Q. Is it a good idea to take aspirin every day? If so, how much? If not, what can I do instead?
A. Aspirin is one of the most used of medicines, but it is a medicine, so it is very important that you talk to your doctor before deciding if regular aspirin use is right for you. You should not take aspirin if you have an inherited bleeding disorder, like hemophilia, or liver disease that results in a bleeding disorder, or if you have a history of the kind of stroke caused by bleeding into the brain.
Other conditions that aspirin may make worse include:
• an allergy to aspirin or other salicylates,
• asthma,
• stomach ulcers or a history of stomach ulcers,
• reduced kidney function,
• uncontrolled high blood pressure, or if you use “ACE” blood pressure medicines.
Use of aspirin for more than 10 years has been associated with a 44% increase in the most common and most disabling form of cataracts, especially among individuals younger than 65 years of age.
Aspirin has long been used when needed to reduce pain and fever, but more recently daily use has been widely recommended to reduce heart disease and strokes, and it may even prevent some forms of cancer. Only people who have never had a heart attack but who are at risk of having one soon may benefit. In these people, use of as little as one-quarter of an aspirin (81 milligrams) every three days can reduce the risk of coronary heart disease. Increasing even to 300 milligrams every day does not yield extra benefit. Enteric coated aspirin has a similar risk of bleeding or perforation as plain aspirin. If one uses aspirin for as long as three months, it should not be discontinued abruptly since stopping appears to result in an unexpectedly high risk of serious heart problems.
The situation with aspirin illustrates the contrast between medicines and nutrients. Because aspirin is a drug, it operates within minutes, but if used regularly it may have undesirable side effects. Nutrients typically require weeks of regular use to produce noticeable benefits, but seldom produce any ill effects. For instance, a major action of aspirin is to block inflammatory prostaglandins. This can also be accomplished with supplements of gamma linolenic acid, obtained from a borage oil supplement. Aspirin “thins” the blood, resulting in improved circulation. The same thing can be accomplished, in time and without side effects, with a magnesium supplement combined with a fish oil supplement.
Proponents of routine aspirin use make the point that aspirin as a single substance has many potential positive actions, while it requires many (about 50) nutrients as well as some dietary changes to realize your goals from nutritional intervention. However, the advantage of the nutritional approach is that any side effects will likely be only unforeseen benefits.
Nutrients cannot compete with aspirin for quick pain relief, but occasional use is quite different from regular use. There is a time and place for both.
This article appears in November 12 • 2004.