Friday, January 04, 2008

Nutrients for Surgery January 2008

FHN Complementary Medicine Monthly Newsletter January 2008

Doc, What Nutrients do I stop before surgery, and what do I take to promote healing?

We hear that question all the time. So I thought we should review what we recommend as a general rule. Obviously everyone is different and if you are taking certain nutrients that you aren’t sure of, talk it over with a health care provider. Also if there are complications this list can change and grow substantially. So much for the disclaimers!!!

What to stop before surgery.

Let me give you the list the American Medical Association publishes and their reasons.

Echinacea: immune suppression (could interfere with wound healing), liver inflammation in combination with certain drugs

Ephedra: (ma huang) heartbeat irregularities, blood pressure

Feverfew: bleeding

Garlic: bleeding

Ginkgo Biloba: bleeding

Ginseng: bleeding, low blood sugar

Goldenseal: high blood pressure and swelling

Kava: increase anti-seizure medications and/or anesthesia effects

Licorice: high blood pressure; swelling; electrolyte imbalances

Saw Palmetto: interact with hormone therapies

St. John’s Wort: prolong anesthesia effects

Valerian: increase anti-seizure medication effects or prolong anesthesia effects

A few comments: Licorice in the therapeutic doses found in most supplements has been shown to be perfectly safe. (VERY LARGE Doses have been a problem). There is no good clinical evidence to back up the claim against echinacea , as a matter of fact the reverse is true.( It helps immune system function). Ginseng’s blood sugar lowering effects have been greatly overplayed, as most literature points out it will help normalize blood sugar. So if you are extremely high and on meds it may bring it down to the point that the meds need to be reduced.

I would add to the list of herbs to stop 2 weeks prior to surgery:

Dong Quai (Angelica sinensis ): Bleeding

Dan Shen ( Red Sage): Bleeding ( The Chinese use this herb as a cheaper substitute for ginseng in many formulas)

Vitamin E should always be stopped several weeks before surgery for it’s bleeding effects

So what should you take to help heal from the surgery.

This is a program from Alan Gaby MD and Jonathan Wright MD.

Begin this program 2 weeks prior to surgery and continue it for 4 weeks after surgery. Take:

· High-potency multiple vitamin and mineral supplement (including Vitamin K)

· Vitamin C, 1,000 mg, 2-3 times a day

· Vitamin E, 400 IU/day (Start this after surgery)

· Vitamin A, 25,000 IU/day

· Zinc (picolinate or citrate), 30 mg/day

· Copper, 2 mg/day

· Flavonoids:
-- Citrus bioflavonoids, 500-1,000 mg., 2-3 times a day; or
-- Herbal Flavonoids 2-3 capsules per day;
-- Centella asiatica (Gotu Kola standardized extract

· Proteolytic enzymes are recommended to reduce inflammation and swelling at the surgical site. Choices include:
-- Pancreatin, 1,400 mg, 2-3 capsules, 3 times a day; or
-- Bromelain (2,000 mcu/g), 250 mg, 2-3 capsules, 3 times a day.

Enzymes should be started as soon as possible after surgery and continued for one week. The dosage may be reduced by half after the first 3 days. Enzymes work best when taken on an empty stomach.

Homeopathic Arnica 30x this can be started right after surgery as sublingual drops.

Probiotics before and after.


Drs. Glenn and Julie Smith

Complementary Medicine


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