dong quai

n.
A perennial aromatic herb (Angelica sinensis) native to China and Japan, yielding a root that is used medicinally for gynecological disorders such as premenstrual syndrome, menstrual cramps, and menopausal symptoms.

[Chinese (Mandarin) dāng guī : dāng, should, ought + guī, return (from the belief that it causes blood to return where it should).]

The root of Angelica Sinensis, used in traditional Chinese medicine. See also angelica.

Description

Dong quai (Angelica sinensis), also called Chinese angelica, is a member of the Umbelliferae (Apiaceae), or carrot family. This Oriental medicinal herb is sometimes called the empress of herbs, or female ginseng.

Dong quai grows best in such damp places as moist meadows, river banks, and mountain ravines. It may be biennial or perennial. The bitter-sweet root, described by some herbalists as resembling carved ivory, is used medicinally. Dong quai, variously known as dang gui or tang kuei, produces a round, hollow, grooved stem that grows as high as 7 ft. The lower leaves are large and tri-pinnate, each further divided into two or three leaflets. The smaller upper leaves are pinnate, which means that the leaflets are arranged in opposite rows along the leaf stalk. The leaves of dong quai resemble those of carrot, celery, or parsley and emerge from dilated sheaths surrounding a bluish-colored stem that is branched at the top. Honey-scented, greenish-white flowers grow in large compound flat-topped clusters and bloom from May to August.

General Use

Dong quai is one of the most extensively researched Chinese medicinal herbs. It is well known as a female remedy thought to benefit women throughout the menstrual cycle and during the transition to menopause. A recent study indicates that dong quai is a popular herbal remedy among women being treated for ovarian cancer. Dong quai has been used in China for thousands of years to treat ailments of the female reproductive system and as a tonic herb to treat fatigue, mild anemia, high blood pressure and poor circulation in both men and women. Chinese herbalists prepare dong quai in combination with other herbs, including astragalus (Astragalus membranaceus) as a fatigue tonic, mugwort (Artemesia vulgaris), bai shao (white peony), chai hu (bupleurum root),and rou gui (cinnamon bark) in medicinal formulas for women. Secondary herbs are used to enhance the action of the primary ingredient or to provide additional properties that work synergistically with the primary ingredient. Research in the United States indicates that dong quai has no demonstrable estrogen-like effect on menopausal women when it is used alone. However, other research has shown that dong quai, when used in combination with other herbs, resulted in a reduction of the severity of hot flashes, vaginal dryness, insomnia, and mood changes. Dong quai should not be regarded as a replacement for natural estrogen. Its unique mechanism of action reportedly promotes the synthesis of natural progesterone, a hormone whose production declines during menopause. Dong quai's ability to relieve menstrual problems has been attributed to its muscle-relaxing properties and its ability to quiet spasms in the internal organs. Dong quai has a tonic effect on all female reproductive organs and increases blood flow to the uterus. It acts to increase vaginal secretions and to nourish vaginal tissue. Dong quai root's analgesic properties help diminish uterine pain and have been found to be as much as 1.7 times as effective as aspirin. The herb has also been useful in the treatment of migraine headaches.

One recent Western study, however, has called into question the value of dong quai for treating menopausal symptoms. The authors of the study found that black cohosh appears to be a more effective herbal remedy for hot flashes and other symptoms associated with menopause.

Research in China indicates that dong quai stimulates production of the red blood cells that carry oxygen throughout the body. Its sedative properties relieve emotional distress and irritability. It is used to treat mild anemia and as a liver tonic. The herb is beneficial to the endocrine and circulatory systems, promoting healthful blood circulation. Its laxative properties ease constipation, particularly in the elderly. This beneficial herb has also been proven effective against certain fungi, such as Candida albicans, the primary cause of vaginal yeast infection. Dong quai also helps to dissolve blood clots.

Dong quai contains high amounts of vitamin E, iron, cobalt, and other vitamins and minerals important to women, including niacin, magnesium, potassium, and vitamins A, C, and B₁₂. The plant contains numerous phytochemicals, including coumarins, phytosterols, polysaccharides, and flavonoids.

European angelica (A. archangelica) stimulates secretion of gastric juices and has been used to treat digestive problems, flatulence, and loss of appetite. The root of European angelica has sometimes been used in cases of prolonged labor or to treat problems with retention of the placenta after childbirth.

American angelica (A. atropurpurea) has also been used by some herbalists for menstrual complaints, though the Chinese dong quai is most often used in formulas for women.

Preparations

The medicinal part of the angelica plant is the root. Dong quai root can be prepared as an infusion or decoction, tincture, tablet, or capsule. It is also available dried, either whole, diced, or sliced. The herb is nontoxic, but recent findings suggest caution in using it over an extended period of time. The dried root may be chewed in quarter inch segments two to three times daily, up to three to four grams per day.

Infusion or decoction: Research indicates that extracts of dong quai that retain the volatile constituents act to raise blood pressure and relax uterine muscles. An infusion of the root, steeped in hot water, retains the volatile constituents and is useful to treat dysmenorrhea and to quiet uterine spasm. For amenorrhea, where stimulation of the uterine muscles is sought, a decoction is the indicated. Simmer the root in water to evaporate the volatile constituents. Most Chinese herbalists use dong quai in combination with other herbs depending on the problems being addressed and these are prepared together.

