Dong quai

Plant Description

Dong quai grows at high altitudes in the cold, damp, mountains of China, Korea, and Japan. This fragrant, perennial plant -- a member of the celery family -- has smooth purplish stems and umbrella-shaped clusters of white flowers and winged fruits in July and August. The yellow-brown thick-branched roots are used as medicine. It takes 3 years for the plant to reach maturity. The root is harvested and made into tablets, powders, and other medicinal forms.

Medicinal Uses and Indications

Few studies have investigated dong quai for use in humans. Some lab tests suggest that dong quai contains compounds that may help reduce pain, open blood vessels, and stimulate and relax the muscles of the uterus. More studies are needed to see whether dong quai works and is safe.

Treatment

Dong quai is sometimes suggested for the following conditions:

Menopausal symptoms

Some women say dong quai relieves symptoms such as hot flashes. Researchers are not sure whether dong quai acts like estrogen or blocks estrogen in the body. Studies are conflicting, and one study found that dong quai did not help to relieve menopausal symptoms.

Other

Dong quai has also been suggested for these conditions, although there is no good scientific evidence:

• Amenorrhea (absence of menstruation)
• Heart disease. One study suggested that a combination of dong quai, Asian ginseng (Panax ginseng), and astragalus (Astragalus membranaceus) decreased symptoms of chest pain in a small group of people with heart disease.
• High blood pressure
• Premature ejaculation, as one ingredient in a cream applied to the skin

Dosage and Administration

You can find dong quai in a variety of forms, including tablets and powders. In China and Japan, it is given as an injection in a hospital or health center. You should not use injections at home.

Dong quai should be stored in a cool, dry place.

Pediatric

You should not give dong quai to a child.

Adult

Researchers do not know what a safe dose is, so there is no recommended dose.

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

Powdered herb (available in capsules): In one study for menopausal symptoms, people took 500 to 600 mg tablets or capsules up to 6 times daily.

Tincture (1:5 w/v, 70% alcohol): 40 to 80 drops (equivalent to 2 to 4 mL, there are 5 mL in a tsp.), 3 times daily is one possible dosing schedule, however, individual doses will vary and it is unusual for Dong quai to be prescribed alone. It is usually part of a formula containing synergistic herbs.

Precautions

You should not drink the essential oil of dong quai because it has a small amount of cancer-causing substances.

People who have chronic diarrhea or abdominal bloating should not use dong quai.

People who are at risk of hormone-related cancers, including breast, ovarian, and uterine cancers, should not take dong quai because researchers are not sure if it acts like estrogen in the body.

Side Effects

Dong quai, particularly at high doses, may make you more sensitive to sunlight and cause skin inflammation and rashes. Stay out of the sun or use sunscreen while taking dong quai.

Pregnancy and Breastfeeding

DO NOT use dong quai during pregnancy. It may cause the uterus to contract and raise the risk of miscarriage. Nursing mothers should not take dong quai because no one knows if it is safe when you are breastfeeding.

Pediatric Use

DO NOT give dong quai to a child because no one knows whether it is safe for children.

Interactions and Depletions

Dong quai may interact with some medications and herbs, includin the following:

Blood thinners (anticoagulants and antiplatelets: Dong quai may raise the risk of bleeding, especially if you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. The same is true of using dong quai with many herbs and supplements. Talk to your doctor before taking dong quai. These are some of the herbs and supplements that may act like blood thinners:

• Feverfew (Tanacetum parthenium)
• Fish oil and other omega-3 fatty acids
• Garlic (Allium sativum)
• Ginger (Zingiber officinale)
• Ginkgo (Ginkgo biloba)
• Ginseng (Panax ginseng)
• Licorice (Glycyrrhiza glabra)
• Chinese skullcap (Scutellaria baicalensis)
• Turmeric (Curcuma longa)

Hormone medications: There is not much research on using dong quai with hormone medications, such as estrogens, progesterones, birth control pills, tamoxifen, or raloxifene (Evista). But, because dong quai may act like estrogen in the body, you should not take it with hormone medications except under your doctor's supervision.

St. John's wort: Both Dong quai and St. John's wort can make you more sensitive to sunlight. Talk to your doctor before taking them together.

Supporting Research

Al-Bareeq RJ, Ray AA, Nott L, Pautler SE, Razvi H. Dong Quai (angelica sinensis) in the treatment of hot flashes for men on androgen deprivation therapy: results of a randomized double-blind placebo controlled trial. Can Urol Assoc J. 2010 Feb;4(1):49-53.

Carroll DG. Nonhormonal therapies for hot flashes in menopause. Am Fam Physician. 2006;73(3):457-64.

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.

Choi HK, Jung GW, Moon KH, et al. Clinical study of SS-Cream in patients with lifelong premature ejaculation. Urology. 2000;55:257-61.

Circosta C, Pasquale RD, Palumbo DR, Samperi S, Occhiuto F. Estrogenic activity of standardized extract of Angelica sinensis. Phytother Res. 2006;20(8):665-9.

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.

Kan WL, Cho CH, Rudd JA, Lin G. Study of the anti-proliferative effects and synergy of phthalides from Angelica sinensis on colon cancer cells. J Ethnopharmacol. 2008 Oct 30;120(1):36-43.

Kelley KW, Carroll DG. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. J Am Pharm Assoc (2003). 2010 Sep-Oct;50(5):e106-15. doi: 10.1331/JAPhA.2010.09243. Review.

Kupfersztain C, Rotem C, Fagot R, Kaplan B. The immediate effect of natural plant extract, Angelica sinensis and Matricaria chamomilla (Climex) for the treatment of hot flushes during menopause. A preliminary report. Clin Exp Obstet Gynecol . 2003;30(4):203-6.

LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Hudson, OH: LexiComp; 2000:425-426.

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

Williamson JS, Wyandt CM. An herbal update. Drug Topics. 1998;142(6):66-75.

Wojcikowski K, Wohlmuth H, Johnson DW, Rolfe M, Gobe G. An in vitro investigation of herbs traditionally used for kidney and urinary system disorders: Potential therapeutic and toxic effects. Nephrology (Carlton). 2008 Sep 22. [Epub ahead of print]

Wong VK, Yu L, Cho CH. Protective effect of polysaccharides from Angelica sinensis on ulcerative colitis in rats. Inflammopharmacology. 2008 Aug;16(4):162-7.

Yang T, Jia M, Meng J, Wu H, Mei Q. Immunomodulatory activity of polysaccharide isolated from Angelica sinensis. Int J Biol Macromol. 2006;39(4-5):179-184.

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.