Posted by randycupertino 9/5/2025
But I could certainly imagine that a mother with autistic traits could be someone who takes painkillers more often than the average person.
Though I'd expect that if aspirin did have an affect that it'd change the prevalence or severity of autism in children having genes related to autism.
There'd be a first order correction fornthe likelihood that aspirin is causitive by controlling for increased ibuprofen and tylonol usage as well. The second order correction would be whether autistic people were more likely to use aspirin over ibuprofen or tylonol, etc.
Nevertheless, comparing the observed correlations of Tylenol with aspirin and ibuprofen would be the first thing to check. Seems unlikely to me that the OP's suggestion could be controlled for that way. I'll be curious if Kennedy's report checks those basic things.
Yep. Two of my 5 are clearly HFA (1 diagnosed) and another shows strong indications. My wife and I have numerous family members that are somewhere on the spectrum. It's how this works.
I think it’s harmful to pretend that reality is inscrutable and that science struggles to give answers. It’s fuel for the RFK Jr type of societal parasite.
You don't need to worry about people losing trust in science because science does not require trust. Those who are unsatisfied with anything less than certainty need something other than science.
And it’s not about complete certainty. It’s that it actually is very difficult to prove genetic heritability vs effects in the womb because you can’t do twin studies, going back to my original comment.
Pretending to be more certain about it than reality IS misinformation. When you lie, people believe you less. They don’t want to give you money anymore. As we are finding out currently. I think “pro-science” liars are much more harmful than whatever “science skeptics” they find online.
You seem weirdly fixated on this point, and to your rhetorical disadvantage.
It is difficult to tell whether you are being accidentally or willfully ignorant. Maternal effects are well-accounted for in research. It is extremely improbable that we’ll ever find out that they have anything but a very minor influence on ASD compared to genetic factors.
Lol, no it's not. Genetic heritability vs other types of heritability is not accounted for in multiple areas like height and IQ and it seems you are just ignorant of it.
> weirdly fixated
> rhetorical disadvantage
Are you just playing a debate game or having a discussion?
It makes a lot of sense given with I've seen talked a lot about in autism and adhd groups, with some symptoms overlapping.
Do you have a scientific source for this?
https://www.open.edu/openlearn/mod/oucontent/view.php?id=669...
There are many causes of autism. Research suggests that autism spectrum disorder (ASD) develops from a combination of:
Genetic influences and
Environmental influences, including social determinants
Yes environmental factors are there too, otherwise it would be 100%, but there's enough evidence pointing to genetics that it is really disappointing when people try to find spurious links to false causes instead.
What heritability actually means https://dynomight.substack.com/p/heritable
> I couldn’t help but notice that there’s near-universal confusion about what “heritable” means. Partly, that’s because it’s a subtle concept. But it also seems relevant that almost all explanations of heritability are very, very confusing.
For example, they say speaking Turkish isn’t heritable but speaking English is. Weird!
> Heritability can be high even when genes have no direct causal effect. It can be low even when there is a strong direct effect. It changes when the environment changes. It even changes based on how you group people together. It can be larger than 100% or even undefined.
He's obsessed with "pollutants" in the broadest possible sense. That's why he crusaded against environmental pollutors for most of his adult life.
He also rejects germ theory in favor of the idea that disease is caused by environmental pollution getting into the body.
That's why he supports a return to (his broken understanding) of "natural" living.
Ok, but do you have any objective measure to back up this claim?
The fact that we haven't identified candidate genes for autism and a bunch of other mental health issues doesn't mean these aren't hereditary or have hereditary triggers that make outbreaks easier.
> if anything it is epigenetic caused by environmental pollutants and hormone exposure
Doubtful. The difference to older times is, we now properly diagnose mental health issues instead of just labeling affected people as "loons", locking them away in institutions or, like it happened with witch-burnings and in the NS Aktion T4, outright murder them.
Epigenetic changes absolutely can be passed to children even over multiple generations--this is already proven.
Which epigenetic changes are caused by T2D and whether they predispose the next generation to T2D would be the question.
How we pass on acquired traits to offspring is not well understood at all. We know there’s a mechanism, but not how it works or how selective it is.
https://www.cuimc.columbia.edu/news/study-shows-how-effects-...
Would you believe that things are more complex than neat categories discovered in 1850 that you learn in fifth grade?
