Herbs that affect surgery and when to stop them--report on an article in JAMA

The Journal of the American Medical Association just came out with a report of the risks of herbal medicine while undergoing surgery. They warn that you have to tell your doctors about exactly what you are taking.

In particular, this study looked at echinacea, ephedra (also known as ma huang), garlic, ginkgo, ginseng, kava, St. John's wort, and valerian.

Echinacea may cause problems with immunity. No data on when to stop taking it

Ephedra increases heart problems and stroke. Stop at least 24 hours before surgery.

Garlic increases blood loss. Stop 7 days before surgery

Ginkgo increases blood loss. Stop at least 36 hours before surgery

Ginseng increases blood loss, low blood sugar. Stop at least 7 days before surgery.

Kava increases the effect of anesthesia unpredictably. Stop at least 24 hours before surgery

St. John's wort increases the effect of anesthesia and interferes with many/most other drugs. Stop at least 5 days before surgery.

Valerian increases the effect of anesthesia unpredictably and causes withdrawal symptoms. No data on when to stop.

The full article is at

http://jama.ama-assn.org/issues/curr.../jrv10013.html

SOURCE: The Journal of the American Medical Association 2001;286:208-216.

Thank you for those vital pieces of information.

In addition to what was listed in your post, my Doc told me to lay off the Vitamin E and Vitamin C and any products containing aspirin at least 7 days before surgery as all of these can thin the blood and cause excessive bleeding during surgery.

My best wishes to everyone for a speedy and complete recovery.

Thanks for the info. I heard it on the news last night and had heard it before.

My doc had me stop everything except my vitamins and my migraine prevention med and my estrogen two (2) weeks prior to my surgery. He said especially any and all herbs and aspirin products.

Prayers to everyone for a safe and speedy recovery.

BarbH

I am on black cohosh, dong quai, licorice, and vitex to keep hot flashes and mood swings in check. Dong quai is a blood thinner and licorice raises blood pressure. My doctor said to stop taking everything one week before surgery. I see the anesthesiologist on Tuesday. I'll let everyone know if I get a different response

Does this mean I can't eat garlic? Or is it just the garlic pills you shouldn't take? I can hardly cook without garlic and my surgery is two days away! I guess I won't eat any more just in case!

Cass

I assume that they only mean high dose garlic pills -- I mean goodness! - no pizza, pesto, paella, and a zillion other good things pre-op?!

Marian Paroo is right. They were looking at lots of controlled studies using supplements--so it's a concentrated pill of garlic they're talking about. So eat what you want! Pamper the princess!

These are great words of advise. Wish I had known before my lap because I woke up in the middle of it. I was :burning: because my never said a word when I told him I was on herbs. You don't want to wake up so stop at least 3 weeks before you surgery.

ladytd --

For once I'm speechless! I heard of that kind of thing happening, it must have been horrible.

Here, I don't know since when, though, the med students are required to learn a lot about herbal medicine. Even if the curriculum isn't too supportive of it, they do acknowledge it as a fact.

Well, it was awful. I remember thinking I couldn't breathe and they all had theit backs to me and I had that tube down my throat and strapped to the table. Believe it or not my first thought was whose belly is that! I was on shark cartilage and glucosamine and I do believe they told me after that the shark cartilage is the one to be careful of before going into surgery.
After my surgery I thought I would :explode: at the when he had told me before it didn't matter. Since I have found out that it does. Just remember to tell them at pre-op what kinds you are taking. I was told at pre-op that I should stop at least 3 weeks in advance and I was glad I had already stopped taking them after I awoke during my lap.

GOOD LUCK TO ALL