Hey, Dr Bernard here. This is medicine. There’s a
label on the bottle, required by law, that tells you how to take it. Cooking food in it, is not how
you take it. You can cause massive, irreversible damage to your body using it improperly like
that, as I’ll tell you about in this video. Also, the Nyquil chicken meme isn’t new.
Someone sent this to me on Twitter, July 12, 2020. If you search, the exact image was making its rounds on Twitter that particular day.
So, the FDA Consumer Update about Social Media Challenges Involving Medicines, mentioning
NyQuil Chicken September 15, 2022, I’m guessing, was written by an FDA staffer who remembered
that particular image, and wrote it in to the Update sometime in between these 2 years. I don’t
believe they went out of their way to report this specific trend, it was just an example that
they cited. Then the media picked up on it, and the idea was presented as new and amplified
by orders of magnitude. This wasn’t an ultra viral trend before the news stories dropped, so because
of that, I don’t know of any specific cases of NyQuil Chicken poisonings leading to a hospital
admission, at the time of recording this. However, the ingredients in here are used by at least 60
million Americans every week. It’s safe when used per label, but sometimes mistakes happen, and
we do have tens of thousands of cases of those poisonings involving these medicines every year.
So in an effort to make it so there aren’t any specific cases of nighttime cold and flu medicine
chicken going forward, I will tell you about what an actual poisoning of this looks like, by using the
story prompt of someone cooking chicken like this. A Man Cooked Chicken In Nighttime Cold and Flu Medicine. This Is How His
Liver Shutdown his Brain. OP is a 19 year old man, presenting
to the emergency room, unconscious. His mother Lana, tells the admitting nurse that
her son had suffered at least 2 seizures before she noticed that his skin and the whites
of his eyes were a greenish yellow color. She had no idea what he had been doing for
at least the last 48 hours, because he had locked himself in his room before she broke in
after hearing him shaking all over the floor. OP was someone who liked memes. Every day, first
thing in the morning, he’d reach for his phone to dump images online. His parents believed
that their son had a problem. Sometimes, they’d see him sitting alone in a room, silent and
staring off into space, when suddenly they’d hear him cackling maniacally because he remembered
a random meme he posted online 2 years ago. He’d spend hours everyday just scrolling, and
the funnier he found a post, the more his face would express no emotion while he breathed
a larger volume of air, out of his nose. One day, OP came across chicken cooked in
night time cold and flu medicine. He saw the rich turquoise greenish color of the meat outside,
and the partially cooked inside. Chicken pink raw, however taste very good, he thought, as he
prepared himself for what he was about to do. In the kitchen now, OP whipped out
some chicken breasts into a pan, and he poured at least 2 bottles of night time
cold and flu medicine. He made sure to record it all so he could meme the video. But as the
chicken was starting to cook in the medicine, he felt the smoke waft up into his nose, and a
stinging pain started piercing into his eyes. It must be ready to eat now, he thought, as he
ate the chicken, and drank the remaining juice. In the minutes after finishing his meal, OP
thought he felt his vision starting to slow down. He could hear a bell ringing in his ears,
like he was sitting at a funeral. Time to play some cringe video games, he thought,
as he stumbled over to his computer. As the hours passed, OP kept thinking that he
was seeing lights flashing and hearing sounds that may not have actually been there.
He thought his dad walked in on him, opening the door and slurring out
the words, “are ya winning son?,” as the door slammed shut. OP wasn’t sure
if he dreamed that, because the next thing he could remember was waking up on the
floor with a mouth as dry as the desert, only getting up because he had to scramble to the
bathroom and empty his stomach into the toilet. As the day continued, OP kept feeling
worse. Every time he emptied his stomach, he noticed the contents in the toilet were a
greenish yellow color, the same color as his skin and the whites of his eyes. He wasn’t sure
if he couldn’t think correctly anymore because he was wondering if what was being pushed into
the toilet from his stomach was actually parts of his skin sloughing off and melting into
the ground. His breathing starts to become labored, and as his stomach starts to hurt more
and more, he can feel his head start pounding. He can feel his eyes push out of his skull, as
he lays down on the floor in a fetal position. As at least 36 hours pass, OP starts to convulse.
