Dong Quai Extract: The Complete Scientific Guide

🧬 What is Dong Quai Extract? Complete Identification

Dong quai extract is a concentrated botanical preparation derived from the dried root of Angelica sinensis and has been used in Chinese medicine for >1,500 years.

Medical definition: Dong quai extract is a multi-component herbal extract prepared from the rhizome (root) of Angelica sinensis (Oliv.) Diels that contains volatile phthalides, phenolic acids and coumarin-like compounds and is marketed as a dietary supplement in the United States.

• Alternative names: Danggui, Dang Gui, Chinese angelica, female ginseng (colloquial).
• Scientific classification: Family Apiaceae (Umbelliferae); Genus/species Angelica sinensis.
• Chemical formula (representative constituents): ligustilide C12H14O2, ferulic acid C10H10O4, coumarin C9H6O2.
• Origin & production: Extracted from dried root by aqueous, alcoholic, steam-distillation (volatile oils) or supercritical CO2 methods; standardized extracts typically declare ferulic acid and/or ligustilide marker content.

📜 History and Discovery

Traditional use of Angelica sinensis for gynecologic indications is documented in Chinese materia medica for at least 1,500 years.

• 7th–10th century: Early mentions in Tang and Song dynasty texts prescribing Angelica species for women's blood and menstrual disorders.
• 16th–18th century: Integrated into canonical TCM formulas such as Si Wu Tang for menstrual regulation.
• 19th century onward: Western botanists classified the plant and herbarium records appeared.
• 1950s–1970s: Phytochemical isolation efforts identified phthalides (ligustilide family), ferulic acid and coumarins.
• 1980s–2000s: Preclinical pharmacology studies highlighted vasodilatory, antiplatelet and mild estrogenic activities.
• 2000s–present: Standardization, GC-MS/HPLC fingerprinting and safety interaction awareness (anticoagulants, pregnancy) became central to research and regulation.

Traditional vs modern use: In TCM, Danggui is used to "nourish and invigorate blood" and regulate menstruation; modern research aims to characterize constituent actions (NO-mediated vasodilation, platelet modulation, anti-inflammatory/antioxidant activity) but clinical evidence remains limited and heterogeneous.

⚗️ Chemistry and Biochemistry

Dong quai extract is chemically complex: volatile phthalides (ligustilide family) predominate in the aroma and many bioactivities, while phenolic acids (ferulic acid) provide antioxidant and anti-inflammatory activity.

Molecular composition

• Volatile phthalides: ligustilide, senkyunolide variants (lipophilic; major bioactive aroma-contributing molecules).
• Phenolic acids: ferulic acid, caffeic acid derivatives (polar; antioxidant behavior).
• Coumarins/umbelliferones: low levels but clinically relevant for photosensitivity and bleeding concerns.
• Polysaccharides and trace alkaloids: contribute to aqueous-extract profile.

Physicochemical properties

• Solubility: phthalides soluble in organic solvents (ethanol, oils); phenolic acids water/methanol soluble.
• Stability: phthalides are chemically unstable and vulnerable to oxidation, heat and light; phenolics are more stable.
• Storage: cool, dark, low-oxygen packaging prolongs volatile constituent integrity.

Galenic forms

• Dried root powder (capsules/tablets)
• Ethanolic extract/tincture (concentrated)
• Aqueous decoction (traditional tea)
• Volatile oil fraction (essential oil)
• Standardized extracts (marker-based: ferulic acid, ligustilide)
• Combination multi-herb formulas (Si Wu Tang, etc.)

💊 Pharmacokinetics: The Journey in Your Body

Comprehensive human PK for whole Dong quai extract is limited; most quantitative PK data are constituent-level and show rapid absorption and extensive first-pass metabolism with elimination of conjugated metabolites within 24–48 hours.

Absorption and Bioavailability

Absorption: Small intestine is main absorption site. Lipophilic phthalides are absorbed by passive diffusion; phenolic acids use passive diffusion and carrier-mediated transport.

• Time to peak (Tmax): constituent-dependent; typical 0.5–3 hours in animal/human constituent studies.
• Bioavailability: variable; phthalides often low single-digit % oral bioavailability in animal models due to instability and first-pass metabolism; ferulic acid shows moderate bioavailability with measurable conjugates in plasma.
• Influencing factors: formulation (ethanolic extracts increase lipophilic constituent absorption), food (fat increases phthalide absorption), gut flora and co-administered drugs.

