Paracetamol (aka Acetaminophen) is found in some of the store-bought painkillers for children. Think Calpol/Kids Tylenol. Some research has linked Paracetamol to potentially negative elements for small and growing people. Specifically around brain development and immune health. So, we take a look at this research to assess whether or not you should consider to an alternatives/reduced use when it comes to pain relief for your child. 

First thing’s first: no parent wants their child to be in pain. Small children will get bugs, it is par for the course. It’s actually even necessary for building a developing immune system. For many of us, painkillers for kids are a godsend. Bringing down temperatures and soothing aches and pains. So far so good….

However, as with most things in life, no ‘drug’ comes for free. There are always potential side effects depending on the person.

We think that awareness is really important. Awareness of the risks as well as the benefits. Particularly as there are other painkillers out there which do not contain this ingredient. Ibuprofen is also commonly used for example.

In other words there are alternatives.

Below we go through the science behind this to help you make the best choice for you/your family.

However, one important thing to bear in mind before you dig. There is rarely one single factor that ‘causes’ any issue. So do not worry if (like the vast majority of parents – me included) you have given your child a painkiller containing Paracetamol. What we realise more and more is that when we get ‘problems’ it is often a result of many things acting together.

There is never any single incident. The research below simply suggests there could be potentially increased risks, combined with other factors. This is not a suggestion that a single dose will have a sudden nasty consequence. So no panic or feeling bad (we know ‘mum-guilt’ is very real!). This is simply to raise factors you may not have considered when you’re deciding the right pain relief for your child.

So, could Paracetamol impact developing brains and immune systems? 

Here is what the research is suggesting:

Paracetamol as a pain medication started to be recommended much more routeinly to pregnant women and children in the 80s. Why? This is when Aspirin began to get linked to Reye syndrome so people switched.

However, the alternative that was suggested: Acetaminophen (aka. Paracetamol) is increasingly appearing to have its own potential impact on a developing person. What’s also interesting is that a lot of the modern day diseases in children have taken a massive step up since this period in time. Could be other factors of course, but worth noting:

‘several investigators noted that the marked increase in autism, asthma, and ADHD in the early 1980s corresponded with the replacement of aspirin with acetaminophen. In addition, Schultz noted that the long-term, steady increase in the prevalence of autism was punctuated by short-term decreases coinciding with widely publicized cases of acetaminophen poisoning that temporarily deterred the public from using the drug’. (1)

To be clear: there is not proof of direct causation. There are however a number of red flags being raised.

So, what exactly is causing the issue here? 

The main issue seems to be the way that this drug works and is subsequently detoxed by the body. Particularly a young body. It is always worth remembering that some drugs are broken down differently by an immature body vs an adult body.

Most drugs are detoxed via the liver. The trouble is, this process depletes the body’s own defence system in children: Glutathione click here to read more as to why this is so crucial and Sulfate.

Why are these important?

Both are needed to detox and eliminate the drug from the body. However both are also needed to detoxify a whole host of other nasties that are around in our environment. When we get too much of this/not enough defence we can get inflammation and oxidative stress . Both of which we are increasingly realising are the root causes of many chronic diseases.

‘oxidative stress is now associated with modern diseases. Oxidative stress, like inflammation, is associated with cancer, coronary artery disease, and a number of psychiatric disorders. It is widely thought that inflammation and oxidative stress go hand in hand.’ (1)

Click here for a guide to oxidative stress and inflammation and why they can cause us issues. 

So – if you’re sick or have a vaccine, adding another element in the form of Paracetamol (which requires the body to detox) can cause overload and potential problems. Particularly for a small and rapidly developing person.

‘acetaminophen affects glutathione levels…Glutathione metabolism is fundamental to many biological processes and alterations in glutathione homeostasis are implicated in numerous human diseases including immune and inflammatory disorders. Polymorphisms in glutathione pathways have been associated with both autism and inflammatory disorders’ ie. asthma/autoimmune diseases. (3)

Translation: this drug is depleting one of the key molecules that can leave us vulnerable to immune and inflammatory based illnesses.

This is something that Dr Paul Thomas talks about in his excellent book: ‘The Vaccine friendly plan’. 

In fact studies in adults also show that even at a low dose Acetaminophen triggers immune system activation and oxidative stress response. (1) 

‘The wide range of factors associated with the induction of autism is invariably linked with either inflammation or oxidative stress, and sometimes both. The use of acetaminophen in babies and young children may be much more strongly associated with autism than its use during pregnancy, perhaps because of well-known deficiencies in the metabolic breakdown of pharmaceuticals during early development. Thus, one explanation for the increased prevalence of autism is that increased exposure to acetaminophen, exacerbated by inflammation and oxidative stress, is neurotoxic in babies and small children.’ (1)

Once again: small people are especially vulnerable.

It makes sense, but always good to remember: an immature and developing system can find breakdown of pharmaceutical products more challenging.

Animal studies have shown long term effects when Acetaminophen it is administered during ‘a time sensitive window in early postnatal life’ with ‘significant long term modifications to brain development…lower social interactions and lower sensory function in male brains.’ (1)

There are those (mainly who have vested interests) who may try and discredit these studies. However, when choosing which research to read, we always check who it is written by. Principally as the big drug companies themselves churn out a lot. We also check who funded the research, and basic things like sample size. Yes nothing is certain, and to be very clear this is not showing a direct causation, however, the reality is that there are now numerous credible studies of large size that are raising red flags. Flags that I as a parent, at least want to know about. I’m sure you do too.

