There is research correlating autism and mothers taking certain medications (painkillers, antidepressants). Since autism is hereditary, there is a significant chance that these mothers are autistic too. Autistic people have a vastly high risk of depression, and often have unusual pain thresholds, requiring more painkillers. I would not be surprised of the correlation was real, but the direction of action was reversed; after all, it's plausible that autism causes the need for taking more medication.
This was my thought as well. I’m likely on the spectrum (as I have learned recently, because of my kids) and I would consider myself hypersensitive. To a variety of sensory inputs - noise, smell, touch, heat, cold, tickling and probably also pain. The latter being hard to quantify of course.
But I could certainly imagine that a mother with autistic traits could be someone who takes painkillers more often than the average person.
That’s very interesting! I’ve been sleuthing for personal reasons and I’ve recently arrived at the central nervous system element called the nucleus of the solitary tract (NTS), which integrates sensory processes including pain reception. I’m tracing a particular activator of the mineralocorticoid receptors for which NTS has special relevance, but the end target overall seems to be mTOR in the NTS, which isn’t so niche and is studied in autism.
It seems that higher sensitivity to pain could be a very plausible cause. I believe there's studies showing lowered (and altered) pain tolerance with autism.
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.
Ugh yeah, s/aspirin/Tylenol/. My brain always wants to call Tylenol and acetaminophen as generic "aspirins" and it's a hard habit to break. Joys of having ADHD I didn't even notice the switch.
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.
One important point here is that NSAIDs like aspirin and ibuprofen should be avoided at least in the second half of pregnancy. Acetaminophen is usually the “go to” painkiller for pregnant women, which of course skews the result.
> Since autism is hereditary, there is a significant chance that these mothers are autistic too.
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.
How can one know it is due to DNA or how the brain works versus learned behaviour? I suppose it is possible to learn different traits and behaviour from parents so that the offspring behave in an autistic way even if they are not "physically" autistic.
It's actually very difficult to prove that something is genetically heritable vs heritable through other means including diet, medicines, etc. Especially when you want to account for effects in the womb, where you can't do twin studies. Even things like height and IQ, it's not clear how the heritability is passed on, much less something as complicated as high functioning autism.
Science is difficult, yes. Otherwise, no. We know a lot and with high certainty.
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.
We do not in fact know with high certainty the amount of genetic causality in IQ (or the broad validity of IQ itself, but stipulate that isn't a problem). Molecular genetics has shaken things up over the last 8-10 years.
Pretending that we know a lot about something with high certainty so that you can get a one up on RFK Jr types is much more harmful, especially on the long term. The anti RFK Jr types end up being distrusted and put in the same bucket as the RFK Jr types for spreading misinformation.
There are people distrustful of those who proclaim the earth round. There is no threshold of certainty where unreasonable skepticism will be eliminated, science is a tool for the reasonable.
It's not misinformation. Reasonable people know that science determining something is true only means the current evidence strongly indicates its true, and that future results may call anything into question, but we should not expect any particular current finding to be false. It is misinformation to characterize the lack of absolute certainty, which is something science can never produce, as indicative that claims differing from the scientific consensus are equally supported by the evidence.
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.
We do need to worry about people losing trust in science because science depends on public funding.
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.
> 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.
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.
> Maternal effects are well-accounted for in research.
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?
Cool story, but I don’t really lose any sleep over anti-science idiots prompting themselves into sustained relevance over the long term, short term, or even the next electoral term, really.
It's important to note our understanding is far from complete. There may be more genes associated with autism than we currently know. So 30% of cases may have a known genetic factor but that doesn't mean 70% don't have a genetic component.
This is also explained as a genetic factor as chromosomal abnormalities and replication errors are more frequent although cumulative environmental exposures may also play a role.
That's what our genetic councilor said as well. It's important to note autism is a spectrum and quite varied, some of it genetic and some of it related to other factors.
I've read some studies which suggest there's a variety of genes which are linked to autism as well as link to both autism and ADHD. I believe those genes are linked to how different brain circuits interact.
It makes a lot of sense given with I've seen talked a lot about in autism and adhd groups, with some symptoms overlapping.
My link isn't a study it's a layman's terms explanation, but there are lots of studies. Your link mentions a meta analysis of 7 studies concluding that up to 90% is genetic.
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.
> 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.
Autism speaks is a spiritually evil organization and the fact that you unironically linked them implies that you wish to wage cognitive warfare against all autistic people. Autistic people will respond by making sure you reincarnate as a durian fruit.
> there is no evidence of gene expression for autism.
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.
You don't have to identify the root cause for that though, all it takes is studying the prevalence of a disease across family trees, that would be evidence of genetic expression.
Autism appears to be hereditary, but the eugenicists haven't identified a genetic component (nor have any other researchers, who are admittedly less motivated to find one). We're pretty sure that autism is a developmental condition, but the correlations with other things are… weird. (Off-hand: fœtal androgen and œstrogen levels, some chromosomal disorders, some mitochondrial disorders, a handful of rare single-point mutations, maternal autoantibodies, gut flora, something something oxidative stress (doesn't replicate, but keeps coming up).) Maybe they all tie into a "single cause" somehow, but… well, there's no single cause for eye colour (developmentally a much simpler trait), so the whole idea that autism is a deviation from the baseline, explicably attributable to a single factor, is somewhat of an article of faith.
Sure it can. Type 2 diabetes is both hereditary and lifestyle/behavioral influenced . Same with cancer, if you have cancer in your family your risk of getting cancer is higher. I would say most medical issues are both. Heart disease, gout, obesity, hypertension,strokes,asthma etc.
Let me put this a bit differently: Type 2 diabetes is both genetic and can be acquired during one's life (e.g. through bad dietary choices). But a man who develops diabetes does not acquire genetic T2D by doing so - he cannot pass it on directly to his children.
Confusing the effects of starvation with Lamarckian inheritance is a fundamental category error. If starvation affected every cell in your body except for the gametes, that would be worth investigating.
> with Lamarckian inheritance is a fundamental category error
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."
That's a separate effect, known as acromelanism, or "point coloration". It's the result of an enzyme which is inactivated by higher temperatures, not a genetic change - the extent of pointing can change over an animal's lifetime, and the specific pattern isn't inherited. (For instance, if you somehow convinced a cat with color pointing to wear a sweater, its fur would stay light under that sweater, but any offspring it had would not inherit that pattern.)
That isn't a genetic change either, though. Those species of turtle either lack the typical sex-determining chromosomes entirely, or have sex-determining chromosomes which can be inactivated during development. The genotype doesn't change as a result of what temperature the egg is incubated at; its expression does.
It is the safest painkiller currently available. Ibuprofen can cause gut bleeding and renal issues if overdosed on. We all know about opiates.
Some facts - typical adult dose is 1g. Max suggested cap on the drug label is 3g per day (about 6 pills at usual 500mg dose). You need to take 10g (20 pills) to be at real risk of hepatotoxicity.
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.
"...the problem is with impure products and people misusing / abusing them."
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.
I had an opiate after surgery once and the constipation was so bad, it was worse than the pain it was supposed to be treating. I switched to Aleve instead, which was both better at pain management and had fewer side effects.
When I had my wisdom teeth out, they gave me percocet (oxycodone + tylenol). "Take one every 4-6 hours." I split the pills in half and took one just as the pain was starting to come back, generally right after 2 hours. It worked great. Then after several days the pain started coming back in my knees and other joints. Wait... I don't generally have joint pain. I guess that's withdrawal from developing a tolerance, aka addiction. I quickly ramped down and stopped using them shortly thereafter.
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.
> The only side-effect is euphoria. Please do not mention respiratory depression here, that is a non-issue
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.
Oh I know that you’re correct, your phrasing was just hilarious.
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”
> Oh I know that you’re correct, your phrasing was just hilarious.
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!
Acetaminophen related deaths are a few hundred a year in the US.
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.
I think you're missing the point, though. Patients are much more likely to abuse/misuse an opiate, leading to much more than the "therapeutic" dose being taken. But most people aren't going to overdose on ibuprofen or acetaminophen. If they do, it's because they've made a foolish decision ("the pain didn't go away with one pill, so if I take five maybe it will"). When it comes to opiates, taking too much will generally be because of a chemical dependence, not a conscious choice. Even if the ibuprofen overdose is a stupid choice, it's still a conscious one.
> 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.
> taking too much will generally be because of a chemical dependence, not a conscious choice.
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.
Abuse and misuse of opiates is the key problem though. "Just don't abuse them" isn't a solution. As far as I understand, ibuprofen and acetaminophen are not addictive, while opiates are.
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.
I am sorry it made you feel fuzzy. I did not say it works for everyone. My grandma gets delirious from Tramadol, for example. Many people are just simply pain-free on it without getting "high", let alone delirious. I personally do not experience these mental symptoms of opiates so I have no first-hand experiences. I know what euphoria is like, I have taken MDMA, but opiates works more peripherally for me, even the ones that are supposed to pass the CNS greatly.
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. :)
[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.
I think the stronger point of what you're saying is if you can set yourself to avoid addiction—you have a time limited dose, you have no means of acquiring more—then opiate painkillers are the safest option in terms of potential damage to your body.
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.
Thank you. This is what I essentially meant. See, this is what I meant by someone being able to express my thoughts better than I could ever hope for, so again, thank you!
If the safest drug is also the one most prone to misuse, and misuse makes it unsafe, then it is no longer the safest drug. The reason society should be wary is precisely because people misuse it on a scale that vastly eclipses garden variety drugs like acetaminophen.
You are right. It varies a lot though by different opioids and dosage plays a major role, too.
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.
Some people have it. Some do not. I have taken very large amounts of opiates before and I have never ever experienced nausea from them. I think you are not likely to experience it at lower doses from say, codeine or hydrocodone either, but honestly, it varies by individuals.
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 would say it is not so silent, bowel obstruction is very painful which you feel even if you are on opiates. In any case, I hope my other comment proves to be helpful to those taking opiates if they do not already know what to do or pay attention to.
Tylenol isn't addictive. Every opiate is. Even as an alcoholic having to get surgery terrifies me because of how addictive opiates is and that is all doctors push now-a-days.
eta this is nothing to do with purity of the product. I never heard of someone selling themselves for Tylenol/acetaminophen
That is an oversimplification, and there are many studies out there proving that people receiving opiates at the hospital do not get psychologically addicted to it, if you are talking about that.
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.
My mom gave me one 325 mg aspirin dissolved in a spoon of water and a little sugar as a tot - it was tasty!
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.
There is a “better” painkiller than both Tylenol and Ibuprofen (Metamizol), but it has been forbidden on the US based on a study attributing strong side-effects to it, despite it being freely available over the counter on multiple countries for decades without issue.
If this study is true, it should be easy to compare prevalence of autism on these countries that don’t rely on Tylenol.
It's not just banned in the US; it's also banned in France, the UK, Norway, Sweden, Iran, and Canada among others. It is legal OTC in India, the former USSR, China, Mexico, and most of South and Central America. It is the most popular prescribed pain reliever in Germany and the most popular OTC drug in Brazil. It is popular in Spain as well.
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...
I'm sorry but as a non American I can only think about Rehab Officer Tylenol Jones from the
Idiocracy movie since that's the first time I heard about Tylenol without knowing it's a drug, and in the movie everyone had well known American brands as their names due to overreach of corporate marketing into society, but that part of the satire went over my head as a European kid back then, thinking Tylenol was just a person's name and not a drug.
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.
> I wonder if Americans know how much of their society and culture bled incompletely into other countries via 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 feel like I might be stepping on a land mine here, but it’s important to note that even if they don’t prevent transmission, vaccines are important for reducing severity and length of illness and have value as a second line of defense, even for those wearing N95’s in high risk circumstances (such as air travel).
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.
