The Tylenol Debate – Who to Believe, Donald Trump or Physicians?

Donald Trump, backed up by Robert F. Kennedy Jr. and Mehmet Oz, in a press conference this week, attacked Tylenol, using the bully pulpit of his presidency to put the health of Americans and others at risk. Tylenol is the common brand name for acetaminophen in North America. It is also known as Paracetamol in other countries. Tylenol is widely used as a pain reliever today because it is available over the counter and considered safe by physicians when used as directed to address mild to moderate pain. The recommended dosage for Extra Strength Tylenol is two pills every eight hours while symptoms persist and no more than six pills over 24 hours.

An excerpt from Trump’s remarks from the September 21, 2025, announcement relating to the use of Tylenol by women during pregnancy to treat high fever or headaches states:

“Don’t take Tylenol. THERE’S NO DOWNSIDE. You might be uncomfortable; it won’t be as easy, maybe, but don’t take it. If you’re pregnant, don’t take Tylenol and don’t give it to the baby after birth.”

Trump states there is no downside for pregnant women if they don’t use Tylenol. Not so fast. An untreated fever could be the sign of an infection that, if left untreated, could harm an expectant mother and the fetus. Pain and fevers during pregnancy are signs the body is telling you something is wrong.

A high fever, above 38.3°C (101°F) in the first trimester, has been linked to increased risks for children in utero developing congenital defects that can impact the brain, nervous system, and heart. High fevers during pregnancy have been linked to increased incidents of children born with cleft palates. High fevers can lead to increased miscarriages, preterm labour and low birth weight.

Untreated pain and fever aren’t just about handling being “uncomfortable” as Trump proposes. Left untreated during pregnancy, it can cause maternal stress, depression, anxiety, and high blood pressure.

In his statement, Trump described how concerned he has been about rising levels of autism. With Kennedy, his “health guru,” Trump has latched onto the Kennedy-supported theory that links the drug to increasing numbers of children identified as being on the autism spectrum.

Interestingly, physicians and medical researchers studying autism and ADHD have a very different take, linking high fever to these outcomes. So, not using Tylenol could cause autism, the exact opposite of what Trump is advising.

Then there is the opinion of the World Health Organization (WHO) through several published studies that don’t support the conclusions of Trump and his sidekicks.  Tarik Jasarevic from the WHO, in response to Trump’s press conference, stated, “If the link between acetaminophen and autism were strong, it would likely have been consistently observed across multiple studies. This lack of replicability really calls for caution in drawing casual conclusions about the role of acetaminophen in autism.”

During Trump’s press conference, he talked about his ongoing concern over the years related to autism and his desire to see the number of children diagnosed with autism decrease. He stated:

“I want to get the autism rate back down to maybe 1 in 10,000 or 1 in 20,000, or hopefully none. It is artificially induced; it is induced by something. You don’t go from 1 in 20,000 to 1 in 10. That means you’re taking something, and something is wrong. I feel very certain, and I know I’ll be criticized, but I think we’ll have a tremendous result. So, don’t take Tylenol if you’re pregnant, and don’t give it to your child after birth. Just don’t give it…When I leave office, I want to see the numbers drastically reduced.”

What are the actual numbers from the Centers for Disease Control (CDC) on autism? Data from 2022, published in 2025, shows that autism spectrum disorder (ASD) affects approximately 1 in 31 children or approximately 3.2% of children, at the age of 8. This is an increase from 1 in 36 children from previous published demographics, with boys affected 3.4 times more than girls (around 4.9% of boys vs. 1.4% of girls).

Is the increase a reflection of Tylenol use during pregnancy? No. What may explain the rise is the greater awareness and evolving diagnostic and screening practices regarding the autism spectrum disorder (ASD). Since 2013, the broadening definition of ASD has combined several earlier separate conditions into one category, leading to more identified individuals, particularly those exhibiting milder behaviours.

In addition, ASD public and primary physician awareness has increased, leading to more screening and earlier diagnoses, accounting for 50-70% of the rising number. That’s not to suggest that autism may be on the rise from other environmental factors totally unrelated to medications and pregnancy.

Getting back to the medications, Trump didn’t talk about alternatives to address high fever or pain during pregnancy. Those over-the-counter alternatives include aspirin and NSAIDs like Ibuprofen and Advil.

Low-dose aspirin can be beneficial in treating pregnancy conditions like preeclampsia or blood clots. But higher doses of aspirin can lead to spontaneous abortion or children born with congenital defects. Beyond 19 weeks, aspirin use for managing pain and high fever is linked to fetal kidney problems and other birth complications, such as ductus arteriosus, a fetal heart blood vessel complication.

NSAIDS are not recommended for use beyond 20 weeks during pregnancy. In late pregnancy, NSAIDs have been linked to ductus arteriosus, circulatory complications, including blood platelet function, kidney problems, low amniotic fluid levels leading to miscarriages or preterm delivery, as well as childhood asthma.

For families planning to have children who read this blog, the best advice related to Tylenol isn’t coming from Donald Trump. You should talk to your primary family physician, a pediatrician or a gynecologist to sort the facts from the fiction.

A final response to Trump’s claims about Tylenol causing autism comes from Dr. Evdokia Anagnostou, co-leader of the Autism Research Centre at Holland Bloorview Kids Rehabilitation Hospital in Toronto. Anagnostou states, “the safest options we have for treating fever and pain during pregnancy backed by science,” is Tylenol.