Conclusion
Use of herbs and/or "natural" supplements is common among Americans. Green tea, garlic, fish oils, zinc, soy, and glucosamine-chondroitin are some of the popular "natural" supplements. Health care providers need to learn the intended benefits, possible side effects, drug interaction potential, and perioperative consequences of these supplements. Most consumers are under the assumption that "natural" supplements are inherently safe and may not report use of these to the health care provider (Interna tional Food Information Council Foundation, 1998). The health care provider needs to ask the patient about specific use of any herbal or natural supplements. Many reports in the literature describe harmful drug interactions and perioperative complications associated with these supplements (Ang-Lee, Moss, & Yuan, 2001; DeSmet, 2002; Izzo & Ernst, 2001; Peng et al., 2004). Health care providers should advise patients to discontinue these supplements 2 weeks prior to a surgical procedure. Additionally, most experts advise that pregnant and nursing mothers should avoid using these supplements.
Many clinical studies show positive effects of "natural" supplements. However, controversy surrounds some of the widely publicized health benefits of "natural" supplements. Sound scientific evidence is deficient for many over-the-counter "natural' and herbal remedies, which are regarded as dietary supplements and are not regulated by the FDA. Often, the ingredients and dosages of supplements differ from one brand to another. Some reported evidence is based on unreliable, non-randomized, poorly controlled investigations. Some studies may be tainted by publication bias. Additionally, some dietary supplements can be toxic if ingested in excess. The NCCAM is taking an active role in investigating some of the reported health benefits of these supplements. Experts concur that more sound, scientifically designed studies are needed to confirm the health claims made by most of the widely marketed "natural" supplements.
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