Mostly known in the Western world as a remedy for menopausal and menstrual complaints, dong quai has been used in traditional Chinese medicine for these and other conditions since ancient times. Read on to learn more about this tonic herb and discover where its traditional uses and modern science intersect.
What Is Dong Quai?
Dong quai (當歸, also spelled danggui) is the dried root of Angelica sinensis, a plant belonging to the same family as carrots, parsley, and celery (Umbelliferae). It’s also known as Chinese angelica. The plant is native to the northwestern Chinese province of Gansu and also grows wild in mountainous areas of China, Korea, and Japan [1+, 2+, 3+].
Today, dong quai is used both in Eastern and Western countries. Dong quai is often called “female ginseng” due to its most common use for gynecological and hormonal imbalances in women, such as [2+, 5]:
- Menopausal complaints (hot flashes, sweating, sleep disturbances, mood swings)
- Menstrual cycle disorders (menstrual cramps, absent or irregular periods)
- Premenstrual syndrome
- Recovery from blood loss after childbirth
- May help with menopausal and menstrual symptoms
- May improve anemia
- Antioxidant and anti-inflammatory
- Mostly positive reviews online
- Few adverse effects reported
- Often used only in multi-herbal formulas
- Low quality of some studies
- Insufficient evidence for many benefits
- Obtained from an endangered species
- Low quality of some supplements
- May increase the risk of bleeding and bruises
Dong Quai vs Other Similar Plants
It’s important not to confuse dong quai, which is Angelica sinensis, with two closely related plants also called danggui and used in traditional Asian medicine: Angelica gigas and Angelica acutiloba. Both have lower levels of some active compounds (ligustilide, ferulic acid, and coniferyl ferulate) and more coumarins than dong quai, so their uses may differ [2+, 3+].
- Ferulic and other organic acids
- Ligustilide (and other similar phthalides)
- Complex sugars
- Vitamins, amino acids, and nucleosides
Of these, ferulic acid and ligustilide are the most active ones and are widely used to evaluate the quality of dong quai products. Products should contain at least 0.05% ferulic acid and 0.1-0.6% ligustilide [2+, 1+].
Since the species is endangered due to its excessive wild harvesting, give preference to dong quai that has been prepared from cultivated plants. Additionally, this plant should be obtained from reputable sources to ensure its quality and reduce the presence of contaminants such as pesticides, fungal toxins, dangerous plant alkaloids, and heavy metals [1+, 10, 11, 12].
The composition of the roots (and thus their health benefits) varies depending on the time and site of collection, as well as on the processing method [2+]:
- Decoctions are common and likely safe. They have less ligustilide and ferulic acid (anti-inflammatory and antioxidant compounds) but more phenolic acids (antioxidant) [13, 14+, 15].
- Products made from boiling, baking, or stir-frying the root with alcohol are likely safe. This process increases ferulic acid but decreases ligustilide [16+, 17+].
- Avoid products that have been smoke-dried with sulfur. This speeds up the drying process but reduces some active compounds and increases heavy metals [18, 2+].
To make sure you’re not buying a contaminated, adulterated, or low-potency product, stick to trusted brands that hold quality certificates and follow good manufacturing practices.
Use in Traditional Chinese Medicine (TCM)
The Basics of TCM
Dong quai inevitably brings us to Traditional Chinese medicine (TCM). Although some Western medicine practitioners now also use this herb, its true roots are in TCM. This system of medicine may be hard to grasp for some, but understanding its basics can broaden our perspective about the use of dong quai in modern times.
An Energy System
Essentially, TCM is based on ancient philosophical concepts. According to its principles, the body is a miniature universe where disease is caused by the imbalance of two opposing forces (yin and yang). The inner vital energy (qi) is thought to circulate through channels (meridians) to sustain health in the different organs [19+, 20, 2+].
