People’s Pharmacy: Is new aspirin formulation easier on the stomach?

Q. I love the down-to-earth drug information in your columns with the pros and cons of various medications. After reading about the “new” wonder drug aspirin, I started taking an enteric-coated low-dose tablet a few times a week.

My concerns are stroke and cancer, but I have a history of GERD (gastroesophageal reflux disease) and ulcers. Recently I read that enteric-coated tablets could burn holes in my intestines. Not good! Is there any way to safely ingest aspirin and get the health benefits without suffering intestinal issues?

A. You are right that aspirin can be very irritating to the digestive tract. Ordinary aspirin tablets are notorious for causing stomach ulcers. Even enteric-coated tablets could damage the lining of the small intestines (International Journal of General Medicine, Aug. 24).

We recently learned about a new aspirin formulation. It provides a liquid inside a capsule that releases the aspirin in the small intestine. The aspirin is complexed with a phospholipid that hangs on to it so long as the environment is acidic – which the stomach is.

This aspirin product is sold under the brand name Vazalore in both low-dose (81 mg) and regular-strength (325 mg) capsules. One study in the American Journal of Gastroenterology (February 2011) suggests that this lipid-complex aspirin formulation may be less likely to damage the gastrointestinal tract.

Before undertaking long-term aspirin use, however, you should talk with your doctor about the pros and cons. The U.S. Preventive Services Task Force recently issued recommendations discouraging the routine use of aspirin to prevent initial heart attacks, strokes and cancer.

Q. I’ve had Graves’ disease for years, and currently I manage it with methimazole every other day. Before treatment, my symptoms included extreme mental and physical fatigue such as you would experience after a marathon. This crept up slowly over time. The most debilitating symptom was the brain fog, which made me feel very disorganized. I also experienced weight loss.

I had a scan two weeks ago that required iodine, and my sleep has been terribly interrupted since. I had asked the technician if it would bother my thyroid, and she said no. Now I am sure that it did. It is difficult to find good information about hyperthyroidism, and I’d appreciate anything you can offer.

A. Graves’ disease is an autoimmune condition in which the thyroid gland goes into overdrive. Hyperthyroidism often leads to fatigue, anxiety, insomnia, heart palpitations, weight loss, poor concentration, irritability, tremors, weakness and frequent bowel movements. Excess iodine, such as used in imaging contrast media, can trigger thyroid dysfunction (European Thyroid Journal, July).

To learn more about Graves’ disease as well as hypothyroidism and their treatment, you may wish to read our eGuide to Thyroid Hormones. This online resource may be found under the Health eGuides tab at peoplespharmacy.com. If you ever need another scan, please discuss your condition with the radiologist beforehand. It might be possible to use a different contrast medium without iodine.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via via their website peoplespharmacy.com.