Why Daily Aspirin Is the Wrong Move

We sometimes hear this question from readers... and we know why.

They want to know if they should take aspirin every day.

For decades, medical advice for those at risk of heart attack or stroke was to take a daily aspirin. But in recent years, this practice has come under intense scrutiny.

Back in October, the U.S. Preventive Services Task Force (USPSTF) released a statement that folks 40 to 59 years old without a history of cardiovascular disease should talk to their doctors before considering an aspirin regimen. And the USPSTF said that those older than 60 should not use aspirin to prevent heart disease or stroke as the risks from aspirin outweigh the benefits.

(The USPSTF is a panel of 16 MDs and PhDs whose specialties range from behavioral health to pediatrics. These experts look at research and make recommendations on the usefulness of screenings, counseling services, and preventive medications. They write guidelines that any doctor worth his salt will follow.)

The idea is that aspirin "thins out" the blood – it actually decreases the stickiness of the platelets – enough to help it pass through narrowed arteries (though not as much as a prescription-strength blood thinner like warfarin).

But we've known for years that this advice is not always useful... and is sometimes harmful. Aspirin-induced blood thinning can cause internal bleeding, particularly in the stomach. Without much proven benefit so far, taking aspirin to prevent heart attacks may not be worth the risk.

Aspirin therapy does help some folks. If you have already suffered a heart attack, it means you have had a clot or two obstructing part or all of an artery in your heart. Thinning your blood helps in that situation. Likewise, if you have a history of high cholesterol or other risk factors for heart disease (such as obesity, smoking, or physical inactivity), it may be an option you should discuss with your doctor.

To avoid this issue, do what I do: I look for aspirin with an enteric coating. And I only take one 250-milligram aspirin every 10 days or so (an Excedrin formulation). The effects last that long, so you don't need to take one daily.

It varies by individual whether aspirin's benefits outweigh its risks... Take a look at your own risk factors. Do you already have cardiovascular health issues or a family history of heart disease? Or do you have health problems that already put you at higher risk of bleeding like hemorrhoids?

Also, look at less risky steps you could take...

If you're looking for a proven and natural way to lower your heart-disease risk, cut the "white killers" (white bread, white sugar, white rice, and potatoes) from your diet, take regular walks, and practice yoga.

What do you want to see us write about next? Send your suggestions to [email protected].

We have one more topic for this week's Q&A...

Q: This is a rookie question because I'm just learning about stocks and options.

Why can't you have a hard stop and a trailing stop on the same stock?

Feel free just to point me where I should find an answer on the internet. Wiki doesn't do a good job explaining it or I have not found the correct source. – T.M.

A: The short answer is, you can't follow both. A trailing stop and a hard stop are two different types of stop losses. And because they calculate a stop loss differently, you get a different price to sell your shares at.

Let's take another look at our example from last week's Q&A...

 As Stock X's price rises, the trailing stop follows it up, but the hard stop stays the same... no matter how high the share price rises. Again, since each stop method gives you a different exit price as shares rise, you need to choose one or the other.

Of course, the trailing stop doesn't follow the stock down. So if shares fall straight to $8, your hard stop and your trailing stop both remain $7.50. But who is expecting their shares to fall?

The kind of stop you use depends on what you're investing in and what your goals are. In my monthly advisory, Retirement Millionaire, I often recommend 25% hard stops.

Hard stops allow us to let our winners ride. When we use a hard stop and not a trailing stop, we aren't forced to sell because of regular market volatility.

Let me show you why we use these stops in our long-term Retirement Millionaire portfolio with a former holding: aerospace-engineering firm Boeing...

The August 2015 recommendation was a huge winner for us. We sold it in May 2018 for a 151% gain, selling after we thought shares were priced to perfection and had little remaining upside. (Sure enough, today they're down more than 30% from where we sold.) We earned about 55% a year, which doesn't just happen every day. But if we had used a trailing stop instead of a hard stop, our results would have looked very different...

We came within a couple dollars of hitting our hard stop in February 2016 as Boeing shares fell. If we had used a trailing stop, we would have sold for a loss amid this market noise. We would have missed the chance to more than double our money when Boeing shares tore higher in 2017. Hard stops give our investments some room to play out.

On the other hand, if Boeing shares had gone into freefall in April 2018, our stop wouldn't have been triggered until our triple-digit win turned into a 25% loss. Trailing stops help us protect our gains.

Whichever stop you pick, stand by your choice and sell when your stop is triggered... no questions asked.

What We're Reading...

• A history of aspirin.
• Something different: Want a chance to go to the Super Bowl for free? Donate blood.

Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
January 21, 2022