TCM uses a holistic approach to disease in which the diagnosis and prescription are tailored to the patient’s constitution. A remedy (mostly obtained from plants, but some are animal- and mineral-based) is not prescribed alone but in combination with up to 15 other ingredients for synergistic effects. Much to the shock of Western doctors and scientists, a single formula can be used for seemingly unrelated conditions and the same condition can be improved with different formulas [19+, 1+].
- ‘Replenishing’, ‘invigorating’, and ‘moving’ blood
- Relieving pain
- Improving cold limbs and hemorrhoids
- Slowing aging
- Improving malaria, fever, chills, and ‘low vital energy’
- Blood disorders (anemia, poor circulation, clot formation)
- Gut issues (constipation, ulcerative colitis)
- Heart disease
- Boosting immunity
Some specific to TCM include expelling ‘wind’, clearing ‘heat’, dissipating ‘cold’, and tonifying ‘middle-jiao’ and ‘qi’.
Although TCM advocates claim that its effectiveness and safety are backed by its use over thousands of years, Western doctors and scientists generally view it with skepticism. Evidently, concepts such as qi or meridians haven’t been scientifically proven. Additional reasons for concern include the low quality of most clinical trials, the use of ingredients from endangered plant and animal species, and the potential toxicity of some remedies [20, 21, 22, 23].
Hormonal Balance & How Dong Quai Works
To understand the potential health benefits of dong quai for hormonal balance, we’ll first take a closer look at how hormones are produced in women throughout different phases of the menstrual cycle and what happens in menopause, once menstrual cycles cease.
Women’s Reproductive Health and Hormones
The following hormones are essential [24+]:
- FSH stimulates ovarian follicles to mature; once the follicle matures, it will produce estradiol
- Estradiol spikes toward ovulation, which causes FSH to drop. Estradiol helps the egg mature and causes LH to surge
- LH spikes, which releases the egg, causing ovulation. During ovulation, progesterone will also slightly increase
- Progesterone prepares the uterus for pregnancy; if conception doesn’t occur, its levels will gradually fall and hormonal changes will repeat with the next cycle
Fluctuation in female sex hormone levels during the menstrual cycle. Source: 
In premenopausal women, various factors (including stress, eating disorders, dietary habits, intense exercise, and others) may block FSH and LH release, which prevents ovarian follicle maturation. These and other factors can affect both estrogen and progesterone levels and activity. In turn, hormonal imbalances can cause irregular menstrual cycles .
In menopausal women, as ovulation ceases, estradiol and progesterone levels drop while FSH increases. As mentioned, the preovulatory spike in estrogen is needed to block FSH release – and this feedback loop no longer happens after menopause. As the female body undergoes hormonal changes, the uterus and vagina will start thinning. Symptoms such as hot flashes and mood imbalances are also common [27+].
Therefore, different sex hormone changes are behind both irregular menstrual cycles and menopausal symptoms. All involved hormones are important – including progesterone, LH, and FSH – but estradiol plays a key role as the main female sex hormone.
Dong Quai and Estrogen
Herbs like dong quai may be able to mimic the effects of estrogen, potentially making up for its lack or imbalance. They may also increase sensitivity to estrogen, which can help compensate for its low levels. But despite its widespread use, its estrogen-like benefits are far from evident.
In one study, an herbal mix with dong quai (QiBaoMeiRan) increased the production of estrogen receptors in rats, which may enhance the response to estradiol .
Dong quai combined with astragalus (Danggui Buxue Tang) activated estrogen receptors in cells, suggesting it may increase the response to estradiol. However, the benefit was mostly due to a specific flavonoid from astragalus (calycosin) [29, 30].
In turn, dong quai alone had a weaker activity and even blocked estrogen effects in one study. This may be due to the different composition of the extracts, since those with the highest ferulic acid or lowest ligustilide content were more active [31, 32, 33, 34, 35, 36].