In the other room, Lana had no idea where her son was or what he was doing, but as she walks
in and finds him shaking on the floor, she calls for 911 and he’s brought to
the emergency room where we are now. At examination, doctors immediately see several
clues telling them what’s happening. First, OP is jaundiced. This yellowing of his skin and eyes
is from a chemical called bilirubin, something produced from breaking down red blood cells in
the liver. If there’s so much bilirubin floating around in the body that it’s attaching to his
skin and his eyes, then it means that something must be wrong with his liver, and a blood test
finds confirms this because parts of his liver have died, and are leaking their contents around in
his blood. But this isn’t his only problem. The same blood test reports that his kidneys
have also shut down, all of this giving doctors clues as to what’s happening, because they
don’t know exactly what he put in his body. Nighttime cold and flu medicine is typically a
mix of 3 active ingredients. Dextromethorphan, which is a cough medicine, doxylamine, which
is used as the sleep aid giving the way to the night time branding of the medicine, and
acetaminophen, also known as paracetamol, which is a pain reliever and an anti-inflammatory
medicine meaning it can help with the aches and fevers associated with flu. These 3 medicines
alone, explain everything happening to OP. As doctors move OP into the Intensive care
unit, they stick a tube down his throat so that a machine can help breathe for him. Clearly
if he presented to the emergency room in a coma, something happened to his brain,
but which medicine did that? Dextromethorphan, can cause hallucinations and
psychoactive effects. In very large amounts, it can cause serotonin syndrome, where too
much of a chemical that sends signals in the brain can cause problems. OP thought he could see
and hear things, and he might have been able to, but the dose he consumed from the bottles of
this particular formulation, is much less than a dedicated cough syrup. It could have
been enough to cause some hallucinations, but it likely wasn’t enough to cause
serotonin syndrome because he doesn't have the signs and symptoms of that, and so,
dextromethorphan might not be the culprit. But how about the ingredient that increases
drowsiness, the doxylamine? This is why it's branded as nighttime medicine. If it makes
one sleepy, then it should affect the brain right? Well, it could. But doxylamine isn’t just a medicine
for drowsiness. It’s also an allergy medicine, it works similar to how Benadryl does, so OP could
have had hallucinations from this too. But the dose of doxylamine in this formulation isn’t
very high. It could explain his dry mouth and his blurred vision, but it shouldn’t cause liver
and kidney failure, especially in this severity. All of this leaves us with the final active
ingredient, acetaminophen. At the doses indicated on any medicine label, acetaminophen is safe.
However, acetaminophen happens to be in many different over the counter medicines, and while
people may follow the directions on the label of one medicine, they could be taking another
medicine, following that label too. This means that the person following these labels correctly,
are unknowingly doubling or tripling their daily acetaminophen intake. Even worse, they might also
be taking prescription medicine, like hydrocodone for pain, and that also contains acetaminophen.
The active ingredients tell you most of what you need to know. The acetaminophen in here, is
the same active ingredient here. This means that following the label exactly on both bottles
could still net you an overdose if that person isn’t paying attention to what they’re putting
in their body. Always read the label and check. OP consumed at least 2 bottles of nighttime cold
and flu medicine when he cooked his chicken in it, and drank all the remaining liquid.
And the fact that it was liquid, makes things even worse for him. If you take acetaminophen for aches and pains and
fever, you’ll likely take it in tablet or capsule form. In the stomach, it takes time for these to
dissolve, before they pass through and absorb into the blood stream through the small intestines.
Liquid medicines don’t need to dissolve, they’re in a form ready to be absorbed into the
blood, meaning that OP’s poisoning was happening much quicker. When it absorbs into his blood from
the gut, the first place it reaches is the liver. This brings us to an idea called metabolism.
