Preparing for surgery involves reviewing all medications and supplements. While often seen as beneficial for overall health, vitamins and herbal supplements can significantly affect surgical outcomes. Understanding which supplements to avoid before surgery is crucial for a safe procedure.
Understanding the Risks
Certain vitamins and supplements can introduce risks during the perioperative period (the time immediately before, during, and after surgery). A significant concern is increased bleeding. Some supplements interfere with blood clotting, potentially leading to excessive bleeding during or after the procedure. This can prolong surgery, increase the need for blood transfusions, and complicate recovery.
Another risk involves interactions with anesthesia. Some supplements can prolong sedative effects, making it more difficult for patients to awaken. Others might affect blood pressure or heart rate, causing instability. Additionally, certain supplements can impact blood sugar levels, a particular concern for individuals with diabetes. A thorough review of all ingested substances is necessary before any surgical intervention.
Vitamins and Supplements to Discontinue
Several specific vitamins and herbal supplements are generally recommended for discontinuation before surgery due to their potential to cause complications or interfere with recovery.
Vitamin E
Vitamin E, often taken for its antioxidant properties, can increase bleeding risk by interfering with platelet aggregation. Physicians commonly advise stopping high-dose Vitamin E 7 to 30 days before surgery.
Fish Oil
Fish oil, rich in omega-3 fatty acids, has blood-thinning properties that can increase bleeding risk. Discontinue one to two weeks prior to surgery.
Ginkgo Biloba
Ginkgo Biloba, frequently used to support memory, inhibits platelet activity, which can lead to prolonged bleeding. Stop taking Ginkgo Biloba 36 hours to two weeks before surgery.
Garlic
Garlic supplements, despite their cardiovascular benefits, possess antiplatelet effects that can increase bleeding risk. Discontinue garlic supplements 7 to 10 days before surgery.
Ginseng
Ginseng, commonly taken for energy or to manage blood sugar, can increase bleeding risk and may affect blood pressure or heart rate during surgery. It can also reduce blood sugar levels. Discontinue ginseng 7 to 30 days before surgery.
St. John’s Wort
St. John’s Wort, an herbal remedy for mood, can interact adversely with anesthetic agents and other medications by affecting drug metabolism. This can lead to prolonged sedation or other complications. Stop its use at least two weeks before surgery.
Vitamin K
High-dose Vitamin K, while generally supportive of clotting, can interfere with anticoagulant medications like warfarin. For patients taking such medications, Vitamin K intake before surgery is complex and requires medical guidance.
Other Herbal Supplements
Many other herbal supplements lack extensive research regarding their interactions with surgical procedures and anesthesia. Therefore, discontinuing most herbal remedies before surgery is often recommended.
Crucial Pre-Surgery Actions
Beyond knowing which vitamins and supplements to discontinue, taking the correct actions is equally important. Healthcare providers generally recommend discontinuing most problematic supplements one to two weeks before surgery. For some herbal supplements, a longer period of up to three to four weeks might be advised. The exact timing varies based on the specific supplement, its half-life, the type of surgery, and individual health status.
Full Disclosure
It is crucial to provide full disclosure to your medical team, including the surgeon and anesthesiologist, about all vitamins, supplements, and over-the-counter medications. Withholding this information poses serious risks, as supplements are not regulated by the FDA like prescription drugs, and their potency can vary.
Never Self-Adjust
Never self-adjust your supplement regimen or discontinue prescribed medications without explicit instructions from your doctor. Modifying dosages or stopping supplements independently could lead to complications.
Resuming Supplements
Resume supplements after surgery only under medical guidance. Your doctor will advise when it is safe to reintroduce them based on your recovery and any ongoing medications.