If I was given a pound for every time a patient asked me whether they should be taking a daily aspirin for their heart, I’d be sipping margaritas on a tropical island by now.
And I don’t blame them (or you) for being confused. Because when it comes to aspirin guidelines, most doctors have been flying blind for years!
Say what you will about the dangerous cholesterol and blood pressure medications on the market today (and I have plenty to say about them) but at least doctors will actually test you before prescribing them.
But aspirin may be the one drug that doctors will tell you to take without performing any diagnostics – and without barely giving you a once-over.
And that’s a serious mistake. Because there actually is a test that doctors like me have been using for years to make smart aspirin recommendations to our patients.
It could keep you from starting an aspirin regimen you don’t need – and prevent you from taking a dose that could be downright dangerous.
Your blood may be thicker than it should be
First, it’s helpful to understand why some doctors recommend aspirin for preventing a heart attack or stroke (especially if you’ve already had one).
You see, a heart attack, stroke, or pulmonary embolism will occur due to the formation of a blood clot (a thrombosis). While not all blood clots are fatal, anytime one of these events does take a life, you can blame the blood clot. Blood clots can stop your heart, brain, and lungs dead in their tracks.
I’m a big believer in keeping your blood relatively thin to prevent those clots from forming.
The thinner your blood is, the less likely you are to develop a life-threatening clot. I like to say that your blood should flow more like wine than ketchup.
And while there are many natural and non-natural ways to thin your blood, the cheapest and most reliable way is… you guessed it, aspirin. That’s the reason so many doctors have been pushing it for years.
Get an answer that’s as simple as ‘yes’ or ‘no’
So to determine whether you need to (or even should) take aspirin, there’s a test called ‘AspirinWorks’.
While this test is widely available in the US, it has yet to be launched here in the UK. However, hopefully UK patients won’t have to wait too long before they can access it. Dr. Paul A.J. Ames, Consultant in Haemostasis at St. George’s hospital in London, who has been working with the new simple Ł10 urine test, believes it could have a significant impact on the health of hundreds of thousands of patients in the UK and is calling for doctors to take aspirin resistance seriously.
It actually measures the chemical biomarker of thromboxane (specifically, 11-Dehydro Thromboxane B2), the chemical that makes your blood platelets sticky and therefore more likely to form a clot.1
So, elevated thromboxane levels in the urine – and the indication that your blood may be too ‘sticky’ – can reveal a higher risk of stroke and heart attack. In fact, one large study showed that an elevated urinary thromboxane level in an AspirinWorks test result could increase your risk of one of these life-threatening cardiovascular events four times over.2
And you know how aspirin thins your blood? By reducing your levels of thromboxane.
Therefore, if the AspirinWorks test detects that you have elevated urinary thromboxane levels, then it’s relatively conclusive that your blood could use some thinning, and taking aspirin as a preventative measure may be the way to go. That’s a pretty reliable recommendation based on your own body chemistry.
And the medical authorities just keep muddying things up
I’m excited to tell you about this test because without it, your conventional primary care doctor and cardiologist are about to get even more befuddled than before.
That’s because the new draft recommendations released by the US Preventive Services Task Force3 regarding daily aspirin use are so elaborate, it’s hard to figure out whether or not you fit the profile they’re describing!
The USPSTF recommends taking low-dose aspirin daily to prevent cardiovascular disease if you…
- are an adult, 50 to 59 years old AND
- have a 10-year risk of developing cardiovascular disease that’s 10 percent or higher AND
- are not at increased risk for bleeding AND
- have a life expectancy of at least 10 years AND
- are willing to take low-dose aspirin daily for at least 10 years.
So… should you take aspirin to prevent a heart attack or stroke? Without the AspirinWorks test, the best answer you could probably get is a big ol’ shrug.
Get the download on your ideal dose
Since introducing it into my practice, I have found the AspirinWorks test to be reliable, easy, and incredibly informative. I feel so relieved to have the confidence to help patients make this important decision. It’s also been eye-opening to see that a good number of my patients actually do have elevated urinary thromboxane levels.
This test is also incredibly useful because it can even direct HOW MUCH aspirin you should take so that you can stay at the lowest possible dose.
This is such an important aspect of the test because the side effects of ANY drug – prescription or over-the-counter – accrue and become compounded as the dosage increases. In the case of aspirin, you run the risk of bleeding in the gastrointestinal system and brain when you take it – so it’s best if you take as little as possible of it, if you take it at all.
On the other side of the coin, the test also can tell you if you’re resistant to the effects of aspirin – which may mean you’ll need a higher dosage than normal, or you shouldn’t bother taking it at all.
So now what?
If you do decide to start taking aspirin, there is yet another debate you should be aware of: coated versus uncoated. The ‘safety’ coating has been added to some versions to make them easier to swallow, but it doesn’t really make them any safer once they’re in your system (especially as it relates to stomach bleeding), and the coating may actually inhibit aspirin’s ability to prevent blood clotting.
Typically, the consensus is to start with ‘baby’ aspirin, which you can chew, crush, or swallow whole. You should take it with food to keep your stomach from getting irritated.
Of course, you don’t have to take aspirin to thin your blood. While there aren’t many supplements that naturally lower thromboxane levels, aspirin’s natural alternative, white willow bark, is available.
This supplement isn’t as powerful as taking an aspirin (which, if you’re sensitive to aspirin, can be a good thing), but it can still do the trick. White willow bark, which has been dubbed ‘Mother Nature’s rival to aspirin,’ is available in both capsule form and as an extract at your local health food store. Talk to your doctor about any interactions with other medications you may be taking, and what dosage may be right for you as an alternative to a daily aspirin.
Hopefully it won’t be too long before the urine test becomes available in the UK.
Dr. Glenn S. Rothfeld
Nutrition & Healing
Vol. 10, Issue 2 • February 2016
Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.