Pre and Post Surgery Protocol

There are an estimated 50 million inpatient surgeries yearly in the US ranging from ACL reconstruction to hip replacement to GI surgery and beyond. This is a time that we have to 'surrender' somewhat to conventional medicine but we can also support the body pre and post surgery for best outcomes and a faster recovery using food-as-medicine and targeted nutritional supplementation.

Prior to surgery, some important areas to consider are: 

  • Assessment of risk: with your medical team, family or support team it is of course important to weigh out cost-benefit of any procedure and understand the risks, what you can do to prevent complications, what happens if you decline or delay surgery
  • What pre-medications will be required such as antibiotics or blood thinners so that you can mitigate without interfering with goals/outcomes
  • What type of fasting or special diet is required prior to surgery and how you can maximize nutritional status going into your procedure
  • What will be needed for recovery and how you can have a plan in place for meal prep support, items to have on hand post procedure or pack in your hospital bag if staying overnight
  • Are there any lifestyle changes that would support best outcomes such as quitting smoking, starting to exercise or losing weight

Pre-Op & Post-Op Protocol

If you have some lead time going into your surgery, it would be wise to start to prepare your body at least a few weeks ahead of time for best outcomes. This includes bringing in targeted anti-inflammatories to reduce pain and support reduced inflammation and healing as well as supplements to mitigate the impact of medications such as antibiotics and anesthesia. 

Super Turmeric 1-2 twice daily with food* stop 48 hours prior to surgery

EPA DHA Extra 1-2 twice daily with food* stop 48 hours prior to surgery

Cellular Antiox 1 at rise, 1 mid day without food* if you will be going under anesthesia

*These are all part of our Anti-Inflammatory Bundle for savings!

Inflammazyme 2-3 at rise, 2-3 mid day, 2-3 at bed without food stop 48 hours prior to surgery

Rebuild Spectrum Probiotic 1 at bed starting 2 weeks prior if you will be taking antibiotics

Reset, Restore, Renew Detox Packs 1 at bed starting 2 weeks prior if you will be under anesthesia

How to shift your supplements post-op:

As soon as you feel well enough, you can start back on your supplements. Post-op will focus on reduction of inflammation, support for tissue recovery, wound healing and detox from anesthesia or any other medications you needed to take. The higher end of these ranges is recommended for at least 2 weeks. 

Super Turmeric 1-2 three times daily with food, up to 6/day for pain/inflammation

EPA DHA Extra 1-2 twice daily with food, up to 4/day for pain/inflammation

Cellular Antiox 1 at rise, 1 mid day without food if anesthesia was needed

Inflammazyme 2-3 at rise, 2-3 mid day, 2-3 at bed without food (6-9/day for inflammation and tissue recovery)

Rebuild Spectrum Probiotic 1 at rise, 1 at bed 

Reset, Restore, Renew Detox Packs 1 at rise, 1 at bed 

Do I have to stop all supplements prior to a procedure?

Most surgeons and doctors will recommend holding all supplements for 48+ hours prior to a procedure so be sure to discuss with your trusted medical professional prior. For most surgeries, it would be important to hold any that have blood thinning effect. This includes Fish Oil, Turmeric, certain herbs like gingko and ginseng (found in our Adaptogen Boost). 

If experiencing pre-surgery jitters or anxiety, consider adding on:

GabaCalm 1-2 as needed

Social CBD use code ALIMILLERRD 1 mL 1-3 times daily as needed

Supporting Your Body Through Anesthesia

Depending on the procedure, you may have local or general anesthesia. If undergoing general anesthesia, pay special attention to the recommendations for Cellular Antiox and Detox Packs above to help your body to detox after surgery. Certain genetic mutations can cause you to have a more difficult time detoxing after anesthesia. For those with a known MTHFR genetic mutation or prior adverse reaction, you may want to consider layering on:

  • B Complex 1 at breakfast for at least 2 weeks prior and 2 weeks post anesthesia
  • B-12 Boost 1 at rise for at least 2 weeks prior and 2 weeks post anesthesia
  • 10 Day Detox using the Reset, Restore, Renew Detox Packs after your surgery

Additional Considerations for Specific Procedures

Colonoscopy Pre and Post Procedure:

For a colonoscopy, you will be on a clear liquid diet prior to your procedure. It is important to keep electrolytes balanced both prior and post. Bone broth, coconut water and gelatin gummies as long as not made with red juices can all fit into the clear liquid diet. Post-procedure, start with a light meal such as a smoothie made with Naturally Nourished Grassfed Whey or a bone broth based soup. These would also be considerations for those undergoing GI surgery.



Take these in addition to your regular supplements for 2 weeks leading up to procedure. Hold supplements day of, then resume for at least 2 weeks afterward to support gut lining integrity and mircrobiome rebound. 

