Do Your Aspirin Drills

AspirinDrills It’s extremely common for people to say that aspirin is dangerous, damages the intestines, thins the blood, and causes stomach ulcers and uncontrollable bleeding, but you can’t necessarily trust everything you hear.

I’m not a doctor, and I’m not here to give medical, or any other advice. (Always consult your friendly neighbourhood doctor before making medical/pharmaceutical decisions.) I’m not disputing the fact that medicine/science has found some association between aspirin use, and intestinal harm or bleeding issues. But there is also a lot of good scientific/medical evidence, demonstrating that the risks have been, at the very least, overblown. Some have said, claims that aspirin use is risky, began to ramp up, as newer, more profitable drugs came on to the market.

“…deaths attributable to bleeding in subjects randomised to aspirin were 3.9 per 100 000 subjects per year and 5.1 per 100 000 per year in those on placebo…no evidence of any extra cerebral bleeds in 10 000 patients randomised to aspirin…it seems unlikely that aspirin is responsible for peptic ulceration let alone fatal ulceration… low-dose prophylactic aspirin would seem to be remarkably safe, probably far safer than implied…” (P. Elwood, G. Morgan, 2015)

“Of greatest relevance to the risk of prophylactic aspirin is however the risk of a fatal GI bleed in subjects who take low-dose aspirin, relative to the risk in those who take no aspirin…There is no evidence of any significant increase in fatal GI bleeds attributable to aspirin. The risk of death from a bleed is: 3.7 ± 1.6 per 10,000 in subjects randomised to aspirin, and 4.7 ± 1.8 per 10,000 in subjects who had been randomised not to receive aspirin..” (Peter C. Elwood, et al., 2016)

“Of 717 patients with NVUGIB [nonvariceal upper gastrointestinal bleeding] 56 % (402) were taking at least one antithrombotic agent. Seventy-eight (11 %) patients died in hospital, and 310 (43 %) had severe bleeding…being on aspirin was protective against in-hospital mortality, rebleeding, and predictive of a shorter hospital stay…patients who bled on aspirin were less likely to die in hospital of uncontrolled gastrointestinal bleeding and systemic cancer…” (Wehbeh A, et al., 2015)

There are a number of things, that have been shown to be responsible for the various kinds of harm blamed on aspirin use, and there are also a number of things that are known to be able to protect very well, against potential legitimate issues associated with aspirin use.

Statistics can be interpreted in lots of different ways, some that can make the dangers of a particular thing (like aspirin use), seem far greater than they actually are. Interpretations of study results, often accidentally (sometimes even intentionally) conflate the use of harmful NSAIDs (Nonsteroidal Anti-Inflammatory Drugs), with aspirin use, making aspirin look bad.

Not to mention that over the years, there have been numerous studies showing aspirin damaging the lining of the stomach or causing bleeding, which appear to have been poorly designed, often ignoring other factors responsible for problems, or using excessively high, inappropriate doses, leading to conclusions lacking real life relevance regarding aspirin.

And apart from being one of the only NSAIDs, known not to cause serious damage to the intestines, aspirin has even been shown to protect against intestinal lesions caused by other NSAIDs, in a dose dependant manner.

“All NSAIDs tested, except ASA [aspirin], caused hemorrhagic lesions in the small intestine…ASA did not provoke any damage…and prevented the occurrence of intestinal lesions induced by indomethacin, in a dose-related manner.” (Takeuchi K, et al., 2001)

“Low-dose aspirin alone did not significantly increase ulcer incidence. Addition of a cyclooxygenase-2 (COX-2) selective inhibitor to low-dose aspirin increased ulcer incidence, to a rate not significantly less than a nonselective nonsteroidal anti-inflammatory drug (NSAID) alone.” (Laine L, et al., 2004)

In fact regular use of aspirin has been found to be protective for the intestines, against many different irritants, and has also been proven to help safeguard against gastric, colon, and other varieties of cancer.

Aspirin is anti-inflammatory and has antioxidant properties, helping to defend against the breakdown of polyunsaturated fats (PUFAs). Aspirin protects against excessive estrogen production, as well as reducing exposure to bacterial endotoxin, serotonin, nitric oxide and lactic acid. Aspirin improves thyroid energy metabolism (helping shift cells away from fatty acid use, towards glucose oxidation), and reduces free fatty acid release.

