What is Dong Quai?
Dong Quai (Angelica sinensis), also known as Chinese Angelica, Dang Gui, or Tang Kuei, is a perennial herb from the Apiaceae family (same family as carrots, celery, and parsley). It's one of the most important herbs in Traditional Chinese Medicine (TCM), often called "female ginseng" due to its traditional use for women's health conditions.
The medicinal properties come primarily from the root, which has been used for over 2,000 years in Asian medicine. Dong Quai is rarely used alone in TCM but typically combined with other herbs in formulations.
Active Compounds & Constituents
Dong Quai contains over 70 bioactive compounds:
Primary Active Compounds:
Ligustilide: The signature volatile oil compound with antispasmodic, analgesic, and neuroprotective properties
Ferulic Acid: A potent antioxidant with anti-inflammatory and cardiovascular benefits
Coumarins: At least six coumarin derivatives (angelol, angelicone, osthole) that provide vasodilatory and antispasmodic effects
Polysaccharides: Immune-modulating sugars that support immune function and reduce fatigue
Butylidenephthalide & Butylphthalide: Compounds with smooth muscle relaxant properties
Additional Components:
Furanocoumarins (psoralen, bergapten, imperatorin)
Phytosterols (beta-sitosterol, stigmasterol)
Vitamins E, A, and B12
Organic acids (succinic, myristic)
Essential oils
Flavonoids
Important Note: Dong Quai does NOT contain actual estrogen but may have mild estrogenic activity through its phytochemical compounds.
Primary Functions & Benefits
Traditional Uses:
Menstrual Support: Regulating cycles, reducing cramps (dysmenorrhea), and managing irregular periods
Menopausal Symptoms: Addressing hot flashes, night sweats, and hormonal transitions
Blood Health: "Blood nourishing" in TCM - supporting circulation and addressing anemia
PMS Relief: Reducing bloating, breast tenderness, mood swings, and irritability
Evidence-Based Benefits:
Women's Health:
May help normalize menstrual cycles and reduce menstrual pain
Potential relief for some menopausal symptoms (though clinical evidence is mixed)
Supports hormonal balance through phytoestrogenic activity
Cardiovascular & Circulation:
Improves blood flow and circulation
May help regulate blood pressure
Anticoagulant properties (reduces blood clotting)
Potential cardioprotective effects
Anti-Inflammatory & Pain Relief:
Reduces inflammation throughout the body
Analgesic properties for joint and muscle pain
May benefit arthritis and rheumatic conditions
Bone Health:
May help prevent osteoporosis by supporting bone density
Stimulates bone cell formation and regeneration
Particularly relevant for postmenopausal women
Neuroprotective Effects:
Protects nerve cells from oxidative damage
Improves blood flow to the brain
May support cognitive function
Other Potential Benefits:
Blood sugar regulation
Immune system support
Antioxidant protection
May have anti-cancer properties (requires more research)
Recommended Dosages
Standard Supplement Forms:
Capsules/Tablets:
Typical dose: 500-1,000 mg, 1-3 times daily
Standardized extracts: Often standardized to 1% ligustilide content
Maximum: Up to 3,000 mg daily (divided doses)
Powdered Root:
1-2 grams, 3 times daily
Tincture/Liquid Extract:
10-40 drops, 1-3 times daily
1 mL, 3 times daily
Traditional Decoction (TCM preparation):
3-15 grams of crude root extract per day
Clinical Trial Doses:
Studies have used 4.5 grams daily for menopausal symptoms
Combination formulas: 75-500 mg up to 6 times daily
Duration:
Generally safe for up to 6 months of continuous use
Taking it for longer than 6 months may be unsafe due to potential carcinogenic compounds
Consult a qualified TCM practitioner for personalized formulations
Food Sources
Dong Quai is NOT typically consumed as a food but used exclusively as a medicinal herb through supplements and traditional preparations. The root is the only part used medicinally.
