Herbals and Surgery

Written by pharmacist  |  06. March 2003

Dear Dr. Ferzola, I am having surgery next month and want to know will it be necessary to stop my herbal products and other supplements before having this surgery? Linda K. Lake Grove NY
The medical & health journals identify problems with only a handful of herbal products, mainly Garlic, Ginkgo and St. John's wort. Nevertheless many supplements have the possibility to cause harm. For example, some herbs and supplements have antiplatelet effects including ginkgo, garlic, feverfew, ginger, ginseng, evening primrose oil, fish oils, and many others. This effect can prolong bleeding time and can be a severe problem during surgery.
Supplements that affect the bodies' enzyme systems can change the metabolism of other drugs used during surgery. Herbs that can alter metabolism include St. John's wort, Echinacea, red clover, goldenseal, and garlic. There are also others as well.
Some herbal products can increase heart rate and blood pressure, such as Ginseng and licorice. Recent news has made the public aware that ephedra can be a problem. However many do not know that bitter orange, country mallow, and heartleaf are now being put in products in place of ephedra. These may also be dangerous, since they are sources of ephedrine and synephrine.
Some natural products are sedatives that might have additive effects with drugs used for surgery, such as valerian, melatonin, kava, lemon balm, passionflower...and many others.
As a rule of thumb, I advise patients to stop ALL dietary supplements at least 2 to 3 weeks prior to an elective surgery.
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