.
  - jcul 6mo ago
    Yeah, I lived in the UK before and it's a bit mad. You can't buy antihistamines either, only in pharmacies and they are quite expensive. I remember you could get them in Tesco or Asda for like £2.
- domh 6mo ago
  That is interesting. In the UK they're both available pretty much everywhere, and they're some of the cheapest drug prices I've seen anywhere in the world... ~20p for 16 tablets or something.
  - jcul 6mo ago
    I would say 16 tablets would be closer to 6, or even 8 euro here.
vanderZwan 6mo ago
I feel like this is one of those things where Europe and the US are very different, culturally speaking - I've lived in the Netherlands, Germany and now Sweden, and the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it only hurts when I lean on it. Because it's healing. So I don't. Why would headaches or other "inconvenient" pains be different? In my case headaches are usually caused by sleep deprivation causing high sensitivity to external stimuli, muscle tension, dehydration, or some combination of that. So I'll first try to take a nap and/or stick to low-stimuli environments, have a good stretch and/or heated up massage pillow for the neck, and make a quick home-made oral rehydration solution with some salt and sugar. That usually alleviates most if not all of the pain. And I'm not saying painkillers should always be avoided. If I have insomnia-induced headaches in the morning and a long day ahead with many social interactions, then I know that headaches will make me a grumpy asshole, so I'll obviously will take a painkiller for everyone's sake. And sometimes I can only fall asleep if I take a painkiller to get rid of the headache first, so I need it to break the vicious cycle. I'm not saying people should "walk it off" here, just to focus on trying to figure out the actual cause first before medicating the symptom way. That's also healthier in the long run, no?
- vanderZwan 6mo ago
  > That's also healthier in the long run, no? Long-winding tangential anecdote (which is why I'm replying to myself in a separate comment), but I have pretty extreme example of this: I managed to avoid nearly all suffering after getting a tonsillectomy in my mid-thirties, while using almost no painkillers. My ENT surgeons warned that me "I'd hate him for about a month, then I'd love him for never having to deal with [serious medical condition that justified the removal of tonsils] again". He prescribed all kinds of stuff to alleviate the expected suffering, and advised me to try to take the weakest options I was comfortable with, because the heavier ones might have some unpleasant side effects. It's the only time in my life I've been prescribed painkillers at all, actually (this was in Sweden, btw). I got codeine/paracetamol as a coughing suppressor and mild painkiller, a couple of heavier painkillers for if it got worse (I forgot the name but some kind of heavy-duty variation of diclophenac that you can only get with a prescription), and some kind of nasty solution to gargle with that supposedly would numb my throat if it got really bad. I've been told this is nothing compared to what you can expect in the US. Then in the evening after the surgery, when I was trying to eat a soup with my mom, I realized soup didn't hurt as much as drinking plain tap water. And then I thought: isn't it odd that drinking plain water feels like a thousand paper-cuts in the open wound in my throat, but whenever the coughing made the wounds open and bleed, the blood doesn't hurt at all? Blood is mostly water, so what is the difference? Could it be the salt? Is this similar to why drinking demineralized water is bad for you? What's the opposite of demineralized water? Oral rehydration solution. Ok, trivial to make, let's try that. I'll drink it luke-warm to be close to body temperature too. Turns out that that works. Oral rehydration solution is almost painless to drink after a tonsillectomy. I know this is anecdata, but sample size three: I've since shared this information with two friends who got a tonsillectomy, and they've been extremely grateful for this tip. It even seemed to speed up my recovery, probably due to a lack of irritation triggering inflammation. I was eating solid food within days. DAYS. My mom, a retired family physician herself, couldn't believe her eyes. I ended up only needing the codeine/paracemtal in the evening to suppress coughing in my sleep, and brought back all the other pain-killers without opening them.
deleted 6mo ago
[deleted]
smcleod 6mo ago
They do in NZ. Paracetamol is promoted as the safest, most well studied pain relief for short and chronic conditions. In Australia however they have just started limiting how many you can buy at a time for some reason while ibuprofen covers the chemist shelves without any such controls despite the risks.
- ikr678 6mo ago
  IIRC it's because Paracetamol has low threshold for overdose, and is often blended in with other cold and flu medicines in Aus so it is easy to exceed daily dose if you are say, taking some conbination of paracetamol + Sudafed (paracetamol+decongestant) + drinking a Lemsip (lemony vitamin powder with more paracetamol). It is only packet size restricted in supermarkets, you can still buy bulk packs from chemists.
  - smcleod 6mo ago
    Chemist warehouse has big signs up saying you'll be limited to buying a pack of 24 in Melbourne.
acidtechno303 6mo ago
perhaps it's got to do with packaging sizes. i think an acetominophen od is much worse. most of these countries regulate package size for these drugs, yes? US does not
ubercore 6mo ago
American in Norway, it's always amusing when I buy some Ibux at the pharmacy, and get questioned about it and steered towards Paracet instead.

