Tylenol- Listen to Your Doctor Not Politicians
On Monday, September 22, 2025, Mr. Trump took to the White House podium with HHS Secretary Robert F. Kennedy, Jr., and Dr. Mehmet Oz (Administrator for the Centers for Medicare and Medicaid Services) and declared multiple times that pregnant women should “never” take Tylenol (brand name for acetaminophen). He went on to say, without presenting any evidence, that Tylenol in pregnancy “causes” autism. Unfortunately, his words matter. Immediately, and almost universally, medical practitioners and medical organizations contradicted his recommendations and assertions, based on the extensive available science. These professionals understand the chaos and confusion that is created by Mr. Trump’s “never” absolute, when the more beneficial science-based approach is to consider the truths along with the risk-benefit analysis. I will get into the truths as we know them so that you can make your reasoned decisions.
Tylenol is the brand name for the drug acetaminophen and is available over-the -counter and in prescription medications. It is used for the temporary relief of pain, persistent headaches, and fever. Like all medications, it is essential that you follow the package or prescription bottle instructions. Let me reiterate that every medication has potential side effects. These adverse effects can be minimized by taking the recommended dosage. Do not take more than one acetaminophen-containing medication at the same time. In pregnancy, there may be a need for a pain reliever or fever reducer. If either of these go inadequately treated, there are established risks to the mother and the unborn. For instance, untreated fever can lead to miscarriage. Therefore, “toughing it out” like Mr. Trump suggested is not an appropriate option. The other over-the-counter options of aspirin or ibuprofen are clearly not recommended in pregnancy because of known detrimental effects on the fetus. The position of the American College of Obstetrics and Gynecology (ACOG) supports the moderate use of acetaminophen in pregnancy based on two decades of research. Even the current FDA confirms “the fact that acetaminophen is the safest over-the-counter alternative in pregnancy among all analgesics and antipyretics; aspirin and ibuprofen have well-documented adverse impacts on the fetus.”
Studies that look for a link between acetaminophen use during pregnancy and autism do not show a causal relationship, although a few suggest a possible association. Even the FDA’s Press Release of September 22, 2025, uses phrases like “studies suggest” and “may be associated with an increased risk,” while admitting that “a causal relationship has not been established.”
Autism is a “spectrum” of complex developmental conditions. The signs range from uncommon patterns of speech, learning, and/or behavioral maturation to a child being completely non-verbal, and everything in between. The rates of “autism” have been increasing over the last two decades for many varied reasons. Among these is the definition has been broadened to include everything on the aforementioned spectrum. Also, parents, educators, and providers are becoming more aware of the expanded diagnostic criteria and rightfully seeking accommodations to assist these, just like all developing children. There is no evidence of an increase in the frequency of profound cases, although the frequency of total cases, under the new criteria, has increased from 1 in 150 in the early 2000’s to 1 in 31 children, currently. Autism was recognized as a disease in 1911 and given a specific disorder designation in 1943. Note that acetaminophen came about in 1955. Research has identified several hundred inherited and/or mutated genes that may be involved in this spectrum. Although various medications are available for the treatment of different manifestations of the disease spectrum, there is no known preventative treatment. Leucovorin, which is a derivative of folic acid, has been suggested for prevention, but it has not been scientifically studied to the extent that it can be safely recommended.
The patients and families affected by autism and other neurodevelopmental disorders deserve compassion, understanding, public health policies that allow them access to insurance coverage, and funding for medical research that can find answers to unclear issues. Our current leadership in Washington has implemented policies adverse to all these tenets. It is additionally unhelpful to have exaggeration in the face of currently available facts.
If seeking public information, we should rely on sources that consider the available science, such as the National Medical Association, AMA, ACOG, and the American Academy of Pediatrics. These organizations, as well as many of the physicians in the US Congress, and even Dr. Oz, who, the day after Mr. Trump’s pronouncement, back-tracked, recommend the “judicious” use of acetaminophen when needed in pregnancy. For your personal health advice, trust your doctor, not the person with the biggest megaphone who has no medical degree and neither concern nor alignment with the preponderance of the science.
Clyde E. Henderson, MD
Cincinnati Medical Association
