Aspirin unlikely to be cause of bleeding

Dear Dr. Roach: Can taking a 325-mg aspirin daily cause a normal person to become anemic through slow internal bleeding? — L.K.

Aspirin does increase risk of bleeding, and there have been many people who have had the exact scenario you describe, with slow bleeding depleting the body’s iron stores. However, the bleeding often has an identifiable and abnormal source. An ulcer is one in the upper GI tract, but the intestines are more common. Polyps, arteriovenous malformations and diverticuli all may have periodic bleeding. Don’t just stop the aspirin and hope for the best.

Dear Dr. Roach: I am a 70-year-old woman. My father had Parkinson’s disease in his mid-50s. I have a twitching at the tip of my nose. Could that be a sign of Parkinson’s? — F.M.

Nose twitching is very unlikely to be the first sign of Parkinson’s disease. The tremor in PD is almost always in a limb. A classic PD tremor usually starts in one hand, is at the rate of about five movements per second and occurs at rest. Other symptoms early in PD include a generalized slowness of movement (called bradykinesia), rigidity and a predisposition to falls. Nose twitching sounds to me like an involuntary muscle spasm. These can happen in literally any muscle of the body (the eyelid is a common one.

One question I ask my patients who come in with a particular concern is whether they are more interested in getting rid of the symptom or whether they are more concerned that the symptom may represent the first stage of a potentially serious medical issue. For many people, knowing that the symptom is not likely a serious problem (which I can reassure you is very likely the case in you) relieves the worry, and the symptom may just go away on its own, which I suspect will be the case in you.