Excessive biochemical stress and inflammation, are well known to damage the intestines, interfere with digestive function, and promote bacterial and other microbial issues. Aspirin is protective against stress, inflammation, and microbial overgrowth.

Bacterial infections have been shown to be a factor behind the development of intestinal ulceration and bleeding, often blamed on aspirin. Aspirin is one thing which can help protect against bacterial infections, and can also have a powerful synergistic relationship with antibiotics.

“This study aimed to determine…if (and by how much) infection alters the baseline risk of peptic ulcers during LDA therapy…analysis suggests that H. pylori increases the risk of LDA ulcers by almost 70%…” (Sarri GL, et al., 2019)

“…aspirin and salicylate significantly inhibited the growth of H pylori…and reduced the efficiency of colony formation and colony size…aspirin could inhibit the growth of other bacterial species…and increases the susceptibility to antimicrobial agents…” (Wang WH, et al., 2003)

Aspirin can shield against abnormal clotting and brain aneurysms, and protects against cancer, heart disease, Alzheimer’s, diabetes, stroke, arthritis, depression, anxiety and numerous other inflammatory or degenerative conditions which involve bleeding issues.

“Aspirin has been found to be…safe in patients harboring cerebral aneurysms and clinical studies provide evidence that it may decrease the overall rate of rupture.” (Starke RM, et al., 2015)

“…there is no evidence that aspirin is thrombogenic…even…in high therapeutic doses…impressive results…obtained with low doses of aspirin (…100 to 300 mg per day) in preventing aorta coronary bypass thrombosis, in patients undergoing hemodialysis, and in patients with unstable angina. Aspirin…effective in preventing stroke and death in patients with cerebral ischemia when…in doses of approximately 1 gram per day…aspirin is effective…in doses between 300 mg per day and 1500 mg per day in patients who have survived myocardial infarction.” (Buchanan MR, Hirsh J., 1986)

“…there was a mortality benefit from anti-platelet drugs irrespective of their bleeding risk…there was no increased risk of bleeding in cancer patients who received aspirin in the setting of acute coronary syndrome, even in patients with a platelet count of less than 100,000/μl…studies suggest the benefit of aspirin even in patients with thrombocytopenia…” (Philip Toner, et al., 2015)

“We identified substantial reductions in the early risks of all stroke, ischaemic stroke, and acute myocardial infarction with aspirin…up to a 90% reduction in early risk of disabling or fatal recurrent ischaemic stroke after TIA and minor stroke.” (Rothwell PM, et al., 2016)

“…aspirin use is associated with a reduced risk of gastric, esophageal, colorectal, pancreatic, ovarian, endometrial, breast, and prostate cancers, and small intestine neuroendocrine tumors…The longer those who had used aspirin, the lower their risk of cancer was…” (Yan Qiao, et al., 2018)

“…we found that users of low-dose aspirin had a 70% reduction in gastric cancer risk when compared with nonusers…the risk reduction of gastric cancer by aspirin was greater among H. pylori–infected subjects…” (Ka Shing Cheung, et al., 2018)

Doesn’t it seem a little strange, that aspirin can be so good at protecting against diseases like cancer and stroke and heart disease, that are promoted by inflammation, bacterial endotoxin excess, and damage to the digestive system, the very things that help promote issues that aspirin is so often blamed for?

The ability of aspirin to protect against the inflammatory effects of systemic exposure to bacterial endotoxin, is one thing which has been shown to prevent the metastasis of colon cancer. Aspirin also appears to protect against the development of Barrett’s oesophagus in patients with gastro-oesophageal reflux disease (GORD).

