Dong Quai
Angelica sinensis · Dāng Guī 当归
The 'female ginseng' used in women's health formulas.
Evidence tier
Mixed
Research weight
Citations
15 verified / 17
Classification
TCM Herb
❝
What the evidence says. Conflicting results across studies; benefit uncertain.
What is Dong Quai?
Dong Quai (Angelica sinensis · Dāng Guī 当归) is a traditional Chinese medicine herb used for traditional menstrual / menopausal support. NutriDex grades the human evidence as Mixed. Dong Quai (Dāng Guī) is a cornerstone 'blood-tonifying' herb in TCM, almost always used within multi-herb formulas rather than alone. Western trials of Dong Quai by itself for menopausal hot flashes have been largely negative, while some combination formulas show benefit — making it hard to attribute effects to the herb specifically. Evidence overall is mixed and the traditional and clinical-trial contexts differ.
Purported Benefits
✓Traditional menstrual / menopausal support
✓Blood-tonifying (TCM)
✓Often used in combination formulas
Evidence by outcome
The same supplement can be well-proven for one use and unproven for another — here is the human evidence graded outcome by outcome.
| Outcome | Evidence | Effect | Studies |
|---|---|---|---|
| Menopausal hot flashes (Dong Quai alone)RCTs of the herb alone (incl. Hirata 1997, ADT men) consistently showed no benefit over placebo. | Moderate | — no effect · negligible | 3 |
| Menopausal symptoms in combination formulasSome combo trials (e.g. Angelica+chamomile) show large benefit while Dang Gui Buxue Tang was mostly negative; can't attribute to the herb. | Mixed | ↔ mixed | 3 |
| Iron-deficiency anemia (herbal formula adjunct to iron)One meta-analysis in children found higher hemoglobin when Angelica-containing formulas added to iron; Angelica not isolated. | Preliminary | ↑ benefit · small | 1 |
| Progression to end-stage renal disease (CKD)Large observational cohort linked use to ~23% lower ESRD risk with dose-response; observational only, confounding likely. | Preliminary | ↑ benefit · moderate | 1 |
| Warfarin potentiation (bleeding risk)Case report of INR rise to ~4.9 on dong quai, normalizing after stopping; a caution, not a benefit. | Preliminary | ⚠ risk | 1 |
Dosing & Compounds
Typical Dose
Commonly 3–15 g in decoction or formula; rarely used alone in TCM.
Active Compounds
Safety & Cautions
May increase bleeding (avoid with anticoagulants) and photosensitivity. Avoid in pregnancy and hormone-sensitive conditions. Educational only — always check with your doctor or pharmacist before combining Dong Quai with any medicine.
Dong Quai drug interactions
Known or theoretical interactions between Dong Quai and common medications — educational, not exhaustive. Always check with your doctor or pharmacist before combining Dong Quai with any medicine.
Caution
Warfarin
Dong quai may increase bleeding and raise INR when combined with warfarin.
Contains coumarin derivatives and antiplatelet constituents that can enhance warfarin's effect. MSKCC — Dong Quai
Caution
Hormone therapy / tamoxifen
Possible estrogenic activity may be inadvisable with hormone-sensitive cancers or anti-estrogen therapy.
Phytoestrogen-like constituents could influence estrogen-sensitive tissues and oppose anti-estrogens. Memorial Sloan Kettering — Dong Quai
Key Studies ★ 17 studies
meta-analysis
Endometrial cancer meta-analysis 2025
✓ PubMed
Systematic review/meta-analysis of 9 RCTs (889 patients) found Angelica-based herbal formulas significantly improved quality of life (MD -5.89, 95%CI -6.65 to -5.13) and reduced pain and recurrence in endometrial cancer patients.
Meta-analysis
Discover Oncology 2025
✓ Full text
Systematic review/meta-analysis of 9 RCTs (889 endometrial cancer patients) found Angelica-based formulas improved quality of life (MD -5.89, 95% CI -6.65 to -5.13) and reduced pain, alongside immune-function improvements.
Meta-analysis
Front Pharmacol 2024
✓ Full text
Systematic review/meta-analysis of 28 RCTs (3,044 children/adolescents) found East Asian herbal medicine (Angelicae Sinensis Radix used in 50% of studies) added to oral iron raised hemoglobin (MD 12.73 g/L) and reduced GI adverse events (RR 0.43) versus iron alone.
