The People's Perspective on Medicine

845 Aspirin Secrets Revealed

Tune in to our radio show on your local public radio station, or sign up for the podcast and listen at your leisure. Here’s what it’s about:

Aspirin was first developed and marketed more than a century ago. As an inexpensive and ubiquitous over-the-counter medicine, aspirin hardly seems to warrant a second thought.

New research shows, however, that the venerable pain-reliever isn’t just for headaches any more. Learn how aspirin is being used to cut the chance of developing colon cancer, and how it can affect heart disease. Who should be taking aspirin, and what do they need to know?

Guests: Sir John Burn, MD, FRCP, FRCPCH, FRCOG, FMedSci, is Professor at the Institute of Genetic Medicine of Newcastle University in Newcastle upon Tyne, England. He is also lead clinician for the National Health Service North East. The website for his study is http://www.capp3.org/ The photo is of Sir John.

Sidney C. Smith, Jr., MD, FACC, FAHA, FESC, is Professor of Medicine in the division of cardiology and Director of the Center for Cardiovascular Science and Medicine at the University of North Carolina at Chapel Hill. Dr. Smith is past president of the American Heart Association and is a recipient of their Gold Heart Award. He has also served as chair of the American College of Cardiology and is currently President of the World Heart Federation.

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for six weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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ANOTHER home run! Congratulations Terry and Joe.
I also thought you did a great job of keeping the information translated to “plain English”.
I’m concerned about prostate cancer as I have the precursor: benign prostatic hyperplasia. Wanting to know the NNH (Number Needed to Harm) of low dose aspirin therapy, I did some digging and came up with the following:
Ridker PM, Cook NR, Lee IM, et al. A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. N Engl J Med 2005; 352: 1293–304. “A very large randomized trial that used aspirin in a dose below 75 mg daily and provided information on major GI bleeding was recently published. The Women’s Health Study was a placebo-controlled primary cardiovascular prevention trial in over 39 000 women followed for a mean of 10.1 years.[39] Aspirin was given in a ‘non-standard’ dose of 100 mg every other day. This trial reported their data on transfusion-requiring GI bleeding. Among patients receiving aspirin, the relative risk of transfusion-requiring GI bleeding vs. placebo was 1.4 (95% CI: 1.1–1.8) and the annualized increase in absolute incidence attributable to aspirin was 0.018%, much lower than the 0.12% rate from the meta-analysis cited above. Potential explanations for the much lower absolute risk of major GI bleeding in the Women’s Health Study include the very low dose of aspirin, the use of aspirin every other day, the relatively young age of the study population (90% were between 45 and 64 years of age) and the good baseline health status of the study subjects (professional women without a history of cardiovascular disease).” Source: http://www.medscape.com/viewarticle/545101_3 .
By my calculation, A NNH of 5,553 per year, which looks like a very small risk to me. Does that figure seem right to you, Terry and Joe?

I am very pleased to hear the good news about aspirin especially since its use is backed up by many clinicians. I am taking aspirin daily now because I do have type 2 diabetes and high blood pressure it is my belief that aspirin can be beneficial even in preventing breast cancer and as stated before other cancers. I appreciate the wonderful program the peoples’ pharmacy and the sharing of their knowledge with medicine and otc. thanks again

