First and foremost, dang gui is an excellent blood tonic and is, therefore, used widely in cases of blood deficiency with signs and symptoms such as pallor, dizziness, fatigue, dry skin, blurred vision, palpitations, tinnitus, a thin radial pulse and a pale tongue. These may or, as if often the case, may not be accompanied with a diagnosis of anaemia.

It is most commonly used for menstrual disorders, in particular, painful or irregular periods, but is indicated for most gynaecological conditions with their roots in blood deficiency, particularly those paired with blood stasis and, or, cold. These include most menstrual disorders, many ailments arising in pregnancy, post-partum complaints, infertility issues and symptoms of the menopause.

It is also an important medicinal for a variety of pain conditions such as period pain, trauma and abdominal pain stemming from blood deficiency and blood stasis, again particularly for those accompanied by cold. Such pain will typically be fixed, stabbing in nature, aggravated by pressure and cold and relieved with warmth. It is also indicated for wind-damp painful obstruction (bi pain/ arthritis) with underlying blood deficiency.

Dang gui is also often used to moisten the bowels and relieve constipation from dryness which is a common consequence of blood deficiency.

Finally, it is a valuable medicinal for many skin conditions, including those from blood deficiency and, or, cold congealing the blood, sores and abscesses with swelling and slow-healing wounds.

Often referred to as “Women’s Ginseng” for its indispensable contribution to TCM gynaecology, dang gui literally translates as “state of return”, reflecting its exalted ability to restore one to a state of health.

One of the most popular Chinese herbs, it is TCM’s chief medicinal for supplementing blood. Being sweet (tonifying), acrid (dispersing), bitter (draining) and warm in nature, dang gui nourishes, invigorates and harmonises the blood, dispels cold and enters the heart, liver and spleen which control, store and engender the blood, respectively.

Dang gui’s numerous actions are enhanced and expanded further with different preparation techniques. Pao zhi (medicinal processing) is, therefore, of great importance when working with this herb. Chao dang gui (dry-fried) is warmer, drier and less blood-invigorating, making it more appropriate in pregnancy. Jiu zhi dang gui (wine-fried) and cu zhi dang gui (vinegar-fried) enhance its blood-invigorating action. Carbonised dang gui (tan dang gui) is warmer and stops bleeding.

While we typically use the entire root, different parts (head: dang gui tou, body: dang gui shen, tail: dang gui wei) are attributed to different functions. As we move down the root from top to tail, it becomes less tonifying and more blood-invigorating. The tail is also believed to direct blood flow outwards to the extremities.

Ferulic acid (antiplatelet, anti-TNF) and Z-ligustilide (neuroprotective and suggested anticancer, anti-inflammatory and antioxidant activities) are believed to be the biologically active compounds most responsible for dang gui’s therapeutic actions and are used as markers for quality.

Dang gui has an extensive history in Chinese medicine and its use can be traced back nearly 2,000 years to the first known Chinese text to describe individual herbs, the Shen nong ben cao jing (The Divine Farmer’s Classic of the Materia Medica) (25-22AD). 

It is also an important culinary herb and is widely used in China in recipes such as broths and congees during the ‘golden month’ – the month of confinement post-partum, to nourish and strengthen mothers after childbirth – after menstruation, in the frail and elderly. The dried root is very firm and the same root may be used in several soups. Once it has completely softened it is often eaten as a vegetable with rice (4).

Preparing dang gui with alcohol releases its volatile oils, increases its bioavailability, enhances its blood-invigorating and analgesic properties which can explain why, traditionally, it is one of a handful of TCM herbs used individually to make medicinal wine.

Menstruation

Dang gui is the primary herb for most any kind of abnormal menstruation. Blood deficiency can lead to anaemia, absent, light and late periods. Blood stasis and blood-cold can cause painful periods with dark clots. Like blood deficiency, blood-cold can also result in late and light periods. Blood stasis may also manifest in irregular cycles. Dang gui may effectively be used in all of these instances. Ailments accompanying menstruation such as period pain, headaches, body aches and dizziness that arise towards the end of or after the period are often related to blood deficiency. Period pain, headaches, body aches and breast distension occurring before or during the period are often from blood stagnation. Again, dang gui is an excellent herb for all of these symptoms.

Gynaecological

Dang gui is prescribed in a vast array of formulas for most gynaecological conditions including endometriosis, pelvic inflammatory disease, PCOS, polyps and fibroids.

Pregnancy

While many western sources discourage use of dang gui during pregnancy, it has a long history of safe use in pregnancy in Chinese medicine. As it invigorates blood, caution must, of course, be used. Dosage is typically reduced and chao dang gui (dry-fried dang gui) is more appropriate here than other forms as it is less blood-invigorating. Blood deficiency is very common in pregnancy and can lead to fatigue, abdominal pain (obviously ectopic pregnancy and threatened miscarriage must be ruled out) and constipation. It may also be an underlying cause of recurrent miscarriage.

Post-partum

Widely used in post-partum conditions where blood deficiency, stasis and, or, cold (all very common after giving birth) are the cause, including abdominal pain, persistent lochial discharge or retention, constipation, fever, joint pain, severe dizziness and insufficient or absent lactation.

