I advise my patients who are planning surgery to quit supplements and any natural product- even natural teas at least a week or 10 days BEFORE surgery. Natural products are biologically active and COULD adversely affect your surgery and its outcome. Excessive bleeding is a big concern. I do not think that we really know to what extent supplements and natural products can play a detrimental role before, during or after surgery, but why would you take the risk? Here are some commonly used natural products that you should be very cautious about when going for surgery:

(I have taken these lists from NaturalDataBase.com- a very reliable source of information about nutritional supplements and herbs. Their work is very impressive. This is not hearsay data, but from a team of skilled pharmacists and other professionals.) These lists just give you an idea of what might occur. DO NOT assume that if you do not see your supplement or herb here that you are home free- no way!

Commonly used Natural Medicines that Might Affect Platelet Aggregation (Meaning the ability of your blood to clot.)

Andrographis Based on in vitro and animal data

Black tea Caffeine in black tea can have antiplatelet effects based on in vitro data

Boldo Documented interaction between boldo and warfarin

Chondroitin Documented interaction between chondroitin and warfarin

Danshen Documented interaction between danshen and warfarin

Dong quai Documented interaction between dong quai and warfarin

Fenugreek Documented interaction between fenugreek and warfarin

Fish oil High doses associated with antiplatelet effects

Garlic Antiplatelet effects; however, conflicting data about whether garlic causes a clinically significant interaction with warfarin

Ginger Antiplatelet effects; however, conflicting data about whether ginger causes a clinically significant interaction with warfarin

Ginkgo Documented reports of surgical complications in patients taking ginkgo

Glucosamine Documented interaction between glucosamine and warfarin

Green tea Caffeine in green tea can have antiplatelet effects based on in vitro data

Guarana Caffeine in guarana can have antiplatelet effects based on in vitro data

Horse chestnut Active constituents thought to have antiplatelet activity

Policosanol Based on clinical research

Resveratrol Based on in vitro data

Saw palmetto Based on anecdotal evidence

Vitamin E High doses associated with antiplatelet effects

Commonly used Natural Medicines that Might Cause CNS Depression(This means depression of your central nervous system.)

German chamomile Mild sedative effects

Hops Mild sedative effects; usually used in combination with other sedative products

Kava Documented report of additive effects with benzodiazepines; also linked to numerous reports of hepatotoxicity

L-tryptophan Clinical research showing sedative effects; documented reports of additive effects with CNS depressants; also affects serotonin levels

Lavender Mild sedative effects; animal models suggest additive effects with CNS depressants

Lemon balm Mild sedative effects; clinical research suggesting sedative effects

Melatonin Clinical research suggesting sedative effects

Passionflower Mild sedative effects; animal models suggest additive effects with CNS depressants

Skullcap Large doses might cause significant sedation

Theanine Mild sedative effects, possibly due to GABA inhibition

Valerian Clinical research suggesting sedative effects

Commonly used Natural Medicines that Might Affect Blood Glucose (Blood Sugar)

Agaricus mushroom Research suggests it lowers blood glucose by reducing insulin resistance.

Alpha-lipoic acid Clinical research suggesting hypoglycemic effects

American ginseng Clinical research suggesting hypoglycemic effects

Banaba Clinical research suggesting hypoglycemic effects

Bitter melon Clinical research suggesting hypoglycemic effects

Cassia cinnamon Research suggests that it potentiates insulin action.

Chromium Reduces blood glucose through insulin sensitizing effects.

Fenugreek Clinical research suggesting hypoglycemic effects

Glucomannan Clinical research suggesting hypoglycemic effects Gymnema Clinical research suggesting hypoglycemic effects

Panax ginseng Clinical research suggesting hypoglycemic effects

Prickly pear cactus Clinical research suggesting hypoglycemic effects

Vanadium Clinical research suggesting hypoglycemic effects

Commonly used Natural Medicines that Might Affect Blood Pressure

Andrographis Preliminary evidence of hypotensive (low blood pressure) effects

Coenzyme Q10 Clinical research suggesting modest hypotensive (low blood pressure) effects

Horny goat weed Preliminary evidence of hypotensive (low blood pressure) effects

Garlic Prelimimary evidence of modest blood pressure lowering effects

L-arginine Clinical research suggesting modest hypotensive (low blood pressure)effects

Licorice Mineralocorticoid effects can increase blood pressure when used in high doses

Pycnogenol Preliminary evidence of modest blood pressure lowering

Theanine Decreases blood pressure in animal models

There are supplements that can stimulate such as Bitter Orange, Caffeine (Mate, Guarana and Cola Nut) and DMMA (Dimethyamlamine). They too should be stopped and I would want to know why you are taking them as well if I were your physician.

These can adversely affect metabolism and should be stopped before surgery as well:

• Bitter orange     
• Cat's claw     
• Danshen     
• Devil's claw     
• Evodia     
• Feverfew     
• German      chamomile
• Ginkgo     
• Goldenseal     
• Grapefruit     
• Hu Zhang     
• Indole-3-carbinol     
• Ipriflavone     
• Kava
• Quercetin     
• Red clover     
• Schisandra
• Siberian      ginseng
• Valeria