health and wellness
What parents need to know about Tylenol, autism and the difference between finding a link and finding a cause in scientific research
The article discusses the ongoing debate regarding the potential link between prenatal acetaminophen (Tylenol) use and autism. While some studies show weak associations, establishing causation remains challenging. Factors like dosage response and sibling outcome comparisons are critical for understanding this complex issue, highlighting the need for more thorough research and consulting healthcare professionals.
What parents need to know about Tylenol, autism and the difference between finding a link and finding a cause in scientific research
Claims from the Trump White House about links between use of the painkiller acetaminophen – often sold under the brand name Tylenol in the U.S. – during pregnancy and development of autism have set off a deluge of responses across the medical, scientific and public health communities.
As a father of a child with level 2 autism – meaning autism that requires substantial support – and a statistician who works with such tools as those used in the association studies cited by the White House, I find it useful to think about the nuances of association versus causation in observational studies. I hope that this explanation is helpful to parents and expecting parents who, like me, are deeply invested in the well-being of their children.
Association is not causation, but …
Most people have heard this before, but it bears repeating: Association does not imply causation.
An often-cited example is that there is a very strong association between ice cream sales and incidents of shark attacks. Of course, it goes without saying that shark attacks aren’t caused by ice cream sales. Rather, in the summertime, hot weather drives more appetite for ice cream and beach time. The increased number of people at the beach does, in turn, cause the likelihood of shark attacks to increase.
Yet pointing this out on its own is neither intellectually satisfying nor emotionally appeasing when it comes to real-life medical concerns, since an association does suggest potential for a causal relationship.
In other words, some associations do end up being convincingly causal. In fact, some of the most consequential discoveries of the past century in public health, like the links between smoking and lung cancer or the human papillomavirus (HPV) and cervical cancer, started out as findings of very strong association.
So when it comes to the issue of prenatal acetaminophen use and autism development, it is important to consider how strong the association found is, as well as the extent to which such an association could be considered causal.
Establishing causal association
So how do scientists determine if an observed association is actually causal?
The gold standard for doing so is conducting what are called randomized, controlled experiments. In these studies, participants are randomly assigned to receive treatment or not, and the environment where they are observed is controlled so that the only external element that differs among participants is whether they received treatment or not.
In doing this, researchers reasonably ensure that any difference in the outcomes of the participants can be directly attributed as being caused by whether they received the treatment. That is, any association between treatment and outcome can be considered causal.
Yet oftentimes, conducting such an experiment is impossible, unethical or both. For instance, it would be highly difficult to gather a cohort of pregnant women for an experiment and extremely unethical to randomly assign half of them to take acetaminophen, or any other medication for no particular reason, and the other half not to.
So when experiments are simply infeasible, an alternative is to make some reasonable assumptions on how observational data would behave if the association was causal and then see if the data aligns with these causal assumptions. This can very broadly be referred to as observational causal inference.
Parsing what the studies mean
So how does this apply to the current controversy over the potential for acetaminophen use during pregnancy to affect the fetus in a way that could result in a condition like autism?
Researchers who try to understand causal roles and links between one variable and potential health outcomes do so by considering: 1) the size and consistency of the association across multiple attempts to estimate it, and 2) the extent to which such association has been established under observational causal inference frameworks.
As early as 1987, researchers have been working to measure possible associations between acetaminophen use during pregnancy and autism. A number of these studies, including multiple large systematic reviews, have found evidence of such associations.
For instance, a 2025 review of 46 studies that examined association between acetaminophen use and an array of neurodevelopmental disorders, including autism, identified papers with five positive associations between acetaminophen and autism.
In one of those studies, which examined 73,881 births, the researchers found that children who were exposed to acetaminophen prenatally were 20% more likely to develop borderline or clinical autism spectrum conditions. Another examined 2.48 million births and reported an estimated association of only 5%.
Both of those are weak associations. For context, estimations of increased lung cancer risk from smoking in the 1950s were between 900% to 1,900%. That is, a smoker is 10 to 20 times more likely than a nonsmoker to develop lung cancer. By comparison, in the two autism studies above, a pregnant woman who takes acetaminophen is 1.05 to 1.20 times more likely than one who does not take the drug to have a child who would be later diagnosed with autism.
It’s also important to keep in mind that many factors can affect how well a study is able to estimate an association. In general, larger sample sizes provide both greater power to detect an association if one does exist, as well as improved precision over estimating the value of the association. This does not mean that studies with smaller sample sizes are not valid, only that from a statistical perspective, researchers like me place greater confidence in an association drawn from a larger sample size.
