How to see race

Race is a shapeshifting adversary: what seems self-evident takes training to see, and twists under political pressure

We think we know what race is. When the United States Census Bureau says that the country will be majority non-white by 2044, that seems like a simple enough statement. But race has always been a weaselly thing.

Today my students, including Black and Latino students, regularly ask me why Asians (supposedly) ‘assimilate’ with whites more quickly than Blacks and Latinos. Strangely, in the 1920s, the US Supreme Court denied Asians citizenship on the basis that they could never assimilate; fast-forward to today, and Asian immigrants are held up as exemplars of assimilation. The fact that race is unyielding enough to shut out someone from the national community, yet malleable enough for my students to believe that it explains a group’s apparent assimilation, hints at what a shapeshifting adversary race is. Race is incredibly tenacious and unforgiving, a source of grave inequality and injustice. Yet over time, racial categories evolve and shift.

To really grasp race, we must accept a double paradox. The first one is a truism of antiracist educators: we can see race, but it’s not real. The second is stranger: race has real consequences, but we can’t see it with the naked eye. Race is a power relationship; racial categories are not about interesting cultural or physical differences, but about putting other people into groups in order to dominate, exploit and attack them. Fundamentally, race makes power visible by assigning it to physical bodies. The evidence of race right before our eyes is not a visual trace of a physical reality, but a by-product of social perceptions, in which we are trained to see certain features as salient or significant. Race does not exist as a matter of biological fact, but only as a consequence of a process of racialisation.

Occasionally there are historical moments when the creation of race and its political meaning get spelled out explicitly. The US Constitution divided people into white, Black or Indian, which were meant to stand in for power categories: those eligible for citizenship, those subjected to brutal enslavement, and those targeted for genocide. In the first census, each resident counted as one person, each slave as three-fifths a person, and each Indian was not counted at all.

But racialisation is often more insidious. It means that we see things that don’t exist, and fail to recognise things that do. The most powerful racial category is often invisible: whiteness. The benefit of being in power is that whites can imagine that they are the norm and that only other people have race. An early US census instructed people to leave the race section blank if they were white, and indicate only if someone were something else (‘B’ for Black, ‘M’ for Mulatto). Whiteness was literally unmarked.

A brief aside on the politics of typography, in case you’re wondering: throughout this article I leave ‘white’ as is, but I capitalise ‘Black’, as well as ‘Indian’ and ‘Irish’. Why? Well, as the writer and activist W E B DuBois said in the early 20th century, during the decades-long campaign to capitalise ‘Negro’: ‘I believe that 8 million Americans are entitled to a capital letter.’ I could argue that I don’t capitalise white because ‘white’ rarely rises to the level of a cultural identification – but the real reason I don’t is because race is never fair, so it’s fitting for inequality be written into the words we use for races.

Putting whiteness under inspection shows how powerful race is, despite the instability of racial categories. For decades, ‘whiteness’ was an explicit standard for citizenship. (Blacks could technically be citizens, but enjoyed none of the legal benefits. Asians born outside the US were prohibited from becoming citizens until the mid-20th century.) Eligibility for citizenship – painted as whiteness – has remained a category since its inscription in the Constitution, but those eligible for membership in that group have changed. Groups such as Germans, Irish, Italians and Jews were popularly defined as non-citizens and non-white when they first arrived, and then became white. What we see as white today is not the same as it was 100 years ago.

Thomas Nast’s cartoons are notorious in this regard. His caricatures of Irishmen and Blacks are particularly shocking because they are a type we no longer see today. Working-class Irishmen are represented as chimpanzees in crumpled top hats and curled-up shoes. Their faces have a large dome-shaped upper lip surrounded by bushy sideburns:

Figure 1: Thomas Nast’s racist caricatures. In the second image, from 1876, Southern Blacks and Irish Democrats are compared politically and graphically, and found to be of equal weight. Inevitably, any publication that called itself the ‘Journal of Civilization’ did the contemptible boundary work of determining who was and was not civilised. Public domain

At times, Nast partnered the Irishman with an equally offensive image of a Black American, with big ‘Sambo’-style lips, perhaps a large rump and clunky bare feet. Today, few Americans have an image in their minds of what an Irish American should look like. Unless, perhaps, they meet a man named O’Connor with red hair, Americans today rarely think to themselves: ‘Of course! He looks Irish.’

