An announcement from the White House on Monday linked the development of autism with acetaminophen, the active ingredient in Tylenol. A professor and autism researcher from Wisconsin said the definitive claims from the president aren’t supported by evidence.
At a press conference with top health officials, Trump urged pregnant women to avoid taking the medication, which is commonly used to manage fever and pain.
The president also suggested the use of a medication called Leucovorin could be used as a form of treatment for autism.
The Food and Drug Administration had previously said that they had not found clear evidence that acetaminophen is linked with autism, but advised patients to speak with a health care provider.
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Amy Van Hecke is a professor of psychology focusing on developmental psychology and neuroscience at Marquette University. She told WPR’s “Wisconsin Today” that attempting to identify a singular cause for autism is reductionist.
“As much as I think folks want sort of that simple answer, the real answer is much more nuanced,” Van Hecke said. “There are more complex factors at work here, and it won’t be this one simple, easy answer.”
Van Hecke told “Wisconsin Today” what is known about the development of autism and why the issue is so complicated.
The following was edited for clarity and brevity.
Rob Ferrett: What do we know about acetaminophen, Tylenol and the risk of autism?
Amy Van Hecke: I think in the autism research world, we’re always trying to better understand what factors contribute to autism. I think there is this push for what I call “reductionism” of what would be the easy answer. Is there one easy answer? Unfortunately, it’s more nuanced. It’s not going to be that easy answer.
I think (with) the Tylenol studies, the real issue there was that the earlier studies that did show a very slight risk — I think it was a 5 percent increase in mothers who had taken Tylenol in pregnancy versus those who had not — the studies were not as well controlled as they needed to be and didn’t really compare within a family. So things like shared genetic factors or children within one family with different pregnancies who did and did not get Tylenol. Once we include that kind of data, we see that relationship disappear.
So this really speaks to the fact that, likely, it’s not Tylenol that was the issue to begin with. It was a shared genetic issue. It was fevers, it was some other factor that had gone unmeasured in those early studies.
RF: It seems like the ultimate guidance from the Food and Drug Administration is to talk to your doctor about taking this medication, which I think they say about any medication during pregnancy. Does that much change for anyone who is pregnant right now?
AVH: I would like to say no. I would like to say to pregnant women everywhere, to not be scared and to not drastically change what your doctors have been telling you to do.
We do know — and this is the irony in this whole situation — that fevers during pregnancy are a factor that contributes to autism in offspring. If you’re ignoring the fever and not taking Tylenol trying to, “tough it out,” you’re actually potentially getting in more of a risky situation than if you weren’t. The other painkillers that are out there are known to be much more dangerous in pregnancy than Tylenol. Of course, you don’t want to take anything for an extended period of time. That’s indicating an underlying medical issue that you need to have addressed. But to just not take it, that is bad advice.
RF: I want to touch on another part of this announcement. The Trump administration touted a medication called Leucovorin as a form of treatment for autism. What do you make of this recommendation?
AVH: I think the key is to understand that this is a subgroup. When I look at those studies on Leucovorin, what I see are subgroups who have this cerebral folate deficiency, which is actually very hard to measure at this point in time and unreliable to measure. It’s not an easy test you can get at Walgreens. If your child has this, it might involve a spinal tap, for example.
For a subgroup, this might be a treatment. But when we look at those studies and we see that they selected their participants in those studies based on having cerebral folate deficiency, and then when they supplement it, they appear to improve. Well of course they did, because they had it. So it’s this circular logic, and we don’t know whether that applies to the general population of people on the spectrum.
