Paracetamol/Acetaminophen is well understood, and an effective drug when used where applicable.
You are right in that nausea and abdominal pain are common side effects for some people, and simply means you should be trying something else. I've personally never suffered this.
Its ability to reduce fever is unclear, and even in high doses the difference it appears to make is minor. But for pain-relief there is no doubt as to its efficacy, though its effect is inferior to most other drugs available.
However, when taken together with ibuprofen, it provides pain-relief even more powerful than either drug alone.
If your problem is with the brand Tylenol advertising it like snake oil, then you likely have a point.
It can't relieve cold symptoms except for a stuffy nose or significantly reduce fever. It's basically just a very weak painkiller. I only ever take it if ibuprofen isn't doing enough.
Has there been progress since 2022 on figuring out its pain killing mechanism? If it just didn't work for headaches I would understand, mine are migraine and no painkillers work for those, but it has not worked on anything I tried it for, I gave up years ago. It's not even that safe, I don't understand why it's still around.
Lots of drugs and foodstuffs have biological effects we don't understand.
Medicine doesn't always work by looking at exactly how a molecule interacts with every other molecule in a living organism, but rather by simply observing the effects.
It doesn't kill, and it works for most people. Ok, it doesn't for you, that happens. But I can tell you for a fact it does for me.
That we don't understand how it works doesn't stop it from working, and that it doesn't work for you, doesn't mean it's useless for everyone else.
I for one am happy I was able to buy paracetamol in addition to ibuprofen when I needed it to sleep during an extremely painful ear infection, because no over the counter drug on its own was enough.
If anything, public knowledge on what exactly it can and cannot do should be improved, as well as what side effects mean you need to look for something else.
I live in a country where there are strict laws regarding advertising of medical devices and drugs, so there's very little "snake oil" bs around medicines here. If you let them brands try to claim every mild effect an effective ingredient might have makes their product a cure-all for a litany of symptoms.
Asking a pharmacist for a recommendation is always a good idea, that's how I found out I could "stack" the painkilling effect of paracetamol and ibuprofen, and it worked extremely well.
Obviously, it would have been less ideal if like you I experienced side effects when taking paracetamol.
Hey, I heard (but have no proof so you will have to find them) that it is less effective on some ethnicities than others. If you are in that case, you may want to take a look ?