I'm not sure "the press manufactured consent for never-ending COVID reinfections" so much as people figured it would become another cold like the other four coronaviruses, regardless of what anyone wants.
Agreed, and guess how many countries prior to COVID followed our CDC's lead? The answer is most of them.
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.
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.
The conclusion section of that very study says "...further research is needed to confirm these associations and determine causality and mechanisms" and "A causal relationship is plausible..." [emphasis added].
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.
Right, but there are plenty of things that can cause pain. It’s reasonable (although it also sucks) to tell women that they should avoid using Tylenol during pregnancy except for fevers in the short term.
I'm extremely suspicious of anything that looks at 'an increase in autism rates' without considering the same factors that have gone into there being 'more' left-handed people over the past 50 years or so. There are a lot of people in the past who 'weren't left handed' because they were punished as children if they showed left-handed behavior, and that's still a whole lot less stigmatized than autism.
Has the study stratified for improved diagnosis? When I was a child in the 80's teachers weren't looking for the telltale signs, but you better believe there were autistic poeople, they just weren't diagnosed.
> 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.
Admittedly I haven't read the whole study. But how do they account for the confirmation bias in their review – the fact that null results typically aren't published. Studies that look at an intervention (Tylenol) and fail to find an association are less likely to include it as a variable in their model or less likely to publish a null finding.
Reading the paper, I'm wondering why they didn't do an actual meta-analysis, to estimate average effect size or likelihood of publication bias. As it is, it's more of a systematic review.
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.
> 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.
Every charlatan researcher grifting on bogus autism data really is just copying Andrew Wakefield's homework
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.
A friend of mine, Eric Engstrom, died of liver failure after taking (too much) Tylenol. Tylenol use over time can sneak up on you in the form of cumulative liver damage.
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.
My understanding is that if taken in the recommended dose, and not taken for a longer period of time (consecutive doses, I mean) than the bottle says to, you don't end up with cumulative damage.
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.)
You have to take a lot at one time, or chronic overdoses, to damage your liver.
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.
It's a common failure mode and most other OTCs won't kill you if you occasionally accidentally take an extra dose or two. Agreed that it's safe at the correct dose but the hazards are severe and dosing incorrectly is inevitable at population scale.
Headaches have various causes, and you have to look at where the pain is "originating" from to even try and figure out why. Going out of a walk could be due to a sinus getting irritated and going out for fresh air helps relax it. It can also just be a stress headache and going for a walk relaxes you.
Yep, my mom worked in the pediatric ER, she never let Tylenol/acetaminophen in the house, my understanding is that she saw way too many cases of liver damage and death.
Stresses the liver, also if its used frequently for mild inconveniences you should maybe go to the doctor, as frequent headaches or stuff like that can hint to more severe stuff.
It does not stress the liver at recommended doses. Plenty of people get frequent headaches and other aches that have no other severe stuff going on, or really anything that needs to be treated more than symptomatically. Scheduled tylenol is an effective element of a pain regimen for many people.
In the US there’s also deep religious influence that paints suffering as virtue that’s been exploited by capitalists to establish a norm of pushing through the pain and continuing to work instead of taking a break to figure out what the root cause is and address it. Some also just don’t have a choice, because taking time off means not getting paid which means losing a roof over their head.
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.)
If Paracetamol was invented today it would likely never receive an OTC (over the counter sale, meaning you can just buy it from a retail outlet the way you'd buy cough medicine or toothpaste) license in the UK. Yes, it's safe (and for a bunch of people including me, effective) at the licensed dose, but it's useless at about half that dose, and it's toxic, leading to very nasty deaths in some cases, at just about 3-4 times that effective dose.
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 ?
Always surprises me as an American in the UK how hostile the UK is to paracetamol. You buy it in like 300-pill packages in the US, and I've literally never heard of anyone having a single accidental over-dose. I'm not sure I've ever heard of anyone intentionally overdosing on it, but I guess I can't rule that out since I'm aware of who 1-2 people personally have taken "a handful of pills".
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.
> Always surprises me as an American in the UK how hostile the UK is to paracetamol.
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 more referring to the fact that it’s treated like a controlled substance here and sold in limited quantities from behind the counter. It’s the same treatment the U.S. gives to Sudafed which is an input to meth as I understand it.
The problem becomes, 8 tablets a day, minimum of 4 hours between doses is fine for a week or so, but do that for months and the liver toxicity creeps up on you.
I believe the numbers normalize a bit when you adjust for the fact that everyone drives in the U.S. and tends to be alone when driving. So it’s like accident per mile driven and you see it’s around the same. But in the UK many fewer people drive as a proportion of the population and especially those who are more dangerous (e.g. young, old, disabled, drunk) tend to opt out here due to the availability of mass transit which doesn’t work in the U.S.
I'm by no means an expert in assessing OTC drug safety, but your efficacy window feels... fine... to me? I feel like it shouldn't be hard to avoid taking 3-4 times the effective dose of something? But I guess people still do it, and mess up their liver anyway.
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.
You don't need a doctor. In the UK today there are pathways for Advanced versions of several non-doctor careers which get you either limited, or in some cases full blown unlimited prescribing rights. I think ordinary Advanced Midwife is just a set of common pregnancy drugs, stuff so you can keep down food, sleep properly and so on despite some of the nastier but still non-critical pregnancy side effects, but Advanced Nurse Practitioner and Advanced Pharmacist are both full blown prescribing rights.
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.
Not to mention veterinary pathways. My ex GF was volunteering at a vet practice, where they kept no track of their meds, other than "hey boss, we seek to be low on Ketamine, swing past the animal pill shop and get a load of it pls".
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.
personal responsibility is more common in the UK, it is assumed that one can cross the road safely without needing traffic lights for example, or walk along a stretch of an ancient monument without needing a handrail.
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.
It's weird that you're surprised, it's one of the most dangerous otc drugs, and is the leading cause of liver failure on the planet. I'm always surprised that British people treat it like aspirin, because an overdose can easily kill you.
I'm serious. Over 50% of all liver failure is due to acetaminophen, and 20% of liver transplants.
> 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.
Well, c'mon, let's be fair. Your source says overdose-related liver failure. And reading further, most of the overdoses are either intentional (suicide attempts) or a result of addiction and opiate/acetaminophen combination drugs.
Judging from the comments I've seen, nobody believes this because RFK has completely shot his credibility, and I don't blame them either.
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.
> Further, a potential causal relationship is consistent with temporal trends—as acetaminophen has become the recommended pain reliever for pregnant mothers, the rates of ADHD and ASD have increased > 20-fold over the past decades
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.
Ya, an increased risk of 5-20% on an already very low risk.
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.
I read the study and TBH it's more or less expected that a correlation would exist between increased NDD diagnoses and prescriptions common to pregnant women in regions with increased NDD diagnoses.
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.
The irony is that if Tylenol use in pregnancy actually does increase the risk of autism, RFK's destruction of trust in the government's scientific process will probably just push that sort result back. He's a charlatan and totally unscientific regardless.
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.
Right, I think this falls under the "broken clock correct twice a day" saying. RFK Jr says a lot of crazy things, but he probably does occasionally say something that makes sense, through no skill of his own.
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.
You're forgetting that for half the country that trust was destroyed years ago, and RFK actually being aware of and wanting to investigate evidence like this is restoring it.
That half of the country is not having their trust in science restored. They're forcing their superstitions onto everyone else and calling that science.
That is a retrospective meta study, which leads to lots of speculation, but little actual proof of causation.
>> 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...
> 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.
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.
> Judging from the comments I've seen, nobody believes this because RFK has completely shot his credibility, and I don't blame them either.
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.
How can anyone find him credible after he pitched a "gold standard" health report (MAHA) that had hallucinated references, misrepresented research and "oaicite" markers that indicated it was AI generated?
I don't find that to be a controversial statement.
FYI, "DNC" or "RNC" doesn't refer to the party in general, it's the national party committee (also overloaded to refer to the convention). RFK Jr has certainly never been a member of the DNC.
This is about to cause a huge spike in child deaths due to Reye's syndrome. Parents will choose Aspirin to treat their child's fevers, despite warnings, because that's what they took as a kid, and it worked then.
Well this should be provable within about 5 years if this Tylenol is truly the cause. Let's just have a few states in the US eliminate Tylenol usage during pregnancy, and watch the autism disappear.
There really are risks. It's just not worth it during pregnancy. The pain killing effects of tylenol aren't worth the potential risks during pregnancy.
You can't look at just one risk and say it's not worth it.
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.
I didn't mean to say it should never be taken. Sometimes medicines should be taken that have risks for the baby. But it shouldn't be taken for minor headaches and aches and pains like it can be when not pregnant.
To be fair, at least in the US, doctors tend to be overly cautious when it comes to pregnancies. The bar for proven safety for treatments tends to be a bit higher than for non-pregnant people. "We haven't proven anything bad" is usually not good enough.
There are also real risks to ignoring pain and the destructive effects it has to quality of life and mental well being, all of which can have effects on the mother's and the fetus's health.
What is a pregnant person with debilitating pain such as a migraine supposed to do?
As I clarified in another comment, I was talking about avoiding it for common aches and pains. In cases of real migraines, I would be very grateful if tylenol gave any real relief. It never did for me.
Yeah my wife is also pregnant and sometimes it is really tough on her but she doesn't use any medication other than baby aspirin for blood pressure. The alternative is exercise, anti-inflammatory foods, and also realizing that it isn't just your body anymore and you can't hurt somebody else's chances for a very small amount of pain relief.
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.
> Yeah my wife is also pregnant and sometimes it is really tough on her but she doesn't use any medication other than baby aspirin for blood pressure. The alternative is exercise, anti-inflammatory foods, and also realizing that it isn't just your body anymore and you can't hurt somebody else's chances for a very small amount of pain relief.
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:
You may not know this, but pre-eclampsia is not a synonym for hypertension. Instead, hypertension is a manifestation of preeclampsia.
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.
> what other sentient entity is available for consultation?
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.
> You wouldn't say excess alcohol consumption during pregnancy is only up to the mother
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.
>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
Wow, that's a pretty extreme view. They're locking themselves up voluntarily and also locking their baby up. The baby is helpless but not the mother. If she didn't want to and somehow still recklessly got pregnant, she could always get an abortion which may be just a pill from the pharmacy once she missed a period, or more involved if slower. It's a deliberate choice to be responsible for somebody else's life.
Yep, my wife didn’t take Tylenol during pregnancy due to actual studied risks to the child. If she had a headache she just bore the pain. RFK is a loony and I don’t know about the link to autism but Tylenol should not be taken by the mother during pregnancy.
>While the study does not show that acetaminophen directly causes neurodevelopmental disorders,
_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.
> That report will also suggest a medicine derived from folate – a water-soluble vitamin – can be used to treat symptoms of the developmental disorder in some people, according to the Journal.
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.
I wonder if this hating on autism is part of the regime's focus on loyalty. Autistic people tend to make their own plans and are much more independent. I'd never be able to follow orders in an army for example.
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.
As someone who’s done work with the whole spectrum of ASD: it’ll be fascinating to see if the diagnosis gets weaponized eventually. Right now, MAGA seems to still like “Hi-IQ nerd disrupters”; but the administration would be perfectly happy to sell off an ally for political gain.
If it's already in the news, it's already too late to short. News events tend to quickly reverse as well so I'd be looking for a long position at a support level
Not specific to tylenol and autism, but I think important: RFK Jr. will be issuing findings using "gold-standard science" and hold up the findings as definitive (as proof, etc.) at the same time that he completely minimizes and bemoans current scientific processes. While we may be able to tell the difference between RFK's BS science and real science, what does this mean for everyone else? Especially because RFK Jr. does not trust science?
