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Autism, Asthma and Tylenol



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January 18, 2010

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AutismIn the January 2010 issue of Medical Hypothesis, Becker and Schultz suggest that Tylenol may be implicated in both autism and asthma.  The rate of these conditions has risen sharply in recent years but there continues to be controversy over the etiology.  Little hard evidence exists but one study describes the significant increase in autism that began at the same time acetaminophen was recommended to take the place of aspirin.

One preliminary case controlled study provides some confirmation with respect to Tylenol.  The study found a significant increase in autism among children given acetaminophen for symptoms associated with the measles-mumps-rubella vaccination.  The group of children given Ibuprofen for the same symptoms of the vaccination was significantly less likely to be autistic.  The use of Tylenol by pregnant women is also thought to be associated with autism at birth. One author suggests that, if medication needs to be given to children for post vaccination symptoms, low dose aspirin would be a safer choice.  These studies also bring into question the relative danger of vaccinations as acetaminophen may be the responsible agent for cases of autism and not the vaccination itself.

The speculation regarding the etiology of both autism and asthma will no doubt continue for some time until larger and better studies are conducted.  In the mean time there is a small dose of evidence and a heavy dose of speculation regarding the etiologies of these conditions.


Similarities in features of autism and asthma and a possible link to acetaminophen use.

Med Hypotheses. 2010 Jan;74(1):7-11. Epub 2009 Sep 11.

Becker KG, Schultz ST.

Autism and autism spectrum disorders are enigmatic conditions that have their origins in the interaction of genes and environmental factors. In this hypothesis, genes statistically associated with autism are emphasized to be important in inflammation and in innate immune pathways, including pathways for susceptibility to asthma. The role of acetaminophen (paracetamol) in an increased risk for asthma is described and a possible similar link to an increased risk for autism is suggested.

Did acetaminophen provoke the autism epidemic?

Altern Med Rev. 2009 Dec;14(4):364-72.

Good P.

Schultz et al (2008) raised the question whether regression into autism is triggered, not by the measles-mumps-rubella (MMR) vaccine, but by acetaminophen (Tylenol) given for its fever and pain. Considerable evidence supports this contention, most notably the exponential rise in the incidence of autism since 1980, when acetaminophen began to replace aspirin for infants and young children....

Acetaminophen (paracetamol) use, measles-mumps-rubella vaccination, and autistic disorder: the results of a parent survey.

Autism. 2008 May;12(3):293-307.

Schultz ST, Klonoff-Cohen HS, Wingard DL, Akshoomoff NA, Macera CA, Ji M.
University of California San Diego, USA. Stephen.schultz@med.navy.mil

The present study was performed to determine whether acetaminophen (paracetamol) use after the measles-mumps-rubella vaccination could be associated with autistic disorder. This case-control study used the results of an online parental survey conducted from 16 July 2005 to 30 January 2006, consisting of 83 children with autistic disorder and 80 control children. Acetaminophen use after measles-mumps-rubella vaccination was significantly associated with autistic disorder when considering children 5 years of age or less (OR 6.11, 95% CI 1.42-26.3), after limiting cases to children with regression in development (OR 3.97, 95% CI 1.11-14.3), and when considering only children who had post-vaccination sequelae (OR 8.23, 95% CI 1.56-43.3), adjusting for age, gender, mother's ethnicity, and the presence of illness concurrent with measles-mumps-rubella vaccination. Ibuprofen use after measles-mumps-rubella vaccination was not associated with autistic disorder. This preliminary study found that acetaminophen use after measles-mumps-rubella vaccination was associated with autistic disorder.

Is fever suppression involved in the etiology of autism and neurodevelopmental disorders?

BMC Pediatr. 2003 Sep 2;3:9. Epub 2003 Sep 2.

Torres AR.
Centers for Persons with Disabilities, Utah State University, Logan, Utah 84321-6895, USA. rtorres@cpd2.usu.edu

BACKGROUND: There appears to be a significant increase in the prevalence rate of autism. Reasons for the increase are unknown, however, there is a substantial body of evidence that suggests the etiology involves infections of the pregnant mother or of a young child. Most infections result in fever that is routinely controlled with antipyretics such as acetaminophen. The blocking of fever inhibits processes that evolved over millions of years to protect against microbial attack. Immune mechanisms in the central nervous system are part of this protective process.

HYPOTHESIS: The blockage of fever with antipyretics interferes with normal immunological development in the brain leading to neurodevelopmental disorders such as autism in certain genetically and immunologically disposed individuals.

TESTING THE HYPOTHESIS: Epidemiological studies to determine associations between the use of antipyretics and neurodevelopmental disorders should be undertaken. Biochemical tests will involve the examination of fluids/serum by mass spectrometry and the determination of cytokine/chemokine levels in serum and cell culture fluids after stimulation with fever-inducing molecules from bacteria, viruses and yeast. Postmortem brain can be examined by immunohistochemistry or other methods such as fluorescent in situ hybridization (FISH) to determine altered expression levels of chemokines/cytokines and other molecules.

IMPLICATIONS OF THE HYPOTHESIS: 1) The use of antipyretics during pregnancy or in young children may be reserved for more severe fevers. 2) The perplexing genetic findings in autism may be better understood by categorizing genes along functional pathways. 3) New treatments based on immune, cell, pharmacological or even heat therapies may be developed.


Note: The appropriate way to weigh these papers is by reading the entire manuscript.  Copyright law does not permit us to republish the full text of these studies.

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