Dong Quai

Dong Quai Botanical Name:  Angelica sinensis Common Names:  Chinese Angelica, Dang Gui, Danngui, Dong Qua, Tang Kuei, Tan Kue Bai zhi(Note: Dong quai should not be confused with Angelica root or Angelica seed.)   Overview Plant Description Medicinal Uses and Indications Dosage and Administration Precautions Interactions and Depletions Supporting Research

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Overview

Dong quai has been used for over a thousand years as a spice, tonic, and medicine in China, Korea and Japan. Although there have been few definitive studies on dong quai, it is reputed to relieve constipation, increase red blood cell count (which helps treat anemia), and to provide relief from menstrual disorders such as cramps, irregular menstrual cycles, infrequent periods, premenstrual syndrome (PMS), and menopausal symptoms. In Traditional Chinese Medicine, it is used for a variety of purposes, including reproductive, circulatory, and respiratory conditions.

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Plant Description

Dong quai grows at high altitudes in the cold, damp, mountain regions of China, Korea and Japan. This fragrant, perennial plant has smooth purplish stems and bears umbrella-shaped clusters of white flowers and winged fruits in July and August. The yellowish-brown thick-branched roots of the dong quai plant have a number of medicinal uses. It takes three years for the plant to reach maturity, after which time the root is harvested and formulated into tablets, powders, and other medicinal forms.

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Medicinal Uses and Indications

Dong quai contains compounds that, in laboratory tests, have demonstrated activities that may translate into reduction of pain, dilation of blood vessels, and stimulation as well as relaxation of uterine muscles. Animal studies suggest that dong quai may treat abnormal heart rhythm, prevent accumulation of platelets in blood vessels (contributing to plaque formation or atherosclerosis), protect the liver, promote urination, act as a mild laxative, promote sleep, and fight infection.

The scientific evidence regarding the use of dong quai in people is weak. The data consist primarily of laboratory and animal studies as described above, with a few preliminary studies in people. More studies are needed to determine the herb's safety and effectiveness in humans.

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Treatment

Reports and studies of possible uses of dong quai include the following:

• Menopausal symptoms—some women report relief of symptoms such as hot flashes from this medicinal herb; however, clinical studies to date do not support the effectiveness of dong quai for menopausal symptoms.
• PMS—studies suggest that dong quai offers some value when used in conjunction with other Chinese herbs, particularly black cohosh, to treat PMS.
• Anemia—there are individual reports of successful treatment of anemia using dong quai, but to date no studies verify this.
• Heart disease—when used in combination with ginseng (Asian ginseng) and astragalus (Astragalus membranaceus), dong quai decreased symptoms of chest pain and improved exercise tolerance in a small group of people with heart disease.
• Stroke—a series of reports published in China indicate that the use of dong quai just following a stroke demonstrated a decrease in the amount of brain damage; more research is needed.
• High blood pressure—reports indicate that dong quai may lower blood pressure in some individuals.
• Ulcers—animal studies suggest dong quai may soothe ulcers, but studies in people are needed before a definitive conclusion can be drawn.

Other conditions for which dong quai has been used clinically, although studies are still lacking:

• Constipation
• Migraine headache
• Pain
• Liver disorders

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Dosage and Administration

In different parts of the world, dong quai is available in a variety of forms including tablets, powders, and injectable solutions. The latter are used in China and Japan in appropriate hospital or health center settings; injectable solutions are not available commercially in the United States or other Western countries and homemade injectable solutions should never be used.

Dong quai should be stored in a cool, dry place and, like all herbal products, be used prior to the expiration date.

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Pediatric

Dong quai is not recommended for children because no information relating to appropriate doses of the herb for children has been found in the literature to date.

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Adult

Dried herb (raw root) may be boiled or soaked in wine before consuming.

Powdered herb (available in capsules)—500 to 600 mg tablets or capsules up to 6 times per day.

Tincture (1:5, 70% alcohol): 40 to 80 drops (equivalent to 2 to 4 mL; there are 5 mL in a teaspoon) 3 times per day.

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Precautions

Drinking the essential oil of dong quai is not recommended because it contains a small amount of cancer-causing substances. The amount of oil in the herb and its extracts is not significant and is not a health concern.

Dong quai should not be used by those who have chronic diarrhea or abdominal bloating.

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Side Effects

Dong quai, particularly at high doses, may increase an individual's sensitivity to sunlight and subsequently cause skin inflammation and rashes. People taking dong quai should minimize their exposure to sunlight or use sunscreen while taking the herb.

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Pregnancy and Breastfeeding

Dong quai should not be used during pregnancy because it may affect the muscular functioning of the uterus. It should also be avoided by nursing mothers, because there is little information about its effect on the infant through breast milk.

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Pediatric Use

Dong quai should not be given to children because of the lack of information regarding its use in this age group.

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Interactions and Depletions

Dong quai may interact with the following medications and herbs:

Warfarin
Dong quai can increase the potency and, therefore, potential risks of blood-thinning medications, such as warfarin, so it should not be taken with these medicines.

