Dong Quai for Health & Longevity - Quick Reference Sheet

Dong Quai for Health & Longevity

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

Dong quai has a two-thousand-year record of use and a thin, divided evidence base. The clearest signal is menstrual pain, where multi-herb formulas built around the root beat standard painkillers in poorly conducted trials. Taken alone it matched an inactive placebo for menopausal symptoms. Risks are modest in probability and serious in consequence: slowed clotting and weak estrogen imitation. (Full Review)

Protocol

Classical decoction dose
6–12 g/day
Dried root simmered in water with companion herbs, rarely alone; the dose behind the pooled menstrual pain data
Western capsule dose
500–2,000 mg
Powdered root or a 4:1 to 10:1 extract, taken in divided doses; the format that failed the placebo-controlled menopause trial
Best time of day
After meals, divided
Traditionally taken warm, 30 minutes after morning and evening meals; split dosing twice or three times daily
Time to effect
Menstrual pain
1–3 cycles
The pooled trials dosed across one to three menstrual cycles before assessing response
Menopausal symptoms
24 weeks
The controlled trials ran 24 weeks and still found little separation from placebo
Success
12 weeks
A clear, logged improvement in the symptom that prompted use within 12 weeks; absence is a reason to stop

Benefits

Contraindications
  • Pregnancy at any stage, and breastfeeding
  • Estrogen-receptor-positive breast, endometrial (womb lining), or ovarian cancer, active or in remission
  • Tamoxifen and aromatase inhibitors (anastrozole, letrozole)
  • Within 14 days of planned surgery, dental extraction, or spinal or epidural injection
  • Inherited or acquired bleeding disorders (hemophilia, von Willebrand disease, platelets below 100 × 10⁹/L)
  • Active peptic ulcer disease or gastrointestinal bleeding within the past 90 days
  • Severe liver impairment (Child-Pugh Class C)
Key Interactions
  • Warfarin (caution bordering on avoidance)
  • Direct oral anticoagulants (apixaban, rivaroxaban, dabigatran)
  • Antiplatelet drugs (aspirin, clopidogrel, ticagrelor)
  • Over-the-counter analgesics (ibuprofen, naproxen, high-dose aspirin)
  • Supplements with additive clot-inhibiting effects (fish oil, garlic, ginkgo, high-dose vitamin E, nattokinase, curcumin)
  • Estrogenic botanicals (red clover, black cohosh, soy isoflavones, hops)
  • Photosensitizing drugs (doxycycline, amiodarone, thiazide diuretics, retinoids)
  • Therapeutic ultraviolet light therapy, cosmetic laser or peel procedures

Risk & Side Effects

  • High:
  • Medium: Potentiation of anticoagulant and antiplatelet medication; stimulation of estrogen-sensitive tissue
  • Low: Photosensitivity and skin reactions; digestive upset and loose stools; contamination and species substitution
  • Speculative: Interference with hormone-blocking cancer therapy; long-term coumarin exposure and cell damage

Monitoring

Marker Target Why
Hemoglobin 13.5–15.0 g/dL (women); 14.5–16.0 g/dL (men) Tests the blood-building claim directly
Ferritin 50–100 ng/mL (women); 50–150 ng/mL (men) Iron stores must be adequate for any red-cell response
INR 0.9–1.1 if not anticoagulated; the individually prescribed target if on warfarin Detects the documented warfarin interaction
Platelet count 200–350 × 10⁹/L Establishes bleeding margin before adding a clot-modifying botanical
ALT Under 20 U/L (women); under 25 U/L (men) Confirms liver capacity to clear the root's coumarins
hs-CRP Under 1.0 mg/L Baseline inflammation, and the correction factor for reading ferritin
Estradiol No established target; track change from the individual's own baseline Detects any real hormonal effect where laboratory work predicts one

Cadence: Baseline panel before the first dose; repeat labs at 12 weeks, then every 6–12 months. On warfarin, weekly INR for the first four weeks after starting or stopping, then monthly. Symptom tracking runs continuously from baseline.

Qualitative Assessment

  • Menstrual pain severity, recorded per cycle on a 0–10 scale rather than from memory
  • Hot flash frequency and severity, logged daily rather than estimated weekly
  • Unexplained bruising, gum bleeding, or prolonged bleeding from small cuts
  • Skin reactions after ordinary sun exposure
  • Digestive comfort — bloating, belching, stool consistency
  • Breast tenderness or, in men, breast tissue changes
  • Energy on waking and cold tolerance in hands and feet