Dong Quai

Dong Quai is a traditional Chinese herb often called the “female ginseng” because of its popularity in women's health. It contains compounds that may help balance hormones and improve blood flow. For centuries, it has been used in managing symptoms of menopause, such as hot flashes and mood swings, because it is believed to act somewhat like estrogen in the body, although scientific studies provide mixed results on its effectiveness.

Why is it Relevant?

Dong Quai has been used in Chinese medicine for over 2,000 years and has some scientific backing for its health claims. It contains trans-ferulic acid which can be dissolved in fats which might help reduce inflammation.

Women often turn to Dong Quai for relief from menopausal symptoms, menstrual cramps, migraines, and other ailments. Studies suggest that Dong Quai can boost blood flow and ease pain. Additionally, extracts from the herb have been shown to potentially reduce fat build-up.

Dong Quai is also used to manage hot flushes, and some report effective results, though these are based on personal experiences rather than controlled studies.

Why Don't we use it?

St. John’s Wort may not mix well with other supplements and medications because of how it affects the liver's drug-processing system, known as cytochrome P450. This system is like a cleanup crew in our body that breaks down drugs and other chemicals in the bloodstream, including some important vitamins. When someone takes St. John’s Wort, it speeds up this cleanup process. This might sound good, but it can actually cause the body to get rid of other medications too quickly, reducing their effectiveness (5).

St. John’s Wort can interact with a wide range of common medications such as antidepressants, birth control pills, medications for epilepsy, blood thinners, drugs for preventing organ transplant rejection, heart medications, and treatments for anxiety, heart disease, HIV, and cancer (5, 6, 7).

Additionally, St. John’s Wort can make your skin more sensitive to sunlight, which is especially a problem for those already sensitive to the sun (8). A 2024 study on rats found that St. John’s Wort may have toxic effects on liver function and cause photosensitivity when combined with sunlight exposure (9).

Despite its popularity, there aren’t many reliable studies on the safety of St. John’s Wort, and the interactions it has with other supplements and medications make it potentially unsafe. A recent study even suggested that there may be another unknown constituent that is modifying the expression and function of the liver (10). We believe it is important to better understand its effects before considering it.

References

  1. Linde K, Berner MM, Kriston L. St John's wort for major depression. Cochrane Database of Systematic Reviews. 2008;(4):CD000448. doi:10.1002/14651858.CD000448.pub3
  2. Apaydin EA, Maher AR, Shanman R, et al. A systematic review of St. John's wort for major depressive disorder. Syst Rev. 2016;5(1):148. doi:10.1186/s13643-016-0325-2
  3. Abdali K, Khajehei M, Tabatabaee HR. Effect of St John's wort on severity, frequency, and duration of hot flashes in premenopausal, perimenopausal, and postmenopausal women: a randomized, double-blind, placebo-controlled study. Menopause. 2010;17(2):326-331. doi:10.1097/gme.0b013e3181b8e02d.
  4. Ng QX, Venkatanarayanan N, Ho CY. Clinical use of Hypericum perforatum (St John's wort) in depression: A meta-analysis.J Affect Disord. 2017;210:211-221. doi:10.1016/j.jad.2016.12.048
  5. Nicolussi S, Drewe J, Butterweck V, Meyer zu Schwabedissen HE. Clinical relevance of St. John's wort drug interactions revisited. Br J Pharmacol. 2020;177(6):1212-1226. doi:10.1111/bph.14936
  6. Fujihashi A, Ramesh S, Govindarajulu M, Almaghrabi M, Nadar RM, Deruiter J, Moore T, Pondugula S, Agrawal DC, Dhanasekaran M. St. John's Wort: A Therapeutic Herb to Be Cautioned for Its Potential Neurotoxic Effects and Major Drug Interactions. In: Agrawal DC, Dhanasekaran M, eds. Medicinal Herbs and Fungi: Neurotoxicity vs. Neuroprotection. Singapore: Springer Singapore; 2021:369-389. doi:10.1007/978-981-33-4141-8_15
  7. Canenguez Benitez JS, Hernandez TE, Sundararajan R, et al. Advantages and Disadvantages of Using St. John's Wort as a Treatment for Depression. Cureus. 2022;14(9):e29468. doi:10.7759/cureus.29468.
  8. de Wit L, Jeurissen S, Chen W. Risk assessment of herbal preparations containing St John's wort. Rijksinstituut voor Volksgezondheid en Milieu RIVM. 2021. doi:10.21945/RIVM-2019-0115
  9. Abdulla GM. Deterioration of liver function biomarkers induced by St. John's Wort. World J Pharm Life Sci. 2024;10(3):01-05. ISSN 2454-2229.
  10. Schäfer AM, Rysz MA, Schädeli J, Hübscher M, Khosravi H, Fehr M, Seibert I, Potterat O, Smieško M, Meyer zu Schwabedissen HE. St. John’s Wort Formulations Induce Rat CYP3A23-3A1 Independent of Their Hyperforin Content. *Molecular Pharmacology*. 2024;105(1):14-22. doi:10.1124/molpharm.123.000725
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