Starvation is just the most studied aspect of this as it is easier to find control groups. However, you could easily search and find others, which you don't seem to be willing to do for some reason.
This is not groundbreaking research, this has been known for a while. The current focus is to understand possible non-genetic pathways for this. https://en.wikipedia.org/wiki/Epigenetics
"Epigenetics is the study of heritable changes in gene expression that occur without altering the underlying DNA sequence. These changes, also known as epigenetic modifications, affect how genes are turned "on" or "off" and are influenced by factors like environment, lifestyle, and aging."
Further reading: https://www.sciencedaily.com/releases/2021/07/210726102148.h...
So 10 times the typical dose is when you have overdose effects. (basically 20 pills per day vs 2 pills per day).
Not your "wildly unsafe at slightly above usage levels" AT ALL (as someone posted on here)
This is not harmless - this might cause someone to take more dangerous painkillers when acetaminophen (tylenol) might have safely helped them. The autism stuff is plainly false and disproved.
No, I do not think we do, because it causes none of the side-effects associated with NSAIDs, and it is even safer than acetaminophen, i.e. there is no risk of hepatotoxicity whatsoever. The only side-effect is euphoria. Please do not mention respiratory depression here, that is a non-issue, it matters as so much as liver failure matters with acetaminophen overdoses. Opiates are safer than any painkillers currently in existence, the problem is with impure products (i.e. not from the pharmacy), and people misusing / abusing them. They might as well abuse NSAIDs and acetaminophen, and the result is the same: harm. Taken therapeutically though, it is way safer than any other painkillers.
So I am not sure what your intention was with that sentence, because sadly no, people do not realize the therapeutic safety profile.
Tramadol is a nasty atypical opioid though, you could have singled that one out. It affects almost all receptors (serotonin, dopamine, etc.) there is, and it is one of the nastiest opioids out there, but that is why it is called an "atypical" opioid.
Edit: I missed constipation as a side-effect, see my other comment.
That second part "people misusing/abusing them" is a lot bigger than you're letting on. People can get hooked on opiates easily - a quick trip to Wikipedia turns up: "Long-term opioid use occurs in about 4% of people following their use for trauma or surgery-related pain" [1]. That's a pretty big knock-on effect! If you're prescribed opiates you're rolling the dice, and if you have the right mix of brain chemistry and genetics, you might be screwed.
> if you have the right mix of brain chemistry and genetics, you might be screwed.
Right. I experience no euphoria whatsoever from any opiates (in any dose)[1]. Blessing or a curse? I personally call it a blessing because I have an addictive personality so I would get hooked up on it too. It works for my pain and my depression & anxiety, and for that I am grateful, all while not causing euphoria, all it seems to do is just mood stabilization, i.e. I am less likely to be emotionally volatile.
The constipation side-effect can really be frustrating though, but thankfully I can manage it through diet and skipping doses.
[1] It possibly has to do with my neuro{biology,chemistry} and my brain lesions but who knows. Psychiatric medications never affected me the way they typically affect others and I have gone through _a lot_. It might be genetic, metabolic (as well), I have no clue.
Plus it depends on the opioid. Hydrocodone and oxycodone for example leaves the system pretty quickly (ER, too), and once it does, you can defecate without issues. Morphine on the other hand causes awful constipation but can be treated with proper diet. Hydrate, plum jam, magnesium citrate, or laxatives if serious. You can skip a dose or two so you can defecate.
Of course it would be tempting to wax poetic about how I just needed to use my willpower to stop, and so can anyone else - just-world-fallacy while singing my own praises. But it's more honest to admit that while things worked out fine that time, control can be quite illusory. I wouldn't hesitate to use opiates again for extreme pain, but I sure would set up some social accountability systems beforehand.
I like this point because it is complete gibberish. If you simply do not mention the side effect that makes a drug lethal, it sounds a lot like the drug does not have lethal side effects. Obviously we cannot do that with acetaminophen though, we must talk about hepatoxicity when it comes to that drug.
On the one hand we have a drug that can cause both mental and physiological dependence and addiction (so what), has an admitted side effect that encourages some users to escalate their dosage beyond medical guidance (who cares), and can cause you to either stop breathing or aspirate and choke on your own vomit if you take too much (that part is a little tricky so we just proceed as if that is not the case)
On the other hand you have a drug that is hepatoxic at several multiples of its recommended dosage. Obviously the second one is more dangerous becau
Therapeutic doses of opiates do not cause respiratory depression, overdoses do, similarly to how acetaminophen overdoses cause hepatotoxicity, except this is not true, because regular consumption of acetaminophen causes hepatotoxicity, too, whereas opiates, when taken as prescribed, do not cause respiratory depression, in case of opiates, ONLY overdoses do, and therein lies the huge difference.
