Donald Trump will today disclose the “true” cause of autism – if you don’t want to wait, read this

Trump said it more than once, for instance here, that on Monday [today] he will announce the true cause of autism: “I think we found an answer to autism. How about that? Autism. Tomorrow, we’re going to be talking in the Oval Office and the White House about autism, how it happens, so we won’t let it happen anymore. And how to get at least somewhat better when you have it so that parents can help their child, their beautiful child,” Trump said. Elsewhere he and his minons claimed that it will be based on the most comprehensive analysis ever conducted. It was also hinted that the cause will NOT be a vaccine!

So what will it be?

There have been multiple reports that Trump will claim that paracetamol taken during pregnancy causes autism. 

And it gets better: it is being speculated that they also have identified a cure: leucovorin! This drug is essentiall folinic acid; Medline lists over 20 papers suggesting it might be helpful for children with autism. For example, one RCT showed that the change in CARS score was higher in the folinic acid group (3.6 ± 0.8) compared to the placebo group (2.4 ± 0.7, p < 0.001). The theory behind using leucovorin for autism is that some individuals with the condition have a metabolic abnormality called cerebral folate deficiency. In these cases, the brain has low levels of folate (a crucial nutrient for brain development) despite normal folate levels in the rest of the body. This can be caused by the immune system producing antibodies that block the transport of folate into the brain. Leucovorin, a form of folate, can bypass this blockage and help restore folate levels in the brain. However, the claim that leucovorin cures autism is unfounded. There merely is promising, albeit limited, evidence to suggest that it may be an effective treatment for specific symptoms in a subgroup of individuals with autism who have an underlying folate metabolism abnormality. 

The paracetamol claim aligns with a recent review by Mount Sinai and Harvard researchers that suggested a possible link between prenatal acetaminophen use and an increased risk of autism and ADHD. Its authors found an increased risk of adverse neurodevelopmental outcomes following prenatal APAP exposure. Further studies are urgently needed with; precise indication of use and exposure assessment of use both in utero and in early life. Given the current findings, pregnant women should be cautioned against indiscriminate use of APAP. These results have substantial public health implications. Officials might therefore plan to advise pregnant women to avoid using the drug in pregnancy.

Yet, there is contradicting evidence too:  a large sibling study from Drexel University and Sweden’s Karolinska Institutet published in April 2024, for example, found no evidence to support a causal link between the drug’s use during pregnancy and an increased risk of autism. And just days ago, Japanese and US authors concluded that although PS-matched analyses indicated small increases in risk, sensitivity analyses suggested that unmeasured confounding, misclassification and other biases may partially explain these associations.

So, whatever Trump’s big announcement will claim, it might neither be conclusive nor new nor innovative. But it will certainly be a big show trying to highlight the achievements of his administration.

I for one advise caution: the claim that paracetamol causes autism is not supported by a scientific consensus. While some studies have shown an association, others, including large-scale and more reliable sibling studies, have cast doubt on a direct causal link, suggesting that other underlying factors may be at play. I might remind Trump, RFKJr and his team of pseudoscientists of two things:

CORRELATION IS NOT CAUSATION

and

REAL SCIENCE RELIES ON RIGOROUS RESEARCH AND NOT ON POLITICAL THEATRE