| Chemistry
People metabolize APAP differently, it seems.
Normally, the liver turns the APAP and its metabolites into harmless chemicals that are excreted from the body. However, if the liver is overwhelmed, a toxic chemical is produced (abbreviated NAPQI), which kills liver cells.
Much of the liver's ability to metabolize APA depends upon the store of a chemical called L-glutatione, which binds to the toxic NAPQI so that the body can get rid of it. Alcohol competes for the same L-glutatione; that's why it is especially dangerous to drink while taking APAP.
Other things affect the store of L-glutatione, such as fasting, which depletes it.
N-acetyl-cysteine (NAC) is the antidote that emergency rooms administer for acute APAP overdose. If administered quickly after ingestion, the prospects are good. The NAC works by increasing the bioavailabilty of the L-glutatione.
Some people who take APAP regularly also take NAC supplements, which are available over the counter, to lessen the toxicity of the APAP. Milk thistle is also touted by some as a good supplement for liver detox.
Symptoms of liver malfunction may include: yellowish skin and sclera (whites of the eyes); light-colored, loose stools w/ dark-colored urine; fatigue; nausea; pain in the upper right abdominal quadrant; skin rashes & itching, etc.
If you are experiencing any of those symptoms (and I inferred from your post that you are) it is essential to visit a doctor who can do a liver panel to check for proper liver function. They will likely draw a small amount of blood and maybe urine.
There are other causes of these symptoms in addition to chronic or acute APAP ingestion, such as pancreatic or gall bladder problems; hepatitis; drug reactions and interactions, etc.
It is important to rule out anything of concern. Don't delay a visit to your MD to allay your concerns.
Best regards,
Buzz
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