Do we know how Tylenol works? [closed]








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I saw [this xkcd comic](https://www.explainxkcd.com/wiki/index.php/2682:_Easy_Or_Hard) and one of the unsolved entries was "How does Tylenol work?".


So I googled and found a lot of explanations for what acetaminophen does. A bunch of articles says it regulates some brain thing to reduce swelling or something. Seems like we know how it works.


What did Randall mean by this? Do we know how Tylenol works? Seemed like we do.




Just because we know one thing it does doesn't mean we know *all* the things it does.


And just because one of the things it does is [inhibit cyclooxygenase](https://en.wikipedia.org/wiki/Paracetamol#Pharmacology), and another thing it does is relieve pain, doesn't mean that inhibiting cyclooxygenase *always* relieves pain.


And just because acetominophen does inhibit cyclooxygenase and relieve pain in most people [doesn't mean it does that in *all* people](https://www.fda.gov/drugs/drug-safety-and-availability/questions-and-answers-fda-warns-rare-serious-skin-reactions-pain-relieverfever-reducer-acetaminophen).


And since the placebo effect is a thing, and most people don't take [acetominophen](https://en.wikipedia.org/wiki/Placebo) while "blinded" as part of a study, and since the placebo effect is particularly strong at [pain relief](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402571/), a lot of the effects of acetominophen itself will often be confounded with placebo effects.


So, we know some ways that acetominophen works. But we're pretty far away from a complete theory of how acetominophen works, because (a) biology is messy, (b) humans even moreso, and (c) we don't have a complete all encompassing theory of general pharmacology to unambiguously map particular molecules to their effects on mammalian bodies anyway.


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