acetaminophen (Tylenol) during pregnancy increases your baby's risk of ADHD, autism and reproductive disorders

Taking Tylenol while pregnant could alter fetal development in a way that could increase the risk of some neurodevelopmental disorders in the baby.

Acetaminophen (also known as paracetamol) is the active ingredient in more than 600 medications: most famously, Tylenol. The FDA has always considered it appropriate for use during pregnancy. The research has long suggested otherwise. And now a consensus statement by a coalition of international health experts has published a paper warns that “increasing experimental and epidemiological research suggests that prenatal exposure to APAP might alter fetal development, which could increase the risks of some neurodevelopmental, reproductive and urogenital disorders.”

Epidemiological studies “consistently suggest” that taking acetaminophen while pregnant increases the risk of neurodevelopmental disorders. Specifically, it increases the risk of ADHD and autism spectrum disorders and, in girls, language delay. It also increases the risk of decreased IQ.

Studies also suggest the additional concern that taking acetaminophen while pregnant my increase the risk of a number of reproductive disorders in boys. It increases the risk of undescended testicles and distance between the anus and the base of the penis: both are indicators of reproductive disorders later in life.

These results are concerning given the popularity of Tylenol and that it can be purchased over the counter. As many as 65% of pregnant women in the US use acetaminophen. The experts’ consensus statement recommends that pregnant women should not take acetaminophen “unless medically indicated” and that it should be taken at the lowest dose for the shortest time. They also recommend that the FDA should update its safety statement.

Although this consensus statement is one of the first to catch the attention of the mainstream media, it is not the first to catch the problem. As their review indicated, several studies have identified the association between acetaminophen and ADHD. A 2020 Canadian study found that children exposed to acetaminophen in the womb were at double the risk of ADHD and hyperactivity (JAMA Pediatr 2020 Nov 1;174(11):1073-1081).

Acetaminophen has been associated with other important risks. Here are X more reasons to think twice before taking Tylenol.

1. Liver Failure
Acetaminophen is the leading cause of acute liver failure in children. A systematic review of 32 studies, which included 2,982 children, found that, in “developed countries,” acetaminophen toxicity was the most common cause of pediatric acute liver failure (Pediatr Gastroenterol Hepatol Nutr 2020 Nov;23(6):501-510).

Acetaminophen is the leading cause of acute liver failure in adults. An American study found that “acetaminophen hepatotoxicity far exceeds other causes of acute liver failure” Hepatology 2005 Dec;42(6):1364-72; Br J Clin Pharmacol 2021 May;87(5):2392-2396). Even short-term use of acetaminophen, if taken at the maximum recommended daily dose, stresses the liver (JAMA 2006;296:87-93; BMJ 2015;350:h1225).

2. Male Reproduction
Men who use acetaminophen have decreased testosterone, sperm abnormalities (Andrology 2017 Nov;5(6):1082-1088) and take longer to accomplish pregnancies (Hum Reprod 2016 Sep;31(9):2119-27).

3. Behavioural Problems
A study of 7,796 mothers found that Tylenol use as 18 and 32 weeks of pregnancy increased the risk of emotional problems, hyperactivity and conduct problems. Conduct problems are a group of behavioural and emotional problems in children. These children have difficulty following rules and behaving in socially acceptable ways. They may exhibit antisocial, aggressive, dishonest, delinquent, defiant and disruptive behaviours.

4. Robbing You of Emotion
Oddly, taking acetaminophen blunts your emotions.

5. Robbing You of Empathy
Another odd, but related, finding is that taking acetaminophen reduces ability to empathize with others.

6. Robbing You of Fear
Taking Tylenol also blunts your rational fear. A double-blind study found that people who take Tylenol lose their risk aversion.

Nat Rev Endocrinol 2021;

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