Not all herbal remedies are harmless

Herbal and ayurvedic concoctions could cause complications during surgery, say doctors

The use of herbal remedies has been on the rise. Everything from turmeric to garlic has been used by people to try and ward off Covid. While they don’t have any proven benefits, the attitude seems to be that as long as it doesn’t do any harm there is no risk in trying it.

However, a recent tweet by Dr Raghuraj Hegde recounts how a patient “bled buckets” on the table without the use of blood thinners. He attributed this phenomenon to the patient’s use of a herbal concoction of ginger, garlic, turmeric and asafoetida.

Dr Nagabhushan J S, senior consultant of gastrointestinal and colorectal surgery, says that we don’t look at herbal remedies as ‘medicine’ and thus dismiss the possibility that they could cause any negative effects. “It’s difficult to get people to tell us about them unless they come in a commercial pill or kashaya form. Most times patients just tell us the colour of the pill or show us the concoction. Even they don’t know what the ingredients are, so it’s a lot of guesswork to figure out if it could cause a problem,” he says.

Dr Swetha, a naturopathic physician, says that these ingredients are usually ingested through food and she sees no reason as to why they would cause harm during a surgery. “You even apply turmeric to areas where there is bleeding to stop the blood flow, so I don’t think this is a problem,” she says.

Dr Priyanka Rohatgi, clinical nutritionist, strongly disputes this. “Some herbs, including clove, turmeric and cinnamon have a great effect on the body’s anti-inflammatory parameters. Some can slow blood coagulations and others can thin the blood. Depending on the kind of anesthesia you’re getting, there is a different kind of side effect,” she says.

It is ideal to stop any kind of herbal concoctions a week prior to surgery. “All of them have different gastric emptying times. They may be out of your stomach but may linger on in your blood. So a complete detox is required,” she explains.

Ginseng, garlic, ginger, ginkoba and omega 3 fatty acids in flax and chia seeds could all interfere with the chemicals in anesthesia, she says. “It poses a risk during surgeries now. The effects could range from a bad headache and stomach pain to excessive bleeding,” she says.

Regarding Swetha’s remark on how these items are consumed with food anyway, Priyanka says that it’s high concentrations that would have a harmful effect. “Your body is used to a little amount of these herbs in your food. When taken through supplements and kashayas, these compositions are much higher and concentrated,” she explains.

She says that while most people reveal what medication they are on prior to a surgery, they don’t mention what herbal or ayurvedic preparations they are on. “Generally a surgeon does not ask you all these details. It’s the anesthetic who does and unfortunately the patient only meets one either a day before the surgery or on the day. So it’s important that people are aware of these risks and they come forward and declare it,” she says.

She adds that many people hesitate because they feel they may offend their allopathic doctors by telling them about herbal remedies. “This is wrong, ultimately it’s the patient who gets affected if they withhold this information,” she concludes.