Aspirin and Blood Thinning

"Since I have anemia and use Aspirin, does Aspirin worsen my anemia since it thins the blood?"

Of course, there is Anemia from Dilution (Hemodilution), which occurs when the plasma volume increases without a proportional increase in the formed elements of the blood.

There are a series of pathological conditions when the plasma volume increases (third trimester of pregnancy – “Physiological” Anemia of pregnancy, Congestive Heart Disease, administration of hypertonic solutions, albumin, plasma, etc.).

In our clinical practice, we are compelled to use "blood thinners" (and in foreign literature, the term “Blood Thinner” is found) for Anticoagulants and Antiplatelets. In fact, this term is used to make it easier for the patient to understand the problem, but it complicates our work.

None of these anticoagulant and antiplatelet preparations actually thin the blood in the true sense. If you have a mixture of 1 kg rice with 1 liter of water and want to thin it, you either need to add more water for the same amount of rice, or reduce the amount of rice for the same amount of water. These preparations neither change the number of blood cells nor change the plasma volume, thus they do not cause "Blood Thinning".

Aspirin is an antiplatelet drug, it does not thin the blood, it blocks the function of platelets (antiplatelet effect, for which it is commonly used) and thus prevents their attachment to the blood vessel wall when it is damaged. Consequently, when there is damage to the blood vessel, the stopping of hemorrhage will not be optimal and therefore from blood loss, there may be Acute Posthemorrhagic Anemia.

Another way Aspirin can cause Anemia, is through gastritis and possible gastrointestinal bleeding (Aspirin-induced gastritis and gastrointestinal bleeding), which if significant bleeding + and the antiplatelet effect (that accompanies it) occur, will cause Acute Posthemorrhagic Anemia. If the bleeding is minor and repeated, it might cause Iron Deficiency and/or Iron Deficiency Anemia.

Aspirin does not cause "Blood Thinning", hence it does not cause Anemia from Hemodilution, thus it does not worsen the current anemia for which the patient will be treated, as long as it does not cause small or large blood loss from Aspirin as explained above. As long as we are under these conditions, the patient will receive specific treatment for the anemia and aspirin according to specific recommendations.