Is aspirin really harmful to the gut (bleeding risk)?

[Hans]

Are the risks overblown?
Haidut has posted a few studies showing that it is but it was only a few, so I decided to write an article on it. And seeing that I recommend it a lot (especially to my clients) I wanted to write an article on it to discuss the "side effects".

Is aspirin really harmful to the gut (bleeding risk)? » MENELITE

Salicylic acid and its derivatives/metabolites have so many benefits, yet many people have been fearmongered of some “side effects” that aspirin is thought to cause. In this article series I’m reviewing those side effects, look at the evidence and see if it’s real or not. I’ll be addressing...

men-elite.com

 

[Fexxx]

Thx Hans - I really wish aspirin would be work for me. Tried all the aspirin hacks but after several Days of use may stomach starts to hurt. So yes there is a Risk even when there a Good ways to minimize them.
just my 2cents

 

[Hans]

Thx Hans - I really wish aspirin would be work for me. Tried all the aspirin hacks but after several Days of use may stomach starts to hurt. So yes there is a Risk even when there a Good ways to minimize them.
just my 2cents

Yes that's true. Even though sodium salicylate doesn't cause bleeding, it can still be irritating. Have you perhaps tried white willow bark extract?

 

[StayPositive]

The main problem on gut health with aspirin is it increases intestinal permeability

 

[mostlylurking]

The main problem on gut health with aspirin is it increases intestinal permeability

Links? Documentation?

 

[StayPositive]

Links? Documentation?

pubmed.ncbi.nlm.nih.gov/22377941

https://journals.physiology.org/doi/full/10.1152/ajpcell.00157.2008

Gastrointestinal permeability following aspirin intake and prolonged running - PubMed

We sought to evaluate the effects of exercise and aspirin on gastroduodenal and intestinal permeability. Seven volunteers (age = 29 +/- 3 yr, VO2max = 56.8 +/- 4.1 ml.kg-1.min-1) rested or performed treadmill exercise (60 min at approximately 68% VO2max), with or without aspirin ingestion...

pubmed.ncbi.nlm.nih.gov

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.gastrojournal.org/article/S1542-3565(08)01250-0/pdf&ved=2ahUKEwjL__SOsYrvAhXcCWMBHQ7AC9IQFjALegQIBxAC&usg=AOvVaw0dekK3VUUjlJzjY-A2umW6

SAGE Journals: Your gateway to world-class research journals

Subscription and open access journals from SAGE Publishing, the world's leading independent academic publisher.

journals.sagepub.com

 

[Hans]

pubmed.ncbi.nlm.nih.gov/22377941

https://journals.physiology.org/doi/full/10.1152/ajpcell.00157.2008

Gastrointestinal permeability following aspirin intake and prolonged running - PubMed

We sought to evaluate the effects of exercise and aspirin on gastroduodenal and intestinal permeability. Seven volunteers (age = 29 +/- 3 yr, VO2max = 56.8 +/- 4.1 ml.kg-1.min-1) rested or performed treadmill exercise (60 min at approximately 68% VO2max), with or without aspirin ingestion...

pubmed.ncbi.nlm.nih.gov

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.gastrojournal.org/article/S1542-3565(08)01250-0/pdf&ved=2ahUKEwjL__SOsYrvAhXcCWMBHQ7AC9IQFjALegQIBxAC&usg=AOvVaw0dekK3VUUjlJzjY-A2umW6

SAGE Journals: Your gateway to world-class research journals

Subscription and open access journals from SAGE Publishing, the world's leading independent academic publisher.

journals.sagepub.com

From the first study:
"Ingestion of aspirin before running increased (P < 0.05) intestinal permeability compared to placebo+running and placebo+rest, but not compared to aspirin+rest".
Aspirin at rest didn't cause leaky gut. Prolonged exercise is known to cause leaky gut and glucose can reverse this. So the glucose "placebo" actually helps to prevent the leaky gut, thus "showing" that aspirin causes leaky gut.

Aspirin can be harmful to certain individuals, but it's definitely not everyone, so it's not accurate to say that aspirin causes leaky gut. It could worsen gastrointestinal permeability in certain individuals.

 

[mostlylurking]

pubmed.ncbi.nlm.nih.gov/22377941

https://journals.physiology.org/doi/full/10.1152/ajpcell.00157.2008

Gastrointestinal permeability following aspirin intake and prolonged running - PubMed

We sought to evaluate the effects of exercise and aspirin on gastroduodenal and intestinal permeability. Seven volunteers (age = 29 +/- 3 yr, VO2max = 56.8 +/- 4.1 ml.kg-1.min-1) rested or performed treadmill exercise (60 min at approximately 68% VO2max), with or without aspirin ingestion...

pubmed.ncbi.nlm.nih.gov

https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.gastrojournal.org/article/S1542-3565(08)01250-0/pdf&ved=2ahUKEwjL__SOsYrvAhXcCWMBHQ7AC9IQFjALegQIBxAC&usg=AOvVaw0dekK3VUUjlJzjY-A2umW6

SAGE Journals: Your gateway to world-class research journals

Subscription and open access journals from SAGE Publishing, the world's leading independent academic publisher.