Americans can’t see German, Irish or French, but they could. Not all white people look the same

But Nast was not only sketching nasty caricatures of Irishmen; he was doing so in a way that would appear believable to his audience. In a similar example of invisible ethnicity, 15 per cent of Americans in 2014 reported German heritage. This ethnic group is widespread and numerous. So let me pose a simple question: what do German Americans look like? One in seven Americans are German American; how many of the German Americans you meet have you identified that way? Even more so than later immigrant groups such as Italian, Irish or Jewish, German is invisible.

Americans can’t see German, Irish or French, but they could. It’s not the case that all white people look the same. My parents are both of predominantly Irish heritage. One summer, my family was travelling and had a layover in Ireland long enough for us to see the city of Dublin for the first time. We had not left the airport before my seven-year-old son said what I was already thinking: ‘Everybody here looks like grandma and grandpa!’ My family, according to my seven-year-old, looked like people from Ireland.

A few years later, I was to meet a French colleague at a busy Paris train station at rush hour, but neither of us knew what the other one looked like, and there were hundreds of people. I tried to guess which of the women entering, exiting, waiting, smoking, texting and milling about was the person I was to meet, but to no avail. Then I turned, and from a block away, through a crowd of hundreds, a woman waved directly at me. She had picked me out. I had been vaguely aware, before then, that no matter how familiar I got with Paris, I stood out on the subway: I might feel perfectly French riding the train, reading the advertisements in French and understanding the conductor, but when I got home and looked in the mirror, I knew my face was different from the diverse visages I saw in public.

Later I asked my colleague, and she said she knew I wasn’t French. How so? I asked. She scrutinised me. ‘La mâchoire.’ It was your jaw, she said, with a satisfied smile. Until that day, I never knew there was such a thing as an Irish chin, but I had one. And no doubt, if Nast ever met my earliest American ancestors on the street, he’d know they looked Irish too. We don’t see Irish anymore, we don’t recognise it, we no longer caricature it. But we could.

The racial category of Asian is just as unstable and entangled with political power as whiteness is. The US census started counting ‘Chinese’ back in 1870 (with no other category for people from the continent of Asia). Around the same time, the census started counting a similarly excluded group, American Indians, which the Constitution had designated as ripe for expropriation. Tellingly, Indian racial categories were unstable from the start: after not being counted at all, Indians were then included but tallied in the ‘white’ column – except in areas where there were large numbers of Indians, where they became their own category.

For Asians, as Paul Schor points out in his fascinating history Counting Americans (2017), the US government counted Chinese and Japanese but still left the rest of Asia blank, adding ‘Filipino, Hindu, and Korean’ in the 20th century. For something so clearly created by people, lists of racial groups are never comprehensive and typically ill-defined. Looking across the Eurasian continent, the US government today is still vague about where white ends and Asian begins. People in the US who were born east of Greece and west of Thailand are often unsure which boxes to check in the US census every 10 years. Like storm-borne waves or wind-blown sand dunes, race is a daunting obstacle that shifts and changes.

During the Second World War, China was a US ally, while Japan was an enemy. The US military decided it necessary to identify racial differences between the Chinese and the Japanese. In a series of cartoon illustrations, they tried to educate American soldiers about what to look for – what to see – in order to distinguish a Japanese solider who might be trying to blend in among a Chinese population.

Figure 2: US propaganda for soldiers sought to disseminate physical differences between Chinese and Japanese people. Public domain

Today, the ‘How to Spot a Jap’ leaflets are an offensive novelty – used either to illustrate the history of racist stereotyping or sold on postcards as ironic curiosities. But they can also be examined in another way. In The Civilizing Process (1978), the sociological theorist Norbert Elias studied books on manners from the European Renaissance to understand the process of the creation of what he called habitus. Manners that we see as utterly natural and inevitable today, like not blowing one’s nose at the table, or eating off the serving spoon, or belching or farting in public, are, in fact, socially constructed and learned behaviours.

At the historical moment at which they were introduced, books of manners were required to teach what is today utterly obvious to adults. They make for incredible reading. In his chapter ‘On Blowing One’s Nose’, for instance, Elias quotes a ‘precept for gentlemen’ that matter-of-factly explains: ‘When you blow your nose or cough, turn round so that nothing falls on the table.’ ‘Do not blow your nose with the same hand that you use to hold the meat.’ ‘It is unseemly to blow your nose into the tablecloth.’ Some of the recommendations are as poetic as they are graphic: ‘Nor is it seemly, after wiping your nose, to spread out your handkerchief and peer into it as if pearls and rubies might have fallen out of your head.’ It appears that actions that seem completely natural had to be taught explicitly.

