Herbal Medications and Surgery

Just because it is “herbal” and natural, does not mean it is safe.

Vincristine, a chemotherapy agent, comes from a common garden flower.

Herbal supplements are common, particularly here in the Bay Area.  They are in everything:  single pill diet herbal supplements, power drinks, teas, diet pills, and muscle building supplements.  I joke it is probably in our water too.  There are many issues with herbals. 

• They are not regulated as closely as prescription medications, so you don’t know exactly what is in them. I saw an expose once on asian herbs, where they had taken them to a lab and analyzed the content.  They found high levels of arsenic in one brand.  Of course, the arsenic wasn’t listed on the “ingredient” list. 
• People don’t think of them as being medications.  On my sign in sheet, I ask what medications including herbals the patient takes.  Even with that, many patients don’t mention herbals and vitamins until I specifically question them. 

Why does it matter? Because some herbals make you bleed- a bad quality during many of my surgeries.  Some interfere with anesthesia.  And they can affect other systems: I had a patient who was in liver failure due to an “herbal supplement.”  She had no idea.  We discovered it when routine preop labs showed her liver function tests were through the roof and her platelet level (which helps you clot to stop bleeding- again a good quality during surgery) was low. Eeek!  She was a healthy younger woman.  Those labs made us think of liver failure, infections, cancers- we were thrilled to find it was just the herbal medication, and her functions returned to normal after stopping the herb. 

It takes time to get the herbal medication effect out of your system.  I have my patients stop all herbal medication two weeks prior to surgery, and I don’t let them restart until they are 2- 3 weeks out.  There are some herbals which are okay, but you need to clear each individual one with your surgeon prior to surgery.

SO

Herbal medications are MEDICATIONS.

They can have a profound effect on your body.

Discuss them with your doctor prior to surgery.