Most people know they should tell their doctors about any prescription drugs they are taking, especially when they are planning to have surgery. Many also realize they should report any over-the-counter drugs as well. But not everyone stops to think about the possible risks their herbal supplements could pose to the success and safety of their surgery.
Why It Happens
Many people assume that just because a product is labeled as "natural", it is harmless. The truth is that many powerful drugs (and poisons) are based on natural substances, so it's clear that many natural substances can have a potent effect on the body.
Another problem is that many patients are hesitant to report any alternative therapies (including herbal supplements) to their surgeon, because they are afraid their surgeon may disapprove or lecture them about the use of supplements. However, patients who withhold this information can pay a hefty price.
According to Alan Gold, MD, President of the American Society for Aesthetic Plastic Surgery (ASAPS):
"Despite the fact that the dangerous side effects of some herbal supplements have been widely publicized, plastic surgeons still find that many patients do not fully appreciate the importance of discontinuing these treatments before surgery. Physicians must have at least fundamental knowledge of the common herbal medications and their effects, and then be very proactive in discussing patients’ use of herbal supplements during the history, consultation and informed consent process. Stopping certain herbal supplements prior to surgery is just as critical as stopping aspirin, ibuprofen and many other common drugs.”
What to Avoid
Below is a general list of herbal supplements that may affect surgical outcome and safety. In general, it is recommended that you cease taking any of these supplements at least 2 weeks prior to your surgery date (and don't resume taking them until you have your doctor's OK).
Of course, every patient is different, so you should always disclose all of your supplements and medications (yes, even vitamins) to your doctor when planning your surgery. There may be a specific health condition, risk of interaction, or aspect of your specific procedure that changes things a bit for you. That's why it's so important to be open and honest with your surgeon.
Supplements that can cause bleeding problems:
- Gingko Biloba
- Fish Oils (omega-3 fatty acids)
- Dong Quai
Supplements that can have cardiovascular effects:
Supplements that can cause drug interactions:
- St John's Wort
Supplements that can have anesthetic effects:
- St John's Wort
Supplements known to cause other types adverse events:
- St John's Wort (can cause photosensitivity, especially after laser or chemical peels)
- Ginseng (can cause hypoglycemia)
A Shared Responsibility
The ASAPS encourages doctors to give detailed lists of these supplements to their patients. I encourage you to take responsibility for your own care. The best way to do this, as always, is to arm yourself with information and to practice full disclosure of all your health habits with your physician.
Source: Are Herbal Supplements Putting Aesthetic Surgery Patients at Risk; Report released April 13, 2009 by the American Society for Aesthetic Plastic Surgery (ASAPS)