Evaluate risks and benefits as best you can, informed by whatever science seems to show. Life's complicated and nobody can provide simple correct instructions on the right way to do everything, or even anything. Public health messages are an attempt to do that but they're unreliable and sometimes intentionally misleading or wrong because their purpose is to influence people's behavior, not to be correct.
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.
He was legitimately put into a position of power by the american political system. And this is an article by the BBC, probably the most respected news source on the planet. Crazy is now the norm, the leading voice. It must be confronted.
Your first point is correct, but it (like the second one) has no bearing on the issue of the medical soundness of the department's positions and policy.
But the bbc's reputation does support the facts in the article. I am confident that the stock did drop because of what he said, because i trust the BBC not to make up such things.
I feel the same way, but again, this has no bearing on the issue of the medical soundness of the department's positions and policy.
Going back to the top of this thread, I agree that correlation does not mean causation, but in this case, we do not yet even have a justifiable claim of correlation, and RFK Jr. has repeatedly demonstrated his propensity for substituting unfounded opinion and incorrect data for empirical facts, if it suits his agenda.
Baader-Meinhof phenomenon at work; I commented about the ultrasound/handedness the other day.
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.
I considered that when the news hit but didn't. Even if there's nothing to the report and it's forgotten in a week, that sound you heard Friday was tens of thousands of trail lawyers jizzing in their pants. $1.8 billion powerball ain't got nothing on the payday they're looking at.
Was replying to a commented which was downvoted to death entirely unfairly, so I'll paste my reply as a new comment:
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.
Without chronic ingestion of medications that compete for glucuronidation or certain CYP450 inducers like antiepileptics, FOUR GRAMS even as a single dose is virtually impossible to cause any harm.
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.
Taking one gram every 5-6 hours for a maximum of 4 gram/day IS entirely reasonable.
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.
paracetamol is unusual in this respect, that the toxic dose is so close to the therapeutic dose, but the benefits outweigh the risks.
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.
Maybe by FDA-type standards, 4x is "close", but to me, I would think it absurd to take 4x the recommended dose of something unless directed to by a doctor.
I was recently prescribed 800mg ibuprofen for an injury, where 200mg is the standard OTC dose, and I even questioned that.
you'd be surprised how casual some people are with doses. my old grandma had a big bag of medication she had collected over the years and occasionally she'd sit down and pick a couple like smarties and gulp them down.
when my dad decided to step in, he took her to a doctor to get a full review and confiscate the bag.
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.
Taking 1 gram every couple of hours does NOT seem entirely reasonable when the directions on every Tylenol bottle in the world say to take no more than 1g (2x500mg caps) every FOUR HOURS at most and no more than 4g per 24-hour period. Half the bottle is covered in ominous red warnings about liver damage.
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.
Most of the blue collar coworkers I've had knew full well that you just needed to add some hydrocodone into the mix and you'd be fine w/ a few hundred mg on the acetaminophen for a full shift.
Hmm, a bunch of high IQ people conclude that it’s dumb as hell to destroy your body for worse wages than coding. Who would have thought?
Why should we feel sorry for the skilled trades again? Mechanics are expert famous scammers worse than lawyer (grandma just replaced her blinker fluid!) That’s just one example. Leak detection companies are nearly all scammers too.
No, I haven't, but that doesn't absolve people of their responsibility in actively deciding to chronically overdose on pain meds, if that's what they're doing.
Tylenol itself is not toxic to the liver, the metabolite of glucuronidation is what is toxic. Which means paradoxically impaired liver function can actually reduce the effective toxicity of Tylenol.
I mean, sure, but the most important part you left out: "if you take 4x the recommended dosage, or take it consistently beyond the recommended period of use".
Lots of drugs are toxic if misused or abused. Acetaminophen is not unique in that regard.
>Even if RFK Jr. provides ironclad scientific proof of this link they'll just deny it.
As far as I know he is really well read/informed - most people are not in that league and such people are completely dismissive of anything that is counter-narrative.
As far as I know he's a crackpot who makes up random shit that has no basis in science. Sometimes that random shit is correct, because as we all know, a broken clock is correct twice a day.
Suggesting he's well-read and well-informed is laughable.
>As far as I know he's a crackpot who makes up random shit that has no basis in science.
Well for me then you are in the category of most people. Ill read/informed and will parrot what mainstream 'science' has to say. Anything that one says that is against the common narrative in medicine is struck down by the 's' word. You can laugh at me.
It’s insane that the RFK crowd continues to not consider that the increase is just due to better diagnoses.
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
The problem is that RFK, like Trump, has effectively created a situation where anything they say is immediately discredited by a huge portion of the population.
When something like this happens there’s a non-zero chance some slimy hedge fund is behind this pushing conspiracy theories on gullible folks to tank a stock.
Someone needs to find a new brain worm for the heroin junkie who dabbled in environmental law that gets him doing the right thing™ like:
- 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 think you are severely underestimating the mental gymnastics these people routinely go through to never be wrong about anything.
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.
And the claim is probably bogus. If it were true, we'd expect other evidence (e.g. https://news.ycombinator.com/item?id=45147119) that hasn't showed up. More likely, it's an artefact of autism diagnosis rates varying in different populations, and maybe something to do with autistic mothers' fucky pain tolerances.
More likely to take painkillers + more likely to get your child assessed for autism = observed (tiny) correlation, even in the absence of any causation.
I am not worried about autism, ya goof! there has repeatedly been shown to be no link, and i am already autistic. I am worried RFKJ will make tyelnol harder to get.
Good time to buy. While the cult might take this to heart and stop using Tylenol alltogether, there will be lawsuits to protect the brand and the company, and considering the lack of proof, in the end they will suceed.
They are molesting the money again, but the company can just pivot to drinkable bleech beverages marketed on joe rogan, in the end an evidence-free health care system might be way more profitable in the short term.
If RFK Jr says it's true, that's how I know it isn't. They go to great lengths to point out they're "using gold-standard science", which also makes me certain they aren't. They can't be, because none of this is about autism or science, it's about pushing their political agenda.
> If RFK Jr says it's true, that's how I know it isn't.
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.
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.
There's a threshold where you just don't have a choice. He's made a number of obvious and verifiable health lies - most recently, he described how he can diagnose children with "mitochondrial challenges" by watching them walk around. I have a job, I don't have time to individually investigate all his health claims, the heuristic that he's a liar and everything he says is wrong will have to suffice.
I don't understand the response. Kennedy didn't say "factor" or "metabolic syndrome", he said "I see these kids that are just overburdened with mitochondrial challenges". If all he meant was that many kids are visibly overweight, wouldn't he have just said that?
The charitable interpretation is that it is simply a more sensitive and accurate way to say that.
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.
Have you heard the term “sanewashing”? I don’t think the principle of charity requires us to replace false things he did say with thematically similar things that might have been reasonable. It’s like “explaining” that a crystal healer is just referring to the stress reduction benefits of aesthetically pleasing knickknacks.
My take is that overall he's right. The obesity epidemic should be our primary heath focus. Heart disease and obesity are the primary killers of americans.
You can in fact determine a huge percentage of americans including children are incredibly unhealthy just by looking. Increased focus on exercise and negative incentives on soft drinks and sugary beverages does seem like a major step in the right direction.
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.
The point isn't that it's a clever truth-seeking strategy. I'm sure some number of his health claims are true! He'll probably even publish some new recommendations which were better than the old ones, and promote some accurate groundbreaking research I won't believe. I'll have plenty of time to learn the accurate stuff later when HHS isn't dedicated to convincing me of nonsense.
He explained his views in detail in his confirmation hearing. He believes that pharmaceuticals in general are dangerous and overused, "the third-largest cause of death in our country after heart attacks and cancers" in his words, and wants healthcare to focus more on healthy food than on medicine.
Because that stance has been very beneficial for him financially and politically, ever since his pivot from legitimate and respected environmental lawyer to anti-vaxxer. He transitioned after receiving incredibly positive feedback for amplifying conspiratorial narratives while riding the coattails of the infamous "thimerosal causes autism" panic of the 2000s. https://en.wikipedia.org/wiki/Deadly_Immunity
Which is what? Lots of this admin's actions have made sense once you know the underlying agenda—thanks project 2025 for spelling a lot of it out—but this one has me baffled. Taking on the woke… tylenol industry?
Looking around for sources from before the world ended I can find quite a few reputable studies that show the correlation. The effect size is small ~0.4% in absolute risk but statistically detectable. Like okay, sure. Doctors already tell pregnant women to limit NSAIDs. So… we keep doing that. Mission accomplished?
The advice to avoid NSAIDs in pregnancy (and contraindication in the third trimester) doesn’t cover acetaminophen, though, because it’s not regarded as an NSAID (different mechanism of action and minimal anti-inflammatory effects.)
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.
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.
Why? Should we first suspect carrots of making people grow red hair, suspect eggs of causing pregnancy, and suspect Left Twix of causing left-handedness?
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?
> Until you have a controlled study on pregnant women
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.
Harvard study: the science is inconclusive and more research is needed.[1]
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.
There's a big difference between "using Tylenol may increase the risk of autism" and "Tylenol causes autism".
If this study is accurate, it merely links the two together, and does not provide the reason. The problem with RFK is he's using it as a way to appease his own base to justify an anti-vaccination and anti-science agenda.
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?
Maybe I never take enough but it's also such a weak painkiller that I always prefer to just feel how it feels and sense if I'm getting better or worse. And that is without believing it's super bad for me, just doesn't make sense as a trade-off.
Some times advil works. Some times aspirin works. Some times Tylenol works. Some times none of them work. There’s all kinds of substances that are available freely that can kill you if you take too much. NSAIDS, Imodium, DXM, iron supplements.
It’s the only painkiller allowed for pregnant women, so this leads me to believe this is some other form of conspiracy to control women (since the science does’t exist, it obviously doesn’t cause autism)
Most medications have a buffer, so if you accidentally take an extra dose (instead of just 2 pills every 6 hours, but no more than 6 in a 48 hour period). Acetaminophen does not have that buffer. Even just slightly over the dosing recommendations can be lethal, and for a drug that's in hundreds of products, that's terrifying. Imo you're being exceptionally careless for one of the most dangerous OTC drugs we have available.
How is following the instructions being “exceptionally careless”?
It’s like using bleach to whiten clothes. The bottle says “do not drink”. I don’t drink it, I’m fine. If I misuse it, I’m toast, like with any other myriad household products that can kill you if you use them not as directed.
Follow the instructions for Tylenol. And for a cough syrup. Add in Model or Nyquil. 6 hours go by, you take a second dose of each, and two days later your liver fails.
Which product's instructions did you fail to follow?
I didn’t — checked the labels for all medications I take, verified the medicinal ingredients and know not to double up on the acetaminophen.
I actually prefer cough syrups that don’t have acetaminophen precisely for that reason.
Sorry but being unable to follow instructions is a you problem not a me problem. My point stands: fail to follow instructions for potentially lethal everyday chemicals and you will end up dead. It’s not exclusive to Tylenol.
Why are doctors telling women that it's okay to take Tylenol during pregnancy in the first place? Everything they put in their bodies can have an effect on the baby so medication for pregnant mothers should be severely limited. Why haven't we learned from the 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.
Yeah, it’s refreshing seeing someone not in Big Pharma’s pocket.
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.
Is he in Big Wellness's pocket? I hadn't heard anything about that. Who's paying him off? He's a Kennedy with a net worth of about $15 million so he doesn't exactly need the money. He strikes me as an authentic true believer in his cause, but he could just be a really convincing con man, so I'd love to learn more about this.
Please link to some credible sources showing that he's being paid off by someone.
He literally just repeats whatever trends the crunchy moms on tiktok are latching onto. He's definitely not getting paid, but he's certainly carrying the banner and basking in the praise...
