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From Executive Producer Isaac Saul this is Tangle.
- [01:32]
Ari Weitzman
Good morning, good afternoon and good evening and welcome to the Tangle Pop. I am your host for today Tangle Managing Editor Ari Weitzman. I'm filling in for our Executive Editor, Isaac Saul. It is Wednesday, September 24th, and we are covering President Trump and RFK Jr. S press conference on Tylenol and its link with autism and adhd. I'm going to send it over to John for today's main topic and then you're going to spend a lot of time with me today. I'll be back for my take, which I wrote and for your questions answered.
- [02:07]
John Law
Thanks Art, and welcome everybody. Here are your quick hits for today. First up, in a speech to the United Nations General Assembly, President Donald Trump criticized the organization and its European member states for their handling of immigration issues and international conflicts, saying the UN Was failing to live up to its potential and creating new problems for America. Separately, Trump met with Ukrainian President Volodymyr Zelenskyy at an event after which he said he believes Ukraine can win back all territory lost to Russia with support from the European Union. Number two A Florida federal jury convicted a man of attempting to assassinate President Trump in September of 2024, finding him guilty on five criminal counts. The man reportedly tried to stab himself in the neck with a pen as the verdict was read. He faces a potential life sentence in prison. Number three Adelita Grijalva, a county supervisor, won the special election in Arizona's 7th congressional district to fill the seat previously held by her father, Representative Raul Grijalva, who died in office in March. Grijalva's victory narrows Republicans house majority to 219 to 214. Number four Jimmy Kimmel returned to his late night comedy show, telling his audience that he had not intended to suggest that the suspect in Charlie Kirk's assassination was a Trump supporter. Kimmel also criticized the president for purportedly trying to silence him and thanked several conservatives for defending him. At number five, President Trump signed an executive order designating the anti fascist movement Antifa as a domestic terrorist organization, giving federal agencies a mandate to investigate the group and its members. President Trump issuing a strong warning to pregnant women taking Tylenol is not good, suggesting without evidence the number of children born with autism would decrease if expectant moms stopped using acetaminophen. On Monday, President Donald Trump, Department of Health and Human Services Secretary Robert F. Kennedy Jr. And other Trump administration officials announced a pair of actions the Food and Drug Administration will take to address the increase in autism spectrum disorder in children. First, the FDA will update the warning labels of acetaminophen, the active ingredient in pain relievers like Tylenol, to note a potential association between the ingredient and neurological conditions such as ASD and attention deficit hyperactivity disorder in children, though it also emphasized that no causal link has been established. Second, the agency has initiated the approval of leucorviran calcium tablets for patients with cerebral folate deficiency. As the FDA noted in its announcement, acetaminophen is the only over the counter drug approved for use to treat fevers during pregnancy, which can pose a risk to fetuses. While some studies have found an association between acetaminophen during pregnancy and a subsequent ASD diagnosis, a causal link has not been proven. Separately, leucovirin is a modified version of vitamin B9 that helps the body make red blood cells and supports cell growth. It is especially vital in early pregnancy. Small studies have suggested that a significant percentage of people with autism have antibodies that interfere with how folate is transported within the body. In a press release, HHS noted the conflicting literature and lack of clear causal evidence on the causes of asd, but said these actions were intended to encourage clinicians to exercise their best judgment of acetaminophen for fevers and pain in pregnancy by prescribing the lowest effective dose for the shortest duration when treatment is required. President Trump was more direct in his remarks, saying, don't take Tylenol, don't take it. Fight like hell not to take it, and encouraging pregnant women to tough it out except in extreme circumstances. Although the FDA announcements did not mention vaccines, Trump also warned against giving children too many vaccines at once, saying, don't let them pump your baby with the largest pile of stuff you've ever seen in your life. Many medical researchers and physicians criticize the announcement and Trump's comments. It is clear the Tylenol autism link is not a new question. It has been looked at many times and in many different studies, autism researcher Dr. Diana Schindel said. Without showing any evidence to back them up, the announcements become reckless and potentially harmful. A co author of a report on Tylenol and autism cited by the Trump administration also said she still considers acetaminophen an option for pregnant women with medical guidance and supervision. Separately, other doctors suggested they would not recommend leucovirin to treat ASD until the results of large randomized trials were available. Today we'll share arguments from the right and left on the FDA's announcements and President Trump's comments. Then Managing editor Ari Weitzman will give his take.
- [07:12]
Isaac Saul
We'll be right back after this quick break.
