
The Alzheimer Pandemic: Is Paracetamol to Blame? (2013) - Rickasaurus
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3921468/
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Riedelbc
I am a programming neuroscientist who studies Alzheimer's, and I would like to
say that, while it is not entirely clear whether or not N-acetylcysteine will
prove fruitful as a therapeutic for Alzheimer's, PA/tylenol is not the same
thing as N-acetylcysteine, so the NSAID link is irrelevant in that regards.
The link between these two is that N-acetylcysteine is used as a treatment for
overdose of PA - because of a metabolite which is produced following high
consumption of PA (NAPQI). Importantly, this link does not indicate that they
have inversely correlated mechanisms of action under normal circumstances. PA
may not be worth exploring further, but the understanding of N-acetylcysteine
is still worth exploring. _Note_ I do not study this myself, just putting in
my two cents.

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TacticalCoder
Hey, long time HN user here, I'm a software dev.

I have a question for you, could you give me an email I could reach you at?

Hope to talk to you soon,

~~~
chrisbennet
Your email isn't displayed in your profile. You have to put it in the "about"
section of your profile if you want people to be able to see it.

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tptacek
This is from 2013. Why has it seen essentially no news coverage? I can't, for
instance, easily find it on sites like Science Based Medicine; you'd think
they'd have lit up over this.

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cpncrunch
Because it was debunked back in 1997:

[http://www.neurology.org/content/48/3/626.short](http://www.neurology.org/content/48/3/626.short)

Just another case of HN users clicking on flashy things without stopping to
examine the evidence. Some more examples:

\- deep brain stimulation: hundreds of upvotes here on stories about this, but
then when studies come out showing that it it no better than placebo that
story gets 3 upvotes on HN.

\- fecal transplants for C dificile: again hundreds of upvotes for stories
touting this, but then when it is found to be no better than placebo the story
gets no upvotes on HN.

These are just a few examples, but I see this all the time on HN. It makes me
a little disappointed in the community and thinking that perhaps I should be
hanging out somewhere else instead.

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25cf
Not a biologist by any stretch of the imagination, so I am asking purely out
of ignorance - how does your study debunk the OP's? Yours is about NSAIDs
(i.e. aspirin) decreasing the risk of Alzheimer's, OP's is about paracetamol
(not an NSAID) increasing the likelihood of Alzheimers. Correct me if I'm
misunderstanding something here...

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bunderbunder
It found aspirin most likely has a protective effect.

It found no strong evidence of any association for acetaminophen, but the 95%
confidence interval on the result is pretty wide. So it doesn't entirely rule
out the possibility of there being a relationship, and based on its results
alone it's entirely plausible that a test with more statistical power could
find that it doubles your risk of Alzheimer's disease. But it could also
plausibly find that it has a mild protective effect.

Regardless of which is the case, this study still strongly challenges what's
being suggested by TFA. Even a doubling of Alzheimer's risk resulting from a
lifetime of acetaminophen use is nothing at all like its suggestion that
Alzheimer's is a disease that was unheard of before the development of NSAIDs
related to Tylenol.

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dragonwriter
> its suggestion that Alzheimer's is a disease that was unheard of before the
> development of NSAIDs related to Tylenol.

Minor point: Tylenol isn't an NSAID, nor is the prior drug to which the
article links Alzheimer's.

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tomphoolery
I read on Paracetamol's wikipedia page that "Paracetamol also modulates the
endogenous cannabinoid system"
([https://en.wikipedia.org/wiki/Paracetamol#Society_and_cultur...](https://en.wikipedia.org/wiki/Paracetamol#Society_and_culture)).
Given recent studies that indicate Alzheimer's can be treated by THC
([http://www.ncbi.nlm.nih.gov/pubmed/25024327](http://www.ncbi.nlm.nih.gov/pubmed/25024327)),
it seems that there's some kind of connection between Alzheimer's and the
endogenous cannabinoid system. If that's true, then it could mean paracetamol
is not really the "cause" of Alzheimer's, but rather a part of the real cause:
disruption or malfunction of our brain's cannabinoid receptors. Perhaps we
will finally be able to prove, scientifically and neurologically, that these
receptors cannot be ignored, they play a crucial role in our survival.

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gragas
Just so people are clear, paracetamol is Tylenol.

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simcop2387
Also known as acetaminophen, and a bunch of other trade names[1]

[1]
[https://en.wikipedia.org/wiki/Paracetamol_brand_names](https://en.wikipedia.org/wiki/Paracetamol_brand_names)

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emeraldd
And it happens to be included in several composite pain killers as well.
(Excedrin, Vicodin, ... etc.)

[http://www.knowyourdose.org/common-
medicines/](http://www.knowyourdose.org/common-medicines/)

~~~
15155
For no reason other than to prevent "abuse" by causing the user to destroy
their liver with excess dosages.

