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Dan Shen, also known as red sage or salvia miltiorrhiza, has been used in oriental medicine to treat many disorders and ailments for thousands of years. While Dan Shen has many uses, treating cardiovascular and cerebrovascular disorders are the most common things it is used for. These cardiovascular disorders can include recovering from a myocardial infarction, treating an acute ischemic stroke, hypertension, and inhibiting platelet adhesion in those prone to hypercoagulative disorders.

Patients with mild to moderate hypertension (high blood pressure) can benefit from Dan Shen. A recent study showed that taking 2,000 mg per day over 12 weeks reduced both the patients’ systolic blood pressure as well as pulse rate [1].

A clinical study of 300 people with angina pectoris took Dan Shen and their symptoms improved in 82% of the people, including ECGs improvements in 50%. This supports a previous study of 323 patients with angina where 20.3% had remarkable improvement and 62% had moderate improvement while taking Dan Shen [2].

Patients who have had a myocardial infarction (heart attack) and undergone percutaneous coronary intervention were shown to have a better success rate when taking Dan Shen [3]. Dan Shen works as a cardio-protective agent by causing vasodilation, inhibiting platelet aggregation, and protecting against myocardial ischemia [4]. By reducing the development of atherosclerosis taking Dan Shen can help prevent cerebral infarctions. Studies also have shown Dan Shen to lower ones overall cholesterol, specifically LDL-C (“bad cholesterol”) [5]. Additive effects occur with Dan Shen’s ability to increase vasodilation by increasing nitric oxide and scavenging free radicals, resulting in increased blood flow and decrease inflammation and oxidative stress on the body [6]. Dan Shen can uniquely help with decreasing cardiovascular issues by acting on many different pathways, addressing multiple causes of cardiovascular disease.

For patients who aren’t on prescription blood thinners Dan Shen has the potential to help as a natural blood thinner. Research has shown it to work in multiple pathways including inhibiting platelet aggregation, interfering with the extrinsic pathway of blood coagulation, possessing anti-thrombin III like activity, and also promoting fibrinolytic pathway [7]. By acting on many different pathways at once Dan Shen may be the best all natural way to maintain healthy blood flow and help prevent blood clots and associated issues. Via similar actions studies have shown it to help with diabetic retinopathy [8].

While Dan Shen is most often used for its cardiovascular properties studies have shown it potentially work as an anti-cancer agent and also against HIV. When administered to human colon adenocarcinoma cells it was shown to both inhibit growth and induce apoptosis of the tumor cells [9]. Experimentation of HIV cells showed Dan Shen to inhibit viral replication of HIV cells [10].

Many people suffer from depression or low energy levels  due to inadequate dopamine and/or epinephrine levels in the body. Initial research has shown Dan Shen to cause an increase in dopamine release, and could potentially be used as an addition to normal treatments for patients suffering from depression or low energy levels [11].

In traditional Chinese medicine Dan Shen is used on patients with liver issues. It is one of the most commonly used herbs for liver disorders and can also help treat Hepatitis B Virus in addition to stimulating increased liver activity [12] [13].

The active compounds in Dan Shen contain broad-spectrum antimicrobial properties, especially against bacteria and fungus. Lyme literate physicians have been including Dan Shen to also treat bartonella infections. Tanshinones and phenolic acids are identified as the main antimicrobial components, but other components also exist to boost the antimicrobial properties of Dan Shen [16].

The broad applications of Dan Shen make it a welcome addition to your patient with cardiac, coagulation, and hepatic issues as well as being anti-fungal and anti-bacterial.

CONTRAINDICATIONS

Patients taking blood thinners such as warfarin should avoid taking Dan Shen due to an exaggerated effect of the warfarin and increased risk bleeding of bleeding. As a precaution Dan Shen should not be taken while also taking NSAIDS or other blood thinners. You should also not take if on digoxin and consult your doc if on other heart medications. Do not take during pregnancy.

Recommended dosage is 1-2 caps 3x/day.

Resources

1. Yang, Tsung-Yuan, James Cheng-Chung Wei, Ming-Yung Lee, C. M. Balance Chen, and Kwo-Chang Ueng. “A Randomized, Double-blind, Placebo-controlled Study to Evaluate the Efficacy and Tolerability of Fufang Danshen (Salvia Miltiorrhiza) as Add-on Antihypertensive Therapy in Taiwanese Patients with Uncontrolled Hypertension.” Phytotherapy Research Phytother. Res. 26.2 (2011): 291-98. Web.

