I find at this time of year many of us look for that extra “edge” to help us sustain our energy level for Christmas shopping and parties! Our patients are no different. Two of the most common supplements that provide an extra boost are products containing ginkgo biloba and Ginseng. For the average lay person, their only concern is the speed of onset of the “boost of energy” they will receive. They most likely have no idea that this over-the-counter medication can have serious consequences and interactions.
Ginko inhibits platelet activating factor (PAF) and is used for stroke, anxiety, asthma, headaches and memory enhancement. It is contraindicated in patients with seizures as it lowers the seizure threshold. It also should not be used in patients with any bleeding disorder. The use of ginkgo should be discontinued at least two weeks before surgery.
Ginseng lowers the adrenal hormone cortisol in diabetes and increased cortisol levels in non-diabetics. Low doses of ginseng will increase blood pressure. High doses will decrease blood pressure. High doses all help the body to adapt to stress. The recommend dosage is a four-week interval of use followed by a two-week period of rest. Ginseng is contraindicated in patients with active bleeding, renal failure and acute infection. It can also alter hemostasis. It’s use must be discontinued two weeks before surgery. When ginseng is combined with epinephrine, which is also known to increase blood pressure, palpitations and tachycardia can been seen. The effects of drugs with hypoglycemic action, such as insulin, can be increased. Blood glucose should be closely monitored.
Does your medical history include any questions on herbal supplements or Ginko Biloba and Ginseng in particular? Other OTC supplements that have significant effects are Garlic, St. John’s Wort, Echinacea,Saw Palmetto, Rose Hips, Valerian, Grapeseed, Kava Kava and Green Tea.
Don’t feel like you have to remember all this: When these articles are complete, I’ll compile all this information into a worksheet, or you can email me . firstname.lastname@example.org.
I’ll cover these in our next “blog”
Now that you have read all this….How about getting a little extra sleep or a “power nap” before “burning the midnight oil”!