VITAMINS & SUPPLEMENTS · GUIDE
Brain Supplements Before Surgery and Anesthesia: Bleeding and Anesthesia Considerations
What anesthesiology and health bodies say about memory and focus supplements before surgery, including ginkgo, ginseng, valerian, kava and caffeine, and why to tell your team.
Content last updated . This page has not been medically reviewed.
Back to NootropicsWhy teams ask
The American Society of Anesthesiologists (ASA) says some supplements can prolong the effects of anesthesia, increase bleeding, raise blood pressure, interfere with other medicines or cause heart problems. [2] It also reports that studies show half of people who use herbal supplements do not tell their doctors before surgery. [2] The FDA adds that some supplements can interact with medicines, interfere with lab tests or have dangerous effects during surgery. [3]What the sources say about ingredients sold for focus and memory
Caffeine and surgery
Caffeine is not on the ASA list we read. Two older studies looked at caffeine and headache after surgery, because stopping daily caffeine can cause withdrawal headache. In a trial of 40 patients having minor surgery under general anesthesia, 10 of 20 (50%) on placebo reported headache. [8] In a survey of 233 surgical outpatients, postoperative headache occurred in 22% of regular caffeine drinkers and 7% of others. [9] These are small, old studies of ordinary caffeine habits. Fasting rules and caffeine on the day of surgery are for your anesthesia team to decide. See also caffeine withdrawal.Who should be especially careful
People who take blood thinners or have a bleeding disorder, have heart rhythm or blood pressure problems, have liver or kidney disease, are pregnant or breastfeeding, or are having surgery for a child should ask a clinician or pharmacist. Read Supplements before surgery and medication interactions.Frequently asked questions
Do I need to tell my anesthesiologist about a memory supplement?
Yes. ASA asks you to include all medicines, herbs and supplements, including vitamins. [2] MedlinePlus also says to check with your provider about supplements before any type of surgery. [10]
Can ginkgo affect bleeding during surgery?
ASA says ginkgo can increase the risk of bleeding, and NCCIH says it may do so in people taking anticoagulants such as warfarin. [2][4]
How long before surgery should I stop a supplement?
Sources describe clinicians asking for two to three weeks, but your team decides for your case. [7][6]
Does drinking coffee before surgery matter?
Studies link stopping regular caffeine with headache after surgery, but fasting and caffeine instructions come from your anesthesia team. [9]
Is a supplement safe if I have used it for years?
ASA notes that supplements can cause problems during surgery even if you have taken them without problems before. [2]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read the evidence labels
Labels used on this page: warning from a professional body (a list, without trial data), review of the literature, small trial in a specific group, and Proper evidence not found.
| Ingredient | What the source says | Type of source |
|---|---|---|
| Ginkgo | ASA says it can increase the risk of bleeding. [2] NCCIH says it may increase bleeding risk in people taking anticoagulant drugs such as warfarin. [4] | Professional body and NIH centre |
| Ginseng | ASA says it can increase heart rate and the risk of bleeding. [2] A 2015 review reported cardiovascular instability with ginseng, ephedra and kava. [5] | Professional body; review |
| Green tea | A 2015 review reported bleeding risks for garlic, ginkgo, ginseng, green tea, saw palmetto, St John's wort and fish oil. [5] | Review |
| Valerian (sold as a sleep aid) | ASA says it can prolong the effects of some types of anesthesia. [2] | Professional body |
| Kava (sold for anxiety) | ASA says it can increase the effect of anesthesia. [2] | Professional body |
The 2015 review also says the effects of supplements on coagulation and platelet function are difficult to predict. [5] A 2014 anesthesia review says more than 90 herbal products are associated with bleeding and that there is no existing protocol for standardizing these products. [6] For fuller herb notes see herbal nootropics safety and the ginkgo guide.
When to stop: what the sources describe
- The FDA says your health care professional may ask you to stop dietary supplements two or three weeks before the procedure, to avoid dangerous changes in heart rate, blood pressure or bleeding risk. [7]
- ASA says an anesthesiologist may recommend stopping supplements at least two weeks before. [2]
- A 2014 review of anesthesia practice describes attempting to stop herbal products two to three weeks before. [6]
These are statements about what clinicians may ask, not instructions for you. The right timing depends on the product, the operation and your health. Bring all your supplement and medicine bottles to the appointment, as ASA suggests. [2]
What we could not find
References
- NCCIH: Using Dietary Supplements Wisely. Read 2026-10-23.
- American Society of Anesthesiologists: Herbal and Dietary Supplements and Anesthesia (2020). Read 2026-10-23.
- FDA 101: Dietary Supplements. Read 2026-10-23.
- NCCIH: Ginkgo, Usefulness and Safety. Read 2026-10-23.
- Wang CZ et al. Commonly Used Dietary Supplements on Coagulation Function during Surgery. Medicines (Basel) 2015. Read 2026-10-23.
- Abe A et al. Perioperative analgesia and the effects of dietary supplements. Best Pract Res Clin Anaesthesiol 2014. Read 2026-10-23.
- FDA: Mixing Medications and Dietary Supplements Can Endanger Your Health. Read 2026-10-23.
- Hampl KF et al. Perioperative administration of caffeine tablets for prevention of postoperative headaches. Can J Anaesth 1995. Read 2026-10-23.
- Weber JG et al. Perioperative ingestion of caffeine and postoperative headache. Mayo Clin Proc 1993. Read 2026-10-23.
- MedlinePlus: Dietary Supplements. Read 2026-10-23.