Genetic inheritance isn’t what matters. What we literally see is shaped by politics

The ‘How to Spot a Jap’ flyers were printed to serve much the same function as the manners books that Elias studied. They tried to create and implant a racial habitus that distinguished the Japanese from the Chinese. That Second World War poster looks offensive today – crude, reductionist, insulting – and it is. We think that recognising such ridiculousness makes us less racist than the people who made it. It doesn’t. It merely means that we have different racial categories than in 1942.

Chinese and Japanese people look no more ‘similar’ or ‘different’ from one another than Irish Americans do from French Americans. That doesn’t mean that there aren’t differences as a matter of statistical distribution, but only that what we think we know about race has to be learned, and that what people ‘know’ and ‘see’ as salient and obvious changes over time. Most Americans cannot distinguish a white American of Irish origin versus one of French origin walking down the street, yet they hardly need pamphlets explaining what to look for to tell if someone is white or Black. If the distinction between Japanese and Chinese had remained as significant in the US today as it was to US soldiers during the Second World War, many people would see it as similarly self-evident.

On-the-street racial distinctions don’t have to be ‘perfect’. People often don’t recognise the author Malcolm Gladwell as Black, although he is; other times whites are mistaken for Blacks. For the purposes of making or unmaking a racial difference, genetic inheritance isn’t what matters. What we literally see is shaped by politics. The same two groups can be visibly different racially or indistinguishable racially, depending on the political context and power relations by which they’re categorised.

Francis Galton was a pioneer in modern statistics. But he was also a eugenicist. Among other things, Galton became notorious for photos in the late 19th century that purported to reveal the ‘Jewish type’. At the time, people believed that Irish, Jewish, Japanese, Chinese or German denoted races. When Jews were a race, people thought that they could tell who was Jewish by looking at them. Today, many Jewish people recoil at the idea that there is a Jewish ‘race’, and find the suggestion that there is a Jewish ‘look’ inherently racist. At various times, then, the US Army, Thomas Nast and the father of the statistical method of regression analysis all believed that there were visually distinct and observable races that many Americans today would be generally unable to identify – certainly not with the level of certainty they’d feel with respect to racial categories such as Caucasian, African American, Latino or Asian.

I suspect that a visitor from a planet without race would have a very difficult time slotting anyone on Earth into the racial categories we use today. If they were asked to group people visually, there is no statistical possibility that they’d use the same set of arbitrary boxes, and even if these categories were described for them in detail, they would probably not sort actual people in the same way as the modern US does.

That we think we see race naturally, when in fact it’s socially constructed, is the third eye through which we see the world. The census prediction that the US will be majority minority is less a conclusion than a question: ‘What future will immigrants of colour build in the US?’ The answer involves not just changes that transpire between one group and another, but changes to the membership of those groups and their symbolic meaning. In response to demographic shifts, the very boundaries of whiteness are likely to shift, as indeed they’ve done before.

In the worst case, a majority non-white US could take its cue from apartheid-era South Africa

In The History of White People (2011), Nell Irvin Painter argues that the idea of ‘whiteness’ has expanded several times to include more and more people. First came the Irish and previously ‘suspect’ non-Protestants, who ‘gained’ whiteness in the late 1800s. The next great expansion of whiteness came with the social upheaval and physical relocation of both servicemen and migrating industrial workers during the Second World War. In the war economy, groups including Italians, Jews and Mexicans became upwardly mobile, and sought to present themselves in allegiance with Anglo-Saxon beauty ideals (the only Jewish Miss America was crowned in 1945) – all of which helped to recast them as ‘white’. The narrative of white inclusivity continued from the Roosevelt era into the postwar period. Finally, intermarriage eventually dissolved previous notions of racial boundaries. Few white Americans could claim a single national race (Swedish, German, French) with any confidence, and whiteness could no longer sustain the idea of nation-based races. For Painter, this most recent change closed the book on any scientific basis for race, and helped to make the US a country where people are much more mixed, across old racial boundaries, than ever before.