Distribution and Metabolism

Distribution: Animal data show tissue presence in liver, kidney and reproductive tissues; some phthalides cross blood–brain barrier in experimental models.

Metabolism: Extensive phase I oxidation and phase II glucuronidation/sulfation; gut microbiota contributes to transformation of certain glycosides and conjugates. CYP enzymes (in vitro data implicate CYP3A4, CYP2C family) and UGTs are implicated but whole-extract clinical relevance is incompletely defined.

Elimination

Routes: Renal excretion of conjugates (urine) and biliary elimination for some metabolites; volatile constituents may be exhaled or metabolized.

Half-life: Constituent-specific; ferulic acid conjugates typically have elimination half-lives in the order of 1–4 hours, while phthalides are rapidly metabolized with limited plasma persistence; most measurable metabolites clear within 24–48 hours.

🔬 Molecular Mechanisms of Action

Dong quai extract exerts multiple putative activities including endothelial NO upregulation, antiplatelet action, anti-inflammatory and weak estrogenic signaling via constituent-specific interactions.

• Cellular targets: endothelial cells, platelets, vascular smooth muscle, immune cells and estrogen receptor–expressing tissues.
• Key pathways: nitric oxide (NO)–cGMP vasodilation, platelet aggregation inhibition (thromboxane/ADP pathways), NF-kB downregulation and weak ERα/ERβ modulation.
• Gene effects: in vitro/animal data show eNOS activation, reduced TNF/IL-6 transcription and modulation of selected CYP genes.
• Enzymatic modulation: in vitro inhibition/induction of CYP3A4 and UGTs by specific constituents; platelet-related COX/thromboxane interference observed in cell/platelet assays.

✨ Science-Backed Benefits

This section summarizes plausible clinical benefits supported primarily by preclinical data and limited clinical trials; high-quality RCT evidence remains sparse and heterogeneous.

🎯 Dysmenorrhea and Menstrual Regulation

Evidence Level: low to medium

Physiology: May improve uterine perfusion and modulate smooth muscle contractility, reducing ischemic pain during menses.

Molecular mechanism: Increased endothelial NO, reduced prostaglandin-mediated uterine contractions and anti-inflammatory effects.

Target population: Women with primary dysmenorrhea or TCM-defined menstrual irregularities.

Onset: Symptomatic benefit often assessed across 1–3 menstrual cycles.

Clinical Study: No verifiable PubMed citation is available in this environment. Please allow a literature search to supply exact trial citations and quantitative outcomes (e.g., % pain reduction, p-values, sample sizes).

🎯 Support for Functional/Subjective Anemia

Evidence Level: low

Physiology: Traditional use to "nourish blood"; may improve subjective fatigue and microcirculation but does not replace iron therapy for iron-deficiency anemia.

Molecular mechanism: Vasodilation, anti-inflammatory action and improved peripheral perfusion may relieve symptoms accompanying low hemoglobin.

Target: Individuals with non-iron-deficiency fatigue related to menstrual blood loss or TCM diagnoses.

Clinical Study: No verified human RCT with robust hematologic endpoints is available here; literature search required for numeric effect sizes.

🎯 Circulatory / Peripheral Perfusion Support

Evidence Level: low to medium

Physiology: Extract constituents relax vascular smooth muscle and increase NO availability, which can improve peripheral blood flow.

Onset: Acute vascular responses in preclinical models; clinical subjective changes may take days–weeks.

Clinical Study: Specific human studies and quantitative improvements (e.g., blood flow percentage changes) require literature verification.

🎯 Antiplatelet / Bleeding Risk Modulation

Evidence Level: medium

Physiology & mechanism: In vitro inhibition of platelet aggregation and alteration of thromboxane/prostacyclin balance; presence of coumarin-like molecules increases bleeding potential in combination with anticoagulants.

Clinical relevance: Increased bleeding events and INR changes have been reported in pharmacovigilance and case reports when combined with warfarin or antiplatelets.

Clinical Study: No specific trial citations available without PubMed access; please authorize database lookup for exact case series/quantitative risk estimates.

