Vitamins, supplements, surgery - a bad risk

April 13, 2009 9:35:39 AM PDT
More Americans are turning to vitamins and supplements. But for anyone headed for surgery, that can spell big trouble.

According to the Chicago-based market research firm Information Resources, sales of vitamins and supplements shot up 8 per cent in the last quarter of 2008. While there have been increases in vitamin sales during past economic downturns, none was as dramatic as this one.

That has doctors at the American Society for Aesthetic Plastic Surgery worried.

A report in the March/April issue of their journal, "Aesthetic Surgery" notes that more than 40% of plastic surgery patients use herbal supplements in the 2 weeks prior to surgery. However, 70 per cent never mention the use of alternative and complementary medicines to their doctors.

The surgery group says there are two primary reasons - some patients feel their doctors don't know about these medicines; or that those doctors would disapprove of the supplement use.

Other patients simply don't realize that the supplements could affect the surgery, and their recovery from it. They believe herbal supplements are inherently safe, and free of risks.

Dr. David Rowe, lead author of the report in the plastic surgery journal, says the most dangerous times are during and right after the surgery. Dr. Rowe says supplements most often affect bleeding, the heart, and alertness.

The article says doctors shouldn't rely on patients to tell them what they are taking. They should give those patients a comprehensive list of supplements that can cause trouble.

The Society published this list:

Herbal Medications to Avoid Within 2 Weeks of Surgery

Bleeding Effects
Gingko biloba
Fish oils (omega-3 fatty acids)
Dong Quai

Drug Interactions
St. John's Wort
Valerian root

Cardiovascular Effects
Ephedra (tachycardia, hypertension and palpitations)
Garlic (hypotension - low blood pressure)

Anesthetic Effects
Valerian root
St, John's wort

St. John's wort and Dong Quai (photosensitivity)
Ginseng (hypoglycemia)

"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," says Alan Gold, MD, president of the American Society for Aesthetic Plastic Surgery (ASAPS). "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."

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