Please see the very recent European study that shows aspirin causes dry macular degeration to become wet (the wet condition leads to blindness.) I was taking 81 mg. of aspirin a day because I have frequent daily short bouts of atrial fibrillation. The cardiologist and neurologist told me aspirin is not a good anti-coagulation and I should be on coumadin or Pradaxa. I refused to take either.
But I took the aspirin for three months although I developed bruises on my arms and legs from taking the aspirin. Apparently it thinned my blood because I had the bruises, bleeding under the skin, without any trauma to the bruised areas to cause bruising.
I was concerned the aspirin might cause my dry, stable macular degeneration to turn wet and then I would go blind, and my doctors assured me they had never heard of that happening.
You can check the internet and find the European study that says aspirin does cause MD to turn wet and cause blindness. Aspirin is a dangerous drug. Several doctors have told me aspirin has such bad side effects it could not get approval to go on the market if it were not already on the market.
People’s Pharmacy response: Thank you for bringing this to our attention. We too have heard the remark about aspirin not being approved today, but we think it indicates that aspirin is simply far more complicated than previously recognized. Not all bad, not all good, and definitely NOT for everybody.
Here are a couple of abstracts for people interested in the macular degeneration issues. Neither is from Europe:
Ophthalmology. 2011 Aug;118(8):1603-11. Epub 2011 Jun 24.
Central and hemicentral retinal vein occlusion: role of anti-platelet aggregation agents and anticoagulants.
Hayreh SS, Podhajsky PA, Zimmerman MB.
Source
Department of Ophthalmology and Visual Sciences, College of Medicine, University of Iowa, Iowa City, Iowa. sohan-hayreh@uiowa.edu
Abstract
OBJECTIVE:
To investigate systematically the role of anti-platelet-aggregating drugs or anticoagulants in central retinal vein occlusion (CRVO) and hemi-CRVO.
DESIGN:
Cohort study.
PARTICIPANTS:
Six hundred eighty-six consecutive patients with CRVO (567 patients, 585 eyes) and nonischemic hemi-CRVO (119 patients, 122 eyes).
METHODS:
At first visit, all patients had a detailed ophthalmic and medical history (including the use of anti-platelet aggregating drugs or anticoagulants), and comprehensive ophthalmic and retinal evaluation. Visual evaluation was carried out by recording visual acuity, using the Snellen visual acuity chart, and visual fields with a Goldmann perimeter. The same ophthalmic evaluation was performed at each follow-up visit. At the initial visit, CRVO and hemi-CRVO were classified as nonischemic and ischemic.
MAIN OUTCOME MEASURES:
Visual acuity, visual fields, and severity of retinal hemorrhages.
RESULTS:
All 3 types of CRVO, showed a significantly greater severity of retinal hemorrhages among aspirin users than nonusers (P

YEARS ago, Fresh Air with Terry Gross Interviewed a “scientist” (in quotes only because I don’t recall the field of study or credentials) who left me with this 10-15+ year old memory: “The three unheralded and most important drugs [for health] finding use during [this entire century] are ASA, Aloe Vera, and Green Tea.”. From my own research since that time, I find it proven over and over and over in the Scientific Literature.

What is the name of the exact Johns Hopkins article published in the Annals of Surgery that you cited in the program? I would like to take a look at the statistics. Thanks.

Please do a column on alternatives to aspirin. I can no longer take it, due to it’s effects on my stomach.

I listened to the People’s Pharmacy program on February 4th. The comments on aspirin were very interesting and somewhat useful to me. However the promise to provide a method of evaluating risk versus beneficial aspects were not as promised.
I’m about 70 years old and off and on over the past 15 years had been taking baby aspirin once per day.
Because my tolerance of statin medications is negative and cholesterol values have become greater than desired, recently, I’ve begun taking aspirin again. About 15 years ago when I began doing so, the rectal bleeding that resulted led to severe anemia. This was obviously not a desirable trade-off.
More recently I’ve found that rectal bleeding begins after taking the aspirin for some 6 weeks. Then not taking aspirin for “a while” and a similar period of not bleeding is likely to occur when taking aspirin is resumed.
The incentive to do this is the aspirin does work to alleviate very uncomfortable flushing that accompanies taking Niaspan when aspirin is not taken before hand.
Over the years I’ve found there to be a major negative trade-off for not stopping prescribed medication treatments when negative results occur.
MD’s are not very knowledgeable about the basis of the negative reactions of medications so they often will agree to stop a medication when an adverse effect occurs than to go along with a trial and error approach over time, even if the potential benefits may be desired.

very interesting program. I have been treated for colorectal cancer. I am trying to find information on internet but cannot find answer.. perhaps you have an opinion or a resource for me to try..
Does white willow react the same way as aspirin? Although it is not as strong, perhaps it reacts to cancer cells the same way as aspirin?
Thank you for what you can share. I realize you are not in any way giving me medical advise or making a medical recommendation.