🎯 Anti-inflammatory Effects

Evidence Level: low to medium

Mechanism: Downregulation of NF-kB and MAPK signaling, reduced TNF-alpha and IL-6 in cellular/animal models.

Application: Adjunctive support for mild inflammatory complaints; not a first-line anti-inflammatory drug.

Clinical Study: Human biomarker trials are limited; a literature search will supply quantitative cytokine change data where available.

🎯 Antioxidant Activity

Evidence Level: medium (preclinical)

Mechanism: Ferulic acid and related phenolics scavenge ROS and can upregulate endogenous antioxidant enzymes in vitro via Nrf2-related pathways.

Target: Individuals seeking general oxidative stress support; clinical outcome data limited.

Clinical Study: Specific human oxidative biomarker studies need verification with primary literature.

🎯 Neuroprotective / Analgesic (Preclinical)

Evidence Level: low

Mechanism: Phthalides may reduce ischemia-related neuronal injury, modulate calcium handling and reduce oxidative/inflammatory cascades in animal models.

Clinical translation: Not established for routine human neuroprotection.

Clinical Study: No validated human RCT evidence in this environment; consult updated literature for translational studies.

🎯 Menopausal Symptom Support (Adjunctive)

Evidence Level: low

Mechanism: Weak phytoestrogenic signaling plus vascular modulation may attenuate vasomotor symptoms in some women when used in multi-herb formulas.

Onset: Weeks to months; highly individual.

Clinical Study: Most human data derive from multi-herb formulas rather than isolated Dong quai; precise clinical trial citations require literature search.

📊 Current Research (2020-2026)

High-quality, recent randomized controlled trials specifically isolating standardized Dong quai extracts between 2020–2026 cannot be cited here because I lack live PubMed/DOI access in this environment.

If you would like a fully referenced list of at least six verified studies (2020–2026) with PMIDs/DOIs, please permit an online literature search or provide access to PubMed. Below are recommended search targets you can authorize: "Angelica sinensis randomized trial 2020", "ligustilide pharmacokinetics human", "Dong quai warfarin interaction case report".

💊 Optimal Dosage and Usage

There is no NIH/ODS or FDA established RDI for Dong quai; commonly used supplement ranges are 500–3,000 mg/day depending on preparation and standardization.

Recommended Daily Dose

• Dried root powder: 1,000–3,000 mg/day divided
• Ethanolic standardized extract: 500–1,500 mg/day (product-dependent)
• Volatile oil fractions: Use manufacturer guidance; typically lower mg doses due to concentration

Therapeutic range: 500–3,000 mg/day. Start low (e.g., 500 mg/day) and titrate based on response and tolerability.

Timing

• Take with meals to improve tolerance and absorption of lipophilic constituents.
• For menstrual support, some protocols begin dosing several days pre-menses and continue through cycle; clinical evidence for timing is limited.

Forms and Bioavailability

• Whole-root powder: Broader spectrum, lower phthalide bioavailability.
• Ethanolic extract (standardized): Better phthalide recovery and likely higher bioavailability for lipophilic constituents.
• Aqueous decoction: Good for polar phenolics; poor for volatile phthalides.
• Volatile oil: High phthalide exposure but unstable; safety concerns at high concentration.

🤝 Synergies and Combinations

Dong quai is classically combined with Paeonia lactiflora and Rehmannia glutinosa in Si Wu Tang; these combinations are used for menstrual regulation and may offer complementary mechanisms.

• Paeonia lactiflora: may augment antispasmodic and analgesic effects.
• Iron supplements: commonly combined in TCM for symptomatic anemia support though evidence for improved iron absorption is lacking.
• Antioxidant vitamins: additive antioxidant effects with vitamin E/C are plausible.

⚠️ Safety and Side Effects

Typical adverse events are generally mild (GI upset, photosensitivity); serious bleeding events occur when Dong quai is combined with anticoagulants—this interaction is the principal safety concern.

Side effect profile (estimated frequencies)

• Gastrointestinal upset: 1–5% (estimated)
• Skin photosensitivity/rash: rare
• Allergic reactions: rare
• Excessive bleeding (with anticoagulants): uncommon but clinically significant

Overdose

Toxic dose: Not well-defined in humans. Signs of excessive exposure: nausea, vomiting, hypotension, prolonged bleeding and photosensitivity. Management is supportive; seek medical care for significant bleeding.

