If you’re having surgery or a medical procedure, your doctors will ask you for a list of the medications you are taking, such as those that lower your cholesterol, relieve your headache or ease your upset stomach. But don’t stop there. Be sure to mention the ginkgo you’re taking to improve your memory, the echinacea to boost your immune system, the multivitamin for your general health or any other herbal or dietary supplements you are taking.
If you take herbal or dietary supplements, you’re not alone. It’s a $27-billion-a-year business, with half of all Americans taking them.
But just like some prescription and over-the-counter medications, herbal supplements can cause problems during surgery, such as reacting with the anesthesia used to control your pain.
What is the Concern about Herbal and Dietary Supplements?
Unlike prescription and over-the-counter medications, supplements aren’t closely inspected by the U.S. Food and Drug Administration (FDA). This means the companies that make them don’t have to prove they’re safe or even that they work. It also means the ingredient levels in each product can vary, and some levels might not be safe.
Even if you’ve been taking them without problems, some supplements can increase the risk of surgery or procedure because they:
• Prolong the effects of anesthesia
• Increase the risks of bleeding
• Raise blood pressure
• Interfere with other medications
• Cause heart problems
Before you have surgery, you will meet with your physician anesthesiologist, a medical doctor who specializes in anesthesia, pain and critical care medicine and works with your other physicians to develop and administer your anesthesia care plan. With 12 to 14 years of education and 12,000 to 16,000 hours of clinical training, these highly trained medical specialists help ensure safe, high-quality care before, during and after surgery.
In your pre-surgery visit, your physician anesthesiologist will answer your questions about the surgery and anesthesia and ask you detailed questions about your health and the medications you take. Be sure to include all of your medications, herbs and dietary supplements, including vitamins. Many people don’t think of this — in fact, studies show half of people who use herbal supplements do not tell their doctors before surgery.
t’s a good idea to bring all of your medication and supplement bottles with you to your appointment. This will help your physician anesthesiologist know what and how much of the various medications you are taking. In some cases, your physician anesthesiologist may recommend you stop taking supplements at least two weeks before your procedure.
| Potential risks of common herbs and supplements |
| Ephedra (Ma-Huang) — An appetite suppressor, it can interact with some blood pressure medication to cause dangerous increases in blood pressure or heart rate. |
| Garlic — Some people take it to lower their cholesterol and blood pressure, but it can increase bleeding. |
| Ginkgo — Used to improve memory, it can increase the risk of bleeding. |
| Ginseng — Taken to improve concentration, ginseng can increase your heart rate and the risk of bleeding. |
| Kava — Used to ease anxiety, Kava can increase the effect of anesthesia. |
| St. John’s Wort — Used to ease anxiety and help with sleep problems, but it may prolong the effects of anesthesia. |
| Valerian — A sleep aid, it can prolong the effects of some types of anesthesia. |
| Vitamin E — Some people take it to slow the aging process but it can increase bleeding and cause blood pressure problems. |