Alcohol tincture: Combine fresh or dry, chopped root with enough alcohol to cover in a glass container. Alcohol should be of good quality. A 50/50 alcohol/water ratio is optimal. If the alcohol is not 100 proof, add pure water to obtain a 50/50 ratio. Brandy, vodka, and gin are often used. Seal the mixture in an air-tight container and set aside in a dark place for about two weeks. Shake daily. Strain through cheesecloth or muslin and store in dark containers for up to two years. Dosage: 10-40 drops of the fresh root tincture one to three times daily.

Precautions

Pregnant or lactating women are advised not to use dong quai. Menstruating women who are experiencing unusually heavy bleeding should discontinue use of dong quai without advice of a qualified herbal practitioner, because in certain preparations the herb may act to increase the blood flow. Consult a qualified herbalist before use if fibroids are present, or when there is unusual breast tenderness.

Dong quai should not be used as a substitute for hormonal replacement therapy, or HRT. Women who are concerned about the possible side effects of HRT should consider fo-ti or such other herbs as licorice and hops.

Side Effects

Dong quai has been considered quite safe; however, it may cause minor gastric upset in sensitive individuals. Stomach upset can be eliminated if dong quai is combined with other herbs in preparation. The herb may also increase sensitivity to the sun and other ultraviolet exposure in fair-skinned individuals.

More seriously, a study published in 2002 reported that dong quai appears to encourage the growth of breast cancer cells independent of its estrogenic activity. The researchers recommend cautious use of dong quai until definitive studies can be performed. Interestingly, two teams of researchers in the United States and China respectively reported in 2003 that dong quai appears to suppress the growth of human prostate cancer cells.

Interactions

Some herbalists suggest that fruit consumption be decreased when using dong quai.

As of 2003, dong quai has been reported to interact with some prescription medications, particularly anticoagulant and antiplatelet drugs. Dong quai appears to have an additive effect with these medications, increasing bleeding time. In May 2002 the FDA added dong quai to the list of herbal products not to be used together with sodium warfarin (Coumadin).

Dong quai has also been reported to interact with bleomycin (Blenoxane), an anticancer drug used to treat tumors of the cervix, uterus, testicle, and penis, as well as certain types of lymphoma.

Resources

Books

The Alternative Advisor, The Complete Guide to Natural Therapies and Alternative Treatments. Alexandria, VA: Time-Life, Time Warner, Inc., 1997.

Gladstar, Rosemary. Herbal Healing for Women. New York: Simon & Schuster, 1993.

The PDR Family Guide To Natural Medicines And Healing Therapies. New York: Three Rivers Press, 1999.

PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company, 1998.

Werbach, Melvyn R., M.D., and Michael T. Murray, N.D. Botanical Influences on Illness, A Sourcebook of Clinical Research. 2nd ed. Tarzana, CA: Third Line Press, 2000.

Periodicals

Amato, P., S. Christophe, and P. L. Mellon. "Estrogenic Activity of Herbs Commonly Used as Remedies for Menopausal Symptoms." Menopause 9 (March-April 2002): 145-150.

Huntley, A. L., and E. Ernst. "A Systematic Review of Herbal Medicinal Products for the Treatment of Menopausal Symptoms." Menopause 10 (September-October 2003): 465–476.

Ng, S. S., and W. D. Figg. "Antitumor Activity of Herbal Supplements in Human Prostate Cancer Xenografts Implanted in Immunodeficient Mice." Anticancer Research 23 (September-October 2003): 3585–3590.

Oerter Klein, K., M. Janfaza, K. A. Wong, and R. J. Chang. "Estrogen Bioactivity in Fo-Ti and Other Herbs Used for Their Estrogen-Like Effects as Determined by a Recombinant Cell Bioassay." Journal of Clinical Endocrinology and Metabolism 88 (September 2003): 4077–4079.

Powell, C. B., S. L. Dibble, J. E. Dall'Era, and I. Cohen. "Use of Herbs in Women Diagnosed with Ovarian Cancer." International Journal of Gynecologic Cancer 12 (March-April 2002): 214-217.

Scott, G. N., and G. W. Elmer. "Update on Natural Product-Drug Interactions." American Journal of Health-System Pharmacists 59 (February 2002): 339-347.

Shang, P., A. R. Qian, T. H. Yang, et al. "Experimental Study of Anti-Tumor Effects of Polysaccharides from Angelica sinensis." World Journal of Gastroenterology 9 (September 2003): 1963–1967.

Organizations

National Center for Complementary and Alternative Medicine (NCCAM) Clearinghouse. P.O. Box 7923, Gaithersburg, MD 20898-7923. (888) 644-6226. .

U. S. Food and Drug Administration (FDA). 5600 Fishers Lane, Rockville, MD 20857. (888) 463-6332. .

Other

Herbal Hall: Home for Herbs.http://www.herb.com/herbal.html.

Khalsa, Karta Purkh Singh. "The Chinese Way to Women's Health." Delicious Magazinehttp://www.delicious.online.com. (March 1997).

Life Extension Foundation. "Female Hormone Modulation Therapy." Nutrition Science Newshttp://www.lef.org. (March 1998).

Walker, Christy, Amy Bigus, and Deanna Massengil. "Dong Quai." http://www.geocities.com/chadrx/dong.html.

[Article by: Clare Hanrahan; Rebecca J. Frey, PhD]

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