This website discusses the benefits and side effects of various supplements, herbs and drug products, including danshen. Different people may experience different side effects and benefits of a product. Danshen has not been scientific studied thoroughly, you must consult with your doctor before use it. You are encouraged to report adverse side effects to FDA, its website is www.fda.gov., or report the adverse side effects to the manufacturer. Reasonable care has been taken in preparing this document and the information provided herein is believed to be accurate. The information is not intended to be a substitute for professional medical advice. ALL RIGHTS RESERVED.
Danshen Salvia miltiorrhiza (丹參; dānshēn), also known as red sage, Chinese sage, tan shen, or dan shen, is a perennial plant, native to China and Japan. People use the danshen root to make medicine. Danshen benefits may be many, danshen has been used for treating diabetes, chronic renal failure, heart conditions and strokes. Danshen is also used for treating menstrual disorders, chronic liver disease, rapid heartbeat, tight chest, acne, psoriasis and eczema. Danshen contains a few important active ingredients and they are danshensu, salvianolic acid B, tanshinone I and tanshinone IIA. This article highlights recent research findings about danshen benefits. _________________________________________________________________________________________
Danshen Benefits Danshen has been shown to have anti-oxidative activity. [5]
Danshen Benefits - Cardiovascular Protection In China, Danshen has been wildly used to treat cardiovascular diseases for hundreds of years. Animal studies have suggested that danshen may have benefits of blood pressure lowering; anti-fibrinolytic activities and inhibitory effect of platelet aggregation [1,2] Danshen aqueous extract, danshensu, tanshinone, dihydrotanshinone and salvianolic acid B are found to have vasorelaxant effects. [7-10]
Salvianolic acids, key dansehn ingredient, have potent anti-oxidative capabilities. Cardiovascular protection of salvianolic acids is not only because salvianolic acids act as reactive oxygen species scavengers, but also due to the reduction of leukocyte-endothelial adherence, inhibition of inflammation and metalloproteinases expression from aortic smooth muscle cells, and indirect regulation of immune function. [A1] In the following section, I summarize some evidence to support danshen benefits of cardiac protection.
Recent Animal Studies Tanshinone II-A, a key Danshen ingredient, decreased and stabilized atherosclerotic plaques in Apolipoprotein-E knockout (ApoE(-/-)) mice maintained on a high cholesterol diet. [A2] In a seperated study, this danshan ingredient significantly improved cardiac function and attenuated fibrosis in 2K2C hypertensive rats. The protective action of Tanshinone II-A is likely mediated by its antioxidant effect, independent of BP control, partially via inhibiting NADPH oxidase. {A3]
Myocardial hypertrophy has been linked to the development of a variety of cardiovascular diseases, and is a risk factor for myocardial ischemia, arrhythmias, and sudden cardiac death. Danshensu, another key ingredient of Danshen, significantly decreased heart weight/body weight and left ventricular weight/body weight ratios in rats suffered from myocardial hypertrophy. [A4]
Clinical Human Study The efficacy of a danshen dripping pill (danshen) for secondary stroke prevention was evaluated in patients with ischemic cerebrovascular disease. The danshen treatment also contained Panax notoginseng and Dryobalanops camphor. Patients who had suffered from ischemic stroke or a transient ischemic attack (TIA) within the previous 20 days were divided into groups to receive either danshen or non-danshen treatment. Recurrent stroke/TIA was observed in five patients (9.6%) with danshen treatment and in 13 patients (24.1%) without danshen during the follow- up. Recurrence in the patient group taking danshen treatment was lower than that in the control group. No significant differences in intracranial hemorrhage and mortality were detected between groups. Blood C reactive protein decreased significantly in patients with danshen treatment l compared with patients without danshen treatment. These results indicate that danshen treatment may reduce the risk for stroke/TIA recurrence, and this reduction of risk may be associated with its antiinflammatory effects. [A5]
In another study, 100 coronary patients were randomized to adjunctive treatment with danshen and gegen combination (3 g) or placebo (6 capsules) for 24 weeks in double-blind parallel fashion, followed by optional open- label danshen combination (1.5 g/day) for 6 more months. Brachial flow-mediated dilation (BFMD) and carotid intima- media thickness (CIMT) were measured using ultrasound. After 24 weeks and compared with baseline, there was a mild decrease in low density lipoprotein (LDL) cholesterol in both groups. BFMD improved during denshan treatment and less so during placebo treatment, while improvement in CIMT was observed only in the danshen group. After open-label danshen treatment for 6 more months, further improvement in both BFMD and CIMT thickness was observed. [A6]
