Dong quai dietary supplements are obtained from the roots of Angelica polymorpha. Dong quai extracts contain at least 6 coumarin derivatives including bergapten, osthol, oxy-peucedanin, and psoralen and two furocoumarin derivatives, sen-byak-angelicole and 7-demrthylsuberosin. Coumarin derivatives have anticoagulant, vasodilating, and antispasmodic activity. Also, osthol may have central nervous system stimulant activity. Other components found in the essential oil include n-butyl-pthalide, cadinene, isosafrole, and safrole. Safrole may be carcinogenic, so ingestion should be avoided. Root extracts may contain various lactones and vitamins A, E, and B12 Dong quai extracts may have a modulatory effect on endogenous estrogens. Common trade names include Women's Ginseng, and combination products such as Menopausal Formula, Nature's Fingerprint, PMS Formula, and Rejuvex. Reported uses Dong quai is widely used in traditional Chinese medicine and continues to be popular in China and elsewhere. It's used to treat menstrual disorders, as an analgesic in rheumatism, and to suppress allergy symptoms. Dong quai is used to treat anemia, hepatitis, hypertension, migraines, neuralgias, rhinitis, and gynecologic disorders including irregular menstruation, dysmenorrhea, premenstrual syndrome, and menopausal symptoms. Dong quai contains compounds that, in laboratory tests, have demonstrated activities that may prove to help reduce pain, dilate blood vessels, and stimulate and relax uterine muscles. Animal studies suggest that dong quai may treat abnormal heart rhythm, prevent accumulation of platelets in blood vessels (contributing to plaque formation -- atherosclerosis), protect the liver, promote urination, act as a mild laxative, promote sleep, and fight infection. Scientific evidence on the use of dong quai in people is weak. The data consist primarily of laboratory and animal studies, with a few preliminary studies in people. More studies are needed to determine the herb's safety and effectiveness in humans. Administration Capsules: 500 mg by mouth, or 1 to 2 capsules three times a day Liquid extract: 1 to 2 gtt three times a day. Hazards Dong quai may cause bleeding gums, diarrhea, blood in the stool, hematuria, photodermatitis, bleeding, fever, or cancer. When used with warfarin, dong quai can potentiate anticoagulant effects. Similar effects are possible with other anticoagulants. There is also an increased risk of photosensitivity reactions with dong quai. Patients taking an anticoagulant should avoid use. Because of potential effects on uterine contractions and unknown direct effects on the developing fetus, pregnant and breast-feeding patients shouldn't use dong quai. Clinical considerations Monitor patient for signs of easy bruising or bleeding. If dong quai must be used with another anticoagulant, closely monitor PT and International Normalized Ratio. Monitor patient for photosensitivity reactions. If patient is pregnant or breast-feeding, advise her not to use dong quai. Advise patient to keep this and other herbal products out of reach of children. Tell patient to remind pharmacist of any herbal or dietary supplement that he's taking when obtaining a new prescription. Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available. Research summary The concepts behind the use of dong quai and the claims made regarding its effects haven't yet been validated scientifically.
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