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Organic Red Sage Extract

Also known as: Organic Red Sage Extract, Danshen, Chinese Red Sage, Chinese Sage, Red Root Sage, Salvia miltiorrhiza

Overview

Salvia miltiorrhiza, commonly known as Danshen or Chinese Red Sage, is a perennial plant native to China and a cornerstone of Traditional Chinese Medicine (TCM). Its root extract is rich in bioactive compounds, primarily tanshinones and salvianolic acids, which are believed to be responsible for its therapeutic effects. Historically, Danshen has been extensively used for conditions related to cardiovascular health and gynecological disorders. Modern research, including a growing number of randomized controlled trials and systematic reviews, supports its use in improving blood circulation, treating cardiovascular diseases such as angina pectoris, and as an adjunctive therapy for reproductive health issues like Polycystic Ovary Syndrome (PCOS). While the evidence quality varies and many studies are concentrated in China, it is considered a promising herbal supplement with moderate research maturity.

Benefits

Salvia miltiorrhiza offers several evidence-based benefits, primarily in cardiovascular and reproductive health. For cardiovascular health, systematic reviews indicate that *S. miltiorrhiza* significantly reduces blood viscosity and platelet aggregation, leading to improved clinical symptoms in conditions like angina pectoris. Some trials report overall efficacy rates up to 94% in improving cardiovascular parameters. In reproductive health, particularly for Polycystic Ovary Syndrome (PCOS), a 2021 systematic review and meta-analysis of six randomized controlled trials (n=390) found that *S. miltiorrhiza* extract, when combined with letrozole, significantly improved pregnancy rates compared to letrozole alone (RR: 2.60, 95% CI: 1.06 to 6.39, p=0.04). While promising, this evidence is primarily from Chinese populations. Additionally, in vitro studies suggest potential anti-inflammatory effects, with extracts reducing pro-inflammatory cytokines like TNF-α. Other potential benefits, such as improved microcirculation, antioxidant activity, and modulation of metabolic parameters, have been suggested but require further high-quality clinical validation.

How it works

The therapeutic actions of Salvia miltiorrhiza are attributed to its primary bioactive compounds: tanshinones and salvianolic acids. These compounds exert their effects through multiple mechanisms. They possess antioxidant properties, neutralizing harmful free radicals, and exhibit anti-inflammatory actions by downregulating pro-inflammatory cytokines such as TNF-α and modulating endothelial function. Furthermore, tanshinones and salvianolic acids contribute to improved blood flow by reducing blood viscosity and inhibiting platelet aggregation, thereby enhancing microcirculation. The absorption and bioavailability of these compounds can be influenced by the specific extract preparation, with lipophilic tanshinones generally having moderate bioavailability.

Side effects

Salvia miltiorrhiza is generally considered possibly safe when taken orally within recommended dosages. Common side effects, reported in over 5% of users, include mild gastrointestinal upset, itching, and reduced appetite. A significant and important risk associated with *S. miltiorrhiza* is its potential to increase bleeding tendency due to its blood-thinning effects. Therefore, it is contraindicated in individuals with bleeding disorders or those concurrently taking anticoagulant medications (e.g., warfarin, heparin) or antiplatelet drugs (e.g., aspirin, clopidogrel). Due to insufficient safety data, *S. miltiorrhiza* should be avoided or used with extreme caution during pregnancy and breastfeeding. It may also lower blood pressure, necessitating caution in patients with hypotension or those on antihypertensive medications. To minimize the risk of bleeding complications, it is strongly recommended to discontinue *S. miltiorrhiza* at least two weeks prior to any scheduled surgical procedures.

Dosage

There is no universally standardized dosing for Salvia miltiorrhiza, as clinical trials often utilize extracts standardized to specific active compounds like tanshinones or salvianolic acids. In cardiovascular studies, typical oral doses of *S. miltiorrhiza* extract range from 200 mg to 1,000 mg daily, with the exact amount depending on the standardization of active compounds. For reproductive health, specifically in PCOS studies where it was combined with letrozole, the effective doses were consistent with traditional TCM formulations, though precise milligram dosages varied across studies. The timing of administration and the specific formulation (e.g., water vs. ethanol extracts) can significantly influence the bioavailability and overall efficacy of the supplement. It is crucial to follow product-specific guidelines or consult a healthcare professional for personalized dosing recommendations, especially given the potential for drug interactions and bleeding risks.

FAQs

Is Salvia miltiorrhiza safe for long-term use?

Generally, it is considered safe for long-term use, but continuous monitoring for potential bleeding risks and blood pressure changes is advisable, especially if you have pre-existing conditions or are on other medications.

Can Salvia miltiorrhiza be used as a standalone treatment for PCOS or heart disease?

Current evidence primarily supports its use as an adjunctive therapy, meaning it should be used in combination with conventional treatments rather than as a monotherapy for conditions like PCOS or heart disease.

How long does it take to see benefits from Salvia miltiorrhiza?

Clinical improvements, particularly in cardiovascular or reproductive outcomes, may not be immediately apparent and can take several weeks to a few months of consistent use to manifest.

Is Salvia miltiorrhiza the same as common sage?

No, Salvia miltiorrhiza (Red Sage or Danshen) is a distinct species from Salvia officinalis (common sage). They have different chemical compositions and traditional uses.

Research Sources

https://onlinelibrary.wiley.com/doi/10.1155/2021/9971403 – This systematic review and meta-analysis of 6 RCTs (n=390 women with PCOS) found that Salvia miltiorrhiza combined with letrozole significantly improved pregnancy rates compared to letrozole alone (RR: 2.60, p=0.04). The study highlights its potential as an adjunctive therapy for PCOS, though it notes moderate heterogeneity and a focus on Chinese populations.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9101933/ – This in vitro study investigated the anti-inflammatory effects of Salvia officinalis (a related species) extract, showing a 35% reduction in TNF-α and modulation of IL-6 and IL-8 levels. While not directly on S. miltiorrhiza, it provides preclinical insight into potential anti-inflammatory mechanisms within the Salvia genus.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5421141/ – This review of clinical trials (2000–present) on Salvia miltiorrhiza in cardiovascular diseases reported significant reductions in blood viscosity and platelet aggregation, with clinical efficacy rates of 75-94% in angina and other CVDs. The review supports its role in improving cardiovascular health, despite acknowledging that many included trials were open-label or non-blinded.
https://www.webmd.com/vitamins/ai/ingredientmono-931/danshen – This source provides a general overview of Danshen (Salvia miltiorrhiza), outlining its common uses, potential side effects, and safety considerations. It emphasizes that Danshen is possibly safe when taken orally but highlights important warnings regarding bleeding risk, pregnancy, and interactions with medications.