Is my daily regimen of 81mg aspirin (acetylsalicylic acid), 10,000 IU vitamin D3, 200 mcg vitamin K2, and coconut oil safe for my atherosclerotic disease with a cardiac stent?

Safety of Daily Regimen for a 73-Year-Old Male with Atherosclerotic Disease and Cardiac Stent

Your daily regimen of 81mg aspirin is appropriate and should be continued indefinitely, but the high-dose vitamin D3 (10,000 IU) with K2 supplementation requires caution and possible dose adjustment.

Aspirin Therapy Assessment

• Low-dose aspirin (75-162 mg daily) is strongly recommended as a Class I recommendation with Level of Evidence A for all patients with coronary artery disease unless contraindicated 1
• The 81mg "baby aspirin" dose you're currently taking is appropriate and preferred over higher maintenance doses due to lower bleeding risk while maintaining efficacy 2, 3
• For patients with coronary stents, aspirin therapy should be continued indefinitely, regardless of stent type (bare-metal or drug-eluting) 2
• In elderly patients (>65 years), the 81mg daily dose is particularly appropriate as it balances antithrombotic benefits with lower bleeding risk 2, 3

Vitamin D3 and K2 Supplementation Concerns

• Your current vitamin D3 dose of 10,000 IU daily exceeds the recommended upper limit for most adults and may pose risks:

  • High-dose vitamin D supplementation can lead to hypercalcemia, kidney stones, and potential cardiovascular calcification 4
  • While vitamin K2 (200 mcg) may help direct calcium to bones rather than arteries, the combination with high-dose vitamin D3 has not been extensively studied in patients with established atherosclerotic disease 4

• Recent research suggests that dietary vitamin K intake (both K1 and K2) may be associated with reduced atherosclerotic cardiovascular disease risk, but this doesn't necessarily support high-dose supplementation 4

Coconut Oil Considerations

• Coconut oil is high in saturated fat, which may raise LDL cholesterol levels
• For patients with established atherosclerotic disease, the American Heart Association recommends limiting saturated fat intake 1
• Consider replacing coconut oil with oils higher in unsaturated fats (olive oil, canola oil) for better cardiovascular outcomes

Recommendations

1. Continue your 81mg daily aspirin as it's appropriate for secondary prevention in your case with a cardiac stent 1, 2

2. Consider reducing your vitamin D3 supplementation to 1,000-2,000 IU daily, which is more in line with standard recommendations for adults over 70 years

3. Discuss with your healthcare provider about monitoring your serum vitamin D levels (25-hydroxyvitamin D) to ensure they're in the appropriate range (generally 30-50 ng/mL)

4. Consider limiting coconut oil consumption and replacing with heart-healthier oils like olive oil

Important Caveats

• If you have any bleeding disorders or are taking other anticoagulants or antiplatelet medications, the risk-benefit profile of aspirin may change 5
• If you're scheduled for any surgical procedures, discuss your aspirin use with your healthcare provider, as it may need to be temporarily adjusted 1
• Vitamin D supplementation needs may vary based on your baseline levels, sun exposure, and other individual factors