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My Favorite Herb:
Extract of Willow Bark (Aspirin)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article originally printed in the January 29-30, 2005 issue
Reprinted on page 8 in the May 23-24, 2009 issue of
The Mississauga News under the feature: Health, Wellness & Beauty, Medicine Matters.

Without any doubt whatsoever, it is extract of willow bark! This is one medicine that has been around for thousands of years and keeps on amazing me with new uses. It has even gone to the moon and is a basic ingredient in my black bag. More commonly, you may know this wonder drug as ASPIRIN.

Salicin is the active ingredient in several plants including willow bark that has been extracted in brews over the years as a remedy for fever and pain. In the last century, Salicin was produced as a powder which was very bitter tasting and irritating to the stomach. In 1897, Felix Hoffmann, a German chemist, sought to treat the arthritis afflicting his family members and synthesized acetylsalicylic acid (ASA) which was easier to swallow and less irritating.

Aspirin is an excellent pain reliever and anti-inflammatory medicine. When I was a child, it was the first choice for fever, and many people remember the small orange tasting little pills that dissolved in our mouths. By the early 1970's a rare condition called Ryes Syndrome sometimes developed in children when they were given aspirin for high fevers associated with viral illnesses. The popularity plummeted and parents switched to the "safer" acetaminophen compounds found in the Tylenol brands and others. But other interesting observations began to emerge. For one thing, aspirin was found to be able to thin the blood. This was certainly an advantage for conditions where the blood clots such as embolic strokes and heart attacks. Nowadays, the first thing to do when a heart attack is suspected is to pop an aspirin. In one study, it was estimated that this simple maneuver alone could save as many as 50,000 lives in North America. It still is a popular drug for headaches and arthritis. How popular? Over 80 billion aspirin tablets are served up each year!

One action of aspirin is to bind to an enzyme called COX-2 (cyclooxygenase 2). This enzyme is a protein found in most normal tissue which job is to help manufacture prostaglandins. Prostaglandins signal pain, and begin a process of inflammation meant to heal injury. Prostaglandins can also cause blood platelets to clump and form clots. In the stomach, they help maintain the lining from harmful acids. Understanding the action of aspirin explains the so-called side effects. Aspirin also inhibits the COX-1 enzyme in the stomach. Less prostaglandin means less lining and more stomach irritation. To get around this, manufacturers coat their products so that they pass through the stomach with minimal irritation. The term "baby blue" is used for the 81mg coated aspirin product that is widely used to help prevent stroke and heart attack.

Even more exciting is the newer uses for Aspirin. There are observations emerging that suggest that it may play a role in the prevention of gastro-intestinal cancer, help lower blood pressure in problem pregnancies, and slow the development of cataracts. Just imagine, all these benefits found in one drug, herbal substance, or whatever you want to call it. On the flip side, it still accounts for a great many overdoses, ulcers and bleeding problems in persons who cannot tolerate it or take too much of it. Despite this, it still remains a favorite of mine. The old joke of "Take two aspirins and call me in the morning" needs to be modernized to "Take one aspirin and live to see me next year!"

Related resources:

Should You Take Aspirin for Heart Disease? Medically Reviewed by James Beckerman, MD, FACC, WebMD, May 29, 2020. "How Does Aspirin Help the Heart? It eases inflammation, helps prevent blood clots, and it can reduce your risk of death. What Are the Risks? It can increase your chance of having stomach ulcers and abdominal bleeding. During a stroke, aspirin can boost your risk of bleeding into the brain."
Take the Aspirin Quiz from Health Library. Online Medical Reviewer: Fraser, Marianne, MSN, RN, Hurd, Robert, MD, and Pierce-Smith, Daphne, RN, MSN, CCRC, 3/1/2019.
Daily aspirin therapy: Understand the benefits and risks from MayoClinic.
'An Aspirin a Day' - Just Another Cliché? By Tamar Nordenberg, U.S. Food and Drug Administration (FDA).
Is It Safe to Take Aspirin and Ibuprofen Together? From Healthline. Medically reviewed by Alan Carter, Pharm.D., Written by University of Illinois, Sep 18, 2018.
An Aspirin a Day ... or Not? By Gina Shaw, WebMD Archives. Aspirin's protective powers may now guard against cancer, too.
Uses, benefits, and risks of aspirin from Medical News Today. Medically reviewed by Alan Carter, Pharm.D., Written by Yvette Brazier, Sep 29, 2020. What is aspirin? Aspirin is a common drug for relieving minor aches, pains, and fevers. People also use it as an anti-inflammatory or a blood thinner. Article provides an overview of aspirin, including its uses, risks, interactions, and possible side effects.
Aspirin for primary prevention of cardiovascular disease: Advice for a decisional strategy based on risk stratification by Alberto Aimo and Raffaele De Caterina, Anatolian Journal of Cardiology, 2020 Feb; 23(2): 70-78.
A major change for daily aspirin therapy from Harvard Health Publishing, Harvard Medical School, Nov 1, 2019. "But taking aspirin increases the risk for bleeding in the stomach and brain."
Should everyone take an aspirin a day? fromHarvard Health Publishing, Harvard Medical School, Mar 16, 2010. "Researchers from six large primary prevention trials of aspirin pooled their data and analyzed them as if they were from a single large trial. It's a legitimate technique called meta-analysis. In this relatively healthy group of 95,000 volunteers, the reduction in heart attacks and strokes in people taking aspirin was almost counterbalanced by major bleeding in the gastrointestinal system and the brain. The researchers concluded that for individuals without previously diagnosed cardiovascular disease, 'aspirin is of uncertain net value.'"

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