When preparing for surgery, patients often overlook the potential impact of dietary supplements. While widely perceived as natural, these products can significantly affect the body, particularly during a surgical procedure. It is important to discuss all supplements, including vitamins, minerals, and herbal remedies, with your healthcare provider well in advance of any scheduled surgery.
Why Stopping Supplements is Crucial
Supplements can interfere with surgical procedures through several mechanisms. A primary concern is their potential to increase bleeding. Some supplements can thin the blood or inhibit clotting, leading to excessive blood loss during or after surgery.
Another significant interaction involves anesthetic medications. Certain supplements can alter anesthesia effects, potentially making sedatives more potent, less effective, or causing unpredictable side effects. This can complicate the precise management of anesthesia during an operation.
Furthermore, some supplements can influence vital physiological parameters like blood pressure and heart rate, causing unpredictable fluctuations. Maintaining stable blood pressure and a regular heart rhythm is important for patient safety. Blood sugar levels can also be affected, which is a critical consideration for managing patient health. Finally, some supplements may stress the liver and kidneys, organs vulnerable during surgery and recovery.
Supplements That Increase Bleeding Risk
Several supplements are known to increase the risk of bleeding during surgical procedures. Fish oil, rich in omega-3 fatty acids, can inhibit platelet aggregation. Similarly, high doses of Vitamin E (typically above 400 IU per day) can act as a blood thinner by interfering with vitamin K metabolism and inhibiting platelet aggregation.
Ginkgo Biloba is associated with an increased bleeding risk due to its potential to inhibit platelet aggregation. High doses of garlic may also potentiate anti-platelet effects, especially when combined with other blood-thinning medications.
Ginger, particularly in high doses, can inhibit platelet aggregation. Ginseng has been linked to an increased bleeding risk and can also affect blood sugar levels. Turmeric, or curcumin, may possess mild blood-thinning properties at high supplemental doses.
Feverfew is another herb that can increase bleeding risk, especially when taken with other blood-thinning medications. Dong Quai can increase the risk of bruising and bleeding, especially if taking anticoagulant medications. St. John’s Wort also carries an association with bleeding risk.
Supplements Affecting Anesthesia and Other Body Systems
Beyond bleeding, several supplements can interact with anesthesia or affect other vital body systems. St. John’s Wort can prolong the sedative effects of anesthetic agents and alter the metabolism of certain drugs. Valerian can potentiate general anesthetics, leading to prolonged sedation. Kava can increase anesthesia effects and has been associated with hepatotoxicity. Melatonin may also interact with anesthesia.
Ephedra, a stimulant, can cause increases in blood pressure and heart rate. Bitter Orange, which contains synephrine, can also increase heart rate and blood pressure, potentially complicating anesthesia management. Yohimbe and Licorice are additional supplements that can influence blood pressure and heart rate, with licorice potentially causing hypertension.
Blood sugar control can be impacted by certain supplements. Chromium and Alpha-lipoic acid can lower blood sugar levels, which may interfere with glucose management during and after surgery. Gymnema Sylvestre is another herb known for its blood sugar-lowering effects. Some supplements pose risks to liver and kidney function. Kava has been linked to liver toxicity, and other herbs like Comfrey and Chaparral are also known for their potential to cause liver damage.
Critical Steps Before Your Surgery
Given the potential for interactions, clear communication with your healthcare team is important. Inform your surgeon, anesthesiologist, and other medical providers about every supplement you are taking, including vitamins, minerals, herbal remedies, and over-the-counter products. Many hospitals require a detailed list of all medications and supplements.
The timing for discontinuing supplements before surgery can vary significantly depending on the specific supplement, the type of surgical procedure, and your individual health status. Do not attempt to determine this timeline yourself. Instead, ask your doctor for specific instructions on when to stop each supplement.
Avoid self-medicating or making decisions about stopping or continuing supplements without professional medical guidance. Your healthcare team will provide personalized advice based on your complete medical history. Preparing a written list of all supplements, including their dosages and how long you have been taking them, can be helpful for your pre-operative appointments.