Scientific Name: Dong Quai
Other Names: Angelica polymorpha, Angelica sinensis, Chinese Angelica, Danggui, Tang-Kuei

Who is this for?

Uses

Dong quai is used mainly in combination with other herbals to relieve menstrual cramps, regulate menstrual periods, and lessen menopausal symptoms. Although it has been used for centuries in China to treat such conditions and other disorders of the female reproductive tract, results of controlled human studies of dong quai’s effectiveness are not conclusive. It does contain some antispasmodic components that may help to reduce cramping. However, in at least one small, clinical trial of postmenopausal women, dong quai was no more effective than placebo (inactive sugar pills) for relieving hot flashes, vaginal dryness, and other symptoms of menopause. Other studies—mainly conducted in oriental countries and mostly using laboratory animals—have found varying levels of estrogenic effects. Like herbals such as black cohosh and red clover, dong quai was long believed to contain chemicals shaped like the female hormone, estrogen. That theory has been challenged by results of recent studies, however. While dong quai may have some estrogen-like effects, much more study is needed to determine what causes those effects and to prove or disprove its traditional uses.

In traditional Chinese medicine, dong quai is often included in combination herbal products, which are used to treat allergies, arthritis, asthma, or high blood pressure. Animal studies of dong quai have shown it has a slight ability to increase immune system function by activating certain immune cells and deactivating others. Therefore, it may help to relieve allergy symptoms. In addition, laboratory and animal studies have shown that dong quai has mild anti-inflammatory properties, which may make it useful in treating arthritis, asthma, and other inflammatory conditions. It has also been used to treat lung tissue that has been injured by radiation treatments for cancer due to its anti-inflammatory effects. One of the chemicals in a related plant has been shown to promote relaxation of blood vessels, which may help to reduce blood pressure. However, no clinical evidence supports the use of dong quai for blood pressure control. More research is necessary before dong quai can be recommended for any of its traditional uses.

Whether dong quai contains active estrogenic components is uncertain. Long believed to contain female hormones, dong quai is now thought to work in non-hormonal ways. Women with conditions such as endometriosis, uterine fibroids, and cancers of the breast, ovaries, or uterus are still advised not to take dong quai. Men with prostate cancer should also avoid taking dong quai.

In several studies of laboratory animals, varying amounts of dong quai caused unpredictable contraction or relaxation of the uterus, which could result in miscarriage. Although no reports of miscarriage in humans have been published, pregnant women should not use dong quai.

Precautions

Very little information is available on how dong quai might affect an infant or a small child. Therefore, its use is not recommended during breast-feeding or early childhood.

What side effects should I watch for?

Major Side Effects

Several of the chemicals found in dong quai have been shown to cause cancer in laboratory animals that were given very large amounts of them for long periods. No evidence from human studies documents this risk, however.

Less Severe Side Effects

Dong quai can make unprotected skin more sensitive to sunlight or artificial light used in tanning parlors. Individuals who use dong quai should be sure to use sunscreen, as well.

One case has been reported of temporary breast enlargement in a man who took a combination product that contained dong quai. The exact cause of this breast enlargement is not known, but it is thought to have been due to contamination in the product being used.

What interactions should I watch for?

Prescription Drugs

Dong quai and herbal combination products that include it may contain chemicals called coumarins, which may increase the time blood needs to clot. When dong quai is taken with antiplatelet or anticoagulant drugs, which also lengthen bleeding time, the effect of the drug may be increased. Uncontrolled bleeding may result.

• Antiplatelets include clopidogrel and Ticlid
• Anticoagulants include heparin and warfarin

Non-prescription Drugs

Dong quai may decrease the ability of blood to clot after an injury. Aspirin can also delay clotting, so dong quai should not be taken at the same time as aspirin.

Herbal Products

Theoretically, if dong quai is used with other herbs that reduce blood clotting, bleeding may occur. Some of the most common herbal products that might inhibit blood clotting include:

• Danshen
• Devil's Claw
• Eleuthero
• Garlic
• Ginger (in large amounts)
• Ginkgo
• Horse Chestnut
• Panax Ginseng
• Papain
• Red Clover
• Saw Palmetto

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals. For specific information on how dong quai interacts with drugs, other herbals, and foods and the severity of those interactions, please use our Drug Interactions Checker to check for possible interactions.

Should I take it?

Dong quai grows in northern and western areas of China. A perennial plant related to celery, it can grow as tall as 8 feet. It has large hollow stems that are ridged like celery and are often purple in color. Light green or yellow flowers bloom in the summer, small yellow fruits appear in the fall, and the seeds ripen in October or November. The leaves of dong quai are divided into a number of small leaflets and its small flowers are arranged in flat groups. Fresh dong quai stems are sometimes eaten raw and both the stems and the roots may be cooked as a vegetable or included in soups. As a vegetable, dong quai provides moderate amounts of folic acid, iron, and vitamin B12.

Although dong quai stems and seeds are used occasionally in medicine, the main medicinal part is the root, which has a pleasant spicy smell and a sweet-spicy taste. Harvested from plants that are 2 years to 3 years old, the roots resemble parsnips or carrots. They can be used fresh, but more frequently they are dried and powdered to be made into extracts or capsules. Extracts are concentrated liquid preparations usually made by soaking chopped or mashed plant parts in a liquid such as alcohol, and then straining out the solid parts. Dong quai is seldom used alone. Most often it is included with other herbals in combination products.

Dosage and Administration

Although dosing for dong quai varies considerably, a common recommendation for its use to treat menstrual problems is 3,000 mg to 4,000 mg (3 grams to 4 grams) per day in three divided doses. Note that dong quai is usually combined with other herbals for general use. It is rarely taken by itself. Individuals who choose to take a product containing it should follow the directions on the package of the product that is purchased.

Summary

Although Chinese healers have used dong quai for centuries—usually combined with other herbals—to treat conditions such as asthma and high blood pressure, dong quai is best known currently for relieving menstrual and menopausal symptoms. Little evidence exists, however, to prove its effectiveness for treating any medical condition.

Risks

Pregnant women should not take dong quai due to its unpredictable effects on uterine muscles. Men with prostate cancer and women with endometriosis, breast cancer, or cancers of the uterus or ovaries should also avoid taking it. Small children and women who are breast-feeding are also advised not to take dong quai.

Side Effects

Taking dong quai appears to be associated with few major side effects, even though some of the chemicals it contains may be cancer-causing in large amounts. In the amounts used in medicine, the risk of developing cancer is not thought to be significant. Dong quai may make skin more likely to sunburn, however.

Interactions

Dong quai may contain small amounts of chemicals that reduce the blood's ability to clot. Therefore, it could increase the anti-clotting effects of prescription anticoagulants and antiplatelets, aspirin, and other herbal products.

Last Revised August 29, 2007

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Last Revised August 29, 2007

Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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