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...
>> 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...
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.
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.
EDIT: Indeed it is! The US government is scooby-doo villains? https://www.npr.org/2024/08/05/nx-s1-5063939/rfk-jr-central-...
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.
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.
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...
You may not owe people who you feel are disgusting quacks better, but you owe this community better if you're participating in it.
I wouldn’t entirely rule out there being environmental factors, but from the data I could gather it seems that acetaminophen usage has decreased in pregnancy over the last several decades in the US, while autism has increased.
This all seems to go back to the boomer generation believing the world was simpler when they grew up and that it was somehow ruined. That may be true about some things but the reality of their generation is they had no idea what people were going through, and didn’t have the language to describe it
How much are people willing to bet that the incidence of autism will remain unchanged and the administration will disavow everything.
“Nobody knew autism was so complicated.” — future Trump, probably.
When you go to the doctor because you child is on the spectrum. "Fill out this form Mam", on it is the question "Did you take Tylenol during the pregnancy?"
- You check "Yes" -> Your fault, should have known better. No help for you.
- You check "No" -> Well then it can't be autism, that's "scientifically" proven. No help for you.
"Autism rates have gone down 500% during my r/e/i/g/n/ administration!"
Tylenol was introduced in 1955. Autism was first scientifically documented in 1926. If Tylenol causes autism, how did those parents in the 1920s get their hands on it?
Also, wouldn't there been a clear link between Tylenol sales and the occurrence of autism? Where is the data showing that the adoption of Tylenol in the 1960s resulted in a rise in autism, and that the "rise" of autism in the 1990s is linked to an increase in Tylenol use?
The claim is that Tylenol is a factor that increases the risk of autism. It is not the cause of 100% of all cases.
That said, the first synthesis of Paracetamol in the USA was Johns Hopkins in 1877, so maybe the answer is they went to Baltimore.
- going after quacks who promote bleach, horse dewormers (maybe that's the problem), and raw milk
- adopt the precautionary principle
- approve EU sunscreen compounds without animal testing and banning reef/human unsafe ones
- leave science to scientists
- increase regulatory oversight over food manufacturing, additive, and supply chain regulation so there aren't canyons of non-enforcement or exclusions between FDA and USDA
Or, maybe, this is really radical... find someone else competent to do the job.
I remember an old study linking ultrasounds to lefthandedness. It was legit. Families with access to ultrasounds lived in countries/areas where lefthandedness was more culturally accepted, places where it was not drilled out of kids. The study was correct, but anyone touting it as causation was totally incorrect.
Fyi, sharks are way more likely to attack people with australian accents. Never go swimming with an auzzi.
I wonder whether the political actors in question don't understand correlation != causation, or whether they hope that enough of the populace does not understand it in order to further some goal. But what goal? Buying cheap drug shares? Seems ... silly.
We all know he cannot prove anything, even if Tylenol loses, ensure they cost RFK jr lots of $ in defending himself.
Or is it, perhaps, possible that, if there is indeed a real increase in the rate of autism, it's because of something that has nothing to do with our modern pharmaceuticals?
Could it perhaps be related to the increases in various kinds of air pollution? Water pollution? Pesticides or herbicides in our foods? Or even the dramatic increase in EM signals being broadcast everywhere?
Until there are reputable studies that can actually show something resembling a causal link, getting angry at the medical community, pharmaceutical manufacturers, or vaccine makes for saying they are not responsible is pointless and counterproductive. So far as everyone knows, it really wasn't them.
And while there may be some small subset of people "accusing suffering parents of being crazy", by and large that's also not something that's happening.
There was a marked increase in left-handedness once the 'stigma' of it was removed.
And modern agriculture practices result in lower amounts of less toxic substances in the food supply.
The West is on a decreasing trend of all those kind of pollution since the 70s.
“Or even the dramatic increase in EM signals being broadcast everywhere?”.
It’s funny people are entertaining the hypothesis that EM radiation causes autism in the same conversation where they are trying to assure you that a drug that’s increasingly taken by pregnant women and that is proven to pass the placenta, is 100% harmless and can’t have anything to do with increased levels of autism.
