Autism and acetaminophen (paracetamol) use in pregnancy - the evidence
The press conference in the USA yesterday raised a concerning question - does the use of acetaminophen (paracetemol) cause autism?
I feel it is important to look at the larger picture here - so I will share what we know, what we are not so clear about and how best to move forward without portioning blame on yourself or others.
Let’s start with the thing we know for sure – there is not one, single, ‘root cause’ of autism. Research points to an underlying genetic susceptibility, with multiple factors influencing each individual, including:
medications
environmental toxins
maternal infections
immunological factors
mitochondrial dysfunction
methylation dysfunction
nutrient deficiencies
gut microbiome
inflammation and allergies.
Some studies support the claim that paracetamol use in pregnancy may be associated with a likelihood of autism or ADHD, while other studies find no link.
In clinical practice I see patients whose mums used paracetemol during pregnancy, and their children did not develop autism. And I have patients who were never exposed to paracetemol or vaccines, and still developed autism.
As stated above - there is no single cause for autism, there are many and it is complex and individual. There is still so much research being undertaken and needs to be undertaken. What is important here is that no one should feel guilty or portion blame for decisions they made, with the information they had available at the time.
There are studies supporting both opinions:
Some studies show increased risk: A 2025 systematic review of 46 studies found that higher-quality research more often showed a link between prenatal acetaminophen exposure and increased likelihood of autism or ADHD.(1)
Some studies show no risk: A Swedish cohort of nearly 2.5 million children found no increased likelihood when comparing siblings (which controls for shared genetics and environment).(2)
Cord blood study: In the Boston Birth Cohort, higher cord blood acetaminophen metabolites were linked to increased likelihood of autism and ADHD.(3)
What and how - the simple biochemistry explanation
Acetaminophen depletes glutathione — the master antioxidant in the body and champion detoxifier. When glutathione is low, oxidative stress rises, which can affect brain development.(4)
What we still don’t know
Cause and effect - confounding factors like fever, infection, dose, and timing during pregnancy all need consideration
We don’t yet know which trimesters or doses carry the most risk, or which children are most vulnerable because of their genetic susceptibilities.
Education = empowerment - what you can do now:
Use acetaminophen only when really necessary - keep yourself and your child within safe limits of fevers, but understand the role of a fever in the body - it is not something to be feared.
Learn about alternatives that reduce the need for acetaminophen. For fevers there are many evidence-based options including homeopathy, essential oils, and acupressure points. .
If you do use acetaminophen, support glutathione levels:
Sulfur-rich foods (broccoli, cauliflower, Brussels sprouts, kale, onions, garlic)
Vitamin C-rich fruits
Epsom salt baths
Glutathione supplements when extra detox support is needed. Consult a healthcare practitioner for guidance on dosages.
Key takeaways
Autism and ADHD are not caused by one thing - both conditions are complex and multifactorial.
Acetaminophen may play a role in some genetic susceptible children, but the bigger picture includes the hereditary component, microbiome, environmental toxins, methylation, mitochondrial function, and nutrients
Don’t blame yourself for decisions you made with what you knew at the time. Focus on what you can do: support detox and glutathione, ensure you’re nurturing the microbiome and limit exposure to environmental triggers (see blog on Reducing the chemical load).
Every child with and without autism is unique, with their own strengths and challenges. These studies are not about finding one thing that causes autism and therefore we can simply remove and it’s cured. We are seeking ways to support children who may need extra help with speech and language, learning and motor dysfunction, and/or daily functioning.
References:
Baccarelli A, et al. Environ Health. 2025;24(1):22.
Ahlqvist VH, Sjöqvist H, Dalman C, et al. JAMA. 2024;332(5):452-461.
Ji Y, Azuine RE, Zhang Y, et al. JAMA Psychiatry. 2020;77(2):180-189.
Chen Y, et al. Int J Mol Sci. 2025;26(17):8585.