JAMA: Herb Use May Interfere with Post-Op Recovery

CHICAGO--In the July 11 Journal of the American Medical Association (JAMA) (286:208-16, 2001), researchers found that certain herbs may interfere with a patient's recovery time. According to a review conducted by researchers led by Michael Ang-Lee from the University of Chicago, echinacea, ephedra, garlic, ginkgo, ginseng, kava, St. John's wort and valerian were all found to be causes of concern during post-op recovery.

Researchers conducted a keyword search using the terms "herbal medicine," "phytotherapy" and "alternative medicine" in their search for articles, which were published between 1966 and 2000 and found in the MEDLINE and Cochrane Collaboration databases. Researchers then extracted information regarding dietary supplements' safety, pharmacodynamic (the effects of a supplement on a human) and phamacokinetic (how the body processes a supplement).

The eight herbs chosen for this review were based on their popularity among supplement users. According to this review, researchers concluded that complications occur during post-op recovery because of the anti-clotting attributes of garlic, ginkgo and ginseng; the "cardiovascular instability" of ephedra; and the onset of hypoglycemia from ginseng. Additionally, herb-drug interactions between kava and valerian may heighten the effects of anesthesia. And, as it has been stated in other studies, St. John's wort may increase the absorption rate of various prescriptive drugs.

The authors concluded that physicians should be aware of the effects of these herbs on their patients' recovery rates and be proactive by asking their patients pre-surgery if they are taking any herbs. This study can be found on the JAMA site (http://jama.ama-assn.org).

The Council for Responsible Nutrition (CRN) stated in a press release that this review "provides a useful resource to the professional health-care community."

"Dialogue and open-mindedness must be a two-way street, however," said John Cordaro, president and chief executive officer of CRN. "Physicians should know what supplements their patients take and understand the science behind those supplements, especially if prescription medications or surgery are likely options or necessities for those patients." CRN added that it plans to hold an industry roundtable to discuss possible label warnings about these interactions for dietary supplements.

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