Once an association – even a small one – is established, researchers then must consider the extent to which causation can be claimed. One way to do this is through what’s called dose-response. This means looking at whether the association is higher among women who took higher doses of acetaminophen during pregnancy.
The study mentioned above that looked at 2.48 million births shows an example of dose-response. It found that pregnant women who reported taking higher doses have higher autism risk.
Another way to examine possible causality in this context is to analyze sibling outcomes, which that same paper did. Researchers looked at whether associations between acetaminophen and autism persisted within families with more than one child.
For example, in a family with two children, if the mother used acetaminophen during one pregnancy and that child was later diagnosed with autism, but she did not use it during the other pregnancy and that child was not diagnosed, then this strengthens the causal claim. Conversely, if acetaminophen was used during the pregnancy of the child who was not diagnosed with autism and not used during the pregnancy of the child who was, then that weakens the causal claim. When this was included in the analysis, the dose-response disappeared, and in fact the overall 5% increased risk mentioned before likewise disappeared. This weakens the claim of a causal relationship.
Consult your doctor
At present, there is clearly not enough evidence to establish a causal association between prenatal acetaminophen use and autism.
Yet as a parent who wonders if my daughter will ever be able to write her name, or hold a job or raise kids of her own, I understand that such explanations may not appease the fears or concerns of an expecting mother who is suffering from a fever.
Naturally, all of us want absolute certainty.
But that’s not possible when it comes to acetaminophen use, at least not at this time.
Your doctor will be able to provide you with much sounder advice than any existing study on this topic. Your OB-GYNs are very likely aware of these studies and have much better judgment as to how these results should be considered in the context of your personal medical history and needs.
Researchers, meanwhile, will continue to dig deeper into the science of this critically important issue and, hopefully, provide greater clarity in the years to come.
Mark Louie Ramos, Assistant Research Professor of Health Policy and Administration, Penn State
This article is republished from The Conversation under a Creative Commons license. Read the original article.
Dive into “The Knowledge,” where curiosity meets clarity. This playlist, in collaboration with STMDailyNews.com, is designed for viewers who value historical accuracy and insightful learning. Our short videos, ranging from 30 seconds to a minute and a half, make complex subjects easy to grasp in no time. Covering everything from historical events to contemporary processes and entertainment, “The Knowledge” bridges the past with the present. In a world where information is abundant yet often misused, our series aims to guide you through the noise, preserving vital knowledge and truths that shape our lives today. Perfect for curious minds eager to discover the ‘why’ and ‘how’ of everything around us. Subscribe and join in as we explore the facts that matter. https://stmdailynews.com/the-knowledge/
Discover more from Daily News
Subscribe to get the latest posts sent to your email.
Lifestyle
Understanding Cardiovascular Disease Risk Factors: Numbers to Know in 2026
The American Heart Association’s 2026 update reveals a decrease in deaths from heart disease and stroke, despite rising rates of high blood pressure, diabetes, and obesity. Following their Life’s Essential 8 guidelines can prevent 40% of cardiovascular deaths, emphasizing the importance of healthier lifestyles for improved heart health.
Understanding Cardiovascular Disease Risk Factors: Numbers to Know in 2026
(Family Features) Taking care of your heart with healthy behaviors may be at the top of your wellness priority list already, and there may be good news about the effects of adhering to expert recommendations.
New information from the American Heart Association’s 2026 Heart Disease & Stroke Statistics Update shows deaths from heart disease and stroke are on the decline. However, rates continue to climb for high blood pressure, diabetes and obesity – all of which are health risk factors that contribute to cardiovascular disease.
Following expert guidance can be your prescription for better health as 80% of heart disease and stroke is preventable.
To help maintain and improve your cardiovascular health, consider following the American Heart Association’s Life’s Essential 8, which is a set of four health behaviors (eat better, be more active, quit tobacco and get healthy sleep) and four health factors (manage weight, control cholesterol, manage blood sugar and manage blood pressure).
In the United States, optimal Life’s Essential 8 scores could prevent up to 40% of annual all-cause and cardiovascular disease deaths among adults.
Consider these highlights from the statistics update:
- Heart disease remains the leading cause of death in the U.S. and stroke is the No. 4 leading cause of death.
- Together, heart disease and stroke accounted for more than a quarter of all deaths in the U.S. in 2023.
- Cardiovascular diseases, including all types of heart disease and stroke, claim more lives in the U.S. each year than all forms of cancer and accidental deaths — the Nos. 2 and 3 causes of death – combined.
- On average, every 34 seconds, someone died of cardiovascular disease in 2023.