Menopause

Dang gui is often used to treat menopausal symptoms, in particular those stemming from blood stasis with symptoms such as hot flashes, mental restlessness, insomnia, high blood pressure and abdominal pain. It is also featured in formulas treating menopause from an imbalance in the kidneys and heart.

Infertility

Cases of infertility with underlying blood deficiency are common, as adequate blood supplies are needed for a healthy endometrium in which the embryo may implant and be nourished. Dang gui is used in many formulas aimed at enhancing a woman’s fertility, such as gui shao di huang tang (Angelica, Paeonia, Rehmannia Decoction) a popular choice for promoting the menstrual cycle if amenorrhoea is the cause of infertility.

Musculoskeletal

May be used for any pain resulting from blood deficiency, cold causing blood stasis, blood stasis or qi stagnation with pain and swelling. Benefits ‘wind-damp’ painful obstruction stemming from blood deficiency; arthritic pain which presents with swollen joints, a sensation of heaviness in the body and is aggravated by damp weather.

Gastrointestinal

Blood deficient constipation arises because the nourishing, moistening action of blood is lost leading to dryness and accumulation in the large intestine. This is especially common in the elderly and post-partum. Dang gui’s blood-tonifying, moistening properties lubricate and unblock the bowels.

Skin

Slow-healing sores indicate qi and blood deficiency. Dang gui’s blood-tonifying and invigorating actions help to heal and relieve pain in swollen, painful abscesses and sores, including chronic suppurative, non-healing sores. It is also an important herb for dry skin conditions from blood deficiency which, in TCM, may generate wind, manifesting as itching. This is often found in the elderly, those with long-term illnesses, in the latter stage of pregnancy and during or after the period. It is the chief herb in the formula yang xue run fu yin (Nourish the Blood and Moisten the Skin Decoction). As it warms and invigorates blood, it also benefits skin conditions where cold has congealed the blood such as chilblains and purpura and is the chief herb in dang gui si ni tang (Tangkuei Decoction for Frigid Extremities).

Note: There are many varieties of angelica species used as dang gui. Angelica acutiloba is believed in Japanese herbalism to perhaps be even more tonifying than A. sinensis. A. archangelica (Angelica) is a separate herb used in western herbalism and is not to be confused with dang gui.

Clinical studies around dang gui’s use in menopause and perimenopause have garnered mixed findings, however, some have yielded promising results. A randomised control trial (RCT) in 55 postmenopausal women found that the herbal preparation Climex (a combination of dang gui and chamomile) had a significantly greater effect on reducing the number and intensity of hot flushes compared to placebo. After the first month, Climex had a 68% reduction in daytime hot flushes, a 74% reduction in nighttime hot flushes and a marked improvement in sleep and energy (9).

Another RCT studied the effect of dang gui bu xue tang (DGBXT; a 1 : 5 combination of dang gui and huang qi (astragalus)) on acute menopausal symptoms and concluded that DGBXT was statistically superior to placebo only in the treatment of mild hot flushes (10).

A clinical study into dang gui’s use for chronic abdominal pain compared a dang gui pill with atropine (anticholinergic) and placebo, with an efficacy rate of 93.3%, 97.1% and 0% for each group, respectively. 

Dang gui’s statistically significant efficacy in reducing abdominal pain was the blocking of muscarinic, alpha nd H1 receptors, an analgesic effect and an antiseptic effect (11).

Dang gui’s hematopoietic action was demonstrated in a case study of a patient with anaemia unresponsive to human erythropoietin and underlying chronic renal failure whose haematopoiesis significantly improved after regularly consuming dang gui (12).

In a study with 1404 patients comparing the efficacy of dang gui, sage and dextran injections for acute cerebral infarction (stroke), efficacy rates for reducing infarct volume and neurofunction deficits were 78.7%, 63.6% and 59.3%, respectively (13).

A study of patients with coronary artery disease compared injections of a dang gui, ren shen (ginseng), huang qi (astragalus) herb combination and placebo and found, among other benefits, that frequency and severity of angina episodes reduced by 90% and ischemic ST-T changes on ECG improved in 56% of cases (14).

Dang gui’s translation, “state of return”, is held in folklore to derive from a legend wherein a man leaves his wife to live in the mountains. After an allotted period of time, presuming he will not return, his wife remarries. She soon falls ill and the man returns with a herb discovered on his travels. This herb restores her to health and is thus named dang gui.

Dang gui and red date tea

This is a very simple herbal tea that may easily be made at home. It benefits people with menstrual discomfort and those needing a boost after their period.

Ingredients:

• 3 slices of dang gui
• 8 pitted hong zao (Jujube dates)
• 1 flat tbsp of gou qi zi (Goji berries)
• 2 bowls of water

Method:

• Rinse each ingredient briefly under cool water and put them in a non-metallic pot with two cups of water.
• Cover and boil over medium heat for 10 minutes or until the water boils.
• Reduce the heat to Low and simmer for 20 minutes, or until the tea reduces to about a cup. Serve.

Note: Dang gui slices should be rinsed very briefly to preserve the nutrients and flavour. See the safety section for cautions and contraindications.

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