> Why are doctors telling women that it's okay to take Tylenol during pregnancy in the first place?
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.
This is just another far-right ideological attempt at restricting women's bodily autonomy - this time the angle just happens to be nonscientific fearmongering about medicines.
See what you have done democrats? The reason these lunatics are everywhere including HN is solely because liberals didn't pass universal health care. If the choice is between the big pharma corporate puppetshow or the batshit insane fascist freakshow, eventually people go with the crazies.
Ibuprofen is NSAID (non steroid anti inflammatory), oaracetamol is not. Related but different.
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.
The entire medical community is doing their impression of Shaggy, i.e. "it wasn't me!" But there are thousands of suffering parents and children and this lack of empathy really does nothing for no one. Another hand-wavy response I have heard is that given the new Autism Spectrum diagnosis, many more kids are now diagnosed with autism. That being said, none has even come up with a reasonably derived estimate saying that of the 5X increase in autism over the last 25 years, we can confidently say that nX of this is due to changing diagnosis standards. And if n is anything less than 5, the medical community has work to do in solving this problem and not passing the blame and accusing suffering parents of being crazy.
I almost can't even blame him he is so off the deep end. I still do of course, he should have the self-awareness to have never accepted and it is his massive ego that keeps him doing crazy, dangerous things. But whenever this mentally ill person does things that make the news, I never hear anybody blame the people who put him in that position, and leave him there despite the clearly harmful things he does every day. So shame and blame on everybody involved.
No, because, as forgotoldacc points out, Trump is going to just keep doing whatever he wants regardless, and he wasn't appointed based on actual expertise or prior success: he was appointed because he validates the biases of Trump's base.
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’s a marked increase in mental illnesses diagnosed. My parents were heavily depressed and anxious, but in their day it was taboo to seek help and admit such a diagnosis. We are so much more sophisticated today.
“Could it perhaps be related to the increases in various kinds of air pollution? Water pollution? Pesticides or herbicides in our foods?”
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.
To be clear, I don't think that's a likely factor. I mention it merely because it is one of the dozens of factors that have changed over the past few decades that have nothing to do with the pharmaceutical industry.
>Until there are reputable studies that can actually show something resembling a causal link,
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.
So now that we're all terrified that one of our various pharmaceuticals might, hypothetically cause an increased chance of autism, we have to take them all off the market and do extensive testing of absolutely everything? All the painkillers, blood pressure medicines, immunosuppressants for transplant patients, antipsychotics and antiseizure meds—everything?
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 not talking about medicines, we are talking about some that is frequently ingested/exposed to people. Things like plastics, additives, pesticides, EM signal. These are novel chemicals/radiation and are potentially slow toxins and showing a causal link from population studies is near impossible.
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.
We don't even know that autism is something that's caused. When sampling an integer, there's some probability you'll get a prime; perhaps when making a human, there's just some inherent probability you'll get an autistic person. (Afaik, we don't even know enough to put a likelihood on this class of theories.)
>Perhaps you need to be reminded of the whole sentence you quoted from my post, rather than just the first subclause?
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.
No one supporting this quack's actions and opinions has any right to claim that the people devoting their lives to understanding, managing and healing illnesses, are the ones lacking empathy and not the ones doing their best to make healthcare less accessible, discrediting and shutting down any research that doesn't support their biases and irresponsibly spreading misinformation.
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.
There is research correlating autism and mothers taking certain medications (painkillers, antidepressants). Since autism is hereditary, there is a significant chance that these mothers are autistic too. Autistic people have a vastly high risk of depression, and often have unusual pain thresholds, requiring more painkillers. I would not be surprised of the correlation was real, but the direction of action was reversed; after all, it's plausible that autism causes the need for taking more medication.
This was my thought as well. I’m likely on the spectrum (as I have learned recently, because of my kids) and I would consider myself hypersensitive. To a variety of sensory inputs - noise, smell, touch, heat, cold, tickling and probably also pain. The latter being hard to quantify of course.
But I could certainly imagine that a mother with autistic traits could be someone who takes painkillers more often than the average person.
That’s very interesting! I’ve been sleuthing for personal reasons and I’ve recently arrived at the central nervous system element called the nucleus of the solitary tract (NTS), which integrates sensory processes including pain reception. I’m tracing a particular activator of the mineralocorticoid receptors for which NTS has special relevance, but the end target overall seems to be mTOR in the NTS, which isn’t so niche and is studied in autism.
It seems that higher sensitivity to pain could be a very plausible cause. I believe there's studies showing lowered (and altered) pain tolerance with autism.
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.
Aspirin???!! Its not mentioned in the OP. No one here mentioned it. WTF???!
Ugh yeah, s/aspirin/Tylenol/. My brain always wants to call Tylenol and acetaminophen as generic "aspirins" and it's a hard habit to break. Joys of having ADHD I didn't even notice the switch.
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.
One important point here is that NSAIDs like aspirin and ibuprofen should be avoided at least in the second half of pregnancy. Acetaminophen is usually the “go to” painkiller for pregnant women, which of course skews the result.
I'm waiting for someone to blame coffee.
> Since autism is hereditary, there is a significant chance that these mothers are autistic too.
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.
How can one know it is due to DNA or how the brain works versus learned behaviour? I suppose it is possible to learn different traits and behaviour from parents so that the offspring behave in an autistic way even if they are not "physically" autistic.
Heritability can be studied, you know.
It's actually very difficult to prove that something is genetically heritable vs heritable through other means including diet, medicines, etc. Especially when you want to account for effects in the womb, where you can't do twin studies. Even things like height and IQ, it's not clear how the heritability is passed on, much less something as complicated as high functioning autism.
Science is difficult, yes. Otherwise, no. We know a lot and with high certainty.
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.
We do not in fact know with high certainty the amount of genetic causality in IQ (or the broad validity of IQ itself, but stipulate that isn't a problem). Molecular genetics has shaken things up over the last 8-10 years.
Pretending that we know a lot about something with high certainty so that you can get a one up on RFK Jr types is much more harmful, especially on the long term. The anti RFK Jr types end up being distrusted and put in the same bucket as the RFK Jr types for spreading misinformation.
There are people distrustful of those who proclaim the earth round. There is no threshold of certainty where unreasonable skepticism will be eliminated, science is a tool for the reasonable.
I don’t see how you can talk about science being a tool for the reasonable while advocating for “pro-science” misinformation.
It's not misinformation. Reasonable people know that science determining something is true only means the current evidence strongly indicates its true, and that future results may call anything into question, but we should not expect any particular current finding to be false. It is misinformation to characterize the lack of absolute certainty, which is something science can never produce, as indicative that claims differing from the scientific consensus are equally supported by the evidence.
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.
We do need to worry about people losing trust in science because science depends on public funding.
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.
> 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.
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.
> Maternal effects are well-accounted for in research.
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?
Cool story, but I don’t really lose any sleep over anti-science idiots prompting themselves into sustained relevance over the long term, short term, or even the next electoral term, really.
Maybe you would lose sleep over “pro-science” idiots going into sustained irrelevance as they spread their misinformation.
Heritability != DNA.
According to my friend who is a geneticist, 30% of cases of autism can be found in DNA. Clearly not all cases are.
It's important to note our understanding is far from complete. There may be more genes associated with autism than we currently know. So 30% of cases may have a known genetic factor but that doesn't mean 70% don't have a genetic component.
True. But we’ve also seen environmental correlations as well, as well as things like age of the father, etc.
This is also explained as a genetic factor as chromosomal abnormalities and replication errors are more frequent although cumulative environmental exposures may also play a role.
That's what our genetic councilor said as well. It's important to note autism is a spectrum and quite varied, some of it genetic and some of it related to other factors.
I've read some studies which suggest there's a variety of genes which are linked to autism as well as link to both autism and ADHD. I believe those genes are linked to how different brain circuits interact.
It makes a lot of sense given with I've seen talked a lot about in autism and adhd groups, with some symptoms overlapping.
Well diagnosing autism is incredibly subjective anyway. It’s not like a broken arm.
> Since autism is hereditary
Do you have a scientific source for this?
Twin studies are a classic demonstration of this: comparing identical twins to non-identical twins lets us prove a genetic component.
https://www.open.edu/openlearn/mod/oucontent/view.php?id=669...
You cannot do twin studies for effects in the womb. It's the same womb!
Thanks but this is only one study and they even conclude that some non-genetic factors may also contribute to causing autism
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
Source: https://www.autismspeaks.org/what-causes-autism
My link isn't a study it's a layman's terms explanation, but there are lots of studies. Your link mentions a meta analysis of 7 studies concluding that up to 90% is genetic.
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.
Possibly of interest:
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.
Autism speaks is a spiritually evil organization and the fact that you unironically linked them implies that you wish to wage cognitive warfare against all autistic people. Autistic people will respond by making sure you reincarnate as a durian fruit.
Do you have any links to the research to back you claims?
tl;dr: Spurious correlation machines produces results. Pirates and Climate change surprisingly disagree.
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With the current political climate, I think we are more likely to find the Health Department promoting cigarettes as a healthy way to relax.
I don't blame you for being too frustrated by RFK to look into him, but this isn't quite his brand of stupidity.
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.
Or at least take protection money for not talking down certain brands.
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> the industrial revolution has corrupted the human genome far more than we can measure.
Ok, but do you have any objective measure to back up this claim?
he already hedged his bets with "more than we can measure", so it's a religious statement, not a scientific one.
> there is no evidence of gene expression for autism.
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.
You don't have to identify the root cause for that though, all it takes is studying the prevalence of a disease across family trees, that would be evidence of genetic expression.
Autism appears to be hereditary, but the eugenicists haven't identified a genetic component (nor have any other researchers, who are admittedly less motivated to find one). We're pretty sure that autism is a developmental condition, but the correlations with other things are… weird. (Off-hand: fœtal androgen and œstrogen levels, some chromosomal disorders, some mitochondrial disorders, a handful of rare single-point mutations, maternal autoantibodies, gut flora, something something oxidative stress (doesn't replicate, but keeps coming up).) Maybe they all tie into a "single cause" somehow, but… well, there's no single cause for eye colour (developmentally a much simpler trait), so the whole idea that autism is a deviation from the baseline, explicably attributable to a single factor, is somewhat of an article of faith.
Your first sentence is correct, but your second sentence is not.
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Sure it can. Type 2 diabetes is both hereditary and lifestyle/behavioral influenced . Same with cancer, if you have cancer in your family your risk of getting cancer is higher. I would say most medical issues are both. Heart disease, gout, obesity, hypertension,strokes,asthma etc.
Let me put this a bit differently: Type 2 diabetes is both genetic and can be acquired during one's life (e.g. through bad dietary choices). But a man who develops diabetes does not acquire genetic T2D by doing so - he cannot pass it on directly to his children.
> But a man who develops diabetes does not acquire genetic T2D by doing so - he cannot pass it on directly to his children.
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.
You could get a Nobel prize or two by proving this statement.
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.
So having rehabilitated the Luddites, HN is now moving on to Lysenko. Peachy.
You not knowing something doesn’t make it not exist.
https://www.cuimc.columbia.edu/news/study-shows-how-effects-...
https://pmc.ncbi.nlm.nih.gov/articles/PMC4377509/
https://www.brown.edu/news/2016-12-12/famine
Confusing the effects of starvation with Lamarckian inheritance is a fundamental category error. If starvation affected every cell in your body except for the gametes, that would be worth investigating.
> with Lamarckian inheritance is a fundamental category error
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
The average health literacy of the HN crowd leaves me to believe that the median HN user is grossly overweight, among other things…
Check out 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."
Himalayan rabbits having black fur where their skin is cold and white fur where it's warm is a useful and obvious example of this.
