#367 - Tylenol, pregnancy, and autism: What recent studies show and how to interpret the data

The Peter Attia Drive

Peter Attia, MD

Health & Fitness, Medicine, Fitness

4.7 • 7.3K Ratings

🗓️ 6 October 2025

⏱️ 87 minutes

🔗️ Recording | iTunes | RSS

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Summary

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In this special episode of The Drive, Peter addresses the recent headlines linking acetaminophen (Tylenol) use during pregnancy to autism in exposed children. Recognizing the confusion these claims have sparked among patients, listeners, and the broader public, Peter uses this episode to provide a framework for thinking critically about complex conditions and the research related to them. He highlights the dramatic rise in autism diagnoses over recent decades, noting that multifactorial conditions rarely have a single cause, and emphasizes the importance of resisting oversimplified explanations. Peter also stresses that humans are not naturally wired for scientific thinking, making disciplined frameworks like the Bradford Hill criteria essential for evaluating causality in epidemiology. Ultimately, he uses this framework to explore the evidence surrounding acetaminophen use during pregnancy and its potential link to autism.

We discuss:

Laying the groundwork for this discussion, the rise in autism rates, and the value in using frameworks [1:00];
The FDA pregnancy drug categories, where Tylenol falls within that framework, and a structured method for evaluating scientific evidence and causality [6:00];
What exactly are the claims being made about acetaminophen and autism? [13:45];
The increase in autism rates and why so many things are being linked to autism: the multiple comparisons problem [15:00];
Evaluating the review paper that triggered the recent concern over acetaminophen and autism [21:45];
Breaking down the largest studies on prenatal Tylenol exposure and autism: is there a causal link? [35:00];
Why observational studies can’t prove causality, the role of confounding variables, and the importance of frameworks like the Bradford Hill criteria [43:30];
Applying the Bradford Hill criteria: testing the case for Tylenol and autism [45:45];
Putting it all together to answer the question: Does acetaminophen use during pregnancy increase the risk of autism? [56:15];
If autism risk is overwhelmingly genetic, what explains the dramatic rise in autism diagnoses? [59:15];
Other risk factors for autism: parental age, maternal health, environment, and where Tylenol fits in [1:09:15];
Medication use during pregnancy: balancing risks, benefits, and FDA categories [1:15:15];
Considerations for taking Tylenol during pregnancy [1:19:30];
Final thoughts: critical thinking, balanced risk assessment, and the importance of context when evaluating medications like Tylenol during pregnancy [1:22:30]; and
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Transcript

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0:00.0	Hey everyone. Welcome to the Drive podcast. I'm your host, Peter Attia. This podcast, my website, and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone.
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1:04.2	Welcome to a special episode of The Drive, everyone.
1:07.0	If you've been following the headlines recently, you may have seen, of course, stories linking
1:11.5	acetaminophen or Tylenol use during pregnancy to autism.
1:16.2	Not surprisingly, those headlines have generated a lot of questions, a lot of controversy, and
1:20.3	a lot of confusion.
1:21.7	I've heard about this a lot from every direction, my patients, listeners of the podcast, friends, family members, people writing in
1:30.4	through the website. Basically, it's like I'm sure many people in the space, we've all been
1:34.0	inundated by it. And the more I thought about it, the more I realized this was a great opportunity
1:38.8	to, I think, maybe put forth a framework for how to think about these things critically.
1:44.6	While we initially thought we would just do this in the newsletter last week, once we got into it, we realized
1:48.6	now this doesn't really lend itself to an article or even a short video. It really commands
1:54.1	effectively the discipline of what we do in the AMAs, the Ask Me, anything's, of course, unlike the
1:59.3	normal AMAs, this is going to be made available to everybody.
2:02.4	So before we dive in, though, I want to kind of lay out some groundwork.
	...

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