I have always considered aspirin to be the “Miracle Drug”….you have just enhanced my perception. Thank you for another great and informative program.

I listened carefully to your show about aspirin and got TOTALLY confused. Too much research and useless info unless one is a scientist. What I got out of it is: If your female..don’t take aspirin in any amount unless one has a genetic history of heart problems. Same for Colon Cancer unless you have some kind of Lynch Syndrome. As for males…I guess if one’s doctor recommends it, it’s OK? Just thought you should know that sometimes your show is WAY OVER THE TOP!
Thanks for trying to educate us lay folks.

When I was a kid back in the ’50s my mom would give my sister and I a coke and a couple of aspirin for things like headaches, flu symptoms, etc. (this was before parents got spooked by Reye Syndrome stories). So I’ve been taking aspirin for a long time (other kids would try to convince us that the coke-aspirin combo was some kind of illicit drug).
After I got out of grad school in the early ’70s I worked as a medical research tech. One project I was on was the VA’s original aspirin and unstable angina study. We would test/calibrate the equipment sometimes using our own blood samples. I was sold then on aspirin’s benefits vs ischemic heart disease just by looking at the paper chart showing its effect on platelet aggregabiltity (you need to make sure your listeners understand that aspirin is a very potent anticoagulant).
In my 30s I began periodically developing a mysterious and pretty serious skin rash or redness (a couple of weeks after the redness would go away my skin would peel like a sunburn). To make a very long story short I traced it down to aspirin. But later I found it was associated with taking acetaminophen as well, then anything with salicylates (the worse case I ever had was after drinking green tea for several days). I can take 325 mg of prophylactic aspirin every 3 days or so without problems, and I do that.
Your show seems to imply that aspirin’s putative anticancer effects are a relatively recent discovery. This is not correct, as I remember years ago hearing about it being useful for colon cancer prevention. The speculation was that its anti-inflammatory effects were the reason. Perhaps it is the salicylate theory Dr Burns alluded to that is new?
LA MD needs to chill some. I’m still involved in medical research, and it’s easy to see that we live in an era of very severely diminishing returns on investment. Sure there are some headline results, but they don’t hold a candle to the effects on morbidity and mortality that, say, developments in large scale public sanitation did a long time ago, and they come at eye-popping dollar costs. For me it’s really cool in this era of super sexy pharmaceuticals and medical devices seeing fuddy duddy old aspirin getting some respect.

I had Rheumatic fever and was given high dosages of aspirin, high enough to cause black stools. The population that had rheumatic fever might be large enough to see some effects of aspirin on many things.

