Angelica sinensis

What is Angelica sinensis?

Angelica sinensis is the root of a plant in the carrot family. Most shops sell it as dong quai or dang gui. It is used mainly for period pain and menopause symptoms.

The root is dried, then sliced, powdered or made into capsules and liquid extracts. In Chinese herbal practice it is rarely taken alone. It is usually one root among several in a set formula.

It has been used for many centuries. Long use in a tradition is not proof that it works, and it is not proof that it is safe. Both still have to be tested.

Here is the honest verdict. Human evidence is thin, and the best-known trial found no benefit for hot flushes. The root can also raise bleeding risk if you take a blood thinner (anticoagulant).

How does Angelica sinensis work?

No one has shown, in people, how dong quai produces any benefit. Most of what is said about it comes from lab dishes and animal work.

In test tubes, ligustilide relaxes smooth muscle, the muscle in the gut and womb wall. That is the usual story offered for period cramps. Whether it happens in a woman's body is not established.

In cell studies, ferulic acid and some coumarins slow platelets, the cells that start a clot. This fits the real-world reports of bleeding with warfarin. It is also the reason to treat the bleeding risk as the main hazard.

In animals, root polysaccharides appear to nudge the making of red blood cells. This is the basis of the old "blood tonic" idea. It has not been confirmed in human trials.

Tradition described it as warming and moving, said to "nourish and move the blood". That is a system of ideas, not a tested mechanism.

What forms does Angelica sinensis come in?

You will meet it most often as dried root slices or as capsules.

- Dried sliced root, simmered in water to make a decoction (a strong herbal tea). - Powdered root, loose or in capsules and tablets. - Liquid extracts and tinctures, usually in alcohol.

- Granules made from a brewed formula, dissolved in hot water. - Soup roots sold in Chinese grocers, cooked with chicken or ribs. - Fixed formulas such as Si Wu Tang and Dang Gui Bu Xue Tang, where it sits beside other herbs.

The essential oil is not a kitchen or home product. Do not swallow it.

Quality varies widely. Products rarely state how much ligustilide or ferulic acid they hold.

Where it comes from:

Chinese doctors wrote about dang gui from at least the Han era, some two thousand years ago. Early drug books, such as the Shennong Ben Cao Jing, listed it among the common roots.

Classical texts placed it in the "blood" group of herbs. Writers said it built blood and kept it moving. It was given for scant or painful periods, for pale weak patients, and after childbirth.

It spread into Japanese Kampo and Korean practice, and later into Western herb shops. By the 1990s it was marketed in Europe and North America as a women's herb.

This is a record of what was taught and done. It is not a record of tested results, and it is not a reason to dose yourself.

What does Angelica sinensis help with?

• Period pain and cramps: This is the oldest and most common use. Chinese texts gave it, in formulas, for cramping and clotted flow. Human evidence is weak. The few trials test multi-herb mixes, not the root alone. That makes it hard to credit any result to dong quai.
• Irregular or scant periods: Tradition used it to "move the blood" and settle the cycle. It was a staple of women's formulas. No good trial supports this. Irregular bleeding has many causes, some serious. See a doctor before treating it yourself.
• Menopause hot flushes and night sweats: This is the main Western selling point. It is also the one use with a real trial behind it, and the result was negative. In a 24-week trial, dong quai root worked no better than a dummy pill for hot flushes (PMID 9418700). On current evidence, do not expect relief.
• Tiredness linked to low blood counts ("blood tonic" use): Classical practice paired it with astragalus to build blood after illness or birth. In animals, root sugars appear to nudge red cell production. That has not been shown in people. Low blood counts need a diagnosis, not a tonic. Iron deficiency and other causes are treatable.
• Cold hands and feet, said to be poor circulation: Texts called the root warming and said it moved blood to the limbs. It appears in old formulas for cold, numb hands. There is no human trial for this. Persistent cold or colour change in fingers should be checked by a doctor.
• Mild constipation: The oily root was thought to moisten the bowel, mainly in older or frail patients. Loose stools are a known side effect, which fits. No trial has tested it for constipation. Simple steps such as fluid, fibre and movement have far better support.

What are the side effects of Angelica sinensis?

• Bloating, gas or belly upset
• Loose stools or diarrhoea
• Easy bruising or longer bleeding from small cuts
• Heavier periods
• Skin that burns faster in sunlight
• Rash or itching, more likely if you react to celery or carrot
• Headache
• Low blood pressure feeling, such as light-headedness

Good to know:

Most reported effects are mild and settle when people stop. Gut upset is the one most often named.

The serious concern is bleeding. Case reports link dong quai with warfarin to clotting test spikes and bruising. Stop before planned surgery.

Sun sensitivity is a real, if less common, issue. The root holds coumarins, plant compounds tied to sunburn and rash.

Serious harm from the root alone is rarely reported. That is partly because few careful studies have looked.

How much Angelica sinensis should you take?

• Recommended daily: Labels on dong quai capsules often list 500 mg to 2 g of root powder a day. Chinese herbal textbooks list 3 g to 15 g of dried root a day, simmered in water, as part of a formula. Those are the figures printed on packs and in textbooks. They are not advice for you, and they do not fit everyone. Strength varies between products, so the same number on two labels can mean different things. If you take any prescribed drug, ask your doctor or pharmacist before you start.
• Best time of day: Time of day does not seem to matter. No study has compared morning with evening use. Many people split the amount across the day, simply to be kinder to the stomach. Pick a time you will remember. If you spend long spells in strong sun, be aware the root may make skin burn faster.
• With or without food: Food is the usual choice, because the root can upset an empty stomach. Bloating, gas and loose stools are the common complaints. Soup forms are eaten with a meal by design. Capsules sit better taken with water and food. Alcohol tinctures are strong on an empty stomach. Dilute them in water if you use them.
• Time to effect: Be ready for it to do nothing. In the main menopause trial, 24 weeks of use matched a dummy pill. Traditional practice expected a shift over one or two monthly cycles. That expectation has not been tested. A quick strong change is more likely a side effect than a benefit. Side effects such as loose stools or bruising can show up within days.
• How long to take it: Trials have run up to about 24 weeks, with no proven benefit. Traditional courses were often short and tied to the cycle, then reviewed. There is no tested safe length for long daily use. Open-ended use raises the sun-sensitivity and bleeding concerns without a known payoff. Stop and rethink if nothing has changed after a few weeks.