Sage Root (Red)

What is Salvia miltiorrhiza?
Salvia miltiorrhiza, also known as red sage, is a flowering plant native to China and Japan. It is part of the mint family. The plant’s roots are called Danshen and have been used in Traditional Chinese Medicine for over 2000 years [1, 2].

Traditionally, Danshen is given to people with problems related to the heart and circulatory systems, such as high blood pressure or stroke [3, 1].

Traditional Meets Modern
It is often included as part of other traditional medicine. For example, Salvia miltiorrhiza, notoginseng, and borneol can be combined to make Danshen dripping pills. These pills are the first Traditional Chinese Medicine (TCM) that has successfully completed a Phase 2 clinical trial under the U.S. Food and Drug Administration (FDA). This means that it may become the first TCM remedy approved by the FDA in the future [4, 5, 6].

This FDA-monitored study involved 15 centers across the US and 125 patients with angina pectoris, a type of chest pain from heart disease. Due to poor heart function, people with angina have lower exercise tolerance and quality of life. In this study, they discontinued most other heart medications. And after 8 weeks, the pills effectively improved their heart symptoms and exercise capacity [6].

Danshen dripping pills are currently undergoing trials in the US. They are a great example of a TCM remedy undergoing proper scientific testing – and while the results have been encouraging so far, the quality of many of the available studies has been low.

However, clinical studies have yet to determine whether their use is safe, and these pills are not regulated outside of China. They fall in the grey area of regulation; we recommend caution when evaluating any products that claim to be Danshen dripping pills.

The evidence to back up other benefits of Danshen is weaker but still holds a lot of promise. In most instances, the use of high-quality, regulated supplements from this herb is safe. We carefully break down the research so you know what to expect and what dangers to watch out for.


Early studies indicate potential use in heart disease
Long history of traditional use
Generally considered safe
May cause side effects including nausea and dizziness
May interact with medications
Many available studies are poor in quality and show signs of bias
Currently unregulated; potentially contaminated or dangerous formulations
This plant contains over 200 active compounds [2].

Salvia miltiorrhiza produces tanshinones, special kinds of molecules first found in this herb. Over 40 tanshinones have been identified in Danshen, and they are thought to be responsible for many of the herb’s properties, such as its effects on the heart [7, 8, 9, 10].

The roots of the plant contain a number of antioxidants, such as salvianolic acid and other organic acids [11, 1].

The herb also contains vitamins and minerals, like vitamin E and potassium [12].

There are some small differences in the content of these components among plants from different places. However, the amounts of important molecules like tanshinones are comparable among plants from different areas [12, 13].

Mechanism of Action
Researchers have conducted a number of cell and animal studies on Salvia miltiorrhiza with the goal of determining how it works on the cellular and tissue level.

According to cell studies, Salvia miltiorrhiza may help the heart and decrease blood pressure by:

Activating ion channels that help widen blood vessels [14].
Decreasing the levels of stress-related proteins in blood vessel cells [15, 11].
Helping blood vessel cells survive when they are injured [16].

Some researchers believe that the herb’s benefits for people with diabetes are likely related to its ability to boost blood flow, lower inflammation, and quench cellular stress. Its protective effects on the kidney also probably contribute to preventing diabetes-associated kidney disease [17, 18, 19].

What’s more, it may aid in wound healing by promoting the formation of blood vessels and decreasing inflammation and cell death [20].

According to cell studies, this herb might help the brain and nervous system by:

Helping brain cells survive when there isn’t enough oxygen, which happens during a stroke [21].
Preserving myelin sheaths – coatings around brain cells that help them send electric signals more efficiently [22].
Decreasing the formation of Alzheimer’s disease-related plaques [23].
Many of the compounds in Salvia miltiorrhiza increased the activities of neurotransmitters, like acetylcholine, in the brain, which may be related to the herb’s usefulness for insomnia, anxiety, and depression [24].

It might kill cancer cells by:

Generating reactive oxygen species selectively in cancer cells, which can damage their DNA [25].
Activating molecular signals in cancer cells that lead the cells to die, stop growing, or even turn into non-cancerous cells [26, 27, 28].
Cutting of the tumor’s blood supply, effectively causing the tumor cells to starve [29].
Danshen also appears to have antibacterial and anti-inflammatory effects. Components of the plant might also block male sex hormones, which can otherwise trigger or worsen acne [30].

It likely affects kidney and liver health by modulating the activity of the immune system and the body’s energy usage [31, 32, 33].