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Herbs and Supplements – What you need to know!

open-bottle-pillsAs with prescription medications, certain herbs and supplements can have inadvertent effects or consequences that may be relevant when undergoing anesthesia and surgery.  Increased bleeding risk, blood pressure variations and unpredictable response to anesthesia have all been ascribed to certain supplements.  It is important to notify your physician about not only your prescription medications, but also your vitamins, herbs and other supplements. Unfortunately, a fair number of surgeons and anesthesiologists may be unfamiliar with both the supplements and their potential interactions or effects on medical and surgical treatment. It is prudent for us to take charge of this information and make sure we as patients are aware and discuss it with our healthcare providers.  This often needs to take place a week or two before surgery so that certain herbs or supplements can be stopped ahead of time so their effects can wear off.

Many supplements have been characterized as having potential undesirable interactions during surgery and anesthesia; however, the effect itself is why we may use the supplement in the first place.  For example, an herb that helps prevent blood clots can be beneficial, just not during an operation when we want to encourage clotting in the surgical field and decrease blood loss.

In general, supplements can affect three areas of anesthesia and surgery:

  1. Decreased blood clotting, hence, increased bleeding risk: Vitamin E, Ginko Biloba, Omega 3 (Fish Oil greater than 3gm/day), Garlic, Ginseng, Bilberry, Feverfew, Ginger and Red Clover
  2. Depression or elevation of blood pressure: Black Cohosh, Fenugreek, Garlic, Hawthorn, Ginseng, Ephedra and St. Johns Wort.
  3. Effects on anesthesia: St. John’s Wort, Kava, Ephedra (Ma Huang), Melatonin and Valerian

This is a list of some of the more common supplements and herbs that may have effects.  Discuss what you’re taking with your healthcare providers ahead of time and decide if you need to stop taking them prior to anesthesia and surgery.

About Jeff Pearl, MD

Dr. Jeff is a trained general, pediatric cardiac, and transplant surgeon. Nutrition has always been an important concern for surgeons in regards to patients healing from surgery. He has had a longstanding interest in health, nutrition and supplements, and been an advocate of the use of nutrition and supplements in the hospital setting to aid in his patient’s recovery. He has a history of basic science and clinical research and a keen ability to interpret studies and statistics to determine their true significance. He is the father and step-father to several teenage athletes and knows firsthand the challenges they face in balancing their time, eating habits and use of supplements. He is adamant about trying to educate our youth about better nutrition. Dr. Jeff recognizes the challenges that healthcare faces and the need for people to take charge of their own health and disease prevention. He loves being outside and is one of those crazy few seen hiking or biking in the middle of the day in summer.

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