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One of Chinese medicine’s chief herbs and its leading blood tonic

Dang Gui

Radix angelicae sinensis / Angelica sinensis (Oliv.) Diels Apiaceae

Dang gui is a hugely versatile and important herb with its strength in addressing women’s health conditions with underlying blood deficiency and stasis. While an invaluable gynaecological aide, it benefits both men and women and its warming, nourishing, moistening and invigorating properties are used for a wide range of conditions including musculoskeletal, dermatological and digestive complaints.

  • How does it feel?

    Dang gui has a strong, sweet, earthy flavour with a bitter aftertaste, tingling and warmth that linger on the tongue and remind one of its invigorating energetics. Its aroma is likewise powerful, sharp and pungent and immediately transports one to a TCM herbal dispensary where it is so frequently being prepared and laid out on the scales.

  • What can I use it for?

    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.

  • Into the heart of Dang Gui

    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.

  • Traditional uses

    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.

    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.

  • Traditional actions

    Traditional Chinese Medicine actions:

    • Tonifies blood and regulates menses
    • Invigorates and harmonises blood and disperses cold
    • Moistens the intestines
    • Reduces swellings, expels pus, generates flesh, alleviates pain

    Western herbal medicine actions:

    • Blood tonic
    • Emmenagogue
    • Sedative
    • Analgesic
    • Mild laxative
    • Antibacterial
    • Anti-inflammatory
  • What practitioners say

    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.  

  • Research

    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 night time hot flushes and a marked improvement in sleep and energy.

    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.

    A clinical study in to 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.

    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.

    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 defecits were 78.7%, 63.6% and 59.3%, respectively.

    A study of patients with coronary artery disease compared injections of a dang guiren 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.

  • Did you know?

    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.

Additional information

  • Safety

    Use with caution in cases of diarrhoea from dampness. Avoid if yin deficiency and heat signs. Use with caution and smaller doses in pregnancy. May interact with anti-coagulant drugs, in particular, warfarin. Avoid with hormone-sensitive cancers.

  • Preparation

    Traditionally, soaked in water for at least 20-30 minutes then decocted in non-metallic pots with water with one or more herbs on a low-moderate heat for around 20-30 mins. Also prepared in pill, powder and tincture form.

  • Dosage

    Dry herb: 3-15g, tincture: (1:5, 60%) 1-2ml up to three times daily. Larger doses, up to 30g, maybe used in some instances, such as post-partum.

  • Plant parts used

    Root

  • Constituents

    • Polysaccharides: high molecular weight polysaccharide
    • Phenylpropanoids: ferulic acid
    • Coumarins: low levels of angelol, angelicone, oxypeucedanin, osthole, 7-desmethylsuberosin
    • Furaoncoumarins: psoralen, bergapten, imperatorin
    • Phytosterols: beta-sitosterol
    • Aromatic compounds: asligustilide, butylidenepthalide, butylphthalide, n- butylidenepthalide, n- butylphthalide, ligustilide, senkyunolide A
    • Vitamins: A, B12, E, C, folinic acid, biotin
  • Recipe

    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.

