How A Low Carb Lifestyle Has Similar Effects As Aspirin

A question was asked as seen below about low carbs and aspirin;

Do you advise your patients to take a low dose aspirin each day if they are on a low carb diet?

My Response;

Before I start anyone on aspirin I will perform a carotid doppler to check the carotid arteries (the arteries that supply the brain with blood). If there is even mild thickening I will start them on 81 mg of aspirin a day. If there is no thickening and they are on low carb, I tell them not to take aspirin.

The reason I start aspirin on even mild thickening is that a study was performed about 4 years ago (in the Journal 'Stroke') which showed that even mild thickening of the carotids equated with thickening within the smaller diameter coronary arteries, with a subsequent increased risk of heart attacks seen.

Now here's where it gets very interesting from a biochemical perspective. Aspirin works by irreversibly inhibiting an enzyme known as cyclooxygenase. This enzyme creates prostaglandin and thromboxane, two chemicals which act to make our platelets more stickier, hence facilitating the formation of clots. Stop the production of those chemicals, stop the creation of clots.

It's that simple.

Guess what else inhibits that cyclooxygenase thing. That's right, a low carb diet. This is where it gets a little trickier but here's how it works;

When we eat less carbs, we release less insulin. Insulin exerts it's effects on cells by working through something known as the second messanger sytem. One of these messangers found inside the cell contains a molecule known as arichidonic acid. What i didn't mention above is that cyclooxygenase works on arichidonic acid to create thromboxane and prostaglandin. When we eat less carbs we have less arichidonic acid around for the creation of those 2 molecules that make clots. Thus, low carb diets equate with thinner blood so to speak and this is why people on a low carb diet can get away without taking aspirin.

Hope I didn't confuse you.

I guess the short answer is if we are on a low carb diet, we will biochemically create less clots. I should've just said that, but I like the biochemical explanation as well.

dr jim