Perhaps this mixing means that the US is finally warming to multiracial identity. But if that is indeed happening, it’s not because of demographics, but because of the tireless efforts of activists who continue to fight racism and racial segregation. Movements for racial justice succeed not simply because of demographic shifts but because racial privileges cannot justify themselves in the face of an organised alternative. Many countries have been minority white yet held on to whiteness; to the extent that whiteness meant citizenship, these were states that were ruled by a minority and oversaw the hyper-exploitation of a much larger part of the country. In the worst case, a majority non-white US could take its cue from apartheid-era South Africa, or Brazil, or Guatemala, where a small light-skinned group has enjoyed privileges at the expense of many more who are excluded.

The path to justice therefore involves attacking the prerogative to categorise people in order to justify their exploitation or colonisation. That means acknowledging and challenging the basis of racial categories. It’s not about a token embrace of multicultural colour: it’s about power, and power is far too wily for us to expect it to stand still and be overtaken by demographic change. We need to confront the force of racial privilege no matter who inhabits the privileged caste at any given moment. It’s no good imagining that innate human diversity will render the system powerless.

The US shift towards majority non-whiteness is not destiny, but it is an opportunity. Painter notes that when external conditions change, it becomes possible to imagine different racial hierarchies. The geographical and social remixing of the Second World War cooked down the diverse European identities in the US into a single racial category of ‘white’. Likewise, Asian immigrants occupied one role when Asian immigration was largely working class, West Coast, limited in numbers, and male, as it was at the end of the 19th century. But the racial constraints on Asian Americans shifted when immigration law came to favour professionals, and brought middle- and working-class people, women and men, in larger numbers than before to more US cities.

Using shifting social situations to upend racial hierarchies is not just about challenging racism, but race itself. This doesn’t mean the disingenuous denial of race when racism still very much exists, but a collective challenge to its right to determine our lives. The Black Lives Matter movement seeks to take away the police’s prerogative to use violence against African Americans with no legal sanctions; success would undermine an important means of maintaining racial segregation and inequality. What would it mean, once and for all, to bury the shameful, misplaced pride some white people have for the South’s role in the Civil War, and acknowledge instead the irredeemable mistakes of their forefathers? What would it mean to frankly acknowledge each nation’s racial past, and think about what reparations would set us on a path to greater prosperity? Race is neither inevitable nor something we can wish away. Instead, we must take advantage of the instability in what we perceive, and redistribute the power that perpetuates race.

Race never stays still. As the sociologist Richard Alba pointed out in The Washington Post last month, the prediction that the US will be majority non-white by 2044 relies on a definition of race that is static, and doesn’t acknowledge the surprising reality that people’s races change. Nearly 10 million people listed their racial identification differently on the 2010 census than they had in 2000. Alba criticises the census for ‘binary thinking’ which counts anyone with Hispanic heritage as Hispanic, and through a quirk in the census questions, effectively ignores any other racial identity that they could claim. ‘[A] majority-minority society should be seen as a hypothesis, not a foreordained result,’ Alba wrote, of the 2044 claim. This is important, because when it comes to fighting racism, we can’t rely on demographic shifts to do the work for us. Instead, if we recognise that race looks solid but is shifting, we can find additional ways to destabilise the structures of racial inequality.

Getting rid of racism requires clarity about the nature of the enemy. The way to defeat white supremacy is to destroy it. The US will truly be ‘majority non-white’ only when white is no longer the privileged citizenship category, when white is no more meaningful than the archaic Octoroon or Irish. This is not to discount the anxiety about cultural loss conjured by talk of an imagined colourblind future, but to recognise the inextricability of racial identities and power inequality. With work, perhaps the next expansion of whiteness will be into oblivion.

Use paracetamol to relieve a sore throat instead of antibiotics , says NICE

Dear Pregnant women, beware! Paracetamol might affect sex drive in male progeny

The use of pain reliever paracetamol when pregnant is linked to reduced sex drive and aggressive behaviour in males, finds study.

Taking paracetamol during pregnancy might damage the development of male behaviour.

Although paracetamol is usually considered safe during pregnancy, a new research from the University of Copenhagen in Denmark suggests that if you are pregnant, you should think twice before popping these pills as their use is linked to reduced sex drive and aggressive behaviour in males. In an animal model, the use of the popular pain reliever paracetamol was found to damage the development of male behaviour, according to a paper published in the journal Reproduction.