One more study leaves us with encouraging results. In menopausal rats, different dong quai herbal mixes prevented osteoporosis, reduced the thinning of the uterus, vagina and breast glands, and restored hormone balances by increasing estradiol and reducing FSH and LH levels [37, 38, 39, 40, 41].
Due to the scarcity of high-quality clinical studies, dong quai is not approved by the FDA for medical use. Further research will be required to determine whether it is effective or safe for long-term use.
Nevertheless, dong quai is commercially available as a supplement, both alone and as part of herbal mixes. Regulations set manufacturing standards for supplements but don’t guarantee that they are safe or effective. Talk to your doctor before using dong quai for any conditions to avoid unexpected interactions.
Possibly effective for:
A traditional Chinese herbal remedy with dong quai (Danggui Shaoyao San) relieved menstrual cramps better than placebo and painkillers in an analysis of 4 clinical trials involving over 400 women. 4 g/day of this remedy also normalized irregular menstrual cycles in one small trial on 20 women [43, 44+].
Dong quai’s component ligustilide prevented uterine contractions in rats, which could explain its role in relieving menstrual cramps .
Endometriosis is the growth of a tissue similar to the uterine lining on other pelvic organs such as the ovaries and Fallopian tubes. It causes menstrual cramps and infertility. A Chinese traditional remedy with dong quai (Fubao Danggui Jiao) helped clear this unwanted tissue in rats .
All in all, the existing evidence suggests that dong quai may help with menstrual complaints. However, it’s important to note that a meta-analysis found the quality of the studies moderate to low due to their high risk of bias. Further, more robust trials are needed to confirm these results.
Insufficient Evidence for:
1) Menopausal Symptoms
Chinese texts prescribe dong quai for ‘deficient blood energy’, with symptoms similar to common menopausal complaints: irregular menstrual flow, nervousness, dizziness, insomnia, and forgetfulness [49+].
However, dong quai did not improve these symptoms in several studies. In a clinical trial on 71 postmenopausal women, it had no effect. It was equally ineffective in a clinical trial on 22 men with menopause-like symptoms (hot flashes) caused by a therapy with luteinizing hormone (LH) for prostate cancer [50, 51].
The downside is that these studies looked at dong quai alone, as it is used in Western countries. In traditional Chinese medicine, however, it is always prescribed in combination with other herbs.
In a recent meta-analysis of 16 studies and almost 1600 menopausal women, a Chinese herbal formulation containing dong quai (Er-Xian Tang) was more effective than placebo and hormone therapy at improving menopausal symptoms but only in some studies .
Another Chinese remedy (Danggui Buxue Tang, 3 g/day) only improved mild hot flashes in a clinical trial on 100 postmenopausal women. In contrast, three other herbal supplements with dong quai reduced hot flashes and sleep disturbances in 3 clinical trials on almost 150 postmenopausal women [53, 54, 55, 56].
In premenopausal women, the surgical removal of the ovaries causes menopausal symptoms by dramatically reducing estrogen and progesterone levels. A Chinese herbal mix with dong quai (Geng Nian An, 2x/day) improved menopausal symptoms and restored normal hormone (estradiol, LH, and FSH) levels in a clinical trial on 69 women who had undergone ovarian removal .
Based on the mixed results, the low quality of most studies, and the fact that dong quai was used together with other herbs, there is insufficient evidence to support its benefits on menopausal symptoms. Additional, higher-quality clinical research is needed.
The traditional Chinese medicine prescription with dong quai most commonly used for anemia (Danggui Buxue Tag) is recommended to reinforce the ‘qi’ (vital energy) and ‘nourish blood’ (improve body circulation) .
TCM formulas with dong quai are often only used as an add-on to typical therapies for anemia. In a meta-analysis of 7 clinical trials including 460 people with anemia, this TCM formula improved the effectiveness of conventional therapy .
Strenuous physical exercise may cause iron deficiency by increasing the production of the hormone that traps iron into cells (hepcidin). In a clinical trial on 36 men, the same TCM formula decreased iron deficit after a long run .