Wrong approach. You prove that something is safe first (and there are ways to do it, one has to creative though) and then have people use it. One does not introduce something in the population and then trying to prove a causal link through stats. There are too many variable and it becomes easy to pass the buck by massaging numbers.
Surely you understand that that makes no sense at all? All of these medicines have already been tested and shown to be safe, based on the science and understanding of the time. That's why they're on the market in the first place.
For better or for worse, the burden of proof is now on those who want to show that they are dangerous.
We are primarily talking about Tylenol. Paracetamol. Acetaminophen.
Perhaps you need to be reminded of the whole sentence you quoted from my post, rather than just the first subclause?
> Until there are reputable studies that can actually show something resembling a causal link, getting angry at the medical community, pharmaceutical manufacturers, or vaccine makes for saying they are not responsible is pointless and counterproductive.
The post I was replying to originally was specifically saying that the medical community needed to be accepting blame for causing autism.
This is bullshit. We do not know what causes autism. We certainly do not have any compelling evidence that anything the medical community is doing is causing autism.
My mistake, I did not quote your original comment correctly.:
I meant to quote:
>Could it perhaps be related to the increases in various kinds of air pollution? Water pollution? Pesticides or herbicides in our foods? Or even the dramatic increase in EM signals being broadcast everywhere?
>This is bullshit. We do not know what causes autism. We certainly do not have any compelling evidence that anything the medical community is doing is causing autism.
I would not put it past them. Harmful until proven otherwise is the approach I would take with most drugs/vaccines in the market out there, today. There is no third party testing for any drug/vaccine today - so pharma is free to manipulate the stats, and they have done it in the past.
Acetaminophen is better studied than like 99% of foods and supplements.
What? Who is supposedly calling parents of autistic children "crazy"?
Like cutting funding for autism research [1] and kids with autism on Medicaid [2]?
[1] https://www.disabilityscoop.com/2025/06/02/nih-autism-resear...
[2] https://nebraskaexaminer.com/2025/09/05/nebraska-lawmakers-h...
True. Infact I'd go so far as to say the medical community causes many of the health problem.
Speaking about empathy most people don't have it, not just the medical community. Even the victims will be victimizers at some point, it's very twisted situation.
( Btw, you have a very obvious pseudonym...)
Paracetamol/acetaminophen (the active ingredient in tylenol) is super toxic to the liver. Lots of people overdose on it, some by accident and some deliberately. As little as FOUR GRAMS can cause jaundice and fuck up your liver. If you have a fever, taking 1 gram every couple of hours might seem entirely reasonable, but it can kill you.
Regardless of any autism links, it's good to be careful with this stuff.
I don't know how you jumped from "it's dangerous to take in to high amounts, even 4 times the recommended dose is dangerous" to "the recommened dose is dangerous".
When taken correctly it is very safe and had fewer side effects then NSAIDs like ibuprofen.
A person in power makes unsubstantiated (and often disproven claims), and makes major decisions that affect all our lives based on those claims.
And the response ignores the fact that the people in power are making decisions based on complete nonsense and pointing to something fairly trivial that everyone knows about anyways.
I mean, I haven’t been to a doctor who hasn’t pointed out that there are limits to how much acetaminophen one can take. There’s a reason anything above a 650mg dose is prescription only. Theirs is a reason if you’re suffering from a severe fever doctors will give you both acetaminophen and ibuprofen and have you alternate them.
If there is a tiny minority that is apparently unaware of the fact that Tylenol in high doses can have adverse effects or at the very least not even aware of the fact that most medications need to be taken as prescribed or within the suggested limits, that’s a minuscule part of the problem relative to people in power making decisions based on unproven claims.
How many other medications would that apply to? Countless, I imagine. That’s why we have dosages on every bottle.
after I had dental surgery, I took paracetamol and ibuprofen in alternate doses every 4h - I would have been in screaming pain if I couldn't have both as an option.
I was recently prescribed 800mg ibuprofen for an injury, where 200mg is the standard OTC dose, and I even questioned that.
It’s like saying jumping on subway tracks when there’s no train is entirely reasonable when there are ample warnings on the platform to not do that.
