Angelica sinensis for Health & Longevity - Quick Reference Sheet

Angelica sinensis for Health & Longevity

Created on 08/25/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 5 Audit

An old Chinese root whose evidence belongs to the multi-herb formulas it sits in rather than to the root itself. Those formulas reduce menstrual pain more than painkillers, improve red-cell measures in kidney-related anemia, and improve breathing tolerance in lung scarring. Tested alone, the root has repeatedly done nothing. Blood-thinner interaction unresolved; hormone-driven tumour growth seen in animals. (Full Review)

Protocol

Standard traditional protocol
3–15 g/day dried root
Warm water decoction split across two doses, in cycles of 4–12 weeks; almost always within a formula rather than alone.
Trial-derived supplement protocol
6 g/day granules, 12 weeks
Danggui Buxue Tang granules; the dose-escalation trial found 1.5 and 3 g/day produced weaker responses.
Single versus split dosing
Split dosing
Every positive controlled trial used twice-daily granules or a decoction divided across the day; once-daily administration is untested.
Time to effect
Menstrual pain
1–3 cycles
Set by the pooled Danggui Shaoyao San and Danggui Sini decoction trials against analgesics.
Anemia and kidney measures
12–24 weeks
Set by the renal anemia meta-analysis and the 24-week proteinuria trial in glomerulonephritis.
Earliest useful judgement
8 weeks minimum
Nothing in the literature supports judging the herb before at least eight weeks of consistent use.

Benefits

Contraindications
  • Current or prior estrogen-receptor-positive breast cancer
  • Tamoxifen or aromatase inhibitors (letrozole, anastrozole)
  • Endometrial hyperplasia or unexplained vaginal bleeding
  • Pregnancy at any stage, particularly the first trimester
  • Breastfeeding
  • Warfarin with an unstable or above-target international normalised ratio
  • Inherited bleeding disorder, platelet count below 100 × 10⁹/L, or active peptic ulcer
  • The two weeks before and after surgery, dental extraction, or neuraxial procedure
  • Hereditary hemochromatosis or transferrin saturation above 45%
Key Interactions
  • Warfarin (absolute caution, monitor closely)
  • Direct oral anticoagulants (apixaban, rivaroxaban, dabigatran; caution)
  • Antiplatelet drugs (clopidogrel, ticagrelor, prasugrel; caution)
  • Aspirin and NSAIDs (ibuprofen, naproxen; monitor)
  • Estrogen therapy and hormonal contraceptives (caution)
  • Photosensitising drugs (doxycycline, amiodarone, voriconazole, retinoids; caution)
  • Other blood-moving supplements (ginkgo, high-dose fish oil, garlic extract, vitamin E, nattokinase, curcumin; monitor)
  • Iron supplements (potentiating, generally desirable)
  • Sedatives and alcohol (monitor)

Risk & Side Effects

  • High: Potentiation of warfarin and other anticoagulants
  • Medium: Growth stimulation of estrogen-receptor-positive breast cancer cells; gastrointestinal upset and laxative effect
  • Low: Gynecomastia and hormone-like effects in men; photosensitivity from furanocoumarins; skin and respiratory sensitisation; heavy-metal and adulterant exposure
  • Speculative: Carcinogenic potential of safrole-type constituents; uterine stimulation and pregnancy risk

Monitoring

Marker Target Why
Hemoglobin 13.5–15.0 g/dL (women), 14.5–16.5 g/dL (men) Tracks whether the blood-tonic effect is producing anything measurable
Hematocrit 38–44% (women), 42–48% (men) The endpoint that improved most consistently in the renal anemia meta-analysis
Ferritin 50–150 ng/mL Iron store status; identifies both a deficit to correct and an overload ceiling
Transferrin saturation 25–40% Detects iron overload risk from hepcidin suppression, especially in hemochromatosis carriers
International normalised ratio Within the individual's prescribed warfarin target, usually 2.0–3.0 The only marker with a documented human interaction consequence
Estimated glomerular filtration rate Above 90 mL/min/1.73 m², or stable against the individual's own baseline Tracks the kidney population in which the proteinuria finding was generated
Urine albumin-to-creatinine ratio Below 30 mg/g, or falling from the individual's own baseline The endpoint that outperformed losartan in the glomerulonephritis trial
Platelet count Above 100 × 10⁹/L The baseline measure for antiplatelet users, and the threshold below which the root is avoided

Cadence: Warfarin users: international normalised ratio at 1, 2 and 4 weeks after starting, then quarterly, and again after stopping. Everyone else: blood count, iron panel and, where relevant, kidney markers at 12 weeks, then every 6 months.

Qualitative Assessment

  • Menstrual pain intensity and analgesic tablets used per cycle, tracked across at least three cycles
  • Hot flush and night sweat frequency and severity, logged daily rather than recalled
  • Energy and exertional fatigue during habitual training, compared against a pre-start reference week
  • Stool frequency and consistency, as the earliest signal that the dose is too high
  • Bruising, gum bleeding, or unusually long bleeding from minor cuts, as the earliest signal of the anticoagulant interaction
  • Cold hands and feet, the traditional indication and the symptom users most often report changing first