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Organic Red Rooted Sage Extract

Also known as: Red-rooted sage, Red sage, Chinese sage, Danshen, Salvia miltiorrhiza

Overview

Salvia miltiorrhiza, commonly known as red-rooted sage or Danshen, is an herbal extract derived from the dried roots of a plant native to China, widely utilized in Traditional Chinese Medicine (TCM). It is primarily recognized for its applications in cardiovascular health, urological conditions, reproductive disorders, and bone health. The extract is rich in bioactive compounds, notably tanshinones (lipophilic diterpenes) and salvianolic acids (hydrophilic phenolic acids), which contribute to its therapeutic effects. Research on Salvia miltiorrhiza is maturing, with an increasing number of randomized controlled trials (RCTs) and systematic reviews, particularly in its cardiovascular and urological applications. The quality of evidence varies but includes well-conducted RCTs and meta-analyses, especially for conditions like lower urinary tract symptoms (LUTS) and polycystic ovary syndrome (PCOS). Its traditional use and emerging scientific validation position it as a significant botanical supplement.

Benefits

Salvia miltiorrhiza offers several evidence-based benefits across various health domains. For men, a 12-week randomized controlled trial demonstrated that daily doses of 400 mg and 800 mg significantly improved International Prostate Symptom Scores (IPSS) and erectile function in men with lower urinary tract symptoms (LUTS), including reductions in urinary frequency, urgency, and nocturia, with high-quality evidence. In women, a systematic review and meta-analysis of six RCTs indicated that Salvia miltiorrhiza, when combined with letrozole, significantly increased pregnancy rates in women with Polycystic Ovary Syndrome (PCOS) compared to letrozole alone, showing moderate to high-quality evidence. Furthermore, systematic reviews of clinical and preclinical studies suggest its potential in osteoporosis management by inhibiting bone resorption and promoting bone formation, though clinical evidence is still emerging. Lastly, clinical data points to its benefits in cardiovascular health by improving blood viscosity, reducing platelet aggregation, and enhancing ECG parameters, suggesting a role in cardiovascular disease prevention and treatment, though more large-scale RCTs are needed to solidify this evidence.

How it works

Salvia miltiorrhiza exerts its therapeutic effects through its active compounds, tanshinones and salvianolic acids, which modulate multiple biological pathways. It demonstrates anti-inflammatory and antioxidant properties by inhibiting key signaling pathways like NF-κB and MAPK. In bone metabolism, it regulates osteoclastogenesis (bone resorption) and promotes osteoblastogenesis (bone formation) by influencing pathways such as NFATc1 and cathepsin K. The extract also improves microcirculation and blood flow by reducing blood viscosity and platelet aggregation, thereby enhancing cardiovascular function. In reproductive health, particularly in PCOS, it may contribute to hormonal modulation, potentially enhancing ovulation and pregnancy rates when used as an adjunct therapy. The absorption and bioavailability of its compounds vary, with lipophilic tanshinones potentially benefiting from specific formulations for optimal uptake.

Side effects

Overall, Salvia miltiorrhiza extract is considered safe with a low incidence of adverse effects in clinical trials. Common side effects are rare and generally mild. For instance, a 12-week randomized controlled trial on LUTS reported no serious adverse events. This study also indicated no significant changes in prostate-specific antigen (PSA) or testosterone levels, suggesting a lack of adverse hormonal effects. While generally well-tolerated, caution is advised regarding potential drug interactions, particularly with anticoagulants, due to its documented effects on platelet aggregation. Although not extensively documented, this interaction could theoretically increase the risk of bleeding. Contraindications and considerations for special populations, such as pregnant or breastfeeding women, or individuals with pre-existing bleeding disorders, require further study. However, current evidence supports its safety in the adult populations studied in clinical trials.

Dosage

Effective dosages of Salvia miltiorrhiza extract in clinical trials for lower urinary tract symptoms (LUTS) range from 400 mg to 800 mg daily, typically administered over a 12-week period. For instance, a study on LUTS observed significant improvements at both 400 mg and 800 mg daily doses. In the context of Polycystic Ovary Syndrome (PCOS), Salvia miltiorrhiza has been used as an adjunct to letrozole, though specific dosing varied across the studies included in the meta-analysis. Optimal dosing for other indications like osteoporosis and cardiovascular health is less precisely defined and may depend on the specific extract standardization and formulation. When considering timing and formulation, it's important to account for bioavailability; lipophilic components like tanshinones may benefit from lipid-based delivery systems to enhance absorption. There are no widely established upper limits or safety thresholds beyond the studied clinical trial doses, but adherence to recommended dosages is advised.

FAQs

Is red-rooted sage extract safe for long-term use?

Current clinical trials, typically up to 12 weeks, report a good safety profile. However, long-term safety data beyond this duration are limited and require further research.

Can it be used alone or only as adjunct therapy?

Evidence supports both standalone use, such as for lower urinary tract symptoms, and adjunct use, like in combination with letrozole for polycystic ovary syndrome.

How soon can benefits be expected?

Improvements in conditions like lower urinary tract symptoms and erectile function have been observed within 12 weeks of consistent use in clinical trials.

Are there concerns about hormone levels?

Clinical trials have not observed significant alterations in hormone levels, such as prostate-specific antigen or testosterone, indicating no adverse hormonal effects.

Research Sources

https://pmc.ncbi.nlm.nih.gov/articles/PMC11723278/ – This multicenter, double-blind, placebo-controlled RCT involving 136 men with LUTS found that Salvia miltiorrhiza extract at 400 mg and 800 mg daily significantly improved IPSS and erectile function scores over 12 weeks, with no serious adverse events. The study demonstrates the extract's efficacy and safety for male LUTS.
https://onlinelibrary.wiley.com/doi/10.1155/2021/9971403 – This systematic review and meta-analysis of six RCTs (n=390) concluded that Salvia miltiorrhiza combined with letrozole significantly increased pregnancy rates in women with PCOS compared to letrozole alone. The findings suggest a beneficial adjunctive role for Salvia miltiorrhiza in PCOS treatment.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1483431/pdf – This systematic review of clinical and preclinical studies suggests that Salvia miltiorrhiza extracts inhibit bone resorption and promote bone formation by modulating osteoclast and osteoblast activity. The research indicates potential for its use in osteoporosis management, though more clinical trials are needed.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5421141/ – This narrative review summarizes clinical data indicating that Salvia miltiorrhiza improves blood viscosity, platelet aggregation, and ECG parameters, suggesting potential benefits in cardiovascular disease prevention and treatment. While promising, the review highlights the need for more large-scale randomized controlled trials.