- On average, about two people died of heart disease every 3 minutes in the U.S. in 2023.
- On average in 2023, someone died of stroke every 3 minutes, 14 seconds in the U.S.
- Nearly half of U.S. adults now have high blood pressure.
- Nearly 29.5 million U.S. adults have diagnosed diabetes.
- About 50% of U.S. adults have obesity or severe obesity, and 28.1% of youth ages 2-19 have obesity.
- Only 1 in 4 U.S. adults meets national physical activity guidelines. Only 1 in 5 U.S. youths ages 6-17 are physically active for 60 minutes or more every day of the week.
To learn more about how to reduce your risk of cardiovascular disease, visit heart.org.
Photo courtesy of Shutterstock
SOURCE:
Discover more from Daily News
Subscribe to get the latest posts sent to your email.
Food and Beverage
Get Smart About Your Heart: 4 tips to improve heart health
Heart health is essential for overall well-being, particularly as heart disease is a leading cause of death in the U.S. Key strategies include regular checkups, healthy eating—especially fruits like grapes—consistent exercise, and stress management to minimize risks.
(Family Features) A crucial component of overall well-being, heart health can be a barometer for living a long, healthy and happy life. Because heart disease is the leading cause of death in the United States, according to the Centers for Disease Control and Prevention, taking steps to reduce your controllable risk factors – including poor diet, stress and inactivity – can set you on the right path.
From regular checkups and reducing stress to eating well – including heart-healthy snacks like grapes – and exercising regularly, these simple steps can help boost your heart health.
Know Your Numbers
Knowing key health metrics such as blood pressure, cholesterol levels, blood sugar levels and body mass index can help you and your health care provider identify potential risks early. Schedule annual checkups and discuss any concerns you may have about your heart health. Early detection and risk factor management can reduce the likelihood of developing heart disease.
Eat More Fruits and Vegetables
Incorporating a variety of colorful fruits and vegetables into your diet can ensure you get a broad range of vitamins, minerals, fiber and antioxidants, all of which contribute to a healthy cardiovascular system. For example, leafy greens like spinach and kale are high in potassium, which helps manage blood pressure. Fresh grapes contain 7% of the daily recommended intake of potassium, are a good source of vitamin K and are also a natural source of beneficial antioxidants and other polyphenols, including flavonoids, that can help relax blood vessels and promote healthy circulation. Some studies also suggest grapes have a beneficial impact on blood lipids and more.
In fact, one study found women who consumed 1 1/4 cups of grapes every day benefited from reduced blood triglyceride levels, LDL cholesterol levels, inflammatory proteins and other markers of heart disease.
Bright, juicy and bursting with flavor, Grapes from California can be enjoyed by the handful or blended with rich bananas, tangy Greek yogurt and a hint of almond in The Great Grape-Acai Smoothie Bowl for a delicious blend of fruity flavors at breakfast, lunch or snack time – it not only tastes great, but supports a healthy heart.
Get Moving
Regular physical activity is one of the most effective ways to improve heart health. Exercise strengthens the heart muscle, improves blood circulation and helps maintain a healthy weight. Aim for at least 150 minutes of moderate-intensity aerobic exercise per week, as recommended by the American Heart Association, such as walking, jogging or swimming with strength training exercises like lifting weights or using resistance bands mixed in to help reduce the risk of heart disease and improve overall cardiovascular health.
Manage Stress
Consider your stress level: chronic stress can negatively impact heart health, increasing blood pressure and other risk factors for heart disease. Techniques such as deep breathing, meditation, yoga and regular physical activity can help manage stress levels and maintain a healthy heart. Additionally, taking time to engage in hobbies, spending time with loved ones and ensuring adequate sleep are stress-reducing activities that improve overall well-being and heart health.
To learn more about the heart-health benefits of grapes, and find additional heart-friendly recipes, visit GrapesFromCalifornia.com.
The Great Grape-Acai Smoothie Bowl
Servings: 1
Chicken:
- 1/2 cup red Grapes from California, fresh or frozen
- 1/2 banana
- 1 frozen acai fruit pack (3 1/2 ounces)
- 1/2 cup plain, nonfat Greek yogurt
- 1/4 teaspoon almond extract
Topping:
- 1/4 cup sliced red Grapes from California
- 1 tablespoon sliced, toasted almonds
- 1 tablespoon pepitas
- 1 teaspoon chia seeds
- In small blender, combine grapes, banana, acai, yogurt and almond extract; process until smooth.
- Pour into bowl and top with sliced grapes, sliced almonds, pepitas and chia seeds.
