Pain Relievers And Asthma: 8 Things To Know

For several years now, researchers have blamed common analgesics (pain relievers) and antipyretics (fever reducers), mainly acetaminophen (Tylenol) and ibuprofen (Advil, Motrin), as potential causes of asthma symptoms and new-onset asthma. However, more recent evidence seems to vindicate pain medicine. Here are 8 things to know.

1. Tylenol becomes the leading pain medicine

In 1980, Aspirin was linked with Reye’s Syndrome. This was also the same year that Tylenol was marketed as the pain reliever hospitals choose first. This quickly turned out to be a huge boon for the makers of Tylenol, whose sales skyrocketed over the ensuing years. Later in the decade ibuprofen became available as an alternative over the counter pain reliever and fever reducer.

2. Asthma rates skyrocket and Tylenol was blamed for it

About 15 years later, the results of a study showed that asthma rates increased 75% among all populations between 1980 and 1994. Even more stunning, asthma rates in children increased a whopping 160% during the same time frame. This resulted in a variety of theories to explain the spike in asthma rates, and among them was that Tylenol was the culprit.1

3. Studies seemed to confirm that Tylenol was guilty

Study after study showed a clear link between Tylenol and asthma. A study published in August of 2008 showed that, compared to those in the control group, children who were given Tylenol at least once a month was 50% more likely to experience asthma symptoms. Even those who were given Tylenol once a year had a 40% greater chance of developing asthma.2,3

Study after study like this seemed to confirm early suspicions that Tylenol was guilty. Other studies showed that Tylenol was also guilty of causing asthma attacks in those diagnosed with asthma. However, some studies showed no link between Tylenol and asthma. So, this kind of added to the confusion.

4. The finger also pointed at ibuprofen

And, ultimately, since ibuprofen use also increased during this time, theories were postulated, and studies seemed to confirm, that it was also guilty of causing new-onset asthma and of causing asthma attacks. Study after study continued to confirm suspicions that common pain relievers were guilty.3,4

5. Most studies only involve Tylenol

Keep in mind that since acetaminophen is the most commonly used pain reliever and fever reducer, it’s the one most often used in studies. It is generally considered a weaker pain reliever to ibuprofen, although it is more widely used because it's better tolerated than Aspirin and ibuprofen, which have both been shown to irritate the stomach.3

6. Tylenol seems to lower glutathione levels

A theory arose that taking Tylenol reduces glutathione. It’s a protein produced by many cells in your body, but it’s also an antioxidant that prevents free radicals from causing oxidative stress, which can cause damage to cells, such as cells lining airways. Various studies have linked this with both asthma symptoms and new-onset asthma.

Tylenol mostly affects glutathione levels in the liver, although it has also been shown to lower glutathione levels in the lungs. However, there are also other things that might lower glutathione.4-6

7. The suspicions inspired concerns

Parents and physicians alike often wondered if they should even recommend these common pain relievers and fever reducers for children. Despite the link, the makers of Tylenol continued to insist their product was safe for adults and children of all ages. Many researchers continued to agree with the makers of Tylenol, noting that the link may simply be a coincidence. So, further studies were encouraged to learn more.

8. New evidence seems to vindicate pain relievers

Apparently, this continued research paid off, or so it looks at the present time. There appears to have been a bias that impacted all of the previous studies, one which seemingly overlooked why parents were giving pain relievers like acetaminophen and ibuprofen to children. A study published in 2013 showed that children given pain relievers in the first year of life had an elevated risk for developing asthma. However, when respiratory infections were accounted for, the elevated risk was negligible.

This study seems to show that the previous studies failed to account for the fact that respiratory infections are a common cause of new-onset asthma. So it would appear, based on this one study, that it wasn’t the pain relievers that were to blame for new-onset asthma but these respiratory infections.3,4,7

What to make of all this?

Certainly, this latest study is reassuring to parents and physicians. As with all medicines, the potential risks should always be weighed against any potential benefits. However, I think the general consensus of the medical community is that both acetaminophen and ibuprofen are safe and won’t exacerbate or cause new-onset asthma. Despite this, most researchers continue to claim that more research is needed in this area.4

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