Several herbs and vitamins must be avoided just before surgery

The one vitamin you should never take before any surgery

My friend Lily wondered what she was getting into.

Every few years Lily visits a plastic surgeon. He removes squamous cell skin cancer lesions.

At their first appointment she told him about her supplement use. He duly noted each item and advised her to stop using gingko biloba about a week before surgery. Gingko thins the blood. And with any surgery, there will be blood.

When that doctor retired, he recommended a new surgeon.

So, starting again at square one, she went in for their first pre-op examination. But when she started to tell him about her supplement use, he stopped her. He said, “I’m sure that won’t be an issue.”

Her first thought: “Uh oh. Is this a red flag?”

Lily knew the drill. She stopped using gingko before the surgery. Everything went fine. No harm. No foul.

But she was right about the red flag. No doctor should dismiss patient supplement use.

And with surgeons, this oversight is potentially very dangerous.

Herbs with fish

Researchers at Cleveland’s University Hospitals clearly respect supplement use.

They conducted a review to assess the benefits and risks of widely used herbal supplements. From that analysis, they compiled this list of herbs 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 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

The Cleveland study has one drawback. It focuses only on herbal use. This might leave the impression that vitamin supplements have no impact on surgery.

But that’s not the case.

As Dr. Spreen has pointed out, high levels of vitamin C complicate anesthesia.

Dr. Spreen: “Very high doses of C over time cause the body to ‘awaken’ dormant enzyme systems. 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 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 other supplements — including a good multi — should be taken generously after surgery.

The post-op Spreen list…

• Vitamin A
• B complex
• Vitamin E
• Selenium
• NAC
• Alpha lipoic acid
• Milk thistle extract
• Zinc
• Omega 3 fatty acids

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