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doi: 10.1210/jendso/bvab048.1678 [DOI] [Google Scholar] 27.Ruíz-Pacheco MG, Hernández I, Hernández-Estrella G, Basurto L, Vargas-Ortega G, González-Virla B, et al

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Glucuronidation Increases BUT Is Insufficient While glucuronidation (the other safe pathway) does increase during pregnancy: This increase in glucuronidation CANNOT compensate for the simultaneous: • 33% decrease in sulfation (another safe pathway) • 80% increase in oxidation to toxic NAPQI **The Result:** When both safe pathways become saturated or overwhelmed, significantly more acetaminophen is forced through the toxic CYP2E1 pathway, creating 43% more NAPQI—at precisely the time when glutathione reserves are most depleted