Angelica sinensis · herb
Evidence tier: insufficient
Supports female hormonal balance, eases menstrual irregularities, and is traditionally used for relieving dysmenorrhoea and supporting menopausal transitions
Uncertain, and the honest answer is that the proposed mechanisms failed their own test. Ferulic acid and Z-ligustilide relax uterine smooth muscle in laboratory preparations, and the herb has weak phytoestrogen activity at the oestrogen receptor. But Hirata's trial measured the oestrogenic endpoints directly (endometrial thickness, vaginal cell maturation) and found NO oestrogenic effect in women at the traditional dose. So the phytoestrogen mechanism, whatever it does in a dish, does not appear to operate in people at the dose people take. Separately, and unrelated to any benefit, dong quai contains furocoumarins, which are the documented cause of its photosensitivity.
Insufficient. Dong quai's flagship claim is menopausal symptom relief, and the one well conducted randomised controlled trial of dong quai alone was NEGATIVE. Hirata et al. (Fertility and Sterility 1997, volume 68, pages 981 to 986) randomised 71 postmenopausal women to dong quai (4.5 g of dried root daily) or placebo for 24 weeks and found no significant difference in vasomotor symptoms, and no oestrogenic effect on endometrial thickness or vaginal maturation. That is the definitive test of the definitive claim, and it failed. A second randomised, double blind, placebo controlled trial in men on androgen deprivation therapy also found dong quai ineffective against hot flashes. MSK About Herbs summarises the menopausal trial evidence as inconclusive. Trials of MULTI HERB Chinese formulas containing dong quai sometimes report benefit, but nothing in them can be attributed to dong quai, and the isolated herb has been tested twice and failed twice. Everything else (dysmenorrhoea, menstrual regulation, 'female hormonal balance') rests on traditional Chinese medicine use, not on trials. Safety is where dong quai actually earns attention, and it is not benign. It shows oestrogenic activity in the laboratory and stimulated proliferation of MCF-7 breast cancer cells, so MSK lists hormone sensitive cancers under do not use. It carries an anticoagulant signal and MSK warns it 'may increase your risk of bleeding' with warfarin. It contains furocoumarins and causes photosensitivity and photodermatitis. MSK's do not use list includes pregnancy, where dong quai 'can raise your risk of miscarriage'.
No regulator sets a dose. The dose used in the negative Hirata trial, and the traditional decoction dose, is 4.5 g of dried root daily. NIH LactMed records 2 g of dried aqueous extract three times daily.
Take 1 to 2g of standardised root extract or 2 to 4ml of tincture twice daily with food. Allow 4 to 8 weeks for hormonal balancing effects. Not for use during pregnancy due to uterine stimulating properties.
Avoid in pregnancy, traditional use as uterine stimulant and emmenagogue. Avoid in breastfeeding. May increase photosensitivity. Interacts with warfarin (may increase INR). Avoid with hormone sensitive conditions.
Pregnancy: avoid
Breastfeeding: avoid
Active compounds: ligustilide, ferulic acid, angelicide, furocoumarins
Remedies using Dong Quai · Browse by body system · Check it against what you take
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.