| The Truth About Aspirin It may not protect your heart... but natural solutions can Mark Stengler, ND
La Jolla Whole Health Clinic
Special from Bottom Line/Natural Healing
March 1, 2009
E very morning, some 50 million Americans pop a low-dose aspirin into their mouths with the hope that it will help prevent a heart attack or stroke. For many, taking a daily aspirin is a habit, a no-brainer -- a seemingly simple way to protect against cardiovascular disease. The problem: Aspirin is overprescribed and causes many uncomfortable and possibly dangerous side effects. In addition, a little-known phenomenon called aspirin resistance means that, for some people, aspirin provides no protection at all. Good news: There are several natural alternatives to aspirin that have the potential to help more people without the damaging side effects. What Is Aspirin? Aspirin-like substances date back to the ancient Greeks, who used a powder made from willow tree bark to relieve fever and pain. Aspirin belongs to a class of drugs called nonsteroidal anti-inflammatory drugs (NSAIDs). They work by inhibiting the enzymes that make prostaglandins, chemicals that promote inflammation, pain and fever, and are necessary for blood clotting. Aspirin's Serious Side Effects People often think of aspirin as a completely benign substance. It is not. In fact, its side effects may surprise you...  Gastrointestinal bleeding. In the US, about 103,000 hospitalizations and 16,500 deaths occur annually from gastrointestinal bleeding related to NSAIDs, including aspirin.
Dyspepsia. This condition, which is characterized by pain or discomfort in the upper abdomen, is reported by 12% of users of aspirin and other NSAIDs. Gastroduodenal lesions. In a study of arthritic patients taking NSAIDs for pain, 30% developed painful gastroduodenal lesions or sores in the stomach and/or small intestine. Cataracts. Prolonged aspirin use can increase risk for cataracts (hardening and clouding of the lens of the eye) by 55%, according to a study in Ophthalmology. Aspirin Resistance For a number of people, aspirin neither prevents blood clots nor reduces inflammation. Aspirin resistance has no symptoms. Sadly, people find out that the daily aspirin they are taking has no effect only when they suffer a heart attack or stroke. There currently is no single laboratory test for, or accepted definition of, aspirin resistance. Estimates of how many people are aspirin resistant vary widely, from as low as 5.5% to an astonishing 60%, according to a recent study in Journal of the American College of Cardiology. Aspirin is a mild anticoagulant -- it reduces the risk of an abnormal blood clot forming that could cause a heart attack or stroke. Stronger anticlotting medication, such as warfarin (Coumadin) or heparin, generally is given to people who are at higher risk of developing blood clots. Possible side effects from these stronger medications include hemorrhage and hypersensitivity (characterized by chills, asthma, red marks and itchy skin). Natural Anticlotting Protection Everyone concerned with heart health should follow a Mediterranean-style diet, consisting mainly of whole grains, vegetables and olive oil, as well as cold-water fish, such as salmon. This type of diet has been shown to significantly reduce the risk for heart attack and stroke. Next: Take steps to reduce your risk for cardiovascular disease. Risk is determined by age, gender, family and medical history, smoking, cholesterol levels and other cardiovascular risk markers, blood pressure, weight and whether you have diabetes. In addition, holistic physicians often use a blood test to track fibrinogen, a protein essential to blood clot formation. High fibrinogen levels can indicate a risk of developing a blood clot. I monitor fibrinogen levels and use a laboratory test to measure the time it takes for a patient's blood to clot. I order these tests every few months until the readings are normal. If you are already taking any anticoagulant medication, including aspirin, check with your doctor before taking any of the supplements below. People who take an anticoagulant are at greater risk for hemorrhage because the medication reduces the body’s ability to form a blood clot and stop internal or external bleeding. My recommendations: Three natural anticoagulants -- and one clot-busting enzyme -- can be used in place of aspirin. These supplements, which are available at health-food stores, can be used as follows... For those who don't have heart disease and want to prevent it, take fish oil, vitamin E and bromelain. For those with atherosclerosis (fatty buildup in the arteries), take nattokinase and fish oil. For those with elevated fibrinogen, take nattokinase and fish oil, and then add vitamin E and bromelain if lab tests indicate fibrinogen has not decreased after two months. Fish oil. Omega-3 essential fatty acids are necessary for natural cardiovascular disease prevention and