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.
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.
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.
Here’s a question for you: Do you regularly drink anything that doesn’t have caffeine or alcohol in it, at all?
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.
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?
Probably a lupus. (Would suck it turned out to be the case xD)
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.
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…
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
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!
Ok, follow up question. If you don’t take a painkiller in the morning, how does the headache progress?
CBG can be really helpful for headaches. I use it for migraines and a lot of times i can wait until i get home to take prescription meds that make me feel weird. Lots of people use it as a preventative with about half the frequency/severity. Helps with migraine nausea too.
Migraines come during sleep like that, but if Paracetamol works no way is it a migraine. That stuff literally does nothing for any pain I’ve had, ever.
I agree with everyone here, this seems like a lifestyle thing - if your body is indeed sensitive to stress and relaxation, you are not doing it any favors with the paracetamol. Likely too stressed in day, too relaxed at night, the sudden change a trigger. Obviously you don’t want to fix that by being tense while asleep, so tackling the day stress responses make more sense. Do you exercise?
What happens if you just have either coffee or the Adderall in the morning, without the painkiller drug?
What happens if you just have either coffee or the Adderall in the morning, without the painkiller drug?
Not tested excessively, but quite sure it’s not relieving the headache whatsoever.
I do not exercise. Usually I cycle to uni about 40mins a day, 4 times a week. I’ve exercised more rigorously in the past, running each day, but the effect is not significant… So unfortunate. But exercise is quite wearisome
Have you seen a neurologist or headache specialist or only a GP? If there is a cause maybe it can be treated and you can find relief. I do get migraines, but not every day, not even every week. My other guess is allergies, but in any event, keep a good record of what you are doing and feeling, and bring the information to a doctor! I don’t think it’s wrong at all to post and ask though, you get more ideas and that will help.
Running doesn’t help me as much as a vigorous yoga class, the “flow” kind that is more athletic and movement based, then moves to static poses at the end. Or dancing, that works too. The cycling sounds like enough, honestly, anything that is regular and kind of exhausting, will relax your mind.
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.
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.
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.
Find another doctor, and another one after that…
Unfortunately, most doctors SUCK, if you have even a slightly complicated or unusual problem.
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)
Wow interesting! I’ll be saving for a pillow like this. I thought about measuring blood pressure in the morning, as well. But I doubt these things come cheap. I’m curious though how you linked cannabis is causing headache to, nerves in my neck area might be causing headaches. I’ve been cooking up a lot of potential (intermediate) causes, but nothing like this.
Trigeminal nerve pain can be triggered/worsened by an enlarged vein pushing against the nerve at just the right spot. Cannabis causes hypotension via vasodilation, hence the potential trigger.
The thing is, veins don’t grow perfectly parallel, which means hypertension can also cause pain via vasoconstriction, if the vein slightly spirals around the nerve and also constricts; think like a snake wrapped around an arm and squeezing. So it’s possible both localized vasodilation and vasoconstriction are causing these headaches, considering the times the headache is worst ("cannabis use or after waking up) and mild but constant (after stimulants like caffeine).
If your pressure is a bit high during the day, a very small dose of a vasodilator drug taken after your medication would normalize it and that would, hopefully, stop the pain overall. You could still have orthostatic blood pressure issues too, but certain mild exercises can help with those too (assuming there’s no other underlying blood flow issues).
But there’s not enough data to say conclusively, hence taking your blood pressure as directed, as well as throughout the day sitting (after sitting at least 3 minutes without moving much) to see if there’s any abnormalities with it, as well as the orthopedic pillow. If the pillow helps it also narrows down the cause.
That said, if it’s the trigeminal nerve and you can’t control the veins there well through medication… Good luck I suppose. Most surgeons won’t want to cauterize because of mild (yet constant) pain. Acupuncture could achieve the same result, but that would be a scary gamble, because there’s also potential they hit the nerve wrong with the micro needle and instead worsen the pain. That would be a last result solution, assuming it’s the trigeminal nerve causing you issues.
Forgot to mention, don’t know where you live, but Omron makes good enough yet affordable blood pressure machines. Just don’t ever get anything for the wrist.