And then we did not even mention NSAIDs which cause from ulcers to cardiovascular events, even if taken as prescribed.
As for addiction, I would not like to get into the topic of addiction because a lot of people have an obsolete view on it and people already have their mind made up with regarding to it. Similarly to how my parents' generation think mental illnesses do not exist or that you can just "think away" depression.
Under the caveats of a competent physician and a completely med-compliant patient, opiates are perfectly safe. Those are enormous caveats though, given the history and prevalence of incompetent physicians and noncompliant patients (at least in the US).
Generally if you see someone complaining about opiates being dangerous, they’re likely factoring in opiates as things that exist in the context of society rather than a strictly clinical context. You can’t really use the reasoning of one context to dispute the other, it looks silly because you have to say stuff like “ignore all the deaths and the mechanism of those deaths”
My bad. :P
But yeah, I agree. Eastern Europe is on the other spectrum with regarding to opiates. They do not even get prescribed codeine, regardless of severity of pain. You will get naproxen instead along with a possible stroke. :D
> context of society
I would hope so. According to my experiences here on HN, they (some people) just decided opiates are bad (because of "junkies") and that was it.
But yeah, people made opiates look terrible and it is a bummer, it is another case of "this is why we can't have nice things". Kratom is legal here (for now) and people with pain use it, but probably will be taken away from them sooner or later.
In any case, thanks for the reply, pleasantly surprising!
Opiate related deaths in the US have been around 50,000+/yr.
I don't personally know anyone who has died from acetaminophen usage or even particularly injured. I personally know several people who had their lives nearly destroyed by opiate abuse, and a few others who have died. And it's not like I'm hanging out with junkies all the time.
As someone put it:
> Under the caveats of a competent physician and a completely med-compliant patient, opiates are perfectly safe. Those are enormous caveats though, given the history and prevalence of incompetent physicians and noncompliant patients (at least in the US).
Have you considered that your perception may have been distorted by irresponsible people? Please put that perception aside when comparing the side-effects of opioids and NSAIDs.
> regular consumption of acetaminophen causes hepatotoxicity, too
That would be misuse/abuse, though. The bottle label tells you to seek a doctor's advice if you need to take it longer than a certain period of time. Sure, people can fail to read that and not know about it, or just choose that the risk of complications is acceptable given their pain situation, but that's still not as bad as chemical dependence driving the decision-making.
Don't get me wrong, I'm not saying we should ban opiates or never prescribe them, and I imagine the result of the backlash toward decades of over-prescribing has been a foolish swing to the other extreme. But I still don't think we should prefer opiates over ibuprofen/acetaminophen when the latter will do the job. Maybe that's not what you were arguing, but I do take issue with your suggestion that opiates are safer.
This is an oversimplification and not universally true, but I do not wish to get into the details of it and addiction in general. We could brush away every decisions based on "chemical imbalances", too, if we so want. :)
> we should prefer opiates over ibuprofen/acetaminophen when the latter will do the job
Yes, after a careful risk assessment. If you are likely to get ulcers, or a stroke, or any cardiovascular events from NSAIDs, then you might want to consider something safer. Tylenol would be safer in this case, but what if that does not help with the pain at all? In any case, I do not necessarily disagree, and I was not advocating for blind consumption of opioids. If Tylenol works, take it with milk thistle (with high silybilin content) and you will be fine, even if you take it on the daily.
Opiates are only the best option if we ignore addiction, but we can't seriously do that.
AFAICT, I don't tend toward addiction, but I would much prefer ibuprofen or acetaminophen over opiates; I know that I can use those responsibly and not overdose and damage my gut or my liver, but I don't have the same confidence toward opiates. Not to mention I can't get opiates without a prescription, while the others are available OTC. I'm not going to go to the doctor to get an opiates script just for a headache or minor-injury pain.
I've been prescribed codeine before after minor surgery, and I was fine from the not-getting-addicted perspective, but wow does that drug mess with your brain. Sure, I'm not going to deprive myself of an effective painkiller when I really need it, but I'd rather not be in a fuzzy mental state if the pain is manageable with something else.
