(Note: I'm not a medical practitioner. I'm merely sharing this information because it may be of your interest. I like learning about aspirin because I use it daily and try to be cautious with it :) )
Many people report bleeding issues from aspirin/salicylates even from low doses, and even taking vitamin K with it. Others seemingly don't get any bleeding issues even at chronic high doses. I've always wondered why that would be. For example, in the past I never took aspirin for anything, yet I got petechiae or bruises from time to time -not frequently, but they happened-. But since my many dietary changes and supplement aids that I've applied for the last 2 years, proneness to petechiae, etc, has virtually subsided, yet I've been taking high dose aspirin daily, 1-4 grams for 18 months.
Assuming there's no underlying coagulation problems, the most convincing reason I've found so far for aspirin/salicylates apparent induction of bleeding issues in some people has to do with their vascular status, more specifically with vitamin C and how it's crucial for blood vessel integrity and how aspirin may deplete or lower vitamin C status -which would be a tragedy for someone who already has some sort of vitamin C deficiency AND/OR is in such a state of heightened oxidative stress that their vitamin C requirements are heavily increased-.
Vitamin C and the blood vessels
Let me share quotes of some of the most important roles of vitamin C in blood vessel integrity:
Role of vitamin C in the function of the vascular endothelium. - PubMed - NCBI
Inflammation in the vascular bed: importance of vitamin C. - PubMed - NCBI
Regarding vitamin C needs, many people don't consume enough. Others may indeed consume what could be termed the recommended daily amounts, but may be in fact in a deficit and have increased needs if they have experienced chronic oxidative stress -this may be, for example, due to chronic disease, chronic stress, infection, malnutrition, etc...- For example, it is well known that smokers need a higher daily vitamin C intake. And the list goes on.
The Aspirin/Salicylates-Vitamin C connection
So far it has become clear that having good blood vessel integrity is a very important factor for the prevention of bleeding issues related to their malfunction. Vitamin C is of paramount importance to vessel integrity, and there are situations where both vascular integrity and Vitamin C status are compromised. Many of us already knew that. What may be news, at least to me, is that there's evidence that aspirin and salicylates lower vitamin C status, and this may be one important explanation to the bleeding issues that certain people experience when supplementing those substances. The people more readily affected seem to be those already without adequate vitamin C intake -again, the requirements for vitamin C vary from person to person-, and the people with subclinical scurvy. So it is not hard to see that such escenario, paired with aspirin's blood thinning properties, may lead to bleeding side effects of all sorts. Conversely, people who have a good vitamin C status and/or consuming extra vitamin C seem to suffer much less from the bleeding side effects. And regarding the gastric mucosa, since it relies heavily on vitamin C for protection and renewal, it follows that aspirin is able to negatively affect it via vitamin C depletion.
It's just not vitamin C. Malnourishment in general seems to render a person more susceptible to aspirin/salicylates side effects, for example the gastric ones, since there's lessened ability to perform epithelial cell turnover for gastric mucosa renewal. And aspirin is indeed hard on the gastric mucosa. (Note 1: I personally have suffered lots of aspirin related G.I distress. After months of ups and downs, I discovered that a big thing for reducing the distess is getting the aspirin into the bloodstream ASAP, and sodium acetylsalicylate -the full reaction with sodium bicarbonate- a.k.a "Soluble aspirin" is absorbed much faster than pure aspirin -which sits for a long time on the stomach wall due to poor solubility-. I've had success with it, and also take periodic breaks -a couple of days off it- to allow mucosa repair. My G.I problems with aspirin have since very much disappeared.)
I got the information from the book "Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies" (2008) by Mitchell Bebel Stargrove, Jonathan Treasure, and Dwight L. McKeewhich, which you can find in GoogleBooks, pages 367 and 368.
(Note 2: Aspirin is an interesting substance since although it may lead to bleeding issues in susceptible people, it seems to offer improved survival in people who experience vascular bleeding events compared to non-users. There are some studies posted in the forum.)
(Note 3: Vitamin C supplementation may enhance anticoagulation effects of aspirin. Good to keep in mind)
Thanks for reading!
Many people report bleeding issues from aspirin/salicylates even from low doses, and even taking vitamin K with it. Others seemingly don't get any bleeding issues even at chronic high doses. I've always wondered why that would be. For example, in the past I never took aspirin for anything, yet I got petechiae or bruises from time to time -not frequently, but they happened-. But since my many dietary changes and supplement aids that I've applied for the last 2 years, proneness to petechiae, etc, has virtually subsided, yet I've been taking high dose aspirin daily, 1-4 grams for 18 months.
Assuming there's no underlying coagulation problems, the most convincing reason I've found so far for aspirin/salicylates apparent induction of bleeding issues in some people has to do with their vascular status, more specifically with vitamin C and how it's crucial for blood vessel integrity and how aspirin may deplete or lower vitamin C status -which would be a tragedy for someone who already has some sort of vitamin C deficiency AND/OR is in such a state of heightened oxidative stress that their vitamin C requirements are heavily increased-.