The researchers said that the dosage administered to the mice was very close to the recommended dosage for pregnant women. But they cautioned that because the trials are restricted to mice, the results cannot be transferred directly to humans. However, the researchers’ certainty about the harmful effects of paracetamol means it would be improper to undertake the same trials on humans, explained David Mobjerg Kristensen, who was associated with the University of Copenhagen during the study.

Paracetamol can inhibit the development of the male sex hormone testosterone in male foetuses.

“In a trial, mice exposed to paracetamol at the foetal stage were simply unable to copulate in the same way as our control animals. Male programming had not been properly established during their foetal development and this could be seen long afterwards in their adult life. It is very worrying,” Mobjerg Kristensen, now associated with the Institut de Recherche en Sante, Environnement et Travail (IRSET) in France, said.

Previous studies have shown paracetamol can inhibit the development of the male sex hormone testosterone in male foetuses, thus increasing the risk of malformation of the testicles in infants. But a reduced level of testosterone at the foetal stage is also significant for the behaviour of adult males, Mobjerg Kristensen added. Testosterone is the primary male sex hormone that helps develop the male body and male programming of the brain. The masculine behaviour in mice observed by the researchers involved aggressiveness towards other male mice, ability to copulate and the need for territorial marking.

“We have demonstrated that a reduced level of testosterone means that male characteristics do not develop as they should. This also affects sex drive,” Mobjerg Kristensen said. But even if paracetamol is harmful, that does not mean it should never be taken, even when pregnant, the researchers said. “I personally think that people should think carefully before taking medicine. These days it has become so common to take paracetamol that we forget it is a medicine and all medicine has side effects. If you are ill, you should naturally take the medicine you need. After all, having a sick mother is more harmful for the foetus,” Mobjerg Kristensen noted.

According to Britain’s National Health Service (NHS), “paracetamol is usually safe to take” during pregnancy. Kristensen emphasised that pregnant women should continue to follow the guidelines given by their country’s health authorities and recommends people to contact their GP if in doubt about the use of paracetamol

Two pints of beer better for pain relief than paracetamol, study says

But health experts warn to drink moderately

 Your head is pounding, the room’s spinning and your stomach is lurching – when you’re hungover, reaching for painkillers can often seem like a good idea.

But according to a new study, hair of the dog really could do the trick.

And not just for dealing with a hangover – according to new research, drinking two beers is more effective at relieving pain than taking painkillers.

Over the course of 18 studies, researchers from the University of Greenwich found that consuming two pints of beer can cut discomfort by a quarter.

By elevating your blood alcohol content to approximately 0.08 per cent, you’ll give your body “a small elevation of pain threshold” and thus a “moderate to large reduction in pain intensity ratings”.

The researchers explained: “Findings suggest that alcohol is an effective analgesic that delivers clinically-relevant reductions in ratings of pain intensity, which could explain alcohol misuse in those with persistent pain, despite its potential consequences for long-term health.”

It’s not clear, however, whether alcohol reduces feelings of pain because it affects brain receptors or because it just lowers anxiety, which then makes us think the pain isn’t as bad.

Dr Trevor Thompson, who led the study at London’s Greenwich University, told The Sun: “[Alcohol] can be compared to opioid drugs such as codeine and the effect is more powerful than paracetamol.

“If we can make a drug without the harmful side-effects, then we could have something that is potentially better than what is out there at the moment.”

However experts are also speaking out to clarify that the results of the new study don’t mean alcohol is good for us.

Rosanna O’Connor, director of Alcohol and Drugs at Public Health England, said: “Drinking too much will cause you more problems in the long run. It’s better to see your GP.”

Government guidelines recommend no more than 14 units of alcohol a week for both men and women, which equates to six pints of beer, or six 175ml glasses of wine.

Women who take paracetamol and ibuprofen risk going deaf.


  • Taking two pills a week for more than six years has been linked with hearing loss
  • The drugs are thought to cut blood supply to the inner ear and expose it to noise
  • And painkillers are responsible for 1 in 20 women suffering from partial deafness
  • The latest findings back up similar research in men, according to experts 

Women who take paracetamol or ibuprofen just twice a week could be damaging their hearing permanently.

Taking two painkillers a week for more than six years has been linked with significant hearing loss, with the drugs thought to cut blood supply to the inner ear and expose it to noise damage.

As many as one in 20 women suffering partial deafness could blame their painkiller use, a study has found.

Women who take paracetamols or ibuprofen just twice a week could be damaging their hearing permanently, scientists claim

The findings back up similar research in men, suggesting middle-aged women, who commonly take paracetamol and ibuprofen for headaches and back pain, should consider cutting down.