“…lipopolysaccharides (LPS) could enhance the metastasis potential of…colon cancer [CRC] cell lines….aspirin effectively decreased the metastasis capacity of colon cancer cells…Aspirin treatment lead to the downregulation of TLR4…which resulted in the decrease of…cells migration…induced by LPS…aspirin not only can reduce the occurrence of CRC but also reduces the risk of metastasis in CRC…” (Ying J, et al., 2018)

“Our molecular investigations have yielded a potential explanation for case-control studies finding that aspirin protects against the development of Barrett’s oesophagus, while other NSAIDs do not…” (Huo X, et al’, 2018)

Aspirin can also inhibit biofilm formation from Candida albicans infection. Drug resistance of biofilms, is known to make the treatment of infections difficult. Salicylate has also been used to make E.coli infections more treatable with certain types of antibiotics.

“…aspirin possesses potent antibiofilm activity in vitro and could be useful in combined therapy with conventional antifungal agents…Pathogenic fungi in the genus Candida can cause…serious systemic diseases and are…important agents of hospital-acquired infection…Aspirin…can inhibit the production of some of these components by as much as 95%…” (Mohammed A. S. Alem, L. Julia Douglas, 2004)

Dissolving aspirin in water and consuming it with a meal, has been shown to help avoid or minimize initial irritation, oftentimes caused by added excipients or binding ingredients. Consuming aspirin with equal parts sodium bicarbonate or glycine (or both), has been demonstrated to protect against intestinal damage. High doses of aspirin can deplete glycine, and glycine depletion is known to be involved with aspirin issues.

“Use of low doses of enteric-coated or buffered aspirin carries a three-fold increase in the risk of major UGIB [upper-gastrointestinal bleeding]. The assumption that these formulations are less harmful than plain aspirin may be mistaken.” (Kelly JP, et al., 1996)

“Two aspirin tablets in 100 ml fluid will produce microscopical damage to the human stomach…sodium bicarbonate in amounts equivalent to one-third of a teaspoonful of baking soda protects the gastric mucosa against aspirin-induced damage…” (Bowen BK, et al., 1977)

“In contrast to plain ASA, where 9 of 10 volunteers reported gastrointestinal side effects, all subjects receiving ASA in combination with glycine did not complain from any dyspeptic symptoms, i.e. epigastric pain etc.” (Müller P, et al., 1991)

A small amount of vitamin K2 taken with aspirin, has been shown to help prevent minor bleeding or bruising issues, which can arise for some people with regular (especially high dose) aspirin usage.

“The approach to the treatment of vitamin K deficiency depends on the clinical setting and the severity of bleeding… reversal of the vitamin K deficiency by the administration of vitamin K is generally adequate…drugs implicated to cause the deficiency…include…large doses of aspirin.” (Gopakumar H, et al., 2010)

For those who are interested, there are also studies showing aspirin use can improve fertility, and protect against preeclampsia and miscarriage. And aspirin has been used to effectively treat psychiatric and neurodegenerative disorders, including depression, schizophrenia, bipolar disorder, and Alzheimer’s disease.

There is also evidence suggesting that aspirin, taken before bed, can reduce the impact of night time stress, lower blood pressure, protect against early morning heart attacks (the most common time when stress is highest), and potentially improve sleep or ameliorate the negative effects of lack of sleep.

Are you surprised that the potential risks associated with taking aspirin, are so heavily promoted, and the multitude of life saving benefits from regular aspirin use, are not so well known?

Read more here.

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Proc Soc Exp Biol Med. 1985. Salicylic acid blocks indomethacin-induced cyclooxygenase inhibition and lesion formation in rat gastric mucosa. Ligumsky M, et al.

Dig Dis Sci. 2015 Jul;60(7):2077-87. Aspirin Has a Protective Effect Against Adverse Outcomes in Patients with Nonvariceal Upper Gastrointestinal Bleeding. Wehbeh A, Tamim HM, Abu Daya H, Abou Mrad R, Badreddine RJ, Eloubeidi MA, Rockey DC, Barada K.

Lancet. 2010 Nov 20;376(9754):1741-50. Long-term effect of aspirin on colorectal cancer incidence and mortality: 20-year follow-up of five randomised trials. Rothwell PM, Wilson M, Elwin CE, Norrving B, Algra A, Warlow CP, Meade TW.

