Thursday, August 27, 2009

Dong Quai

Dong quai has a long history of traditional medicinal use in both Chinese medicine and native American medicine, and it continues to be used for female conditions to balance the effects of menopause (hot flashes and night sweats) and PMS (cramping). The active components in dong quai are thought to be the coumarins, ferulic acid and ligustilide. The coumarins are known to increase blood flow, and ferulic acid and ligustilide are known to have muscle relaxing effects. Although there have been no known “estrogenic compounds” found in dong quai, it has been confirmed to have both estrogenic and anti-estrogenic activity in vitro (Amato et al., 2002). Dong quai is sometimes used in “bust enhancing” herbal products, but no clinical studies have been conducted on it for this purpose (Fugh-Berman, 2003). Dong quai has been shown to possess in vitro nonspecific immunostimulatory activity (Wilasrusmee et al., 2002).
Dong quai was included in a phytoestrogen combination which was found to be beneficial to treating migraines associated with the menstrual cycle in a clinical study, but it is unknown how much dong quai contributed to its efficacy (Burke et al., 2002). After only one negative clinical study, dong quai was abandoned from clinical practice by many in the U.S., however, considering the its long history of use and reported success in alternative medicine settings, it seems dong quai deserves more clinical research and more credit.
Scientific Support
Hirata et al. (1997) examined the use of dong quai in postmenopausal women in a double-blind, randomized, placebo-controlled clinical trial. Outcome parameters measured its effect on endometrial thickness (by ultrasonography), cellular maturation of vaginal cells, the Kupperman index (for determining menopausal symptoms), and frequency of hot flashes. Seventy-one women were included in the study and given either dong quai or placebo for 24 weeks. No statistically significant differences were found between treatment and placebo groups for any of the parameters measured. The authors concluded that dong quai does not produce estrogen-like responses in postmenopausal women for the parameters measured.
Safety / Dosage
Generally, dong quai is administered in the dosage range of 250-1000 mg daily (taken in divided doses) for the relief of menopausal or menstrual symptoms. There is no consensus on the standardization of dong quai as activity has been found in different fractions of the plant extracts. Dong quai is considered quite safe, but there is some concern of potential to increase photosensitivity due to its content of coumarins. Another concern is a potential drug interaction with aspirin because of dong quai’s antiplatelet activity (Abebe, 2003; Abebe, 2002).
1.Abebe W. An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations. J Dent Hyg. 2003 Winter;77(1):37-46.
2.Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002 Dec;27(6):391-401.
3.Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause. 2002 Mar-Apr;9(2):145-50.
4.Burke BE, Olson RD, Cusack BJ. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomed Pharmacother. 2002 Aug;56(6):283-8.
5.Fugh-Berman A. "Bust enhancing" herbal products. Obstet Gynecol. 2003 Jun;101(6):1345-9.
6.Hirata JD, Swiersz LM, Zell B, Small R, Ettinger B. Does dong quai have estrogenic effects in postmenopausal women? A double-blind, placebo-controlled trial. Fertil Steril. 1997 Dec;68(6):981-6.
7.Rosenberg Zand RS, Jenkins DJ, Diamandis EP. Effects of natural products and nutraceuticals on steroid hormone-regulated gene expression. Clin Chim Acta. 2001 Oct;312(1-2):213-9.
8.Wilasrusmee C, Kittur S, Siddiqui J, Bruch D, Wilasrusmee S, Kittur DS. In vitro immunomodulatory effects of ten commonly used herbs on murine lymphocytes. J Altern Complement Med. 2002 Aug;8(4):467-75.
9.Wilasrusmee C, Siddiqui J, Bruch D, Wilasrusmee S, Kittur S, Kittur DS. In vitro immunomodulatory effects of herbal products. Am Surg. 2002 Oct;68(10):860-4.
EDITOR'S NOTE: This monograph can be found in The Health Professional's Guide to Dietary Supplements (Lippincott, Williams & Wilkins) by Shawn M. Talbott, PhD and Kerry Hughes, MS.

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