Aspirin still required after blood counts normalised ?

[Baby_steps]

Hi all,

I have had ET and later PV for several years. Thanks to Pegasys my blood counts have all been in the normal range for nearly 1.5 years now. My hematologist still wants me to continue taking Aspirin but I am keen to discontinue it because I am also dealing with IBS and want to be able to take other supplements (like Omega 3) without risk of excessive blood thinning. I’m curious what advice other people have been given in this situation?

Thanks so much !

[RoundTheWorld]

Hello Baby_steps.

My understanding is that aspirin is an anti-platelet therapy that affects how the platelets behave (reducing their tendency to stick together and form blood clots) rather than/more than reducing the number of platelets to thin the blood.

Pegasys thins the blood by reducing the number of blood cells in it.

(Not sure if that helps as I don't know how Omega-3 interacts with either med).

[ainslie]

it doesn’t matter if your counts are normalised or not, we mostly need aspirin with MPN, enteric coated can be easier than the ordinary aspirin, if your doc reccomends it I would go with it, the potential risks are too high

[hunter5582]

Reaching hematologic targets with PV reduces the risk of thrombosis but does not eliminate it. Aspirin or another antiplatelet or anticoagulant medication is recommended for most patients. There are other blood thinning medications that can be considered if you have trouble tolerating aspirin due to the GI issues.

Supplement-aspirin interactions do need to be considered. While some supplements risk potentiating the aspirin, not all do. This is an issue to discuss with a knowledgeable medical provider. I consult with an Integrative Medicine doctor for this reason. I am taking Curcumin, L-Glutathione, and a Pro-Resolving Mediator along with the aspirin to help manage systemic inflammation. I do not experience any increased hemorrhage. The supplements help with the inflammatory symptoms and are clearly worth using for me.

We always have to do a risk/benefit analysis with any medication or supplement we take. Nothing we take is without risks, including the aspirin. We need to ensure that the benefits outweigh the risks with each decision. Sometime, the only way to find out is to take a reasonable risk and try different interventions. It is best to do this with expert consultation.

Wishing you all the best.

[Baby_steps in reply to hunter5582]

Thank you so much for sharing your insights, very helpful ! 🙂

[AndyT]

I’ve been advised that I need to continue taking aspirin as with ET our platelets are stickier than normal, so there’s still a risk of thrombosis despite mine being in normal range for the last 7 years, on treatment with Pegasys.

[Baby_steps]

Thank you all for your input. Reassuring to know that the advice I have been given is best practice! 🙂

[KLCTJC]

I am actually going to ask my oncologist this exact thing next week. My counts are really good. Will be curious to see what they say. I think it is like Hunter said the docs will weigh risk vs benefit. But I am going to ask because my HCT is 36, PLT 183, wbcs 3. So just not sure I need it but will see what they say.

[Baby_steps in reply to KLCTJC]

I’d be interested to hear what advice you get ! 🙂