They are not great for your liver. Especially long-term consistent use. You should be taking periodic liver function tests.
You should be taking periodic liver function tests.
That’s not a bad idea… :(
N-acetyl-L-cysteine, commonly sold under the name NAC, is an amazing over the counter liver aid you should think about adding to your med list. It’s one of the most energy intensive detox molecules made by your liver. Taking it orally provides your liver a helping hand and allows it to focus more on detoxification rather than producing the required tools for detox. But definitely talk to your doc about it all, yet it’s something you can do to help out without much worry as its basically a fancy amino acid.
I see! I thought about this as well. I was indeed also worrying whether this itself had any (unforeseeable) side-effects. Hmm, just a fancy amino acid? I hope this is indeed as innocent as it sounds.
How come you have a headache every morning ? Sounds pretty worrying to me.
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…
I have AuDHD, and… yeah, I sometimes get so tense that I get muscle aches because of stress that I create myself.
That being said, I also suggest you talk to a doctor, because it would be way better if there was a way to fix it. If you can’t, then harm reduction in painkillers makes sense, but if there’s a simple solution (like nighttime stretching or going to bed earlier), you’ll save yourself a lot of worry and pain.
Additionally, please don’t feel pressured to discuss this here (though I’m happy to talk to you further about it, I’m just not trying to pry), but something to consider: I tend to, as a result of my AuDHD, process really unpleasant personal situations somewhat subconsciously. What I mean is that I’m often not aware of negative emotions until I notice their psychosomatic effects on my body. I used to get headaches 3-5 days a week that would basically send me to bed after work. When my awful boyfriend broke up with me, they went away. I was incredibly unhappy with him and didn’t realize it, but I still carried a lot of tension that expressed itself physically.
For another example: I’m now in grad school and I’m a stereotype of an ADHD student (not everyone with ADHD is like this, but I definitely procrastinate until deadline stress can carry me through), so it’s very difficult. Since I started my master’s, I’ve also started vomiting, a lot. I’m getting checked out (tomorrow, actually) to see if there’s a physical cause, but I’m 90% sure it’s just stress. I’ll be done with my degree in February, but if it were a job instead of a temporary thing, I’d probably have to quit or develop some more effective coping skills.
I just wanted to throw that out there and suggest that you might be physically reacting to a source of stress or tension in your life, and you might want to weigh whether that tension is worth the headaches or whether you can employ coping skills and assertively reduce that stress.
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.
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).
Honestly, the only good advice is to consult a doctor.
Most of those Stackoverflow answers telling you you’re going at your problem the wrong way are correct, too.
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.
A headache every morning sounds like a different medical problem that may have a more permanent solution. You may want to consult a medical professional about that. When you do, you may as well ask about the risk to your liver.
The problem with acetaminophen is that it’s perfectly safe and kind of a wonder drug, right up until your liver is overwhelmed and the stuff suddenly turns into a strong liver poison. I’m no doctor so I can’t tell you if your medicine and coffee go by the same chemical pathways or if it poses a risk to overwhelming the specific cells that deal with the painkillers, though. I don’t think coffee and Ritalin need to be broken down by the liver, but I’m no doctor.
However, every package of acetaminophen I’ve seen states that you should not use it for longer than a few weeks at a time without consulting a doctor. That’s regardless of any other medicine you may be using, or sticking to the maximum dosage. It can be totally safe to use, but a medical profesional needs to make a judgement call on that. They may, for instance, want to do bloodwork to check that your liver isn’t damaged in any way before they clear you.
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.
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.
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.
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.
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…?
Every morning headaches can be a sign of sleep apnea. Not saying you have it. Go to a doctor.
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
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.
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.
Paramedic here who worked a lot with toxicology patients: You are entirely right.
It’s always horrific.
Yeah, that’s what I’ve read, a day or two of feeling shitty, a day of feeling better and been dead.
Afaik constant use of paracetamol has most impact on stomach, it does something to the lining.
Or maybe that was ibuprofen?Not a medical professional either way so
Edit: Root cause aside as people have already told you here, I would try CBD it might help and shouldn’t strain the body as much.
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.
I get headaches from weed
Well, there’s your problem, then.
Another thing to talk to your doctor about.
