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LONDON, ENGLAND, July 10, 2001: Patients are being warned that herbal medications can increase the risk of serious complications during surgery. The preparations can speed up or slow down the heart rate, inhibit blood clotting, alter the immune system and change the effects and duration of anaesthesia. Scientists have found some preparations have an impact if taken up to a week before a patient goes under the knife. Among the herbs studied were echinacea, ginkgo biloba, garlic, St John's wort and valerian -- all widely-available in tablet form. University of Chicago researchers have published guidelines on when patients should stop taking herbal medicines in the Journal of the American Medical Association and hope their work will encourage doctors to discuss the potential dangers with patients. Studies suggest that as many as one third of pre-surgical patients take herbal medications and many fail to disclose herbal use during pre-operative assessment, even when prompted. Between 1993 and 1998 a total of 2,621 adverse reactions attributed to herbs, including 101 deaths, were reported to the United States Food and Drug Administration. This report does not mention the many adverse reactions which occur because of prescription drug use before surgery.