Dong Quai

Dong quai is prepared from the root of Angelica sinensis, an aromatic perennial herb in the family Apiaceae, the same botanical family as carrots and parsley ^[2]. Native to China and cultivated in cool, high-altitude regions of East Asia, the plant is widely known as female ginseng because of its long association with women's health ^[2]. In traditional Chinese medicine the dried root is one of the most commonly used remedies.

Historically, dong quai has been used, usually as part of multi-herb formulas, for menstrual irregularities, cramping, and menopausal symptoms, and it is described in traditional practice as a tonic that nourishes and moves the blood ^[2]. Chemical analyses have identified a range of constituents, among them the aromatic compound ligustilide and related phthalides, ferulic acid, polysaccharides, and phytosterols. The root also contains natural coumarin derivatives, and analyses have noted constituents with antithrombotic and light-sensitizing properties ^[3].

Despite its popularity, modern scientific research has not established that dong quai is effective for the conditions it is traditionally used to treat ^[2]. A frequently cited double-blind, placebo-controlled trial in postmenopausal women found that dong quai taken on its own did not relieve hot flashes and produced no measurable estrogen-like effect on the body ^[1]. Broader reviews of complementary treatments for menopause have likewise concluded that the evidence for dong quai is insufficient to recommend it ^[2].

The most clearly documented safety concern involves the plant's coumarin content: a case report described a woman stabilized on the anticoagulant warfarin whose blood-thinning effect increased markedly after she began taking dong quai, raising the risk of bleeding ^[3]. For this reason, caution is advised when it is combined with warfarin or other blood-thinning agents ^[3]. Some of its constituents can also make the skin more sensitive to sunlight. In the United States and other Western countries dong quai is sold as a dietary supplement, frequently in combination products, and is not regulated or approved as a drug ^[2].

Usually well tolerated, but the coumarin content means it can add to the effect of blood thinners like warfarin, raising bleeding risk. It may cause photosensitivity and GI upset in some people. It's not recommended in pregnancy because of potential effects on the uterus.