treatment. Research has shown that patients with coronary artery disease (plaque in the arteries of the heart) who were given fish oil supplements had a mild-to-moderate regression of atherosclerosis as measured by angiography. This means that even people with existing plaque have a chance to reduce it with fish oil. The beneficial omega-3 fatty acids in fish oil are combined eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Best fish sources: Oily, cold-water fish (salmon, herring, sardines, mackerel, anchovies), either broiled or baked. (Vegetarians can get their omega-3s from flaxseed or hemp seed.) To prevent coronary disease, consume two to three servings of fish weekly or take 1,500 milligrams (mg) daily of combined EPA and DHA. For those who already have atherosclerosis and high levels of fibrinogen, take 3,000 mg daily of combined EPA and DHA (1,500 mg twice daily with meals). Keeping atherosclerosis under control can be a lifelong battle, so patients can take these amounts indefinitely. Vitamin E. In moderate doses, this antioxidant has natural blood-thinning properties. Vitamin E is a collection of eight related compounds -- tocopherols and tocotrienols. Look for mixed tocopherol and tocotrienol vitamin E -- it is better than any single tocopherol formulation. Take 800 international units (IU) to 1,200 IU daily. Ask your holistic doctor or cardiologist about the amount that is right for you based on your cardiovascular health. Bromelain. Found in pineapples, this enzyme acts as an anticoagulant by helping to break down excess fibrin (a blood protein made from fibrinogen that forms at the site of a blood clot). Take 500 mg three times daily, not around mealtimes. If you have ulcers, don't take bromelain. Nattokinase. Extracted from the traditional Japanese food natto, this enzyme is made from fermented soybeans. With its strong fibrin-dissolving effect, nattokinase is a more aggressive approach to treatment than other natural therapies. It is recommended for people with elevated fibrinogen or a history of heart disease. Researchers have found that it can effectively and safely prevent blood clots without any side effects. Some holistic practitioners have even been able to help their patients who are taking medications such as warfarin switch to nattokinase. For people with atherosclerosis or high fibrinogen, take 2,000 fibrinolytic units (FU) to 4,000 FU of a nattokinase supplement twice daily under the supervision of a health-care professional. Supervision is important with all anticoagulants because there is the danger that too much can lead to hemorrhage and too little to heart attack or stroke. Nattokinase should not be taken with other blood thinners, such as aspirin or warfarin. Who Should Take Aspirin For some people, aspirin is indeed a lifesaver. With few exceptions, anyone who thinks he/she is having a heart attack should chew and swallow 325 mg of aspirin immediately. (Chewing any of the supplements will not have the same effect.) Most heart attack patients also are advised to continue taking this amount daily for one month under a cardiologist's care -- because people who survive a heart attack are especially prone to another one in the weeks afterward. After one month, I believe only one group should continue to take aspirin -- those at high risk for cardiovascular disease who are unwilling to take supplements and change their diets and lifestyles. Caution: Don't take aspirin if you are allergic to it... suspect that you are having a stroke... or have been told by your physician not to take it. If you are on aspirin therapy, keep in mind that regular use can deplete your body of several nutrients. To protect yourself, take the following daily -- folic acid (400 micrograms, or mcg), vitamin C (500 mg), vitamin B-12 (100 mcg), zinc (30 mg). When using zinc long-term, also take copper (1 mg). Best: Don't take these supplements at the same time of day that you take aspirin. Who Should DEFINITELY Not Take Aspirin I disagree with the way many doctors routinely put patients with any risk for cardiovascular disease (or no particular risk at all) on a daily aspirin. This includes a wide swath of people -- men over age 40... women over age 50 who have atherosclerosis or high cholesterol... people over age 40 who have diabetes... people who have a parent or sibling with heart disease... and others. In addition, some people should flat-out avoid aspirin (although after a heart attack, a cardiologist would determine use), including... People with active peptic ulcers. Aspirin erodes the stomach lining. Those with poor kidney or liver function. Aspirin can further damage these organs. Patients taking anticoagulant medications, such as warfarin. It can increase the risk of bleeding. Asthma patients. Aspirin can make breathing difficult in some patients whose asthma is triggered by the chemicals in aspirin.
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