The substances that some folks use and abuse, are often administered through
the lungs in the form of smoke, or it’s put into a nasal or mucous membrane,
or it’s injected. If you look at how the blood vessels are mapped in the body, these routes
of administration get the substances to the brain, before they get to the liver. This is
significant, because the liver metabolizes, or breaks down, everything that enters your
body. When you ingest medicine by mouth, half, if not more of the dose you took, is metabolized
in the liver first, inactivating the medicine in an effort to protect your body from something
that’s 1) not made in your body and 2) shouldn’t be in excess in your body. Smoke and injection
bypass reaching the liver first, so that a higher amount can get to the target organ. All
of this explaining everything happening to OP. As the nighttime cold and flu medicine absorbs
into his liver, all the acetaminophen starts to get processed. The interesting thing about the
liver, is that it uses multiple ways to metabolize any given substance. These different pathways
make the liver more robust in the case that should one pathway be overwhelmed for some reason, a
different one can step in to continue the process. This is what happens to acetaminophen. But in
the case of overdose, bad things start to happen. As more and more acetaminophen floods into
OP’s liver, the first non-toxic metabolite isn’t made as much. The liver moves on to the
second pathway, breaking acetaminophen into a reactive chemical. Because it’s robust, the
liver is still fine with this, it has stores of a chemical named glutathione that can neutralize
this reactive chemical. But because OP consumed so much acetaminophen, more and more reactive
metabolite keeps accumulating, and the liver starts to run out of glutathione, and there’s
no more pathways for the liver to handle this. When chemicals are reactive, they want to become
more stable. In the body, you typically don’t want reactive chemicals floating around, because
they’ll try to stabilize themselves by taking bits and pieces from parts of the body. And in
OP’s case, the toxic acetaminophen metabolite is reacting with his liver. At first, it interferes
with the mitochondria, making it harder for cells to produce energy. But then it starts ripping off
parts of cells in an effort to stabilize itself. As the cells start to die because they’re reacting
with the metabolite, the liver starts to lose its capacity to process the body’s waste, becoming
even less capable of handling acetaminophen. As the days continue, OP’s blood starts showing
that these dead parts of his liver are floating around in his body. Even more acetaminophen
metabolite floods his liver, killing even more cells, as the liver shuts down and waste continues
to build up his body. Bacteria and cells in the gut produce ammonia, which in normal function
is processed by the liver. It’s converted to glutamine. As OP’s liver keeps necrosing from the
massive ingestion of acetaminophen, the ammonia spills into his blood causing hyperammonemia.
Hyper meaning high. Ammon referring to ammonia, a substance produced by the normal breakdown of
proteins and -emia meaning presence in blood. The brain tries to compensate for this presence
in blood because brain cells have some ability to metabolize ammonia to glutamine, just like
the liver can. But as the massive amount of ammonia overwhelms OP’s brain cells, a fluid
imbalance starts to happen as the brain starts to swell. At first, the skull has a little room
for the brain to expand, but as the liver quickly becomes unable to handle anything because it has
completely shut down, more and more ammonia spills in causing the brain to swell even more. All of
the survival mechanisms in the brain cells become overwhelmed suddenly, as the brain starts to crush
up against the sides of the skull, smashing blood vessels and causing the brain to ooze through the
sutures of the skull causing permanent damage. Is there anything that can be done for OP?
Well, maybe. Time is the most important factor. Unmetabolized acetaminophen isn’t
toxic, but there isn’t currently a way to stop the liver from metabolizing it. If the
liver can handle the toxic metabolite with its stores of glutathione, then the solution
is to replenish the stores of glutathione. N-acetylcysteine is the antidote because
it does just that, and prevents the toxic chemical from reacting with liver cells. If
permanent damage is extensive in the liver, then the antidote wont help, because
the damage has already been done, and a liver transplant would be the only
remaining solution. Because OP had neurologic signs and symptoms when he presented to the
emergency room, things don’t look good for him. In the FDA consumer update, it says Boiling a
medication can make it much more concentrated. Boiling wont create a higher dose, it
won’t create more of the active ingredient, but it will take some liquid out. More concerning
is the idea of stability. Heating something up means the molecules move faster. This increased
kinetic energy can make everything less stable, and the chemicals may break
apart in order to stabilize, and you won’t know exactly what you’re
getting at that point. Whichever the case is, don’t cook anything with any
prescription or over the counter medicine. OP was not able to get a liver transplant in time,
and he was not able to make a recovery. His case was from an intentional massive acetaminophen
ingestion, no idea what product specifically it was, because like I said earlier, acetaminophen
is included in so many common over the counter and prescription medicines that 60 million Americans
consume it weekly. At doses on the label, and if you have no prior health conditions, and you’re
only just taking this one medicine, our bodies have enough glutathione to handle the metabolite.
It does take a lot of this to cause damage like in OP’s case, but if you accidentally combine too
many medicines like how an elderly person in the retirement home might, or you think it’s a funny
meme to mess around with whole bottles like this, the damage can be permanent. This is why you
don’t want to cook food, in this medicine. Thanks for watching. Take
care of yourself. And Be well.
Theres no way people were really cooking nyquil chicken thats a absolute meme. To the level of eating tyde pods
Fuck the syrup. I stick with the freebase or gelcaps haha.
Say it with me kids:
IF YOURE BUYING OTC COUGH MEDS FOR RECRRATIONAL USE, ONLY BUY THE SYRUP/PILLS THAT CONTAIN DXM HBR OR DXM POLYSTYREX/POLI ONLY AS THE ACTIVE INGREDIENT. DXM ONLY.