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Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
People with known allergy/hypersensitivity to Angelica radix or members of the Apiaceae/Umbelliferae family (anise, caraway, carrot, celery, dill, parsley) should avoid Dong quai. Skin rash has been reported with the use of Dong quai, although it is not clear if this was an allergic response. An asthma response has occurred after breathing in Dong quai powder.
Side Effects and Warnings
Although Dong quai is accepted as being safe as a food additive in the United States and Europe, its safety in medicinal doses is not known. There are no reliable long-term studies of side effects. Most precautions are based on theory, laboratory research, tradition, or isolated case reports.
Components of Dong quai may increase the risk of bleeding due to anticoagulant and anti-platelet effects. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. Discontinue use prior to surgical or major dental procedures.
It remains unclear if Dong quai has the same effects on the body as estrogens, if it blocks the activity of estrogens, or if it has no significant hormonal effects. It remains unclear if Dong quai is safe in individuals with hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, or endometriosis. It is not known if Dong quai possesses the beneficial effects that estrogen is believed to have on bone mass or potential harmful effects such as increased risk of stroke or hormone-sensitive cancers.
Increased sun sensitivity with a risk of severe skin reactions (photosensitivity) may occur due to chemicals in Dong quai. Prolonged exposure to sunlight or ultraviolet light should be avoided while taking Dong quai.
Safrole, a volatile oil in Dong quai, may be carcinogenic (cancer-causing). Long-term use should therefore be avoided, and suntan lotions that contain Dong quai often limit the amount of Dong quai to less than one percent.
Dong quai has traditionally been associated with gastrointestinal symptoms (particularly with prolonged use), including laxative effects/diarrhea, upset stomach, nausea, vomiting, loss of appetite, burping, or bloating. Published literature is limited in this area.
Dong quai preparations may contain high levels of sucrose, and should be used cautiously by patients with diabetes or glucose intolerance.
Various other side effects have rarely been reported with Dong quai taken alone or in combination with other herbs. However, side effects have not been evaluated in well-designed studies. These include: headache, lightheadedness/dizziness, sedation/drowsiness, insomnia, irritability, fever, sweating, weakness, abnormal heart rhythms, blood pressure abnormalities, wheezing/asthma, hot flashes, worsening premenstrual symptoms, reduced menstrual flow, increased male breast size (gynecomastia), kidney problems (nephrosis), or skin rash.
The safety of Dong quai injected into the skin, muscles, or veins is not known and should be avoided.
Pregnancy and Breastfeeding
Dong quai is not recommended during pregnancy due to possible hormonal and anticoagulant/anti-platelet properties. Animal research has noted conflicting effects on the uterus, with reports of both stimulation and relaxation. There is a published report of miscarriage in a woman taking Dong quai, although it is not clear that Dong quai was the cause. Dong quai is traditionally viewed as increasing the risk of abortion. There is insufficient evidence regarding the safety of Dong quai during breastfeeding.
NS_patient-dongquai
Portions of this document last updated:Sept. 1, 2009
THE NATURAL STANDARD RESEARCH COLLABORATION
(www.naturalstandard.com)
