Millions of surgeries occur in the United States annually, the most common being lens and cataract procedures, tonsillectomy, and hernia repair. Personal factors and underlying medical conditions can affect post-surgical healing, potentially leading to postoperative complications and prolonged hospital stays. An integrative approach that focuses on supporting cellular and physiological mechanisms to help manage inflammation and immune function may contribute to improved surgical outcomes and a smoother recovery.
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What is a Post-Operative Protocol?
A post-operative protocol is a nutritional program emphasizing nutrients that may support healing and help reduce scar formation after surgery. Individuals who follow a post-operative protocol might experience a more comfortable recovery, with less discomfort and swelling.
Functional Medicine Labs to Consider Before Surgery
Functional medicine labs can help practitioners personalize options for their patients. Below are some of the common labs considered for patients scheduled for surgery.
Complete Blood Count (CBC)
A CBC screens for anemia or other red blood cell disorders, immune function, and clotting factors. Additionally, a CBC can provide insights into nutritional status, as some vitamins and minerals can lead to changes in blood cells measured on this panel. Addressing potential anemias and managing infections before surgery may support recovery post-operatively. Additionally, understanding bleeding or clotting tendencies can provide valuable information to the surgeon to help ensure patient safety.
Comprehensive Metabolic Panel (CMP)
A CMP includes 14 biomarkers that assess blood glucose, electrolytes, liver function, and kidney function. This test is a comprehensive health screening tool that can help detect imbalances and health conditions that might complicate surgery and recovery.
Hemoglobin A1c (HbA1c)
HbA1c is a 3-month blood sugar average and is the biomarker used to assess blood sugar control. Studies show a clear correlation between blood glucose and wound healing. Patients with type 1 and type 2 diabetes may be at higher risk of slower wound healing and infection at the surgical site because high blood sugars can affect white blood cell function and circulation. (1)
Thyroid Panel
Optimal thyroid function is important during the pre and post-operative periods because thyroid hormones impact metabolism, heart function, the nervous system, immune function, and muscle strength. A complete thyroid panel assesses the thyroid axis to screen for thyroid function.
Iron Panel
It is important to assess and manage iron levels prior to surgery. Iron deficiency can contribute to iron deficiency anemia (IDA), affect collagen synthesis, and influence thyroid function. A complete iron panel, including serum iron, ferritin, transferrin, iron saturation, and total iron binding capacity, offers a comprehensive analysis of the body's iron status and utilization.
Comprehensive Nutritional Analysis
A comprehensive nutritional analysis, like Genova's NutrEval, goes beyond iron to screen for insufficiencies and deficiencies in vitamins, minerals, antioxidants, fatty acids, and amino acids that are important to the healing process.
Other Lab Tests to Consider
In addition to the labs mentioned above, patients should follow their surgeon's advice and complete any requested pre-operative blood work and testing. These tests are important for a comprehensive health analysis to help ensure the best surgical outcomes and patient safety. Commonly considered tests, in addition to a CBC, CMP, and HbA1c, include a chest x-ray and an electrocardiogram (ECG).
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Functional Medicine Considerations for Post-Operative Recovery
A personalized approach can be developed based on an extensive intake and lab results. Below is an example of considerations for post-operative recovery for patients scheduled for surgery.
Diet and Nutrition Considerations for Post-Operative Recovery
Good nutrition is important for a healthy immune system. You may notice that appetite is reduced after surgery, so making mindful dietary choices to choose nutrient-dense foods and maximizing intake when your appetite is good are important. A plant-based diet provides phytonutrients, vitamins, and minerals that can help support tissue repair and immune function. Incorporating high-protein foods into the diet (e.g., dairy, lean meats, seafood, bone broth, legumes) can help meet increased energy requirements during the healing state. (10)
Staying well-hydrated is just as important as staying well-nourished. Dehydration can affect skin elasticity, making it more susceptible to infection and slower healing. Also, dehydration may increase the risk of complications like urinary infections and electrolyte imbalance. (10)
Supplement Considerations for Post-Operative Recovery
Nutritional supplements can provide additional protein, vitamins, and minerals that you may be unable to get through diet alone. Below are commonly considered supplements by functional medicine providers during post-operative recovery.
Arnica
Although homeopathy is controversial, homeopathic Arnica is traditionally used for trauma, bruising, and discomfort. A recent 2021 meta-analysis suggested that homeopathic Arnica may help manage post-surgical symptoms like swelling and discomfort, with effects comparable to standard anti-inflammatory medications (e.g., ibuprofen).
Dose: Homeopathic Arnica 30C; five pellets dissolved under the tongue every 3-4 hours
Duration: 7 days
Multivitamin
A comprehensive, high-potency multivitamin/mineral supplement is an easy way to fill nutritional gaps in the diet and help maintain nutritional balance. Multivitamins are generally considered safe and inexpensive, and available research suggests their use post-operatively may help manage discomfort and support recovery.
Dose per label instructions
Duration: 4-6 weeks
Antioxidants
ACES + Zn by Carlson is a comprehensive antioxidant formula that contains vitamins A, C, E, selenium, and zinc. Antioxidants help protect cells from free radical damage and support a healthy immune system. Additionally, vitamin C is important for collagen synthesis, and zinc is a crucial mineral for wound healing. (2-6)
Dose: take two soft gels three times daily with food
Duration: Begin three days after surgery, and continue for one month
Vitamin D
Vitamin D plays a vital role in many aspects of healing, including cell proliferation, neuromuscular and immune function, bone remodeling, and glucose metabolism. Low vitamin D status is associated with worse surgical outcomes in patients.
Dose: 5,000-10,000 IU of vitamin D3 daily, depending on preoperative vitamin D status
Duration: 1 month
Flavonoids
Flavonoids are natural plant compounds with a high antioxidant capacity, capable of reducing reactive oxygen species and promoting cardiovascular health. Over 5,000 plant flavonoid compounds exist in food, including anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols. Supplementing with Fruit Anthocyanins may support soft tissue integrity and promote healthy circulation. (7-9)
Dose: 1 tbsp daily
Duration: 1 month
Bromelain
Bromelain is a type of proteolytic enzyme concentrated from the pineapple plant that may help manage discomfort and swelling at the surgical site and support the body's natural healing processes.
Dose: 500 mg three times daily on an empty stomach
Duration: Start as soon as possible after surgery and continue until the bottle is finished.
Probiotics
Your surgeon may prescribe antibiotics before or after surgery to help prevent infection. Taking a probiotic alongside antibiotics can help maintain beneficial intestinal bacteria and manage antibiotic-associated gastrointestinal side effects like diarrhea.
Dose: 5-10 billion CFU daily; take at least two hours away from antibiotics
Duration: Start the same day you start the antibiotic and continue 2-4 weeks after the course of antibiotics has finished.
When to Retest Labs
Patients should plan to continue the post-operative protocol for 4-6 weeks after surgery to support healing. Labs can be repeated during this timeframe to assess health status and adjust the approach as needed. Patients should always follow up with their doctors sooner if they experience any complications or unexpected side effects during the post-operative recovery period.
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Summary
Healing from surgery can be a long, challenging process that may be affected by underlying medical conditions and nutrient levels. Consider scheduling an appointment with a functional doctor if you have a future surgery scheduled. Functional doctors interpret lab results with a focus on differentiating between normal and optimal values to support health at the cellular level before surgery. Based on labs and patient history, an approach can be customized to meet an individual's increased energy demands and support the body's natural healing mechanisms post-operatively. A post-operative recovery plan may encourage a smoother recovery and help manage potential challenges that can occur after surgery.
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