Nutritional information per serving: 420 calories; 19 g protein; 63 g carbohydrates; 12 g fat (26% calories from fat); 2.5 g saturated fat (5% calories from saturated fat); 5 mg cholesterol; 45 mg sodium; 8 g fiber.
SOURCE:
California Table Grape Commission
Discover more from Daily News
Subscribe to get the latest posts sent to your email.
Child Health
Recognizing the Signs of Pediatric Growth Hormone Deficiency: How Early Recognition and Advocacy Helped One Family Find Answers
Diane Benke noticed her son Alex’s height concerns starting at age 7, despite his pediatrician’s reassurances. After persistent worries, they consulted an endocrinologist, leading to a diagnosis of Pediatric Growth Hormone Deficiency (PGHD). Following treatment changes, including a switch to weekly hormone injections, Alex’s growth improved, allowing the family to focus on their well-being.
(Family Features) “Our concerns about Alex’s growth began around the age of 7,” said his mother, Diane Benke.
Though Alex measured around the 50th percentile for weight, his height consistently hovered around the 20th percentile. Benke’s instincts told her something wasn’t quite right.
“I kept asking our pediatrician if this could mean something more,” she said. “Each time, I was reassured that everything was fine. After all, I’m only 5 feet tall myself.”
At first, Benke tried setting her worries aside. Alex was one of the youngest in his class, and she wondered if he could simply be a “late bloomer.”
However, as Alex progressed through elementary school, particularly in the 4th and 6th grades, his height percentile dropped into the single digits. The height difference between Alex and his peers became impossible to ignore.
Despite Benke’s growing concerns, their pediatrician continued to assure them Alex was fine.
“We were told as long as he was making some progress on the growth chart, there was no need to worry,” she said, “but we were never actually shown the charts.”
It wasn’t until one of Benke’s friends confided that her own daughter had recently been diagnosed with Pediatric Growth Hormone Deficiency (PGHD) that she decided to seek an endocrinologist.
“Although it took several months to get an appointment,” Benke said, “we were determined to get more answers.”
Navigating the Diagnosis Process
Getting a diagnosis for many medical conditions can be a long journey. However, early detection and diagnosis of PGHD is important. It can help minimize the impact on overall health and support optimal growth.
Once Alex was seen by a pediatric endocrinologist, he underwent a series of evaluations, including bloodwork, a bone age X-ray to compare his chronological age with his skeletal age and a growth hormone stimulation test, which measures the body’s ability to produce growth hormone. He also had a brain MRI to rule out the potential of any pituitary abnormalities.
The results of these tests confirmed the diagnosis of PGHD, a rare condition that occurs when the pituitary gland does not produce enough growth hormone. PGHD affects an estimated 1 in 4,000-10,000 children.
Some common signs parents might notice include: their child being significantly shorter than other kids their age, slower growth rate over time, delayed puberty, reduced muscle strength or lower energy levels, slower bone development and delayed physical milestones.
“Receiving Alex’s diagnosis was a relief,” Benke said. “It provided clarity and a path forward.”
Moving Forward with Treatment
“While the diagnosis process was exhausting, starting treatment made the process worthwhile,” Benke said.
For decades, daily injections of a drug called somatropin, which is similar to the growth hormone your body produces, have been the standard of care for PGHD. It wasn’t until 2015 that the Growth Hormone Research Society recognized the need for a long-acting growth hormone (LAGH), offering once-weekly dosing as an alternative to daily injections.
Benke explained navigating the insurance approval process was another challenge.
“Our insurance required us to try a daily medication before approving a weekly option,” she said.
Alex spent three months on daily medication, often missing doses, before he was approved to switch to a weekly treatment option.
“The weekly option made such a positive impact,” Benke said. “We now have minimal disruptions to our daily routine and Alex hasn’t missed a single dose since.”
Beyond a more convenient dosing option, the change gave Benke peace of mind.
“We could focus more on being a family again, without the daily worries of his next dose,” she said.
If you’re concerned about your child’s growth, talk to their doctor as soon as possible. Early diagnosis is important, as treatment becomes less effective once a child’s bones stop growing.
Benke’s advice to other parents: “Trust your instincts. If something feels wrong, seek out a specialist and push for answers and don’t give up, even when faced with hurdles… Stay hopeful and persistent – it’s a journey worth fighting for.”
Visit GHDinKids.com to download a doctor discussion guide to help prepare for your next appointment.
SOURCE:
Skytrofa
Author
Discover more from Daily News
Subscribe to get the latest posts sent to your email.
