ASPIRIN – The Unassuming Wonder Drug
Take two aspirin and call me in the morning. It might be an old doctor-patient joke, but “many a truth is spoken in jest.” It seems the more medical researchers learn about how acetylsalicylic acid or aspirin works in the body, the more we realize why it has long been dubbed a “wonder drug.” Today more than ever, there are important reasons to pay homage to this often-overlooked staple of the American medicine cabinet.
From the lowly willow
It turns out the active ingredient in aspirin, salicylate, has been relieving fever, pain and inflammation for thousands of years (that we know of). A stone tablet of medical text from the Third Dynasty of Ur (Ancient Mesopotamia) around 2000 B.C. lists willow among other plant and animal-based remedies. Throughout the centuries, our predecessors used willow bark and sometimes myrtle (another salicylate-rich plant) to relieve pain and discomfort, and reduce fever and swelling. Hippocrates recommended it to ease the pain of child-bearing in the fifth century B.C., and it was cited to treat the four signs of inflammation – redness, heat, swelling and pain, by the Roman encyclopedist, Celsus in his De Medicina, around 30 A.D.
There is evidence a natural form of the active ingredient in aspirin (salicylate from willow bark) was noted as a remedy for pain and fever in early Mesopotamia and Egypt.
In the 19th century European scientists began attempting to isolate and purify the active components of many medicines, including willow bark. Through the middle decades of the 19th century, the use of salicylate medicines – including salicin, salicylic acid, and sodium salicylate – grew considerably. In 1897, scientists at the German drug and dye firm Bayer began investigating acetylsalicylic acid as a less-irritating replacement for standard common salicylate medicines, and by 1899, Bayer named this drug Aspirin and was selling it around the world.
Aspirin’s worldwide popularity continued to grow and was boosted by its effectiveness during the Spanish flu pandemic of 1918. After 1920 there were hundreds of aspirin brands for sale in the U.S. However, by mid-century with the advent of other pain relieving drugs, such as acetaminophen and ibuprofen, these newcomers significantly cut into aspirin’s market share. Also, in the early 1980s studies linking aspirin consumption in children to Reye’s syndrome, a potentially deadly disease, brought warnings from the U.S. Food and Drug Administration, further suppressing sales.
Aspirin makes an amazing comeback.
Aspirin’s effects on blood clotting began to get attention as early as the 1960’s and after numerous studies, aspirin came to be widely accepted as a preventative for initial or recurrent heart attacks and clotting strokes in men. In the 1980s, especially after FDA approval for use as a heart attack preventive and wide-spread support from the medical community, aspirin regained its former position as the top-selling analgesic in the U.S. Since that time aspirin has become one of the first lines of defense for someone having a heart attack. Many paramedic teams now carry aspirin in their ambulances to administer to patients experiencing symptoms of a heart attack.
Could aspirin be a factor in cancer prevention?
In three new studies conducted by medical researchers at the University of Oxford, there is evidence that a daily dose of aspirin can reduce the risk of developing a variety of cancers. In one study patients taking aspirin had nearly 25% lower risk of cancer after five years. In another study, which consisted of five large British trials, over around six and a half years, aspirin users had a 36% lower risk of developing metastatic cancer and a 46% reduced risk of developing colon, lung or prostate cancer.
The reason aspirin might prevent cancer is not yet known, but some researchers believe it could be due to its anti-inflammatory effects. Aspirin may also slow the build up of mutations that ultimately lead to the cancer. The drug seems to slow the spread of disease by preventing cancer cells from being carried around the body on blood platelets.
Aspirin is also being used to reduce the risk of some problem pregnancies and may have a future role in prevention of cataracts and migraine headaches. And, aspirin may help slow the advancement of vascular or multi-infarct dementia, which is caused by lots of little blood clots in the brain and is more common than previously believed. By reducing clotting, it improves blood flow in the brain and has helped people respond better when their cognitive skills are tested.
Know the facts and talk to your doctor.
Sensitivity to aspirin, allergies, and the risk of internal bleeding, are among the reasons that make the decision to take a daily aspirin one that should only be made by patients and their physicians. When aspirin is prescribed for heart disease or stroke patients, the dosage is usually very low. The average prescribed daily dosage is generally between 81 mg, the amount in a baby aspirin, to 325 mg, the dosage of a regular strength aspirin, although doses as low as 75 mg can be effective. Because the use of aspirin in cancer prevention is still experimental, no specific recommended dosage has been established, however in the University of Oxford studies, patients were given a daily low-dose aspirin (75 mg to 300 mg).
Non-steroidal anti-inflammatory medications, such as ibuprofen (Motrin, Advil, and others) or medications for aches and pains such as acetaminophen (Tylenol and others), also reduce the clotting action of blood platelets. Consult your doctor before you take both aspirin and other NSAIDs to prevent excessive bleeding.