Prenatal Acetaminophen Exposure Linked with Autism Spectrum Disorders

Your doctor may have recommended you take acetaminophen during pregnancy.

Your doctor may have recommended you give acetaminophen to your infant after vaccination or to bring down a fever.

Acetaminophen, the main ingredient in Tylenol, is one of the most commonly used over-the counter pharmaceuticals in America. It is used to relieve fever, pain, and other symptoms..
But new peer-reviewed science suggests these standard obstetric and pediatric recommendations may be causing harm.

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This study, “Acetaminophen use in pregnancy and neurodevelopment: attention function and autism spectrum symptoms,” was published in the International Journal of Epidemiology in June 2016. It explores the link between acetaminophen exposure to the fetus and autism spectrum disorders (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).

This Spanish study may be the nail in the coffin for the use of this drug as at least two other large-scale Scandinavian studies have also shown acetaminophen has negative effects on the developing fetus.

Developing babies at higher risk from toxic exposure

When an egg is fertilized, a single cell produces the vast complexity of tissues and organs that become a baby. This process is highly susceptible to dangerous environmental toxins, which we doctors call teratogens, and which can cause miscarriage or significant congenital defects.

During the mid-twentieth century, a surge in birth defects resulting in missing limbs was directly related to the anti-nausea drug, thalidomide. Though thalidomide was never approved for use in the United States, another drug--diethylstilbestrol—was. Doctors told women this synthetic hormone was “safe during pregnancy” and obstetricians prescribed it to prevent miscarriage. Some doctors even prescribed it to make a healthy pregnancy healthier. Devastatingly, we learned later that children whose mothers took DES were later succumbing to aggressive vaginal, cervical, and testicular cancers once they hit their teens.

With the rise in environmental pollution and unsafe pharmaceuticals, the rise in congenital defects and neurological issues to children has also risen, as Dr. Philip Landrigan, M.D., notes in his work. It’s imperative to the health of our children that expectant parents understand and avoid any possible sources of teratogens.


Acetaminophen strongly linked to autism

In this new Spanish study, a team of researchers investigated the effects of acetaminophen exposure on fetuses for a period of five years. The study included 2,644 mother-child pairs, of whom 40% indicated using acetaminophen during their pregnancy.

Although the authors were limited by the memory of the mother’s on their acetaminophen consumption, particularly the amounts and frequency consumed, researchers discovered a dose dependent relationship between the amount of acetaminophen consumed and the onset of ASD and ADHD in children whose parents used acetaminophen.

It should be noted that the authors hired a psychiatrist to diagnose and evaluate each child in the study, taking in consideration the varieties of ADHD and ASD that may exist. This is crucial since many studies previously relied on questionnaires from the subjects and didn’t evaluate the variety of ASD and ADHD symptoms in the patients. At the same time, as the researchers noted, genetic variability and other possible confounding variables from other environmental sources were not investigated. Yet, the study did eliminate a large source of potential confounding from socioeconomic status in the population study. In general, the study showed that acetaminophen has a strong link to contributing to the onset of ASD and ADHD in children.


Pregnant? Throw your Tylenol in the trash

I tell the expectant families in my integrative pediatric practice that pharmaceuticals should be avoided as much as possible during pregnancy. Why? Because too many studies show that even very small amounts of ingested pharmaceuticals can pass to the developing fetus. The mother and baby are intimately connected during this period and great care must be taken to protect the fetus from potential hazards. Many, if not most, pharmaceuticals recommended by doctors or touted as safe during pregnancy have not actually been studied on fetuses or children (because it is considered medically unethical to conduct tests on pregnant women). These drugs must be treated with caution.

A colleague at Duke University’s Medical School, Dr. William Parker, Ph.D., who is an expert in immunology, has been conducting an exhaustive review of the scientific literature on acetaminophen. His best recommendation is to keep it far away from pregnant women and far away from children.


We still have much to learn in the medical community on the brain and the influence of drug’s on its complex circuitry but we have enough information now to say definitely that we must avoid acetaminophen during pregnancy and infancy.



Want to read more about tossing the Tylenol?

A helpful article on safer alternatives by Dr. Aviva Romm, M.D.
A helpful article on acetaminophen and autism by Dr. Jennifer Margulis, Ph.D.
A helpful article on immune disruption and acetaminophen-induced neurodevelopmental disorder by Dr. William Parker, Ph.D.

Jonathan Kopel, an M.D./Ph.D. candidate at Texas Tech University Health Sciences Center, contributed to this article.
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