Hormone medications
Although there is little research on the use of dong quai with hormone medications such as estrogens, progesterones, oral contraceptives, tamoxifen or raloxifene, health practitioners advise against using them together due to the possibility of adverse effects.

Blood-thinning herbs
Although reported extremely rarely and not published in the scientific literature, combining dong quai with other herbs that thin the blood could possibly increase the risk of bleeding in some people. Herbs with such potential that should be used only with tremendous caution and supervision when combined with dong quai include feverfew (Tanecetum parthenium), garlic (Allium sativum), ginger (Zingiber officinale), ginkgo (Ginkgo biloba), ginseng (Asian ginseng), licorice (Glycyrrhiza glabra), chinese skullcap (Scutellaria baicalensis), and turmeric (Curcuma longa).

Herbs or medications that cause sun sensitivity
Given that dong quai may increase an individual's sensitivity to sunlight, it should not be taken with other medications or herbs (such as St. John's wort) that cause the same reactions.

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Supporting Research

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Blumenthal M. Twenty-seven major botanicals and their uses in the United States. In: Eskinazi D, Blumenthal M, Farnsworth N, Riggins CW. Botanical Medicine. Larchmont, NY: Mary Ann Liebert, Inc.; 1999:18-19.

Chen SG, Li CC, Zhuang XX. Protective effects of Angeical sinensis injection on myocardial ischemia/reperfusion injury in rabbits [in Chinese]. Zhonggou Zhong Xi Yi Jie He Za Zhi. 1995;15(8):486-488.

Cho CH, Mei QB, Shang P, et al. Study of the gastrointestinal protective effects of polysaccharides from Angelica sinensis in rats. Planta Med. 2000;66(4):348-351.

Dai L, Hou J, Cai H. Using ligustrazini and angelica sinensis treat the bleomycin-induced pulmonary fibrosis in rats [in Chinese]. Zhonghua Jie He He Hu Xi Za Zhi. 1996;19(1):26-28.

DerMarderosian A, ed. Dong Quai. In: Facts and Comparisons The Review of Natural Products. St. Louis, MO: Wolters Kluwer Co.: 1997.

Fetrow CW, Avila JR. Professional's Handbook of Complementary and Alternative Medicine. Springhouse, PA: Springhouse Corporation; 1999.

Foster S, Tyler VE. Tyler's Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 4th ed., Binghamton, NY: Haworth Herbal Press; 1999.

Fugh-Berman A. Herb-drug interactions. Lancet. 2000; 355(9198):134-138.

Hardy ML. Herbs of special interest to women. J Am Pharm Assoc. 2000;40(2):234-242.

Hirata JD, Swiersz LM, Zell B, Small R, Ettinger B. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril. 1997;68(6):981-986.

Israel D, Youngkin E. Herbal therapies for perimenopausal and menopausal complaints. Pharmacother. 1997:17(5):970-984.

Kuhn M, Winston D. Herbal Therapy and Supplements: A Scientific and Traditional Approach. Phildelphia, Pa: Lippincott; 2001.

Liao JZ, Chen JJ, Wu ZM, Guo WQ, Zhao LY, Qin LM, et al. Clinical and experimental studies of coronary heart disease treated with Yi-qi Huo-xue injection. J Tradit Chin Med. 1989;9(3):193-198.

McGuffin M, Hobbs C, Upton R, Goldberg A. American Herbal Products Association's Botanical Safety Handbook. New York, NY: CRC Press; 1997.

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Shaw CR. The perimenopausal hot flash: epidemiology, physiology, and treatment. Nurse Pract. 1997;22(3):55-56, 61-66.

Shi YM, Wu QZ. Idiopathic thrombocytopenic purpura in children treated with replenishing qi and tonifying kidney and the changes in thrombocyte aggregative function. [Article in Chinese]. Zhong Xi Yi Jie He Za Zhi 1991;11(1):14-16.

Smolinske A. Dietary supplement-drug interactions. J Am Med Womens Assoc. 1999;54(4):191-196.

Sun SW, Wang JF. Efficacy of danggui funing pill in treating 162 cases of abdominal pain. [Article in Chinese]. Zhongguo Zhong Xi Yi Jie He Za Zhi 1992;12(9): 517, 531-532.

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Yim TK, Wu WK, Pak WF, Mak DH, Liang SM, Ko KM. Myocardial protection against ischaemia-reperfusion injury by a Polygonum multiflorum extract supplemented 'Dang-Gui decoction for enriching blood', a compound formulation, ex vivo. Phytother Res. 2000;14(3):195-199.

Zhao L. Prevention of hypoxic pulmonary hypertension with "qi-xue" injection [in Chinese]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1990;12(1):51-55.

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Review Date: March 2001 Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh (Pediatric Dosing section February 2001), Johnson Drugs, Natick, MA; Steven Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's Administrative Hospital, Londonderry, NH; David Winston, Herbalist, Herbalist and Alchemist, Inc., Washington, NJ.

 

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.

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