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John Law
Alright, first up, let's start with what the right is saying. The right is mixed on the announcement, but many say the Trump administration is pursuing answers to many parents questions. Some cast doubt on the veracity of studies linking acetaminophen to autism. Others say the FDA is giving parents options, not taking them away. In Red State, Eli shepherd criticized experts panic at questions they don't want asked. I'm not here to prove or disprove whether prenatal Tylenol use could contribute to autism. That's not the point. The point is the reflexive, knee jerk hostility toward even asking the question. When did science become less about discovery and more about protecting reputation? Shepard wrote. Medical history is one long cautionary tale of settled science gone wrong. Doctors once told women that smoking during pregnancy was safe. They prescribe thalidomide to expectant mothers, only to discover later that it caused birth defects. The arrogance is the problem. Too many in medicine and public health are more worried about being right than being honest. They confuse protecting their brand with protecting people. And when you put brand management over patient safety, you stop being scientists and start being bureaucrats, shepard said. If future studies confirm there is no link between Tylenol and autism, great parents deserve to know that, too. But why the sheer panic at the possibility? Why the immediate press campaigns? Why the defensive posturing designed to shut down the conversation before it starts? In Unherd, Cremi Rukhaya argued, RFK's autism report twists correlation into causation the HHS's rationale for the new Tylenol warning is based on a systemic review led by Harvard Dean of Public health Andrea Baccarelli. Dr. Baccarelli's review contends that there is a strong, consistent association between prenatal acetaminophen exposure and AD and other NDDSs. The review emphasized that this result was exceptionally robust, that it stood strong in studies controlling for bundles of different confounders with negative control exposure periods and with propensity score matching, rukhae wrote. The only problem is that none of these methods are reliable, and the authors actually ignored some good evidence that contradicts their conclusion. The main failing point of the review is that its authors knew about good evidence in the form of sibling control studies, studies where scientists compare a sibling who is exposed to Tylenol in utero to a sibling who wasn't exposed to it, and they ignored these results. But those studies were the strongest. It just happens to be the case that those studies didn't find anything alarming, khrukaje said. To me, that seems like the correct explanation for why the authors were so gung ho to attack them on spurious grounds. In Politico, Dr. Jay Bhattacharya Dr. Marnie Makary and Dr. Mehmet Oz described the Trump administration's new steps to tackle autism. While the pathophysiology of autism is still being understood, one potential area of interest is the folate transportation system in the central nervous system. A relatively inexpensive generic prescription drug called leucovirin can help some children to heal by bypassing the transportation blockage. Peer reviewed publications and randomized clinical trials have documented that up to 60% of folate deficient children with ASD can have improved verbal communication if given leucovarin, the authors wrote. Americans are tired of waiting, so we are cutting regulatory red tape to enable families to pursue treatment now as directed by their physician. Observational evidence has suggested that when moms take acetaminophen during pregnancy, especially close to delivery, it is correlated with subsequent diagnosis of conditions like autism and ADHD in their children, the author said. At the same time, we also recognize the literature continues to evolve and evidence from family control studies have failed to find a correlation. What should parents do in light of this evidence and lack of clear alternatives? We believe acetaminophen should be used judiciously in pregnancy and under medical supervision of an obstetrician as a practical, prudent medical approach that balances risks and benefits. All right, that is it for what the right is saying. Which brings us to what the left is saying. The left is critical of the announcement and calls Trump's and Kennedy's remarks meritless and dangerous. Some say the policy changes will create more suffering for pregnant women. Others question the administration's framing of autism as a crisis. The Washington Post editorial board said this shoddy autism science helps no one. The much ballyhooed news conference made clear that the administration intends to march headlong into its anti vaccine delusions. Health and Human Services Secretary Robert F. Kennedy Jr. Announced that his department will investigate vaccines as potential causes of autism, promising no areas of taboo. Even though realms of studies have already relentlessly debunked the association, the board wrote. The administration's claims about acetaminophen are weak, too. Though studies have found an association between prenatal use of the drug and autism, that link disappears when scientists account for other factors. At best, Trump's rant on Monday merely undermines the government's credibility. Many Americans understand autism's complexity and will find the administration's pronouncement to be further evidence of its untrustworthiness. At worst, it could do serious damage. The president's comments about vaccines are likely to turn more people against immunizations making society more vulnerable to disease outbreaks, the board