In fact, new studies supporting the view that prenatal Acetaminophen use associated long-term negative effects on brain function are currently being published on a monthly basis.’ (1)

Asthma, eczema and autoimmune diseases:

One multinational study with more than 200,000 children found a dose dependent association between the use of Acetaminophen in the first year of life and the occurrence of inflammatory diseases such as asthma and eczema later in life. (1)

Once again although there is no known single cause. Asthma and eczema have been linked to inflammation and oxidative stress in the body. There are many causes of which this may be one. 

The causal relationship has of course been questioned (particularly between Acetaminophen and asthma). However, the consensus is now that a relationship exists. What’s interesting is that there has been a population wide increase in asthma of more than 40% since the 80’s. This happens to coincide with the switch from aspirin to acetaminophen use. (1)

This doesn’t end with asthma and eczema. It is also being linked in part to other complex neurological diseases like ADHD and autism.

First and foremost, once again: it is really important to note that these diseases often have multiple triggers and we certainly don’t know of any one single mechanism. It is suspected that many of these more common disorders in children are a combination of genetics and environmental triggers. However, we are starting to appreciate some environmental factors can have greater risks than others – including Acetaminophen.

When it comes to ADHD there is evidence that suggests an association with its development and Paracetamol use during pregnancy. We know it gets in to a baby’s system if ingested during pregnancy and does cross the placenta. It has been traced in infant’s urine after prenatal exposure for example (2).

Alarmingly in the US for example reports have suggested that acetaminophen is used by ∼65% to 70% of pregnant women in the United States and by ∼50% to 60% of pregnant women in western and Northern Europe. (2)

‘Researchers conducting a large Danish birth cohort study found an association between prenatal acetaminophen use and both a clinical attention-deficit/hyperactivity disorder (ADHD) diagnosis and ADHD symptoms in offspring (2)

Another study of 50,000 children in Norway for example showed that use during pregnancy was correlated to psychomotor, temperamental and behavioural developmental issues in children at three years old. Another showed hyperactivity and emotional symptoms at seven alongside ADHD.

Now, once again, these disorders, like asthma, are increasingly being considered epigenetic based disorders. That means there is likely some genetic predisposition that is triggered by certain and likely numerous environmental exposures in combination. Paracetamol being ONE potentially in question. So this is not to say this is the only cause:

‘Although gene structure (DNA) remains stable over a lifetime (except for mutations) gene expression is very labile. Genes are readily turned on or off by epigenetic mechanisms and environmental factors like toxins and even stress. Three environmental toxins most implicated in the U.S. autism epidemic are 1. analgesic/antipyretic acetaminophen (Tylenol), 2. oral antibiotic amoxicillin/clavulanate (Augmentin), and most recently 3. herbicide glyphosate’ (4)

However, it appears postnatal use in early childhood could be the thing to really watch as an increased risk factor. Something that you can therefore choose to avoid.

Could this be a reason behind the constantly debated vaccine/autism link?

There has been, and continues to be, huge debate over whether or not vaccines do or can cause/trigger autism in a child. There are passionate supporters both sides. Many parents with children who have regressive autism do continue to attribute the onset of the disease to a vaccine, despite evidence on the other side that it is not the case. However – perhaps there is another link?

Some research is arguing that it is not the vaccine alone, but instead potentially the combination of vaccine (or metal within) plus administration of painkiller/Acetaminophen following that could potentially be a trigger. Similarly this argument is made to explain the link between high rates of autism and circumcision that has been reported.

‘An online parent survey by Schultz and colleagues found children given acetaminophen for pain/fever of the measlesemumpserubella vaccine (MMR) were far more likely to become autistic than children given ibuprofen: “Acetaminophen use after MMR vaccination was associated with an increase of sixfold in the likelihood of AD when considering only children 1-5 years ..’ (4)

Conclusion: many of these diseases which are on the rise in young kids have multiple causes and triggers. However, as parents all we can do is to identify where there is more or less of a risk and adjust our choices accordingly. The research associated with Acetaminophen/Paracetamol, at least for me, raises enough red flags to avoid it, particularly as there are alternatives (Children’s Ibuprofen: if your child is over 3 months old – always speak to your doctor). Ultimately, knowledge remains power and often the full picture is not given to us, so it’s good to question and to go looking. After that it is up to you.

References:

1. PARKER W, HORNIK CD, NEVISON CD: The role of oxidative stress, inflammation and acetaminophen exposure from birth to early childhood in the induction of autism: Journal of International Medical Research: 2017 Apr: 45(2): 407-438

2. YSTROM E, GUSTAVSON K, REICHBORN-KJENNERUD T: Prenatal Exposure to Acetaminophen and Risk of ADHD: Pediatrics: 2017 Nov: 140(5)

3. BECKER KG, SCHULTZ ST: Similarities in features of autism and asthma and a possible link to acetaminophen use: Medical Hypotheses: 2010 Jan: 74(1) 7-11

4. GOOD P: Evidence the U.S. autism epidemic initiated by acetaminophen is aggravated by oral antibiotic amoxicillin/clavulante (Augmentin) and now exponentially by herbicide glyphosate (Roundup): Clinical Nutrition ESPEN: Feb 2018: Vol 23 171-183

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