Dong quai as a dietary supplement
Dong quai, also known as Angelica sinensis, is a traditional herbal remedy primarily used in Chinese medicine, recognized for its potential health benefits, particularly for women's health. Commonly referred to as a "female tonic," it is often recommended for conditions such as dysmenorrhea, premenstrual syndrome (PMS), and menopausal symptoms like hot flashes. Despite its long-standing use, scientific evidence supporting these applications is limited, with most studies being preliminary and lacking rigorous design.
The herb is typically administered through tinctures or capsules, and while it is generally considered safe, it may cause mild gastrointestinal distress in some individuals. Caution is advised, as dong quai can interact with blood-thinning medications and may not be suitable for those with certain health conditions, including individuals with a history of breast cancer. Its effects on hormone levels are still not fully understood, and reliability in products labeled as dong quai can vary due to potential contamination with unlisted substances. Consequently, it is recommended that individuals interested in using dong quai seek guidance from qualified herbalists to ensure safety and proper usage.
Dong quai as a dietary supplement
DEFINITION: Natural plant product used as a dietary supplement for specific health benefits.
PRINCIPAL PROPOSED USES: Dysmenorrhea, menstrual disorders, premenstrual syndrome
PROPOSED USES: Menopausal symptoms, anemia, constipation, high blood pressure, improving circulation
Overview
One of the primary herbs used in traditional Chinese herbal medicine, Angelica sinensis, or dong quai, is closely related to A. archangelica, a common European garden herb and the flavoring in Benedictine and Chartreuse liqueurs. The carrot-like roots of this fragrant plant are harvested in the fall after about three years of cultivation and are stored in airtight containers before processing.
Traditionally, dong quai is said to be one of the most important herbs for strengthening the xue. The Chinese term xue is often translated as “blood,” but it actually refers to a complex concept in traditional Chinese medicine, of which the Western notion of blood is only a part. In the late nineteenth century, an extract of dong quai known as Eumenol became popular in Europe as a “female tonic,” which is how most people consider it in the West.
Uses and Applications
Dong quai is often recommended as a treatment for menstrual cramps, premenstrual syndrome (PMS), and other problems related to menstruation, as well as for hot flashes and other menopausal symptoms. However, the scientific evidence supporting these uses is very weak, consisting primarily of test tube and animal studies and a few open studies of people. Only double-blind, placebo-controlled studies can actually show a treatment effective. A twenty-four-week study that compared the effects of dong quai with a placebo in seventy-one postmenopausal women found no benefit. Another study from 2010 found a benefit in using dong quai to treat hot flashes. However, the study participants were men undergoing androgen deprivation therapy for prostate cancer.
A study published in 2020 in The ASCO Post's Integrative Oncology series explained some possible benefits of using dong quai in patients with some diseases. The study indicated that patients with acute coronary syndrome and renal insufficiency who were given dong quai in addition to their standard medications had improved clinical outcomes. Breast cancer survivors who had been treated with the drug tamoxifen, which may cause other cancers, lowered their risk of developing endometrial cancer with the use of dong quai as compared with women who did not use the supplement. However, more testing is needed before dong quai can be recommended to patients with these diseases. Other suggested uses for dong quai that need additional scientific study include treating anemia, constipation, high blood pressure, and improving circulation.
Dosage
It is recommended that dong quai be used under the supervision of an herbalist qualified in traditional Chinese herbal medicine. The herb is not dangerous, but it is difficult to self-prescribe Chinese herbal formulas.
A typical dosage of dong quai is ten to forty drops of dong quai tincture, one to three times daily, or one standard-size gelatin capsule, three times daily.
Safety Issues
Dong quai is generally believed to be nontoxic. According to Chinese studies, which may not have been up to current scientific standards, very large amounts have been given to rats without causing harm. Side effects are rare and primarily consist of mild gastrointestinal distress and occasional allergic reactions (such as rash).
Contrary to popular belief, dong quai does not appear to have estrogen-like actions. However, according to an article in the Singapore Medical Journal, a thirty-five-year-old man who used a prepared herbal formula called dong quai pills developed enlarged breasts. Such enlargement would typically result if a man used estrogen. The authors of the article blamed the dong quai itself. However, a more likely explanation is that the prepared herbal formula was “spiked” with synthetic estrogen. There are numerous reports of prepackaged Asian herb products containing unlabeled constituents, including conventional medications designed to enhance their effect.
In a test-tube study, dong quai was again found to be nonestrogenic, and yet it nonetheless stimulated the growth of breast cancer cells. Although the mechanism of this effect is not known, the results suggest that women who have had breast cancer should avoid using dong quai.
Dong quai may interact with the blood-thinning drug warfarin (Coumadin), increasing the risk of bleeding, according to one case report. Dong quai might also conceivably interact with other blood-thinning drugs, such as heparin, aspirin, clopidogrel (Plavix), ticlopidine (Ticlid), and pentoxifylline (Trental).
Certain constituents of dong quai can cause photosensitivity (increased sensitivity to the sun), but this has not been observed to occur in people using the whole herb.
Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established. One case report suggests that dong quai usage by a nursing mother caused elevated blood pressure in both the mother and the child.
Important Interactions
Dong quai might interact with blood-thinning drugs and increase the risk of bleeding. Dong quai may also interact with medications affecting hormone levels.
Bibliography
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