Meta-analysis
Ann Transl Med 2017
✓ PubMed
Meta-analysis of 7 RCTs (460 patients) found Danggui Buxue Decoction plus standard therapy did not significantly improve hemoglobin in renal anemia overall (WMD -8.75, 95% CI -18.64 to 1.13), with benefit only in the 5:1 Astragalus:Angelica subgroup.
rct
Lin 2010 (ADT RCT)
✓ PubMed
In a randomized double-blind placebo-controlled trial in 22 men (17 completed) on LHRH-agonist androgen deprivation therapy for prostate cancer, daily Dong Quai for 3 months produced no significant difference in hot flash severity, frequency, or duration versus placebo.
rct
Haines 2008 (DBT RCT)
✓ PubMed
A 6-month randomized double-blind placebo-controlled trial of Dang Gui Buxue Tang (Angelica sinensis + Astragalus, 1:5) in 100 symptomatic Hong Kong Chinese women found overall no significant benefit over placebo for vasomotor symptoms, with superiority only for mild hot flushes and no serious adverse events.
RCT
Kupfersztain 2003 (RCT, n=55)
✓ PubMed
RCT of a combined Angelica sinensis + Matricaria chamomilla preparation (Climex) vs placebo: 90-96% reduction in hot flash frequency/intensity over 3 months vs 15-20% with placebo, with improved sleep and fatigue. Suggests benefit only in combination, not as a single-herb effect.
review
Zhao 2025 (review)
✓ PubMed
Comprehensive review summarizing ten pharmacological actions of Angelica sinensis polysaccharides (ASP), including anemia improvement via increased hemoglobin/RBC, immunomodulation, antioxidant and antitumor effects; authors note clinical trials and safety data are still lacking.
cohort study
Taiwan CKD cohort 2023
✓ PubMed
In a longitudinal cohort of 64,218 chronic kidney disease patients (18,348 Angelica sinensis users), herb use was associated with ~23% lower end-stage renal disease risk vs non-use, with up to ~52% reduction at highest cumulative doses (dose-dependent).
Observational
Wu 2023
✓ Full text
In a propensity-matched longitudinal cohort of 64,218 CKD patients (2001–2017), Angelica sinensis use was associated with a 23% lower risk of end-stage renal disease (aHR 0.77, 95% CI 0.69–0.86), with a dose-response effect (aHR 0.48 at cumulative dose ≥15 g).
Review
Lin 2017 (Review)
✓ PubMed
Review of Danggui Buxue Tang (Astragali Radix : Angelicae Sinensis Radix in fixed 5:1 ratio) for women's/menopausal ailments; details standardized preparation, marker constituents (ferulic acid, calycosin, formononetin, astragaloside IV) and estrogenic/hematopoietic mechanisms underlying traditional 'blood-tonifying' use.
review
Warfarin interaction review (Singapore Med J)
✓ Full text
A review documents a case of a 46-year-old woman on warfarin 5 mg/day whose INR rose to 4.05 and 4.90 after taking dong quai (~565 mg 1-2x/day) and normalized to 2.48 a month after stopping, attributed to pharmacodynamic potentiation via coumarin constituents (ferulic acid, osthole) rather than altered warfarin levels.
preclinical study
Wang 2024 (polysaccharides)
✓ PubMed
In a mouse blood-deficiency model, Angelica sinensis polysaccharides (notably neutral APS-H2O) raised hematopoietic regulators (EPO, G-CSF, IL-3) and lowered TNF-alpha, restoring blood parameters toward normal, supporting the herb's traditional blood-tonic use.
Study
Hirata 1997
✓ PubMed
Dong Quai alone did not reduce menopausal hot flashes vs placebo.
reference
LactMed (NIH/NCBI)
✓ Full text
The NIH Drugs and Lactation Database (LactMed) reports no published data on dong quai levels in breast milk or effects on breastfed infants and advises that dong quai is best avoided during breastfeeding, citing potential bleeding-risk and photosensitivity concerns.
Study
Combination-formula trials
Verify ↗
Some multi-herb formulas containing Dong Quai eased symptoms.
Preclinical
Preclinical
Verify ↗
Mild estrogenic and antispasmodic activity reported in lab studies.