SUPPLEMENTS TO DISCONTINUE BEFORE AND AFTER SURGERY

Nowadays, many patients are taking nutritional supplements in increasing amounts. While generally beneficial and safe, their use around the time of surgery may not be desirable. Certain nutritional supplements may cause adverse reactions during or after surgery, including: prolonged bleeding, interference with anesthesia, cardiovascular disturbances, and interactions with prescription drugs. To ensure surgical safety, please discontinue the use of the following nutritional supplements, two weeks prior to surgery and two weeks after surgery.

Bilberry (Vaccinum myrtillus) Ginkgo Biloba (Ginkgo Biloba) Melatonin Contains compounds called anthocyanoside, and One of the oldest living tree specimens and one of A hormone that is secreted by the pineal flavonoid compounds that strengthen blood the best researched herbal medicines. Ginkgo blob gland located in the brain. Since melatonin vessels, improve circulation and can be useful in improves blood circulation by strengthening the controls the body’s sleep-wake cycle, it is treating eye disorders, Bilberry can affect blood vascular system and inhibiting platelet aggregation. cells called platelets and may increase bleeding. Ginkgo is also used to help prevent mental often used to counteract sleeplessness and deterioration in the elderly. Ginkgo has significant jet lag. Melatonin may potentiate the Cayenne (Capsicum frutescens) blood-thinning activity which is three times central nervous system effects of Also known as red pepper, cayenne lowers levels stronger than Vitamin E. barbiturate drugs (produce relaxation and of cholesterol in the blood, which can help to sleep) and general anesthetics. lower blood pressure. Cayenne may affect Ginseng (Panax quinquefolium/Panax ginseng) platelets and an overdose can cause significant Ginseng is a so-called adaptogen (increases Red Clover (Trifolium pretense) drop in body temperature. physiological resistance to stress) and an An herb that is a rich source of antioxidant. Commonly taken to enhance physical Dong Quai Angelica sinensis) and cognitive performance. Ginseng acts as an isoflavones and used to treat a number of An all-purpose women’s herb used to provide anticoagulant and may interact with cardiac, high- conditions associated with menopause. An energy and regulate female hormones. An active blood pressure medications and blood-glucose active constituent in Red Clover includes constituent in Dong Quai is a Coumadin-like lowering medications. Coumadin derivatives, which may compound, which may increase existing potentiate existing anticoagulant anticoagulant (blood thinning) medications. Hawthorne (Crataegus laevigata) medications. Hawthorne is used for deteriorating heart function and may be helpful for angina, arteriosclerosis and Echinacea (Echinacea augustfolia) St. John’s Wort (Hypericum perforatum) Used to boost the immune system and for some mild types of abnormal heart rhythm infections of the respiratory tract. Echinacea may (arrhythmia). Hawthorne can enhance the effects of An herbal medicine used to treat mild to negatively affect the liver when general the heart medication digitalis (Lanoxin and moderate depression and seasonal anesthetics or certain other medications are Digoxin). affective disorder (SAD). Since St. John’s used. Wort works like the antidepressants called Kava Kava (Piper methysticum) monoamine oxidase (MAO) inhibitors, it Feverfew: (Tanacetum parthenium) Kava root preparations reduce stress-related anxiety may react with these drugs. In addition, From the Latin word, febrifuge, which means and the effects of anxiety disorders. Kava Kava may many other drug interactions have been potentiate the effects of medications including: fever-reducing, the herb is used mainly to treat reported with St. John’s Wort. migraine headaches. Feverfew may increase barbiturates, alcohol, antidepressants, bleeding, especially in patients taking certain antipsychotics, and general anesthetics. blood-thinning medications. Valerian (Valeriana officinalis) Licorice Root (Glycyrrhiza glabra) Valerian eases insomnia, stress-related Fish Oil Traditionally used for coughs and as a soothing anxiety and nervous restlessness. Valerian The Omega-3 essential fatty acids found in fish remedy for skin. Glycyrrhizic acid in real is a sedative herb and may increase the oil are beneficial for lowering blood pressure, licorice may cause high blood pressure, lower side effects of other anti-anxiety cholesterol and triglyceride levels and reducing potassium levels in the blood and enhance medications or prescription painkillers. the risk of heart disease. Fish oil had blood- swelling (edema). thinning properties which can be problematic during surgery. Vitamin E Ma Huang (Ephedra sinica) Vitamin E is a fat soluble vitamin that is a Garlic: (Allium sativum) More widely known as ephedra, the herb was strong antioxidant and may protect cells Used therapeutically to prevent and treat found in weight loss an energy supplements from free-radical damage. This nutrient arthrosclerosis (hardening of the arteries) and until it was banned by the Food & Drug may play a role in the prevention and elevated cholesterol. Garlic may augment the Administration (FDA) in 2003. Although treatment of cardiovascular disease and effects of blood-thinners like Coumadin* some products have substituted ephedra with other aging related degenerative disorders. (warfarin) and non-steroidal anti-inflammatory bitter orange, both herbs have similar effects Vitamin E also has anti-clotting activity drugs (NSAIDs) causing abnormal bleeding time. on the cardiovascular system including that can prolong bleeding time during Ginger (Zingiber Officinale) hypertension, rapid heart rate, surgery. Stimulates the digestive system and helps relieve cardiomyopathy (heart muscle inflammation) motion sickness, nausea and vomiting. Use of and abnormal heart rhythm) Yohimbe (Corynanthe yohimbe) ginger may alter bleeding time and interfere with As a natural “Viagara*), yohimbe is cardiac and anticoagulant touted as a sexual stimulant and as a potential treatment for male impotence. Yohimbe can raise the heart rate and blood pressure, and increase the potency of anesthetics.