Aspirin – Update on the Risks and AlternativesZoltan P. Rona, MD, MSc April 1, 2023
In May 2014, the U.S. Food and Drug Administration (FDA) advised against the use of aspirin to prevent heart attacks or strokes in people with no history of these diseases. This is because there was no evidence proving any benefit.
Despite this proclamation, I continued to see many healthy patients in my private practice swallowing daily aspirin tablets on the recommendation of either their family doctors or specialists. All that it appears to have done for healthy people was to give them false hope or a religious experience.
At best, it provides a good placebo effect or a benefit in terms of some blood loss for those with high ferritin (iron) levels. Another way of looking at recommending aspirin to healthy people is to see it as a religion without scientific evidence that backs it up.
The FDA made a point of saying that the use of aspirin exposes the public to serious risks of bleeding in the stomach and brain. While the blood thinning benefits of aspirin in people who have already had heart attacks is not being questioned here, the evidence that it can prevent a first heart attack has not been forthcoming. The bottom line here is that there is no proof that healthy people need to take a daily aspirin tablet to prevent disease. Aspirin generated $1.27 billion in sales for Bayer in 2013, which in my opinion was money poorly spent.
Media hype and doctor recommendations are responsible for the over 50 million people in North America taking aspirin regularly. Fear of disease appears to be the main driving force behind this. Aside from its widely recognized use as an analgesic and anti-inflammatory agent, aspirin has become increasingly popular with the medical profession for a growing list of other maladies.
Despite a lack of evidence, the American Heart Association recommends aspirin for the prevention and treatment of heart disease and stroke, while the American College of Chest Physicians recommends it for any of the risk factors for coronary artery disease including obesity, diabetes, elevated LDL-cholesterol, high blood pressure, smoking, and a family history of heart disease.
Proponents of daily aspirin use offer false hope for both the prevention and treatment of obesity, heart disease, stroke, cancer, tension headaches, arthritis, and seemingly every human discomfort. Yet according to the FDA, the science to support any of these claims is simply not there.
Aspirin Side Effects
“Each year, use of NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) accounts for an estimated 7,600 deaths and 76,000 hospitalizations in the U.S.” (NSAIDs include aspirin, ibuprofen, naproxen, diclo-fenac, ketoprofen, tiaprofenic acid.)”
Aspirin side effects include the following:
• Age related macular degeneration (AMD) was one condition about which a finding was published in a 2012 edition of the Journal of The American Medical Association that showed a “small but statistically significant association” between frequent aspirin use and a rare form of AMD, a leading cause of blindness.
• Bleeding gastrointestinal irritation (heartburn, nausea, vomiting, diarrhea, inflammatory bowel disease)
• Cancer: Aspirin has been linked to pancreatic cancer according to one study; more studies are needed to conclusively prove this connection.
• Erectile Dysfunction is another unwanted side effect of daily aspirin use. One study showed a 22% increase of this problem in daily aspirin users.
• Increased gastric permeability leading to leaky gut syndrome and altered immunity.
• Gastrointestinal hemorrhage (ulcers): A Searle news release noted that GI complications caused by NSAIDs remain one of the most prevalent drug toxicities in the nation – leading to approximately 76,000 hospitalizations and 7,600 deaths annually – a mortality rate comparable to that of asthma, cervical cancer, or melanoma (skin cancer).
• Hemorrhagic stroke: Heavy doses of 325-milligram adult aspirin (for example, 15 or more tablets a week) can double the risk of hemorrhagic stroke. Older women with high blood pressure, taking large doses of aspirin, can triple their risk of hemorrhagic stroke. In elderly patients with atrial fibrillation, the benefit of prophylactic aspirin to prevent strokes is unproven.
- In addition, aspirin has other unwelcome side effects:
• Aspirin can prolong pregnancy and childbirth and lead to bleeding in both baby and mother.
