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How the Liver Handles Tylenol The liver metabolizes almost all of it (see diagram above): 90% : Processed safely through glucuronidation and sulfation 2%: Eliminated through the kidneys (urine) 510% : Processed by the enzyme CYP2E1 creates a toxic byproduct called NAPQI (N-acetyl-p-benzoquinone imine)
The tension between widespread off-label use and these defensive guidelines leaves clinicians without a robust evidence base when facing real-world decision-making challenges
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it is whether they get a meaningful amount of the vitamin at all
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