Background: Plants and Medicine

Plants have long been used as the basis for many medications. Ancient Egyptians used aloe vera to “prolong life”, bushmen in the Kalahari in Africa used cactus hoodia to fight off hunger. There are many additional “herbal supplements” that are used by millions of Americans. For example, individuals may use Echinacea to strengthen their immune system or gingko to enhance memory.


Risks of Supplements and Surgery

The American Society of Anesthesiologists, as well as other health organizations, recommend that no herbal supplements be taken at least 2 weeks prior to surgery. For example, be wary of the following: [i], [ii]

  • Black cohosh: This herbal may interact with anesthesia medicines and cause low blood pressure or increased risk of bleeding.
  • Echinacea: This herb comes from the purple cornflower and is taken for colds, infections, arthritis, and ulcers. If you have liver disease and you have anesthesia while taking echinacea, you could end up with liver damage.
  • Ephedra: This herb from the plant Ephedra Sinica is used for asthma and to suppress appetite. When combined with some anesthesia drugs, can cause high blood pressure and abnormal heart rhythms. The FDA banned it in 2003.
  • Garlic: Garlic supplements are used to lower blood pressure and cholesterol. Garlic can increase the effects of medications used to control blood sugar, blood thinners, and some OTC pain relievers, and can increase bleeding during or after surgery.
  • Ginkgo: Ginkgo biloba is used to improve memory. But it may cause prolonged bleeding during or after surgery and make the sedation effects of anesthesia last longer.
  • Ginseng: Ginseng is commonly used for an energy boost or to lower blood sugar levels. During surgery, ginseng may cause high blood pressure and a rapid heart rate.
  • Hoodia: This herbal medicine causes changes in the blood sugar and increases the risk of bad side effects involving the heart.
  • Kava: Kava comes from the piper methysticum plant and is used for muscle relaxation and to calm the nerves. It may be dangerous for people to have surgery because of its interactions with other drugs. It may also cause liver damage.
  • John’s Wort: Also known as goatweed, this herb is taken to relieve depression and anxiety. During a surgical procedure, St. John’s Wort may interfere with some anesthesia drugs and make it harder for you to recover from its effects.
  • Valerian: This herb from the plant Valeriana officinalis is used to relieve anxiety. It may increase the effects of anesthesia and make it more difficult to wake up after surgery or cause irregular heart rhythms.


Risks of Vitamins and Surgery

Just as natural herbal supplements present risks for someone preparing for surgery, vitamin supplements can present risks as well. For example: [iii]

  • Vitamin E: Vitamin E has been found to have antioxidant properties. However, vitamin E can slow blood clotting, which may cause surgical complications, especially if you are also taking anti-clotting agents such as warfarin, also known as Coumadin.
  • Vitamin C: Vitamin C is another antioxidant. Your body uses vitamin C to build and repair skin, bone, and connective tissue cells. While studies support the use of vitamin C in conjunction with heart surgeries, the same supplement may not be compatible with weight reduction surgeries, such as gastric bypass. This is because it can contribute to the development of kidney stones following the surgery.
  • Vitamin K: Vitamin K promotes skin healing, so it is often recommended for use after surgery. However, it does affect blood clotting, so consult your doctor about the amount of vitamin K you need if you are taking Coumadin.

With all of this in mind, it’s best to always inform your doctor of any supplements you are taking.  This is especially true prior to any surgical procedure to avoid unnecessary risks.







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