The Downside of Taking Aspirin: When Bleeding Won’t Stop | The Survival Doctorby James Hubbard, MD, MPH

I’m constantly amazed by the effect even the lowest dose of aspirin has on bleeding. I’ll be putting pressure on a cut, and the bleeding will just not be stopping. The person with the cut will have already told me they have no known bleeding disorders and haven’t taken any aspirin, and I’ll ask again.

“Well, I did take something a few days ago. It may have had aspirin in it.” Or, “Oh, I do take a baby aspirin.” Voila. I have my answer. I’ll just have to apply pressure for ten minutes instead of five, Or twenty minutes instead of ten. Aspirin doesn’t stay in the system that long, but its effect on bleeding does.

Here’s how.

If a blood vessel is injured, platelets are the first line of defense to stop bleeding. Almost immediately they start gathering at the injured site. And the bleeding triggers them to become stickier. They form a plug at the site. This gives time for a second line of clotting formation (fibrin) to build a stronger clot.

Aspirin decreases the chemical in the blood that makes platelets stickier. And, although the aspirin leaves the system within hours, its effect extends the whole lifetime of the platelet—five to ten days.

The Downside of Taking Aspirin: When Bleeding Won’t Stop | The Survival Doctor

This is a blood smear under a microscope. The fuchsia dots are platelets clotting. The reddish circles are blood cells.

Now usually, this is easily remedied by applying pressure longer to give the platelets longer to clot. (They don’t lose all their stickiness.) But, if the bleeding is internal—say, from a stomach ulcer or in a blood vessel in the head—putting pressure on it is not an option. Hence, the person is at significantly greater danger to have a larger amount of bleeding.

The only thing to do for that is get the person to a medical facility ASAP. Meantime, stop the aspirin. Eating foods high in vitamin K (essential in clotting) might help a little (unless it’s an abdomen wound and it’s dangerous to eat or drink).

What to Do For Cuts if You’re Taking Aspirin
  1. Expect to hold pressure longer.
  2. Apply a pressure dressing to continue the pressure.
Stop the Aspirin?

If you’re taking aspirin daily to prevent a heart attack, and the bleeding is not internal, this is a tricky question best answered by your doctor.

  1. Remember the aspirin already has a permanent effect on the platelets in your system. It’s true new, unaffected platelets are being formed all the time, as your older platelets die off, so stopping the aspirin will gradually help.
  2. If you stop aspirin for five or more days, it can have a rebound effect on your platelets, making them stickier and increasing your risk for a heart attack.
The Survival Doctor's Guides to Wounds and Burns

Bottom line: If the cut is small, don’t worry. If it’s larger and it’s harder to stop bleeding and you can’t get to a doctor, stop the aspirin for a day or two.

>> Bleeding tips always at the ready: The Survival Doctor’s Guide to Wounds.

What If It’s Not the Aspirin?

Other medicine and foods than can increase bleeding time include:

  • Any nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and others, which can prolong bleeding a bit, but not as much as aspirin
  • Other blood thinners such as Coumadin and Plavix
  • Certain herbs such as garlic, ginger, ginkgo, and feverfew
  • Fish oil
  • Vitamin E

Things that can improve blood clotting include:

  • Food rich in vitamin K (which intestinal bacteria also makes)
  • Green, leafy vegetables
  • Dried basil, sage, and thyme
  • Hot and bell peppers
  • Olive oil, soybean oil
  • Beans
  • Whole wheat
  • Oats

So what about you? Have you ever had bleeding that was hard to stop? What did you do?

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Platelets image by Tleonardi (GFDL or CC-BY-3.0, via Wikimedia Commons