Salvia miltiorrhiza (a member of the Lamiaceae family) is also known as red sage, redroot sage and danshen. It is a perennial sage, highly valued for its roots in Chinese and Japanese medicine. Native to these countries, it grows in grassy places in forests and along streams at 90 to 1200m above sea level.
Active ingredients
The root and rhizomes are used and the main bioactive ingredients in danshen are water-soluble phenolic acids and the lipophilic tanshinones, including salvianolic acids, rosmarinic acid, aldehydes and caffeic acid.
The salvianolic acids are the main antioxidant, anti-inflammatory and antithrombotic with cardioprotective activities, while the taninones have more antitumour, cardioprotective, neuroprotective and analgaesic activities.
Therapeutic uses
Cardiovascular
By removing blood stasis, danshen plays a major role in cardiovascular health as it protects vascular endothelial cells by reducing oxidative stress and inflammation, enhances anticoagulant and fibrinolytic activity, inhibits platelet activation and aggregation and dilates blood vessel walls. Danshen also lowers blood cholesterol and promotes blood circulation. It has been shown to reduce atherosclerosis, have a protective effect on cardiac fibrosis induced by iron overload, improves outcomes after a myocardial infarction and prevents further damage from ischaemia.
In Traditional Chinese Medicine (TCM), danshen is bitter in taste, cold and enters the heart meridians. In Chinese medicine, danshen is the most frequently prescribed single herb to reduce high blood pressure.
Neurological
In the nervous system, danshen has demonstrated significant neuroprotective effects by inhibiting oxidative stress and neuroinflammation. Research (mainly in rats) shows benefits in improvement in long-term memory and cognitive function, improved recovery from ischaemic strokes and brain injury, protection from damage caused by diabetes and blood sugar abnormalities and protection against brain damage from excess alcohol. Research has also shown improvements in dementia, Alzheimer’s disease, temporal lobe epilepsy and spinal cord injuries using danshen.
Liver
Danshen plays major roles in liver health, reducing inflammation, fatty liver, fibrosis of the liver (including fibrosis associated with hepatitis) and reducing the iron overload that exacerbates these conditions.
Danshen also has synergistic activity with Boswellia (in hepatitis) and St Mary’s Thistle.
Pancreatitis
An interesting seven-day clinical trial was conducted on 36 patients with acute pancreatitis (half of whom were treated with danshen and half not treated) plus a further 14 healthy controls. In the patients with pancreatitis, their levels of inflammatory markers (IL-6, IL-8 and TNF) were significantly elevated, whereas those of the healthy cohort were normal. After seven days, the inflammatory markers of the treated group had reduced significantly more than the nontreated group.
Danshen’s ability to reduce inflammation and repair and strengthen the intestinal barrier and improve gut microbiota has also shown promise in repairing various inflammatory gut conditions such IBD, ulcerative and Crohn’s disease.
Reproductive system
With its ability to increase blood flow and dissipate stasis, danshen has also been used to induce menstruation, relieve menstrual pain and reduce the symptoms of PCOS.
Osteoporosis
Another traditional use in TCM is in treating skeletal conditions such as osteoporosis. Thirty-six clinical trials were identified using danshen to treat post-menopausal, senile and secondary osteoporosis. Overall, these showed high efficacy and low toxicity. On analysis, compounds isolated from danshen displayed anti-resorptive and bone formation-stimulating activities in different pathways of the bone remodelling cycle, indicating the potential uses of danshen in protection and improvement of osteoporotic symptoms.
Cautions and contraindications.
Danshen may potentiate the effects of anticoagulant medication such as warfarin and aspirin so avoid if taking these medications, unless monitored by a practitioner. There are also some who are allergic to the plant and may experience dizziness, headache or gut upsets, but otherwise it has very low toxicity.