Of course, I think, ultimately it is for you to decide whether it is worth the risk (feeling fuzzy) or not. It is not for me to decide what works for you. :)
> …
> the problem is with […] people misusing / abusing them.
I think these two facts are inextricably linked, and is what makes them indirectly dangerous for some people.
Ultimately, it is "pick your poison[1]".
[1] Or others will pick it for you (control, regulation, whatever). You said "some people", which is true. I do not experience euphoria from opiates and I am sure I am not alone with this. In my case it is a blessing because I do have an addictive personality. Some other people do not get psychologically addicted to opiates despite euphoria. There is a great study, I think if you search for "rat park study", you can find it. The whole topic is complicated anyways, so I will just say that yeah, you are right, generally speaking.
There's no avoiding it when it comes to some people's chronic pain but it's a tragedy we've ruined the reputation for opiate painkillers because they were prescribed for long periods which all but guarantees addiction. Folks in US hospitals have to unnecessarily suffer short term acute pain because squeamishness around prescribing effective painkillers in a situation where there's virtually no risk.
Morphine causes more constipation than oxycodone does, for example (not to mention IR vs ER formulations), and in some people morphine causes more sedation and oxycodone might be more stimulant-ish, so they may be opioids / opiates, but they can be significantly different.
That said, constipation can indeed be a major issue, especially in the elderly, but they are most likely are already taking or being given laxatives.
For adults without any GI problems, they can safely be on a better diet and take magnesium citrate before they want to defecate (if they have no kidney issues either). It takes 4-12 hours for magnesium citrate to work. There is an even better form of magnesium, but magnesium citrate should be fine, along with prunes or prune jam, lots of hydration and so forth.
I take opiates for pain, and the way I manage constipation (which is indeed frustrating) is through diet (fibre, prune jam, and so forth) and skipping two days (of the ER formulation) if I have no stool for a few days, along with taking magnesium citrate. I would not recommend taking opiates AND laxatives all the time (or rather, I do not recommend treating OIC with regular consumption of laxatives). Constipation would not be a problem with lower doses and IR formulations though, or much less so.
Just FWIW, if you can pass gass, your bowels are not obstructed, and it is a good sign, so if you take opiates, pay attention to that. If you cannot pass gas and you have abdominal pain, then it can easily become a medical emergency. You should not get to this point though, either by taking less, switching to a different formulation (ER -> IR), or switching to a different opioid, along with a better diet.
Additionally, if you do not take opioids (especially ER ones) on a regular basis (similarly to how some people only take NSAIDs once in a while), then constipation is not going to be an issue at all.
I hope this answers your concerns regarding opioid-induced constipation.
It would suck if I experienced nausea, and it would equally suck if I experienced euphoria from opiates, because I have an addictive personality. Thankfully I do not experience euphoria at all from opiates.
BTW I remember having ulcers from NSAIDs before, that is yuck, too. I ended up vomiting blood and I had to be admitted to the hospital. I think I would choose constipation (which can be managed) over this. But yeah, if opiates caused nausea for me, I would not take them for sure.
Ultimately, people should figure out what works for them and stick to it. Unfortunately it might work until it does not, i.e. causes harm. Some people get no ulcers from taking NSAIDs on the daily, and I did just from a few days of taking it (and it was not even naproxen!). :| I am also allergic to metamizole which is the most common painkiller around here (Algopyrin, Optalgin). For my grandma, it seems to work best for her, although she may want to try pregabalin, as her pain is neuropathic (too). She was given tramadol not that long ago and she got somewhat delirious. They probably gave it to her deliberately because she was making a scene at the hospital.
> I have an addictive personality
I take it this means: "I was a heroin junkie"?
eta this is nothing to do with purity of the product. I never heard of someone selling themselves for Tylenol/acetaminophen
And surely I am not alone with not experiencing euphoria from opiates. It is probably a low % of people though, I do not deny that.
> purity of the product
Overdoses and negative public perception does have to do with that though.
I took the typical two 325 mg aspirin for headache thru college and grad school.
Years later I had a cracked rib and was prescribed 800 mg ibufprofen twice daily. The rib pain vanished for the duration (and my swim times improved significantly)! I became a convert to Advil.