said. The acetaminophen finding might also scare women away from treating their own pain based on flimsy data while discouraging more plausible areas of study. In the Guardian, Moira Donegan suggested Trump's claims will heighten the suffering of pregnant women in the US Pregnant women do not lack for judgmental, frightening and dubiously factual instructions about their health. Everywhere they are told that they risk the health of their fetus by partaking in a series of banal everyday activities, be it jogging or having coffee or eating a certain cheese that they are told will lead by obscure mechanisms that are never quite explained to impossible and devastating health outcomes for their children to be, donegan wrote. Now this cynical exploitation of pregnant women's fears, deployed to them at a time when they are most vulnerable, is coming from no less a place of authority than the White House itself. Trump advised pregnant women to simply endure their suffering. A mother will have to tough it out, he told them. Readers will forgive me if I posit that perhaps pregnant women in the US Are already suffering enough, donegan said. But pregnant women are not a punchline. Their hopes for their families, their fears for their bodies, their health, their comfort, their dignity, all of these are things Trump is willing to sacrifice at the altar of his own ego. In the New York Times, Maya Zalovitz wrote about what the government autism announcement got so wrong. Experts disagree on the causes of that increase in autism rates, but for President Trump and Health Secretary Robert F. Kennedy Jr. It's a clear sign that autism has become a crisis that must be eradicated, Zalovet said. The Trump administration seems to see autistic people as a burden on society that should be eliminated, not as citizens who are valuable. Mr. Kennedy has said that autism destroys families and called it cataclysmic during the press conference. But there is much more to autism than this bleak view suggests. Like many brain differences, autism isn't just an affliction, as many autistic people do. I tend to seek escape in systems which are more predictable to us than people. I sometimes think we can fall in love with them the way that you would with another person. Science, of course, is the system to understand all systems and and so to see it under attack in the name of fixing us of all things is brutal, zalovitz wrote. Moreover, autistic folks tend to love stability and routine and struggle mightily with chaos. To see the nation's scientific agencies following Mr. Kennedy's lead and promoting pseudoscience is shattering all Right, let's head over to Ari for his take.
- [16:34]
Ari Weitzman
Monday's joint press conference with Trump and Kennedy was just the last stage of a game of telephone that started with a few papers suggesting a causal link between acetaminophen and neurological disorders, and that ended with President Trump saying don't take Tylenol to pregnant women. So let's follow that chain from the start. In 2017, a few studies drew media attention to the claim that taking acetaminophen or Tylenol during pregnancy increase the risk for autism or ADHD in babies. In its recent press release, the FDA cited two other studies from 2019 and 2020 as further proof of this link. However, larger and more robust studies contradict their core findings. In particular, a study released this month, September 2025, examined over 200,000 children and also set up controls for siblings, and that study found no causal link between acetaminophen and and autism. Also in 2024, a study published in the Journal of the American Medical association, or jama, showed a moderate increased relative risk of asd, or autism spectrum disorder and ADHD from taking acetaminophen. However, those increased relative risks are very small, from 1.33% risk of autism to 1.53%, and even smaller for other neurological developmental disorders. The authors attributed the increased risk to correlate with not the drug itself, but with the symptoms of developmental disorders pregnant women were taking Tylenol to treat, like headaches and fevers. The study concluded bluntly that acetaminophen use during pregnancy was not associated with children's risk of autism, ADHD or intellectual disability. All of this begs the question, why would the FDA ignore those findings and cherry pick their chosen studies? Why not highlight other, more elevated relative risk factors for autism and adhd, like smoking during pregnancy or advanced maternal age or air pollution? Why make such a sweeping proclamation at all? So I'm just speculating here, but maybe Secretary Kennedy, who has shown a tendency to blame Big Pharma for all of society's ills, felt somewhat predisposed to find a causal link with Tylenol. Since Tylenol causes autism, has become a recent companion to the vaccines cause autism mantra, and many of his friends in law happen to be suing Tylenol in court right now. Perhaps, and perhaps after he promised in April to find a cause of autism by this September, he felt pressured to latch onto a recent Harvard study showing a tenuous link between autism and Tylenol before this self imposed deadline, even though that study's author said further study was needed. Maybe I'm just noticing trends here. But no matter his motivation, Kennedy announced this link with President Trump, who decided to blast the message that autism may be entirely preventable and use his megaphone to advise pregnant women not to take Tylenol full stop. Members of the White House are reportedly concerned and frustrated that President Trump's comments went too far. And he certainly seemed to leave prudence behind when making his remarks. Let's remember acetaminophen is the only pain