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dong quai (angelica)

What Is It?
Health Benefits
Forms
Dosage Information
Guidelines for Use
General Interaction
Possible Side Effects
Cautions
References 
Evidence Based Rating Scale
 

What Is It?

Dong quai has been used in Asia for thousands of years as a tonic for the female reproductive system. In fact, it ranks just below ginseng as the most popular Herb in China and Japan, although its effectiveness has yet to be substantiated by conventional Western standards.

Dong quai is derived from the gnarled root of the Chinese perennial Angelica sinensis and the root of the native Japanese A. acutiloba. Both species have eight-foot hollow stems graced by umbrella-shaped clusters of white flowers. When in bloom, the blossoms resemble Queen's Anne lace, a botanical cousin. Common names for the herb include angelica, Chinese angelica, dang gui and tang kuie. Interestingly, European and American angelica species (A. archangelica and A. atropurpurea) are used medicinally as well, but for a different constellation of symptoms altogether, none of them gynecological.

 

Health Benefits

Dong quai helps to promote uterine health and regulate the menstrual cycle. Some researchers contend that active ingredients called coumarins are responsible for its effectiveness. Coumarins dilate blood vessels, stimulating the central nervous system and increasing blood flow throughout the body. They may also relax the smooth muscles of the uterus, which would help to explain the herb's traditional use for menstrual cramps.

Other experts claim that dong quai's powers should be attributed to its phytoestrogens, which are weaker than the estrogens produced by the body but do manage to bind to estrogen sites on human cells. Potentially negative effects of a women's own estrogens--such as breast cancer risk--may be offset in this way. More long-term studies of dong quai are needed, however, to fully assess how it affects the body, a task made all the more challenging because dong quai tends to appear in combination products. It's commonly added to herbal Decongestant mixes for sinus problems, for example, and to special "women's formulas" for PMS (premenstrual syndrome) and menstrual cramping.

Specifically, dong quai may help to:

 

·  Relieve PMS and menstrual irregularities. Dong quai's reputation as a female tonic rests largely with its ability to reduce the symptoms of PMS (premenstrual syndrome) and regulate the menstrual cycle (1). Countless women have used it to treat amenorrhea (irregular or absent periods) and menorrrhagia (heavy bleeding or prolonged periods). The herb's long-standing popularity for reducing menstrual cramps has been ascribed to its anti-inflammatory and antispasmodic actions.

·  Reduce the frequency of premenstrual migraines.  Dong quai treats not only menstrual irregularities but, also the symptoms associated with the menstrual cycle. Many women experience an increase in the number of migraine headaches as they approach ovulation, due to fluctuating Hormone levels. Researchers have preliminarily demonstrated that the phytoestrogenic properties of dong quai may help reduce the frequency of migraine headaches during this susceptible time (2).

·  Reduce the pain of endometriosis. Dong quai works well in combination with chasteberry to restore the hormonal imbalances that can cause the often severe pain of this disorder. When taken together, the herbs can also relax the uterine muscle.

·  Minimize menopausal symptoms. In combination with herbs such as black cohosh, chasteberry, and Siberian ginseng, dong quai appears to be useful for controlling hot flashes and reducing vaginal dryness. The herb's phytoestrogens may help by compensating for menopause-related drops in natural estrogen levels. However, in recent studies involving postmenopausal women, dong quai proved to be no more effective than a Placebo in relieving such common menopausal symptoms as hot flashes and vaginal dryness (3, 4). In one study, the herb and the placebo both reduced the frequency of hot flashes by 25% to 30% (5). This type of disappointing result may simply highlight the importance of taking dong quai in combination with other herbs.

·   Nourish body fluids, counter fatigue, and lower blood pressure. As a rich source of Vitamin B12, dong quai may play a role in stimulating red blood cell production. It may therefore indirectly boost energy and lessen fatigue by increasing the number of red blood cells transporting oxygen throughout the body. When used in conjunction with other herbs, dong quai also mildly dilates blood vessels, facilitating the heart's pumping ability and possibly lowering blood pressure as a result. Chinese doctors have long prescribed the herb for high blood pressure and circulatory problems.

Note: Dong quai has also been found to be useful for a number of other disorders. For information on these additional ailments, see our Dosage Recommendations Chart for dong quai.

 

Forms

  • Tincture
  • tablet
  • softgel
  • liquid
  • dried herb/tea
  • capsule

Dosage Information

Special tip:

--When buying the pill or liquid form of dong quai, look for extracts standardized that contain 0.8% to 1.1% liguistilide.

·   For PMS, menstrual cramps, menstrual irregularities, and endometriosis: Take 600 mg daily, either in the form of 200 mg pills three times a day, or 30 drops (1.5 ml) of fluid Extract three times a day.

·  For menopausal discomforts: Take 600 mg daily in the form of 200 mg pills three times a day.

Be sure to check out our Dosage Recommendations Chart for Dong Quai, which lists therapeutic dosages for specific ailments at a glance.

