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Red sage extract

Also known as: Red sage, Danshen, Salvia miltiorrhiza

Overview

Salvia miltiorrhiza root extract, commonly known as red sage extract or Danshen, is derived from the dried roots of the plant. It is a traditional Chinese medicine supplement primarily used for cardiovascular, reproductive, and bone health. The extract contains bioactive compounds such as tanshinones and salvianolic acids, which are phenolic compounds with significant antioxidant properties. Research indicates its primary applications include the treatment of lower urinary tract symptoms (LUTS), erectile dysfunction, polycystic ovary syndrome (PCOS), and osteoporosis. The research maturity for Salvia miltiorrhiza is moderate, with several randomized controlled trials (RCTs) and systematic reviews/meta-analyses available, particularly in reproductive and bone health contexts. The quality of evidence varies but includes well-conducted RCTs and meta-analyses with adequate sample sizes and controls, supporting its traditional uses with modern scientific backing.

Benefits

Red sage extract offers several evidence-based benefits, particularly in reproductive health, bone health, and urinary/erectile function. For lower urinary tract symptoms (LUTS) and erectile function, a recent randomized controlled trial demonstrated that *S. miltiorrhiza* root extract significantly improved LUTS and erectile function in men, showing statistically significant improvements in symptom scores compared to placebo. In the context of reproductive health for women with PCOS, a systematic review and meta-analysis of six RCTs (n=390) found that *S. miltiorrhiza* combined with letrozole significantly increased pregnancy rates (RR 2.60, 95% CI 1.06–6.39, p=0.04) compared to letrozole alone, indicating enhanced fertility outcomes. For bone health, a systematic review of clinical and preclinical studies suggests that *S. miltiorrhiza* extracts inhibit bone resorption and promote bone formation by modulating signaling pathways (MAPK/NF-κB/NFATc1), showing efficacy rates between 77% and 96.67% in traditional clinical trials. Additionally, the extract exhibits potent antioxidant activity, attributed to its phenolic compounds, which stabilize free radicals and protect against oxidative stress.

How it works

The therapeutic effects of *Salvia miltiorrhiza* extract are primarily attributed to its bioactive compounds, notably tanshinones and salvianolic acids. These compounds exert their effects through multiple mechanisms. In bone health, they inhibit osteoclastogenesis and bone resorption by suppressing key signaling pathways such as MAPK/NF-κB/NFATc1 and reducing cathepsin K activity. Concurrently, they promote osteoblastogenesis and angiogenesis, facilitating bone regeneration. The extract's potent antioxidant activity stems from its phenolic compounds, which neutralize free radicals by donating electrons or hydrogen, thereby protecting against oxidative stress. Furthermore, *S. miltiorrhiza* may modulate hormonal and vascular functions, which are believed to contribute to its beneficial effects on erectile function and reproductive outcomes. The absorption and bioavailability of these compounds vary, with lipophilic tanshinones and water-soluble salvianolic acids having distinct pharmacokinetic profiles.

Side effects

Overall, *Salvia miltiorrhiza* extract is considered safe, with no serious adverse events reported in clinical trials. Common side effects are rare and, when they occur, are typically mild, such as gastrointestinal discomfort. While no significant drug interactions or contraindications have been robustly documented in the provided research, caution is generally advised when combining *S. miltiorrhiza* with anticoagulants due to its potential, though not explicitly detailed in these sources, for blood-thinning effects. Individuals on blood-thinning medications should consult a healthcare provider before use. Special populations, such as pregnant women, should also seek medical advice from healthcare providers before incorporating *S. miltiorrhiza* into their regimen, as its effects on these groups have not been extensively studied.

Dosage

Clinical trials investigating *Salvia miltiorrhiza* extract have utilized daily doses ranging from 400 mg to 800 mg for conditions such as lower urinary tract symptoms (LUTS) and reproductive indications. For polycystic ovary syndrome (PCOS), the extract was used as an adjunct to letrozole, with the exact dosing varying across different studies. There is currently no standardized maximum dose established for *S. miltiorrhiza*. While typical herbal doses for other sage species can range up to 1500 mg daily, for *S. miltiorrhiza* specifically, it is recommended to adhere to the parameters observed in clinical trials. The timing of administration and the specific formulation of the extract (e.g., ethanol vs. water extracts) can influence its efficacy and bioavailability, suggesting that product-specific guidelines should be considered.

FAQs

Is red sage extract effective for erectile dysfunction?

Yes, evidence from randomized controlled trials indicates that red sage extract can improve erectile function in men, particularly those also experiencing lower urinary tract symptoms.

Can it be used alone for PCOS?

While beneficial, red sage extract is most effective for PCOS when used as an adjunct to standard treatments, such as letrozole, rather than as a standalone therapy.

Are there safety concerns?

Red sage extract is generally considered safe with a low incidence of mild side effects. However, if you are taking blood thinners, it is advisable to consult a healthcare provider due to potential interactions.

How soon do benefits appear?

Clinical trials typically assess the benefits of red sage extract over periods ranging from 8 to 12 weeks, suggesting that consistent use over several weeks may be necessary to observe effects.

Research Sources

https://www.mdpi.com/2072-6643/17/1/24 – This randomized controlled trial investigated the effects of *S. miltiorrhiza* extract on men with lower urinary tract symptoms (LUTS). The study found that daily doses of 400-800 mg significantly improved both LUTS and erectile function scores compared to placebo over 12 weeks, demonstrating good methodology and proper controls.
https://onlinelibrary.wiley.com/doi/10.1155/2021/9971403 – This systematic review and meta-analysis of six RCTs (n=390) evaluated *S. miltiorrhiza* in women with PCOS. It concluded that combining *S. miltiorrhiza* with letrozole significantly increased pregnancy rates compared to letrozole alone, highlighting its potential as an adjunct therapy despite some heterogeneity in study designs.
https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1483431/pdf – This systematic review, encompassing both clinical and preclinical studies, explored the anti-osteoporosis effects of *S. miltiorrhiza*. It found that the extract inhibits bone resorption and promotes osteogenesis by modulating key signaling pathways, with reported clinical efficacy rates between 77% and 96.67%, providing comprehensive mechanistic insights.
https://www.mdpi.com/2304-8158/11/3/390 – This source discusses the potent antioxidant activity of *S. miltiorrhiza* extract, attributing it to its phenolic compounds. These compounds effectively stabilize free radicals and protect against oxidative stress, contributing to the extract's overall therapeutic profile.