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Does Tylenol Cause Asthma in Teens?

Results released this week in an international study suggest that adolescents who take acetaminophen, better known under the brand name Tylenol, have a higher risk of asthma, allergic  nasal  conditions and the skin disorder eczema.

This is not a new theory however, as there have been numerous studies for two decades regarding whether or not Tylenol is linked to asthma, allergic nasal conditions and/or eczema in every age group: adult men, adult women, adolescents, children and infants.

Researches, led by epidemiologist Richard Beasley, Director, Medical Research Institute in Wellington, New Zealand, reported their findings in the American Journal of Respiratory and Critical Care Medicine, in the International Study of Asthma and Allergies in Childhood. This research is the third in an extensive four phase study of asthma, eczema and rhinitis and how they are related to environment, risk factors and differences in disease management, and examine patterns found and environmental data.

Results in the first two phases of the study revealed epidemiological evidence that the use of acetaminophen may increase the risk of developing asthma.  Children, ages 13-14 years in different populations worldwide were assessed for the risk of asthma and other allergic disorders associated with current use of acetaminophen.

As part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three, 13 to 14 year old children completed written and video questionnaires, obtaining data on current symptoms of asthma, rhinoconjunctivitis and eczema, and a written environmental questionnaire obtaining data on putative risk factors including acetaminophen use in the past 12 months.

Examining their use of acetaminophen, other drugs, and asthma symptoms, more than 322,000 adolescent children from 113 centres in 50 countries participated.  They were also shown a video containing five scenes of clinical asthma and asked whether they had experienced any symptoms similar to those shown. About 73% of the teens said they had used acetaminophen at least once in the previous year and 30% said they had used it monthly.

Factoring in maternal education, smoking, diet and siblings, the team found that participants who had used the drug at least once per year were 43% more likely to have asthma, while those who used it at least monthly were 2.5 times as likely to suffer from the condition. The risk of rhinoconjunctivitis (severe nasal congestion) was 38% higher for those who used it once per year and 2.39 times as high for those who used it monthly.  The risk for eczema was comparable at 31% and 99%, respectively.

Authors concluded, "Acetaminophen use may represent an important risk factor for the development and/or maintenance of asthma, rhinoconjunctivitis and eczema in adolescent children."  Explaining why there has been an increase in the prevalence of asthma since introducing the drug 50 years ago.

In a statement, McNeil Consumer Healthcare, which manufactures Tylenol, said that the drug "has over 50 years of clinical history to support its safety and effectiveness" and that no clinical trial has demonstrated that the drug causes asthma. The drug "is the preferred pain reliever for asthma sufferers," the company said.

Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen can trigger the production of leukotrienes, a naturally occurring chemical substance that promotes an inflammatory response in the lungs.  Asthma is a disease that affects your lungs. It causes repeated episodes of wheezing, breathlessness, chest tightness, and nighttime or early morning coughing.  Dosage amounts of these drugs that could trigger enough leukotrienes to actually cause asthma have not been determined.

Dr. Harold Nelson, M.D., asthma and allergy expert at National Jewish Health, in Denver, believes it may not be too soon to cut back on acetaminophen use.  "The data is so overwhelming that even in [the] absence of a randomized controlled trial, it would be prudent for parents to avoid the use of acetaminophen in their kids," he says. "The evidence has been building for a while, and it is very, very convincing."

Nelson suggests that overall trends in asthma prevalence may support a link between acetaminophen and asthma.  "The onset of the so-called asthma epidemic in the U.S. was in 1980, and that is about the time that aspirin was recognized as probable cause for Reyes syndrome.  Cases of pediatric asthma went up when aspirin use went down."

Joseph Mercola, DO, trained in both traditional and natural medicine states, "Another good reason to not pop Tylenol like candy, as it appears that it will increase your risk of asthma. It is also unwise to use Tylenol, aspirin or any other drug for that matter, to control a fever as it will impair the body's natural ability to fight the infection. In children, a high fever may actually be responsible for developing proper immune response and a decrease in overall allergies."

Mercola's ideas often fly in the face of the 'medical establishment' and while some don't appreciate his naturalistic approach to health, has been featured in TIME magazine, LA Times, CNN, Fox News, ABC News, Today Show, CBS’s WashingtonUnplugged with Sharyl Attkisson, and other major media resources.

WebMD states: "Fever is the body's normal and healthy reaction to infection and other illnesses, both minor and serious. It helps the body fight infection. Fever is a symptom, not a disease.  A temperature of up to 102F can be helpful because it helps the body fight infection."

A couple of things to consider in this debate/accusation that acetaminophen, ibuprofen, NSAIDS and naprosyn lead to asthma: 

    **Are children being given these drugs to lessen the effect of undiagnosed asthma symptoms which ultimately turns into full blown asthma in their adolescent years, rather than the drugs causing the disease?

    **In the last 50 years, the increase in families where both parents work outside of the home has risen astronomically, with more children in day care situations than ever before.  Children are not admitted to these facilities, or to school, if they have a fever. A lot of parents are allowed very few or no sick days to care for them.  Tylenol, or any of these drugs, that claim to be safe for consumption and are powerful pain and fever reducers, may be a parent's best friend, offering relief for the child and not having to deal with absenteeism at work.  Most parents are unaware of the benefit and purpose of a fever.  Perhaps more children are being treated for fevers negating their purpose to make the body stronger.

"The implications that aspirin, NSAIDs, and now Tylenol increase asthma risk doesn't leave a whole lot of anti-fever or analgesic drugs to treat children who get sick all the time," Dr. Neil Schachter, M.D., Professor of Pulmonary and Community Medicine, Mount Sinai Medical Center, in New York City says. "Talk to your doctor or child's pediatrician before making any changes."

If, in fact, these drugs do trigger the production of leukotrienes, promoting an inflammatory response in the lungs, leading to asthma, perhaps it's not the drug itself that causes the disease,some experts contend, but rather the act of stifling a fever before it is allowed to build the body's natural defenses against infection.

Laura Lamp King