Senior author Dr Gary Curhan, from Brigham and Women’s Hospital in the US, said: ‘Hearing loss is extremely common and can have a profound impact on quality of life.

‘Finding modifiable risk factors could help us identify ways to lower risk before hearing loss begins and slow progression in those with hearing loss.’

Almost one in 12 women take paracetamol on two days of every week, the US study found, usually to ward off routine aches and pains. This could be only two pills over the two days, or a greater dose.

But paracetamol, ibuprofen and non-steroid anti-inflammatory drugs taken this often for more than six years raise the risk of developing hearing loss by nine per cent.

This was found by examining 55,850 women between the age of 44 and 69 – almost half of whom reported a hearing problem.

Around one in six people in the UK have hearing problems, which can leave people feeling cut off and lonely and has been found to speed up memory loss and dementia.

As many as one in 20 women suffering partial deafness could blame their painkiller use, the new study has found

The study suggests this could be down to paracetamols, which most people think little of swallowing routinely but evidence shows can reduce the blood supply to the cochlea, or inner ear.

Paracetamol is also believed to deplete antioxidants within the ear, making the cochlea more vulnerable to noise-induced damage. Painkillers damage the tiny hairs within the ear which help us hear and have been linked in younger and older women with a higher risk of hearing loss.


Regular doses of ibuprofen may lower smokers’ risk of lung cancer, research last week revealed.

It is known the painkiller, a non-steroidal drug, eases inflammation in the body.

But researchers at Ohio State University found clear evidence that – taken in small doses at regular intervals – it can dispel much of the inflammation that leads to tumors in the lungs.

It is one of the first studies to have examined specific types of anti-inflammatory medication, and how they affect smokers’ cancer risk.

Dr Curhan added: ‘Although the magnitude of higher risk of hearing loss with analgesic use was modest, given how commonly these medications are used, even a small increase in risk could have important health implications.’

It is the first study on the duration of paracetamol use and hearing loss, taken as any damage to the ears after 1990 in the women from the US Nurses’ Health Study. However aspirin, which now tends to be taken in lower doses, was not associated with loss of hearing.

Sohaila Rastan, executive director of biomedical research at charity Action on Hearing Loss, said: ‘This study suggests that there may be a small increased risk of hearing loss in women who take over-the-counter painkillers for a long period of time.

‘However, more research is needed to establish whether painkillers are the actual cause of this hearing loss or if other factors are involved.

‘It would also be important to understand how painkillers might be damaging the ear, if they are indeed the cause.’



Randomized controlled trial of the effect of regular paracetamol on influenza infection


Background and objective

Anti-pyretic treatment is recommended in the management of influenza infection. In animal models anti-pyretic treatment increases mortality from influenza. We investigated the effects of paracetamol on viral and clinical outcomes in adults with influenza infection.


This is a randomized, double-blind, placebo-controlled trial of adults aged 18–65 years with influenza-like illness and positive influenza rapid antigen test. Treatments were 1 g paracetamol four times a day, or matching placebo, for 5 days. Pernasal swabs were taken for influenza quantitative RT-PCR at Baseline and Days 1, 2 and 5. Temperature and symptom scores were recorded for 5–14 days or time of resolution respectively. The primary outcome variable was area under the curve (AUC) for quantitative PCR log10 viral load from Baseline to Day 5.


A total of 80 participants were randomized: no one was lost to follow up, and one withdrew after 4 days. There were 22 and 24 participants who were influenza PCR-positive in placebo and in paracetamol groups respectively. Mean (SD) AUC PCR log10 viral load was 4.40 (0.91) in placebo and 4.64 (0.88) in paracetamol; difference was −0.24, 95% CI: −0.78 to 0.29, P = 0.36. In all participants there were no differences in symptom scores, temperature, time to resolution of illness and health status, with no interaction between randomized treatment and whether influenza was detected by PCR.


Regular paracetamol had no effect on viral shedding, temperature or clinical symptoms in patients with PCR-confirmed influenza. There remains an insufficient evidence base for paracetamol use in influenza infection.

New study suggests taking paracetamol while pregnant affects male babies .

According to new research, taking paracetamol regularly for several days at a time while pregnant could contribute to reproductive disorders in male babies.

