Controversial Topics - Tylenol

By: Nick Sienkiewicz, DPT, CSCS

After the bombshell report coming out of Washington DC, I wanted to add some clarity to any present confusion about these new reports on Tylenol. First and foremost,

let’s take the politics out of it. This is a health information newsletter, not a politic one. Quite frankly, I think most of the contention arising from this report are due to the political involvement and the nature of how it was released. Having controversial government officials delivering this report muddies the water on this topic significantly. Due to this participation from politicians, your cognitive biases based on the party with which you side can keep you close minded to the actual content of the message. So, let’s remove the political intertwinement and keep it to the attested health implications of Tylenol. When you genuinely read the report, a large study from Harvard is one of the main pieces of scientific evidence detailed. One of the most renowned scientists in the world is quite literally quoted in the report. We cannot overlook this aspect of the news release. Scientists have been studying Tylenol for a very long time. They are clear to exclaim that the relationship is NOT causal but rather the mounting evidence has been showing positive associations between Tylenol use and neurodegenerative disorders, like autism and ADHD. The conclusion is that we need to pause our current frequent and casual use of Tylenol, perform more research, and educate consumers of healthcare about these potential implications. Moreover, the report explicitly says Tylenol should be avoided in pregnancy if able, except in cases of high fever. This is a perfect example of a contextual situation for the particular use of Tylenol. Therefore, scientists are now simply encouraging a more limited use profile for Tylenol rather than our current healthcare model utilizing Tylenol regularly for people of all ages and health backgrounds.

 You all know how I feel about antibiotics and their over prescription in our modern society. Well, Tylenol currently has a similar position in my opinion. I believe modern healthcare’s recommendations for Tylenol are not only too frequent, but also overly relaxed, without really ever discussing  any associated negatives or trade offs with patients. Furthermore, Tylenol being an over-the-counter medication makes it even easier to use unnecessarily. There’s no doubt Tylenol is an effective drug, especially for reducing fevers. However, it is not risk free. Very few providers or scientists talk about how significantly it depletes your body’s glutathione, which is your body’s master antioxidant. Low glutathione status is present in many chronic conditions plaguing our modern world (See one here). Of course, this is by no means saying that it’s a causal relationship. Nonetheless, people should be aware of this adverse effect from Tylenol because the relationship is meaningful. At the very least, patients should be educated on this occurrence and potentially offered an option for replenishing glutathione in conjunction with taking Tylenol similar to the way some doctors will now recommend probiotics following a course of antibiotics. Sadly, this is not the case when it comes to Tylenol. Additionally, many of the illnesses your body is fighting at any given time have been shown to deplete glutathione, at least initially. It is common for an acute illness to hinder glutathione at first, then we see a subseqeunt rise in conjunction with your immune system’s defense against the infection. Thus, logic implies that the combination of sickness and Tylenol consumption could pose longer term issues to our body’s glutathione status. It is plausible that Tylenol could dampen this natural rebound of glutathione that is characteristic of acute sickness. Hopefully, this report will create more awareness of this relationship, for doctors and patients alike.  

 The fever reduction potential of Tylenol is powerful, but at what cost are we disrupting the body’s natural mechanisms. Yes, there is a point of too high. Nevertheless, you can monitor a fever, and watch for significant elevations. If it never rises beyond the upper limit, there are substantially less concerns and/or risks. On the other hand, taking a medication is an all or nothing intervention. Sure, you can monitor dosages, starting with the lowest dosage and titrate up. However, once you take it, you can’t go back on that dose (the way to actually go back on it medically in a hospital setting in the case of an overdose is to push NAC, which is a major precursor to glutathione). Unfortunately, we’ve been indoctrinated to view fevers as bad in all circumstances. The reality is that the fever response is a positive thing, as long as it’s managed by the body. There are most definitely cases when a person’s fever response isn’t cutting it and the body requires support to battle an infection. In these instances, Tylenol could be a very viable choice. However, this is not the way Tylenol has been presented to the people for the past few decades in our medical culture. The essence of this recent report is simply striving for more transparency in medicine. Consumers of healthcare deserve to know this information when being recommended Tylenol. Prescribing the medication with no additional information, simply saying it’s safe is not fair to the patient. With that being said, knowing an appropriate time to use Tylenol is nuanced. There is no right answer. Context matters, and individuals deserve all of the information to be the best decision maker possible in their own unique situation. Unfortunately, this has not been the case with Tylenol. We’ve been led to believe that Tylenol is the “right” answer in the case of fever, even in pregnancy. We need to look at this through the blend of two lenses: science and logic. When individuals are provided ALL of the science, they can then use their own logical processes to decide what is best for themselves or family members in a given situation.

 As many of you know, my younger brother has autism. With autism being the focal condition discussed in the report, there’s no doubt I paid a little extra attention. Be that as it may, I’ve been down this rabbit hole many times before, and here’s the reality: chronic conditions, such as autism, are complex and multi-factorial. There is not a singular cause. The scientists cited in the brief were adamant about this element. They were very clearly stating that Tylenol is NOT the cause of autism, but rather an association; albeit one that is stronger than originally anticipated. Tylenol may be a piece of the puzzle, but we’ll truly never know the size of that piece (and its magnitude is likely different for every individual with this type of diagnosis). As with any other multi-faceted issue, in order to address or reverse it, you typically have to manipulate multiple factors. You have to strive to control the controllable. As it relates to Tylenol, this could potentially be a very modifiable factor, as long as you possess awareness and understanding of these underlying implications. This does not mean you should never take it. There is a time and place. We just need more pause and logical deliberation prior to intervening with Tylenol than we currently have in our medical culture. 

As a final thought, this information should not make anyone feel bad about using Tylenol or having used it in the past. Even in the situation of a mother who has a child with autism, there should be no remorse or guilt about Tylenol use during pregnancy. To reiterate, autism and most other childhood conditions are multi-factorial, so Tylenol alone is never the cause. Possessing any kind of contrition or shame in this regard impedes your ability to move forward as it relates to the health journeys of your child and yourself. You don’t know what you don’t know until you know it! As we gain more knowledge, it allows us to be improved decision makers for future health decisions. This is the essence of this newsletter: advocacy and empowerment to help us all thrive as we navigate our own individual health journeys! Next week, I want to discuss alternative options for Tylenol and strategies to offset any potential adverse effects when you do need to utilize Tylenol, because I never want to just leave you with the problems. I always want this newsletter to equip you with solutions!

TLDR: Don’t let political biases distort your interpretation of the report. The conclusion is simply that the compilation of research points to an alarming connection between Tylenol use and development of neurodegenerative disorders, like autism, demanding further investigation. Due to this surfacing of the inarguable data, we should proceed with more caution than has been used historically with Tylenol. Although it has been shown to be effective at what it claims to do, such as reducing fever, there are always possible side effects, like any other medication. It’s not about never using Tylenol. We just need to understand the potential implications of the drug, so we as individuals can be the most informed decision maker possible when deciding on a course of action as it relates to our own health. The party you side with has no meaning here; this is about the health of our human species, with extra emphasis on future generations! Ultimately, it’s not about being pro or anti-Tylenol. Every human should strive to be an advocate for the most optimal health choices for themselves and their family in any given situation or circumstance!