That's a separate effect, known as acromelanism, or "point coloration". It's the result of an enzyme which is inactivated by higher temperatures, not a genetic change - the extent of pointing can change over an animal's lifetime, and the specific pattern isn't inherited. (For instance, if you somehow convinced a cat with color pointing to wear a sweater, its fur would stay light under that sweater, but any offspring it had would not inherit that pattern.)
A better example might be how some animals (turtles in particular) have their sex defined by their egg temperature
That isn't a genetic change either, though. Those species of turtle either lack the typical sex-determining chromosomes entirely, or have sex-determining chromosomes which can be inactivated during development. The genotype doesn't change as a result of what temperature the egg is incubated at; its expression does.
Further reading: https://www.sciencedaily.com/releases/2021/07/210726102148.h...
That's exactly the point. Gene expression can be modified by the environment
Are the imprinted patterns then inherited, though?
No. Sounds like I was wrong earlier.
It's literally almost always both.
You can have a genetic tendency to a certain outcome which is exacerbated by environmental factors. This is very common.
That's exactly what autism is established to be... it has some genetic factors but it develops in the womb.
Reread the parent comment.
And so what doesn't make sense to you about those two sentences?
Polydactyly is both hereditary and acquired during development.
It is the safest painkiller currently available. Ibuprofen can cause gut bleeding and renal issues if overdosed on. We all know about opiates. Some facts - typical adult dose is 1g. Max suggested cap on the drug label is 3g per day (about 6 pills at usual 500mg dose). You need to take 10g (20 pills) to be at real risk of hepatotoxicity.
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.
> We all know about opiates
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.
"...the problem is with impure products and people misusing / abusing them."
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.
[1] https://pubmed.ncbi.nlm.nih.gov/30063596/
I do not disagree with that.
> 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.
I had an opiate after surgery once and the constipation was so bad, it was worse than the pain it was supposed to be treating. I switched to Aleve instead, which was both better at pain management and had fewer side effects.
When I had my wisdom teeth out, they gave me percocet (oxycodone + tylenol). "Take one every 4-6 hours." I split the pills in half and took one just as the pain was starting to come back, generally right after 2 hours. It worked great. Then after several days the pain started coming back in my knees and other joints. Wait... I don't generally have joint pain. I guess that's withdrawal from developing a tolerance, aka addiction. I quickly ramped down and stopped using them shortly thereafter.
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.
> The only side-effect is euphoria. Please do not mention respiratory depression here, that is a non-issue
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
You misunderstood me, then.
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.
Oh I know that you’re correct, your phrasing was just hilarious.
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”
> Oh I know that you’re correct, your phrasing was just hilarious.
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!
Acetaminophen related deaths are a few hundred a year in the US.
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.
I appreciate your sensible and articulate responses here.
I think you're missing the point, though. Patients are much more likely to abuse/misuse an opiate, leading to much more than the "therapeutic" dose being taken. But most people aren't going to overdose on ibuprofen or acetaminophen. If they do, it's because they've made a foolish decision ("the pain didn't go away with one pill, so if I take five maybe it will"). When it comes to opiates, taking too much will generally be because of a chemical dependence, not a conscious choice. Even if the ibuprofen overdose is a stupid choice, it's still a conscious one.
> 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.
> taking too much will generally be because of a chemical dependence, not a conscious choice.
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.
Abuse and misuse of opiates is the key problem though. "Just don't abuse them" isn't a solution. As far as I understand, ibuprofen and acetaminophen are not addictive, while opiates are.
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.
I am sorry it made you feel fuzzy. I did not say it works for everyone. My grandma gets delirious from Tramadol, for example. Many people are just simply pain-free on it without getting "high", let alone delirious. I personally do not experience these mental symptoms of opiates so I have no first-hand experiences. I know what euphoria is like, I have taken MDMA, but opiates works more peripherally for me, even the ones that are supposed to pass the CNS greatly.
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 only side-effect is euphoria.
> …
> 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.
I do not disagree.
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.
I think the stronger point of what you're saying is if you can set yourself to avoid addiction—you have a time limited dose, you have no means of acquiring more—then opiate painkillers are the safest option in terms of potential damage to your body.
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.
Thank you. This is what I essentially meant. See, this is what I meant by someone being able to express my thoughts better than I could ever hope for, so again, thank you!
If the safest drug is also the one most prone to misuse, and misuse makes it unsafe, then it is no longer the safest drug. The reason society should be wary is precisely because people misuse it on a scale that vastly eclipses garden variety drugs like acetaminophen.
Yeah, "misuse" IS a side effect.
They do cause constipation
You are right. It varies a lot though by different opioids and dosage plays a major role, too.
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.
And nausea. Yuck.
Some people have it. Some do not. I have taken very large amounts of opiates before and I have never ever experienced nausea from them. I think you are not likely to experience it at lower doses from say, codeine or hydrocodone either, but honestly, it varies by individuals.
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 taken very large amounts of opiates before
> I have an addictive personality
I take it this means: "I was a heroin junkie"?
The risk of NSAID ulcers can be vastly reduced by Pantoprazole (Protonix®)
You can see blood that you vomit, But NSAIDs also cause kidney damage, which you don't realize until it is extensive. Lost nephrons don't come back.
I know, and there is something called Venter (sucrate). Combining both works best.
The silent killer
I would say it is not so silent, bowel obstruction is very painful which you feel even if you are on opiates. In any case, I hope my other comment proves to be helpful to those taking opiates if they do not already know what to do or pay attention to.
Possible that this is an elaborate defence of an addict - addiction being the known major problem with them?
Tylenol isn't addictive. Every opiate is. Even as an alcoholic having to get surgery terrifies me because of how addictive opiates is and that is all doctors push now-a-days.
eta this is nothing to do with purity of the product. I never heard of someone selling themselves for Tylenol/acetaminophen
That is an oversimplification, and there are many studies out there proving that people receiving opiates at the hospital do not get psychologically addicted to it, if you are talking about that.
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.
My mom gave me one 325 mg aspirin dissolved in a spoon of water and a little sugar as a tot - it was tasty!
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.
Isn't it highly recommended to not give Aspirin to young people because of Reye’s syndrome risks?
Yes, contraindicated for under-16s everywhere I've worked.
For flu/fever it’s not recommended. Of course that’s mostly when you would give kids aspirin. Little kids don’t usually get headaches.
There is a “better” painkiller than both Tylenol and Ibuprofen (Metamizol), but it has been forbidden on the US based on a study attributing strong side-effects to it, despite it being freely available over the counter on multiple countries for decades without issue.
If this study is true, it should be easy to compare prevalence of autism on these countries that don’t rely on Tylenol.
It's not just banned in the US; it's also banned in France, the UK, Norway, Sweden, Iran, and Canada among others. It is legal OTC in India, the former USSR, China, Mexico, and most of South and Central America. It is the most popular prescribed pain reliever in Germany and the most popular OTC drug in Brazil. It is popular in Spain as well.
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...
There's far more than one study now linking metamizole to agranulocytosis.
> The autism stuff is plainly false and disproved.
If you consider the relevant research you might think differently: https://hsph.harvard.edu/news/using-acetaminophen-during-pre...
https://en.m.wikipedia.org/wiki/Eric_Engstrom
I'm sorry but as a non American I can only think about Rehab Officer Tylenol Jones from the Idiocracy movie since that's the first time I heard about Tylenol without knowing it's a drug, and in the movie everyone had well known American brands as their names due to overreach of corporate marketing into society, but that part of the satire went over my head as a European kid back then, thinking Tylenol was just a person's name and not a drug.
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.
> I wonder if Americans know how much of their society and culture bled incompletely into other countries via 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 wonder if Americans know how much of their society and culture bled incompletely into other countries via movies.
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!!"
There's a Rammstein song, „we all live in Amerika, Coca-Cola, wunderbar!”
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I feel like I might be stepping on a land mine here, but it’s important to note that even if they don’t prevent transmission, vaccines are important for reducing severity and length of illness and have value as a second line of defense, even for those wearing N95’s in high risk circumstances (such as air travel).
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.
I'm not sure "the press manufactured consent for never-ending COVID reinfections" so much as people figured it would become another cold like the other four coronaviruses, regardless of what anyone wants.
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It it was like that it would be a US specific thing but basically every country on earth has mostly stopped worrying about COVID.
Agreed, and guess how many countries prior to COVID followed our CDC's lead? The answer is most of them.
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.
That's kind of interesting - I didn't know the ZeroCovidCommunity existed.
> the safest painkiller currently available
Likewise I find it one of the least _effective_ painkillers on the market.
What do you prefer?
Given the side effects for the low level of pain that it can handle?
Nothing.
Narcotic analgesics are a godsend when you actually need them.
Here's the relevant study from earlier this year: https://hsph.harvard.edu/news/using-acetaminophen-during-pre...
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.
The conclusion section of that very study says "...further research is needed to confirm these associations and determine causality and mechanisms" and "A causal relationship is plausible..." [emphasis added].
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.
Right, but there are plenty of things that can cause pain. It’s reasonable (although it also sucks) to tell women that they should avoid using Tylenol during pregnancy except for fevers in the short term.
As part of a scientific study, sure.
As general medical advice, no, it's not reasonable. Acetaminophen provides real benefits, giving up those benefits requires actual proof of harm.
I'm extremely suspicious of anything that looks at 'an increase in autism rates' without considering the same factors that have gone into there being 'more' left-handed people over the past 50 years or so. There are a lot of people in the past who 'weren't left handed' because they were punished as children if they showed left-handed behavior, and that's still a whole lot less stigmatized than autism.
Has the study stratified for improved diagnosis? When I was a child in the 80's teachers weren't looking for the telltale signs, but you better believe there were autistic poeople, they just weren't diagnosed.
> 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.
Admittedly I haven't read the whole study. But how do they account for the confirmation bias in their review – the fact that null results typically aren't published. Studies that look at an intervention (Tylenol) and fail to find an association are less likely to include it as a variable in their model or less likely to publish a null finding.
Reading the paper, I'm wondering why they didn't do an actual meta-analysis, to estimate average effect size or likelihood of publication bias. As it is, it's more of a systematic review.
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.
> 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.
Every charlatan researcher grifting on bogus autism data really is just copying Andrew Wakefield's homework
I'm always surprised at the hostility to Acetaminophen on HN (or Paracetamol as we call it here in the UK).
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.
It’s the most popular in the UK because that’s what NHS GPs tell you to take for absolutely everything.
A friend of mine, Eric Engstrom, died of liver failure after taking (too much) Tylenol. Tylenol use over time can sneak up on you in the form of cumulative liver damage.
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.
My understanding is that if taken in the recommended dose, and not taken for a longer period of time (consecutive doses, I mean) than the bottle says to, you don't end up with cumulative damage.
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.)
You have to take a lot at one time, or chronic overdoses, to damage your liver.
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.
It's a common failure mode and most other OTCs won't kill you if you occasionally accidentally take an extra dose or two. Agreed that it's safe at the correct dose but the hazards are severe and dosing incorrectly is inevitable at population scale.
Headaches have various causes, and you have to look at where the pain is "originating" from to even try and figure out why. Going out of a walk could be due to a sinus getting irritated and going out for fresh air helps relax it. It can also just be a stress headache and going for a walk relaxes you.
Oh I fully agree that it working depends on the cause of the headache. But when one doesn't know the cause, it's well worth a try.
Yep, my mom worked in the pediatric ER, she never let Tylenol/acetaminophen in the house, my understanding is that she saw way too many cases of liver damage and death.
Its so popular people will take it for mild inconveniences, which is absolutely not what you should do.
Why not?
Stresses the liver, also if its used frequently for mild inconveniences you should maybe go to the doctor, as frequent headaches or stuff like that can hint to more severe stuff.