Aromatic
An ‘aromatic’ remedy, high in volatile essential oils, was most often associated with calming and sometimes ‘warming’ the digestion. Most kitchen spices and herbs have this quality: they were used both as flavouring and to ease the digestion of sometimes challenging pre-industrial foods. Many aromatics are classed as ‘carminatives’ and are used to reduce colic, bloating and agitated digestion. They also often feature in respiratory remedies for colds, chest and other airway infections. They are also classic calming inhalants and massage oils, and are the basis of aromatherapy for their mental benefits.
Astringent taste
The puckering taste you get with many plants (the most familiar is black tea after being stewed too long, or some red wines) is produced by complex polyphenols such as tannins. Tannins are used in concentrated form (eg from oak bark) to make leather from animal skins. The process of ‘tanning’ involves the coagulation of relatively fluid proteins in living tissues into tight clotted fibres (similar to the process of boiling an egg). Tannins in effect turn exposed surfaces on the body into leather. In the case of the lining of mouth and upper digestive tract this is only temporary as new mucosa are replenished, but in the meantime can calm inflamed or irritated surfaces. In the case of open wounds tannins can be a life-saver – when strong (as in the bark of broadleaved trees) they can seal a damaged surface. One group of tannins, the reddish-brown ‘condensed tannins’ are procyanidins, which can reduce inflammation and oxidative damage.
Bitter
Bitters are a very complex group of phytochemicals that stimulate the bitter receptors in the mouth. They were some of the most valuable remedies in ancient medicine. They were experienced as stimulating appetite and switching on a wide range of key digestive functions, including increasing bile clearance from the liver (as bile is a key factor in bowel health this can be translated into improving bowel functions and the microbiome). Many of these reputations are being supported by new research on the role of bitter receptors in the mouth and elsewhere round the body. Bitters were also seen as ‘cooling’ reducing the intensity of some fevers and inflammatory diseases.
Blue-purple colouring
Any fruits with a blue-purple colouring contain high levels of the polyphenols known as anthocyanins. These work 1) on the walls of small blood vessels, helping to maintain capillary structure to reduce a key stage in inflammation, and improving the microcirculation to the tissues; 2) to improve retinal function and vision; 3) to support connective tissue repair around the body.
Cooling
Traditional ‘cold’ or cooling’ remedies often contain bitter phytonutrients such a iridoids (gentian), sesiquterpenes (chamomile), anthraquinones (rhubarb root), mucilages (marshmallow), some alkaloids and flavonoids. They tend to influence the digestive system, liver and kidneys. Cooling herbs do just that; they diffuse, drain and clear heat from areas of inflammation, redness and irritation. Sweet, bitter and astringent herbs tend to be cooling.
Hot
Traditional ‘hot’ or ‘heating’ remedies, often containing spice ingredients like capsaicin, the gingerols (ginger), piperine (black or long pepper), curcumin (turmeric) or the sulfurous isothiocyanates from mustard, horseradich or wasabi, generate warmth when taken. In modern times this might translate as thermogenic and circulatory stimulant effects. There is evidence of improved tissue blood flow with such remedies: this would lead to a reduction in build-up of metabolites and tissue damage. Heating remedies were used to counter the impact of cold, reducing any symptoms made worse in the cold. .
Mucilaginous
Mucilages are complex carbohydrate based plant constituents with a slimy or ‘unctuous’ feel especially when chewed or macerated in water. Their effect is due simply to their physical coating exposed surfaces. From prehistory they were most often used as wound remedies for their soothing and healing effects on damaged tissues. Nowadays they are used more for these effects on the digestive lining, from the throat to the stomach, where they can relieve irritation and inflammation such as pharyngitis and gastritis. Some of the prominent mucilaginous remedies like slippery elm, aloe vera and the seaweeds can be used as physical buffers to reduce the harm and pain caused by reflux of excess stomach acid. Mucilages are also widely used to reduce dry coughing. Here the effect seems to be by reflex through embryonic nerve connections: reduced signals from the upper digestive wall appear to translate as reduced activity of airway muscles and increased activity of airway mucus cells. Some seed mucilages, such as in psyllium seed, flaxseed (linseed) or guar bean survive digestion to provide bulking laxative effects in the bowel. These can also reduce rate of absorption of sugar and cholesterol. .
New-mown hay aroma
The familiar country odour of haymaking, of drying grass and other plants, is largely produced by coumarins (originally isolated from tonka beans – in French coumarou) and widely used in perfumery. They are chemically categorised as benzopyrone lactones and are important phytochemicals, with strong antioxidant activity in the laboratory and likely effects in modulating inflammation. They were most often associated with the calming effect linked to their use in stuffing mattresses and pillows and plants, high In coumarins were commonly used for these properties.
Resinous
Resins are most familiar as tacky discharges from pine trees (and as the substance in amber, and rosin for violin bows). They were most valued however as the basis of ancient commodities like frankincense and myrrh (two of the three gifts of the Three Wise Men to the baby Jesus) and getting access to their source was one benefit to Solomon for marrying the Queen of Sheba (now Ethiopia). Resins were the original antiseptic remedies, ground and applied as powders or pastes to wounds or inflamed tissues, and were also used for mummification. With alcohol distillation it was found that they could be dissolved in 90% alcohol and in this form they remain a most powerful mouthwash and gargle, for infected sore throats and gum disease. They never attracted much early research interest because they permanently coat expensive glassware! For use in the mouth, gums and throat hey are best combined with concentrated licorice extracts to keep the resins in suspension and add extra soothing properties. It appears that they work both as local antiseptics and by stimulating white blood cell activity under the mucosal surface. They feel extremely effective!
Salty
The salty flavour is immediately distinctive. A grain dropped onto the tongue is instantly moistening and a sprinkle on food enkindles digestion. This easily recognisable flavour has its receptors right at the front of the tongue. The salty flavor creates moisture and heat, a sinking and heavy effect which is very grounding for the nervous system and encourages stability. People who are solid and reliable become known as ‘the salt of the earth'.
Sharpness
The sharp taste of some fruits, and almost all unripe fruits, as well as vinegar and fermented foods, is produced by weak acids (the taste is generated by H+ ions from acids stimulating the sour taste buds). Sour taste buds are hard-wired to generate immediate reflex responses elsewhere in the body. Anyone who likes the refreshing taste of lemon or other citrus in the morning will know that one reflex effect is increased saliva production. Other effects are subjective rather than confirmed by research but there is a consistent view that they include increased digestive activity and contraction of the gallbladder.
Sweet
In the days when most people never tasted sugar, ‘sweetness’ was associated with the taste of basic foods: that of cooked vegetables, cereals and meat. In other words sweet was the quality of nourishment, and ‘tonic’ remedies. Describing a remedy as sweet generally led to that remedy being used in convalescence or recovery from illness. Interestingly, the plant constituents most often found in classic tonics like licorice, ginseng are plant steroids including saponins, which also have a sweet taste.

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