Dong Quai

Effects and Benefits

Core Identification

Common Names:
- Dong Quai
- Tang Kuei
- Dan Gui
- Chinese Angelica
- Female Ginseng
- Queen of Herbs (Chinese)

Latin Name: Angelica sinensis

Category: Herb

Important Note: Despite its reputation as a "women's herb," dong quai does NOT work through estrogenic activity—pharmacological research confirms the root is devoid of estrogen action. Its effects work through direct uterine muscle modulation and blood circulation enhancement. European angelica (Angelica archangelica) is a related but distinct species with different properties.

Uses

Traditional Uses

• Blood tonic and blood mover - Traditional Chinese Medicine, documented since 500 BCE
• Postpartum recovery - Chinese medicine; prevents infections and restores energy after childbirth
• Menstrual regulation - Chinese medicine; eliminates cramps and pain when taken consistently over weeks to months
• Chi (vital energy) tonic - Traditional Chinese Medicine; strengthens heart, lung, and liver meridians
• Constipation and abdominal pain - TCM use for lubricating the bowel
• Tissue trauma, swellings, bruising - Traditional Chinese applications

Modern Uses

• Menstrual cramps (dysmenorrhea) | Research quality: Moderate (clinical trials)
• Key findings: Dong quai's effectiveness in dysmenorrhea appears to work through direct uterine muscle modulation rather than hormonal action. Water-soluble compounds stimulate uterine contraction while alcohol-soluble volatile oils relax the uterus—this biphasic action helps coordinate uterine contractions. A combination formula containing dong quai, Corydalis, white peony, and Ligusticum showed 93% improvement rate for dysmenorrhea in clinical trials.

• Source citations: Bone - A Clinical Guide to Blending Liquid Herbs; WRCHM - Western Materia Medica I; Balch - Prescription for Herbal Healing

• PMS and menopause symptoms | Research quality: Mixed/Inconclusive

• Key findings: Clinical evidence for menopausal hot flashes is mixed. A Kaiser Permanente study found no significant benefit for hot flashes in women with natural menopause. However, some women report benefit—particularly those entering menopause after surgery, who tend to have more severe symptoms. Dong quai may be more effective for intermittent hot flashes than unremitting heat. One pilot study combining dong quai with milk thistle and red clover showed reduced hot flashes, night sweats, and improved sleep.

• Source citations: Balch - Prescription for Herbal Healing; Hirata et al. (1997) - Fertility and Sterility

• Hormone regulation and fertility | Research quality: Traditional/Moderate

• Key findings: Brings on delayed or absent menses, evens out irregular cycles, promotes fertility, and eases menopausal changes. Ferulic acid, one of dong quai's key compounds, increases sperm cell motility and viability by protecting cell membranes from free radical damage.

• Source citations: WRCHM - Western Materia Medica I; Bone - A Clinical Guide to Blending Liquid Herbs; Zheng & Zhang (1997)

• Postpartum support | Research quality: Traditional

• Key findings: Excellent for women who are anemic, weak, or have recently given birth. Prevents postpartum infections and restores energy. Dong quai exerts a stimulating effect on hematopoiesis (blood cell formation) in bone marrow, supporting its traditional use as a blood-building tonic.

• Source citations: Soule - The Woman's Handbook of Healing Herbs; Bone - A Clinical Guide to Blending Liquid Herbs

• Cardiovascular support | Research quality: Moderate (animal/in vitro studies)

• Key findings: Dong quai teas contain compounds that prolong the resting period between heartbeats and dilate coronary blood vessels, increasing coronary blood flow and lowering blood pressure. Has quinidine-type antiarrhythmic effect on the heart. Strongly inhibits platelet aggregation and thromboxane formation. Animal studies show prevention of coronary atherosclerosis and lipid deposits in arteries.

• Source citations: WRCHM - Western Materia Medica I; Balch - Prescription for Herbal Healing; Bone - A Clinical Guide to Blending Liquid Herbs

• Liver protection | Research quality: Moderate (animal/clinical)

• Key findings: In animal studies, dong quai protected the liver from carbon tetrachloride toxicity and enhanced oxygen utilization in liver tissue. In an uncontrolled clinical trial, dong quai improved abnormal protein metabolism and increased plasma protein levels in 60% of patients with chronic hepatitis or hepatic cirrhosis.

• Source citations: WRCHM - Western Materia Medica I; Bone - A Clinical Guide to Blending Liquid Herbs

• Immune support | Research quality: Moderate (in vitro/animal)

• Key findings: Dong quai enhances general immunity by stimulating formation of white blood cells, lymphocytes, and phagocytes. Research shows it increases lymphocyte activity to form mature antibodies, increases interleukin-2 (IL-2) formation, enhances B cells' capacity to respond to T helper cells, and stimulates T lymphocyte production.

