Find out which herbs and vitamins must be avoided just before surgery

Spill the beans

I know it can be hard, but you really do have to share all your supplement use information with your M.D., no matter how enlightened or unenlightened he might be about the usefulness of vitamins, herbs, and other supplements.

The same is true with a surgeon, of course. But since a surgeon isn’t your primary doctor, you might not think to provide complete details about supplement use.

New evidence shows why this could be a terrible mistake.

Herbs take a holiday

Researchers at Cleveland’s University Hospitals Case Medical Center recently provided a very useful study for any patient about to undergo surgery — whether it’s a quadruple bypass or a simple out-patient cosmetic procedure.

After the UHCMC team conducted a review to assess the benefits and risks of widely used herbal supplements, they compiled this list of herbs that might be best to avoid in the two weeks prior to surgery:

* For bleeding effects: gingko biloba, garlic, ginseng, dong quai, feverfew, fish oils
* For drug interactions: echinacea, goldenseal, licorice, St. John’s wort, kava, valerian root
* For cardiovascular effects: ephedra, garlic
* For anesthetic effects: valerian root, St. John’s wort, kava
* For photosensitivity effects: St. John’s wort, dong quai
* For hypoglycemia effects: ginseng

The study discusses the general usefulness as well as the potential surgical drawbacks of each of these herbs except one: fish oils. Obviously, fish oils are not herbs, but the authors don’t explain why they strayed outside the world of botanicals to include this item on their list.

The C effect

One of the drawbacks of the focus on herbs in the UHCMC study is that it might leave patients and doctors with the impression that vitamin use is of no concern before surgery.

But that’s definitely not the case.

For example, as Dr. Spreen has previously pointed out, high levels of vitamin C complicate the anesthesia process.

Dr. Spreen: “Very high doses of C over time cause the body to ‘awaken’ dormant enzyme systems that more fully utilize high doses of the nutrient. For those people I tell them to TAPER the C over time, reaching nearly zero just before surgery (not weeks before).

“This is because such high doses are good enough detoxifiers that more anesthetic drugs may be necessary for the anesthesiologist to keep you under. BUT, the absolute INSTANT you tolerate oral intake, you jack the C back up to heroic levels.”

In addition, Dr. Spreen recommends that other supplements — including a good multi, along with vitamins E, A, and B-complex, selenium, NAC, alpha lipoic acid, milk thistle extract, zinc, and essential fatty acids — should be taken generously after surgery, provided your doctor agrees, of course.

Sources: 
“Perioperative Risks and Benefits of Herbal Supplements in Aesthetic Surgery” Aesthetic Surgery Journal, Vol. 29, No. 2, March/April 2009