Aspirin (Daily Low-Dose)
Common brand names: Aspirin 81 mg, Baby Aspirin
Three nutrients listed against this medication. The most severe is marked moderate.
At a glance
One of the three is marked well documented. The other two carry their own evidence levels.
At a glance
- IronModerate · Well documented
- Vitamin CMild · Moderate evidence
- FolateMild · Traditionally cited, limited evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Daily low-dose aspirin may increase occult gastrointestinal blood loss and/or otherwise affect iron balance. In the trial that observed higher incident anemia and a larger ferritin decline, the precise mechanism was not fully established.
Common signs, Fatigue, pallor, reduced exercise tolerance, shortness of breath, low ferritin
McQuilten et al. (Ann Intern Med, 2023; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 37335992): in the ASPREE randomized trial, 100 mg daily aspirin significantly increased incident anemia and ferritin decline in healthy older adults, including in an analysis excluding major bleeding. The mechanism was not determined.
Periodic ferritin and hemoglobin checks are reasonable on long-term daily aspirin. Replete iron only if labs confirm deficiency. Excess iron carries its own risks, which is why iron is given against a measured deficiency.
Mechanism, A high single dose of aspirin taken at the same time as vitamin C blunted the expected rise in vitamin C in an older human study. Whether this applies to 81–100 mg daily aspirin is unknown.
Common signs, Usually subclinical; relevant mainly with borderline dietary vitamin C intake
Basu (Int J Vitam Nutr Res Suppl, 1982; PMID 6811490): aspirin co-administered with vitamin C blunted the expected rise in plasma and leukocyte vitamin C. The dose and timing differ substantially from daily low-dose aspirin, so the relevance to cardiovascular-dose aspirin is unknown.
Dietary vitamin C is the relevant source here. Routine high-dose supplementation is not required, and dose separation has not been shown to matter at low dose.
Mechanism, Salicylate can displace folate from plasma binding proteins and increase its clearance. This is documented at anti-inflammatory (high) doses; at the 81 mg cardiovascular dose the effect is minimal.
Common signs, Usually none at low dose
Displacement of protein-bound folate by salicylate is described at high aspirin doses; direct evidence of folate depletion at daily low-dose (81 mg) is limited. Flagged honestly rather than overstated.
No action beyond a folate-adequate diet is needed at cardiovascular (low) doses. This is relevant mainly for people on high-dose aspirin therapy.
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Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
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