What are the potential risks & benefits of ASA:
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Evidence in support of using daily ASA [aspirin] 81 mg to prevent heart attack has gone from weak to weaker to nonexistent as supported by recent published research in medical literature.
The risk of using daily ASA to prevent heart attack exceeds any benefits.
Patients taking aspirin showed a higher risk for recurrent heart attack and associated heart problems.
British meta-analysis of 7374 diabetics concluded that aspirin does not lower heart attack risk.
ASA interferes with prostaglandin and platelets the blood cells that allow blood to clot. Long term low dose aspirin therapy may double the risk for a gastrointestinal bleeding.
ASA use also destroys the lining of the gastrointestinal tract, increasing the risk for duodenal ulcers, H. Pylori infection Crohns disease, diverticular disease, inflammatory bowel disease (IBD), and intestinal perforations. More than 10 percent of patients taking low-dose aspirin develop gastric ulcers.
Aspirin also depletes the body of important nutrients, including vitamin C, vitamin E, folic acid, iron, potassium, sodium, melatonin and zinc.
ASA and other NSAIDs have been linked to a 22 percent increase in the risk of erectile dysfunction (ED), according to Kaiser researchers who studied more than 80,000 men.
Frequent use of ASA can induce Breast Cancer in women, macular degeneration, cataracts and kidney failure.
Using heart healthy diet, avoiding trans fats, sugar, and following the wellness IQ protocol [in this website] is much safer yet effective method to prevent heart attacks. There are natural antioxidants published in the American College of Cardiology shown to be more effective than ASA with no side effect. Email us for details.
Ulcers are open sores that can occur in various areas of the body. In the stomach, these sores are known as peptic, or gastric, ulcers and are usually in the stomach lining, where stomach acid continues the damage. Duodenal ulcers occur in the duodenum, the first section of the small intestine.
Symptoms for both kinds of ulcers include a burning stomach sensation, belching, bloating, vomiting, and nausea. Duodenal ulcers may also cause back pain.
If left untreated, both peptic and duodenal ulcers may eat through the stomach wall or duodenum, causing the sudden onset of serious pain requiring immediate medical attention. In other instances, ulcers cause bleeding that may be visible in bowel movements or after vomiting.
There are a number of tests your doctor can request to determine if you have an ulcer. These may include:
An endoscopy, inserting a small camera into your intestinal tract
A stomach acid test
Tests for the presence of H. pylori within blood, stool, or tissue samples
If your physician determines that you do have an ulcer, you will be given antibiotics to rid your stomach and intestines of the H. pylori, as well as acid blocking medication to reduce stomach acid while the ulcer heals. (Even if your ulcer is caused by NSAIDs, reducing H. pylori has a positive effect.)
I have found an antibiotic alternative that works extremely well.
Mastica, derived from a Greek shrub, has been used since Roman times to treat stomach ailments of all kinds. Research shows that mastica supplements eliminate H. pylori, allowing patients to avoid the downsides of antibiotics, which include killing all stomach bacteria, including those that are absolutely necessary for good health. I recommend taking 500 mg twice daily, once in the morning and again in the evening for a minimum of 30 days. By then, the ulcer should be healed, but some patients continue taking mastica just to be sure it is gone
In addition, be prepared to make some lifestyle changes. Smoking and drinking alcohol are off limits for ulcer patients, as are NSAIDS. Coffee and other acidic drinks are not recommended.
Once the initial infection is cleared, I recommend the following supplements to prevent recurrence.
Curcumin is a supplement I recommend for pain relief. Curcumin fights pain-causing inflammation. A recent animal study also shows that curcumin can help prevent ulcers. The test showed that subjects given curcumin did not develop any ulcers, while those given salt water or aspirin did.
Probiotics, the beneficial bacteria that should be part of a healthy microbiome. One recent study determined that probiotics can protect the stomach lining from ulcers, while a second noted that probiotics were highly effective at healing existing ulcers. Supplements are needed to ingest therapeutic levels. It is especially important to take probiotics if you are taking an antibiotic prescription.
Baking soda and apple cider vinegar Another simple treatment for ulcer pain relies on a combination of 1 teaspoon organic apple cider vinegar and a dash of baking soda. The mixture will fizz at first, but that is perfectly normal. When the fizzing stops, add 8 ounces of fresh, filtered water and drink. I recommend this before meals throughout the day.
Aloe vera liquid: Extracts of aloe vera, a type of plant that thrives in low-water regions, have been used for centuries to treat digestive disorders, including soothing and healing ulcers. Today, you can buy processed liquid aloe vera in health food stores. Simply follow the dosage instructions on the product you choose. Aloe vera is also helpful for irritable bowel and ulcerative colitis.
For a long time, plain old aspirin was the mainstay of management of most aches and pains. Aspirin carries out its analgesic effects by inhibiting the production of prostaglandins, which are messengers of pain, so inhibiting prostaglandin synthesis is evidently a good thing. Except that prostaglandins are also vital in protecting the mucous lining of the GI tract, especially the stomach. Aspirin has, besides its analgesic properties, at least three other properties. It is an antipyretic, meaning that it reduces fever. It is also an anti-inflammatory, and it has antiplatelet (anti-clotting) activity. When the prostaglandin-inhibiting activity of aspirin is combined with its antiplatelet activity, that adds up to a considerably increased risk that people taking high-dose aspirin for long periods will have bleeding in their GI tract that wont healbecause the blood is too slow to clot!
The NSAIDs non-steroidal anti-inflammatory drugs (the term is an obvious effort to make it clear that these drugs are not steroids and do not have any of the dangerous steroid side effects) also inhibit prostaglandin synthesis via the cyclo-ozygenase (COX) pathway; unlike aspirin, they do not have anti-platelet effects. Therefore patients who take these non-aspirin NSAIDs may be somewhat less affected by GI bleeding, but they can have GI side effects.
