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Organic Dang Gui

Also known as: Dang Gui, Dong Quai, Chinese Angelica, Angelica sinensis

Overview

Angelica sinensis, commonly known as Dang Gui or Dong Quai, is a root extract from a perennial plant native to China, widely utilized in Traditional Chinese Medicine (TCM). It is typically consumed as a dried root or incorporated into various herbal formulas. Traditionally, Dang Gui has been employed for gynecological conditions such as menstrual disorders and menopausal symptoms, as well as for improving blood circulation and acting as an anti-inflammatory agent. Contemporary research is exploring its potential applications in conditions like diabetic foot, coronary artery disease, hyperthyroidism, and bone marrow suppression. The herb contains bioactive compounds including phthalides, organic acids, and polysaccharides, which are believed to contribute to its diverse pharmacological effects. While research maturity is moderate, with an increasing number of systematic reviews and meta-analyses, the quality of evidence is mixed, with many studies originating from Chinese databases.

Benefits

Dang Gui, primarily when used in multi-herb formulas, demonstrates several evidence-based benefits. For diabetic foot, Danggui Sini Decoction (DSD) significantly improves clinical effective rates, supported by a meta-analysis of five studies with low heterogeneity. In coronary artery disease, specifically angina pectoris, modified DSD combined with Western medicine significantly enhances clinical efficacy, reduces angina attack duration, lowers inflammatory markers, and improves cardiac function, as shown in a meta-analysis of 13 RCTs (n=1,232). For hyperthyroidism, Danggui Liuhuang Decoction combined with antithyroid drugs improves treatment outcomes and safety profiles compared to antithyroid drugs alone, according to a systematic review and meta-analysis. Additionally, Dang Gui exhibits potential anti-thrombotic effects and can modulate drug metabolism enzymes (e.g., CYP450), which may influence the pharmacokinetics of co-administered drugs. The evidence primarily stems from Chinese patient populations, with statistically significant improvements reported in clinical efficacy rates and symptom scores over treatment durations of weeks to months.

How it works

Dang Gui exerts its therapeutic effects through multiple mechanisms, primarily targeting inflammation, oxidative stress, and vascular function. Network pharmacology and molecular docking studies suggest that its bioactive compounds modulate various cytokines, improve microcirculation, and inhibit pro-inflammatory enzymes such as COX-1 and COX-2. It primarily interacts with the cardiovascular, endocrine, and immune systems. At a molecular level, Dang Gui influences inflammatory mediators, enzymes involved in drug metabolism (specifically CYP450 isoforms), and signaling pathways crucial for blood flow and tissue repair. The absorption and bioavailability of its compounds can vary, and co-administration with other herbs or drugs may alter its pharmacokinetics, contributing to its complex multi-target action.

Side effects

Dang Gui is generally considered safe when used in traditional doses as part of herbal formulas, with no major safety concerns reported in meta-analyses. The most commonly reported side effect is mild gastrointestinal discomfort, which occurs occasionally. However, there is a potential for uncommon or rare side effects, particularly herb-drug interactions. Dang Gui can modulate CYP450 enzymes, which may affect the metabolism and pharmacokinetics of co-administered drugs, especially anticoagulants and certain cardiovascular medications. Therefore, caution is advised when combining Dang Gui with these drugs. Contraindications generally include pregnancy and bleeding disorders in TCM practice, although high-quality randomized controlled trial data to support these specific warnings are limited. Data on special populations are also limited, as most studies exclude pregnant women and individuals with severe comorbidities.

Dosage

The optimal dosage for Dang Gui is not standardized and varies significantly depending on the specific herbal formula and the condition being treated. It is most commonly administered as part of decoctions, such as Danggui Sini Decoction, with doses typically standardized within TCM practice. However, clinical trials often show variability in dosages. A maximum safe dose has not been well defined, but traditional use suggests safety within the prescribed limits of multi-herb formulas. Dang Gui is usually taken daily as part of these multi-herb decoctions for several weeks to months to achieve therapeutic effects. The decoction form is the most studied, while extracts and powders have less research supporting their efficacy. Co-administration with other herbs or drugs may influence its absorption and metabolism, and there are no specific cofactors identified as required for its action.

FAQs

Is Danggui safe to use with Western medications?

Potential interactions exist, especially with anticoagulants and drugs metabolized by CYP450 enzymes. Medical supervision is recommended to avoid adverse effects.

How soon can benefits be expected from Danggui?

Clinical trials typically report observable effects within weeks to months of consistent use, depending on the specific condition being treated.

Is Danggui effective alone or only in combination with other herbs?

Most scientific evidence supports Danggui's efficacy when used in combination with other herbs or conventional treatments, rather than as a standalone supplement.

Can Danggui be used for all types of blood disorders?

Current robust evidence primarily supports its use for specific conditions like diabetic foot and hyperthyroidism. Broader claims for all blood disorders lack sufficient data.

Research Sources

https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1347021/full – This meta-analysis and network pharmacology study found that Danggui Sini Decoction (DSD) significantly improves the clinical effective rate in diabetic foot patients. Molecular docking studies further supported a multi-target action, suggesting DSD's therapeutic effects are mediated through various biological pathways. The study highlighted the potential of DSD as an effective treatment for diabetic foot, despite the small number of included studies.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11183329/ – This systematic review and meta-analysis of 13 RCTs (n=1,232) demonstrated that modified Danggui Sini Decoction combined with Western medicine significantly improved clinical efficacy, reduced angina attack duration, lowered inflammatory markers, and enhanced cardiac function in patients with coronary artery disease and angina pectoris. The findings suggest a beneficial role for DSD in managing angina, although heterogeneity in formulas was noted.
https://pubmed.ncbi.nlm.nih.gov/39732298/ – This systematic review and meta-analysis indicated that Danggui Liuhuang Decoction combined with antithyroid drugs improved treatment outcomes and safety profiles compared to antithyroid drugs alone in patients with hyperthyroidism. The study suggests a synergistic effect, enhancing efficacy and potentially mitigating side effects of conventional treatment, though it noted potential publication bias and small sample sizes.
https://pubs.acs.org/doi/10.1021/acsomega.1c01847 – This experimental study, primarily using animal models, investigated the pharmacokinetic effects of Danggui. It found that Danggui can affect drug metabolism enzymes, particularly CYP450 isoforms, which may alter the pharmacokinetics of co-administered drugs. This preclinical evidence highlights the potential for herb-drug interactions and underscores the need for caution in clinical settings.