I’ve been on low dose aspirin for about fifteen years. Simon reckoned it was a simple thing to do that would be cardioprotective, since my beloved dad died of a heart attack at an early age.
Unbeknownst to me, in the intervening years, it’s fallen out of fashion somewhat. It’s still useful if you’ve got known ischaemic heart disease – angina, heart attacks – but not so much for prevention any more. Still, it hasn’t had any downsides that I’ve noticed. Until this week. I mentioned my dramatic bicycle spill on Monday evening, didn’t I? And here is the physical result.
As it happens, at the same time I have another less spectacular bruise on my lower leg after the dogs smacked into me during an elaborate high speed play fighting session at the beach last weekend. So, it seems to me that maybe the risk/benefit ratio for taking aspirin has changed for me and it might be time to stop it. But not so fast! It turns out that aspirin is probably helpful in preventing bowel polyps and possibly even bowel cancer. I’ve got a family history of that too so that’s also good news for me.
It’s not the only time in my career that the view of some drugs have changed as experience and research continues. The big example from before my time was Thalidomide. Hailed as a fabulous cure for morning sickness in pregnancy, it took way too long for people to figure out it was causing birth defects, most famously missing limbs. It’s since been repurposed in use for some severe illnesses.
When I was at med school, HRT was promoted as a way of protecting older women from heart disease as well as treating the symptoms of menopause (not that anyone in medicine seemed to care about menopause in those days – hey ho!) Then, it was deemed to be too dangerous to use as it increased the risk of breast cancer. Now, it’s back in vogue again, thank goodness.
Similarly, many existing drugs can be repurposed, as ongoing experience show that they can be used to treat other illnesses from those they were originally invented for. Unfortunately, research into these applications struggle to get funding as the pharmaceutical companies can’t make any money from it. I’m no conspiracy theorist, but what’s the benefit of treating some rare condition (or even cancer) with an off patent drug when you can make squillions from treating baldness or erectile dysfunction (both ironically treated with drugs originally developed for other purposes)? Well, it doesn’t do to get too cynical about these things. I have my mental wellbeing to worry about. And after all, there’s no better prescription for health than exercise, eating well, and getting enough sleep. As long as you don’t have some rare disease, you’ll be fine.
I’m attempting to share the link to a New York Times article on this topic below, so even if the link doesn’t work, you’ll know I’m not making it all up.