It's really difficult to be certain as to problems, side effects and drug interactions which may occur with herbal medications such as you've mentioned. Because they are classified as supplements, they do not fall under the scrutiny of the Food and Drug Administration as do drugs, and thus the producer does not have the same duty to fully test the product for both effectiveness and untoward effects. Also, there is not the same assurance as to the purity of the product, the standardization of dosage and/or the bio-availability of the substance. All of these factors are important considerations when taking medications.
That being said, goldenseal is said to be contraindicated for persons with hypertension, irrespective of whether or not one is undergoing surgery, as one of its constituents may raise blood pressure. Echinacea should be used with caution with several medications, including corti-steroids and other medication which might affect the immune system. It is generally cautioned that echinacea, when used for more than a few weeks might have a suppressive effect on the immune system. By no means do I mean to indicate that this is a complete list of side-effects and drug interactions.
Unfortunately, many folks believe that just because something is natural, it can't hurt you, and that is clearly not the case.
In my view, so much is unknown about all of these products that I wouldn't feel comfortable having one of my surgical patients take them. I have performed foot surgery for many years and have never been aware of anyone in good health who required or were likely to have benefited from these herbs.
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