socalgal2 6mo ago

Here in my body, it tells me acetaminophen does absolutely nothing for pain where as ibuprofen does. I wouldn't take ibuprofen for fever

bluGill 6mo ago
I once got it to make a small difference for pain - but I was in the hospital (surgery recovery) where the doctors were giving me more than the daily maximum.
criddell 6mo ago
This might sound like woo, but sometimes I'll find a quiet place and just sit there and focus on the pain. I try to really understand the sensation that's being registered as pain by trying to notice all the properties of it (is it throbbing, burning, etc...). Occasionally I'll find that the more I try to identify specific features of the sensation, the harder it gets to do so and the pain sensation fades away.
- vjvjvjvjghv 6mo ago
  I do that too. But at least if you are a meditator on my level, there are limits. I sometimes get migraines and focusing on the pain while you are shivering, sweating and close to throwing up at the same time just doesn’t work for me.

schnitzelstoat 6mo ago

It’s the same in the UK - paracetamol is the default. Ibuprofen is better for reducing swelling, inflammation etc.

rustyhancock 6mo ago
Ibuprofen is better are reducing fever and managing headaches. Paracetamol is the safer version Phenacetin. You used to be able to buy aspirin, phenacetin and caffeine..but phenacetin with withdrawn. APC when it was marketed was very popular but soon you were told to never give children aspirin for a fever so we used Paracetamol. Then Phenacetin was withdrawn and paracetamol became part of APC (like Alka selzta XS , or just the popular caffeine paracetamol combos) Paracetamol came in as safer but similar, yet no where near effective. It captured bith the market feeling of its pros and cons. So we interpreted it as safer than alternatives (especially aspirin for children due to Reye syndrome). But also dangerous which might be why OPs view was that ibuprofen is safer. The NNT (number of people you'd need to take it) to be headache free after 2 hours is about 12-20 for paracetamol. But only 7-10 for ibuprofen. It's quite surprising that paracetamol became the defacto analgesic given it performs so poorly but it was historical inertia. And plenty of people argue that if we were to start over we would not make paracetamol OTC.
- sixeyes 6mo ago
  Wiki for phenacetin says it's mechanism of action is being metabolized into paracetamol. IDK about your "nowhere as effective". It was withdrawn for sometimes being metabolized into another, toxic and carcenogenic, molecule.
  - rustyhancock 6mo ago
    Here is a summary of COCHRANE evidence on Paracetamol "widely used and ineffective"[0]. It's a paradox no? Paracetamol is only the presumed only active metabolite, and that is why paracetamol rapidly replaced phenacetin. There is a quirk though, phenacetin actually delivers paracetamol to your brain and spine (where it primarily reduces pain) faster than an oral dose of paracetamol. Similarly IV paracetamol is far more effective that oral paracetamol. Phenacetin was also considered mildly addictive, and induced a gentle euphoria and then sedation.(We still see sedation after paracetamol in children and the elderly). But general use we don't see these effects in paracetamol, why did phenacetin do this more effectively? Probably the higher peak levels around nerve endings. These effects are both wanting of an explanation of phenacetin is just paracetamol and directly analegisic. [0] https://web.archive.org/web/20240721144157/http://www.evidentlycochrane.net/paracetamol-widely-used-ineffective/ https://web.archive.org/web/20240721144157/http://www.eviden...

watwut 6mo ago

The only issue with treating pain with paracetamol is that it does not work at all against the pain. It works against fewer or maybe mild inflammation and what not ... but it does absolutely nothing with actual pain. It is placebo at best.

sitharus 6mo ago
> but it does absolutely nothing with actual pain Neither paracetamol nor ibuprofen work by blocking pain. Depending on the type of pain and your physiology it can range from really effective to not at all. I only take paracetamol, it works better than both ibuprofen and opioids for me. I know other people who have the exact opposite experience. There’s no absolute here.
- omnimus 6mo ago
  Yeah paracetamol does absolutely nothing to me with pain. I thought its mainly fever medicine.
  - cassianoleal 6mo ago
    Same here. Paracetamol also gives me pretty strong stomach aches whereas ibuprofen rarely has a gastric effect and when it does it's mild at best. I've been told by many people that the opposite should be true but oh well. I wish they dipyrone was sold here, but alas I can only get it when I travel abroad.
    - sitharus 6mo ago
      With medicine both can be true, the response depends on so many factors in your body. Same way that for some people, particularly those with ADHD, taking stimulants can make them sleepy.
- tpm 6mo ago
  Yeah, for me paracetamol is worse in everything - fever, pain, etc. For mild stuff I use ibuprofen, if it gets worse, diclofenac works every time.