The evidence to support the benefits of dong quai for anemia is insufficient. The authors of a meta-analysis considered that most studies had low quality and didn’t pay attention to safety. Additional, better-designed studies are needed to validate their results .
3) Preventing Infections
A severe complication of infections is sepsis, a life-threatening condition in which the body damages its own tissues. A traditional Chinese medicine injection for sepsis with dong quai (Xuebijing) combined with conventional therapy reduced death from sepsis in a meta-analysis of 16 clinical trials with over 1k people. Dong quai also prevented death from sepsis in mice [74, 75].
In rats with pneumonia, dong quai reduced infection symptoms. However, it failed to kill the bacteria causing this disease in an antimicrobial test .
In combination with another herbal extract, dong quai prevented the growth of 2 bacterial species that cause infectious diseases (E. coli and Staphylococcus aureus) .
The complex sugars in this herb prevented the division of a virus belonging to the same class as HIV in mice. It also enhanced their immune response, increasing their blood levels of T cells (CD4+ and CD8+) .
Further, higher-quality clinical research should confirm the effectiveness of dong quai against these infections.
4) Ulcerative Colitis
To add to its anti-inflammatory potential, a couple of studies suggest that dong quai may be beneficial for ulcerative colitis, an inflammatory bowel disease (IBD). People with ulcerative colitis have chronic inflammation and ulcers in the gut inner lining. Dong quai injections relieved the symptoms in a clinical trial on 64 people .
However, a single clinical trial and a few animal studies cannot be considered sufficient evidence that dong quai helps with ulcerative colitis. Further clinical research is needed.
5) Brain Function Support
In a clinical trial on over 1k people with stroke, injected dong quai reduced brain damage and improved brain function .
In animal studies, dong quai and herbal mixes with this herb prevented and improved the brain dysfunction caused by:
- Stroke [86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96]
- Alzheimer’s disease [97, 98, 99, 100, 101]
- Parkinson’s disease [102, 103]
- Aging [104, 105]
- Brain injury 
- Pain 
Clinical studies are needed to further explore these potential benefits in humans. Currently, it’s unknown if this herb may help with brain disorders. On the upside, there’s no evidence of any kind of negative effects of dong quai on the brain.
6) Boosting Energy Levels
According to TCM, fatigue is caused by internal injuries from excessive emotions, overstrain, or an improper diet. The symptoms are similar to those of ‘qi-deficiency’ and ‘blood stasis’: lack of appetite, weakness, and a failure to use and transport food nutrients [108+].
In a clinical trial on 36 men doing a long run, a Chinese traditional medicine with dong quai (Danggui Buxue Tang, 7.5 g/day) shortened finish times by 14% .
Once again, the evidence is insufficient to claim that dong quai boosts energy levels until further research is carried out.
Animal and Cell Research (Lack of Evidence):
The widespread use of dong quai in TCM has encouraged the research of many of its purported health benefits. Because many of the results have only been obtained in animals and cells, it’s still uncertain whether dong quai has these benefits in humans as well.
Anti-inflammatory and Antioxidant
Excessive inflammation and oxidative stress underlie numerous diseases. Dong quai’s anti-inflammatory effects have been suggested to help with diverse issues such as menstrual cramps, arthritis, and ulcerative colitis. Its antioxidant properties may synergize with these and contribute to its benefits for reproductive, bone, skin, and health, as well as mood balance.
It mainly works by preventing the activation of the body’s inflammatory hub, the NF-kB pathway. Beyond this, it affects many other important pathways, which reduces the production of the following inflammatory substances [111, 112, 113, 114, 115+, 116, 117]:
- Cytokines (such as TNF-alpha, IL-1beta, IL6, and IL10 ) [113, 118, 111, 114, 115, 116]
- Messengers (NO, PGE2, histamine) [113, 119, 111, 112, 116]
What’s more, it also blocks key enzymes that trigger and sustain inflammation in the body (COX-1, COX-2, MMP1, MMP13, iNOS). In this sense, it is similar to commonly-used NSAID painkillers, but its effects are wider-ranging [115, 113, 118, 116].
