I've been taking gingko biloba and St. John's Wort for several years now. The doctor has advised me to quit taking all herbal supplements before having a total knee replacement done. These products really seem to help me. Why can't I keep taking them as usual?

Herbal products can affect the patient about to have surgery or who has recently had an operation. First the supplements can directly affect any drugs you may need for the total knee replacement (TKR). They can alter the way the drug is absorbed and sent throughout the body.

Herbal products can also affect the way other medications are broken down and eliminated from the body. Your risk of bleeding can increase. Sometimes the herbs affect the way your body handles the anesthesia.

Wisely, doctors try to reduce as many risks as possible for the patient going into surgery. There are enough possible problems with any operation. For best results, follow your doctor's advice. You can always start taking these two products again once you've recovered from the TKR.

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