Diabetes Most of the studies were done with animal models. Danshen may have benefits on diabetes, but clinical studies are needed to prove this claim. A recent study demonstrated the effect of danshen on diabetic nephropathy in an rat model. High levels of 24-h urinary protein excretion as well as some other signs were reduced after a treatment of danshen (500 mg/kg) for 8 weeks. [A14]
Metabolic Syndrome A mixture of Gynostemma pentaphyllum, Coptis chinensis and danshen prevented weight gain with decreased visceral fat in rats suffered from metabolic syndrome. Further this danshen mixture significantly reduced plasma triacylglycerols (triglycerides), and cholesterol. [A15]
Ulcer Danshen decoction was found to accelerate the healing of ulcer induced by acetic acid, increased the content of mucus and inhibited the formation of gastric ulcer in a study of mice. [4]
Lipid Profiles and Osteoporosis Zhang ZP from Guangdong Medical College found that danshen root compounds increased HDL-cholesterol and partially prevent the occurrence of osteoporosis in mice suffered from hyperlipemia-induced osteoporosis. [11]
Cancers Danshen root extracts probably may have benefits on people suffered from certain cancers. Lots of in-vitro studies are supporting this beneficial claim. But, clinical studies are needed to confirm the in vitro anti-cancer activities are "transferable" to the human body. Here, I highlight a few interesting recent findings:
Tanshinone IIA, a key ingredient of danshen, has been shown to have anti-cancer activities in test-tube. This danshen ingredient exhibited dose-dependent and time-dependent anticancer effects on liver cancer BEL-7402 cells through apoptosis and G(0)/G(1) arrest in the test-tube study. [A7] An earlier study, tanshinones in danshen were found to inhibit the growth of prostate cancer cells in vitro and in mice. [A12]
Cryptotanshinone is a biologically active compound from the root of danshen. The anti-cancer activities of this danshen ingredient is in synergy with tumor necrosis factor-alpha (TNF-α) for the induction of apoptosis in human chronic myeloid leukemia (CML) KBM-5 cells. [A8] An earlier study, showed this danshen chemical anti-tumor effect on two melanoma cell lines with low/high-metastatic capacity (B16/B16BL6). [A13]
Miltipolone, another danshen ingredient, was discovered as a good and broad-spectrum inhibitor against the growth of cancer cells. It acts as a Fe(2+) chelator to conduct its inhibitory activity. [A9]
5,16-dihydrotanshinone I extracted from danshen root was found to be the most effective compound of danshen extracts against breast cancer cells in a study. This danshen compound was also found to be able to induce apoptosis of prostate carcinoma cells via induction of ER stress and/or inhibition of proteasome activity. [A10]
Another danshen active ingredient, Salvianolic acid B, significantly inhibited or delayed the growth of head and neck squamous cell cancer (HNSCC) in both cultured HNSCC cells and HNSCC xenograft animal models, probably the mechanism involved the inhibition of COX-2/PGE-2 pathway, the promotion of apoptosis, and the modulation of angiogenesis. [A11]
Danshen was also found to strongly inhibit the proliferation of both breast cancer cells MCF-7 vec cells and MCF-7 HER2 cells. MCF-7 HER2 cells is related to the overexpression of HER2. HER2 is a receptor tyrosine kinase, and is involved in signal transduction pathways leading to tumor cell proliferation. And, MCF-7 HER2 cells were more resistant to the Danshen-induced inhibition of Akt phosphorylation and p27 up-regulation. [13]
Please, note that most of these studies are done with pure chemicals, instead of danshen whole plant. It is not clear if a commercially-available danshen supplements have the benefits of anti-cancer.
Anti-viral activities A study from Chang Gung University suggests a danshen extract may be used as anti-enterovirus 71 agent. [12]
Scientific evidence for danshen benefit is insufficient, more studies are needed to prove danshen benefits. _______________________________________________________________________________________