It does not stress the liver at recommended doses. Plenty of people get frequent headaches and other aches that have no other severe stuff going on, or really anything that needs to be treated more than symptomatically. Scheduled tylenol is an effective element of a pain regimen for many people.
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Please don't do this here.
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Please don't post snarky putdowns or sneer at others. It only makes things worse.
Look at their bio. Why do you want them on this website, dang?
Sometimes, when treated nicely, people change.
Although I rarely take any form of painkiller, I've had headaches so bad I could barely exist. In those cases, pain killers were an important relief.
Yup. Anyone that flippant about "just a headache" definitely doesn't experience actual bad headaches themselves, and lacks empathy for those who do.
Drink more water
What makes you think people who take a painkiller for chronic pain generally don't report it to their doctor?
1. A lot of people won't go to a doctor in the united states
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.
In the US there’s also deep religious influence that paints suffering as virtue that’s been exploited by capitalists to establish a norm of pushing through the pain and continuing to work instead of taking a break to figure out what the root cause is and address it. Some also just don’t have a choice, because taking time off means not getting paid which means losing a roof over their head.
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If you go to doctor with mild annoyance, they wont take you seriously.
> or Paracetamol as we call it here in the UK
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.)
If Paracetamol was invented today it would likely never receive an OTC (over the counter sale, meaning you can just buy it from a retail outlet the way you'd buy cough medicine or toothpaste) license in the UK. Yes, it's safe (and for a bunch of people including me, effective) at the licensed dose, but it's useless at about half that dose, and it's toxic, leading to very nasty deaths in some cases, at just about 3-4 times that effective dose.
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 ?
Always surprises me as an American in the UK how hostile the UK is to paracetamol. You buy it in like 300-pill packages in the US, and I've literally never heard of anyone having a single accidental over-dose. I'm not sure I've ever heard of anyone intentionally overdosing on it, but I guess I can't rule that out since I'm aware of who 1-2 people personally have taken "a handful of pills".
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.
> Always surprises me as an American in the UK how hostile the UK is to paracetamol.
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 more referring to the fact that it’s treated like a controlled substance here and sold in limited quantities from behind the counter. It’s the same treatment the U.S. gives to Sudafed which is an input to meth as I understand it.
The problem becomes, 8 tablets a day, minimum of 4 hours between doses is fine for a week or so, but do that for months and the liver toxicity creeps up on you.
If you feel the need for 8 tablets a day for months, go see a doctor. Your liver is probably the least of your concerns.
It doesn't make much sense to think of efficacy windows for driving, it's not a medical intervention.
Besides US traffic deaths are crazy high by UK standards.
I believe the numbers normalize a bit when you adjust for the fact that everyone drives in the U.S. and tends to be alone when driving. So it’s like accident per mile driven and you see it’s around the same. But in the UK many fewer people drive as a proportion of the population and especially those who are more dangerous (e.g. young, old, disabled, drunk) tend to opt out here due to the availability of mass transit which doesn’t work in the U.S.
The small packages available in the UK are entirely to reduce the chance of suicide.
iiuc it's really hard to OD on tylenol but really easy to end your quality of life through drug interactions with tylenol
I'm by no means an expert in assessing OTC drug safety, but your efficacy window feels... fine... to me? I feel like it shouldn't be hard to avoid taking 3-4 times the effective dose of something? But I guess people still do it, and mess up their liver anyway.
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.
You don't need a doctor. In the UK today there are pathways for Advanced versions of several non-doctor careers which get you either limited, or in some cases full blown unlimited prescribing rights. I think ordinary Advanced Midwife is just a set of common pregnancy drugs, stuff so you can keep down food, sleep properly and so on despite some of the nastier but still non-critical pregnancy side effects, but Advanced Nurse Practitioner and Advanced Pharmacist are both full blown prescribing rights.
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.
Not to mention veterinary pathways. My ex GF was volunteering at a vet practice, where they kept no track of their meds, other than "hey boss, we seek to be low on Ketamine, swing past the animal pill shop and get a load of it pls".
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.
personal responsibility is more common in the UK, it is assumed that one can cross the road safely without needing traffic lights for example, or walk along a stretch of an ancient monument without needing a handrail.
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.
It's weird that you're surprised, it's one of the most dangerous otc drugs, and is the leading cause of liver failure on the planet. I'm always surprised that British people treat it like aspirin, because an overdose can easily kill you.
I'm serious. Over 50% of all liver failure is due to acetaminophen, and 20% of liver transplants.
https://pmc.ncbi.nlm.nih.gov/articles/PMC4913076/
> 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.
Well, c'mon, let's be fair. Your source says overdose-related liver failure. And reading further, most of the overdoses are either intentional (suicide attempts) or a result of addiction and opiate/acetaminophen combination drugs.
I've heard people claim that Acetaminophen wouldn't be approved as an OTC drug if introduced today as it is too liver toxic.
Judging from the comments I've seen, nobody believes this because RFK has completely shot his credibility, and I don't blame them either.
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...
> Further, a potential causal relationship is consistent with temporal trends—as acetaminophen has become the recommended pain reliever for pregnant mothers, the rates of ADHD and ASD have increased > 20-fold over the past decades
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.
Ya, an increased risk of 5-20% on an already very low risk.
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.
I read the study and TBH it's more or less expected that a correlation would exist between increased NDD diagnoses and prescriptions common to pregnant women in regions with increased NDD diagnoses.
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.
I forget, is that the same RFK Jr who dumps dead bear carcasses in parks?
EDIT: Indeed it is! The US government is scooby-doo villains? https://www.npr.org/2024/08/05/nx-s1-5063939/rfk-jr-central-...
The irony is that if Tylenol use in pregnancy actually does increase the risk of autism, RFK's destruction of trust in the government's scientific process will probably just push that sort result back. He's a charlatan and totally unscientific regardless.
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.
Right, I think this falls under the "broken clock correct twice a day" saying. RFK Jr says a lot of crazy things, but he probably does occasionally say something that makes sense, through no skill of his own.
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.
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You're forgetting that for half the country that trust was destroyed years ago, and RFK actually being aware of and wanting to investigate evidence like this is restoring it.
That half of the country is not having their trust in science restored. They're forcing their superstitions onto everyone else and calling that science.
Their trust was destroyed by Dr. Oz and Facebook posts.
Mine was destroyed after they caused a walkout at the CDC.
We are not the same
That is a retrospective meta study, which leads to lots of speculation, but little actual proof of causation.
>> 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...
https://pmc.ncbi.nlm.nih.gov/articles/PMC6822099/
> 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.
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.
> Nobody should be making policy on this yet
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.
> 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.
> Judging from the comments I've seen, nobody believes this because RFK has completely shot his credibility, and I don't blame them either.
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.
How can anyone find him credible after he pitched a "gold standard" health report (MAHA) that had hallucinated references, misrepresented research and "oaicite" markers that indicated it was AI generated?
I don't find that to be a controversial statement.
[1] https://www.science.org/content/article/trump-officials-down...
FYI, "DNC" or "RNC" doesn't refer to the party in general, it's the national party committee (also overloaded to refer to the convention). RFK Jr has certainly never been a member of the DNC.
This is about to cause a huge spike in child deaths due to Reye's syndrome. Parents will choose Aspirin to treat their child's fevers, despite warnings, because that's what they took as a kid, and it worked then.
[1] https://en.wikipedia.org/wiki/Reye_syndrome
Well this should be provable within about 5 years if this Tylenol is truly the cause. Let's just have a few states in the US eliminate Tylenol usage during pregnancy, and watch the autism disappear.
Any volunteers?
At this stage, the entirety of the US is a sample of less-than-willing volunteers…
There really are risks. It's just not worth it during pregnancy. The pain killing effects of tylenol aren't worth the potential risks during pregnancy.
https://www.mountsinai.org/about/newsroom/2025/mount-sinai-s...
You can't look at just one risk and say it's not worth it.
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.
I didn't mean to say it should never be taken. Sometimes medicines should be taken that have risks for the baby. But it shouldn't be taken for minor headaches and aches and pains like it can be when not pregnant.
To be fair, at least in the US, doctors tend to be overly cautious when it comes to pregnancies. The bar for proven safety for treatments tends to be a bit higher than for non-pregnant people. "We haven't proven anything bad" is usually not good enough.
There are also real risks to ignoring pain and the destructive effects it has to quality of life and mental well being, all of which can have effects on the mother's and the fetus's health.
What is a pregnant person with debilitating pain such as a migraine supposed to do?
As I clarified in another comment, I was talking about avoiding it for common aches and pains. In cases of real migraines, I would be very grateful if tylenol gave any real relief. It never did for me.
Unfortunately drugs like sumatriptan have extremely limited data
What’s the alternative? Pregnant people are people too. They can’t take Ibuprofen, or opioids, or even Tylenol now.
Yeah my wife is also pregnant and sometimes it is really tough on her but she doesn't use any medication other than baby aspirin for blood pressure. The alternative is exercise, anti-inflammatory foods, and also realizing that it isn't just your body anymore and you can't hurt somebody else's chances for a very small amount of pain relief.
This is like saying "The risk of a traffic accident on the way to the hospital is unacceptable so I'll make her walk 12 miles to the hospital."
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.
Right. And the benefits for tylenol are small.
But you aren't looking at the risks? Chronic pain can't be great for a pregnant woman and her developing fetus either, no?
What is the benefit of treating fever?
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.
And the risks are infinitesimally smaller.
Dude. That ignores one half of the analysis that we are discussing here.
> Yeah my wife is also pregnant and sometimes it is really tough on her but she doesn't use any medication other than baby aspirin for blood pressure. The alternative is exercise, anti-inflammatory foods, and also realizing that it isn't just your body anymore and you can't hurt somebody else's chances for a very small amount of pain relief.
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...
This is doctor prescribed. It is an extremely low dose. https://www.acog.org/clinical/clinical-guidance/committee-op...
You may not know this, but pre-eclampsia is not a synonym for hypertension. Instead, hypertension is a manifestation of preeclampsia.
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.
Did that doctor prescribe it to your wife? If not, you’re missing the point of the parent comment and that would be incredibly concerning.
Yes a doctor prescribed it to my wife.
> what other sentient entity is available for consultation?
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.
> You wouldn't say excess alcohol consumption during pregnancy is only up to the mother
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.
>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
Wow, that's a pretty extreme view. They're locking themselves up voluntarily and also locking their baby up. The baby is helpless but not the mother. If she didn't want to and somehow still recklessly got pregnant, she could always get an abortion which may be just a pill from the pharmacy once she missed a period, or more involved if slower. It's a deliberate choice to be responsible for somebody else's life.
It's to reduce the risk of preeclampsia.
Being miserable and in pain is also bad for the baby fwiw
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Honestly I wouldn't know if it'd make a difference. The magnitude of pain relief we're talking about is puny.
Honestly, it's probably just good practice for being a parent. The first thing you learn is that pain is your new normal. You just get used to it.
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.
Yep, my wife didn’t take Tylenol during pregnancy due to actual studied risks to the child. If she had a headache she just bore the pain. RFK is a loony and I don’t know about the link to autism but Tylenol should not be taken by the mother during pregnancy.
>While the study does not show that acetaminophen directly causes neurodevelopmental disorders,
_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.
> That report will also suggest a medicine derived from folate – a water-soluble vitamin – can be used to treat symptoms of the developmental disorder in some people, according to the Journal.
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...
I wonder if this hating on autism is part of the regime's focus on loyalty. Autistic people tend to make their own plans and are much more independent. I'd never be able to follow orders in an army for example.
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.
As someone who’s done work with the whole spectrum of ASD: it’ll be fascinating to see if the diagnosis gets weaponized eventually. Right now, MAGA seems to still like “Hi-IQ nerd disrupters”; but the administration would be perfectly happy to sell off an ally for political gain.
Don’t you wish we have a short sell reporting data so we can check if people in the know already shorted the stock?