Oral Surgery

In addition to the pre and post op considerations above, consider adding on some antimicrobial support

  • Herbal Immune 1 at rise, 1 mid day (no food) for 2 weeks prior and at least 2 weeks post procedure
  • Berberine Boost 2 twice daily with food for 2 weeks prior and at least 2 weeks post procedure
  • If bone is involved such as a dental implant, add OsteoFactors 1 three times daily with food
  • Use Periobrite Mouthwash to disinfect the mouth

Orthopedic Surgery or Large Incision

  • For a bone fracture or with known osteoporosis, osteopenia or osteoarthritis, add on OsteoFactors 1 three times daily with food and Vitamin D Balanced Blend 1/day with food
  • For surgeries with large incisions, add GI Lining Support 1 scoop at rise, 1 scoop at bed as glutamine will support wound healing
  • To prevent scarring and support connective tissue, add on Bio-C Plus 1-2 twice daily with food

Post-Surgical Constipation

Constipation is a common side effect of pain medications and can be worsened if not able to get up and move your body. Ensure adequate fluid and electrolyte support and consider:

    Food-as-Medicine For Surgery Recovery

    Nutritional Status is especially important going into a surgical procedure, in fact it is estimated that up to 40% of acutely hospitalized patients are malnourished.

    A ketogenic diet can be incredibly supportive of surgical outcomes as it is muscle sparing and can support favorable body composition.

    Ensure adequate protein! Up to 2g/kg is needed for wound healing so if you have a large incision you may need to significantly increase your protein intake.

    Support Connective Tissue with collagen, gelatin and bone broth! This is helpful for virtually any procedure  

    Additional resources:

    Naturally Nourished Podcast Episode 234: Pre and Post Op For Surgery

    Ali’s Natural C-Section


    Aghajanian P, Hall S, Wongworawat MD, Mohan S. The Roles and Mechanisms of Actions of Vitamin C in Bone: New Developments. J Bone Miner Res. Nov 2015;30(11):1945-1955.

    Ahmed OS, Rogers AC, Bolger JC, Mastrosimone A, Robb WB. Meta-Analysis of Enhanced Recovery Protocols in Bariatric Surgery. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract. Feb 27 2018.

    Alexander JW, Supp DM. Role of Arginine and Omega-3 Fatty Acids in Wound Healing and Infection. Advances in wound care. Nov 01 2014;3(11):682-690.

    Arya S, Kim SI, Duwayri Y, Brewster LP, Veeraswamy R, Salam A, Dodson TF. Frailty increases the risk of 30-day mortality, morbidity, and failure to rescue after elective abdominal aortic aneurysm repair independent of age and comorbidities. J Vasc Surg. Feb 2015;61(2):324-331.

    Bourke CD, Berkley JA, Prendergast AJ. Immune Dysfunction as a Cause and Consequence of Malnutrition. Trends in immunology. Jun 2016;37(6):386-398.

    Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochemical Society transactions. Oct 15 2017;45(5):1105-1115.

    Jankowski CJ. Preparing the Patient for Enhanced Recovery After Surgery. International anesthesiology clinics. Fall 2017;55(4):12-20.

    Karahan A, AAbbasoglu AA, Isik SA, Cevik B, Saltan C, Elbas NO, Yalili A. Factors Affecting Wound Healing in Individuals With Pressure Ulcers: A Retrospective Study. Ostomy/wound management. Feb 2018;64(2):32-39.

    Maheshwari RK, Singh AK, Gaddipati J, Srimal RC. Multiple biological activities of curcumin: a short review. Life sciences. Mar 27 2006;78(18):2081-2087.

    Majid OW, Al-Mashhadani BA. Perioperative bromelain reduces pain and swelling and improves quality of life measures after mandibular third molar surgery: a randomized, double-blind, placebo-controlled clinical trial. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons. Jun 2014;72(6):1043-1048.

    Pereira RF, Bartolo PJ. Traditional Therapies for Skin Wound Healing. Advances in wound care. May 01 2016;5(5):208-229.

    Russell L. The importance of patients' nutritional status in wound healing. British journal of nursing (Mark Allen Publishing). Mar 2001;10(6 Suppl):S42, s44-49.

    Schmitt B, Vicenzi M, Garrel C, Denis FM. Effects of N-acetylcysteine, oral glutathione (GSH) and a novel sublingual form of GSH on oxidative stress markers: A comparative crossover study. Redox biology. Dec 2015;6:198-205.

    Sprague S, Madden K, Slobogean G, Petrisor B, Adachi JDR, Bogoch E, . . . Bhandari M. A Missed Opportunity in Bone Health: Vitamin D and Calcium Use in Elderly Femoral Neck Fracture Patients Following Arthroplasty. Geriatric orthopaedic surgery & rehabilitation. Dec 2017;8(4):215-224.

    Sprague S, Slobogean GP, Bogoch E, Petrisor B, Garibaldi A, O'Hara N, Bhandari M. Vitamin D Use and Health Outcomes After Surgery for Hip Fracture. Orthopedics. Oct 1 2017;40(5):e868-e875.