The common painkiller is generally considered the safest option for pregnant women, but the new results suggest that a week of regular paracetamol use could reduce testosterone production in developing testes by 45 percent.

 “This study adds to existing evidence that prolonged use of paracetamol in pregnancy may increase the risk of reproductive disorders in male babies,” Rod Mitchell, an endocrinologist from the University of Edinburgh in the UK, said in a press release. “We would advise that pregnant women should follow current guidance that the painkiller be taken at the lowest effective dose for the shortest possible time.”

Continuous testosterone production is crucial for the healthy development of the male reproductive organs, and previous research has found a link between reduced testosterone exposure in utero and reproductive disorders such as infertility, testicular cancer and undescended testicles.

In order to work out how paracetamol affects reproductive development, the team studied mice that had foetal human testicular tissue grafted onto them – these grafts have previously been shown to mimic the developing testes of unborn baby boys. The researchers gave the mice three doses of paracetamol a day for either 24 hours or seven days.

The mice that were given the paracetamol for just one day showed no effects, but the mice that were given the painkiller for a week had testosterone production in their testes grafts reduced by 45 percent. The results have been published in the journal Science Translational Medicine

This research is obviously limited, because it was conducted on an animal model and doesn’t reflect the true environment of a human embryo. But a Danish study in 2010 also found a link between undescended testicles in male babies and painkiller use during pregnancy after looking at the babies of more than 2,000 pregnant women, so there’s enough evidence to warrant further investigation.

Of course, that doesn’t mean pregnant women should never take painkillers. In fact, there are times when taking paracetamol can be the best option for the baby.

“The study specifically relates to paracetamol use over at least several days,” Martin Ward-Platt, a spokesperson for the Royal College of Paediatrics and child Health in the UK, who wasn’t involved in the study, told the BBC. “Fever during pregnancy can be harmful to the developing embryo, with links to a significant increase in the rates of spina bifida and heart malformations, so small doses of paracetamol are sometimes necessary.”

The researchers are now looking into the exact duration and amount of paracetamol that triggers this testosterone drop in the developing testes, in order to provide safer and clearer guidelines for mothers in future.

Paracetamol may harm unborn boys’ fertility, pregnant women warned .

Scientists say study adds to existing evidence that too much paracetamol in pregnancy may increase risk of reproductive disorders in male babies

Paracetamol risk for unborn boys

Prolonged paracetamol use by pregnant women may reduce testosterone production in their unborn sons, research has found.

Scientists at the University of Edinburgh said their study adds to existing evidence that too much paracetamol in pregnancy may increase the risk of reproductive disorders in male babies.

They said expectant mothers should follow existing guidelines that the painkiller be taken at the lowest effective dose for the shortest possible time.

Research carried out on mice found that rodents given three doses of paracetamol a day for a week had a 45 per cent reduction in testosterone compared to a placebo.

The hormone, which is produced in the testicles, is crucial for life-long male health. Reduced exposure to testosterone in the womb has been linked to an increased risk of infertility, testicular cancer and undescended testicles.

Paracetamol ‘fails to ease low back pain’
NHS spends £80m a year on paracetamol prescriptions

The study saw scientists test the effect of paracetamol on mice carrying grafts of human testicular tissue, which have been shown to mimic how the developing testes grow and function during pregnancy.

They gave the mice a typical three-times daily dose of paracetamol over a period of either 24 hours or seven days, and measured the amount of testosterone produced by the human tissue an hour after the final dose of paracetamol.

They found there was no effect on testosterone production following 24 hours of paracetamol treatment, but after a week of exposure the amount of testosterone was reduced by 45 per cent.

Current NHS guidance on paracetamol use during pregnancy advises that, as with any medicine, it should be taken at the lowest effective dose for the shortest possible time.

Dr Rod Mitchell, of the University of Edinburgh, said: “This study adds to existing evidence that prolonged use of paracetamol in pregnancy may increase the risk of reproductive disorders in male babies.

“We would advise that pregnant women should follow current guidance that the painkiller be taken at the lowest effective dose for the shortest possible time.”

The Royal College of Midwives’ head of education, Carmel Lloyd, said: “If women do take medicines such as paracetamol when they are pregnant, they should use the lowest effective dose for the shortest possible time. If the recommended dose doesn’t control their symptoms or they are often in pain, they should seek more advice from their midwife or doctor.