If it's already in the news, it's already too late to short. News events tend to quickly reverse as well so I'd be looking for a long position at a support level
he's talking about the person who created the news...
Unusual whales does a lot of reporting of this nature.
One could also take a look at pages like cheddar which track what they claim is unusual flow in options.
I can't wait for autism diagnosis to be linked to psychologists & paediatricians, and their subsequent banning.
https://ehjournal.biomedcentral.com/counter/pdf/10.1186/s129...
Data does appear to show a possible link, definitely at the least warrants further research.
Not specific to tylenol and autism, but I think important: RFK Jr. will be issuing findings using "gold-standard science" and hold up the findings as definitive (as proof, etc.) at the same time that he completely minimizes and bemoans current scientific processes. While we may be able to tell the difference between RFK's BS science and real science, what does this mean for everyone else? Especially because RFK Jr. does not trust science?
Nobody should have been trusting science to begin with. Maybe it will help to show science-believers that they should be more cautious.
What's the alternative? What should one trust instead?
No one. This world is radically subjective and all appearances are deceiving. Even solipsism doesn’t work because you can’t trust yourself!
We live in Cartesian radical subjectivity - and no cogito to save you from the evil demon.
Evaluate risks and benefits as best you can, informed by whatever science seems to show. Life's complicated and nobody can provide simple correct instructions on the right way to do everything, or even anything. Public health messages are an attempt to do that but they're unreliable and sometimes intentionally misleading or wrong because their purpose is to influence people's behavior, not to be correct.
Coorelation does not mean causation.
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 had an ultrasound and I’m left handed. I finally know why!
You shoudln’t even be entertaining this lunacy with any response. Anything coming out of the RFK jr health department is batshit.
He was legitimately put into a position of power by the american political system. And this is an article by the BBC, probably the most respected news source on the planet. Crazy is now the norm, the leading voice. It must be confronted.
Your first point is correct, but it (like the second one) has no bearing on the issue of the medical soundness of the department's positions and policy.
But the bbc's reputation does support the facts in the article. I am confident that the stock did drop because of what he said, because i trust the BBC not to make up such things.
I feel the same way, but again, this has no bearing on the issue of the medical soundness of the department's positions and policy.
Going back to the top of this thread, I agree that correlation does not mean causation, but in this case, we do not yet even have a justifiable claim of correlation, and RFK Jr. has repeatedly demonstrated his propensity for substituting unfounded opinion and incorrect data for empirical facts, if it suits his agenda.
"legitimately" is a stretch, given all the information that has come fourth in the past year.
what you resist persists
https://en.wikipedia.org/wiki/Rhyme-as-reason_effect
Yep, Democratic Party refused to do a real primary so he switched sides
Baader-Meinhof phenomenon at work; I commented about the ultrasound/handedness the other day.
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.
Who sold short? How big a bribe will be given to reverse this?
Well, time to pick up Tylenol shares on the dip.
Maybe? Looks like it hasn't performed well over 5 years. I'd still rather hold something that I wanna hold for a long time.
Johnson & Johnson split off their consumer pharmaceuticals into a new company (Kenvue) in 2023, so there isn't 5 years of stock price data.
I considered that when the news hit but didn't. Even if there's nothing to the report and it's forgotten in a week, that sound you heard Friday was tens of thousands of trail lawyers jizzing in their pants. $1.8 billion powerball ain't got nothing on the payday they're looking at.
Was replying to a commented which was downvoted to death entirely unfairly, so I'll paste my reply as a new comment:
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.
Without chronic ingestion of medications that compete for glucuronidation or certain CYP450 inducers like antiepileptics, FOUR GRAMS even as a single dose is virtually impossible to cause any harm.
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.
Taking one gram every 5-6 hours for a maximum of 4 gram/day IS entirely reasonable.
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.
So in summary: taking 4x the recommended dose of a medication is dangerous?
How many other medications would that apply to? Countless, I imagine. That’s why we have dosages on every bottle.
paracetamol is unusual in this respect, that the toxic dose is so close to the therapeutic dose, but the benefits outweigh the risks.
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.
Maybe by FDA-type standards, 4x is "close", but to me, I would think it absurd to take 4x the recommended dose of something unless directed to by a doctor.
I was recently prescribed 800mg ibuprofen for an injury, where 200mg is the standard OTC dose, and I even questioned that.
you'd be surprised how casual some people are with doses. my old grandma had a big bag of medication she had collected over the years and occasionally she'd sit down and pick a couple like smarties and gulp them down.
when my dad decided to step in, he took her to a doctor to get a full review and confiscate the bag.
I don’t understand these responses.
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.
Taking so much paracetamol so often will totally lose its effect after 2-3 doses. If you continue, then it's considered suicide attempt zone.
Taking 1 gram every couple of hours does NOT seem entirely reasonable when the directions on every Tylenol bottle in the world say to take no more than 1g (2x500mg caps) every FOUR HOURS at most and no more than 4g per 24-hour period. Half the bottle is covered in ominous red warnings about liver damage.
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.
Some of y’all have never worked a blue collar job in your lives and it shows.
Most of the blue collar coworkers I've had knew full well that you just needed to add some hydrocodone into the mix and you'd be fine w/ a few hundred mg on the acetaminophen for a full shift.
Hmm, a bunch of high IQ people conclude that it’s dumb as hell to destroy your body for worse wages than coding. Who would have thought?
Why should we feel sorry for the skilled trades again? Mechanics are expert famous scammers worse than lawyer (grandma just replaced her blinker fluid!) That’s just one example. Leak detection companies are nearly all scammers too.
No, I haven't, but that doesn't absolve people of their responsibility in actively deciding to chronically overdose on pain meds, if that's what they're doing.
What’s your point here?
>Paracetamol/acetaminophen (the active ingredient in tylenol) is super toxic to the liver
This is very true. ( and no, he is not exaggerating)
Tylenol itself is not toxic to the liver, the metabolite of glucuronidation is what is toxic. Which means paradoxically impaired liver function can actually reduce the effective toxicity of Tylenol.
Fair enough.
I mean, sure, but the most important part you left out: "if you take 4x the recommended dosage, or take it consistently beyond the recommended period of use".
Lots of drugs are toxic if misused or abused. Acetaminophen is not unique in that regard.
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>Even if RFK Jr. provides ironclad scientific proof of this link they'll just deny it.
As far as I know he is really well read/informed - most people are not in that league and such people are completely dismissive of anything that is counter-narrative.
As far as I know he's a crackpot who makes up random shit that has no basis in science. Sometimes that random shit is correct, because as we all know, a broken clock is correct twice a day.
Suggesting he's well-read and well-informed is laughable.
>As far as I know he's a crackpot who makes up random shit that has no basis in science.
Well for me then you are in the category of most people. Ill read/informed and will parrot what mainstream 'science' has to say. Anything that one says that is against the common narrative in medicine is struck down by the 's' word. You can laugh at me.
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It’s insane that the RFK crowd continues to not consider that the increase is just due to better diagnoses.
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
Better diagnosis and that autism covers a wider range of symptoms.
Can't we find a way to cure lawyerism? That's a terrible debilitating sickness.
I expect that Kennedyism is also hereditary. Another one.
I've been talking about this for a little while: https://news.ycombinator.com/item?id=45006936
I'll take RFK being the stopped clock on this over him causing yet more harm to the medical community and to Americans' health.
The problem is that RFK, like Trump, has effectively created a situation where anything they say is immediately discredited by a huge portion of the population.
My wife is already disproportionately denied pain management compared to me - I’d be very, very concerned about how this result gets implemented.
But at least they figured out autism by September, right?
https://jamanetwork.com/journals/jama/fullarticle/2817406 seems like a good review.
Up until yesterday it was vaccines. Now it’s acetaminophen, and nobody is batting an eyelash at the about face.
The discussion about vaccines has been toxified in blue states - may as well throw out another reason to keep the crunchy skeptics on board.
When something like this happens there’s a non-zero chance some slimy hedge fund is behind this pushing conspiracy theories on gullible folks to tank a stock.
Someone needs to find a new brain worm for the heroin junkie who dabbled in environmental law that gets him doing the right thing™ like:
- 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.
If he’s right, we’ll know before the end of Trump’s term.
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.
They’re going to mess with the data to make whatever story they tell ‘right’.
> “Nobody knew autism was so complicated.” — future Trump, probably.
"Autism rates have gone down 500% during my r/e/i/g/n/ administration!"
I think you are severely underestimating the mental gymnastics these people routinely go through to never be wrong about anything.
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.
ugh, i am allergic to ibuprofen and aspirin (all NSAIDs to be precise). tylenol is my only OTC option.
You’re not going to become autistic all of sudden after taking Tylenol. The claim is that it effects the fetus during pregnancy
And the claim is probably bogus. If it were true, we'd expect other evidence (e.g. https://news.ycombinator.com/item?id=45147119) that hasn't showed up. More likely, it's an artefact of autism diagnosis rates varying in different populations, and maybe something to do with autistic mothers' fucky pain tolerances.
More likely to take painkillers + more likely to get your child assessed for autism = observed (tiny) correlation, even in the absence of any causation.
I am not worried about autism, ya goof! there has repeatedly been shown to be no link, and i am already autistic. I am worried RFKJ will make tyelnol harder to get.
Good time to buy. While the cult might take this to heart and stop using Tylenol alltogether, there will be lawsuits to protect the brand and the company, and considering the lack of proof, in the end they will suceed.
They are molesting the money again, but the company can just pivot to drinkable bleech beverages marketed on joe rogan, in the end an evidence-free health care system might be way more profitable in the short term.
Buy the dip?
The amount of anti-science hysteria and sexism in this comment section is abhorrent. I expected better from HN.
This man says everything causes autism.
Woah, what if EVERYTHING causes autism?!
everything This man says causes autism.
If RFK Jr says it's true, that's how I know it isn't. They go to great lengths to point out they're "using gold-standard science", which also makes me certain they aren't. They can't be, because none of this is about autism or science, it's about pushing their political agenda.
> If RFK Jr says it's true, that's how I know it isn't.
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.
> don't let morons take over your party
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.
While you're probably right in the outcome, you probably shouldn't argue based on the genetic fallacy[1]
1: https://www.scribbr.co.uk/fallacy/the-genetic-fallacy/#:~:te...
There's a threshold where you just don't have a choice. He's made a number of obvious and verifiable health lies - most recently, he described how he can diagnose children with "mitochondrial challenges" by watching them walk around. I have a job, I don't have time to individually investigate all his health claims, the heuristic that he's a liar and everything he says is wrong will have to suffice.
What's the primary factor contributing to metabolic syndrome in children?
And are you really claiming you can't determine that factor by looking?
I don't understand the response. Kennedy didn't say "factor" or "metabolic syndrome", he said "I see these kids that are just overburdened with mitochondrial challenges". If all he meant was that many kids are visibly overweight, wouldn't he have just said that?
The charitable interpretation is that it is simply a more sensitive and accurate way to say that.
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/
Have you heard the term “sanewashing”? I don’t think the principle of charity requires us to replace false things he did say with thematically similar things that might have been reasonable. It’s like “explaining” that a crystal healer is just referring to the stress reduction benefits of aesthetically pleasing knickknacks.
My take is that overall he's right. The obesity epidemic should be our primary heath focus. Heart disease and obesity are the primary killers of americans.
You can in fact determine a huge percentage of americans including children are incredibly unhealthy just by looking. Increased focus on exercise and negative incentives on soft drinks and sugary beverages does seem like a major step in the right direction.
I agree with this criticism.
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.
The point isn't that it's a clever truth-seeking strategy. I'm sure some number of his health claims are true! He'll probably even publish some new recommendations which were better than the old ones, and promote some accurate groundbreaking research I won't believe. I'll have plenty of time to learn the accurate stuff later when HHS isn't dedicated to convincing me of nonsense.
