Seniors

Make sure you tell your doctor if you are taking herbs or other supplements. Among the herbs that can cause complications before or during surgery:

• Garlic, ginkgo and ginseng can cause bleeding

• Ephedra can raise blood pressure and heart rate

• Ginseng can lower blood sugar levels

• Kava and valerian can make anesthetics more potent

• St. John's Wort can interfere with some drugs

• Echinacea can cause allergic reactions or alter immune function

What to do:
Stop taking garlic, ginseng and St. John's wort roughly a week before surgery, and ginkgo, kava and ephedra a day or two before surgery.

There is no reliable information on how early to stop taking echinacea or valerian.

A simpler suggestion from the American Society of Anesthesiologists is to stop taking any herbal supplement at least two to three weeks before an operation.