I recently had a patient ask me which supplements they should stop before surgery, and it struck me that this is a topic many people may not discuss with their doctors as often as they should—considering that more than half of adults in the United States report using dietary supplements, this is a meaningful conversation to have. When preparing for surgery, many people focus on preoperative instructions like fasting or avoiding certain medications. However, dietary supplements often fly under the radar, even though they can have significant effects during surgery. While supplements are often marketed as "natural," they are not without risks—especially when combined with anesthesia or other surgical interventions.
To help you prepare, here’s a list of common supplements that may interfere with surgery and why they should be avoided. Always discuss any supplements you are taking with your doctor before your surgery.
Supplements That May Pose Risks Before Surgery
CBD Oil
Why Stop? CBD oil may increase the risk of bleeding.
What to Know: While more research is needed, CBD’s potential blood-thinning properties make it essential to consult your doctor if you’re using this supplement.
Echinacea
Why Stop? Echinacea, used to boost the immune system, can harm the liver.
What to Know: Impaired liver function could affect how anesthesia is processed, increasing the risk of complications.
Ephedra
Why Stop? This herbal appetite suppressant can cause high blood pressure and an erratic heart rate during surgery.
What to Know: Even small doses of ephedra may create significant cardiovascular risks under anesthesia.
Garlic (Supplement Form)
Why Stop? Garlic supplements, often taken to lower blood pressure or cholesterol, can increase the risk of bleeding.
What to Know: While dietary garlic in food is usually safe, concentrated doses in supplement form pose a higher risk.
Ginkgo
Why Stop? Ginkgo is commonly used to improve memory but can increase the risk of bleeding.
What to Know: Ginkgo’s blood-thinning properties can lead to complications with wound healing or excessive bleeding.
Ginseng
Why Stop? Ginseng, used to boost energy levels, can also increase the risk of bleeding.
What to Know: Ginseng’s interaction with blood clotting mechanisms makes it particularly risky for surgical patients.
Kava
Why Stop? Kava is taken for anxiety relief but can prolong the effects of anesthesia.
What to Know: This herb’s sedative properties may amplify the effects of anesthesia, leading to a longer recovery time.
St. John’s Wort
Why Stop? St. John’s wort, often used to relieve depression and anxiety, can interfere with anesthesia medicines and prolong their effects.
What to Know: This herb can also interact with many medications, so it is essential to stop taking it well before surgery.
Valerian
Why Stop? Valerian, commonly used for sleep or anxiety, can interfere with anesthesia medicines and extend their sedative effects.
What to Know: If you’ve been using Valerian regularly, talk to your doctor about safely tapering off.
Vitamin E
Why Stop? Vitamin E can increase the risk of bleeding.
What to Know: Though important for skin and cardiovascular health, this fat-soluble vitamin can inhibit proper blood clotting.
How Long Before Surgery Should You Stop These Supplements?
As a general rule, many of these supplements should be stopped at least one week before surgery to reduce the risk of complications. However, your timeline may vary based on the type of surgery and your health history. Be sure to consult your doctor for personalized advice.
Why It's Important to Disclose Supplements to Your Doctor?
Some patients hesitate to disclose supplement use, assuming that “natural” products are harmless. However, supplements can have powerful effects on the body, especially when combined with anesthesia, other medications, or the physical stress of surgery. Your healthcare team needs a full picture of what you’re taking to ensure your safety.
By being proactive and open with your doctor, you can reduce potential risks and ensure a smoother surgical experience.
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