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.
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].
- 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
- Could potentially cause abortions
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.
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 [6, 7].
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 .
Chinese texts prescribe dong quai for ‘deficient blood energy’, with symptoms similar to common menopausal complaints: irregular menstrual flow, nervousness, dizziness, insomnia, and forgetfulness .
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 [13, 14].
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 [16, 17, 18, 19].
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 .
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 .
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 [37, 38].
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+) .
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 .
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 [49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59]
- Alzheimer’s disease [60, 61, 62, 63, 64]
- Parkinson’s disease [65, 66]
- Aging [67, 68]
- Brain injury 
- Pain 
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 .
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% .
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.
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 [74, 75, 76, 77, 78, 79, 80]:
- Cytokines (such as TNF-alpha, IL-1beta, IL6, and IL10 ) [76, 76, 81, 74, 77, 78, 79]
- Messengers (NO, PGE2, histamine) [76, 82, 74, 75, 79]
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 [78, 76, 81, 79].
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) [83, 84, 85, 86, 87, 88, 89, 90].
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 .
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) [93, 94, 95, 96, 97, 98].
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 [99, 99].
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 [100, 101, 102, 103].
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) [106, 108, 103, 102, 105, 107, 104].
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) [109, 110, 111, 99, 112].
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 [114, 115, 116, 117, 118]
- An anticancer drug (doxorubicin) 
- The main hormone that narrows blood vessels and increases blood pressure (angiotensin II) 
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 [124, 125, 126, 127, 128, 129].
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 [130, 131].
In animal studies, dong quai prevented and improved kidney damage caused by:
- Diabetes [132, 133, 134, 135, 136]
- Poor blood supply 
- An autoimmune disease (membranous nephropathy) 
- An anticancer drug (cisplatin) [139, 140]
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 [141, 142]
- Toxins (carbon tetrachloride) [143, 144, 145]
- 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 .
In animal studies, Danggui Buxue Tang and other Chinese traditional medicines with dong quai prevented and improved tissue scarring in the:
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) [162, 163, 164].
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. [169, 170, 171, 172].
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 [173, 174, 175, 176, 132, 177].
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 [178, 179, 180, 181, 182, 183, 184, 185, 186]
- Liver [187, 188, 189, 179, 190, 191, 192, 193]
- Leukemia [194, 195, 187, 196, 197]
- Lung [198, 179, 192]
- Colon [179, 199, 192]
- Cervical [200, 201]
- Soft tissue and bone (sarcoma) [187, 202]
- Bladder [203, 204]
- 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 [193, 209, 210, 211, 212, 213].
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.
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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 the dried root of Angelica sinensis, a plant in the same family as carrots and celery. Early clinical evidence supports the use of dong quai as a menstrual aid; 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.
All other clinical evidence about dong quai’s traditional uses is significantly less robust. A handful of studies have found potential benefits for menopausal symptoms, anemia, infections, gut health, brain health, and energy levels, but the evidence is either weak or conflicting. All other purported benefits have only been investigated in animals and cells.