Vitamin C and the blood vessels
Let me share quotes of some of the most important roles of vitamin C in blood vessel integrity:
Role of vitamin C in the function of the vascular endothelium. - PubMed - NCBI
"One of the organs most affected by ascorbate is the endothelium, which regulates the distribution of ascorbate throughout the body and where ascorbate has many functions. Ascorbate has long been known to enhance endothelial synthesis and deposition of Type IV collagen to form the basement membrane of blood vessels. More recent studies reveal other potential functions of the vitamin in the endothelium, especially as related to control of endothelial cell proliferation and apoptosis, smooth muscle-mediated vasodilation, and endothelial permeability barrier function."
"Ascorbate has several effects on endothelial function and survival. It causes endothelial cells to proliferate and to form capillary-like structures in cell in culture (136, 139). It is likely that the effect of ascorbate to stimulate endothelial cell proliferation is due to its ability to increase the synthesis of type IV collagen (143, 157), as in the absence of ascorbate there is little generation of mature type IV collagen by cultured endothelial cells (184) or of type IV collagen mRNA relative to that of elastin in blood vessels (94)."
"Inhibitors of collagen synthesis prevented ascorbate-dependent barrier tightening, leading the authors to conclude that the effect required collagen synthesis."
"Finally, ascorbate both prevented and reversed the effect of oxidized LDL to increase endothelial barrier permeability, an effect that was mimicked by several other antioxidants"
Inflammation in the vascular bed: importance of vitamin C. - PubMed - NCBI
"In guinea pigs losing weight due to scurvy, decreases type IV collagen mRNA relative to that of elastin were evident in blood vessels (Mahmoodian & Peterkofsky, 1999). This results in friable vessels and especially capillaries that are likely to rupture, creating the petechial hemorrhages and ecchymoses seen in scurvy"
"Opposing the healing process of endothelial proliferation is apoptosis, which contributes to endothelial dysfunction (Dimmeler et al., 1998; Rossig et al., 2001). Apoptosis in endothelial cells can be induced by a variety of factors, including hyperglycemia, oxidized LDL, TNF-α, and angiotensin II (Ho et al., 2000; Recchioni et al., 2002). Ascorbate has been shown to prevent apoptosis due to inflammatory cytokines and oxidized LDL in cultured endothelial cells"
Regarding vitamin C needs, many people don't consume enough. Others may indeed consume what could be termed the recommended daily amounts, but may be in fact in a deficit and have increased needs if they have experienced chronic oxidative stress -this may be, for example, due to chronic disease, chronic stress, infection, malnutrition, etc...- For example, it is well known that smokers need a higher daily vitamin C intake. And the list goes on.
The Aspirin/Salicylates-Vitamin C connection
So far it has become clear that having good blood vessel integrity is a very important factor for the prevention of bleeding issues related to their malfunction. Vitamin C is of paramount importance to vessel integrity, and there are situations where both vascular integrity and Vitamin C status are compromised. Many of us already knew that. What may be news, at least to me, is that there's evidence that aspirin and salicylates lower vitamin C status, and this may be one important explanation to the bleeding issues that certain people experience when supplementing those substances. The people more readily affected seem to be those already without adequate vitamin C intake -again, the requirements for vitamin C vary from person to person-, and the people with subclinical scurvy. So it is not hard to see that such escenario, paired with aspirin's blood thinning properties, may lead to bleeding side effects of all sorts. Conversely, people who have a good vitamin C status and/or consuming extra vitamin C seem to suffer much less from the bleeding side effects. And regarding the gastric mucosa, since it relies heavily on vitamin C for protection and renewal, it follows that aspirin is able to negatively affect it via vitamin C depletion.
It's just not vitamin C. Malnourishment in general seems to render a person more susceptible to aspirin/salicylates side effects, for example the gastric ones, since there's lessened ability to perform epithelial cell turnover for gastric mucosa renewal. And aspirin is indeed hard on the gastric mucosa. (Note 1: I personally have suffered lots of aspirin related G.I distress. After months of ups and downs, I discovered that a big thing for reducing the distess is getting the aspirin into the bloodstream ASAP, and sodium acetylsalicylate -the full reaction with sodium bicarbonate- a.k.a "Soluble aspirin" is absorbed much faster than pure aspirin -which sits for a long time on the stomach wall due to poor solubility-. I've had success with it, and also take periodic breaks -a couple of days off it- to allow mucosa repair. My G.I problems with aspirin have since very much disappeared.)
I got the information from the book "Herb, Nutrient, and Drug Interactions: Clinical Implications and Therapeutic Strategies" (2008) by Mitchell Bebel Stargrove, Jonathan Treasure, and Dwight L. McKeewhich, which you can find in GoogleBooks, pages 367 and 368.
(Note 2: Aspirin is an interesting substance since although it may lead to bleeding issues in susceptible people, it seems to offer improved survival in people who experience vascular bleeding events compared to non-users. There are some studies posted in the forum.)
(Note 3: Vitamin C supplementation may enhance anticoagulation effects of aspirin. Good to keep in mind)
Thanks for reading!
