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Dong Quai (angelica sinensis) in the treatment of hot flashes for men on androgen deprivation therapy: results of a randomized double-blind placebo controlled trial

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To determine whether Dong Quai, a Chinese herbal compound purported to be efficacious in treating menopausal vasomotor symptoms, has a therapeutic benefit in treating hot flashes among prostate cancer patients receiving androgen deprivation therapy. A randomized double-blind placebo controlled trial was conducted involving 22 men receiving luteinizing hormone-releasing hormone agonist therapy for prostate cancer with bothersome hot flashes. After recording a baseline log of the frequency, duration and severity of daily hot flashes, patients were randomly assigned in a 1:1 ratio to receive daily placebo or Dong Quai for 3 months. Vasomotor and adverse events were recorded daily. Blood work including serum prostate-specific antigen (PSA), international normalized ratio of prothrombin time and partial thromoboplastin time were recorded at baseline and at the termination of the study. Seventeen of the 22 patients enrolled completed the trial. Baseline vasomotor duration and severity were equivalent between the groups, however the number of hot flashes were significantly more in the Dong Quai group (p = 0.02). With respect to the change in number of hot flashes per day, there was a slight decrease in the mean number among the Dong Quai group which was insignificant. The absolute change and average percentage change in perceived hot flash severity was similar in both groups. There was no significant decrease in the duration of the hot flashes between the 2 groups. Disease progression based on either PSA increase or change in digital rectal exam was not observed in any patient. In this small pilot study, there were no significant differences in the severity, frequency or duration of hot flashes among men receiving placebo or Dong Quai.
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... Although most studies indicated the positive effects of therapeutic herbal interventions on menopausal symptoms, a number of studies showed that some herbs had no effect on menopausal symptoms. [90][91][92][93][94][95][96] The reason for these discrepancies may be due to differences in sampling methods, low sample Soya drinks have no effect on the mood of postmenopausal women. [90] Clinical trial. ...
... Dong Quai No effect on hot flashes. [94] No effect on vasomotor symptoms. [95,96] Clinical trial, a randomized, double-blind, placebo-controlled. ...
... [95,96] Clinical trial, a randomized, double-blind, placebo-controlled. [94][95][96] [ [94][95][96] Randomized controlled clinical trial. [105] Improve the quality of sleep. ...
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... The highest amount of VA in plants is in the root of Angelica sinensis [26], which has been widely used in Traditional Korean Medicine for centuries especially for female health issues [27]. Currently, some studies have reported the positive effects of Angelica sinensis on prostate cancer [28,29]. Canrium schweinfurthii Engl, the African olive, which also contains VA, was reported to have protective effects against prostate cancer [30]. ...
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Benign prostatic hyperplasia (BPH) is a common disease in the male population, especially in elderly men. Vanillic acid (VA), a dihydroxybenzoic derivative used as a flavoring agent, is reported to have an anti-inflammatory effect. However, there are no reports of its effects on BPH to date. BPH was induced with a pre-4-week treatment of daily subcutaneous injections of testosterone propionate (TP), and the normal control group received injections of ethanol with corn oil instead. Six weeks of further injections were done with (a) ethanol with corn oil, (b) TP only, (c) TP + finasteride, and (d) TP + VA. Finasteride was used as a positive control group. VA had protective effects on the TP-induced BPH. In the VA treatment group, the prostate weight was reduced, and the histological changes including the epithelial thickness and lumen area were restored like in the normal control group. Furthermore, in the VA treatment group, two proliferation related factors, high molecular weight cytokeratin 34βE12 and α smooth muscle actin, were significantly down-regulated compared to the TP-induced BPH group. The expressions of dihydrotestosterone and 5α-reductase, the most crucial factors in BPH development, were suppressed by VA treatment. Expressions of the androgen receptor, estrogen receptor α and steroid receptor coactivator 1 were also significantly inhibited by VA compared to the TP-induced BPH group. In addition, we established an in vitro model for BPH by treating a normal human prostatic epithelial cell line RWPE-1 with TP. VA successfully inhibited proliferation and BPH-related factors in a concentration-dependent manner in this newly established model. These results suggest a new and potential pharmaceutical therapy of VA in the treatment of BPH.
... Dong quai (Angelica sinensis root) has been used in Chinese traditional medicine for thousands of years for various female health conditions (e.g., dysmenorrhea, pelvic pain, symptoms of menopause) (Chye 2006;Al-Bareeq et al. 2010;Fang et al. 2012). In spite of its history, dong quai provided no clinical relief of menopausal symptoms (Hirata et al. 1997). ...
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The purpose of this study is to use a molecular docking approach to identify potential estrogen mimics or anti-estrogens in phytochemicals found in popular dietary herbal supplements. In this study, 568 phytochemicals found in 17 of the most popular herbal supplements sold in the United States were built and docked with two isoforms of the estrogen receptor, ERα and ERβ (a total of 27 different protein crystal structures). The docking results revealed six strongly docking compounds in Echinacea, three from milk thistle (Silybum marianum), three from Gingko biloba, one from Sambucus nigra, none from maca (Lepidium meyenii), five from chaste tree (Vitex agnus-castus), two from fenugreek (Trigonella foenum-graecum), and two from Rhodiola rosea. Notably, of the most popular herbal supplements for women, there were numerous compounds that docked strongly with the estrogen receptor: Licorice (Glycyrrhiza glabra) had a total of 26 compounds strongly docking to the estrogen receptor, 15 with wild yam (Dioscorea villosa), 11 from black cohosh (Actaea racemosa), eight from muira puama (Ptychopetalum olacoides or P. uncinatum), eight from red clover (Trifolium pratense), three from damiana (Turnera aphrodisiaca or T. diffusa), and three from dong quai (Angelica sinensis). Of possible concern were the compounds from men's herbal supplements that exhibited strong docking to the estrogen receptor: Gingko biloba had three compounds, gotu kola (Centella asiatica) had two, muira puama (Ptychopetalum olacoides or P. uncinatum) had eight, and Tribulus terrestris had six compounds. This molecular docking study has revealed that almost all popular herbal supplements contain phytochemical components that may bind to the human estrogen receptor and exhibit selective estrogen receptor modulation. As such, these herbal supplements may cause unwanted side effects related to estrogenic activity.
... According to our knowledge, there are no pre-clinical studies addressing its effects in PCa. However, a small randomized clinical trial was conducted in men receiving ADT where dong quai was shown to be ineffective in reducing hot flashes [41]. Similarly, randomized trials in women also found no effect of dong quai on hot flashes beyond a placebo, irrespective of whether the herb was used alone or as part of a complex multi-ingredient intervention [120]. ...
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... A randomized double-blind placebo-controlled trial was carried out with men taking Dong quai for 3 months. No significant differences in the severity, frequency or duration of hot flashes were found in comparison to control (Al-Bareeq et al., 2010). ...
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