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Sunday, November 6, 2011

Aspirin: Do the Benefits Outweigh the Risks?


A recent article published in the Lancet reported that long-term daily use of aspirin can reduce the risk of colon cancer.

A daily aspirin has also been promoted as a way to reduce the risk heart attacks and stroke, although a recent meta-analysis of randomized trials (a study of the best studies) found little scientific evidence to support this practice.

But what are the risks of taking aspirin every day?
  •  Increased bleeding and bruising
  • Nausea, heartburn, vomiting, diarrhea
  • Allergic reaction, skin rash, difficulty breathing, seizures
  • Tinnitus (ringing in the ears) and hearing loss
  • Lower levels of hemoglobin and increased risk of anemia
  • Gastrointestinal bleeding and ulcers
  • Hemorrhagic stroke

That's right: Aspirin may decrease the risk of an ischemic stroke, caused by a blood clot, but it can increase the risk of a hemorrhagic stroke, caused by bleeding in the brain.

Additionally, a recent study reported that regular aspirin use can increase the risk of developing Crohn's disease, an inflammatory and autoimmune disease of the gastrointestinal tract. Researchers in the UK followed more than 135,000 European adults between the ages of 30 and 74, and found that a daily dose of aspirin was associated with six-fold increase in Crohn's disease.

It's also important to remember that aspirin can have dangerous interactions when combined with certain medications and supplements including:
  • Alcohol
  • Warfarin (Coumadin)
  • Heparin
  • Ibuprofen (Advil, Motrin)
  • Corticosteroids
  • Some antidepressants (clomipramine, paroxetine)
  • Omega-3 fatty acids and fish oil
  •  Evening primrose oil
  • Policosanol
  • Ginkgo biloba

Like aspirin, fish oil can prevent blood clots and fight inflammation.
It can also reduce the risk of cancer and heart disease, without the side effects of aspirin. And fish oil is a good source of healthy fat.

Also like aspirin, fish oil can interact with medications and supplements. Before you start any new supplement, including fish oil, talk to your naturopathic doctor for individualized recommendations. 

References:

Berger JS et al. Aspirin for the prevention of cardiovascular events in patients without clinical cardiovascular disease: a meta-analysis of randomized trials. American Heart Journal. 2011 Jul;162(1):115-24.e2.

Chan SS et al. Aspirin in the aetiology of Crohn's disease and ulcerative colitis: a European prospective cohort study. Alimentary Pharmacology and Therapeutics. 2011 Sep;34(6):649-55. doi: 10.1111/j.1365-2036.2011.04784.x.

Goldstein JL et al. Haemoglobin decreases in NSAID users over time: an analysis of two large outcome trials. Alimentary Pharmacology and Therapeutics. 2011 Oct;34(7):808-16. doi: 10.1111/j.1365-2036.2011.04790.x.

Rothwell PM et al. Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Lancet. 2010 Nov 20;376(9754):1741-50.

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