• Source citations: WRCHM - Western Materia Medica I; McIntyre - The Complete Herbal Tutor

• Peripheral vascular disorders | Research quality: Clinical use (China)

• Key findings: In China, an injection containing dong quai has been successfully used to treat Buerger's disease (thromboangiitis obliterans) and constrictive aortitis. Its blood-moving and circulation-enhancing properties address poor peripheral blood flow.
• Source citations: Bone - A Clinical Guide to Blending Liquid Herbs; McIntyre - The Complete Herbal Tutor

Active Compounds

Primary Active Ingredients:
- Phthalides (Ligustilide, butylidene phthalide, n-butylphthalide) - Responsible for antispasmodic, circulation-enhancing, and uterine-relaxing effects
- Ferulic acid - Antioxidant, anti-inflammatory; protects sperm cell membranes; inhibits platelet aggregation
- Coumarins and furocoumarins - Contribute to anticoagulant properties and circulation effects; may cause photosensitivity
- Polysaccharides - Immune-modulating, hepatoprotective, blood-building effects

Secondary Compounds:
- Volatile oils (0.4-0.7%): Carvacrol, safrol, isosafrol, sesquiterpenes (cadinene)
- Organic acids: Succinic acid, nicotinic acid, angelic acid, folinic acid, palmitic acid
- Vitamins: Vitamin E, Vitamin B12 (0.25-40 mcg/100g), beta-carotene
- Other: Beta-sitosterol (phytosterol), uracil, adenine

Mechanism Notes:
- Water-soluble compounds stimulate uterine contraction
- Alcohol-soluble volatile oils relax uterine smooth muscle
- This biphasic action explains dong quai's ability to both coordinate contractions and relieve cramping depending on preparation form

Dosage Information

Standard Dosage:
- Form: Capsules or tablets
- Amount: 2-3 grams per day
- Frequency: Divided into 2-3 doses daily

Therapeutic Dosage:
- Form: Capsules, decoction, or as part of traditional formula
- Amount: 2-4 grams per day
- Purpose: For menstrual regulation, PMS, menopausal symptoms
- Duration: Allow 1-3+ months for full benefits; consistent daily use is more effective than intermittent use

Extract/Tincture Dosage:
- Tincture: Contains alcohol-soluble compounds that relax uterus (use for cramps/spasms)
- Tea/Capsules: Contain water-soluble compounds that stimulate uterus (use for sluggish circulation, delayed menses)

Maximum Safe Dosage:
- Daily maximum: Generally considered safe at standard doses; follow product guidelines
- Warning threshold: Doses over 500mg taken 1-2 times daily for extended periods (4+ weeks) may affect clotting time, especially in those on anticoagulant therapy

Bioavailability Notes:
- In Traditional Chinese Medicine, dong quai is rarely used alone—it's typically combined with other herbs for enhanced effect and balance
- Different preparations (tincture vs. tea/capsule) deliver different active compounds with different effects

How to Take It

Timing:
- Best time of day: Morning and/or evening; consistency matters more than specific timing
- With food or on empty stomach: With food recommended
- Specific timing notes: For hormone balancing and menstrual regulation, take daily over extended periods (weeks to months) rather than only during menstruation. Effects are cumulative and build over time.

Preparation Considerations:
- For menstrual cramps/spasms: Tincture form preferred (alcohol extracts the uterine-relaxing volatile oils)
- For blood building/delayed menses: Tea or capsule form preferred (water extracts the uterine-stimulating compounds)

Synergies - What It Works Well With

Complementary Supplements:
1. Peony Root (Bai Shao) - Traditional Chinese pairing for blood nourishment; classic dysmenorrhea formula combines dong quai, Corydalis, white peony, and Ligusticum with 93% improvement rate
2. Bupleurum Root (Chai Hu) - Traditional Chinese pairing for liver support and hormone regulation; combined for PMS and emotional symptoms
3. Ligusticum (Chuan Xiong) - Classic blood-moving combination; enhances circulation to reproductive organs
4. Corydalis - Combines for pain relief and dysmenorrhea
5. Black Cohosh - Both support menopausal symptoms through complementary mechanisms
6. Vitex (Chaste Tree Berry) - Both support hormone balance; combine for comprehensive menstrual and menopausal support
7. Red Root - Combined for ovarian cysts and fluid congestion
8. Astragalus - Both are chi tonics; combined for immune and energy support

