Summary of Salvia miltiorrhiza
Primary Information, Benefits, Effects, and Important Facts
Salvia Militorrhizashen is a traditional asian herbal medication for circulatory ailments. It has shown efficacy in treating various markers of heart health, and is typically seen as a very heart healthy herb., or Dan
Danshen works through a few primary ingredients, which all work synergistically on various parameters of heart and circulatory health.
It is the largest herbal market in China, and is commonly sold as dripping pills (to be absorbed under the tongue) or as oral tablets. Both are effective, but the dripping pills appear to provide more of the active ingredients.
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Salvia militorrhiza (also known as Danshen) is an asian herb historically known to have beneficial effects on the circulatory system. Danshen, as well as a blend called 'Fufang Dansehn' containing Panax notoginseng and Cinnamomum camphora, are the two most widely selling herbs in China.
Over 80 different compounds have been identified in Danshen, 50 of which are water-soluble and the remaining 30 fat-soluble. The fat-soluble components are diterpene compounds belonging to the subclass 'tanshinones', or which the two main studies tanshinones are tanshinone IIA and cryptotanshinone. The water soluble components consist of various (up to 15) polyphenolic acids including salvianolic acids, protocatechuic aldehyde and acid, and danshensu (salvianic acid A). Other notable compounds are beta-sitosterol, ursolic acid, baicalin, and sometimes a vitamin E or tannin content.
Out of all of these compounds, the main ones with pharmacological importance seem to be the salvinoic acids (including danshensu) and the tanshinones (including tanshinone IIA).
Tanshinone IIA has been shown to be rapidly absorbed orally in either isolation or as Danshen; the compound cryptotanshinone is not taken up orally and metabolizes into tanshinone IIA upon intravenous injection, although a lipid nanoparticle transport alleviates this.
Danshensu (salvinaic acid A) is also rapidly absorbed after oral ingestion, while salvinoic acid B has a much lesser uptake rate.
It appears that Danshensu in the form of sublingual dripping pills results in higher bioavailability than orally ingested pills.
2.2. Enzymatic Interactions
Fourteen days of supplementation with Danshen tablets (Salvia miltiorrhiza alongside Panax notoginseng and Cinnamomum camphora) thrice daily does not appear to significantly alter the pharmacokinitics of theophylline, a drug mostly metabolized by CYP1A2 (to a lesser extent, CYP2E1).
3Contributions of individual ingredients to its clinical efficacy
Danshensu (Salvianic acid A) has been shown to dilate coronary arteries, inhibit platelet aggregation, improve microcirculation and protect the myocardium from reperfusion injury of the ischemic heart. It can also inhibit myocardial cell apoptosis while protecting cells from free radicals and homocysteinemia.
Salvionolic acid B can contribute to cardiac protection by inhibiting the oxidation of LDL proteins (preventing uptake by macrophages) and inhibiting platlet aggregation. It can also inhibit angiotension-II induced hyperplasmia, stress-activated protein (SAP) kinase activiy, and the DNA synthesis of noncardiomyocytes while stimulating NO production of the endothelial cell. It also has protective effects against cerebral ischemia-reperfusion injury.
Tanshinone IIA has been implicated in reducing myocardial infarct size and cardiac cell hypertrophy (via angiotension II inhibition). It also serves as an anti-oxidant in myocardial mitochondrial membranes and against the oxidation of LDL proteins.
It has been historically used in China with efficacy to treat heart diseases such as angina pectoralis, and has recently shown efficacy in cerebrovascular diseases and hyperlipidemia; Essentially circulation ailments.
5Adverse interactions and Toxicity
Three studies noted slight thirst and gastrointestinal side effects when using a 'dripping pill' formulation of Danshen.
Beyond that, the LD50 value for Danshen was found to be 25.807 g/kg in mice, which is 3934 times the therapeutic dose of 6.56 mg/kg bodyweight. 400 times the therapeutic dose for 90 days was found to be safe in mice.
Due to Salvia Militorrhiza's anti-thrombotic and blood pressure lowering abilities, it adversely interacts with the pharmaceutical Warfarin and causes enhanced bleeding and hindering of wound healing when combined.
Combining Danshen with salicyclate (derivative of aspirin) results in much less bioavailability of Danshen when using therapeutic doses of salicyclic acid, thus using Aspirin and Danshen is not advised.