• Susceptible regular aspirin or acetaminophen users are two to three times more likely to experience the beginning stages of chronic kidney failure, compared with those who do not use these painkillers on a regular basis. About 15% of the people on dialysis today are there as a result of the damage that Tylenol and/or aspirin did to their kidneys.
• Both aspirin and acetaminophen may also be associated with diverticular disease of the colon.
• People who are taking aspirin in combination with the blood-pressure-lowering ACE inhibitor drugs after angioplasty may be at risk for a dangerous drug interaction and a three-fold increase in risk of death.
• Prolonged aspirin use may raise the risk for cataracts; the long-term (more than 10 years) use of aspirin is associated with a 44% higher increase of posterior subcapsular cataracts, compared with nonusers or short-term users of the drug. Posterior subcapsular cataracts are the most common and most disabling form of cataract. This aspirin-related risk is larger among younger (under 65 years of age) individuals compared with older subjects. (Ophthalmology 1998; 105:1751-1758).
• Chronic rhinitis and nasal polyps: aspirin sensitivity sinusitis may cause long-term facial pain, headaches, and a loss of smell.
• Hives (urticaria), and hyperactivity
• Reye’s Syndrome in children; aspirin is the leading cause of poisoning in young children.
• Ringing in the ears (tinnitus), and hearing loss
• Vertigo, mental confusion, and drowsiness
• Excessive sweating and thirst
• Inhibition of cartilage repair and accelerated cartilage destruction
There is a mortality of 2% in cases of acute aspirin overdose. Chronic overdose carries a 25% death rate. Some signs and symptoms may range from mild nausea and vomiting, abdominal pain, lethargy, ringing in the ears, dizziness, seizure, or cerebral edema depending on the dose consumed. Treatments for toxicity include activated charcoal, intravenous dextrose and normal saline, sodium bicarbonate, and dialysis.
How Does Aspirin Work?
A chemist walks into a pharmacy and asks the pharmacist, “Do you have any acetylsalicylic acid?” The pharmacist asks, “Do you mean aspirin?” The chemist replies, “That’s it, I can never remember that word.”
Aspirin prevents blood-clotting factors called platelets from sticking to each other. It does so by blocking a platelet enzyme called cyclooxygenase. Aspirin, by inhibiting cyclooxygenase, can decrease the production of lipid peroxides (free radicals) and thromboxane, a powerful vasoconstrictor. This enzyme inhibition lasts for the lifetime of the platelet, which is approximately 10 days. Aspirin suppresses the activity of pro-inflammatory chemicals in the body known as the PGE2 family of prostaglandins. It thus indirectly increases the activity of anti-inflammatory prostaglandins of the PGE1 family.
There are some researchers and clinicians who have been able to demonstrate a direct link between the presence of fungi in the body and cardiovascular disease of all kinds. This is known as the “fungal mycotoxin etiology of atherosclerosis” and has been promoted by Dr. Costantini and other researchers working for the World Health Organization. According to these doctors, aspirin is an antifungal drug, which can go a long way towards offsetting the negative effects of fungi and their mycotoxins. They believe that it is this antifungal property of aspirin which prevents heart disease, stroke and cancer – diseases all suspected to have a fungal mycotoxin etiology. Dandruff, a scalp condition caused by fungi, often responds well to shampoos containing aspirin or salicylate derivatives.
Top 10 Natural Alternatives to Aspirin
1) GLA (GAMMA LINOLENIC ACID) found in plants like borage, black currant seed, and evening primrose has been shown to increase activity of the PGE1 family, producing an anti-inflammatory effect similar to aspirin. Flaxseed oil does not contain GLA, but is rich in linoleic acid which can be converted to GLA in the body to produce these same anti-inflammatory effects. GLA has been documented to lower serum cholesterol, reverse some cases of obesity, clear eczema, lower blood pressure, control allergies, improve autoimmune disease, and prevent arthritis.
