Dong Quai


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Scientific Name: Angelica sinensis

Common Names: Chinese angelica, dang gui, tang kuei, tan kue

Overview

Dong quai is a perennial herb indigenous to China, Japan, and Korea. Its root has been used for centuries as a spice, tonic, and medicine. Dong quai is mentioned in Shen Nong Ben Cao Jing, the second-century Chinese herbal treatise, as a treatment for gynecologic disorders.

Today, dong quai continues to be an important remedy in traditional Chinese medicine for treating menstrual disorders and menopausal symptoms, for anemia, and to improve blood circulation. It is thought to “tonify” and “invigorate” the blood and is often used in formulations with other herbs.

Dong quai is widely promoted as a “woman’s herb” and is sometimes referred to as “female ginseng” because Asian ginseng is used as a tonic for men. It is sought by many patients with breast cancer to relieve hot flashes and other adverse effects related to cancer treatments, despite the fact that current evidence of its efficacy is limited and inconclusive.

The agent has estrogenic effects; patients with hormone-sensitive cancers should avoid its use. Other concerns include lack of standardization and adulteration with plants that are morphologically similar.

Dong quai is sold in Asian grocery markets, in health food stores, and on the Internet. The dried root is boiled or soaked in wine for consumption, whereas the powdered root is available in the form of tablets, capsules, and tinctures.

The Science

Dong quai has been studied in vitro and in animal models, but human data are limited. Z-ligustilide and ferulic acid, the main components, are the agent’s biologically active compounds.

In vitro studies using dong quai extracts suggest antitumor,1 antituberculosis,2 neuroprotective,3 and hematopoietic4 properties. Polysaccharides isolated from dong quai root exhibited protective effects against cyclophosphamide-induced toxicity,5 doxorubicin-induced cardiotoxicity,6 and radiation-induced pneumonitis7 in animal models.

Data from clinical trials of dong quai for menopausal symptoms are inconclusive.8 A small study failed to find efficacy of dong quai against hot flashes in men.9 Dong quai acts as a phytoestrogen in vitro,10 and stimulates proliferation of MCF-7 cells.11

Adverse Effects

Gynecomastia has been reported with use of dong quai.12

Case report: A 53-year-old woman suffered subarachnoid hemorrhage following use of a supplement containing red clover, dong quai, and Siberian ginseng for perimenopausal hot flashes. Her symptoms resolved after discontinuing use of the supplement.13

Contraindications

Dong quai can potentiate the effects of anticoagulants.14

Patients with hormone-sensitive cancers should avoid dong quai because it has estrogenic effects.11

Disclosure: Drs. Cassileth and Yeung and Ms. Gubili reported no potential conflicts of interest.

Integrative Oncology is compiled by Barrie R. Cassileth, MS, PhD, and Jyothirmai Gubili, MS, Memorial Sloan-Kettering Cancer Center. The About Herbs website is managed by K. Simon Yeung, PharmD, Lac, Memorial Sloan-Kettering Cancer Center.

References

1. Tsai NM, Lin SZ, Lee CC, et al: The antitumor effects of Angelica sinensis on malignant brain tumors in vitro and in vivo. Clin Cancer Res 11:3475-3484, 2005.

2. Deng S, Wang Y, Inui T, et al: Anti-TB polyynes from the roots of Angelica sinensis. Phytother Res 22:878-882, 2008.

3. Bu Y, Kwon S, Kim YT, et al: Neuroprotective effect of HT008-1, a prescription of traditional Korean medicine, on transient focal cerebral ischemia model in rats. Phytother Res 24:1207-1212, 2010.

4. Liu PJ, Hsieh WT, Huang SH, et al: Hematopoietic effect of water-soluble polysaccharides from Angelica sinensis on mice with acute blood loss. Exp Hematol 38:437-445, 2010.

5. Hui MK, Wu WK, Shin VY, et al: Polysaccharides from the root of Angelica sinensis protect bone marrow and gastrointestinal tissues against the cytotoxicity of cyclophosphamide in mice. Int J Med Sci 3(1):1-6, 2006.

6. Xin YF, Zhou GL, Shen M, et al: Angelica sinensis: a novel adjunct to prevent doxorubicin-induced chronic cardiotoxicity. Basic Clin Pharmacol Toxicol Dec 101:421-426, 2007.

7. Xie CH, Zhang MS, Zhou YF, et al: Chinese medicine Angelica sinensis suppresses radiation-induced expression of TNF-alpha and TGF-beta1 in mice. Oncol Rep 15:1429-1436, 2006.

8. Wong VC, Lim CE, Luo X, et al: Current alternative and complementary therapies used in menopause. Gynecol Endocrinol 25:166-174, 2009.

9. Al-Bareeq RJ, Ray AA, Nott L, et al: 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 4:49-53, 2010.

10. Liu J, Burdette JE, Xu H, et al: Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem 49:2472-2479, 2001.

11. Lau CB, Ho TC, Chan TW, et al: Use of dong quai (Angelica sinensis) to treat peri- or postmenopausal symptoms in women with breast cancer: Is it appropriate? Menopause 12:734-740, 2005.

12. Goh SY, Loh KC: Gynaecomastia and the herbal tonic “Dong Quai.” Singapore Med J 42(3):115-116, 2001.

13. Friedman JA, Taylor SA, McDermott W, et al: Multifocal and recurrent subarachnoid hemorrhage due to an herbal supplement containing natural coumarins. Neurocrit Care 7:76-80, 2007.

14. Page RL 2nd, Lawrence JD: Potentiation of warfarin by dong quai. Pharmacotherapy 19:870-876, 1999.



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