relief option the FDA has approved to treat a range of ailments to during pregnancy. And if women can't take Tylenol for a fever or for pain, there are alternatives like ibuprofen or just nothing at all could result in very serious and immediate harm. So for the President of the United States to say don't take Tylenol, he better have a serious, compelling and definitive body of scientific evidence behind him. He does not. Not everyone has the time or expertise to parse through scientific studies, so we need reliable direction from people in positions of authority. On one hand, we have the President, who is not a scientist and could not pronounce the name of the drug he told pregnant women not to take. On the other hand are non governmental health groups, which are staffed and run by scientists. Every one of those organizations that I've seen make a statement in the last 48 hours has said that Tylenol is safe to take during pregnancy. I'm certainly not suggesting that you blindly trust the experts, but I know that which argument to me seems more convincing. Science is complicated, it's nuanced and it's ever evolving. But blasting a dictum based on marginal findings will only deliver division and confusion. And that division regarding autism isn't new. If you go to Google and you search autism rates increasing, your first hit, probably like mine, is an article from Johns Hopkins that says profound autism has not increased over the past 10 years. If you're someone with a child who has profound autism and you struggle to find support for that child and you worry about what will happen to your child if you die, you will probably leave that article with some cognitive dissonance. So you go back and you look at the search results and you see the number two hit, which is from an April 2025 press release from Health and Human Services that says autism epidemic runs rampant. So your options are either A, it's not a problem, or B, don't take Tylenol or vaccines. As has become common with Kennedy, he has identified a real issue here, the increase in autism rates is real and it is a problem. I know that many people disagree, and I'm aware of the several rebuttals to this stance, but I don't think they're convincing. And I can explain why Most people will say that the increased incidence of autism, including profound autism, is 100% attributable to increases in diagnostic standards. Very few people will dispute the CDC's finding that 1 out of every 31 children in the United States aged 3 to 17 is currently diagnosed with autism spectrum disorder. Nor is there much disagreement that this incident rate has been on the rise, up from 1 out of 36 in 2020, 1 out of 68 in 2010, and 1 out of 150 in 2000. But what many will say is that these figures don't represent an epidemic. They represent only a change in how we detect asd. And this stance is fairly mainstream. Epidemiologist Suzanne o' Sullivan recently appeared on Derek Thompson's Plain English podcast to explain how we're living in an age of diagnosis that affects not just autism, but adhd, ptsd, and a host of other psychiatric disorders. In that episode, o' Sullivan claimed explicitly that all of the diagnostic inflation of autism happens at the mild end of the spectrum and that there is no evidence that cases of severe autism have increased. But there is evidence of this. Here's some of that evidence. Social Security insurance Support for people with asd, which is reserved for the most profoundly impacted those are the cases with severe verbal deficits who require routine assistance has increased by over 300% from 2005 to 2015. Enrollments in special education programs have exploded in California, Massachusetts and Minnesota, where researchers said diagnostic methods do not largely explain the increasing trends. Researchers who have explicitly studied whether autism has increased over time have concluded that it has, and they have said that the increase cannot be attributed to diagnostics alone. Lastly, a 2023 public health report study found that incidents of both non profound and profound autism have increased from 2000 to 2016, from 3.9 to 14.3 non profound cases, and from 2.7 to 4.6 profound cases in every 1000 people. The evidence is not just real, it's convincing. These numbers provide good reason for Kennedy to direct a $500 million initiative to fund studies investigating this increase in the prevalence of autism, with a few caveats. First, none of this research should be directed towards exploring a causal link between autism and childhood vaccination. Kennedy in the past has claimed that there could be or even is a link between autism and vaccinating children, which is arguably the one thing we can most confidently say does not cause autism. Nor should discussing the existence of an autism epidemic in and of itself imply that those with ASD are lesser people, or that we should try to prevent people with that diagnosis from being born at all. Unlike the majority of ASD diagnoses, the autism cases that Kennedy is focused on are most commonly referred to as level 3 autism or profound autism. That's a term that was defined by the medical journal the Lancet in 2021 to describe people, quote, who are unable to advocate for themselves and are likely to need 24 hour support throughout their lives. Simply put, there is a chasm between the mainstream. There is actually not a problem stans, and the actual data here and now Secretary Kennedy is filling that void with absolute junk. Obviously, Kennedy deserves ample criticism for supplying all the junk, but our inability to agree on the basic facts is providing the chasm. And if that chasm widens, more junk will follow.
- [26:03]
Isaac Saul
We'll be right back after this quick break.