Guidelines for Use

·  Women taking dong quai for menstrual complaints may want to consider using products that combine dong quai with other menstrual-regulating herbs, such as Siberian ginseng, licorice, and chasteberry. When attempting to regulate a menstrual period, try taking this kind of a mixture for three months and then taking a break for a month before starting again.

·   When treating PMS symptoms, confine your use of dong quai to the days you're not menstruating. However, when treating menstrual cramps only (and not PMS symptoms), start taking dong quai two or three days before you expect your period and continue until your period is over.

·   When treating hot flashes, you'll have to take dong quai daily for at least two months before noticing any changes.

General Interaction

·   If you take an anticoagulant (blood-thinning) medication or a nonsteroidal anti-inflammatory drug (such as ibuprofen), check with your doctor before trying dong quai (6).

For information on interactions with specific generic drugs, see our WholeHealthMD Drug/Nutrient Interactions Chart .

 

Possible Side Effects

·  Dong quai may have a mild laxative effect.

·  Menstrual bleeding may increase when taking dong quai.

·   Stop taking dong quai if a skin rash or photosensivity develops.

 

Cautions

Because of its ability to dramatically shift hormone levels in the body, Whole Health MD recommends its use only under the guidance of a health care clinician. Further, we recommend caution in using it due to its effects on anti-coagulation, hormone-related conditions, hormone therapies, contraception and possible pregnancy.

·   Don't take dong quai if you're pregnant or nursing (7).

·  Limit your exposure to the sun when taking dong quai, especially if you are fair-skinned; it contains substances called psoralens that can react with sunlight to cause a rash or severe sunburn.

·   If you have diarrhea, check with your doctor before taking dong quai.

·   Some “bust enhancing” products contain dong quai. These formulations have not been shown to increase bust size (8). The safety of these products has not been evaluated – do not start them without first discussing it with your doctor.

 

References

  1. Zhiping H, Dazeng W, Lingyi S, et al. Treating amenorrhea in vital energy-deficient patients with Angelica-sinesis-astragalus membranaceus menstruation-regulating decoction. J Tradit Chin Med. 2002; 6(3):187-190.
  2. Burke BE, Olson RD, Cusack BJ. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomed Pharmacother. 2002; 56(6): 283-88.
  3. Kronenberg F, Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. 2002; 137(10):805-813.
  4. Huntley AL, Ernst E. A systematic review of herbal medicinal products for the treatment of menopausal symptoms. Menopause. 2003; 10(5):465-476.
  5. Seibel MM. Treating hot flushes without hormone replacement therapy. J Fam Pract. 2003;52(4):291-296.
  6. Page RL, Lawrence JD. Potentiation of warfarin by Dong quai. Pharmacotherapy.1999. 19(7):870-6.
  7. Nambiar S, Schwartz RH, Constantino A. Hypertension in mother and baby linked to ingestion of Chinese herbal medicine. West J Med. 1999; 171(3):152.
  8. Fugh-Berman A. “Bust-enhancing” herbal products. Obstet Gynecol. 2003; 101(6):1345-1349.

Evidence Based Rating Scale  

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

Condition

Rating

Explanation

 A Warning  

 

WholeHealthMD recommends use of this supplement only under the guidance of a licensed clinician.

 

 

 

 

Endometriosis

 

 

 

  

 

 

Conflicting evidence indicates further research is needed. 

 

 

 

 

 

 

 

 

High blood pressure

 

 

 

 

 

 

 

 

 

Anecdotal evidence indicates some efficacy of dilating blood vessels when combined with other herbs. More research is needed to confirm or refute these findings.

 

 

 

 

 

 

 

 

 

Menopause

 

 

 

 

 

 

 

 

 

 

Several studies indicate efficacy when combined with black cohosh, chasteberry, and Siberian ginseng. More research is needed to confirm its individual effect.

 

 

Migraines

 

Preliminary evidence and anecdotal evidence indicate efficacy in reducing frequency of migraine headaches related to PMS.

 

 

Perimenopause

 

 

 

 

 

 

Some limited evidence for effectiveness. More research is needed.

 

 PMS

 

 

 

Small studies indicate some efficacy when combined with chasteberry. More research is needed to confirm its individual effect. Dong quai is contraindicated in pregnancy and should not be used by women experiencing heavy menstrual flow. Its use is recommended only under the supervision of an experienced health care professional such as a Traditional Chinese Medicine physician.

 

Ailments Dosage
Endometriosis
200 mg of standardized extract or 1/2 tsp. liquid extract 3 times a day
Menopause
400-800 mg a day of standardized extract in 2-3 divided doses, or 1/4 to 1/2 tsp. liquid extract 3 times a day
Perimenopause
400-800 mg a day of standardized extract in 2-3 divided doses; or 1/4 to 1/2 tsp. liquid extract 3 times a day
PMS
200 mg 3 times a day or 20 drops liquid extract twice a day

Drug/Nutrient Interactions
View Drug Interactions



Date Published: 10/23/2005
Date Reviewed: 10/23/2009



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