2) VITAMIN E (mixed tocopherols) in high doses retards blood clotting. Caution should be exercised if one is using both aspirin and vitamin E (or blood thinners like coumadin with vitamin E) because the combinations have a synergistic effect. Studies indicate that supplementation of as little as 200 IU daily in men can reduce the risk of a heart attack by 46%; in women the risk reduction is 26%. Whether natural source or synthetic source, all forms supply the body with at least some vitamin E activity. The natural forms of vitamin E are d-alpha-tocopherol, d-alpha-tocopheryl acetate, d-alpha-tocopheryl succinate, and mixed tocopherols. The synthetic forms are dl-alpha-tocopherol, dl-alpha-tocopheryl acetate, or dl-alpha-tocopheryl succinate.
Studies indicate that the most biologically active are the esterified natural forms – d-alpha-tocopheryl acetate and d-alpha-tocopheryl succinate. Both have been found to provide full antioxidant activity in the body and are the ones recommended by the top authorities on vitamin E at the Shute Institute and Medical Clinic in London, Ontario.
Recent studies indicate that excessively high levels of stored iron in the body (ferritin) are associated with a greater risk of heart disease and diabetes. High dose vitamin E supplements can interfere with iron absorption. If you have been prescribed iron to correct iron deficiency, take your iron supplement about 12 hours apart from vitamin E. Iron absorption is enhanced by sufficient acid in the stomach. Iron destroys vitamin E in the body.
3) GARLIC is probably the best-known herb that lowers cholesterol (by up to 10%) and triglycerides (by up to 13%) while raising “good” HDL-cholesterol (by up to 31%). Garlic prevents thrombus formation and lowers blood pressure. It prevents platelet stickiness and has natural anti-bacterial, anti-fungal, and anti-parasitic properties. Onions also have these effects, but are not as strongly as garlic. A 2006 study from the Journal of Nutrition showed that aged garlic is also able to retard the progression of coronary artery calcification, which can lead to arterial blockages.
4) MAGNESIUM has anticoagulant properties which, when combined with vitamin E, produce significant blood clotting reduction. In practice, it is always wise to balance magnesium intake with both calcium and potassium.
5) OMEGA-3-EPA oils reduce platelet stickiness. Good dietary sources include flaxseed oil, rice bran oil, trout, mackerel, salmon, herring, sardines, cod, halibut, and shark. With fish consumption there are mercury toxicity issues, especially with larger fish like tuna and sea bass. If you want to get omega-3 without the mercury, you will have to use a supplement because, by law, any omega-3 sold in Canada must be mercury-free.
6) POLICOSANOL an extract made from the wax of sugar cane, can lower LDL cholesterol while increasing good HDL cholesterol. Policosanol reduces inflammation and inhibits abnormal platelet aggregation, which promotes arterial blood clotting.
7) GINKGO BILOBA extract from the oldest surviving tree species on earth (dating back over 300 million years) contains flavonoids and terpenoids, which inhibit or prevent blood clot formation. Ginkgo also has potent antioxidant properties and may benefit numerous circulatory problems, including those associated with impotence.
8) BROMELAIN is a proteolytic enzyme (helps digest protein) which is not only anti-inflammatory in its effects, but prevents excessive coagulation of the blood by clearing undigested fibrin and other harmful proteins out of the bloodstream.
9) SERRAPEPTASE is an enzyme derived from the silkworm which appears to be one of the most potent and effective of all the anti-inflammatory enzymes. In high enough doses, serrapeptase is capable of dissolving atherosclerotic plaque. See more at: https://vitalitymagazine.com/article/reversing-chronic-inflammation
10) CURCUMIN (BCM-95 extract of turmeric) is a very powerful anti-inflammatory and analgesic agent that is well documented to provide aspirin-like effects without any of the side effects. My favourite form of curcumin is the BCM-95 extract of turmeric. It’s 100% natural and has at least seven times the absorption rate of synthetic versions. It does not require any special additive, natural or otherwise, to enhance absorption and is well tolerated. An effective anti-inflammatory dose of curcumin for most conditions is 1000 mg, three times daily with food. See more at: https://vitalitymagazine.com/article/natural-alternatives-to-cortisone
Caveat: If one continues to eat a lot of sugar, refined foods, saturated fat (e.g. red meat, fried foods, dairy products, etc.), and if one does not exercise, smokes cigarettes, and drinks alcohol to excess, neither aspirin nor any of the aforementioned alternatives can be guaranteed to do much good. Exercise releases endorphins – powerful chemicals made by the body that reduce inflammation and subsequent pain.