The COX pathway has become a source of great interest because of the discovery that there are two of these pathways, labeled COX-1 and COX-2. Most of the NSAIDs ibuprofen, naprosyn, etc are non-selective COX inhibitors, meaning that they interact with both pathways. But it turns out that while the COX-1 pathway is the one that produces the beneficial prostaglandins (as well as other necessary GI tract actors), the COX-2 pathway is the one that produces the nasty prostaglandins involved in pain and inflammation. Therefore, agents that selectively inhibited the COX-2 pathway might reduce the bad effects while preserving the useful ones.
This valuable discovery led to the development of the COX-2 inhibitors Vioxx (rofecoxib) and Celebrex (celecoxib). As nearly everyone on the planet knows, Vioxx hit a pothole very quickly, when it became known that in its clinical trials it had been associated with an unusually high percentage of cardiovascular side effects, including deaths from heart attacks and strokes. Vioxx was taken off the market rather quickly after its introduction. Celebrex was less affected by CV events, and it has remained on the market.
The controversy has not vanished, however. There are indications that all the NSAIDs may, to varying degrees, have CV effects. The risk that an NSAID will contribute to the risk of a CV event is greatest in patients who are already at significant CV risk, such as patients who have already sustained whats termed an acute coronary syndrome, meaning a heart attack, a stroke, or obstruction of an artery requiring intervention. The NSAID associated with the least CV risk appears to be naproxen (Naprosyn), while the one with the greatest CV risk appears to be diclofenac (Voltaren). The increase in risk in low-risk individuals is very low, difficult to quantify, and causality is difficult to establish. It may be that persons who take NSAIDs chronically and in large doses may be at higher risk for cardiac events due to other causes.
The NSAID dilemma nicely illustrates the calculations that both patients and doctors need to go through in picking a drug. When patients are in pain, quelling the pain is usually their uppermost concern. The choice of a treatment depends largely on the balance between benefit and risk, and it is vital for the patient neither to under- or overestimate the risk.
A very rare side effect that steers millions away from a potentially useful drug
About ten million of us here in the USA and many millions more elsewhere have osteoporosis. As the name suggests, in osteoporosis the bones become porous and crumbly; it is a progressive disease of bone loss. In persons without this condition, bones are constantly being remodeled in fact, bone remodeling is the term for a continuing process whereby old bone tissue is absorbed and replaced with new, stronger bone tissue. The process of building new bone comes to a halt in persons with osteoporosis, and the consequences can be devastating, including spinal and hip fractures that leave many people severely handicapped for life.
A class of drugs called bisphosphonates partly addresses this situation. These drugs, including Fosomax (alendronate), significantly slow the absorption of old bone tissue, but have no effect in terms of building new bone. The preservation of the mature bone greatly reduces the potential for the spinal and hip fractures.
But there is a terrifying side effect that could affect patients taking bisphosphonates sudden, unexpected shattering of the thigh bone and sometimes erosion of the jawbone. These side effects are extremely rare. The incidence, according to long-term follow up, is something like 0.02%, compared with an incidence of hip fractures in persons with osteoporosis of about 2%. Which is to say that a person with osteoporosis is about one hundred times more likely to experience a hip fracture than the bisphosphonate-associated side effects. Nonetheless, the prospect of those side effects is so terrifying that millions of persons with osteoporosis totally forego bisphosphonate treatment, accepting the prospect of gradually becoming handicapped or even incapacitated, which is about one hundred times greater than the risk of those extremely rare side effects.
However, there are other options for treating osteoporosis that do build new bone, which the bisphosphonates do not do.
To end on a more cheerful note, newer options for treating osteoporosis
One drug that actually fosters new bone growth, already on the market, is Forteo (teriparatide), from Eli Lilly. And a new drug, abaloparatide, so far not on the market, reported highly encouraging Phase III results on August 16th. The drug maker, Radius Health, announced the results of a clinical trial in 2,463 post-menopausal women. Women taking their drug benefited by an 86% reduction in vertebral fractures compared with women taking the placebo, and this result was considered highly statistically significant, with a P value less than 0.001. That P value means that the odds that the results of the trial were due to chance were less than one in a thousand.
Because the mechanisms of action of abaloparatide and teriparatide are totally different from that of the bisphosphonates, its thought to be extremely unlikely that these agents would have a similar bone-shattering side effect, but as of this time its impossible to rule it out. What these drugs are, essentially, is synthetic analogues of the hormone that foster bone remodeling. They are associated with a range of side effects, but none are in the terrifying class.
Its not clear that abaloparatide is headed for automatic coronation by the FDA, nor yet that this will result in fame and riches for Radius Health. Predicting the fate of biotech outfits is not Doc Gumshoes mtier. However, one likely benefit that abaloparatide approval may convey is perhaps driving down the price of Forteo. Eli Lilly, perhaps anticipating that their drug will soon no longer be the only option for actually rebuilding bone in osteoporotic persons, has hugely increased the price of Forteo, by up to 15% every six months. It is now triple what it was in 2010.
And, by the way, the fact that abaloparatide was studied in post-menopausal women certainly does not mean that it would be used in women only. The trial enrolled post-menopausal women because it is this cohort that has the highest likelihood of experiencing osteoporosis. But some men have that disease as well, and the drug, if approved, would be appropriate for men as well.
Laugh, Love, Leave a Legacy and Live to 101++. [L4] Dr. George Grant, Ph.D., I.M.D. The Caring Doctor