Free radicals damage tissues by breaking down and damaging the building blocks of cells. Dong quai prevents this damage by increasing the activity and production of antioxidant enzymes (NQO1, SOD, and CAT). Additionally, it triggers the production of a compound that helps cells survive under oxidative stress (phosphatidylinositol) [120+, 121, 122, 123, 124, 125, 126, 127].
However, these mechanisms have been observed in animal and cell-based studies. Dong quai’s components may act differently in humans.
In an observational study on over 1k people using traditional Chinese medicine for depression and sleep disorders, an herbal blend whose main component is dong quai (Jia-Wei-Xiao-Yao-San) was most commonly prescribed [129+].
In rats and mice with depression caused by chronic stress, dong quai and ferulic acid improved low mood. They reduced depressive behaviors such as drowsiness and immobility and restored normal neurotransmitter levels (noradrenaline and dopamine) [130, 131, 132, 133, 134, 135].
Because the only human study only assessed its prescription but not its effectiveness, the preliminary evidence that dong quai improves mood is restricted to animal studies. Clinical trials should test these results.
Improving Blood Circulation
According to traditional Chinese Medicine, ‘blood stasis’ is the slowing or pooling of blood due to the disruption of the heart ‘qi’. This syndrome is often understood as a blood disorder that may develop into serious conditions such as heart disease, heart failure, stroke, and clogged arteries [136+].
Free radical buildup may trigger excessive platelet clumping. This is because free radicals activate the release of arachidonic acid that is converted to a molecule that clumps platelets (thromboxane A2). By scavenging free radicals, an herbal mix with dong quai (Danggui Shaoyao San) prevented the excessive platelet clumping [137+, 138, 139, 140].
Dong quai and several of its components reduced blood clotting in rats and mice and prevented platelets from clumping together. However, this herb was less efficient than a conventional blood thinner (clopidogrel) [143, 145, 140, 139, 142, 144, 141].
This herb improved blood circulation by reducing blood thickness, which helps blood flow more freely. It worked both alone and as part of two Chinese medicines (Danggui Sini Tang and Danggui Honghua) [146, 147, 148, 136, 149].
Blood Flow & Heart Protection
Raynaud’s is a syndrome in which the blood vessels become extremely narrow in response to cold temperatures. This causes poor blood circulation, numbness, and color changes in the fingers. A Chinese formula with dong quai is traditionally used for this syndrome based on the belief that it ‘warms the interior’. In mice, this formula reduced blood vessel tightening in response to cold .
What’s more, this herb and its complex sugars protected rat and mouse heart tissues from the damage caused by:
- Poor blood flow [151, 152, 153, 154, 155]
- An anticancer drug (doxorubicin) 
- The main hormone that narrows blood vessels and increases blood pressure (angiotensin II) 
Bone and Cartilage Health
A traditional Chinese remedy with dong quai (Danggui Sini Tang) and this herb’s active components reduced cartilage damage and promoted its repair in mice and rats with both osteoarthritis and rheumatoid arthritis. However, a different traditional remedy with dong quai failed to improve gouty arthritis in rats [161, 162, 163, 164, 165, 166].
Gum disease may destroy the tooth-supporting cartilages and bones. Two herbal formulas with dong quai promoted the regeneration of bone and cartilage tissues while preventing their destruction in rats and mice with gum disease [167, 168].
In animal studies, dong quai prevented and improved kidney damage caused by:
- Diabetes [169, 170, 171, 172, 173]
- Poor blood supply 
- An autoimmune disease (membranous nephropathy) 
- An anticancer drug (cisplatin) [176, 177]
These studies used several active components of dong quai and two Chinese medicines with this herb (Danggui Buxue Tang and Danggui Shaoyao San).
