Dong Quai and Hair Loss

Dong Quai (Angelica sinensis), also known as Dang gui, is used to stop hair loss and is claimed to be able to stimulate hair re-growth. Dong Quai contains phytoestrogens which inhibit the formation of DHT, a major cause of hair loss.

Dong quai is a perennial herb. The root of Dong quai has been used for thousands of years in the treatment of female health problems in Japan, China and Korea. The name Dong quai translates as “return to order” due to its apparent health restorative properties.

Health benefits of Dong quai

The root of Dong quai has analgesic, anticholesterolemic, anti-inflammatory, antispasmodic, emmenagogue, emollient, hepatic, laxative, sedative and peripheral vasodilator properties. It is commonly used as an alternative medicine to regulate the menstrual cycle, relieve period pain and also to ensure a healthy pregnancy and easy delivery.

Dong quai contains vitamin B12, vitamin E, biotin, ferulic acid, nicotinic acid, butylidenephalide, ligustilide, folinic acid, succinic acid, carotene, beta-sitosterol, sequiterpenes, and carvacrol. Dong quai’s pharmacologically active ingredients can be divided into two groups, the water-soluble, non-volatile group and the alcohol-soluble group containing essential oil. While the non-volatile ingredients are believed to stimulate the uterus, the alcohol-soluble group is believed to relax the uterus.

Dong quai is believed to: lower blood pressure; slow heart rate; reduce respiratory rate; dilate coronary vessels and increases coronary blood flow; reduce inflammation and headache; and treat infections and neuropathic (nerve) pain. Dong quai is primarily used to treat women’s ailments, such as pre-menstrual discomfort, menstrual problems, anemia, and symptoms related to menopause.

Although Dong quai has many historical and theoretical uses based on animal studies, there is little clinical evidence supporting the effects of Dong quai for any condition. Few clinical trials have been carried out, most of which have been either poorly designed or reported insignificant results.

Side effects of Dong quai

All members of Genus Angelica contain furocoumarins, which increase skin sensitivity to sunlight and may cause dermatitis. Although Dong quai is accepted as being safe as a food additive in the United States and Europe, its safety when administered at medicinal dose levels is unknown. There are no reliable long-term studies on the side effects of this herb. Most precautions are based on theory, laboratory research, tradition, or isolated case reports.

Components of Dong quai may increase the risk of bleeding due to anticoagulant and anti-platelet effects, although there are no reliable reports of clinically significant bleeding in humans. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. It is recommended that use of Dong quai be discontinued prior to surgical or major dental procedures.

It remains unclear if Dong quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant hormonal effects. It remains unclear if Dong quai is safe in individuals with hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, or endometriosis. It is not known if Dong quai possesses the beneficial effects that estrogen is believed to have on bone mass, or the potential harmful effects such as increased risk of stroke or hormone-sensitive cancers.

Increased sun sensitivity with a risk of severe skin reactions (photosensitivity) may occur due to chemicals in Dong quai. Prolonged exposure to sunlight or ultraviolet light should be avoided while taking Dong quai.

Safrole, a volatile oil in Dong quai, may be carcinogenic (cancer-causing). Long-term use should therefore be avoided.

Dong quai has traditionally been associated with gastrointestinal symptoms (particularly with prolonged use), including laxative effects/diarrhea, upset stomach, nausea, vomiting, loss of appetite, burping, or bloating. Published literature is limited in this area.

Dong quai preparations may contain high levels of sucrose, and should be used cautiously by patients with diabetes or glucose intolerance.
Other side effects can include: headache, lightheadedness/dizziness, sedation/drowsiness, insomnia, irritability, fever, sweating, weakness, abnormal heart rhythms, blood pressure abnormalities, wheezing/asthma, hot flashes, worsening premenstrual symptoms, reduced menstrual flow, increased male breast size (gynecomastia), kidney problems (nephrosis), or skin rash.

The safety of Dong quai injected into the skin, muscles, or veins is not known and should be avoided.

People with known allergy/hypersensitivity to Angelica radix or members of the Aplaceae/Umbelliferae family (anise, caraway, carrot, celery, dill, parsley) should avoid Dong quai. Skin rash has been reported with the use of Dong quai, although it is not clear if this was an allergic response. An asthma response has occurred after breathing in Dong quai powder.

If you have a hemorrhagic disease or other bleeding disorder, excessive menses or severe flu do not take Dong quai. If you have gastrointestinal distress or low blood pressure, talk to your doctor before taking Dong quai .

Scientific studies have reported that certain ingredients contained in Dong quai act in a similar manner to the body’s natural hormone estrogen. If you have or are susceptible to hormonally related cancers, such as breast, ovarian and prostate, talk to your doctor before taking this Dong quai.

Dong quai dosage

Adults (18 years and older)

Dong quai is a component of numerous herbal combinations, and various doses have been used traditionally. Powdered/dried root/root slices, fluid extracts, tinctures, decoctions, dried leaf preparations are available to be taken by mouth. Topical preparations are available to be applied to the skin. Safety of intravenous use is not established, although it has been reported in research.

Decoctions: A daily intake of decoction from 3-15 grams of dried root is suggested.

Standardized extract: Take 200mg 2-3 times a day (standardization of Dong quai: the most current available medical and scientific literature indicates that this dietary supplement should be standardized to 0.8-1.1% of ligustilide per dose).

Dong quai dosage for children (younger than 18 years)

There is not enough scientific data to recommend Dong quai for use in children, and it is not recommended due to potential side effects.

Interactions of Dong quai with other medicines

Dong quai has been found to interact with the following medications:

• Anticoagulant medications
• Antiplatelet medications
• Antihypertensive medications
• Estrogen and estrogen-like medications
• Oral contraceptives

Dong quai may increase the risk of bleeding due to anticoagulant and anti-platelet effects, and may heighten the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants such as warfarin (Coumadin) or heparin, anti-platelet drugs such as clopidogrel (Plavix), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve).

Laboratory studies suggest that Dong quai may increase the effects of drugs that affect heart rhythms, such as digoxin, beta-blockers (e.g. Lopressor, Toprol), calcium channel blockers such as nifedipine (Procardia) or other anti-arrhythmic drugs.

It remains unclear if Dong quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant hormonal effects. It is not known if taking Dong quai increases or decreases the effects of oral contraceptives or hormone replacement therapy such as Premarin which contain estrogen, or on the anti-tumor effects of selective estrogen receptor modulators (SERMs) such as tamoxifen.

Dong quai should not be taken in combination with other drugs that cause photosensitivity, such as tretinoin (Retin-A, Renova), and some types of anti-depressants, cancer drugs, antibiotics, or anti-psychotic medications. Patients taking medications should consult their doctor or pharmacist before starting Dong quai.

Interactions with herbs and dietary supplements

In theory, due to its anticoagulant properties, Dong quai may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Dong quai should not be taken with products containing Hypericum perforatum (St. John’s wort) or capsaicin, which are also reported to cause photosensitivity.

Dong quai and pregnancy and breastfeeding

Taking Dong quai during pregnancy is not recommended due to possible hormonal and anticoagulant/anti-platelet effects of the herb. Animal research has reported effects on the uterus that include both stimulation and relaxation. There is a published report of miscarriage in a woman taking Dong quai, although it is not clear that Dong quai was the cause. Dong quai is traditionally viewed as increasing the risk of abortion. There is insufficient evidence regarding the safety of Dong quai during breastfeeding.