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Herbal supplements and surgery: not always a good mix

By Jane Harrison, R.D., Staff Nutritionist, myOptumHealth

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You're scheduled for surgery. Maybe you're having your wisdom teeth removed, a hysterectomy or gall bladder surgery. You want to be as healthy as possible beforehand. So, you exercise and get plenty of rest. You take your medicines exactly as your doctor prescribed. You're even taking herbal supplements for reassurance.

But wait. Hold those supplements! Did you know that taking herbal medicines could interfere with your recovery from surgery? Even everyday garlic in large amounts can cause problems.

Potential dangers

The American Botanical Council estimates that three in 10 adults in the United States use some type of herbal supplement or preparation. Most often, they are used to treat common ailments such as colds, allergies, heartburn, headaches or insomnia.

But certain herbs can affect the blood clotting process, raise the risk of infection or interfere with important medications. These reactions can be very dangerous. Following is a quick look at just some of the potential problems:

• Echinacea. This herb is used by some to try to prevent infections. But you can be allergic to it, so those with allergies or asthma need to be cautious about using it. Echinacea may also lessen the effectiveness of immunosuppressant drugs. This would make it off-limits for those considering an organ transplant. Long-term use of echinacea (more than 8 weeks) may also increase your risk of infection after surgery and delay healing.
• Garlic. Some believe that garlic may protect the heart. But it can also interfere with blood clotting, which could pose a danger during surgery.
• Ginkgo. Some people take this herb for mental alertness, erectile dysfunction and other conditions. But ginkgo can also interfere with blood clotting, which can cause increased bleeding during surgery.
• Ginseng. Ginseng is taken by some people to protect their body from stress. Unfortunately, it also may lower the glucose (sugar) in your blood. This could be a serious problem if your blood glucose level falls too low.
• Kava. This herb is touted to help with anxiety. Kava may act as a sedative, though, and could interfere with traditional sedatives or anesthesia given during surgery or shortly afterwards.
• St. John's Wort. This herb is used by some to help treat mild symptoms of depression. But St. John's Wort also can increase the metabolism of medications. This may interfere with drugs used in organ transplants. It could also be harmful to those who may need to take an anticoagulation medicine after surgery to prevent blood clots.
• Valerian. This herb is thought to relieve anxiety and promote sleep. But it may interfere with certain anesthetic medications used during surgery. Because valerian may have some addictive qualities, it is a good idea to taper use for several weeks before surgery.

Better safe than sorry

Simple advice to make your surgery safer:

• Tell your doctor or pharmacist if you use herbal supplements - even if you're not asked.  
• Before surgery, show your doctor any prescription medications, herbal preparations and over-the-counter medicines you take routinely. Ask if and when you should stop taking any of your medications or herbs before surgery.

View the original Herbal supplements and surgery: not always a good mix article on myOptumHealth.com 

SOURCES:

• Columbia University. Herbs and supplements: what you should know before surgery. Accessed: 07/14/2008

• Ciocon JO, Ciocon DG, Galindo DJ. Dietary supplements in primary care. Botanicals can affect surgical outcomes and follow-up. Geriatrics. 2004;59(9):20-24. Accessed: 07/14/2008

• Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. Journal of the American Medical Association. 2001;286(2):208-216.