Years later I'm older and minimize my painkillers - most of the time I take nothing but coffee. But if sudden brain pain strikes I take either baby aspirin, ibuprofen, or "Headache Relief", a witches' brew sold by many vendors (typically ~250 mg acetaminophen, 250 mg aspirin and caffeine). So I'm hedging my bets!
If I must use something every day then I use baby aspirin (if worried about heart/circulatory issues) or ibuprofen (if worried about pain). When I need to think clearly (most the time) I avoid acetaminophen.
IMHO people overestimate the "gut bleeding" risk from NSAIDS.
If this study is true, it should be easy to compare prevalence of autism on these countries that don’t rely on Tylenol.
Metamizole is actually a very interesting case, to me, as the associated risk is quite strange. It is legal and popular OTC for the majority of the world population; in the countries where it is legal, there are few deaths from the native population. Among tourists who consume it, however, mortality is unusually high. The Spanish health ministry declared in 2018 that it should not be used in the "floating population", including tourists. There may be a genetic component involving Anglo-Saxons. See: https://www.theguardian.com/science/2023/nov/26/painkiller-b...
Here's a map of its availability: https://commons.wikimedia.org/wiki/File:Metamizole_(Dipyrone...
If you consider the relevant research you might think differently: https://hsph.harvard.edu/news/using-acetaminophen-during-pre...
I wonder if Americans know how much of their society and culture bled incompletely into other countries via movies. Like for example after communism fell the youth here got hooked on American rap and hip-hop so we were using slang from those songs like friends calling each other the N word without knowing the context behind it since that's how black rappers addressed each other and they were rock stars here.
As with anything, it depends. I'd never heard specifically of your Tylenol example, though I'm generally aware of the idea that (pop-)cultural references often won't be understood when viewed/heard by audiences with different cultural context.
But I think many people in the US just don't think about it, because they don't need to and it never occurs to them. If you told them your story, they'd just think "huh, that's funny; makes sense, but I never thought about it that way".
the unbridled joy when a non american sees a red Solo cup irl for the first time
"i thought it was just a thing in movies!!"
Research to develop more effective countermeasures should continue of course, precisely because current vaccines aren’t a full solution. I keep hoping to hear good news about those inhaled vaccines that’ve been in development.
The fact remains that people are slowly waking up to this and altering their behavior even into 2025, since it's not always too late to do so. You can see this in the steady growth of the /r/ZeroCovidCommunity subreddit.
Likewise I find it one of the least _effective_ painkillers on the market.
Nothing.
Narcotic analgesics are a godsend when you actually need them.
It's one of the most commonly used medicines in the UK - and certainly the most popular painkiller.
YouGov even did a survey confirming that - https://ygo-assets-websites-editorial-emea.yougov.net/docume...
The safety aspects of it are not something that gets raised in the UK much - other than suicide attempts, which are going to happen no matter what medicine you use.
Probably the biggest risk comes from people not realising that other medicines (e.g. for cold and flu) often include it, so they double up on a dose.
No, I'm not a doctor and this isn't medical advice.
Personally, a works-most-of-the-time treatment for headaches is going out for a walk. I don't know why it works, but it does.
The damage should only occur if you take more than the recommended dose, or continue using it longer than the recommended period.
(Also not a doctor and this isn't medical advice.)
Taking the maximum daily recommended dose (4g per day, thereabouts, in 1g doses) every day for months on end is fine and won’t do any damage.
I’m sorry about your friend but his experience is unrelated to the fact that using the medication as recommended, even long term, is not harmful in the least.
2. They may be so used to pain they don't think to mention it.
3. A lot of people lie to their doctors for one reason or another.
Mildly amusing anecdote: years ago I visited my then-company's office in London (I'm from the US), and fell sick during my time there. One of my London-local colleagues recommended I get "Night Nurse", and told me of the magical virtues of paracetamol. I'd never heard of it (either the brand name or the drug name), and assumed it was some great drug that for some silly reason the US FDA decided not to approve. It worked perfectly well, but frankly no better than what I'd take at home.
Much later I looked up "paracetamol" and discovered it's the same thing as acetaminophen... "oh, Night Nurse is just the UK version of NyQuil", I realized, somewhat disappointed, the magic lost.
> I'm always surprised at the hostility to Acetaminophen
I wouldn't say I'm hostile toward it, but the number one cause of headaches for me is alcohol consumption, and I was taught that alcohol plus acetaminophen is a strict no-no. Ibuprofen -- in the recommended dose -- is generally fine with alcohol. (I don't binge drink anymore, but as I get older, even 3 or 4 cocktails over the span of 4-6 hours can give me a headache later.)
