What is the TYP consensus regarding Aspirin?
I was taking an enteric coated aspirin for a couple of years and stopped as I thought it was bothering my stomach.
I recently started taking a enteric coated 81mg aspirin a couple times a week, which really bothers my stomach
Isn't the fish oil doing the same thing as an aspirin?
Peace
Joe E O
Dr. Davis
Posted: 8/19/2008 6:53:49 PM
Hi, Joe--
I suspect that fish oil does largely replace the benefits of aspirin, but there are virtually no data I'm aware of examining long-term whether cardiovascular events rates are adequate controlled with just fish oil without aspirin.
The higher the fish oil dose, my gut sense is that there are diminishing benefits of aspirin. I think your solution is the best: use as little aspirin as possible. I also advise my patients to take periodic breaks, e.g., one week off every 3 months or so, to allow any gastritis to heal.
There are overlapping effects of aspirin and omega-3s, but there are important differences as well.
When there is bleeding anywhere, it is much more likely to be aspirin than fish oil, as you see. However, without better data I do not believe that we can claim that fish oil replaces aspirin. They are likely additive effects.
Unfortunately, we are navigating poorly-charted waters here.
Although there are emerging methods to assess adequacy of aspirin effects, there have been difficulties with reliability (sensitivity, specificity, clinical practicality). I've not been finding them useful in clinical practice yet. However, there are some technologies which hold promise, though clinical validation is underway.
My gut sense is that the combination of low-dose aspirin (75-81 mg per day) along with fish oil is a very effective anti-thrombotic regimen that probably makes aspirin resistance a non-question. But I have no data to back that up.
Perhaps we should explore and detail this further in an upcoming Special Report. It would at least give everyone an idea of where this technology is headed.
Fish oil, weight loss, and exercise are three very effective means of reducing fibrinogen. Aspirin does not exert a direct effect, to my knowledge. |
