There is a reason that Trump and RFK, Jr. chose acetaminophen as opposed to any of the other medications that have been studied. Acetaminophen has complex and conflicting data.
First, if there were a clear link between acetaminophen exposure and autism, there would have been a HUGE announcement from the American Association of Psychiatrists. This would have been a eureka moment. There would have been dancing in the streets. No, I’m serious.
Think about this just for a second. We have this mysterious disease. We have found genetic markers associated wth autism. Genes. A nice study from UCLA performed DNA sequencing on over 4000 patients, of which over 1800 children had autism, and 400 children did not. They found a strong association between seven genes and autism. This isn’t the end of the discussion about autism and genes. This is just the start. Over 100 different genes have been associated with autism.
The environment also plays a significant role in developing autism. Advanced maternal age is associated with autism. If the mother is exposed to forever chemicals. If the mother has a substantial infection while pregnant, the child has an increased risk of autism. Gestational diabetes, air pollution, medications – Valproate and Thalidomide, pre-eclampsia, psychoactive drug use, and gestational hemorrhage causing low blood pressure are just a few environmental factors that have been associated with autism.
There is a body of literature that suggests a correlation between acetaminophen and autism. It isn’t just one study but several. There have been both retrospective and prospective observational studies that have shown that exposure to acetaminophen by pregnant women was associated with the child developing something on the autism spectrum. One study was a survey sent to women years after they had given birth. It is hard to imagine how accurate Tylenol usage could be years later. One large study, which suggested a correlation, didn’t control for environmental factors, which makes the data difficult to interpret.
In 2024, an outstanding study was conducted in Sweden. The study was published in the JAMA. The study included over 2.4 million patients. The authors had access to the mother’s medical record. They had good data on drug usage during pregnancy. In this study, the authors were able to control for many of the confounding variables that have plagued other studies. They were also able to investigate siblings, including twins. (The twin data is very interesting.) If you believe that acetaminophen is the cause of autism, then if one twin has autism, the other twin should also have autism 100% of the time, but that is what these researchers found. Once the authors added the sibling data, they found no correlation between autism and acetaminophen.
This brings me back to Trump and old gravel voice (RFK, Jr.). These guys didn’t do any basic research on their own. Instead, they scanned the current literature and then picked acetaminophen out of many drugs that have been found to correlate with autism. They decided that they could make their case to the American public. They knew that the medical community would jump up and down and yell, “No!” They didn’t care. They wanted to create confusion and doubt. This is where Trump lives. He really has never been about finding an answer. He is about creating chaos. This is Trump. This is where we are now.