- [26:08]
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- [26:56]
Ari Weitzman
All right, that's it for my take today, so we're gonna head over to your questions answered. Today's question comes from Margaret from Winchester, Virginia who asks are you all going to look into the two hangings in the South? Yes, we are. So first some context. Last Monday, two men were found dead hours apart in Mississippi. 21 year old college student Demartravion Trey Reed was discovered hanging from a tree on the campus of Delta State University in Cleveland, Mississippi. And Corey Zacchaitis, 36, was found in the same manner near a casino in Vicksburg, Mississippi. The similarity in time, location and method of the deaths immediately sparked questions about whether they could be connected in some way. We still don't have much information on Tuquetis besides that he was described as homeless by the county coroner and that an autopsy has yet to be completed. The day after he died, images spread in news reports and on social media incorrectly identifying Zacatis, a white man, as Gavin Fortenberry, a black 17 year old killed by gun violence in August. Reed was a Black student at DSU, a campus roughly 50 miles from the site of Emmett Till's 1955 lynching. A preliminary investigation conducted by the Boulevard county coroner's office ruled Reid's death a suicide, and a formal autopsy conducted days later confirmed these findings. However, the NAACP raised doubts over the coroner's suicide determination and Reed's parents have also expressed suspicion about their son's cause of death. Amid social media posts alleging further injuries on Reed's body, which the police have denied, Reid's family has obtained a civil rights attorney to pursue further investigation. Meanwhile, Colin Kaepernick's organization, Know youw Rights Camp, has stepped forward to pay for a second autopsy for Reid. With the evidence we have so far, it seems unlikely that the two deaths are connected in any way, but we'll continue to keep an eye on developments as the investigations continue.
- [28:59]
John Law
Thanks Ari. Here's your under the Radar story for today folks. On Tuesday, the Secret Service announced that it had discovered, seized and dismantled a network of electronic devices located throughout the New York Tri State area capable of conducting telecommunications attacks ahead of the United Nations General assembly meeting in New York, officials said the network included roughly 100,000 SIM cards and 300 servers and it could anonymously send 30 million text messages per minute. The Secret Service said the network had already been used to threaten senior U.S. government officials. This network had the potential to disable cell phone towers and essentially shut down the Cellular Network, Matt McCool, the top agent at the Secret Service's New York field office, said. The New York Times has this story and there's a link in today's episode Description alright, next up is our numbers section. Acetaminophen was first synthesized in 1878. Acetaminophen was first used to treat pain and Fevers in 1893. Tylenol was introduced by McNeil Laboratories as an aspirin free pain reliever and Fever reducer in 1955. According to the Centers for Disease Control and prevention, approximately 3.2% of 8 year old children were identified with Autism spectrum disorder in 2022. Approximately 1.5% of 8 year old children were identified with ASD in 2012. Approximately 0.7% of 8 year old children were Identified with ASD in 2002, according to the CDC. The approximate proportion of boys in the US with autism in 2020 was 4 in 100, and the approximate proportion of girls in the US with autism in 2020 Was 1 in 100. And last but not least, our have a nice day story. In June, Autumn Buck got a call from her brother in law. A bird's nest had fallen from a tall tree in his yard, killing one small crow and leaving another injured and immobile.
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- [30:58]
John Law
Buck and her husband attempted to nurse the injured crow back to health, and they received assistance from an unlikely source, their dog, Meeko. Miko stayed close to the crow, chasing cats and other potential predators from the yard. The crow, now named Russell, recovered and has become close companions with Meeko. The two run and fly around together, play fetch and take naps side by side. The Washington Post has this story and there's a link in today's Episode Episode Description all right everybody, that is it for today's episode. As always, if you'd like to support our work, Please go to retangle.com where you can sign up for a newsletter membership, podcast membership or a bundled membership that gets you a discount on both. We'll be right back here tomorrow. For Isaac and the rest of the crew, this is John Law signing off. Have a great day, y'. All.
- [31:44]
Isaac Saul
Peace Our Executive Editor and founder is me, Isaac Sol, and our Executive Producer is John Lowell. Today's episode was edited and engineered by Dewey Thomas. Our editorial staff is led by Managing Editor Ari Weitzman with Senior Editor Will K. Back and Associate Editors Hunter Casperson, Audrey Moorhead Bailey, Saul Lindsey Knuth and Kendall White. Music for the podcast was produced by Diet75. To learn more about Tangle and to sign up for a membership, please visit our website@readtangle.com.
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