New evidence is igniting a debate among health professionals on the connection between asthma and acetaminophen, a commonly used fever reducer. Studies have consistently shown that acetaminophen can cause inflammation of the airways and now a review of studies is convincing some researchers that acetaminophen could be behind the 30-year increase in asthma cases.
There are many factors that implicate acetaminophen in causing or at least worsening asthma, one of which is the timing of the epidemic. Cases of asthma increased dramatically in the 1980's, coinciding with a recommendation by doctors to use acetaminophen instead of aspirin to reduce fevers. In addition, an analysis of data from over 200,000 children found that children who took acetaminophen were more likely to develop asthma. Dr. John T. McBride recently published a paper in the journal Pediatrics warning medical professionals and caregivers not to give acetaminophen to children with asthma or those at risk for the disease. He explained that a single dose of acetaminophen can cause inflammation of the airways by reducing the body's levels of glutathione, a peptide and antioxidant that reduces oxidative stress in the body. He says the connection to the drug is consistent: "Almost every study that’s looked for it has found a dose-response relationship between acetaminophen use and asthma. The association is incredibly consistent across age, geography and culture." Studies have made the connection in adults, children, infants and even in children of mothers who took acetaminophen during pregnancy.
Nevertheless, some researchers remain skeptical of the connection. Dr. Mahyar Etminan, from the University of British Columbia, completed a study that discovered a connection between acetaminophen and an increased incidence of wheezing but he still thinks the connection is not quite clear. "Children who take acetaminophen are usually getting it for fever control, and they get fevers because they have viral infections, which on their own are associated with developing asthma later in life. It’s hard to tease out whether it’s the drug or the viral infection." He also notes that many of the studies that make the connection relied on parents to accurately report the dosage given to children, rather than through controlled methods. However, one controlled study of nearly 2,000 children with asthma found those who took acetaminophen rather than ibuprofen to treat fevers were twice as likely to see a doctor for asthma symptoms.
Although acetaminophen seems like it might be causing or at least aggravating asthma, taking another kind of fever reducer doesn't necessarily avoid the risk. In fact, ibuprofen, aspirin and other anti-inflammatory drugs have produced asthma attacks in some people. Nevertheless, some doctors advocate the anti-inflammtory drugs over acetominophen, while others just recommend reducing the dosage of acetaminophen. For parents and parent's-to-be, the debate is without a clear answer.
How do you reduce fevers in your home?
Studies Suggest an Acetaminophen-Asthma Link [
NYTimes]