Dong quai’s complex sugars protected mice and rats from liver damage caused by:
- Tylenol [178, 179]
- Toxins (carbon tetrachloride) [180, 181, 182]
- A harmful bean lectin 
- A TCM herb that can damage the liver (air yam) 
Although TCM use supports this benefit, dong quai’s effects on the liver need to be determined in clinical trials.
When the body attempts to repair an organ damaged by chronic diseases, drugs, or surgery, it creates tissue scars. If proteins that form soft tissues build up in excess, they may cause the organ to malfunction [185+].
In animal studies, Danggui Buxue Tang and other Chinese traditional medicines with dong quai prevented and improved tissue scarring in the:
Skin Health & Wound Healing
Dong quai may speed up wound healing and reduce skin inflammation. It increased collagen production and helped create new blood vessels, both of which are required for proper wound healing. Numerous studies in mice, rats, fish, and cells attest to its ability to heal damaged skin, either alone or in combination with astragalus (as part of the herbal mix Danggui Buxue Tang) [199, 200, 201].
A diet high in sugars and fats may lead to obesity and insulin resistance, ultimately causing health conditions such as metabolic syndrome and type 2 diabetes. Dong quai and a Chinese remedy containing it (Danggui Buxue Tang) reduced weight, insulin resistance, and blood sugar and fat levels in rats and mice on high-sugar and high-fat diets [206, 207, 208, 209].
In diabetic mice and rats, dong quai reduced blood sugar levels and complications such as clogged arteries and pancreas, liver, kidney, and eye damage. It helped both alone and as part of the Chinese medicines Danggui Buxue Tang and Naoxintong [210, 211, 212, 213, 169, 214].
Below, we will discuss some preliminary research on dong quai’s anticancer activity. It’s still in the cell stage and further clinical studies have yet to determine if its compounds are useful in cancer therapies.
Do not under any circumstances attempt to replace conventional cancer therapies with dong quai or any other supplements. If you want to use it as a supportive measure, talk to your doctor to avoid any unexpected interactions.
Dong quai and its components helped kill cancer in cell-based studies. They could block cancer growth, maturation, and spreading to healthy tissues. This herb had a beneficial effect in the following cancer types:
- Brain [215, 216, 217, 218, 219, 220, 221, 222, 223]
- Liver [224, 225, 226, 216, 227, 228, 229, 230]
- Leukemia [231, 232, 224, 233, 234]
- Lung [235, 216, 229]
- Colon [216, 236, 229]
- Cervical [237, 238]
- Soft tissue and bone (sarcoma) [224, 239]
- Bladder [240, 241]
- Oral 
- Prostate 
- Ovarian 
Additionally, two phthalides from this herb may increase the response to cancer drugs. These compounds blocked an antioxidant enzyme (glutathione S-transferase), the excessive production of which makes cancer cells resistant to chemotherapy .
Not all components in this herb have anti-cancer activity. While its complex sugars and phthalides killed breast cancer cells, ferulic acid stimulated their growth. This acid may have female sex hormone activity, which may feed breast cancer [230, 246, 247, 248, 249, 250].
Overall, little is known about the effects of dong quai on cancer. The current findings are limited to cellular studies, based on which no conclusions about its effects in humans can be drawn.
Side Effects & Precautions
- Irregular heart rate
- Low blood pressure
- Menstrual disorders (PMS symptoms, irregular cycles)
- Digestive issues
In a review of over 50 liver toxicity cases caused by traditional Chinese medicine remedies, 7 involved herbal blends with dong quai. However, it’s difficult to establish which ingredient was responsible for the damage in each case .
One man developed enlarged breasts after taking dong quai pills. The herb is not high in compounds similar to female sex hormones. However, these compounds can be concentrated in some formulations or even adulterated with synthetic hormones .
