Why are NSAIDs bad for anemia

(except for acetominophen)

I’ve been anemic since at least college, and have always been advised to avoid aspirin, then later ibuprofen, naproxen, etc. were added. Unfortunately, I have certain (ahem) problems that only ibuprofen will help with, and not taking it has not been an option.

The explanation that I get is that they thin blood, i.e. interfere with the bloods ability to form clots.

But why does this make anemia worse? It seems like that is only a theoretical problem unless I am actually bleeding somewhere.

Is there something I could do to mitigate the effect? As I said, sometimes not taking ibuprofen is not an option.

Could not blood thinners break up clots? Isn’t that why they give asprins to heart attack victims.

Tylenol and its generics are not NSAIDs, so they reduce pain but not inflammation.

WAG stemming from a few minutes with the Merck Manual and google:

Looks like NSAIDs suppress folic acid:

http://www.masonvitamins.com/healthconcerns/nutriabsorption.htm

And one of the MANY causes of anemia is folic acid deficiency:

The information on Folic acid is interesting. However, I am definitely iron deficient anemic - and yes, I do take iron supplements. Basically my body can’t keep up with the amount of blood I lose (ahem) on a regular basis.

Well, NSAID’s as a class have a number of effects that can contribute to anemia.

As mentioned above, they tend to “thin” the blood and make bleeding more likely and heavier should it occur (eg. menstruation).

Of perhaps greater importance, the NSAID’s all promote bleeding from the stomach. Chronic use of NSAID’s, in particular, is often associated with subtle and ongoing blood loss from the stomach due to stomach inflammation (gastritis). However, even short term use can lead to significant bleeding. Note that even the newer, so-called COX-II inhibitors (eg. Vioxx, Celebrex) can also cause similar problems, albeit with only about half the frequency.

In passing, Tylenol and its generic equivalents, do have some anti-inflammatory effect and are a reasonable first choice for some people with arthritis. I think the reason that this fact is under-appreciated is that because there are generics no drug company has really promoted or invested in them for the treatment of arthritis.