But when I come down with a cold, it's (the cheaper, generic version of) NyQuil for me. A bonus is that NyQuil also contains dextromethorphan (cough suppressant) and doxylamine succinate (antihistamine) (or phenylephrine in the non-drowsy DayQuil variant), which IIRC Night Nurse/Day Nurse did not include. (Looks like it does contain dextromethorphan and promethazine now; not sure if it didn't back then, or if I'm just misremembering.)
That's a very narrow efficacy window. There are modern drugs with a narrow efficacy window but they have pharmacy only licenses or require prescription, which both mean somebody who knows what the hell they're doing sold you the drug, not the automated checkout at a supermarket. That's a vital opportunity to spot that e.g. you're taking this every single day (so it's ongoing pain, probably needs a different intervention, paracetamol is contrandicated) or you have an obvious wound, which needs medical attention not painkillers. Or sometimes very dumb things, like, hey, the actual symptoms you have described mean you're likely pregnant did you even realise that? Would you like a pregnancy test instead ?
The efficacy window of driving cars is pretty narrow, and represents existential risk to third parties. But as with cars, sometimes the balance favors wide availability.
This is so funny because there's a post in another subthread by someone from the UK saying the same thing about Americans being hostile toward it.
I've only been to the UK a few times, but I feel like it's a funny meme that people in the UK unhesitatingly suggest and take paracetamol for everything. I guess that's not really true, or at least has some truth to it but is an exaggeration?
Besides US traffic deaths are crazy high by UK standards.
I'm always very torn on how to best protect people from being stupid. The label on the bottle says not to use the drug for longer than a certain period. Sure, people might not read it, or might not understand the risks and ignore it. Sure, someone might be too dumb / in denial to realize they might be pregnant, and take inappropriate medication. I do really want to protect these people from themselves, but I also don't want to go to the doctor every time I have the common cold to get a prescription for one of the only things that clears up my symptoms enough so I can sleep.
The only thing which I think Advanced Practitioner doesn't get you is going entirely off piste, like fuck it, maybe this untried drug will fix your cough. But the person with their name on the pharmacy paperwork can sign off any ordinary stuff, far beyond just "common cold" treatments, anti-nausea, anything a doctor signs on an average day unless they're in some weird research field. The idea isn't that you'd need a GP appointment but that probably it shouldn't be with the bubblegum and cornflakes in the supermarket without even talking to a professional.
Also there are travel pharmacies, which will sell you prescription drugs, so long as you insist you're about to go travelling somewhere remote.
The whole pretence that dangerous drugs are controlled and kept away from people is a pretty thin veneer.
I've never met anyone here who has ever had any issues associated with paracetamol abuse/overdose, and only a single person who failed to cross the road correctly.
I'm serious. Over 50% of all liver failure is due to acetaminophen, and 20% of liver transplants.
That's not what that study says.
It says it is responsible for 50% of the overdose-related acute liver failures. Acute liver failure is rare, especially compared to chronic liver failure.
It's a meta-analysis that considered a bunch of individual studies, their effect size, and their quality. It claims that Tylenol use has increased alongside a 20-fold increase in autism rates, suggesting causation, and recommends immediate efforts to reduce Tylenol use during pregnancy.
One objection that I've seen is that the lead author, Dr. Baccarelli, has a conflict of interest because he was an expert witness in a lawsuit about acetaminophen and neurodevelopmental disorders. If you think about it though, someone knowledgeable enough to write this paper is exactly the kind of person you'd want to serve as an expert witness.
In other words there is an association, but the study is not able to prove (or even suggest) causation. For example, it does not exclude the possibility that other factors that actually cause autism and Tylenol use are themselves linked. So Tylenol use could be correlated with autism but not a cause of it. In that case, pregnant women who would otherwise use Tylenol not doing so are not reducing the chance of autism. And as the study points out, failing to treat conditions that warrant Tylenol usage can also have negative pregnancy outcomes.
As general medical advice, no, it's not reasonable. Acetaminophen provides real benefits, giving up those benefits requires actual proof of harm.
Maybe, but the same was also true of the now disgraced Andrew Wakefield, although his conflict of interest was even greater since he didn't reveal his funding before publishing his original paper.