Danshen Side Effects and Safety Danshen may lead to side effects such as itching, upset stomach, reduced appetite, drowsiness, dizziness, and thrombocytopenia. For details, please, review: Danshen _______________________________________________________________________________________ Dan Shen PianDanshen Side Effects Reference [1] Kang DG, et al. Anti-hypertensive effect of water extract of danshen on renovascular hypertension through inhibition of the renin angiotensin system. Am J Chin Med. 2002;30(1):87-93. Zou ZW, et al. Antithrombotic and antiplatelet effects of rosmarinic acid, a water- soluble component isolated from radix Salviae miltiorrhizae (danshen) Yao Xue Xue Bao. 1993;28(4):241-5. [4] Liu L, Zhang HQ. Effects of Danshen Decoction on experimental gastric ulcer in rats and mice, Zhong Xi Yi Jie He Xue Bao. 2005 Jan;3(1):35-8. [5] Yue KK, et al. Danshen prevents the occurrence of oxidative stress in the eye and aorta of diabetic rats without affecting the hyperglycemic state. J Ethnopharmacol. 2006 Jun 15;106(1):136-41. Epub 2006 Jan 20. [7] Lam FF, et al. Salvianolic acid B, an aqueous component of danshen (Salvia miltiorrhiza), relaxes rat coronary artery by inhibition of calcium channels. Eur J Pharmacol. 2006 Dec 28;553(1-3):240-5. Epub 2006 Sep 23. [8] Kim DD, et al. Endothelial nitric oxide synthase is a molecular vascular target for the Chinese herb Danshen in hypertension. Am J Physiol Heart Circ Physiol. 2007 May;292(5):H2131-7. Epub 2006 Dec 15. [9] Lam FF, et al. Relaxant effects of danshen aqueous extract and its constituent danshensu on rat coronary artery are mediated by inhibition of calcium channels. Vascul Pharmacol. 2007 Apr;46(4):271-7. Epub 2006 Nov 18. [10] Lam FF, et al. Dihydrotanshinone, a lipophilic component of Salvia miltiorrhiza (danshen), relaxes rat coronary artery by inhibition of calcium channels. J Ethnopharmacol. 2008 Sep 26;119(2):318-21. Epub 2008 Jul 18. [11] Zhang ZP, et al. Effect of Danshen root compound on blood lipid and bone biomechanics in mice with hyperlipemia-induced osteoporosis Nan Fang Yi Ke Da Xue Xue Bao. 2008 Aug;28(9):1550-3. [12] Wu BW, et al. Antiviral effects of Salvia miltiorrhiza (Danshen) against enterovirus 71. Am J Chin Med. 2007;35(1):153-68. [12] Yang W, et al, Danshen (Salvia miltiorrhiza) extract inhibits proliferation of breast cancer cells via modulation of Akt activity and p27 level.Phytother Res. 2010 Feb;24(2):198-204. [A1] Ho JH, et al, Salvianolic acids: small compounds with multiple mechanisms for cardiovascular protection. J Biomed Sci. 2011 May 11;18:30. [A2] Xu S et al, Tanshinone II-A attenuates and stabilizes atherosclerotic plaques in Apolipoprotein-E knockout mice fed a high cholesterol diet. Arch Biochem Biophys. 2011 Aug 26. [A3] Wang P, et al, Tanshinone IIA prevents cardiac remodeling through attenuating NAD (P)H oxidase-derived reactive oxygen species production in hypertensive rats. Pharmazie. 2011 Jul;66(7):517-24. [A4] Tang Y, et al Antioxidant and cardioprotective effects of Danshensu (3-(3, 4-dihydroxyphenyl)-2-hydroxy-propanoic acid from Salvia miltiorrhiza) on isoproterenol- induced myocardial hypertrophy in rats. Phytomedicine. 2011 Sep 15;18(12):1024-30. [A5] Xu G. et al, Danshen extracts decrease blood C reactive protein and prevent ischemic stroke recurrence: a controlled pilot study. Phytother Res. 2009 Dec;23(12):1721-5. [A6] Tam WY, et al The efficacy and tolerability of adjunctive alternative herbal medicine (Salvia miltiorrhiza and Pueraria lobata) on vascular function and structure in coronary patients. J Altern Complement Med. 2009 Apr;15(4):415-21. [A7] Dai Zk et al, Tanshinone IIA activates calcium- dependent apoptosis signaling pathway in human hepatoma cells. J Nat Med. 2011 Aug 19. [A8] Kim JH, et al, Cryptotanshinone enhances TNF-α-induced apoptosis in chronic myeloid leukemia KBM-5 cells. Apoptosis. 2011 Jul;16(7):696-707. [A9] Wang J et al, Identification, structural properties and chelating capacity of miltipolone as a broad-spectrum inhibitor to cancer cells. Eur J Med Chem. 2011 Apr;46(4):1117-21. [A10] Chuang MT et al, 15,16-Dihydrotanshinone I, a Compound of Salvia miltiorrhiza Bunge, Induces Apoptosis through Inducing Endoplasmic Reticular Stress in Human Prostate Carcinoma Cells. Evid Based Complement Alternat Med. 2011;2011: 865435. [A10] Chuang MT et al, 15,16-Dihydrotanshinone I, a Compound of Salvia miltiorrhiza Bunge, Induces Apoptosis through Inducing Endoplasmic Reticular Stress in Human Prostate Carcinoma Cells. Evid Based Complement Alternat Med. 2011;2011:865435. [A11] Zhao Y et al, Salvianolic Acid B, a potential chemopreventive agent, for head and neck squamous cell cancer. J Oncol. 2011;2011: 534548. [A12] Gong Y, et al, Bioactive tanshinones in Salvia miltiorrhiza inhibit the growth of prostate cancer cells in vitro and in mice. Int J Cancer. 2011 Sep 1;129(5):1042-52. [A13] Chen L, et al, Cryptotanshinone has diverse effects on cell cycle events in melanoma cell lines with different metastatic capacity. Cancer Chemother Pharmacol. 2011 Jul;68(1):17-27. [A14] Lee SH et al, The protective effect of Salvia miltiorrhiza in an animal model of early experimentally induced diabetic nephropathy. J Ethnopharmacol. 2011 Aug 11. [A15] Tan Y et al, Chinese herbal extracts (SK0506) as a potential candidate for the therapy of the metabolic syndrome. Clin Sci (Lond). 2011 Apr;120 (7):297-305.