A 48 hour fast can turn standard Paracetamol into acute liver failure. Fasting depletes Glutathione, leaving the liver defenseless against toxic NAPQI. Review the latest guidelines on BMJ Best Practice: https: bestpractice.bmj.com topics en us 1010 PDF) A review of the evidence concerning hepatic glutathione depletion and susceptibility to liver toxicity after paracetamol overdose Acetaminophen or Tylenol Toxicity Lect 19 Pharmacology Sulfate conjugation may be the key to hepatotoxicity in paracetamol overdose Li 2021 British Journal of Clinical Pharmacology Wiley Online Library Refractory high anion gap metabolic acidosis due to chronic paracetamol use: a case report Journal of Medical Case Reports Springer Nature Link
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