💊 Drug Interactions

Dong quai can produce clinically significant interactions—most notably with anticoagulants and antiplatelet agents—so medication review is essential before use.

⚕️ Vitamin K antagonists (e.g., Warfarin)

• Interaction type: Pharmacodynamic (increased bleeding) and possible pharmacokinetic modulation
• Severity: high
• Recommendation: Avoid concurrent use or monitor INR closely; coordinate with anticoagulation clinic if used.

⚕️ Direct Oral Anticoagulants (Apixaban, Rivaroxaban, Dabigatran)

• Interaction type: Pharmacodynamic (increased bleeding risk)
• Severity: high
• Recommendation: Avoid unless under specialist supervision; monitor for bleeding.

⚕️ Antiplatelet agents (Aspirin, Clopidogrel)

• Interaction type: Additive antiplatelet effect
• Severity: high
• Recommendation: Use caution or avoid; monitor clinically.

⚕️ Estrogenic/Hormonal Agents (HRT, OCPs)

• Interaction type: Potential additive estrogenic effects
• Severity: medium
• Recommendation: Exercise caution in hormone-sensitive cancer patients; discuss with prescriber.

⚕️ CYP3A4 substrates/inhibitors/inducers (Statins, CCBs)

• Interaction type: Potential PK modulation—based on in vitro constituent data
• Severity: medium
• Recommendation: Monitor for altered drug effects; consult clinician for narrow therapeutic index drugs.

⚕️ Herbs with antiplatelet/anticoagulant activity (Ginkgo, Fish oil, Garlic)

• Interaction type: Additive pharmacodynamic bleeding risk
• Severity: medium–high
• Recommendation: Avoid multiple concurrent agents with similar bleeding effects.

🚫 Contraindications

Absolute contraindications include pregnancy and concomitant use with anticoagulants unless under close supervision.

Absolute

• Pregnancy (uterotonic risk)
• Known hypersensitivity to Apiaceae family
• Unsupervised use with warfarin or active anticoagulation in patients at high bleeding risk

Relative

• Breastfeeding (insufficient safety data)
• Hormone-sensitive cancers
• Liver disease (possible metabolic interactions)
• Bleeding disorders or thrombocytopenia

Special populations

• Children: avoid—no pediatric dosing
• Elderly: start low and review concomitant medications

🔄 Comparison with Alternatives

Ethanolic standardized extracts are preferred for reproducible phthalide exposure while aqueous decoctions favor phenolic acids; whole-root powder retains broader constituents but is less standardized.

• Compared with Paeonia lactiflora: Paeonia may have stronger antispasmodic effects and is frequently combined with Dong quai.
• Compared with pharmaceuticals: NSAIDs (e.g., mefenamic acid) have stronger evidence for dysmenorrhea; Dong quai is an herbal adjunct with modest supporting data.

✅ Quality Criteria and Product Selection (US Market)

Choose products with botanical authentication, standardized marker content, GMP manufacturing and third-party COAs (USP/NSF/ConsumerLab where available).

• Look for declared Latin name (Angelica sinensis) and plant part (root).
• Prefer multi-marker standardization: ferulic acid plus a phthalide marker (e.g., ligustilide) with assay method described.
• Request COA for heavy metals, pesticides, microbial limits and marker quantification (HPLC/GC-MS data).

📝 Practical Tips

• Start at low dose (e.g., 500 mg/day) and titrate for effect and tolerability.
• Always disclose Dong quai use to prescribers—especially if taking anticoagulants or hormone therapy.
• Store products in cool, dark conditions; volatile-oil rich products may need refrigeration.
• Stop 7–14 days prior to elective surgery to minimize bleeding risk.

🎯 Conclusion: Who Should Take Dong Quai Extract?

Dong quai extract may be considered by women seeking traditional herbal support for menstrual regulation or circulatory support who do not have contraindications (pregnancy, anticoagulant therapy, hormone-sensitive cancer); cautious, informed use with standardized products is essential.

If you require a fully referenced (PMID/DOI) list of clinical studies, precise randomized trial effect sizes and verified recent publications (2020–2026), please authorize a live PubMed/DOI search; I will return a citation-verified update with exact trial statistics, PMIDs and DOIs.