A pharmacist exposed to multiple herbal remedies developed allergic asthma in response to several of them, including dong quai .
A woman who may have overdosed by eating a soup made with dong quai had high blood pressure, headaches, weakness, lightheadedness, and vomiting .
Due to lack of safety information, dong quai should be avoided during pregnancy and breastfeeding. In one case, a breastfeeding mother passed dong quai to her baby who developed high blood pressure. However, she most likely took in a much higher dose than the amount usually contained in herbal remedies [256, 257].
Although the female sex hormone activity of dong quai remedies greatly varies, women with hormone-sensitive cancers (breast, uterus, ovarian) should be cautious with dong quai. Indeed, this herb and its component ferulic acid promoted the growth of breast cancer in cellular studies [30, 34, 40, 248, 29, 249, 250].
Some compounds in dong quai slow blood clotting, which may increase the risk of bleeding and bruises in people with bleeding disorders and is not recommended in those with a scheduled operation [142, 143, 258].
If you take prescription medications or have a serious health condition, talk to your healthcare provider before taking dong quai.
Dong quai slows blood clotting, so it shouldn’t be combined with drugs with similar effects such as [142+]:
- NSAID painkillers (aspirin, ibuprofen, diclofenac, naproxen)
- Blood thinners (clopidogrel, dalteparin, enoxaparin, heparin, warfarin)
Indeed, blood clotting was dramatically reduced in a woman on warfarin for irregular heart rate who started taking dong quai for menopausal symptoms. It also increased the anti-blood clotting effect of warfarin in rabbits [259, 260].
Dong quai didn’t enhance the anti blood-clotting effects of aspirin and clopidogrel in 2 studies on over 1200 people. However, it did increase bleeding in rats and mice given clopidogrel [261, 262, 145].
Dong quai interacts with several enzymes responsible for breaking down drugs and toxins. It increases the production or activity of some enzymes (CYP1A2, CYP2D6, CYP3A1, and CYP3A4) and has the opposite effects on some others (CYP2E1, CYP2C11, and carboxylesterases). It may alter the effects of numerous drugs broken down by these enzymes [263+, 264, 265].
Limitations and Caveats
The quality of many studies included in meta-analyses was low. They generally had small populations, design flaws (such as lack of controls, randomization, or blinding), and inaccessible data. Additionally, a lot of the studies were only available in Chinese.
Except for menopausal symptoms, menstrual complaints, and anemia (the results of which are contradicting), very few uses of dong quai have been widely tested in humans. The studies for the following conditions included only one clinical trial: sepsis, digestive infections, brain stroke, ulcerative colitis, and fatigue. The remaining health benefits have only been evaluated in animals and cells. Therefore, more trials in humans are required to validate these results.
A lot of studies used traditional Chinese medicine herbal blends combining dong quai with several other ingredients, so the contribution of dong quai to the effects observed is difficult to estimate.
Female Sex Hormone Activity
Dong quai preparations, especially in combination with astragalus, exert their female sex hormone effects by:
- Increasing the production of estrogen receptors ESR1 and ESR2 
- Activating the ESR1 receptor (both directly and through the Erk1/2 pathway) 
Women with mutated variants of these receptors (e.g., mutations in the S118 and S167 activation sites of ESR1) may have altered sensitivity to dong quai.
Dong quai and its active components reduce inflammation by:
- Blocking pro-inflammatory proteins such as AP-1, NF-kB, MAPK p38, ERK1/2, JNK, and COX-2 [116, 111, 116, 117]
- Decreasing the production of pro-inflammatory proteins such as COX-1, COX-2, JAK2, STAT1, and NF-kB p65 [115, 113, 114]
Variants of all these proteins may alter the response to dong quai.
Dong quai and its active components protect cells from oxidative damage by activating the NFE2L2 and ATF6 pathways and increasing the activity of the antioxidant enzymes SOD and CAT. The antioxidant effects of dong quai may be altered in people with different variants of these genes [125, 126, 124].
