By Terry Mason, HealthAtoZ Contributing Writer

You're scheduled for surgery. Perhaps you're having your wisdom teeth removed, a hysterectomy or gall bladder surgery. You want to be as healthy as possible beforehand. So, you follow your doctor's advice. You exercise and rest when you're supposed to and take your medicines exactly as prescribed. You're even taking your usual herbal supplements for reassurance. You're doing everything you can, right?

Maybe not. Before surgery, your doctor may not have asked if you routinely take herbal supplements. Some do not, even though taking herbal medicines before surgery can interfere with your recovery from surgery in some surprising ways.

Since many herbal preparations are a mixture of many different herbs, patients should bring herb bottles with them to all their pre-surgery appointments. This includes appointments with your general doctor, surgeon and your anesthesiologist.

As a precaution, consumers also are wise to stop taking any herbs before any surgical procedure. Talk to your doctor about when you should stop taking any herbs, vitamins or supplements, or over-the-counter medications.

The American Botanical Council estimates that 30 percent of all adults in the U.S. use some type of herbal supplement or preparation to treat common ailments such as colds, allergies, heartburn, headaches and insomnia.

Here is a quick look at just some of the problems found when mixing herbal preparations with surgery:

Echinacea

This herb often is used for preventing or treating viral, bacterial or fungal infections. Because some people can be allergic to echinacea, those with allergies or asthma should be cautious of using this supplement at any time. This also is true for people with pre-existing liver conditions. Echinacea may diminish the effectiveness of immunosuppressant drugs, so people who are having any kind of organ transplant should avoid taking echinacea. Long-term use of echinacea (more than 8 weeks) may also cause increased infections after surgery and poor healing.

Garlic

Garlic inhibits your platelet's ability to aggregate, or clot. This means it can become harder to stop any bleeding.

Ginkgo

This herb is taken for a number of conditions, including improving mental alertness, reducing dizziness caused by altitude sickness or vertigo, and erectile dysfunction. Ginkgo also inhibits the platelet-activating factor, part of the normal blood-clotting process. This effect can cause bleeding.

Ginseng

Ginseng is thought to protect the body against stress. Unfortunately, it also may lower the glucose (sugar) in your blood. This could be a serious problem for a person with diabetes and could even cause a dangerous blood sugar drop in people without diabetes.

Kava

Kava commonly is used to treat anxiety. Kava may act as a sedative and might interfere with traditional sedatives given during surgery or shortly after surgery. Kava could interfere with the anesthetic medication that you receive during surgery.

St. John's Wort

This herb is widely used to treat mild to moderate depression. St. John's Wort also can increase the metabolism of medications. This may interfere with drugs used in organ transplants or anyone who may need to take an anticoagulation medicine after surgery to prevent blood clots.

Valerian

This herb is used to calm anxiety and promote sleep. It may interfere with certain anesthetic medications used during surgery. Because valerian may have some addictive qualities, it is a good idea to taper use for several weeks before surgery.

Simple advice to make your surgery safer:

• Even if your doctor or pharmacist does not ask specifically if you use herbal preparations, tell them.



• Before surgery, show your doctor any prescription medications, herbal preparations and over-the-counter medicines you take routinely. Ask if you should stop taking any of your medications or herbs before surgery.



• Because your doctor may not know about herbal preparations, you may want to err on the safe side and stop taking herbal preparations for a week before surgery.

Related Articles What Is Alternative Medicine? Herbalism

External Sources American Botanical Council National Institute of Environmental Health Sciences National Center for Complementary and Alternative Medicine Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. Journal of the American Medical Association. 2001;286:208-216.

This article was reviewed and updated June 2007.