Should You Stop All Supplements Before Surgery?
Finding the Balance Between Safety and Stability for Patients with EDS, MCAS, POTS, Migraine, Chronic Pain, and Other Complex Conditions
Welcome back to the Bendy Bulletin! One of the most common questions I hear from patients preparing for surgery is:
“Do I need to stop all of my supplements before my procedure?”
It’s a reasonable question, but the answer is rarely simple.
Many people living with hypermobility disorders, mast cell activation syndrome (MCAS), postural orthostatic tachycardia syndrome (POTS), migraine disorders, chronic pain, gastrointestinal conditions, and other complex chronic illnesses rely on supplements as part of their daily management plan. Some are taken to correct documented deficiencies. Others help support mast cell stability, autonomic function, sleep, bowel function, wound healing, migraine prevention, or symptom control.
At the same time, surgeons and anesthesiologists must consider potential risks. Certain supplements can affect bleeding, blood pressure, blood sugar regulation, sedation, anesthesia requirements, or how medications are metabolized.
The challenge is that these two goals can sometimes seem to conflict: maintaining surgical safety while maintaining physiologic stability.
In my clinical practice, I frequently see patients who have spent months or years finding a combination of medications and supplements that helps keep their symptoms under control. Then surgery is scheduled and they are told to stop “all supplements” without much discussion about which ones may be helping them function day to day.
For some patients, that approach works well. For others, stopping certain supplements can contribute to worsening mast cell symptoms, autonomic instability, sleep disruption, migraine flares, gastrointestinal issues, or other setbacks at a time when the body is already under significant stress.
The goal is not necessarily to continue everything. The goal is not necessarily to stop everything. The goal is to create an individualized perioperative plan that balances safety with stability.
Two Resources to Help Start the Conversation