Why is he so against medicine?
He explained his views in detail in his confirmation hearing. He believes that pharmaceuticals in general are dangerous and overused, "the third-largest cause of death in our country after heart attacks and cancers" in his words, and wants healthcare to focus more on healthy food than on medicine.
> (...) and wants healthcare to focus more on healthy food than on medicine.
This is the guy who caught a worm in his brain from eating roadkill?
That's how he got where he is today.
Same reason he's anti-fish.
Because that stance has been very beneficial for him financially and politically, ever since his pivot from legitimate and respected environmental lawyer to anti-vaxxer. He transitioned after receiving incredibly positive feedback for amplifying conspiratorial narratives while riding the coattails of the infamous "thimerosal causes autism" panic of the 2000s. https://en.wikipedia.org/wiki/Deadly_Immunity
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Which is what? Lots of this admin's actions have made sense once you know the underlying agenda—thanks project 2025 for spelling a lot of it out—but this one has me baffled. Taking on the woke… tylenol industry?
It’s simple, RFKj is a well-intentioned idiot.
Looking around for sources from before the world ended I can find quite a few reputable studies that show the correlation. The effect size is small ~0.4% in absolute risk but statistically detectable. Like okay, sure. Doctors already tell pregnant women to limit NSAIDs. So… we keep doing that. Mission accomplished?
The advice to avoid NSAIDs in pregnancy (and contraindication in the third trimester) doesn’t cover acetaminophen, though, because it’s not regarded as an NSAID (different mechanism of action and minimal anti-inflammatory effects.)
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.
> it's about pushing their political agenda.
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?
It's about pushing general distrust of the medical/pharmaceutical establishment, in favor of folk wisdom, home remedies, and anything "natural".
> that's how I know it isn't.
Until you have a controlled study on pregnant women who use and don't use the drug, you won't really know for sure.
Until we have a controlled study, we don't really know if using nouns causes autism either. We don't know what causes autism so everything is suspect.
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.
> We don't know what causes autism so everything is suspect.
Obviously what goes into your body should be suspected first, whether it's food, pollutants, or medical interventions.
Why? Should we first suspect carrots of making people grow red hair, suspect eggs of causing pregnancy, and suspect Left Twix of causing left-handedness?
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?
You don't get a 100x increase in a lifetime by using a genetic explanation, sorry
> Until you have a controlled study on pregnant women
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.
Isn't the baseline risk for autism 1 in 30 presently?
Harvard study: the science is inconclusive and more research is needed.[1]
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.
There's a big difference between "using Tylenol may increase the risk of autism" and "Tylenol causes autism". If this study is accurate, it merely links the two together, and does not provide the reason. The problem with RFK is he's using it as a way to appease his own base to justify an anti-vaccination and anti-science agenda.
Just one slight problem:
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?
> If Tylenol causes autism, how did those parents in the 1920s get their hands on it?
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.
Now do Tylenol sales kicking up in the 60s.
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Ok, but please don't fulminate on HN. This is in the site guidelines: https://news.ycombinator.com/newsguidelines.html.
You may not owe people who you feel are disgusting quacks better, but you owe this community better if you're participating in it.
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When I'm his age, I'd be happy to be as fit as he is. I will concede he sounds like death, though.
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Maybe I never take enough but it's also such a weak painkiller that I always prefer to just feel how it feels and sense if I'm getting better or worse. And that is without believing it's super bad for me, just doesn't make sense as a trade-off.
Some times advil works. Some times aspirin works. Some times Tylenol works. Some times none of them work. There’s all kinds of substances that are available freely that can kill you if you take too much. NSAIDS, Imodium, DXM, iron supplements.
Water. https://en.wikipedia.org/wiki/Water_intoxication Meat. https://en.wikipedia.org/wiki/Protein_toxicity
I don’t know about water, but Hydrohydroxic acid is a solvent for ANYTHING! That can’t be good.
It’s the only painkiller allowed for pregnant women, so this leads me to believe this is some other form of conspiracy to control women (since the science does’t exist, it obviously doesn’t cause autism)
“May or may not cause autism”.
Yes? Those definitely were words I used to mock the article/RFK... Do you have anything to add about toxic levels of acetaminophen?
Like most medications - follow the instructions on the bottle and you’ll be fine. No need to satanize it.
Most medications have a buffer, so if you accidentally take an extra dose (instead of just 2 pills every 6 hours, but no more than 6 in a 48 hour period). Acetaminophen does not have that buffer. Even just slightly over the dosing recommendations can be lethal, and for a drug that's in hundreds of products, that's terrifying. Imo you're being exceptionally careless for one of the most dangerous OTC drugs we have available.
How is following the instructions being “exceptionally careless”?
It’s like using bleach to whiten clothes. The bottle says “do not drink”. I don’t drink it, I’m fine. If I misuse it, I’m toast, like with any other myriad household products that can kill you if you use them not as directed.
Follow the instructions for Tylenol. And for a cough syrup. Add in Model or Nyquil. 6 hours go by, you take a second dose of each, and two days later your liver fails.
Which product's instructions did you fail to follow?
I didn’t — checked the labels for all medications I take, verified the medicinal ingredients and know not to double up on the acetaminophen.
I actually prefer cough syrups that don’t have acetaminophen precisely for that reason.
Sorry but being unable to follow instructions is a you problem not a me problem. My point stands: fail to follow instructions for potentially lethal everyday chemicals and you will end up dead. It’s not exclusive to Tylenol.
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Why are doctors telling women that it's okay to take Tylenol during pregnancy in the first place? Everything they put in their bodies can have an effect on the baby so medication for pregnant mothers should be severely limited. Why haven't we learned from the Thalidomide scandal?
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.
Yeah, it’s refreshing seeing someone not in Big Pharma’s pocket.
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.
Is he in Big Wellness's pocket? I hadn't heard anything about that. Who's paying him off? He's a Kennedy with a net worth of about $15 million so he doesn't exactly need the money. He strikes me as an authentic true believer in his cause, but he could just be a really convincing con man, so I'd love to learn more about this.
Please link to some credible sources showing that he's being paid off by someone.
He literally just repeats whatever trends the crunchy moms on tiktok are latching onto. He's definitely not getting paid, but he's certainly carrying the banner and basking in the praise...
Here’s a NYPost link, hardly a liberal rag (being owned by Rupert Murdoch).
https://nypost.com/2025/01/30/us-news/rfk-jr-in-cash-grab-to...
> doesn't exactly need the money.
has this ever stopped anybody?
> Why are doctors telling women that it's okay to take Tylenol during pregnancy in the first place?
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.
> Untreated symptoms are also bad for the baby
[Citation Needed]
> pregnant mothers should just deal with for the good of their unborn child
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?
This is just another far-right ideological attempt at restricting women's bodily autonomy - this time the angle just happens to be nonscientific fearmongering about medicines.
"Not in big pharmas pocket" = "Baselessly refute expert opinion"
See what you have done democrats? The reason these lunatics are everywhere including HN is solely because liberals didn't pass universal health care. If the choice is between the big pharma corporate puppetshow or the batshit insane fascist freakshow, eventually people go with the crazies.
> Why are doctors telling women that it's okay to take Tylenol during pregnancy in the first place?
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
We've known for years that tylenol affected thought processes:
https://www.realclearscience.com/blog/2019/03/30/acetaminoph...
I don’t know why you’re being downvoted—this is a fascinating read!
Ibuprofen is NSAID (non steroid anti inflammatory), oaracetamol is not. Related but different.
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.
The entire medical community is doing their impression of Shaggy, i.e. "it wasn't me!" But there are thousands of suffering parents and children and this lack of empathy really does nothing for no one. Another hand-wavy response I have heard is that given the new Autism Spectrum diagnosis, many more kids are now diagnosed with autism. That being said, none has even come up with a reasonably derived estimate saying that of the 5X increase in autism over the last 25 years, we can confidently say that nX of this is due to changing diagnosis standards. And if n is anything less than 5, the medical community has work to do in solving this problem and not passing the blame and accusing suffering parents of being crazy.
> this lack of empathy
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...
Literally everyone including everyone in "the medical community" would like to know the cause of autism.
So we do the tried and true solution of listening to the deranged quack?
I almost can't even blame him he is so off the deep end. I still do of course, he should have the self-awareness to have never accepted and it is his massive ego that keeps him doing crazy, dangerous things. But whenever this mentally ill person does things that make the news, I never hear anybody blame the people who put him in that position, and leave him there despite the clearly harmful things he does every day. So shame and blame on everybody involved.
I do not usually side with huge corporations, but in this case I hope Tylenol drags that quack into court and make him prove the report.
We all know he cannot prove anything, even if Tylenol loses, ensure they cost RFK jr lots of $ in defending himself.
Does RFK Jr have a track recording of winning his cases or losing them?
Whether he wins or loses is irrelevant. This administration has a track record of ignoring judgements they don't like and facing zero consequences.
His prior legal track record has no relevance to his current work?
No, because, as forgotoldacc points out, Trump is going to just keep doing whatever he wants regardless, and he wasn't appointed based on actual expertise or prior success: he was appointed because he validates the biases of Trump's base.
I’ll have an aspirin thank you. The main problem isn’t going to be solved.
Do they?
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’s a marked increase in mental illnesses diagnosed. My parents were heavily depressed and anxious, but in their day it was taboo to seek help and admit such a diagnosis. We are so much more sophisticated today.
> There’s a marked increase in mental illnesses diagnosed.
There was a marked increase in left-handedness once the 'stigma' of it was removed.
This sinister finding must be further investigated.
And righted?
Certainly no stone left unturned.
“Could it perhaps be related to the increases in various kinds of air pollution? Water pollution? Pesticides or herbicides in our foods?”
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.
To be clear, I don't think that's a likely factor. I mention it merely because it is one of the dozens of factors that have changed over the past few decades that have nothing to do with the pharmaceutical industry.
>Until there are reputable studies that can actually show something resembling a causal link,
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.
> 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
Acetaminophen is better studied than like 99% of foods and supplements.
So now that we're all terrified that one of our various pharmaceuticals might, hypothetically cause an increased chance of autism, we have to take them all off the market and do extensive testing of absolutely everything? All the painkillers, blood pressure medicines, immunosuppressants for transplant patients, antipsychotics and antiseizure meds—everything?
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 not talking about medicines, we are talking about some that is frequently ingested/exposed to people. Things like plastics, additives, pesticides, EM signal. These are novel chemicals/radiation and are potentially slow toxins and showing a causal link from population studies is near impossible.
....nnno?
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.
We don't even know that autism is something that's caused. When sampling an integer, there's some probability you'll get a prime; perhaps when making a human, there's just some inherent probability you'll get an autistic person. (Afaik, we don't even know enough to put a likelihood on this class of theories.)
>Perhaps you need to be reminded of the whole sentence you quoted from my post, rather than just the first subclause?
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.
There is far less environmental contamination now than there was in 1970.
And modern agriculture practices result in lower amounts of less toxic substances in the food supply.
This doesn't really average. There's less lead, but more micro plastics for example. There less cadmium, but more pesticides. Etc.
microplastic contamination, for one, is much higher now than the 1970s. who knows what else we arent measuring for carefully
Or change of living conditions. Running around outside all the time vs sitting in front of a display.
> accusing suffering parents of being crazy
What? Who is supposedly calling parents of autistic children "crazy"?
No one supporting this quack's actions and opinions has any right to claim that the people devoting their lives to understanding, managing and healing illnesses, are the ones lacking empathy and not the ones doing their best to make healthcare less accessible, discrediting and shutting down any research that doesn't support their biases and irresponsibly spreading misinformation.
>lack of empathy
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...)