The studies in general they include are case control and prospective cohort studies, predicting neurobehavioral outcomes from paracetamol use retrospectively or prospectively.
The most interesting ones to me are siblings control studies where they compare siblings with and without exposure or case status to control for unmeasured confounds like genetic or family environment variables.
In those studies they reviewed there is still a link but it's much weaker, mostly limited to mothers using paracetamol for a month or more, and on measures not necessarily reflecting autism per se.
That pattern to me is equally suggestive of something other than paracetamol being the causal factor. It could be reflective of a dose response relationship, but you also have to wonder about what else might be going on among women who feel compelled to take paracetamol for over a month at least during pregnancy.
Maybe a paper to call for further better research but not exactly a clear causal link.
Every charlatan researcher grifting on bogus autism data really is just copying Andrew Wakefield's homework
But it turns out there may actually be some emerging evidence to support this. This recent Harvard meta-analysis [1] from just last month looked at 46 different studies and suggested that there may actually be something happening here although it's not conclusive. Correlation but not yet causation.
Nobody should be making policy on this yet, but it's the kind of thing that I would allocate some research dollars to if I hadn't just fired all of the competent researchers.
1 - https://hsph.harvard.edu/news/using-acetaminophen-during-pre...
I do not have at all the right background to evaluate this research so treat this opinion for what it's worth, but it seems incautious for the authors to close with this note near the end. People like RFK are looking for an explanation for that 20-fold increase. But the hazard ratios in the studies with positive results seem to be along the lines of 1.05-1.20. They do also note changes in diagnosis criteria before this sentence, but it still seems like if they're going to mention a 20-fold increase, they should be even more explicit that any association with increased Tylenol use could only ever explain a very small part of that.
That means mothers who don't take Tylenol have baseline 3% chance their child will be diagnosed with autism. And mothers who took Tylenol (at the levels of the study) may have a 3.15% to 3.6% chance (assuming causation, which has not been proven).
It seems unlikely we "cracked the code" here.
The best justification for the high increase we're seeing in the data is still just that the data itself has changed in how it's measured and tallied and so on.
Being afforded better care during pregnancy should correlate with better attention (and diagnosis of conditions) to offspring.
If one were cynical one might say this was a good call by Andrea Baccarelli, the Dean of the Faculty, to commission a meta study looking for correlations between common treatments and NDD diagnoses in the current climate of funding going toward whomever can put forward a thread to follow in pursuit of autism.
EDIT: Indeed it is! The US government is scooby-doo villains? https://www.npr.org/2024/08/05/nx-s1-5063939/rfk-jr-central-...
Luckily for those of us who care, there are private and foreign government organizations who still take healthcare and science seriously. Unfortunately the only sane solution seems to be to ignore the US authorities on this for the time being.
I mean, he rails against processed food and color/dye additives, some of it being stuff that other countries with reputable FDA-analogues have banned. There could be something to that, even though I can confidently assume his opinions don't come from any sort of scientific rigor.
Some blue states are even (quietly?) jumping on the "MAHA" bandwagon on some issues. Not to categorically say "blue states right, red states wrong", but if your polarized political opponents are putting some of your ideas into practice, maybe not all your ideas are bad, regardless of how unscientifically you may have come by them.
Mine was destroyed after they caused a walkout at the CDC.
We are not the same
>> The researchers noted that while steps should be taken to limit acetaminophen use, the drug is important for treating maternal fever and pain, which can also harm children.
also:
>> Baccarelli noted in the “competing interests” section of the paper that he has served as an expert witness for a plaintiff in a case involving potential links between acetominophen use during pregnancy and neurodevelopmental disorders.
Huh, but digging in a little more does show some stronger studies... hmmmm...
Yes but that is the whole RFK brand. He and his supporters always try to have their cake and eat it too. Claim something, things go wrong and blame others for misconstruing RFK's comments.
The way this is going - RFK is going to make claims based on this paper and when people get harmed, he and his supporters will claim that people who followed RFK's assertion didn't hear him correctly. He clearly said the policy was based on this paper and people should have done more research and read this paper. See this paper says there is correlation and not causation. So, you cannot blame RFK for this mishap.
Maybe we should. We're talking about pregnant women and autism, along with taking a different painkiller. And if the theory is wrong, it'll only take a few years to find out, presumably.