Long time listener.
You have completely, utterly and totally mischaracterized the members of the medical community this morning,
when you said they get excited by and embrace expensive therapies.
Listen to what you said, about fifteen minutes before the end of your program.
You couldn’t be more wrong, and need to correct your slur.
We embrace and are excited by effective therapies, therapies that enhance safety, therapies that are life enhancing.
The portable ultrasound machine allows us to place indwelling catheters for prolonged nerve blocks for pain relief that have allowed us to discharge patients after total joint replacements as much as a day earlier, at a cost savings of thousands of dollars, mobilize them the day of surgery, and greatly reduce their post operative pain —for months.
The Glidescope allows us to safely secure the airways of the army of obese people who are in need of surgery, literally allowing us to intubate people who otherwise might need a tracheostomy to be ventilated, saving thousands of dollars, and changing a literally life-threatening event into a near routine one.
The short-acting muscle relaxants, sedatives and synthetic narcotics that have come to use in my practice lifetime allow the anesthetic to predictably end shortly after the surgical procedure is done, making the need for a ventilator and respiratory therapy care—again,saving thousands of dollars— in our recovery rooms a rarity.
We have not adopted the routine use of BIS monitor, most definitely an expensive therapy that claims to monitor anesthetic depth, because despite a huge campaign to demonstrate it preventing anesthesia recall, it hasn’t made a difference in clinical care.
We are extremely distressed by the harm people do to themselves by the many lifestyle choices they make, and actually do things in our contact with receptive patients like introduce them to the benefits of fish oil and Gary Taubes’ books, despite both those measures having no pertinence to their immediate anesthetic experience.
You severely undermine your credibility among the medical community when you make a statement about what motivates our therapeutic decisions that so disparages who we are.
+++++++++++++
PEOPLE’S PHARMACY RESPONSE
So sorry you misunderstood our point about aspirin.
Aspirin, which is over the counter and cheap, was a very slow sell to the medical community.
In 1949 Lawrence Craven, MD suggested that physicians consider giving an aspirin a day to patients to reduce the risk of a heart attack. It took 40 years for that recommendation to begin to get traction.
James Dalen, MD, editor of the Archives of Internal Medicine in 1981, wrote an article: “An Apple a Day or an Aspirin a Day?” He speculated that if Dr. Craven’s “rule of ‘an aspirin a day’ had been adopted by Americans in 1950, hundreds of thousands of myocardial infarctions and strokes might have been prevented.”
Then there was this by Dr. Charles Hennekens of Harvard: “Sometimes I fear that if aspirin were half as effective and 10 times more expensive it would be taken far more seriously.” Medical World News, Dec. 1992.
So…one of this country’s most eminent physicians and epidemiologists (see his partial bio below) stated 20 years ago pretty much the same thing you are taking me to task for today.
If you look at the medications physicians prescribe in large numbers you will discover that Lipitor (until it went generic a few weeks ago) topped the list…followed by Nexium, Plavix, Lexapro and Crestor. Cymbalta was not far behind. The data supporting the superiority of Nexium, Lexapro and Cymbalta leave a lot to be desired.
We wonder how long it will be before aspirin is considered an important preventive against cancer. If it takes as long as aspirin vs heart attacks…it could be decades. Sir John Burn expressed that point rather well. Tis a shame that a drug like Pradaxa can catch on within weeks of approval by the FDA but it can take aspirin decades to make it into the consciousness of mainstream medicine.
PS…have you had a chance to look at our newest book? We would really appreciate your feedback.
https://www.peoplespharmacy.com/topscrewups-pp/

I have been taking a daily dose of aspirin (81 mg.) for the past 5-6 years as a preventative
cardiac disease regimen. Your 2/4/12 radio program relating to recent aspirin/cancer studies, etc. was most informative to me since I have a family history of colon cancer.
I would like to become involved in any clinical studies that are being conducted in tne West Palm Beach, Florida area. I am 79 years old. Information to my request would be appreciated.
PEOPLE’S PHARMACY RESPONSE:
Sir John Burn is conducting a trial of different doses of aspirin in people with Lynch Syndrome…a very high propensity to develop cool-rectal cancer. You can learn more about it by going to the link on this show to that study.

I have read that White Willow Bark has the same properties as aspirin without the effects on the stomach. If so what amount would be similar to low dose aspirin?

Can you compare benefits Esselstyn plant diet vs aspirin? It sure is working for me! I cannot take aspirin.

I heard the benefits of taking aspirin for colon health on the Nightly News this fall and I had been experiencing painful leg cramps fo r several weeks. After the news my husband said you should try aspirin for your cramping as I had tried every alternative such as increased doses of magnesium, epson salt foot baths with little noticeable change. I ate more kale thinking it was nutrition even though I eat a good diet.
Low & behold I started taking 2 coated aspirin am & pm for one week and the cramps went away!! That was 2 months ago. I’m done with aspirin but thank ‘goodness I heard it on the news. What’t good for the colon can also be good for cramps!!

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