Dong quai has been used for over a thousand years as a spice, tonic, and
medicine in China, Korea and Japan. Although there have been few definitive
studies on dong quai, it is reputed to relieve constipation, increase red blood
cell count (which helps treat anemia), and to provide relief from menstrual
disorders such as cramps, irregular menstrual cycles, infrequent periods,
premenstrual syndrome (PMS), and menopausal symptoms. In Traditional Chinese
Medicine, it is used for a variety of purposes, including reproductive,
circulatory, and respiratory conditions.
Plant Description
Dong quai grows at high altitudes in the cold, damp, mountain regions of
China, Korea and Japan. This fragrant, perennial plant has smooth purplish stems
and bears umbrella-shaped clusters of white flowers and winged fruits in July
and August. The yellowish-brown thick-branched roots of the dong quai plant have
a number of medicinal uses. It takes three years for the plant to reach
maturity, after which time the root is harvested and formulated into tablets,
powders, and other medicinal forms.
Medicinal Uses and Indications
Dong quai contains compounds that, in laboratory tests, have demonstrated
activities that may translate into reduction of pain, dilation of blood vessels,
and stimulation as well as relaxation of uterine muscles. Animal studies suggest
that dong quai may treat abnormal heart rhythm, prevent accumulation of
platelets in blood vessels (contributing to plaque formation or
atherosclerosis), protect the liver, promote urination, act as a mild laxative,
promote sleep, and fight infection.
The scientific evidence regarding the use of dong quai in people is weak. The
data consist primarily of laboratory and animal studies as described above, with
a few preliminary studies in people. More studies are needed to determine the
herb's safety and effectiveness in humans.
Treatment
Reports and studies of possible uses of dong quai include the
following:
Menopausal symptoms—some women report relief
of symptoms such as hot flashes from this medicinal herb; however, clinical
studies to date do not support the effectiveness of dong quai for menopausal
symptoms.
PMS—studies suggest that dong quai offers
some value when used in conjunction with other Chinese herbs, particularly black
cohosh, to treat PMS.
Anemia—there are individual reports of
successful treatment of anemia using dong quai, but to date no studies verify
this.
Heart disease—when used in combination with
ginseng (Asian ginseng) and astragalus (Astragalus membranaceus), dong quai
decreased symptoms of chest pain and improved exercise tolerance in a small
group of people with heart disease.
Stroke—a series of reports published in China
indicate that the use of dong quai just following a stroke demonstrated a
decrease in the amount of brain damage; more research is needed.
High blood pressure—reports indicate that
dong quai may lower blood pressure in some individuals.
Ulcers—animal studies suggest dong quai may
soothe ulcers, but studies in people are needed before a definitive conclusion
can be drawn.
Other conditions for which dong quai has been used clinically, although
studies are still lacking:
Constipation
Migraine headache
Pain
Liver disorders
Dosage and Administration
In different parts of the world, dong quai is available in a variety of forms
including tablets, powders, and injectable solutions. The latter are used in
China and Japan in appropriate hospital or health center settings; injectable
solutions are not available commercially in the United States or other Western
countries and homemade injectable solutions should never be used.
Dong quai should be stored in a cool, dry place and, like all herbal
products, be used prior to the expiration date.
Pediatric
Dong quai is not recommended for children because no information relating to
appropriate doses of the herb for children has been found in the literature to
date.
Adult
Dried herb (raw root) may be boiled or soaked in wine before consuming.
Powdered herb (available in capsules)—500 to 600 mg
tablets or capsules up to 6 times per day.
Tincture (1:5, 70% alcohol): 40 to 80 drops (equivalent to 2 to 4 mL; there
are 5 mL in a teaspoon) 3 times per day.
Precautions
Drinking the essential oil of dong quai is not recommended because it
contains a small amount of cancer-causing substances. The amount of oil in the
herb and its extracts is not significant and is not a health concern.
Dong quai should not be used by those who have chronic diarrhea or abdominal
bloating.
Side Effects
Dong quai, particularly at high doses, may increase an individual's
sensitivity to sunlight and subsequently cause skin inflammation and rashes.
People taking dong quai should minimize their exposure to sunlight or use
sunscreen while taking the herb.
Pregnancy and Breastfeeding
Dong quai should not be used during pregnancy because it may affect the
muscular functioning of the uterus. It should also be avoided by nursing
mothers, because there is little information about its effect on the infant
through breast milk.
Pediatric Use
Dong quai should not be given to children because of the lack of information
regarding its use in this age group.
Interactions and Depletions
Dong quai may interact with the following medications and herbs:
Warfarin Dong quai can increase the potency and, therefore,
potential risks of blood-thinning medications, such as warfarin, so it should
not be taken with these medicines.
Hormone medications Although there is little research on the
use of dong quai with hormone medications such as estrogens, progesterones, oral
contraceptives, tamoxifen or raloxifene, health practitioners advise against
using them together due to the possibility of adverse effects.
Blood-thinning herbs Although reported extremely rarely and
not published in the scientific literature, combining dong quai with other herbs
that thin the blood could possibly increase the risk of bleeding in some people.
Herbs with such potential that should be used only with tremendous caution and
supervision when combined with dong quai include feverfew (Tanecetum
parthenium), garlic (Allium sativum), ginger (Zingiber officinale), ginkgo
(Ginkgo biloba), ginseng (Asian ginseng), licorice (Glycyrrhiza glabra), chinese
skullcap (Scutellaria baicalensis), and turmeric (Curcuma longa).
Herbs or medications that cause sun sensitivity Given that
dong quai may increase an individual's sensitivity to sunlight, it should not be
taken with other medications or herbs (such as St. John's wort) that cause the
same reactions.
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Review Date: March 2001
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh
(Pediatric Dosing section February 2001), Johnson Drugs, Natick, MA; Steven
Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's
Administrative Hospital, Londonderry, NH; David Winston, Herbalist, Herbalist
and Alchemist, Inc., Washington, NJ.
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