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Comment by josefresco | Hacker News Reader

The question is; Should I, a relatively healthy 31 year old male start taking Aspirin daily?

Maybe you should ask a real doctor. Right now you're just going to get people who play doctor on the internet.

Yes, please ask your doctor. Daily aspirin use can cause some problems in some people, such as stomach bleeding, which can be deadly.

I think at this point, even doctors don't know. See I have talked to several, and the answers are always mixed.

Some believe the results, some are just waiting for a more definitive study.

In the end one doctor said "..not to take it even if it has SOME benefits. Aspirin, like any other pill can cause gastrointestinal bleeding. So if there is no reason to take it avoid it..."

All pills can do that? I thought many were designed to dissolve in your stomach like tums. Not sure why they should be exceptionally bad, unless tums cause issues too.

I read "pills" as referring to other Aspirin-class medications (OTC NSAIDs and/or pain relievers), such as Naproxen Sodium, Paracetamol and Ibuprofen.

A pill, after all, is just a transport mechanism. It's the substance of the pill that determines side effects and risk. For example, you don't often hear about multivitamins causing stomach bleeding.

Well they all MIGHT. My understanding is that most pills these days have some kind of protection for your stomach. But it doesn't work 100%, and it doesn't work perfectly on everybody.

If there's a marked decrease in cancer, associated with a mild increase in gastro-whatever bleeding, then it's probably a good trade-off.

If it is mild, it might. I don't know if everybody is willing to take that trade-off. It seems like fixing one problem with another problem.

It's funny, though, how everyone already takes similar trade-offs all the time. E.g., we're trading a high risk of dying a violent death at the hands (or claws) of enemies and predators (life in the primeval savanna) for a lower risk of dying of obesity, diabetes, and so on (modern "civilized" life).

No one's making that choice, it just kind of happened.

That bleeding can cause other problems like anemia, and aspirin can also cause ulcers, which besides the discomfort, can become a serious medical emergency.

This is truly a balancing act, and we really don't know enough to balance it for generally-healthy people at large.

What if the gastrointestinal bleeding is the cause of the decrease in cancer?

This is true. However, you are going to get a far more informed opinion talking to your doctor than you are here or on any other web forum.

Oh god no. Please keep in mind, Aspirin also kills over 20,000 people annually from both gastrointestinal problems and Reye Syndrome.

It might do wonders for the many, but it also has harmful side effects. Me personally knowing and feeling the anguish of those who has lost loved ones to Aspirin.

I personally will NEVER take aspirin opting for other forms of medication.

http://www.wddty.com/aspirin-it-kills-20-000-americans-every...

http://en.wikipedia.org/wiki/Reyes_syndrome

"NSAIDS such as asprin" (wddty.com). So that means that 20,000 is ascribed also to ibuprofen, naproxen, ketoprofen, ketorolac, etc. While there is risk from all of them, the risk is dose-dependent.

The comment was for aspirin daily. So dose dependent is definitely a big thought here.

Reye syndrome affects children under 19 (some say under 16) with a median age of 6 who ingest aspirin after a (typically) viral infection. It is not something that adults should be worried about.

You'd probably ridicule Jenny McCarthy for what she says about vaccines, but your comment is roughly the same thing.

Thanks for the constructive thoughts you add to HN.

Thanks for the ad hominem instead of refuting my point. I attacked your comment, not you.

Digging deeper into the Jenny McCarthy hole, frankly.

That is exactly my question as well. I have been reluctant to take it every day, even though I see so many articles talking about the benefits.

I did some research and I found this as well:

http://kill-or-cure.heroku.com/#term34

http://www.drweil.com/drw/u/id/QAA326650

It is very disappointing that we cannot reach a conclusion, but let's be honest the question everybody is asking is if Aspiring can prevent ALL types of cancer. I think we should start narrowing it down.

Keep in mind that what matters is total mortality and total morbidity, not risk of cancer.

This is absolutely right from the perspective of a primary prevention task force. Individuals might have slightly different values, so perhaps they would accept some tradeoff. (E.g., reducing a 20% lifetime cancer risk down to 10%, while increasing a lifetime fatal bleed risk from 1% to 5%, might be acceptable to some.)

Unfortunately, I readily admit that (1) we can't yet do a reasonable job of giving people their lifetime risk of X; and (2) people (doctors included) aren't great, generally, at statistical thinking.

So yeah, the goal should be to reduce total morbidity and mortality.

I'm not too sure about aspirin, but long-term use of NSAIDs seems like a good way to screw up your stomach.

http://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory...

Happened to me, and I'm only 20. Apparently doctors prescribe these as painkillers all the time, and the gastrointestinal bleeding that sometimes results is one of the main ways prescription drugs kill people.

No.

You expose yourself to known and unknown risks for slight (if any) known benefits and unknown benefits.

Should you, as a relatively healthy 31 year old male, eat better, get more exercise, stop smoking, drink alcohol sensibly, drive safer, etc? I have no idea about you personally, but most people could make reasonably simple lifestyle choices and dramatically reduce their risks of a bunch of stuff and increase their quality of life.

(As always, I'm not a doctor, I have no medical training, etc etc. Disclaimers aren't needed for HN, are they?)

See my numbers cited above. 1 incident of GI bleeding per year out of 833 people taking a once daily, low-dose aspirin. I find those numbers acceptable and will continue to take aspirin. If there are any other medications involved, this further complicates the risk numbers and must be considered. You may not find them acceptable.

Isn't G.I. bleeding grounds for a trip to the emergency room?

This seems like a bigger risk than dying in a car accident by a decently large margin.

1/833 of having the bleeding, _not_ fatal bleeding. Compared to 1/83 lifetime risk of dying in a car accident. http://well.blogs.nytimes.com/2007/10/31/how-scared-should-w...

People (all of us, I'm not picking on you) are terrible at relative risks.

Er, that 1/833 is not a lifetime risk though, it's a yearly risk. So more like 1/10 lifetime risk of a GI bleed. Which is not great, but it depends on how often they're fatal I guess.

saw this last month:

Daily Aspirin May Help Prevent and Treat Cancer.

Taking aspirin every day may significantly reduce the risk of many cancers and prevent tumors from spreading, according to two new studies published on Tuesday.

http://www.nytimes.com/2012/03/21/health/research/studies-li...

http://www.webmd.com/cancer/news/20120320/daily-aspirin-may-...

you'll get a lot of bruises if you take too much

This is what I want to know!

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