Timing & Administration
When to Take:
With meals to minimize gastrointestinal upset
Morning or evening - no significant timing preference
Consistency matters more than specific timing
Absorption Enhancement:
May be better absorbed when taken with food
Traditional TCM formulations often combine it with complementary herbs
No specific requirement for fat intake (unlike fat-soluble vitamins)
Synergistic Supplements & Herbs
Take WITH Dong Quai (Traditional TCM Combinations):
Women's Health Formulas:
Black Cohosh: For menopausal symptoms
Chasteberry (Vitex): For hormonal balance and PMS
Red Clover: For menopausal support
Rehmannia: Traditional TCM pairing for menopause
Astragalus: For immune support and energy
Peony (White Peony): For menstrual cramps and PMS
Bupleurum: For premenstrual irritability
Circulation & Heart Health:
Ginseng (Panax): Often combined in TCM formulas
Hawthorn: For cardiovascular support
Bone Health:
Calcium & Vitamin D: For osteoporosis prevention
Magnesium: For bone density
Famous TCM Formula:
"Four Things Soup" (Si Wu Tang): The most widely used women's tonic in China, containing Dong Quai, Rehmannia, White Peony, and Ligusticum
Interactions & What NOT to Take
AVOID Combining With:
Blood Thinners (MAJOR INTERACTION):
Warfarin (Coumadin): Significantly increases bleeding risk
Heparin: Additive anticoagulant effects
Clopidogrel (Plavix): Enhanced antiplatelet effects
Aspirin: Increased bleeding tendency
Other Herbs That Thin Blood:
Garlic supplements
Ginger (high doses)
Ginkgo biloba
Turmeric/Curcumin
Horse chestnut
Red clover
Feverfew
Danshen
Hormone Therapies:
Birth control pills: May alter effectiveness
Hormone replacement therapy (HRT): Potential additive effects
Estrogen medications: May increase estrogenic side effects
Other Medications:
NSAIDs (ibuprofen, naproxen): Increased bleeding risk
Isotretinoin (Accutane): Potential interactions
Antidepressants: Possible interactions with certain types
Antipsychotic medications: May affect drug metabolism
Clozapine: Dong Quai induces metabolism, reducing effectiveness
Lisinopril (ACE inhibitor): May worsen anemia
Photosensitizing Drugs:
Avoid combining with medications that increase sun sensitivity, as Dong Quai already causes photosensitivity
Who Should Take Dong Quai
Ideal Candidates:
Women with Menstrual Issues:
Irregular or absent periods
Painful menstrual cramps
Heavy or light menstrual flow
PMS symptoms
Perimenopausal & Menopausal Women:
Hot flashes and night sweats
Mood swings and irritability
Hormonal imbalances
Circulatory Problems:
Poor circulation
Cold hands and feet
Anemia ("tired blood" in TCM)
Other Conditions:
Joint pain and arthritis
Chronic inflammation
Mild hypertension
Fatigue and low energy
Who Should AVOID or Use Extreme Caution
Absolute Contraindications:
Pregnant Women:
Can stimulate uterine contractions
May cause miscarriage
Increases risk of birth defects (especially first trimester)
Breastfeeding Women:
Insufficient safety data
Best avoided during lactation
Hormone-Sensitive Cancers:
Breast cancer (past or current)
Ovarian cancer
Uterine cancer
Endometriosis
Uterine fibroids
Any estrogen-dependent conditions
Bleeding Disorders:
Hemophilia
Von Willebrand disease
Thrombocytopenia
Any condition with increased bleeding risk
Surgery Patients:
Stop at least 2 weeks before scheduled surgery
Increases bleeding risk during and after procedures
Heavy Menstrual Bleeding:
May worsen excessive menstrual flow
Use With Caution:
People taking anticoagulant or antiplatelet medications
Those with chronic intestinal diseases (diverticulitis, IBS)
Individuals undergoing radiation therapy
People with sun sensitivity
Anyone taking medications metabolized by CYP3A4 enzyme
Men (though some use for premature ejaculation in topical creams)
Deficiency/Need Indicators
In TCM, Dong Quai is traditionally used for "Blood Deficiency" which manifests as:
Signs You May Need Blood Nourishment:
Pale complexion and pale nail beds
Fatigue and weakness
Dizziness or lightheadedness
Scanty or absent menstrual periods
Dry skin and hair
Poor circulation (cold extremities)
Insomnia
Heart palpitations
Blurred vision
Numbness or tingling in extremities
Anxiety
Western Medicine Equivalents:
Iron deficiency anemia
Poor circulation
Hormonal imbalances
Chronic stress and fatigue
Side Effects & Adverse Reactions
Common Side Effects:
Gastrointestinal upset: Burping, gas, bloating, nausea, diarrhea
Photosensitivity: Increased sensitivity to sunlight, sunburn risk, skin rashes
High blood pressure (in some individuals)
Appetite loss
Headaches
Serious Side Effects:
Easy bruising or bleeding: Nosebleeds, bleeding gums, blood in urine/stool
Gynecomastia in men: Enlarged breast tissue (reversible when discontinued)
Allergic reactions: Rash, hives, difficulty breathing (rare)
Menstrual changes: Heavier or longer periods in some women
Diarrhea (with extended use)
Long-Term Concerns:
Potential carcinogenicity: Contains compounds like safrole that may be cancer-causing with long-term high-dose use
Most experts recommend limiting use to 6 months maximum
Photodermatitis Risk:
The furanocoumarins in Dong Quai (especially psoralen and bergapten) make skin extremely sensitive to UV light. This can cause:
Severe sunburns
Skin rashes and blistering
Long-term skin damage
Protection Required: Use SPF 30+ sunscreen and protective clothing when taking Dong Quai
Toxicity
Acute Toxicity:
Limited data exists, but animal studies show relatively low acute toxicity. Very large amounts have been given to rats without immediate harm.