journals.sagepub.com

the first one: Gastrointestinal permeability following aspirin intake and prolonged running - PubMed
"We sought to evaluate the effects of exercise and aspirin on gastroduodenal and intestinal permeability. Seven volunteers (age = 29 +/- 3 yr, VO2max = 56.8 +/- 4.1 ml.kg-1.min-1) rested or performed treadmill exercise (60 min at approximately 68% VO2max), with or without aspirin ingestion. Placebo (glucose) or aspirin (1.3 g) was taken the night before and prior to rest or exercise (total 2.6 g). A permeability test solution (approximately 1300 mOsm.kg-1), containing 10 g lactulose (L), 5 g mannitol (M), and 10 g sucrose (S), was ingested prior to rest or exercise. Urinary excretion rates (6.h-1), expressed as a percentage of ingested dose, were used to quantify intestinal (L/M ratio) or gastroduodenal (S) permeability. Ingestion of aspirin before running increased (P < 0.05) intestinal permeability compared to placebo+running and placebo+rest, but not compared to aspirin+rest; mean (+/-SE) values for the L/M ratio were 0.248 +/- 0.046, 0.029 +/- 0.012, 0.012 +/- 0.004, and 0.104 +/- 0.057, respectively. Gastroduodenal permeability following aspirin+running (3.25 +/- 1.21%) was also elevated (P < 0.05) compared to placebo+running (0.43 +/- 0.15%) and placebo+rest (0.24 +/- 0.11%), but not compared to aspirin+rest (0.66 +/- 0.27%). Neither running nor aspirin ingestion was associated with gastrointestinal (GI) complaints. Thus, GI permeability while running can be markedly elevated by aspirin ingestion."

I'm having a hard time deciphering this study. Apparently they gave some people some aspirin (and some got none) and then gave all some sugar water (sucrose, lactulose, mannitol) and had some exercise and some not exercise. Then they measured what came out in the urine. Since sugars get sent into the bloodstream pretty quickly by healthy absorption, I do not understand how this proves that aspirin increases permeability of the intestine.

Maybe someone more knowledgeable than me can explain this to me.

I have a history of some pretty serious health issues including leaky gut and almost universal food allergies/sensitivities resulting from partially digested food particles making their way into my blood stream. To me, just because some sugar was absorbed through the intestinal wall does not mean that there's a permeability problem. The absorption of sugar is supposed to happen. If the aspirin reduced inflammation in the gut, maybe the gut was just working better because it was no longer inflamed? Maybe my idea of gut permeability is deranged due to my medical history?

I currently take several grams of aspirin daily. I always dissolve it in boiling water before taking it. I no longer have the dire medical issues that were caused by leaky gut that I endured many years ago. I find the aspirin very helpful and I do not perceive there to be any negatives from taking it.

 

[PowertothePeatple]

I wish I could take it regularly but I also can only take it for a couple days before I start having pain and ulcer symptoms.

 

[Hans]

I wish I could take it regularly but I also can only take it for a couple days before I start having pain and ulcer symptoms.

Have you tried sodium salicylate?

 

[supercoolguy]

I wish I could take it regularly but I also can only take it for a couple days before I start having pain and ulcer symptoms.

Find one w/low additives. 1/4 - 1/2 a tablet EOD. Have some food. Once i did that i was all set. Very Rare do i use a full tab at once.

Do what works for you.

 

[Bluemachine]

Every time I try to read one of your articles the page bugs out when I try to scroll and puts me back to the top of the page. Any idea why?

 

[Mito]

“Buffered, soluble forms of acetylsalicylates caused gastrointestinal bleeding in more than 50% of patients. However, enteric-coated and intravenous forms resulted in significantly less gastrointestinal bleeding”

The study below seems to indicate enteric-coated actually has a higher risk of bleeding?

I think Peat may have been right when he recommends non-coated, non-buffered aspirin. This study claims that the coated and/or buffered versions have several-fold higher risk of GI bleeding than the plain uncoated version.

http://www.thelancet.com/journals/lance ... 8/fulltext

"...Use of low doses of enteric-coated or buffered aspirin carries a three-fold increase in the risk of major UGIB. The assumption that these formulations are less harmful than plain aspirin may be mistaken."

Now, the study looked at low doses (325mg daily). I wonder if their findings would apply to higher doses used by Petarians.
Also, there was a study I saw recently claiming that the GI bleeding risk is primarily caused by H. Pylori under the stimulation of aspirin. Aspirin itself did not cause ANY damage in people not infected with H. Pylori and the human dosage used was quite high (90mg/kg), which would translate to 6g-8g per person per day. Definitely within the range of what some Petarians use. I will post the study when I find it.

 

[TheBeard]

I've searched ray peat forum many times for aspirin as I was highly curious and tempted to try it.

I've read too many negatives, it has discouraged me:
Stomach pain
Dizziness
ES

 

[Hans]

The study below seems to indicate enteric-coated actually has a higher risk of bleeding?

Contradicting studies for sure. I personally would only use plain aspirin, sodium salicylate or salicylic acid.

 

[Hans]

I've searched ray peat forum many times for aspirin as I was highly curious and tempted to try it.

I've read too many negatives, it has discouraged me:
Stomach pain
Dizziness
ES

Perhaps you can try a baby aspirin. It's usually the easiest on the gut.

 

[StayPositive]

Contradicting studies for sure. I personally would only use plain aspirin, sodium salicylate or salicylic acid.

sodium salicylic seems promising

Do we know if all the cox inibition by aspirin comes from it's metabolite (salicylic acid) ?

 

[StayPositive]

Perhaps you can try a baby aspirin. It's usually the easiest on the gut.

Topical aspirin seems good for this too

 

[Hans]

Topical aspirin seems good for this too

Yes good point. But since the absorption is about 20-30% (IIRC), you'll have to apply a relatively large amount, which is also fine.

 

[StayPositive]

Yes good point. But since the absorption is about 20-30% (IIRC), you'll have to apply a relatively large amount, which is also fine.

Do you have a study that shows 20-30% absorption ?

I saw a study showing 10-15%