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Safety Issues
Dong quai is generally believed to be nontoxic. According to Chinese studies, which may not have been up to current scientific standards, very large amounts have been given to rats without causing harm. 1 Side effects are rare and primarily consist of mild gastrointestinal distress and occasional allergic reactions (such as rash).
Contrary to popular belief, dong quai does not appear to have estrogen-like actions. 2 However, according to an article in the Singapore Medical Journal, a 35-year-old man who used a prepared herbal formula called Dong Quai pills developed enlargement of his breasts. 3 Such enlargement would typically result if a man used estrogen. The authors of the article blamed the dong quai itself. However, a more likely explanation is that the prepared herbal formula was "spiked" with synthetic estrogen. There are numerous reports of prepackaged Asian herb products containing unlabeled constituents, including conventional medications designed to enhance their effect. 4 Interestingly, in a test-tube study, dong quai was again found to be nonestrogenic, and yet it nonetheless stimulated the growth of breast cancer cells. 5 Although the mechanism of this effect is not known, the results suggest that women who have had breast cancer should avoid using dong quai.
Dong quai may interact with the blood-thinning drug warfarin (Coumadin), increasing the risk of bleeding, according to one case report. 6 Dong quai might also conceivably interact with other blood-thinning drugs, such as heparin , aspirin , clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental).
Certain constituents of dong quai can cause photosensitivity (increased sensitivity to the sun), but this has not been observed to occur in people using the whole herb.
Safety in young children, pregnant or nursing women, or those with severe liver or kidney disease has not been established. One case report suggests that dong quai usage by a nursing mother caused elevated blood pressure in both the mother and child. 7
Interactions You Should Know About
If you are taking blood-thinning drugs, such as warfarin (Coumadin) , heparin , clopidogrel (Plavix), ticlopidine (Ticlid), pentoxifylline (Trental), or aspirin , dong quai might interact and increase the risk of bleeding.
References
- Zhu DP. Dong quai. Am J Chin Med. 15(3-4):117-25.
- Zava DT, Dollbaum CM, Blen M. Estrogen and progestin bioactivity of foods, herbs, and spices. Proc Soc Exp Biol Med. 217(3):369-78.
- Goh SY, Loh KC. Gynaecomastia and the herbal tonic "Dong Quai". Singapore Med J. 42(3):115-6.
- Nortier JL, Martinez MC, Schmeiser HH, et al. Urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). N Engl J Med. 2000;342:1686-1692.
- Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause. 9(2):145-50.
- Page RL II, Lawrence JD. Potentiation of warfarin by dong quai. Pharmacotherapy. 1999;19:870-876.
- Nambiar S, Schwartz RH, Constantino A. Hypertension in mother and baby linked to ingestion of Chinese herbal medicine [letter]. West J Med. 1999;171:152.