For people who don't have children: most medical advice regarding pregnant women and infants is overwhelmingly cautious and errs on the side of, "if we don't have enough studies confirming it's 100% safe, it's better to stick to the less questionably safe way." I'm not sure why this would be any different.
The issue here is you need to make a trade. It's not like cutting out alcohol. Now you have to decide, what alternative painkiller will replace it.
There was an initial reason why Tylenol became the standard one, because others were assessed to be riskier in other ways.
I agree with you, people should weight all the known risks from all legitimate studies and data, and base policies around that, and this is no exception.
People are worried though that this won't be the case, and that bias is present from the start in this case, and we might end up making the wrong policy call.
All you’re stating is that you’ve found an echo chamber - which is true of Hacker News (and Reddit, and BlueSky). It’s also true of TruthSocial. I guess my annoyance is that this is Hacker news not DNC news - and as such, I’d hope for more than one (or even two!) perspectives.
I don’t think RFK has shot his credibility - even if he did withdraw from the DNC on October 9, 2023, less than two years ago. His perspective seems stable 20 years on after he wrote “Deadly Immunity” in 2005.
If you think he lost credibility, it wasn’t recent.
I don't find that to be a controversial statement.
[1] https://www.science.org/content/article/trump-officials-down...
Any volunteers?
https://www.mountsinai.org/about/newsroom/2025/mount-sinai-s...
Like everything else in life, you must weigh all the risks and benefits.
Untreated fever also carries real risks - neural tube defects, congenital heart defects, orofacial clefts, miscarriage.
You need to treat fever, and NSAIDS have greater risks than acetaminophen.
It's irrational to let a minuscule and unproven risk dominate the decision when the other side of the balance has more evidence of larger risks to weigh.
What is a pregnant person with debilitating pain such as a migraine supposed to do?
Walking 12 miles is not only uncomfortable, it is also higher risk to Mom and baby than driving.
You have to balance all the risks and benefits.
Fever during pregnancy can cause neural tube defects, congenital heart defects, orofacial clefts, miscarriage.
It's great that you care so much about the infinitesimal risks of acetaminophen. You should care 100x more about these risks that are 100x or 1000x greater.
It very much is still your wife's body - what other sentient entity is available for consultation?
I also am not sure if she is seeking professional medical advice - 'baby aspirin' is not a blood pressure medication, full stop. If this is based on non-medical doctor advice, please do consult a fully-qualified obstetrician.
Edit, just because this is very worrying to me, for later viewers, aspirin is an NSAID and its use should be weighed similar to that of other NSAIDs in the context of pregnancy. Consider this web page:
https://www.fda.gov/safety/medical-product-safety-informatio...
The baby aspirin is not for hypertension (it does nothing for hypertension). Its goal is to prevent changes in placental vasculature that may lead to severe pre-eclampsia in those already at risk for pre-eclampsia. One clinical sign that demonstrates risk for pre-eclampsia is high blood pressure.
Surely you don't mean what you imply there? Not being sentient or available for consultation don't justify harming a person. A mother absolutely has a moral responsibility not to cause lifelong harm to the sentient entity her baby will later become. You wouldn't say excess alcohol consumption during pregnancy is only up to the mother's decision about her own body when there are adults walking around with terrible lives because of fetal alcohol syndrome.
That's absolutely the case, though, isn't it? I wasn't aware of any laws that bar pregnant women from buying or consuming alcohol. So it's totally up to them.
I would - because the alternative means we are locking up current human beings to act as incubators for potential, future humans
It's kind of freeing, in a way. Lets you see your own pain from the outside like it's happening to someone else. Takes the power away.
_magic statement_.
Because tylenol is often used to treat a symptom like inflammation, that is where the problem could really lie and needs more studying. Inflammation in the human body causes tons of damage.
Shit, you know why measles is serious in adults? Sure pretty every adult can shrug it off, BUT. It causes mass inflammation in the human body, and because of that, it can and does make men sterile because inflammation kills the testes ability to produce sperm.
I think folate supplementation is generally already a fairly standard recommendation during pregnancy, since deficiency is linked to significant neural tube defects during pregnancy (eg CDC [1]). It's at least interesting that folate-derived medicines may also treat symptoms.
[1] https://www.cdc.gov/folic-acid/about/index.html#:~:text=Abou...
Whereas the current administration is all about loyalty over facts. They even make the meteorological employees do a loyalty test now so they'll follow the narrative and not the science.
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