Avoidance - What NOT to Combine With

Supplement/Herb Interactions:
1. Anticoagulant/antiplatelet herbs - Additive bleeding risk when combined with: European Angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, poplar, red clover, willow | Severity: Moderate
2. High-dose Vitamin E - May increase bleeding risk | Severity: Mild to Moderate

Drug Interactions:
1. Warfarin (Coumadin) - DOCUMENTED INTERACTION: Over 500mg taken 1-2 times daily for 4 weeks increased prothrombin time (PT); effect continued for 4 weeks after discontinuation. One case report of serious bleeding in woman taking warfarin with dong quai (recovered after discontinuing herb). | Severity: Severe
2. Other anticoagulants (Heparin, aspirin, clopidogrel) - Theoretical increased bleeding risk based on antiplatelet activity | Severity: Moderate
3. Hormone medications (birth control pills, HRT) - Theoretical interaction; however, dong quai lacks estrogenic activity so interaction may be minimal | Consult physician | Severity: Moderate
4. ACE inhibitors (captopril, lisinopril, fosinopril) - Both may increase sun sensitivity; increased risk of photodermatitis | Severity: Mild
5. Benzodiazepines - May experience increased muscle relaxation and sedative effects | Severity: Mild
6. Testosterone - Watch for increased androgenic effects (acne, hirsutism, behavior changes) | Severity: Mild

Contraindications - DO NOT USE if:
- Pregnant - Avoid due to effects on uterine muscle activity
- Excessive menstrual bleeding (menorrhagia) - May worsen heavy periods
- Blood clotting disorders or hemorrhagic disease - May increase bleeding tendency
- Currently taking warfarin or anticoagulants - Documented interaction increasing bleeding risk
- Chronic diarrhea - Contraindicated in TCM
- Acute infections (cold, flu) - Avoid during active infection
- Active herpes infection - Avoid for 30 days after first symptoms

Safety Information

Side Effects:
- Fever (uncommon)
- Gastrointestinal disturbances
- Increased bleeding
- Photodermatitis (abnormal skin reaction to sunlight) - rare but possible due to coumarin/psoralen content

Long-Term Use:
- Traditional use supports extended consumption as a tonic herb
- Monitor menstrual flow; discontinue if bleeding becomes excessive
- Warfarin interaction effects persisted for 4 weeks after discontinuation—allow adequate washout period

Surgery Precautions:
- Discontinue at least 2-4 weeks before scheduled surgery due to antiplatelet effects and prolonged clearance time

Sun Exposure:
- May increase skin sensitivity to sunlight (phototoxicity from coumarins and psoralens)
- Persons taking medications that increase sunburn risk should use extra caution

Special Populations:
- Not recommended for use in children
- Nursing mothers should avoid use

Primary Uses At-a-Glance

Primary: Menstrual cramps (dysmenorrhea), PMS, menstrual irregularity, blood tonic, postpartum recovery, poor circulation

Secondary: Menopausal symptoms, fertility support, cardiovascular support, liver protection, immune support, anemia, peripheral vascular disorders

Sources

Local Library:
- WRCHM - Western Materia Medica I (Wild Rose College of Herbal Medicine): Comprehensive constituents list, pharmacological research on uterine/cardiovascular/immune effects, traditional uses, documented since 500 BCE
- WRCHM - Herb-Drug-Nutrient Interaction: Warfarin interaction data (human study), PT/INR effects, herb-herb interaction list
- Bone, Kerry - A Clinical Guide to Blending Liquid Herbs: Pharmacological research summary, clinical trial data (dysmenorrhea 93% improvement, tubal occlusion, hepatitis), confirmation root devoid of estrogenic action
- McIntyre, Anne - The Complete Herbal Tutor: Full constituents list including vitamins/minerals, comprehensive actions, immune and cardiovascular uses
- Balch, Phyllis - Prescription for Herbal Healing: Clinical study references, menopause research summary, mechanism details, contraindications
- Soule, Deb - The Woman's Handbook of Healing Herbs: Core identification, plant description, traditional uses, dosage
- Moore, Michael - Medicinal Plants of the Desert and Canyon West: Red Root combination for ovarian cysts

Referenced Clinical Studies:
- Hirata JD et al. (1997) "Does Dong Quai Have Estrogenic Effects in Postmenopausal Women?" Fertility and Sterility 68(6): 981-986
- Page RL & Lawrence JD (1999) "Potential of Warfarin by Dong Quai" Pharmacotherapy 19(7): 870-876
- Zheng RL & Zhang H (1997) "Effects of Ferulic Acid on Fertile and Asthenozoospermic Infertile Human Sperm Motility" Free Radical Biology and Medicine 22(4): 581-586