“Ideally, women should avoid taking medicines when they are pregnant, particularly during the first three months. Minor conditions such as colds or minor aches and pains often do not need treating with medicines. If women feel they need to take medicines such as paracetamol when they are pregnant, they should talk to their midwife or doctor first; they can also get advice from their local pharmacy.”

Dr Martin Ward-Platt, of the Royal College of Paediatrics and Child Health, said: “The findings of this study send a clear message – expectant mothers should not prolong paracetamol use during pregnancy, only taking it when necessary and as per current NICE guidelines.

“However, the study specifically relates to paracetamol use over at least several days. There are times where one or two doses is needed to treat one-off episodes of fever for example. Fever during pregnancy can be harmful to the developing embryo, with links to a significant increase in the rates of spina bifida and heart malformations, so small doses of paracetamol are sometimes necessary.

“My message to expectant mothers is clear – avoid over-use of paracetamol but if you do have a fever, or any other sort of pain where you would normally use paracetamol, seek medical advice.”


Taking paracetamol has serious effects on your emotions, study finds

Paracetamol is one of the most commonly used painkillers – but scientists now believe it gets rid of feelings of pleasure as well as pain.

Taking paracetamol has serious effects on your emotions, study finds

Users don’t seem to be aware that their emotions have been affected, said the Ohio State University researchers.

Paracetamol is one of the most commonly used over-the-counter drugs, found in hundreds of medicines, and commonly prescribed long-term on the NHS for chronic pain.

Volunteers in a Ohio State University study found that paracetamol users felt less strong emotions in response to a series of photos such as images of kittens.

Lead author Geoffrey Durso said, ‘Most people probably aren’t aware of how their emotions may be impacted when they take paracetamol.

‘Rather than just being a pain reliever, acetaminophen can be seen as an all-purpose emotion reliever.

Paracetamol ‘no good for back pain’


Back pain

Paracetamol is ineffective at treating back pain and osteoarthritis despite being a recommended treatment, a group of Australian researchers has warned.

Their review of 13 clinical trials, published in the British Medical Journal, said the drug did not reduce disability or improve quality of life.

Instead, the group warned, it increased the odds of liver problems.

The NHS is to review its guidelines. Experts say patients should consult a doctor before changing medicines.

Back pain is a leading cause of disability and in the UK alone it is estimated to affect 26 million people each year.

The National Institute for Health and Care Excellence (NICE), which establishes best NHS practice, currently recommends paracetamol for both lower back painand for osteoarthritis.

However, questions have been raised about the quality of the evidence which led to the decisions.

A team at the University of Sydney assessed data from 13 drug trials involving more than 5,000 patients.

They concluded that paracetamol was “ineffective” at reducing back pain.

In osteoarthritis in the hip or knee, they found a small improvement with paracetamol. Yet the impact was so small it was “not clinically important”.

Man with backpain

Gustavo Machado, one of the researchers, argued: “Paracetamol is the most widely used over-the counter medicine for musculoskeletal conditions so it is critical that we review treatment recommendations in light of this new evidence.

“In our research, paracetamol for low back pain and osteoarthritis was also shown to be associated with higher risk of liver toxicity in patients.

“Patients were nearly four times more likely to have abnormal results on liver function tests compared to those taking placebo pills.”


Dr Christian Mallen, from Keele University in the UK, said options other than drugs should be the “cornerstone” of managing the conditions.

However, he added: “While the effectiveness of exercise for both osteoarthritis and spinal pain is established, we know that uptake of and adherence to exercise is poor.”

In the UK, the safety of over-the-counter drugs is being reviewed by the medicines safety regulator.

NICE said it was waiting for the results of that review before conducting its own assessment.

A spokesperson said: “Looking at all of the relevant painkillers together, instead of just one, will then provide a comprehensive overview of this aspect of managing osteoarthritis.”

Jane Tadman from Arthritis Research UK said: “We’ve known for some time that paracetamol may not work for everyone with severe pain from their arthritis, but some people find it helps them and allows them to sleep and to exercise without discomfort.

“Physical activity is probably a better and more effective way of keeping the pain of arthritis and joint pain at bay than taking currently available painkillers.”

Prof Roger Knaggs, from the Royal Pharmaceutical Society, said: “There are other medicines, such as nonsteroidal anti-inflammatory drugs and opioids, which may provide better pain relief but these are associated with a range of other side-effects.

“Anybody with concerns about whether taking paracetamol could cause harm should discuss their concerns with their GP or pharmacist.”