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Antimicrobial Agents and Chemotherapy 48(1):41-7 · February 2004. Effects of Aspirin and Other Nonsteroidal Anti-Inflammatory Drugs on Biofilms and Planktonic Cells of Candida albicans. Mohammed A. S. Alem, L. Julia Douglas.

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PLoS One. 2019 Apr 18;14(4):e0200533. Effect of preconception low dose aspirin on pregnancy and live birth according to socioeconomic status: A secondary analysis of a randomized clinical trial. Agrawala S, Sjaarda LA, Omosigho UR, Perkins NJ, Silver RM, Mumford SL, Connell MT, Naimi AI, Halvorson LM, Schisterman EF.

J Gastroenterol Hepatol. 2019 Mar;34(3):517-525. Helicobacter pylori and low-dose aspirin ulcer risk: A meta-analysis. Sarri GL, Grigg SE, Yeomans ND.

Drugs. 2017 Nov;77(17):1819-1831. Aspirin for Prevention of Preeclampsia. Atallah A, Lecarpentier E, Goffinet F, Doret-Dion M, Gaucherand P, Tsatsaris V.

Cerebrovasc Dis. 2015;39(5-6):332-42. Potential role of aspirin in the prevention of aneurysmal subarachnoid hemorrhage. Starke RM, Chalouhi N, Ding D, Hasan DM.

Brain Res. 2012 Nov 16;1485:77-87. Targeting inhibitory neurotransmission in tinnitus. Richardson BD, Brozoski TJ, Ling LL, Caspary DM.

PLoS One. 2016 Nov 15;11(11):e0166166. Systematic Review and Meta-Analysis of Randomised Trials to Ascertain Fatal Gastrointestinal Bleeding Events Attributable to Preventive Low-Dose Aspirin: No Evidence of Increased Risk. Elwood PC, Morgan G, Galante J, Chia JW, Dolwani S, Graziano JM, Kelson M, Lanas A, Longley M, Phillips CJ, Pickering J, Roberts SE, Soon SS, Steward W, Morris D, Weightman AL.

Gut. 2003 Apr;52(4):490-5. Aspirin inhibits the growth of Helicobacter pylori and enhances its susceptibility to antimicrobial agents. Wang WH, Wong WM, Dailidiene D, Berg DE, Gu Q, Lai KC, Lam SK, Wong BC.

J Pediatr Neurosci. 2010 Jan;5(1):55-8. Vitamin K deficiency bleeding presenting as impending brain herniation. Gopakumar H, Sivji R, Rajiv PK.

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Antimicrob Agents Chemother. 1990 May;34(5):786-91. Potentiation of susceptibility to aminoglycosides by salicylate in Escherichia coli. Aumercier M, Murray DM, Rosner JL.

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European Heart Journal – Cardiovascular Pharmacotherapy, Volume 3, Issue 2, April 2017, Pages 100–107. Non-steroidal anti-inflammatory drug use is associated with increased risk of out-of-hospital cardiac arrest: a nationwide case–time–control study. Kathrine B. Sondergaard, Peter Weeke, Mads Wissenberg, Anne-Marie Schjerning Olsen, Emil L. Fosbol, Freddy K. Lippert, Christian Torp-Pedersen, Gunnar H. Gislason, Fredrik Folke.

Arch Intern Med. 2011;171(16):1487-1493. Prospective Evaluation of Analgesic Use and Risk of Renal Cell Cancer. Eunyoung Cho, ScD; Gary Curhan, MD, ScD; Susan E. Hankinson, ScD; et al.

Hum Exp Toxicol. 1990 Nov;9(6):389-95. Depletion of plasma glycine and effect of glycine by mouth on salicylate metabolism during aspirin overdose. Patel DK, Ogunbona A, Notarianni LJ, Bennett PN.

Med J Aust 2018; 209 (7). Helicobacter pylori infection and the risk of upper gastrointestinal bleeding in low dose aspirin users: systematic review and meta-analysis. Justin CH Ng and Neville David Yeomans.

Br Med J. 1977 Oct 22;2(6094):1052-5. Effect of sodium bicarbonate on aspirin-induced damage and potential difference changes in human gastric mucosa. Bowen BK, Krause WJ, Ivey KJ.