Chronic Toxicity:
Long-term use (>6 months) may pose cancer risk
Contains safrole (a known carcinogen)
Potential for cumulative effects on blood clotting
May cause liver stress with prolonged use
Overdose Signs:
Severe gastrointestinal distress
Excessive bleeding or bruising
Extreme photosensitivity
Severe skin reactions
Note: There are no established toxic dose levels for humans, but following recommended dosages is essential.
Special Considerations
Quality & Safety Concerns:
Species confusion: Different Angelica species (A. sinensis, A. acutiloba, A. gigas) are sometimes substituted but have different chemical profiles
Contamination: Herbal supplements may contain heavy metals, pesticides, or other adulterants
Standardization: Product potency varies widely between manufacturers
Purchase from reputable sources with third-party testing
Traditional vs. Modern Use:
TCM practitioners rarely use Dong Quai alone - it's almost always in combination formulas
Western supplements often contain isolated Dong Quai, which may be less effective
TCM considers individual constitution when prescribing, not just symptoms
Research Limitations:
Mixed clinical evidence: Many studies show no effect on menopausal symptoms
Most positive results come from combination formulas, not isolated Dong Quai
Many studies are small, short-term, or of poor quality
More rigorous research is needed
Men and Dong Quai:
While marketed as "female ginseng," men have used Dong Quai for:
Premature ejaculation (topical application in combination creams)
Circulation issues
Joint pain
However, gynecomastia risk makes it generally unsuitable for male use.
Pregnancy & Fertility Considerations
Pregnancy:
AVOID COMPLETELY
May stimulate uterine contractions
Increases miscarriage risk
Potential birth defects (especially in first trimester)
Traditional Chinese medicine also contraindicates use in pregnancy
Fertility:
Conflicting evidence: Some TCM practitioners use it to support fertility
May help regulate menstrual cycles, indirectly supporting conception
However, no strong scientific evidence for fertility enhancement
Should be discontinued once pregnancy is confirmed
Postpartum:
Some TCM formulas use Dong Quai postpartum for recovery
May support lactation in some traditional formulas
Best used under guidance of qualified practitioner
Evidence Quality & Clinical Research
Strong Evidence:
Antispasmodic and smooth muscle relaxant properties (laboratory studies)
Anti-inflammatory effects (animal studies)
Anticoagulant activity (documented case reports)
Moderate Evidence:
Cardiovascular benefits (limited human trials)
Bone health support (animal and preliminary human studies)
Pain relief for dysmenorrhea (traditional use, limited trials)
Weak/Inconclusive Evidence:
Menopausal symptom relief: Most rigorous studies show no benefit over placebo when used alone
Hot flash reduction in men receiving hormone therapy: ineffective
Effectiveness alone vs. in combination formulas: unclear
Promising Areas Needing More Research:
Anti-cancer properties
Neuroprotective effects
Immune modulation
Blood sugar regulation
Summary & Key Takeaways
Dong Quai is a traditional Chinese herb with a rich history in women's health, particularly for menstrual and menopausal concerns. While it contains numerous bioactive compounds with anti-inflammatory, antispasmodic, and circulation-enhancing properties, clinical evidence for its effectiveness is mixed, especially when used alone.
Key Points:
Best used under guidance of a qualified TCM practitioner as part of combination formulas
Generally safe for short-term use (up to 6 months) in healthy adults
Avoid during pregnancy, breastfeeding, and with hormone-sensitive cancers
Never combine with blood thinners without medical supervision
Always use sun protection due to photosensitivity effects
Purchase from reputable manufacturers with third-party testing
Bottom Line: Dong Quai may offer benefits for menstrual regulation, circulation, and pain relief, but should be approached with caution due to significant drug interactions, photosensitivity, and pregnancy risks. The strongest traditional use is as part of balanced TCM formulations rather than as a standalone supplement. Always consult healthcare providers before starting Dong Quai, especially if taking medications or have existing health conditions.