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Table 3 Recommendations and implications of natural product use as related to preoperative concerns.

From: Evaluation and implications of natural product use in preoperative patients: a retrospective review

Natural Product Evidence based Recommendations: Discontinuation of natural products prior to surgery Perioperative Concerns
Fish Oil 2-3 weeks prior to surgery [15] Perioperative bleeding [15, 20] Hypotension [20]
Glucosamine 2-3 weeks prior to surgery [15] Hypoglycemia [15, 19]
Garlic 1 week [15, 16] At least 2 weeks [22] Perioperative bleeding [9, 13, 1517, 1922] Hypotension [9, 15, 16, 19, 20]
Flax Seed No specific recommendations Perioperative bleeding [18]
Coenzyme Q-10 (ubiquinone) No specific recommendations Hypotension [20] Cardiac effects [20] Perioperative bleeding effects [21]
Saw palmetto 2-3 weeks prior to surgery [15] Perioperative bleeding [9, 15] Tachycardia [9] Angina [9] Water/electrolyte disturbances [19]
Ginseng At least 7 days [13, 15] At least 2 weeks [22] Hypoglycemia [9, 13, 1517, 19] Hypertension [9, 13, 15, 16] Perioperative bleeding [9, 13, 15, 17, 1922] Tachycardia [9, 13] Water/electrolyte disturbances [19] Prolongation of anesthetic effects [19]
Chondroitin 2-3 weeks prior to surgery [15] Perioperative bleeding [15, 19]
Milk Thistle 2-3 weeks prior to surgery [15] Volume depletion [15]
Green Tea No specific recommendations Perioperative bleeding [18, 21] Cardiovascular side-effects [18, 21] Water/electrolyte disturbances [19]