By Dr. Mercola
Acetaminophen, also known as paracetamol (International Nonproprietary Name),1 may be one of the more dangerous drugs you can purchase. This may surprise you since most households carry one or two variations of the product to treat headaches, fever or cold symptoms.
Acetaminophen is classified as an analgesic, or a medication acting to relieve pain. According to the American Association of Poison Control Centers, analgesics are the No. 1 reason people call a poison control center.2
The U.S. Food and Drug Administration (FDA) links 980 deaths per year to acetaminophen and the Centers for Disease Control and Prevention (CDC) determined that, beginning in 2006, the number of people who died after accidentally taking too much acetaminophen exceeded the number who purposely overdosed on acetaminophen.3
However, these numbers may be deceiving, as other researchers have found 56,000 emergency room visits and 26,000 hospitalizations can be attributed to acetaminophen.4
Although frighteningly high for a drug most people routinely keep in their homes, this isn't the only damage acetaminophen may cause.
A recent study published in the Journal of the American Medical Association (JAMA) Pediatrics has linked taking acetaminophen during pregnancy with conduct disorders and hyperactivity in children.5
Acetaminophen During Pregnancy Linked to Hyperactivity and Conduct Disorders
The objective of this British study was to examine the association between behavioral problems in children and mothers who took acetaminophen during pregnancy and/or during the postpartum months, or partners who took acetaminophen.6
The researchers concluded: "Children exposed to acetaminophen prenatally are at increased risk of multiple behavioral difficulties."7 The researchers did find that these results were not explained by social factors or other behavioral challenges linked to increased use of acetaminophen.
As compared to individuals who did not use acetaminophen during their pregnancy, those who took the drug during weeks 18 and 32 had a 31 percent increased risk of hyperactivity and a 42 percent higher relative risk of conduct disorders in their children.8
This study controlled for a number of different variables that could have affected the results, such as genetics, smoking and alcohol use.9 There were over 7,700 participants.
Not everyone was convinced by the results of the study. Even lead author, epidemiologist Evie Stergiakouli, PH.D., of the University of Bristol, stepped around the issue, saying:10
"Observational associations do not necessarily mean that there is a causal association between the risk factor and the health outcome."
However, the researchers also noted (quoted from Medical News Today):11
"Children exposed to acetaminophen use prenatally are at increased risk of multiple behavioral difficulties … Given the widespread use of acetaminophen among pregnant women, this can have important implications on public health advice."
Other Studies Confirm Results and Identify More Risk
While recent, this is not the only study associating acetaminophen with dangerous side effects to your health and the health of your children.
• A recent study from the Center for Research in Environmental Epidemiology (CERAL), Barcelona, Spain, found a link between acetaminophen use during pregnancy and hyperactivity and autism.12
Researchers discovered more symptoms of autism in boys whose mothers took acetaminophen during pregnancy, than in girls.
They found that all children exposed to acetaminophen during pregnancy were 30 percent more likely by age 5 to demonstrate attention impairments linked with hyperactivity disorder or autism.13
• A study found an association between the drug and children later diagnosed with attention deficit hyperactivity disorder (ADHD).14
Children whose mothers used acetaminophen during pregnancy were at higher risk for hyperkinetic disorder, use of ADHD medications or having ADHD-like behavior by age 7. There was a stronger association when mothers took the drug in more than one trimester.
• A study published in 2009 found mothers who used acetaminophen in the third trimester were at higher risk for preterm birth.15
• A study published in 2013 found children exposed to acetaminophen during pregnancy developed motor skills, communication and language skills more slowly than those children who were not exposed.16
• Use of acetaminophen during pregnancy also appears to be linked to pre-eclampsia and thromboembolic diseases,17 and taking the drug for more than four weeks during pregnancy, especially during the first and second trimester, moderately increases the risk of undescended testicles in boys.18
Acetaminophen Use and Toxicity
In this short video, CBS News explains the statistics and risks associated with acetaminophen use. The drug works by blocking feelings of pain and reduces fever without addressing the source of the issue. As your body metabolizes the drug, it may damage your liver. In 2009 the FDA issued this warning:19
"Liver warning: This product contains acetaminophen. Severe liver damage may occur if you take more than 4,000 mg of acetaminophen in 24 hours; with other drugs containing acetaminophen [or three] or more alcoholic drinks every day while using this product."
