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‘Natural’ remedies pose risks to surgery patients

Loma Linda, Calif. — Cosmetic surgery patients who take herbal products, homeopathic medicines and dietary supplements probably are unaware that some of these supplements put them at risk for serious bleeding complications during and after surgery.

A team of physicians from Loma Linda University conducted a comprehensive review to identify herbal supplements, teas, homeopathic medicines and dietary supplements that could increase the risk and duration of perioperative or postoperative bleeding. In “Bleeding Risks of Herbal, Homeopathic and Dietary Supplements,” which appears in the March issue of Aesthetic Surgery Journal, researchers also offer recommendations to guide surgeons as they counsel patients about discontinuing such supplements before and after surgery.

The review focuses on 19 herbs, three herbal formulas, two herbal teas and several other supplements that can cause pre- and postoperative intrinsic bleeding, potentially resulting in serious side effects such as hematomas. According to the review, some of the most popular herbs and supplements with potentially dangerous effects include Chinese peony, garlic, ginger, ginko, ginseng, oil of wintergreen (methyl salicylate) and saw palmetto (Serenoa repens, Salbalserrulata). The authors recommend that physicians screen patients for supplement use and advise complete cessation of supplements two to three weeks before surgery and postponement of supplement use after surgery.

The American Society for Aesthetic Plastic Surgery issued a statement in which lead author Subhas C. Gupta, M.D., chairman of the department of plastic surgery at Loma Linda University School of Medicine, says, “We conducted this review to help surgeons educate, screen and counsel their patients on herbal foods, supplements, teas and other homeopathic remedies that can compromise patient safety.”

Dr. Gupta recommends that surgeons should determine whether the patient is taking any vitamins, herbs or supplements; what vegetables or plant products the patient has been eating during the past month; what types of teas the patient has been drinking recently; and whether the patient has ever taken any herbs or supplements in the past.

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