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Dong Quai Extract

Also known as: Angelica sinensis, Dong Quai, Dang Gui, Dang Qui

Overview

Dong Quai (*Angelica sinensis*) is an herbal supplement derived from the root of a plant native to China. It has a long history of use in traditional Chinese medicine, primarily for women's health issues. The root contains bioactive compounds like ligustilide, ferulic acid, and angelicide. Dong Quai is available in various forms, including capsules, teas, and traditional formulations. While it's often used to treat menstrual and menopausal symptoms, research on its effectiveness is mixed. Some studies suggest potential benefits for cardiovascular health and cancer-related outcomes, but the evidence is generally limited and requires further investigation. The quality of available evidence varies, with some systematic reviews and meta-analyses, but many studies have methodological limitations.

Benefits

The evidence for Dong Quai's benefits is mixed and often inconclusive. While traditionally used for menstrual and menopausal symptoms, studies have not consistently supported its effectiveness for conditions like hot flashes. Some research suggests that formulas containing Dong Quai may improve clinical outcomes in patients with acute coronary syndrome and mild-to-moderate renal insufficiency. Additionally, there is preliminary evidence indicating a potential reduction in diabetes-related mortality and endometrial cancer risk in breast cancer survivors, though these findings are not robust. In vitro and animal studies have shown antitumor, pro-apoptotic, and anti-metastatic effects, but these results need confirmation in human trials. Dong Quai may also offer benefits for women with amenorrhea induced by antipsychotic drugs and in the long-term management of post-operative ovarian endometriotic cysts, although the evidence is not strong.

How it works

Dong Quai's mechanism of action is attributed to its bioactive compounds. Ferulic acid may reduce inflammation and oxidative stress by affecting cytokines and matrix metalloproteinases. Polysaccharides from Dong Quai root may stimulate insulin-like growth factor 1 (IGF1) and IGF1 receptor gene expression, promoting glycosaminoglycan synthesis and bone regeneration. Dong Quai extracts have shown estrogen-agonist activity, which can stimulate the proliferation of both estrogen receptor-positive and -negative breast cancer cells. It also affects molecular targets, including the suppression of tumor growth through Nur77-dependent apoptosis and the induction of VEGF expression, which promotes angiogenesis. Prolonged use can induce CYP3A4, potentially affecting the metabolism of other drugs.

Side effects

Dong Quai is generally well-tolerated, but it can have significant interactions with other medications and may not be suitable for all populations. Common side effects are not well-documented, but it may cause photosensitivity reactions and increase the risk of bleeding in patients taking anticoagulants or antiplatelet drugs. Uncommon side effects are also not well-defined, but it may exacerbate anemia when used with ACE inhibitors. Rare side effects are not well defined, but the herb's estrogenic activity could potentially influence hormone-sensitive conditions. Drug interactions include additive anticoagulant effects, interactions with cytochrome P450 substrates, and alterations in the pharmacokinetics of dual antiplatelet therapy and clozapine metabolism. Pregnant and breastfeeding women should avoid Dong Quai. Patients with hormone-sensitive cancers should consult their physicians before using this herb.

Dosage

There is no standardized dosage range for Dong Quai, and the effectiveness can vary widely depending on the specific formulation and preparation. The minimum effective dose is not well established due to the variability in study designs and outcomes. The maximum safe dose is also not clearly defined, but prolonged use can induce CYP3A4 and potentially affect drug metabolism. There are no specific timing recommendations, but it is often used as part of a broader herbal regimen. Dong Quai can be consumed in various forms, including capsules, teas, and as part of traditional Chinese medicine formulations. The absorption of Dong Quai's active compounds is not well studied, but it may be influenced by the presence of other herbs or medications. It should be used under the guidance of a healthcare provider.

FAQs

Who should avoid Dong Quai?

Patients with hormone-sensitive cancers, pregnant or breastfeeding women, and those taking anticoagulants or other medications should exercise caution or avoid using Dong Quai.

When should I take Dong Quai?

There are no specific timing recommendations, but it should be used under the guidance of a healthcare provider, especially if combined with other medications.

What results can I expect from taking Dong Quai?

The expected results vary widely depending on the condition being treated and the individual's health status. It is important to have realistic expectations based on the available evidence.

Is Dong Quai a proven treatment for all women's health issues?

No, Dong Quai is not a proven treatment for all women's health issues, and its effectiveness for menopausal symptoms is inconclusive.

Research Sources

https://www.mskcc.org/cancer-care/integrative-medicine/herbs/dong-quai – Memorial Sloan Kettering Cancer Center provides a comprehensive overview of Dong Quai, including its uses, potential benefits, and side effects. It highlights the herb's traditional use in Chinese medicine and notes the limited scientific evidence supporting many of its purported benefits, particularly for menopausal symptoms. The resource also emphasizes potential drug interactions and cautions for specific populations.
https://training.cochrane.org/handbook/current/chapter-10 – The Cochrane Handbook provides guidance on conducting systematic reviews and meta-analyses, which are essential for evaluating the quality of evidence for interventions like Dong Quai. It outlines the methodology for assessing bias, synthesizing data, and interpreting results from clinical trials. This resource is valuable for understanding the rigor required to establish the efficacy of herbal supplements.
https://pubmed.ncbi.nlm.nih.gov/30000896/ – This study investigates the impact of herbal medicine on the expression of hepatic drug-metabolizing enzymes and transporters in rats. It provides insights into how herbal supplements like Dong Quai can interact with drug metabolism pathways, potentially affecting the efficacy and safety of other medications. The research highlights the importance of considering herb-drug interactions in clinical practice.
https://www.xiahepublishing.com/m/2835-6357/FIM-2023-00002 – This systematic review examines the effects of Dong Quai on breast cancer patients, finding mixed evidence regarding its impact. Some studies suggest positive, negative, or inconclusive effects, highlighting the variability in study quality and the need for more robust human studies. The review uses a quantitative forest plot to weigh the reliability of the included studies.
https://www.jacc.org/doi/10.1016/S0735-1097(02)01749-7 – This article discusses the use of herbal therapies in cardiovascular disease, including the potential benefits and risks associated with Dong Quai. It emphasizes the importance of understanding the mechanisms of action and potential interactions of herbal supplements with conventional medications. The article provides a clinical perspective on integrating herbal medicine into cardiovascular care.