Herbal Supplements: Risky Before Surgery? Talk to Us!

I remember a patient, let’s call him John, a few weeks before his scheduled heart bypass. He was doing everything right, he thought. Eating well, trying to stay calm. Then he casually mentioned, “Oh, and Doc, I’ve been taking this great garlic supplement for my heart, and a bit of ginseng for energy. They’re natural, so they’re fine, right?” My heart did a little flip. It’s a common thought, that “natural” equals “safe.” But when it comes to herbal supplements and surgery, what seems harmless can actually cause some real bumps in the road.

You see, many of us reach for things like multivitamins, herbal remedies, or other dietary supplements. Maybe it’s echinacea at the first sniffle, ginkgo for memory, or St. John’s wort to lift the spirits. And often, these can be part of a healthy approach. But surgery, especially something like a cardiac procedure, changes the game.

Why “Natural” Can Still Mean “Risky” Before Your Operation

It’s a tricky thing, isn’t it? The word “natural” feels so reassuring. But here’s something I always tell my patients: “natural” doesn’t automatically mean “safe for everyone, all the time.” This is especially true when you’re preparing for an operation.

Think about it:

• No Guarantees: Herbal medications aren’t regulated in the same strict way prescription drugs are. This means the quality, the actual ingredients, how they’re made – even the dosage in each pill – isn’t checked by an agency like the FDA. So, what’s on the label might not be exactly what’s in the bottle. Scary, right?
• Unknown Interactions: These supplements can interact with other things. That includes other herbs, foods, any prescription medicines you take, and crucially, the anaesthesia and other drugs you’ll receive during and after your surgery.

Herbal Supplements and Surgery: What Are the Concerns?

I’ve seen studies, and honestly, the research is pretty clear. Certain herbal preparations can lead to some serious hiccups during or after surgery. We’re talking about things like:

• Bleeding Troubles: Some of the most common concerns involve blood.
• Supplements like garlic, ginkgo, ginger, and vitamin E can thin your blood or affect its ability to clot. This could mean more bleeding during or after your operation.
• They might reduce platelets (those tiny cells that help stop bleeding) or how well they stick together.
• Heart and Blood Pressure Swings: Some herbs, like ephedra (which, thankfully, is less common now but still around in some forms), can cause cardiovascular instability – big swings in your heart rate or blood pressure. Not what we want when your body is already under stress.
• Blood Sugar Dips: Things like ginseng can sometimes lead to hypoglycemia (low blood sugar).
• Anaesthesia Interference: Some supplements, including kava or valerian (often used for sleep or anxiety), can change how anaesthesia affects you. They might make you more sensitive, or they might prolong its effects.
• Drug Metabolism Changes: St. John’s wort is a big one here. It can speed up how your body processes certain medications, making them less effective. This includes some of the critical drugs used during and after surgery.

Even if you’ve been taking a supplement for ages with no problems, surgery is different. You’re getting a whole cocktail of medications you don’t normally take, and we just don’t want any unexpected reactions.

What You Absolutely Must Do Before Surgery

This part is simple, but so, so important. Talk to us. Your doctors, that is.

1. Make a List: Before your pre-surgery appointments, jot down everything you take.

• Prescription medications (of course).
• Over-the-counter drugs (pain relievers, allergy meds, etc.).
• And yes, all herbal supplements, vitamins, “natural” remedies, teas, powders – the lot.

1. Tell Your Team: Share this list with your surgeon, your cardiologist (if you’re having a heart procedure), and the anaesthesiologist. Don’t wait for us to ask; bring it up yourself.
2. Be Honest and Open: There’s no judgment here. We just need the full picture to keep you safe. Some patients feel a bit shy admitting they use herbal remedies, but please don’t. It’s vital information.
3. Follow Advice: We’ll likely ask you to stop taking most, if not all, herbal supplements a couple of weeks before your surgery. This gives your body time to clear them out.

It’s all about making your surgery as smooth and safe as possible.

Take-Home Message: Herbal Supplements and Your Surgery

Okay, let’s boil this down to the key things to remember:

• “Natural” isn’t a synonym for “harmless,” especially when you’re looking at herbal supplements and surgery.
• Many common herbs (like garlic, ginkgo, ginseng, St. John’s wort) can pose real risks, such as increased bleeding or interactions with anaesthesia and other vital medications.
• Herbal products aren’t regulated like prescription drugs, so their purity, strength, and even their actual contents can be uncertain.
• The most important step? Full disclosure. Tell your entire medical team about every single supplement you’re taking, well before your operation.
• We’ll work together to decide what needs to be paused to ensure your safety.

You’re putting a lot of trust in us for your surgery, and we take that incredibly seriously. Helping us know everything you’re taking is a big part of how you can help us take the very best care of you.

You’re not alone in figuring this out. We’re here to guide you.