 2. Bensky, Dan, Andrew Gamble, and Ted J. Kaptchuk. Chinese Herbal Medicine: Materia Medica. Seattle, WA: Eastland, 1993. Print.

 3. “Effect of Anxin Granules Combined with Tirofiba on Patients with Acute Myocardial Infarction after Elective Percutaneous Coronary Intervention.” China Journal of Chinese Materia Medica CJCMM (2014): n. pag. Web.

 4. Cheng, Tsung O. “Cardiovascular Effects of Danshen.” International Journal of Cardiology 121.1 (2007): 9-22. Web.

 5. Liu, D.; Tang, J.Y.; Yan, L. Effect of compound danshen dripping pill on arterial intima-media thickness in patients with newly diagnosed type 2 diabetes mellitus. Zhongguo. Zhong. Xi. Yi. Jie. He. Za. Zhi., 2010, 30(12), 1265-1268.

6. Lin, Tsai-Hui, and Ching-Liang Hsieh. “Pharmacological Effects of Salvia Miltiorrhiza (Danshen) on Cerebral Infarction.” Chinese Medicine 5.1 (2010): 22. Web.

7. Chan, Thomas Yk. “Interaction Between Warfarin and Danshen (Salvia Miltiorrhiza).” The Annals of Pharmacotherapy 35 (2001): 501-04. Web.

8. Pei, W., X. Zhao, Z. Zhu, C. Lin, W. Zhao, and X. Zheng. “Study of the Determination and Pharmacokinetics of Compound Danshen Dripping Pills in Human Serum by Column Switching Liquid Chromatography Electrospray Ion Trap Mass Spectrometry.” Journal of Chromatography B 809.2 (2004): 237-42. Web.

9. Su, Chin-Cheng, Guang-Wei Chen, Jung-Cheng Kang, and Ming-Huan Chan. “Growth Inhibition and Apoptosis Induction by Tanshinone IIA in Human Colon Adenocarcinoma Cells.” Planta Med Planta Medica 74.11 (2008): 1357-362. Web.

10. Abd-Elazem, Ibrahim S., Hong S. Chen, Robert B. Bates, and Ru Chih C Huang. “Isolation of Two Highly Potent and Non-toxic Inhibitors of Human Immunodeficiency Virus Type 1 (HIV-1) Integrase from Salvia Miltiorrhiza.” Antiviral Research 55.1 (2002): 91-106. Web.

11. Chung, Tae-Wook, Byung-Soo Koo, Kyeong-Oh Kim, Hee-Sang Jeong, Min-Gon Kim, Kang-Hung Chung, In-Seon Lee, and Cheorl-Ho Kim. “Salviae Miltiorrhizae BGE Radix Increases Rat Striatal K -Stimulated Dopamine Release and Activates the Dopamine Release with Protection Against Hydrogen Peroxide-Induced Injury in Rat Pheochromocytoma PC12 Cells.” Neurochem Res Neurochemical Research 31.1 (2006): 109-20. Web.

 12. Chen, Fang-Pey, Yen-Ying Kung, Yu-Chun Chen, Maw-Shiou Jong, Tzeng-Ji Chen, Fun-Jou Chen, and Shinn-Jang Hwang. “Frequency and Pattern of Chinese Herbal Medicine Prescriptions for Chronic Hepatitis in Taiwan.” Journal of Ethnopharmacology 117.1 (2008): 84-91. Web.

 14. Qi, Fanghua. “Traditional Chinese Medicine and Related Active Compounds: A Review of Their Role on Hepatitis B Virus Infection.”Drug Discov Ther Drug Discoveries & Therapeutics 7.6 (2013): n. pag. Web.

15. Zhao, Jianglin, Jingfeng Lou, Yan Mou, Peiqin Li, Jianyong Wu, and Ligang Zhou. “Diterpenoid Tanshinones and Phenolic Acids from Cultured Hairy Roots of Salvia Miltiorrhiza Bunge and Their Antimicrobial Activities.” Molecules 16.12 (2011): 2259-267. Web.

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