Use of Acetaminophen (Paracetamol) linked to Autism, Attention Deficit with Hyperactivity, and Asthma

The marked increase in the incidence rate of autism throughout much of the world may be largely due to the marked increase in the use of acetaminophen (or paracetamol) in genetically and/or metabolically susceptible children and perhaps the use of acetaminophen (paracetamol) in pregnant women. This is an observation made by William Shaw, PhD., in his article entitled “Evidence that Increase Acetaminophen use in Genetically Vulnerable Children Appears to be a Major Cause of the Epidemics of Autism, Attention Deficit with Hyperactivity, and Asthma”   in the Journal of Restorative Medicine 2013; 2: 14-29.
The prevalence rate of autism in Cuba is 185 cases in a total population of 11 millions (i.e. 0.00168% of the total population) compared to a prevalence rate of autism in United States of America of 1.5 millions cases  in a total population of 300 millions (i.e. 0.5%, which is 298 times higher than that in Cuba). In Cuba, the usage of acetaminophen is low because its availability is low. It cannot be bought over the counter. It has to be prescribed by doctors. In USA, in  1980, when the use of acetaminophen in children increased following warning of Reye’s syndrome risk with children’s aspirin use, the  number of enrolled persons with autistic disorders and the incidence of asthma  were noticed to rise dramatically.   In 1982 and 1986, when the use of acetaminophen decreased due to acetaminophen scare caused by seven murders in Chicago using cyanide-laced acetaminophen in 1982, and the murder of a woman in New York using cyanide-laced acetaminophen in 1986, the number of enrolled persons with autistic disorders and the incidence of asthma were noticed to drop. The lower prevalence rate of autism in Cuba cannot be related to vaccinations, because children below 6 years of age in Cuba received  34 vaccine agents, as many as in USA.
Many children with autism have defective sulfation; they cannot properly detoxify acetaminophen. Therefore, it becomes  toxic. This then leads to intestinal Clostridia bacteria overgrowth, which in turn causes overproduction of brain dopamine and reduced concentrations of brain norepinephrine. Too much dopamine leads to obsessive, compulsive, and stereotypical behaviours. Too little norepinephrine leads to reduced exploratory behaviour and learning in new environments.
Because of defective sulfation, acetaminophen is detoxified by an alternative pathway called cytochrome p450 2E1. This pathway leads to excessive production of N-acetyl-p-benzoquinone imine (NAPQI), a very toxic metabolite, which depletes glutathione which then reduces the body’s ability to detoxify a host of toxic chemicals in the environment. The increase in NAPQI also creates oxidative stress which leads to protein, lipid, and nucleic acid damage from free radicals, and an increased rate of damage to mitochondrial and nuclear DNA.
It is therefore recommended that pregnant women avoid the use of acetaminophen, but to use instead ibuprofen if there is no hypersensitivity to non-steroidal anti-inflammatory drugs. In children, with temperature below 390C, use tepid baths or cool washcloths to reduce fever. But if fever more than 390C in children, give syrup ibuprofen if there is no hypersensitivity to non-steroidal anti-inflammatory drugs.

Dr Yao Sik Chi
President
Kuching Autistic Association
1st October 2014

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