iamniels 6mo ago

In Western Europe too. > but it does absolutely nothing with actual pain. It is placebo at best. This is simply false.

shlant 6mo ago
you responded to the wrong comment. I assume this want mean for https://news.ycombinator.com/item?id=47860061 https://news.ycombinator.com/item?id=47860061
watwut 6mo ago
It is not false. It does nothing. Head hurts, you take paracetamol ... head still hurts. The belly hurts, you take paracetamol ... nothing change. When I took ibuprofen it did actually made an actual real change.
- franga2000 6mo ago
  "I took it and it didn't work so it's a fake placebo drug" - wow, your scientific method is flawless, have you considered a career at the US Department of Health?
  - chintler 6mo ago
    Guideline #1 for comments- Be kind. Don't be snarky. Converse curiously; don't cross-examine. Edit out swipes.
  - maleldil 6mo ago
    That might be a good fit considering who's in charge today.
- throw1234567891 6mo ago
  Maybe you had an inflammation-induced pain. That would explain why ibuprofen helped, and paracetamol did not.
- rustyhancock 6mo ago
  You're partially right compared to placebo only about 5% of people are painfree over the effect of a placebo when taking paracetamol. Paracetamol got it's start as replacing the more effective but much more dangerous and withdrawn drug Phenacetin. Why don't people notice that it's such a small benefit over nothing? Well because placebo effect is quite good for pain and pain is usually transitory anywhere..if you have a tension headache you're probably going to aim to relax. Turn away from the screen or even have some caffeine and those are more effective than paracetamol!

gregoryyy 6mo ago

Yup - in the UK, paracetamol is usually recommended for general pain relief before Ibuprofen. Additionally, Ibuprofen and NSAIDs have a lot of interactions which can make them unsafe - SSRIs or blood thinners for example.

lloydatkinson 6mo ago
Where does Aspirin fit into this? I only use paracetemol and ibuprofen. The one time I tried asprin I got a stomach pain.
- mrcrm9494 6mo ago
  aspirin is an NSAID, taking it modifies the prostaglandine levels (through its COX inhibition) and this influences the mucosa of your stomach. ibuprofen can still have the same side effects, because its belonging to the same class of drugs.
mghackerlady 6mo ago
Ibuprofen interacts with SSRIs? Anecdotally I've never had any problems with my Escitalopram and the Wikipedia page doesn't mention any interactions
- magicalhippo 6mo ago
  The Norwegian pages I linked to states you should be careful with Ibuprofen and anti-depressants. I did a quick search and these[1][2] articles came up, suggesting increased risk of brain hemorrhaging and 10x increased gastrointestinal adverse effects due to the combination. [1]: https://www.cam.ac.uk/research/discussion/antidepressants-and-pain-killers-should-we-be-worried https://www.cam.ac.uk/research/discussion/antidepressants-an... [2]: https://pmc.ncbi.nlm.nih.gov/articles/PMC1884970/ https://pmc.ncbi.nlm.nih.gov/articles/PMC1884970/

oulipo2 6mo ago

Same in France

apatheticonion 6mo ago

Really? I get headaches semi-frequently and my first line of defense is ibuprofen, I use acetaminophen sporadically as a last resort

dncornholio 6mo ago
Why? Does ibuprofen work better? It's bad for your stomach walls.
- SkyeCA 6mo ago
  > Does ibuprofen work better? In my experience it works far better at managing headaches/migraines.
- pixl97 6mo ago
  There seems to be some percentage of people that acetaminophen seems to do very little for. Ibuprofen has a much more pronounced effect, to the point that I take it at half it's recommended dosage.
- amalcon 6mo ago
  For inflammatory pain (most headaches, most pain from injuries), ibuprofen absolutely works better. For migraines, neither works at all on its own -- though ibuprofen plus caffeine (I generally drink tea) does a little. For overexertion aches and cramps, or fevers, I think either is generally fine.
  - SirMaster 6mo ago
    >For inflammatory pain (most headaches, most pain from injuries), ibuprofen absolutely works better. Unfortunately, for me ibuprofen doesn't seme to help at all with any of these. Like I understand that my pain are often inflammatory based, and i try ibuprofen, but the pain doesn't dull at all even if I take 800mg etc... I take 1000mg acetaminophen and boom my pain is vastly reduced...
sfn42 6mo ago
I take both. 500-1000mg acetaminophen, 200-400mg ibuprofen. Usually helps for headaches which I get frequently. I only take them for the worst headaches though, so probably once every couple of weeks on average.

jcul 6mo ago

In Ireland you can buy acetaminophen in stores, gas stations etc. For ibuprofen you need to go to a pharmacy.