“ Regardless of any autism links” - there you go again with the innuendo. My dude if you want to warn about how dangerous Tylenol is in and of itself when misused, go right ahead, but leave autism out of it, you’re playing right into the “Tylenol cause autism” fearmonger’s hands.
This is very true. ( and no, he is not exaggerating)
Lots of drugs are toxic if misused or abused. Acetaminophen is not unique in that regard.
One gram every 2 hours is 12 grams which is on the lower end of toxic doses.
Despite common belief, concurrent alcohol consumption surprisingly does not increase risk, since alcohol competes for CYP2E1 and reduces the rate of production of the toxic metabolite NAPQI. Similarly for chronic liver disease. The use of NSAIDS (ibuprofen, etc) with cirrhosis is absolutely less safe than tylenol at therapeutic doses.
One could also take a look at pages like cheddar which track what they claim is unusual flow in options.
https://en.wikipedia.org/wiki/Thalidomide_scandal
Tylenol only helps for minor aches and pains that frankly, pregnant mothers should just deal with for the good of their unborn child. The risk is not worth it.
RFK Jr. isn't right on everything, but he's not wrong on everything either and it's refreshing seeing someone head HHS that isn't in big pharma's pocket for a change.
Much better that he be in Big Wellness’s pocket which is an order of magnitude bigger, unregulated, and doesn’t need to provide evidence for their claims.
Please link to some credible sources showing that he's being paid off by someone.
has this ever stopped anybody?
Untreated symptoms are also bad for the baby, and other OTC painkillers are worse than acetaminophen. You have to become informed and choose the least bad option for your situation (trimester, medical history, etc) rather than let a demagogue point your outrage at a random imperfect solution.
[Citation Needed]
Because there's no clear evidence to the contrary. Research and published papers would be more convincing here than an accusation.
> pregnant mothers should just deal with for the good of their unborn child
There's a number of things they should be restricted from for the good of the child of course, as men request. Blessed be the fruit. /s
Who's to say that the mother experiencing a ton of pain doesnt also affect the fetus?
where's your proof that its safe to leave a prefnant woman in pain?
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.
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.
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!!"
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".
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.
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.
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.
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.
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 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!
> 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.
> …
> 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.
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.
Likewise I find it one of the least _effective_ painkillers on the market.
If you consider the relevant research you might think differently: https://hsph.harvard.edu/news/using-acetaminophen-during-pre...
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.
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.
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.)
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.
Besides US traffic deaths are crazy high by UK standards.
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?
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.
I'm serious. Over 50% of all liver failure is due to acetaminophen, and 20% of liver transplants.
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.)
https://www.mountsinai.org/about/newsroom/2025/mount-sinai-s...
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...
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.
I would - because the alternative means we are locking up current human beings to act as incubators for potential, future humans
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.
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?
_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.
More likely to take painkillers + more likely to get your child assessed for autism = observed (tiny) correlation, even in the absence of any causation.
Data does appear to show a possible link, definitely at the least warrants further research.
As long as autism, there can be no causative link. Millions have autism, billions take paracetamol. Autism has, like its cousin schizophrenia, a strong genetic-familial basis. Hardly any environmental factor increases the risk so much to be worrisome.
https://www.realclearscience.com/blog/2019/03/30/acetaminoph...
That doesn't make a lot of sense. Either it's a hereditary condition or it's acquired during development; it can't be both, at the same time, in the same person.
(Edited to clarify - yes, of course I'm aware that conditions can have multiple causes. But those causes remain separate; a condition which was acquired during life generally does not become inheritable.)
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.
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.
"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...
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.
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.
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
Any volunteers?
I'll take RFK being the stopped clock on this over him causing yet more harm to the medical community and to Americans' health.
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.
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.
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.
Every charlatan researcher grifting on bogus autism data really is just copying Andrew Wakefield's homework
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...
News outlets: no credible scientific evidence.
Uh oh spaghettios. The more the leftwing "resists" the more their "science" self-image will disconnect with reality. Like most things with this administration, I think that's the real goal.
[1] 14 August 2025 in BMC Environmental Health. 27 of 46 studies reported a positive association between prenatal acetaminophen and neurodevelopmental disorders like autism and ADHD.
