The Trump administration has thrust Tylenol into the highlight this week with its warnings a few potential hyperlink to autism when taken by pregnant girls.
Nevertheless, the precise steerage coming from the administration is extra nuanced than President Trump’s repeated “don’t take Tylenol” urgings at a Tuesday press convention.
And main well being teams proceed to say Tylenol is secure, arguing the president’s warnings usually are not backed by science.
Speak to your physician; take lowest efficient dose
Regardless of Trump’s alarmist feedback Tuesday, the administration continues to suggest acetaminophen, the lively ingredient in Tylenol, in some instances.
“It remains reasonable,” Meals and Drug Administration (FDA) Commissioner Marty Makary mentioned in a press release, “for pregnant women to use acetaminophen in certain scenarios.”
Mehmet Oz, head of the Facilities for Medicare and Medicaid Companies, mentioned pregnant girls ought to name their docs when experiencing fevers, which might trigger start defects.
“The physician’s nearly actually going to prescribe you one thing, Tylenol is likely to be one of many issues they provide, that is not the issue,” Oz advised TMZ.
“Pregnant women know lots of the typical things you would take for aches and pains and fevers are not a permissible product to be used during pregnancy,” he added. “Acetaminophen is probably your best option, but take it when you really need it.”
Oz mentioned the larger problem was pregnant girls taking acetaminophen for minor points like a headache or stubbed toe.
The administration has repeatedly pointed to a examine launched earlier this 12 months by Mount Sinai Hospital and Harvard’s T.H. Chan College of Public Well being, which discovered an affiliation between Tylenol and a few neurological situations in youngsters.
However the authors had been cautious about any sweeping modifications to medical steerage.
“We recommend judicious acetaminophen use—lowest effective dose, shortest duration—under medical guidance, tailored to individual risk-benefit assessments, rather than a broad limitation,” they wrote.
CNN chief medical correspondent Dr. Sanjay Gupta mentioned that tracks with normal medical apply.
“I think most doctors have long said that treating a fever during pregnancy is important and that you should use the lowest dose for the shortest amount of time,” he mentioned.
What the research say about acetaminophen-autism hyperlink
Whereas the Mount Sinai examine has been the principle justification for the administration’s warning, the FDA’s assertion on its label change to Tylenol admitted the information stays unsure.
“It is important to note that while an association between acetaminophen and neurological conditions has been described in many studies, a causal relationship has not been established and there are contrary studies in the scientific literature,” it mentioned. “It is also noted that acetaminophen is the only over-the-counter drug approved for use to treat fevers during pregnancy, and high fevers in pregnant women can pose a risk to their children.”
The examine additionally cautioned in opposition to drawing any onerous conclusions, calling as a substitute for extra analysis and elevated warning about Tylenol use.
“Further research is needed to confirm the association and determine causality, but based on existing evidence, I believe that caution about acetaminophen use during pregnancy—especially heavy or prolonged use—is warranted,” Andrea Baccarelli, a professor of environmental well being at Harvard, mentioned in a press release.
One other examine in Sweden launched final 12 months checked out almost 200,000 youngsters and located no proof of hyperlinks between acetaminophen and autism.
“Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests that associations observed in other models may have been attributable to familial confounding,” the examine discovered.
Familial confounding refers to when a shared issue between members of the family, corresponding to genetics or atmosphere, creates a deceptive affiliation between inputs and outcomes.
A 2019 Johns Hopkins College examine analyzed umbilical wire blood samples, discovering that “newborns with the highest exposure to acetaminophen were about three times more likely to be diagnosed with ADHD or autism spectrum disorder in childhood.”
Nevertheless, authors of that examine additionally cautioned in opposition to drawing conclusions based mostly on affiliation, saying “more studies are clearly needed to further clarify the concern.”
Gupta mentioned the “paradox of ubiquity” helped clarify the continued scientific uncertainty regardless of the research exhibiting affiliation.
“When something is really commonly used in society, it is hard to figure out if it’s associated with something in particular,” Gupta mentioned. “As a result of people who find themselves taking Tylenol, they could have had fevers, may the fever have one thing to do with this? May there have been one thing else happening? There are plenty of controls it’s a must to do, and it is onerous with one thing as ubiquitous or frequent as Tylenol.”
Balancing threat of fever
Girls’s well being consultants fear that the Trump administration’s warnings will trigger girls to be overly involved about taking acetaminophen, exposing their infants to different well being dangers.
“Acetaminophen is one of the few options available to pregnant patients to treat pain and fever, which can be harmful to pregnant people when left untreated,” the American School of Obstetricians and Gynecologists mentioned in a press release this week. “Maternal fever, headaches as an early sign of preeclampsia, and pain are all managed with the therapeutic use of acetaminophen, making acetaminophen essential to the people who need it.”
“The conditions people use acetaminophen to treat during pregnancy are far more dangerous than any theoretical risks and can create severe morbidity and mortality for the pregnant person and the fetus,” it added. “When considering the use of medication in pregnancy, it’s important to consider all potential risks along with any benefits.”
KFF Well being Information and Politifact gave Trump a “pants on fireplace” score over his declare that there’s “no downside” to not taking acetaminophen throughout being pregnant.
It pointed to a Society for Maternal-Fetal Medication assertion that mentioned, “Untreated fever, particularly in the first trimester, increases the risk of miscarriage, birth defects, and premature birth, and untreated pain can lead to maternal depression, anxiety, and high blood pressure.”