lazzurs 6mo ago
I couldn't get over this after moving here from the UK where you can pick up a pack for 10p in a supermarket.
- jcul 6mo ago
  Yeah, I lived in the UK before and it's a bit mad. You can't buy antihistamines either, only in pharmacies and they are quite expensive. I remember you could get them in Tesco or Asda for like £2.
domh 6mo ago
That is interesting. In the UK they're both available pretty much everywhere, and they're some of the cheapest drug prices I've seen anywhere in the world... ~20p for 16 tablets or something.
- jcul 6mo ago
  I would say 16 tablets would be closer to 6, or even 8 euro here.

vanderZwan 6mo ago

I feel like this is one of those things where Europe and the US are very different, culturally speaking - I've lived in the Netherlands, Germany and now Sweden, and the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it only hurts when I lean on it. Because it's healing. So I don't. Why would headaches or other "inconvenient" pains be different? In my case headaches are usually caused by sleep deprivation causing high sensitivity to external stimuli, muscle tension, dehydration, or some combination of that. So I'll first try to take a nap and/or stick to low-stimuli environments, have a good stretch and/or heated up massage pillow for the neck, and make a quick home-made oral rehydration solution with some salt and sugar. That usually alleviates most if not all of the pain. And I'm not saying painkillers should always be avoided. If I have insomnia-induced headaches in the morning and a long day ahead with many social interactions, then I know that headaches will make me a grumpy asshole, so I'll obviously will take a painkiller for everyone's sake. And sometimes I can only fall asleep if I take a painkiller to get rid of the headache first, so I need it to break the vicious cycle. I'm not saying people should "walk it off" here, just to focus on trying to figure out the actual cause first before medicating the symptom way. That's also healthier in the long run, no?

vanderZwan 6mo ago
> That's also healthier in the long run, no? Long-winding tangential anecdote (which is why I'm replying to myself in a separate comment), but I have pretty extreme example of this: I managed to avoid nearly all suffering after getting a tonsillectomy in my mid-thirties, while using almost no painkillers. My ENT surgeons warned that me "I'd hate him for about a month, then I'd love him for never having to deal with [serious medical condition that justified the removal of tonsils] again". He prescribed all kinds of stuff to alleviate the expected suffering, and advised me to try to take the weakest options I was comfortable with, because the heavier ones might have some unpleasant side effects. It's the only time in my life I've been prescribed painkillers at all, actually (this was in Sweden, btw). I got codeine/paracetamol as a coughing suppressor and mild painkiller, a couple of heavier painkillers for if it got worse (I forgot the name but some kind of heavy-duty variation of diclophenac that you can only get with a prescription), and some kind of nasty solution to gargle with that supposedly would numb my throat if it got really bad. I've been told this is nothing compared to what you can expect in the US. Then in the evening after the surgery, when I was trying to eat a soup with my mom, I realized soup didn't hurt as much as drinking plain tap water. And then I thought: isn't it odd that drinking plain water feels like a thousand paper-cuts in the open wound in my throat, but whenever the coughing made the wounds open and bleed, the blood doesn't hurt at all? Blood is mostly water, so what is the difference? Could it be the salt? Is this similar to why drinking demineralized water is bad for you? What's the opposite of demineralized water? Oral rehydration solution. Ok, trivial to make, let's try that. I'll drink it luke-warm to be close to body temperature too. Turns out that that works. Oral rehydration solution is almost painless to drink after a tonsillectomy. I know this is anecdata, but sample size three: I've since shared this information with two friends who got a tonsillectomy, and they've been extremely grateful for this tip. It even seemed to speed up my recovery, probably due to a lack of irritation triggering inflammation. I was eating solid food within days. DAYS. My mom, a retired family physician herself, couldn't believe her eyes. I ended up only needing the codeine/paracemtal in the evening to suppress coughing in my sleep, and brought back all the other pain-killers without opening them.

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smcleod 6mo ago

They do in NZ. Paracetamol is promoted as the safest, most well studied pain relief for short and chronic conditions. In Australia however they have just started limiting how many you can buy at a time for some reason while ibuprofen covers the chemist shelves without any such controls despite the risks.

ikr678 6mo ago
IIRC it's because Paracetamol has low threshold for overdose, and is often blended in with other cold and flu medicines in Aus so it is easy to exceed daily dose if you are say, taking some conbination of paracetamol + Sudafed (paracetamol+decongestant) + drinking a Lemsip (lemony vitamin powder with more paracetamol). It is only packet size restricted in supermarkets, you can still buy bulk packs from chemists.
- smcleod 6mo ago
  Chemist warehouse has big signs up saying you'll be limited to buying a pack of 24 in Melbourne.

acidtechno303 6mo ago

perhaps it's got to do with packaging sizes. i think an acetominophen od is much worse. most of these countries regulate package size for these drugs, yes? US does not

ubercore 6mo ago

American in Norway, it's always amusing when I buy some Ibux at the pharmacy, and get questioned about it and steered towards Paracet instead.