In 2014, the FDA updated their warning to include:20
"FDA is recommending health care professionals discontinue prescribing and dispensing prescription combination drug products that contain more than 325 milligrams (mg) of acetaminophen per tablet, capsule or other dosage unit."
Unfortunately, there are times you may be taking more acetaminophen than you realize as the drug is a common addition to other pain and over-the-counter cold remedies.
Vicodin and Percocet are two common prescription pain medications that include acetaminophen, increasing your risk of acetaminophen poisoning, one of the more common forms of toxicity, according to the National Institutes of Health (NIH).21
Other common brand name over-the-counter medications that include acetaminophen in their active ingredients include:22
✓ Alka Seltzer Plus
✓ Formula 44
✓ Saint Joseph Aspirin-Free
As the drug is a common ingredient in other over-the-counter medications, and has a narrow therapeutic index, it is easy to accidentally overdose or take enough to cause significant liver damage.23 Doses over 5,000 mg per day if you don't consume alcohol, and 4,000 mg if you do consume alcohol, can trigger significant liver damage. There's 4,000 mg of acetaminophen in just eight extra strength tablets.
While other countries have placed a limit on how much consumers may purchase and have restricted sales to pharmacies, no such limits are placed in the U.S.24 From 2001 to 2010, the related deaths attributed to acetaminophen were twice that of all other over-the-counter pain relievers combined.
Number of Children With ADHD Rising
In both private insurance and Medicaid populations, the number of children being treated with drugs for ADHD continues to rise. According to the CDC, approximately 3 out of 4 children between age 2 and 5 receive medication for ADHD, but only half of those receive any form of psychological services.25
In 2011, approximately 11 percent of children between the ages of 4 and 17 were diagnosed with ADHD. This is a significant rise from 7.8 percent in 2003.26 The rate of diagnosis of ADHD also varies by state in the U.S., with the highest being Kentucky at 18.7 percent and the lowest being Nevada at 5.6 percent.
According to the National Survey of Children's Health, the average age of diagnosis is 6.2 years; 3.5 million children are taking medication for treatment, and boys continue to be twice as likely as girls to be diagnosed with ADHD.27
Medications used to treat this hyperactivity disorder are stimulants, which come with their own list of side effects and dangers. Common side effects include headaches, upset stomach and increased blood pressure. Less commonly, children may experience loss of appetite, weight loss, insomnia and tics.28
Natural Alternatives for Pain, Fever and Anti-Inflammatory Treatment
Although the American College of Obstetrics and Gynecology (ACOG) continues to recommend acetaminophen for treatment of minor discomfort, fever and pain during pregnancy,29 the choice is ultimately yours. It will be you, your child and your family who experience the repercussions from using medication that may affect your child's neurological development.
There are other choices for treatment. Dr. Aisling Murphy, assistant clinical professor at University of California Los Angeles Obstetrics and Gynecology, admitted to CNN:30
"Minor aches and pains (e.g., headaches or mild backache), are common in pregnancy and often are a reason for patients to take acetaminophen. The practice is very common."
However, she also counsels her patients to use other methods first, and avoid any unnecessary medication during pregnancy, including acetaminophen. These alternative modalities may include:
- Hot or cold packs to the area may help reduce discomfort or pain. However, do not use a sauna or hot tub as these raise your core temperature, increasing the risk for miscarriage or some birth defects.31
- Your headache or muscle aches may respond well to massage to increase relaxation and improve blood flow to aching muscles or joints.
- Ginger tea may help relieve tension and sooth your aching head. However, not all herbal teas are safe during pregnancy. Teas contain many of the same nutrients as foods, but in more concentrated forms. Ginger tea may help relieve aching muscles, reduce insulin resistance, ease morning sickness and relieve stress.32 Use fresh organic ginger root to steep your own tea at home and avoid the potential of accidentally ingesting harmful additives.
- Essential oils are another way to relax, unwind and reduce pain and discomfort. A favorite of some midwives is Frankincense topically, in your bath water or as a scent in your room.33,34
- Getting plenty of sleep may also help reduce your perception of discomfort and pain. During pregnancy your body is working to develop a new human being. You require more rest and sleep than you normally would. Lack of sleep may increase your perception of pain and discomfort. If you have trouble falling asleep or staying asleep see my previous article, "16 Chronological Tips to Improve Your Sleep."