Refreeze5224•1d ago
ekianjo•1d ago
Until you have a controlled study on pregnant women who use and don't use the drug, you won't really know for sure.
jeroenhd•21h ago
https://news.ki.se/no-link-between-paracetamol-use-during-pr... concludes that there is no link between acetaminophen and autism based on existing research. https://ehjournal.biomedcentral.com/articles/10.1186/s12940-... concludes the opposite. I'm not qualified to determine which of these studies is more reliable, but the evidence is far from clear if multiple literature studies state the opposite conclusion.
News articles seem to state that the conclusions are clear as day but the same websites were equally sure of the opposite last year.
I'll wait or reliable sources of medical information, which the US government no longer is, to comment on these papers rather than assume whatever paper made the HN frontpage last is the final result of the scientific debate.
ekianjo•18h ago
Obviously what goes into your body should be suspected first, whether it's food, pollutants, or medical interventions.
crote•17h ago
We don't know the cause of autism. We do know that autism has a heritable component, with significant rates of both siblings having it (which could be explained by environmental factors) and both parent and child having it (which cannot be explained by environmental factors). Surely it would make a lot more sense to suspect a genetic component first?
ekianjo•13h ago
kashunstva•15h ago
I wouldn’t look for a prospective randomized controlled trial of this anytime soon. Hard to imagine an IRB approving such a study.
Observational studies do suggest a small but statistically significant association between acetaminophen use in pregnancy and ASD, but the relative risk increase is small, because both the effect size and baseline risk are small.
ekianjo•13h ago
stuaxo•23h ago
CharlesW•22h ago
sixothree•20h ago
SpicyLemonZest•19h ago
krapp•19h ago
This is the guy who caught a worm in his brain from eating roadkill?
esbranson•38m ago
Spivak•23h ago
avalys•22h ago
Spivak•22h ago
kashunstva•15h ago
From a recent meta analysis, a total of 6 studies meeting the inclusion criteria addressed the association between acetaminophen exposure in utero and ASD. The odds ratio for the aggregated data was 1.19 which puts the 0.2-0.4% relative risk increase depending on what baseline incidence you assume (along the lines of your estimate.)
If you take the baseline incidence to be 1% then I calculate the NNH - number needed to harm, at 533, meaning you have to expose 533 pregnant women to acetaminophen to observe one additional case of ASD.
Given that the current public health administration of this era in the U.S. operates by seat-of-the-pants guidance rather than statistical evidence, the statistics are irrelevant to them. My advice would be that health care providers caring for pregnant women have an informed discussion about the risk and call it a day.
y-curious•22h ago
1: https://www.scribbr.co.uk/fallacy/the-genetic-fallacy/#:~:te...
SpicyLemonZest•19h ago
aeternum•19h ago
And are you really claiming you can't determine that factor by looking?
SpicyLemonZest•19h ago
aeternum•7h ago
It puts aside all the big is beautiful and similar takes and points to the fact that many American kids, especially those in certain parts of the country are now afflicted with metabolic syndrome (which is closely associated with mitochondrial disfunction). It is well-known that overloading mitochondria with sugar is quite bad for them and a key contributor to type 2 diabetes.
https://pmc.ncbi.nlm.nih.gov/articles/PMC10036395/ https://pubmed.ncbi.nlm.nih.gov/32428560/ https://pmc.ncbi.nlm.nih.gov/articles/PMC4408906/
SpicyLemonZest•2h ago
impendia•19h ago
If medical facts can reliably be inferred from RFK's statements, by whatever algorithm (i.e. "believe the opposite of whatever he says"), then it follows that he understands what he is talking about. Which would contradict all the evidence I've seen.
SpicyLemonZest•19h ago
add-sub-mul-div•22h ago
And one of the reasons you don't let morons take over your party is that if they ever are right, they won't be believed. If these are actual risks with Tylenol then oops, that take is being lumped in with the antivax hysteria.
esbranson•40m ago
Oops for sure. Like if someone says school closures won't have an effect on infection rates, not only will you not be believed, you'll be "anti-science", whatever that means.
kristianp•16h ago
I've seen this kind of thing mentioned before. As a non USA person, I don't know what the deal is with RFK and autism. Wasn't it vaccines last month?
reverius42•16h ago