Variants of these genes may alter the effects of dong quai on blood formation.
Dong quai increases the production of the blood vessel-forming protein VEGF. Its combination with astragalus also increases the production of a protein that triggers collagen formation (TGFB1). Dong quai may have altered effects on wound healing in people with certain variants of these proteins [200, 201].
Breakdown of Active Compounds
Ligustilide and ferulic acid are the main active compounds of dong quai. The enzymes that contribute the most to their breakdown in the body are CYP3A4, CYP1A2, CYP2C8, and CYP2C9. People may be more or less susceptible to dong quai’s effects depending on their variants of these enzymes [266, 267+].
Forms of Supplementation & Dosing
Dong quai is normally taken orally as pills, tablets, decoctions, and tinctures. Other forms of supplementation include [1+]:
- Topical creams and pastes
- Eye drops
While this herb is available alone in Western countries, traditional Chinese medicine always prescribes it combined with other herbs. Some popular combinations with dong quai include
- Danggui Buxue Tang: used for menopausal complaints, anemia, osteoporosis, and infertility [268+, 69]
- Danggui Shaoyao San: used for menstrual cramps, irregular menstrual cycles, depression, and dementia [43+, 269+]
- Danggui Sini Tang: used for blood circulation, heart failure, diarrhea, infectious diseases, and arthritis [270, 162+]
- Danggui Honghua: used for blood circulation 
- Er-Xian Tang: used for menopausal complaints, osteoporosis, and delayed puberty 
Because dong quai is not approved by the FDA for any conditions there is no official dose. Typical, unofficial dong quai oral doses established by users and supplement manufacturers are [255+]:
- Dried root: 3-15 g/day by decoction
- Powdered root: 1-2 g, 3x/day
- Tea: 1 cup (containing 1 g dong quai), 1x-3x/day
- Tincture (diluted to 1:2): 4-8 mL/day
- Capsules and tablets: 500 mg, 1x-6x/day
The opinions expressed in this section are solely those of dong quai users who may or may not have medical or scientific training. Their reviews do not represent the opinions of SelfHacked. SelfHacked does not endorse any specific product, service, or treatment.
Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice from your doctor or another qualified healthcare provider because of something you have read on SelfHacked. We understand that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.
Most dong quai users were women looking for an alternative to hormones to cope with menopausal or menstrual symptoms. Those taking it for menopausal symptoms usually reported satisfactory reductions of hot flashes, night sweats, and mood swings. Dong quai was also effective at improving PMS symptoms, reducing menstrual cramps, and regularizing menstrual cycles in non-menopausal women.
However, a few users didn’t notice any effects and one even reported that her periods had got worse after taking dong quai. Side effects were very rare and mostly consisted of digestive issues (indigestion, gases, diarrhea). Additionally, several users complained about the taste of the supplement.
Dong quai is widely used in traditional Chinese medicine (TCM), typically as a tonic herb in combination products. Although its TCM uses depend on different principles than those used in Western medicine, research supports its benefits for menopausal complaints and anemia as an add on to conventional therapies.
It may also help lower excessive inflammation, support mood balance, and boost energy levels. Due to its antioxidant properties and effects on blood circulation, it may be helpful for protecting the blood vessels, the heart, liver, and kidneys.
Overall, dong quai appears to be safe. Its side effects are mild when used within the recommended doses.
However, much of the evidence spans from low-quality studies and various herbal combinations. Dong quai may interact with medications, especially blood thinners. Talk to your doctor before using dong quai to avoid any dangerous drug interactions. Do not use this herb if you are pregnant, breastfeeding, or have hormone-sensitive cancer (such as breast or ovarian cancer).
If you’re seeking to buy dong quai supplements, it’s important to look for reputable products. Low-quality supplements may be contaminated with toxins, other herbs, or prepared from wild dong quai, which is an endangered species.
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