- Chinese angelica
- Dang gui
- Tang kuei
- Tan kue
- Female ginseng
For Patients & Caregivers
How It Works
Dong quai is an herb used in traditional Chinese medicine to nourish blood and to treat menstrual and menopausal symptoms.
Dong quai has been used in traditional Chinese medicine for thousands of years. It is often combined with other herbs in special formulations, and is used to treat menstrual and menopausal symptoms and nourish the blood. Root extracts of dong quai were shown to stop growth of cancer cells in lab studies, but human data are lacking. Results of a few studies that tested whether dong quai could be effective for menopausal symptoms were inconclusive.
Dong quai has estrogen-like effects and it was shown to increase growth of breast cancer cells in lab experiments. It may also contain compounds that can cause cancer if taken in high doses. Patients should talk to their doctors before using dong quai.
- To relieve symptoms of menopause Results from a few studies done in postmenopausal women are inconclusive.
- To treat dysmenorrhea Traditional medicine uses dong quai to treat dysmenorrhea but there is no scientific basis to support this use.
- To treat premenstrual syndrome Although traditionally used to treat premenstrual symptoms, there are no clinical studies to support this claim.
Do Not Take If
- You are taking anticoagulants such as warfarin: Dong quai may increase the risk of bleeding, but a human study suggests this effect may be limited.
- You are pregnant or breastfeeding.
- You are undergoing radiation therapy: Dong quai can cause photodermatitis, and therefore might worsen the effects of radiation therapy on the skin.
- You have a hormone-sensitive cancer: Dong quai has estrogenic effects and can further stimulate the growth of cancer cells. Clinical relevance is not known.
- You are taking Lisinopril [angiotensin converting enzyme (ACE) inhibitor]: Simultaneous use of dong quai worsened anemia in a study of rats. Whether it has the same effect in humans is not known.
- You are undergoing Dual antiplatelet therapy (DAPT) with aspirin (ASA) and clopidogrel (CLP): Coadministration with dong quai significantly altered the pharmacokinetics of DAPT with increased systemic exposure in a study of rats. Clinical relevance is not known.
- Sensitivity of the skin and eyes to light, causing swelling, itching, and/or redness
- Excessive development of breasts in men
- Excessive bleeding due to blood-thinning effect
- High blood pressure
- Intracranial hemorrhage: In a 53-year-old woman following use of an herbal supplement containing red clover, dong quai, and Siberian ginseng for hot flashes associated with perimenopause. Her symptoms resolved after discontinuing use of the supplement.
For Healthcare Professionals
Dong quai is an herb, the root of which has been used in traditional Chinese medicine for thousands of years. It is often combined with other herbs in formulations. Dong quai is also available as a dietary supplement and promoted as a woman’s herb to treat menstrual and menopausal symptoms. In vitro, dong quai extracts have demonstrated antitumor (7) (8) (9) (10), pro-apoptotic (40) (41), anti-metastatic (41), anti-tuberculosis (TB) (11), neuroprotective (32), and hematopoeitic (34) effects. In animal studies, polysaccharides extracted from dong quai root showed protective effects against cyclophosphamide-induced toxicity (12), doxorubicin-induced cardiotoxicity (13), and radiation-induced pneumonitis (14). However, these effects have not been evaluated in humans.
Data from an epidemiologic study suggest that dong quai consumption is associated with reduced risk of subsequent endometrial cancer in breast cancer survivors (39). However, clinical data of its effects on menopausal symptoms are inconclusive (1) (2) (3) (4) (5) (6) (29) (33). A small study done in men with hot flashes did not find dong quai effective (31).
Dong quai exhibits estrogenic activity in vitro (15) and stimulates proliferation of MCF-7 cells (16) (17). Patients should consult with their physicians before using this herb.
Mechanism of Action
Ferulic acid, a constituent of dong quai, may play an important role in treating osteoarthritis by reducing hydrogen peroxide-induced interleukin IL-1beta, tumor necrosis factor TNF-alpha, matrix metalloproteinases MMP-1 and MMP-13, and by increasing SOX9 gene expression. SOX9 is a protein involved in the establishment and maintenance of the phenotype of chondrocytes (35). Dong quai polysaccharides demonstrated anti-osteoarthritic activity by stimulating insulin-like growth factor 1 (IGF1) and IGF1 receptor gene expression, thereby promoting UDP-sugars and glycosaminoglycan synthesis (37). Another compound promotes wound healing and bone regeneration by inducing osteoblast proliferation and hyaluronic acid deposition (25).
An aqueous extract from dong quai was reported to have estrogen-agonist activity, and stimulated proliferation of both estrogen receptor-positive and -negative breast cancer cells (17). It also protected against radiation-induced pneumonitis by downregulating proinflammatory cytokines such as TNF-alpha and TGF-beta1 in a murine model (14). Subcutaneous injection of dong quai extract protected mice against cyclophosphamide-induced cytotoxicity by promoting recovery from leukopenia (12). The antitumor effects of dong quai may be due to its inhibitory effects on invasion and metastasis of carcinoma cells (9) and by suppression of tumor growth (7) (8) (10) that may be mediated by Nur77-dependent apoptosis (23) (24). However, dong quai extracts also promote angiogenesis – which plays a key role in both physiologic and disease processes – by inducing proliferation and migration of endothelial cells by upregulating VEGF expression (26).
Bloating, apetite loss (18), diarrhea, photosensitivity (19), gynecomastia (20), and hypertension (43).
Subarachnoid hemorrhage: In a 53-year-old woman following use of an herbal supplement containing red clover, dong quai, and Siberian ginseng for hot flashes. Her symptoms resolved after discontinuing use of the supplement (30).
Anticoagulants: Dong quai may have additive anticoagulant effect (21). However, such effect appears to be limited in a human study (44).
Cytochrome P450 substrates: Prolonged use of dong quai can induce CYP3A4 by activating pregnane X receptor (36). This may reduce the blood levels and effectiveness of substrate drugs. Clinical relevance is not known.
Lisinopril [angiotensin converting enzyme (ACE) inhibitor]: Concurrent use with dong quai exacerbated anemia in a murine model (42). Clinical relevance has yet to be determined.
Dual antiplatelet therapy (DAPT) with aspirin (ASA) and clopidogrel (CLP): Coadministration with dong quai significantly altered the pharmacokinetics of DAPT with increased systemic exposure in a murine model. Clinical relevance is not known. (45)