PLoS One. 2016 Sep 1;11(9):e0161218. Aspirin, but Not Tirofiban Displays Protective Effects in Endotoxin Induced Lung Injury. Jessica Tilgner ,Klaus Thilo von Trotha ,Alexander Gombert,Michael J. Jacobs,Maik Drechsler,Yvonne Döring,Oliver Soehnlein,Jochen Grommes.

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Scientific Reports volume 7, Article number: 13384 (2017). Effects of long-term aspirin use on molecular alterations in precancerous gastric mucosa in patients with and without gastric cancer. Yuki Michigami, Jiro Watari, Chiyomi Ito, Ken Hara, Takahisa Yamasaki, Takashi Kondo, Tomoaki Kono, Katsuyuki Tozawa, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Takeshi Morimoto, Kiron M. Das & Hiroto Miwa.

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JNCI: Journal of the National Cancer Institute, Volume 110, Issue 7, July 2018, Pages 743–749. Aspirin and Risk of Gastric Cancer After Helicobacter pylori Eradication: A Territory-Wide Study. Ka Shing Cheung, Esther W Chan, Angel Y S Wong, Lijia Chen, Wai Kay Seto, Ian C K Wong, Wai K Leung.

Arzneimittelforschung. 1991 Aug;41(8):812-4. German. [The effect of glycine on the gastroduodenal tolerability of acetylsalicylic acid. An endoscopic, controlled double-blind study in healthy subjects]. Müller P, Dammann HG, Bergdolt H, Simon B.

BMB Rep. 2014 Jan;47(1):45-50. Aspirin inhibits lipopolysaccharide-induced COX-2 expression and PGE2 production in porcine alveolar macrophages by modulating protein kinase C and protein tyrosine phosphatase activity. Duan Y, Chen F, Zhang A, Zhu B, Sun J, Xie Q, Chen Z.

BMJ. 2005 Jun 18;330(7505):1440-1. Aspirin for everyone older than 50? Elwood P, Morgan G, Brown G, Pickering J.

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Curr Pharm Des. 2015;21(34):4996-5016. Review. The GABAergic System and the Gastrointestinal Physiopathology. Auteri M, Zizzo MG, Serio R.

Adv Ther. 2003 Sep-Oct;20(5):237-45. Acetylsalicylic acid tablets with glycine improve long-term tolerability in antiplatelet drug therapy: results of a noninterventional trial. Kusche W, Paxinos R, Haselmann J, Schwantes U, Breddin HK.

Dig Dis Sci. 1983 Jan;28(1):1-6. Gastric adaptation occurs with aspirin administration in man. Graham DY, Smith JL, Dobbs SM.

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Cell Biosci. 2018 Jan 4;8:1. Aspirin inhibited the metastasis of colon cancer cells by inhibiting the expression of toll-like receptor 4. Ying J, Zhou HY, Liu P, You Q, Kuang F, Shen YN, Hu ZQ.

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Translational Psychiatry volume 8, Article number: 27 (2018). Treatment of bipolar depression with minocycline and/or aspirin: an adaptive, 2×2 double-blind, randomized, placebo-controlled, phase IIA clinical trial. Jonathan B. Savitz, T. Kent Teague, Masaya Misaki, Matt Macaluso, Brent E. Wurfel, Matt Meyer, Douglas Drevets, William Yates, Ondria Gleason, Wayne C. Drevets & Sheldon H. Preskorn.

Crit Care Med. 2016 Apr;44(4):773-81. Low-Dose Acetylsalicylic Acid Treatment and Impact on Short-Term Mortality in Staphylococcus aureus Bloodstream Infection: A Propensity Score-Matched Cohort Study. Osthoff M, Sidler JA, Lakatos B, Frei R, Dangel M, Weisser M, Battegay M, Widmer AF.

The Journal of Clinical Endocrinology & Metabolism, Volume 102, Issue 5, 1 May 2017, Pages 1495–1504. Preconception Low-Dose Aspirin Restores Diminished Pregnancy and Live Birth Rates in Women With Low-Grade Inflammation: A Secondary Analysis of a Randomized Trial. Lindsey A. Sjaarda, Rose G. Radin, Robert M. Silver, Emily Mitchell, Sunni L. Mumford, Brian Wilcox, Noya Galai, Neil J. Perkins, Jean Wactawski-Wende, Joseph B. Stanford, Enrique F. Schisterman.

