22 Feb Aspirin is Not as Safe as You May Think
Public health authorities have long recommended that people over 50 start low-dose aspirin therapy (a "baby aspirin" or daily 81 mg dose) for inflammation and the prevention of heart disease(1); however, evidence suggests aspirin's dangers outweigh any benefits.
Why do so many people overlook warnings when it comes to taking aspirin? The dangers of aspirin are not as publicized as the adverse effects of NSAIDs, such as ibuprofen.
This may be because aspirin works to reduce hormone-like substances in the body that promote inflammation and blood clotting. But it's likely that some individuals who are taking aspirin for an extended period are not at a significant risk of a heart attack or stroke, thereby putting themselves in danger. Researchers warn that aspirin isn't as effective as claimed, and it's not so harmless either.
Why Isn’t Aspirin as Beneficial as We May Think?
For people with no history of heart disease, the Food and Drug Administration (FDA)(2) concludes that aspirin shouldn't be used routinely. The FDA "does not believe the evidence supports the general use of aspirin for primary prevention of a heart attack or stroke."
Aspirin Has No Beneficial Effects on Healthy Lifespan
A large National Institutes of Health-funded study(3) discovered that using aspirin as a preventative therapy has no beneficial effects on “healthy lifespan”—classified as a life free of persistent physical disability or dementia—in older adults.
Furthermore, the researchers believe that any healthy person over the age of 70 should stop taking aspirin. At that age, providing you don't have heart problems, the risk of taking aspirin start to outweigh the benefits.
In fact, researchers conclude that for a healthy 45-year-old the way to prevent heart disease is by eating healthy and exercising regularly, not by using aspirin. When two groups were analyzed—those taking 100 mg of aspirin and those receiving a placebo—there was no difference in the number of cardiovascular disease cases after seven years.
Dangers of Aspirin: Hemorrhage
Rates of life-threatening hemorrhages(4), such as hemorrhagic stroke and bleeding in the stomach, are much higher in those taking aspirin.
Some people take a baby aspirin every day to thin their blood to prevent a stroke. Sometimes, however, strokes are caused by bleeding in the brain. And when blood-thinning aspirin(5) is taken, it will only exacerbate the problem, which could potentially lead to permanent brain damage or death.
Even though GI bleeding is a known side-effect of taking aspirin, research shows that the risk is greater than many believe, and by the time you reach the age of 75, it becomes life-threatening. By then, the risk of a major stomach bleed is four times more likely than in younger age groups.
Research out of Oxford University discovered that among individuals under the age of 65 taking aspirin, the rate of life-threatening or fatal bleeds was far less; approximately one person out of every 200. Nonetheless, this risk continues to grow the older people get.
Dangers of Aspirin: Ulcers and Intestinal Permeability
Regular use of aspirin is the second leading cause of ulcers, according to the American College of Gastroenterology. Further complications can manifest because of the irritation of the stomach lining, including bleeding or perforated ulcers. It’s conclusive that aspirin and Helicobacter pylori(6), a type of bacteria that infects the stomach, both contribute to ulcer development.
Aspirin was once considered safe beyond the first part of the small intestine, given its rapid absorption in the gastric mucosa. But a few studies have shown that aspirin—even a single dose(7)—can increase intestinal permeability(8) or leaky gut.
Your intestinal barrier plays the role of a gatekeeper. It allows for the absorption of nutrients, while at the same time, protects against the entry of bacteria, fungi, and parasites, as well as allergens. When the barrier malfunctions as in intestinal permeability, it can cause autoimmune disorders and allergies.
Is There an Upside to Aspirin?
The studies that are in favor of using aspirin as a preventative measure suggest that aspirin could decrease your risk of a stroke or heart attack, by about 10 percent. A similar picture is seen with colon cancer.
However, when you factor in the dangers of aspirin, such as life-threatening bleeding from the GI tract or brain, ulcers, and intestinal permeability, the risk-reward ratio becomes a very fine balance.
And compare that to the simple fact that thousands of cancer and heart disease cases a year can be prevented with diet, exercise, stress relief, and suitable dietary supplements.
In My Practice
In my practice, I do occasionally recommend a baby aspirin per day but it is usually the exception and not the rule, and more often than not, I take people off aspirin, as the risks outweigh the perceived benefits. And for cardiovascular risk prevention, there is so much more we can do with lifestyle and nutrition, which comes with no significant risk factors.
If you are taking aspiring routinely or are considering going on an aspirin regimen, have a frank discussion with your health provider. It may be the right decision for your circumstances, just don't assume it is totally safe, and be an informed health consumer.
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