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Stop Taking Supplements Before Surgery?

My doctor knows I take quite a few herbs and isn't completely supportive of it. I'm having laparoscopic surgery in a few weeks, and he has advised me to stop taking any herbs until after the procedure. I'm suspicious. What do you think?

A few months ago, the American Society of Anesthesiologists (ASA) issued a warning that certain herbs or supplements could pose a danger if taken prior to surgery. They are now recommending that consumers stop taking any herbs or dietary supplements two to three weeks before undergoing surgery (to clear it out of your system), and singled out a handful of popular supplements, warning of potential problems with each. The ASA said:
St. John's Wort may intensify or prolong the effects of some narcotic drugs and anesthetic agents.
Ginkgo may reduce the number of platelets, which are needed for blood clotting.
Feverfew "appears to interfere with blood clotting."
Ginseng has been associated with episodes of high blood pressure and tachycardia (rapid beating of the heart).
If there isn't enough time to stop taking your supplements prior to surgery, bring your products to the hospital in their original containers so the anesthesiologist can see the exact ingredients in the products you're taking.

My feeling is that this ASA statement is unnecessarily alarmist -- in my view, most herbal and dietary supplements are unlikely to cause a problem. And parts of it are wrong. St. John's Wort will not intensify effects of anesthetic drugs, for example. In addition, while ginkgo can affect platelet activity, I've never seen data showing it reduces platelet numbers. That said, I do agree that if you're having surgery, it certainly makes sense to make your anesthesiologist aware of any supplement or drug you have been taking -- and temporarily discontinue any medication or supplement that would interfere with blood clotting.

Surgeons routinely instruct patients to stop taking aspirin or any other anticoagulant prior to surgery. I think it is wise to discontinue certain supplements prior to surgery -- don't take high doses of garlic, vitamin E, or ginkgo, for instance. All of these have some anticoagulant effect that could pose bleeding problems during surgery.

The ASA says they are mainly trying to make patients aware that some of the supplements they take may pose health risks during surgery. The organization said a number of members reported significant changes in heart rate or blood pressure in some patients taking the supplements mentioned above. I think these claims warrant further study.

In the meanwhile, I think a more important take-away message here concerns the doctor-patient relationship. I can't stress the importance of being able to talk to your doctor openly. If for some reason you don't feel comfortable, or if you don't share the same philosophies for managing your health, you may want to look for a new doctor.


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