dong quai

Action and Spectrum

Actions and Spectrum: 

The mechanism of action of dong quai is not fully understood, but it is thought to have estrogen-like effects on the body. dong quai contains coumarins and phytoestrogens, which can bind to estrogen receptors and activate them. This can lead to changes in the body’s hormonal balance and may help to alleviate symptoms associated with hormonal imbalances, such as menopause and menstrual irregularities. 

dong quai also contains other active compounds, such as ferulic acid and ligustilide, which have anti-inflammatory and antioxidant properties. These compounds may help to reduce inflammation in the body and protect against oxidative stress, which can contribute to chronic diseases such as cancer and cardiovascular disease. 

The spectrum of activity of dong quai is primarily related to women’s health. It is often used to treat symptoms associated with menopause, such as hot flashes, night sweats, and vaginal dryness. It may also regulate the menstrual cycle and alleviate symptoms associated with premenstrual syndrome (PMS) and menstrual cramps. Additionally, dong quai may treat conditions such as endometriosis and fibroids. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Safrole, in essential oil, is carcinogen 

Potential mutagen 

Photodermatitis (especially A. archangelica) 

Photosensitivity 

Black Box Warning

Contraindication / Caution

Contraindications/caution: 

Contraindications: 

Pregnancy and breastfeeding: dong quai has been used historically to promote menstruation and may stimulate uterine contractions, which can be dangerous during pregnancy. It is not recommended for use during pregnancy or breastfeeding. 

• Bleeding disorders: dong quai can increase the risk of bleeding and should be avoided by people with bleeding disorders or those taking blood-thinning medications. 

• Allergies: Some people may be allergic to dong quai, especially those allergic to other members of the Apiaceae family (such as carrots, celery, or parsley). 

• Hormone-sensitive conditions: dong quai contains compounds that can act like estrogen in the body and may worsen conditions like breast cancer, endometriosis, and uterine fibroids. 

• Liver disease: dong quai can affect liver function and should be used cautiously by people with liver disease. 

• Medication interactions: dong quai may interact with certain medications, including blood-thinning medications, hormonal medications, and drugs metabolized by the liver. It is essential to talk to your healthcare provider before taking dong quai if you are on any medications. 

Caution: 

• Dose-dependent effects: dong quai can have different effects on the body depending on the dosage. High doses can cause adverse effects such as headaches, dizziness, and upset stomach. It is important to follow the recommended dosage instructions. 

• Duration of use: dong quai should not be used for prolonged periods, especially in high doses. Long-term use can lead to liver damage. 

• Interactions with medications: dong quai may interact with certain medications, including blood thinners, anti-inflammatory drugs, and hormone medications. It is essential to talk to a healthcare provider before taking dong quai if you are on any medications. 

• Allergic reactions: dong quai is a member of the Apiaceae family, and some individuals may be allergic to it. Allergic reactions can range from mild skin irritation to anaphylaxis. 

• Pregnancy and breast-feeding: As mentioned earlier, dong quai is not recommended for use during pregnancy or breastfeeding. 

• Surgery: dong quai may increase the risk of bleeding during and after surgery. It is advised to stop taking dong quai at least two weeks before surgery. 

Pregnancy / Lactation

Pregnancy consideration: dong quai is not recommended for use during pregnancy or breastfeeding  

Lactation: dong quai is not recommended for use during breastfeeding 

Pregnancy category: 

Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.   

Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.    

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category 

Pharmacology

Pharmacology: 

The pharmacology of dong quai is complex and needs to be fully understood. While some studies have suggested that it may benefit certain conditions, more research is needed to evaluate its safety and effectiveness fully. 

Pharmacodynamics: 

The pharmacodynamics of dong quai involve its interactions with various receptors and enzymes in the body. One of the primary active compounds in dong quai is ligustilide, which has been shown to have several pharmacological effects. 

• Ligustilide has been shown to have antispasmodic effects on smooth muscle, potentially helpful in treating conditions such as menstrual cramps and gastrointestinal disorders. It has also been shown to have anti-inflammatory effects, which could help treat conditions such as rheumatoid arthritis. 

• In addition, ligustilide has been shown to have neuroprotective effects, potentially through its ability to increase blood flow to the brain and protect against oxidative stress. Some studies have suggested that dong quai may benefit cognitive function, although more research is needed to confirm this. 

Pharmacokinetics: 

Absorption 

dong quai is primarily taken orally in capsules, tablets, or teas. 

The bioavailability of dong quai is low and highly variable due to its complex mixture of active compounds and potential interactions with other drugs or supplements. 

Some studies suggest that the absorption of dong quai may be improved by co-administration with piperine (a compound found in black pepper) or certain types of fats.  

Distribution 

In animal studies, the active compounds in dong quai, such as ligustilide and ferulic acid, have been detected in various tissues and organs.However, there is limited information on the distribution of dong quai in humans.  

Metabolism 

dong quai is metabolized in the liver by enzymes such as CYP3A4 and CYP2D6. 

The active compounds in dong quai undergo various metabolic reactions, such as hydroxylation, demethylation, and glucuronidation, which may affect their biological activity and toxicity. 

Some studies suggest that dong quai may induce or inhibit certain cytochrome P450 enzymes, which could potentially affect the metabolism of other drugs.  

Elimination and Excretion 

The elimination half-life of dong quai in humans is not well established. 

Some studies suggest that the active compounds in dong quai are excreted mainly in the urine and feces 

Adminstartion

Administration: 

dong quai is available in various forms, including capsules, tablets, and teas. The appropriate dosage and administration of dong quai will depend on the individual and their specific health needs. As with any herbal supplement, following the manufacturer’s instructions and not exceeding the recommended dose is essential.  

It is also important to note that dong quai may increase the risk of bleeding and should not be used by individuals with bleeding disorders or those taking blood-thinning medications. Pregnant and breastfeeding women should also avoid dong quai as its effects on fetal development and milk production are not fully understood. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: dong quai 

Why do we use dong quai? 

dong quai (Angelica sinensis) is a perennial plant native to China, Japan, and Korea. It has been used in Traditional Chinese Medicine (TCM) for thousands of years and is often referred to as the “female ginseng” because of its reputation as a female tonic. 

Some of the traditional uses of dong quai include: 

• Menstrual irregularities: dong quai is commonly used to treat menstrual irregularities, including painful periods, absent periods, and heavy bleeding. 
• Menopausal symptoms: dong quai is also used to relieve hot flashes, night sweats, and other symptoms associated with menopause. 
• Anemia: dong quai is believed to help increase the production of red blood cells and improve circulation, making it helpful in treating anemia. 
• Digestive issues: dong quai has been used to relieve digestive issues such as constipation, bloating, and indigestion. 
• Skin health: dong quai is believed to improve skin health by increasing blood flow and promoting cell regeneration. 
• Immune system support: dong quai is thought to support the immune system by stimulating the production of white blood cells.