medium_4361289396It is definitely time to rethink our relationship with one of the most common, if not the most commonly used, over the counter medications, especially for children but for adults as well.

Over the past several years some very concerning evidence has appeared in the medical literature about acetaminophen (Tylenol). This ubiquitous medication is present in virtually every medicine cabinet in the US and in many countries worldwide.

When I trained as a family medicine resident on the obstetrics ward, I was taught that there are only two drugs that are universally agreed to be safe in pregnancy: Sudafed and Tylenol.

Acetaminophen has long been considered the go-to for most aches and pains, fevers, and general malaise and had been thought to be the safer alternative to ibuprofen. But now, after several small studies conducted in the early 2000s raised initial concerns about possible neurological complications which may result from acetaminophen use, we finally have several very large and well-designed trials that to my mind are game-changers.

One of these compared over 48,000 siblings in Norway and found “substantial” correlation between adverse behavioral outcomes in children exposed to acetaminophen in utero.

Similarly, another large trial published in JAMA in 2014 studied 64,000 toddlers in Denmark and concluded a significant correlation between maternal acetaminophen use during pregnancy and ADHD and similar behavioral patterns in their children.

Still other trials have raised the concern of neurotoxicity leading to Autism Spectrum Disorders in children given acetaminophen following vaccination. As is so often the case, we still need more studies to definitively prove causality between acetaminophen and neurological disorders, but here is my take home message:

I unequivocally counsel all of my patients to use alternatives to Tylenol—especially during pregnancy and early childhood—and definitely not after vaccination.

I recommend using natural alternatives.

In our family we use Doterra’s Onguard (an essential oil remedy), and sometimes Boiron’s homeopathic oscillococcinum. For adults I also recommend New Chapter’s Zyflammend and Ortho Molecular’s Inflamma-Blox.

There is certainly a time and a place for NSAIDs (nonsteroidal anti-inflammatories) like ibuprofen (Advil), naproxen (Aleve), and the prescription-only meloxicam. But these should only be used for short periods of time and only after a meal and with optimal hydration since they are quite toxic to the stomach lining as well as the kidneys.

Here are links to some of the key studies:

http://ije.oxfordjournals.org/content/early/2013/10/24/ije.dyt183.abstract

http://archpedi.jamanetwork.com/article.aspx?articleid=1833486

http://www.ncbi.nlm.nih.gov/pubmed/23656698

Cheers to your health and be careful out there!

Dr. T

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