BMC Medicine volume 11, Article number: 74 (2013). Aspirin: a review of its neurobiological properties and therapeutic potential for mental illness. Michael Berk, Olivia Dean, Hemmo Drexhage, John J McNeil, Steven Moylan, Adrienne O’Neil, Christopher G Davey, Livia Sanna & Michael Maes.

Gut. 2018 Apr;67(4):606-615. Aspirin prevents NF-κB activation and CDX2 expression stimulated by acid and bile salts in oesophageal squamous cells of patients with Barrett’s oesophagus. Huo X, Zhang X, Yu C, Cheng E, Zhang Q, Dunbar KB, Pham TH, Lynch JP, Wang DH, Bresalier RS, Spechler SJ, Souza RF.

Hypertension. 2009 Nov;54(5):1136-42. Time-dependent effects of low-dose aspirin on plasma renin activity, aldosterone, cortisol, and catecholamines. Snoep JD, Hovens MM, Pasha SM, Frölich M, Pijl H, Tamsma JT, Huisman MV.

Hypertension. 2015 Apr;65(4):743-50. Time-dependent effects of aspirin on blood pressure and morning platelet reactivity: a randomized cross-over trial. Bonten TN, Snoep JD, Assendelft WJ, Zwaginga JJ, Eikenboom J, Huisman MV, Rosendaal FR, van der Bom JG.

PLoS One. 2016 Nov 30;11(11):e0166103. The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older. Agus DB, Gaudette É, Goldman DP, Messali A.

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8 Responses

  1. Avatar A says:

    What about ear damage and tinitus?

    • DanM@cowseatgrass DanM@cowseatgrass says:

      One of the studies in this article talks about aspirin interfering with and depleting glycine, and glycine being given for aspirin poisoning…glycine is not only known to protect the intestines (and has been used to treat GERD and GI cancers), it also inhibits nervous system excitation and inflammation…and stress in general. Modern diets are generally deficient in glycine and so some people might be oversensitive as a result. Interference with glycine and some other inhibitory substances (see studies below)…Taurine and GABA…has been shown to be involved in tinnitus.

      • Avatar Richard says:

        Dan, So should I supplement with Glycine as opposed to aspirin? What is tinnitus and I also supplement with GABA at night. What are the best supplement stack or protocol to help heal gut and GI track before bed?

        Thanks Love your Work!!

        • DanM@cowseatgrass DanM@cowseatgrass says:

          I personally use glycine together with aspirin, as I have seen evidence showing aspirin depletes glycine, and that this can be a factor causing issues with aspirin use. Tinnitus has been demonstrated to have a multitude of causes, with intestinal irritation and thyroid dysfunction, as well as excess PUFAs, often appearing to be central. Make sure you talk to a doctor or other health professional, but I like to use things like aspirin, glycine, activated charcoal, periactin (cyproheptadine), sodium bicarb, certain antibiotics, carrot salad, well cooked mushrooms, and some other pro-metabolic anti-inflammatory things mentioned in my articles, as well as removing harmful ingredients and making lifestyle changes of many kinds. I believe there are also nervous system issues that can be causative and often need to be addressed to fix digestion related issues. See for great info re neurophysiology.

    • DanM@cowseatgrass DanM@cowseatgrass says:

      This is probably also relevant regarding aspirin, stress, glycine depletion, and intestinal issues…and tinnitus.

  2. Avatar Gelatin Fabrication says:

    I read an article recently, that discussed “mental illness” studies and this article referenced mental illness directed towards a likely inflammation. Since, inflammatory conditions are more likely passed on genetically. And those with inflammation and then a stress or trauma on top of that, with the inflammation that occurred first, are the ones that then have the brain problem. the theory rests that if the inflammation were treated or not present, then the “mental illness” or also seizure may not happen. Suggests also that studies show those who take Aspirin regularly suffer less “mental illness” episodes. Peace.

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