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cba9
Is it just me, or is the "ANALGESICS AS RISK FACTORS FOR F-AD: (2)
EPIDEMIOLOGY" section really uncompelling and the epidemiological evidence
seems to amount to a few inconsistent cross-sectional studies with no
particularly large correlations like implied, and a note that both paracetamol
and Alzheimer's have increased over the past two centuries or so?

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NormanJones
dear correspondents, thank you all for your various comments. much as i would
like to engage with you all i fear i cannot. i am in poor health and have
short life expectation. i would like to make some general comments. first,
science is a serious professional activity, too important to be discussed in a
trivial or superficial manner. if you want to join the debate, please read
both my papers of 2014. a search engine should find them with jones
alzheimer's 2014 allergy. i cannot help it if you find them too hard to
follow. i see it as my job to provide new conclusions from known facts and not
to give seminars. second, open access cost me good money, in excess of £1000;
quite a sum for a pensioner. third, i cannot deal with the many
misunderstandings of my work. i never suggested that acetyl cystein is an
antidote for Alzheimer [ad]. neither do i accept the findings of stewart et al
[1997], whose paper i criticised with good reason in the first of my 2014
papers. fourth, paracetamol is a wholly UNTESTED drug, and for that reason
needs special attention. there have been a number of reports of the harm it
does to the unborn child. i would like to provide references but my home was
raided while i was in hospital in the summer and ALL my notes were stolen. i
have never come across a similar incident, which gives some idea of the
trenchant opposition to my work. fifth, someone aks why there has been no news
coverage? because i am totally isolated here. my emails are read, my mail is
often impounded, the telephone is tapped and at least one room is bugged. this
is a big operation thought to be on behalf of a huge drug company to keep the
whole thing under wraps. thank you for your interest, compliments of the
season, sincerely, robert jones.........

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jgershen
Published in 2013.

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neals
So, was Paracetamol to blame?

~~~
cpncrunch
Unlikely:

[http://www.neurology.org/content/48/3/626.short](http://www.neurology.org/content/48/3/626.short)

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reasonattlm
My comments on this made last year:

\--------

Once you know enough of the basics in a field to get by as a layperson, you'll
find that scientific literature is far removed from being dry and
uncontroversial. There are always heretics and novel positions being advanced
- most of them wrong, but all new fields and new directions start with a few
heretics, and the mainstream is consistently overturned with time, to be
replaced with the new consensus. Distinguishing a good speculative hypothesis
from a work of overreaching fancy can be a challenge wherever you stand in the
hierarchy of knowledge, and the good-looking fallacies far outnumber the seeds
of tomorrow's scientific mainstream. This is why few researchers bother to
spend any time on reviewing this sort of thing when there are so very many
other demands on their time.

One of the SENS Research Foundation folk turned up the open access paper on
paracetamol and Alzheimer's in the course of ongoing reviews of scientific
literature relevant to aging, and thought it heretical enough to share as an
item of interest - as a curio well outside the current consensus, not as
anything to be acted on. It makes for a good read, and is well-researched, but
I think that ultimately the points being made here can be explained away by
the coincidence of development of medical technology, increasing longevity,
and increasing wealth. When it comes down to the biochemistry, the dots aren't
really joined well enough to be very compelling.

So I offer this as an example of the fact that if you go digging around,
you'll find very interesting papers that are well-researched, highly
speculative, and probably wrong. The author of this paper has been advancing
his theory for more than a decade, evidently without gathering much support.
That is all part and parcel of the scientific process.

The conclusion of the paper, that Alzheimer's is an artifact of paracetamol
use, is something of a bold conclusion, and as I noted above I don't think it
stands too well against Occam's razor. It is simpler to point to rising wealth
driving the sedentary, high-calorie lifestyle that greatly raises the risk of
suffering age-related diseases such as Alzheimer's, and note that this
coincides with advances in medical technology that allow for more reliable
identification of the condition, progress in other technologies that improve
record-keeping and reliability in medicine, and the concurrent trend in rising
life spans such that more people survive to ages in which neurodegenerative
conditions become a significant risk.

I still suggest you read the paper, as you'll find that a great deal of
interesting historical data is referenced therein. You'll probably learn some
things that you didn't know about the history of painkillers, for example.

\--------

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cedrus_libani
TLDR: Disease Foo has become more common in the past few hundred years. You
know what else has become more common in the past few hundred years? Bar!
Therefore, Bar causes Foo, QED.

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nikanj
Betteridge's law

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dalbin
Hacker News law of Betteridge's law of headlines.

[https://news.ycombinator.com/item?id=4842803](https://news.ycombinator.com/item?id=4842803)

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davidw
Maybe HN should have a Betteridge law bot that operates when the last
character of a submission's title is '?'.

~~~
jacquesm
It's been mturked.