Other Aspirin Alternatives
• Devil’s claw root powder
• Cloves (especially useful for toothaches)
• Ginger root
• Licorice root
• Wood betony
• White willow bark
• Proteolytic pancreatic digestive enzymes (Wobenzyme, pancreatin)
• Echinacea (in very high dosages, well above those which control infections, echinacea is effective, especially for toothaches)
Many of these nutrients are sold in combination form at health food stores. A naturopath or medical doctor familiar with these remedies can recommend specific dosages. The world’s leading medical journals are increasingly reporting that diet and lifestyle changes by themselves can reverse hardening of the arteries and its complications.
Natural aspirin alternatives are hundreds of times safer. Discuss this issue with your health care practitioner and use his or her experience and expertise to guide you with an individualized health program.
Note: This article is not intended to replace the advice of your physician. For any changes to your healthcare regimen, please consult a qualified health professional.
• Gaudreault, P; Temple, AR; Lovejoy Fh, FH (October 1982). “The Relative Severity of Acute versus Chronic Salicylate Poisoning in Children: a Clinical Comparison”. Pediatrics 70 (4): 566–9.
• Marx, John (2006). Rosen’s Emergency Medicine: Concepts and Clinical Practice. Mosby/Elsevier. p. 2242.
• Use of Aspirin for Primary Prevention of Heart Attack and Stroke https://www.fda.gov/Drugs/ResourcesForYou/Consumers/ucm390574.htm
• Erectile Dysfunction and Aspirin. 2011: https://articles.latimes.com/2011/mar/03/opinion/la-heb-ed-aspirin-03032011
• Bloomberg News. May 5, 2014. Limit Use of Aspirin to Prevent Heart Attack, FDA says: https://tinyurl.com/pter34g
• Aged Garlic Extract Retards Progression of Coronary Artery Calcification. 2006: https://tinyurl.com/lqgk7gc
• Aspirin Linked to Rare Form of Vision Losshttps: https://healthland.time.com/2012/12/18/aspirin-linked-to-rare-form-of-vision-loss/
• On the research regarding curcumin: https://www.ncbi.nlm.nih.gov/pubmed/18324353
• Aspirin and Strokes: https://stroke.ahajournals.org/content/29/5/887.full
• Aspirin and Pancreatic Cancer: https://www.dailymail.co.uk/health/ article-205490/Asprin-link-cancer-risk.html
• Costantini, A.V., Wieland, H., and Qvick, Lars I. Fungalbionics, The Fungal/Mycotoxin Etiology of Human Disease, Vol. 1 Atherosclerosis & Vol. II Cancer. Freiberg, Germany: Johann Friedrich Oberlin Verlag, 1994. Available in Canada from Fungal/Mycotoxin Conference, 12 Sifton Place, Brampton, Ont. L6Y 2N8; 905-450-0445
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Zoltan P. Rona, MD, MSc, offers consultations on nutrition and natural remedies in Thornhill. He has recently retired from medical practice as a Complementary and Alternative medical practitioner and now strictly offers nutritional consultations. He is the medical editor of The Encyclopedia of Natural Healing and has also published several Canadian bestselling books, including Vitamin D, The Sunshine Vitamin. To see more of Dr. Rona’s articles, visit: www.highlevelwellness.ca and for appointments, please call (905) 764-8700; office located at: 390 Steeles Ave. W., Unit 19, Thornhill, Ontario