Red Sage - Salvia miltiorrhiza

Common Names: Red Sage, Chinese Sage, Chinese Red Sage, Chinese Salvia, Red Rooted Sage, Danshen, Dan Shen, Tan Shen, Tan-Shen, Salvia Root, Sage Miltiorrhiza, Salvia miltiorrhiza, Salvia przewalskii, Salvia bowleyana, Ch'ih Shen, Huang Ken, Pin-Ma Ts'ao, Shu-Wei Ts'ao, Tan Seng, Tzu Tan-Ken, Sauge Rouge, Sauge Rouge Chinoise, Racine de Salvia, Radix Salviae Miltiorrhizae, Radix Salvie Miltiorrhiae, Salvia Przewalskii Mandarinorum, Salvia Root (Latin/international)

Latin Name: Salvia miltiorrhiza

Origin: Asia, Australia, Europe, South America, North America

Short Introduction

Growing Red Sage in the Czech Republic can be challenging, but not impossible. The plant prefers different environmental conditions but can be found in botanical gardens. Typically, propagation starts in March or April, with seeds taking about two weeks to germinate. Young plants are kept outdoors in full sunlight during the summer; as temperatures drop, they are brought inside at room temperature. Plant outdoors in a sunny spot the following summer. Red Sage tolerates both wet conditions and occasional drought but does not handle heavy shade. Under optimal conditions, it may reach up to 70 cm in height. Roots are harvested in the third autumn, usually in the evening (October or November), and dried for use. Red Sage prefers well-watered soil and is hardy to about -10°C.

Detailed Description

Red Sage is an ancient herb highly valued in Traditional Chinese Medicine (TCM) for its supportive effects on cardiovascular health and elevated blood sugar.

Botanical Information

Red Sage, also known botanically as Salvia miltiorrhiza, is a perennial with a branched stem typically ranging between 30 and 60 cm in height. Its leaves are broadly divided, with both simple and compound forms. The entire plant is covered with fine hairs and sticky glands. Flowers are arranged in whorls and display pale pink to blue-lavender corolla petals, reaching up to 2.5 cm in length.

Origin and Distribution

Red Sage is native to northeastern China and possibly northern Japan. It has been introduced to other parts of the world through human cultivation.

Usage / Dosage

Red Sage has been used in TCM for centuries and remains extremely popular in China, with growing interest and consumption worldwide, including Japan and the USA, and a developing interest in Europe.

Traditional medicine in neighboring countries—drawing from TCM—primarily recommends Danshen for the treatment and prevention of cardiovascular disorders, particularly atherosclerosis, high blood coagulation, and post-stroke recovery. Red Sage is believed to improve blood rheology by influencing coagulation and promoting circulation. Therefore, it mildly thins the blood, lowers plasma cholesterol levels, and enhances arterial blood flow, potentially supporting cognitive health in mild cases of dementia (commonly prescribed in China). Components of Red Sage also increase vascular elasticity. Modern herbal combinations in traditional medicine incorporate Red Sage to aid in liver and spleen disorders, leveraging its antioxidant capacity.

Within TCM, Danshen is one of the five key ingredients in Tangzhiqing, a blend used to support those with type II diabetes mellitus. Animal studies suggest this blend is both effective and safe. Other major constituents of Tangzhiqing include red peony root, mulberry leaf, lotus leaf, and hawthorn leaf.

Red Sage has traditional uses for asthmatic bronchitis in both children and adults, various types of cirrhosis, hepatitis B, chronic prostatitis, and as a root decoction for external application to promote epithelial tissue healing in mild burns. Folk medicine also recognizes Red Sage for addressing skin allergies, minor wounds, and general burns.

Modern medicine has taken a keen interest in Danshen, resulting in abundant research analyzing its potential therapeutic uses—especially for cardiovascular conditions such as angina pectoris, myocardial ischemia, palpitations, arrhythmias, post-heart attack or stroke recovery, vein inflammations, thrombosis, embolism, varicose veins, atherosclerosis, and chronic venous insufficiency. Scientific publications report varying results depending on the diagnosis, but Danshen is widely regarded as having positive effects on cardiovascular health according to several leading health agencies, including the European Medicines Agency (EMA).

Other research has focused on the strong antioxidant properties of Red Sage, supporting its use in liver strengthening and regeneration (it acts as a potent hepatic antioxidant), and its preventive potential for liver enlargement, splenomegaly, cirrhosis, and hepatitis B.

Interest in Red Sage is gradually growing in the Czech Republic and among those exploring alternative medicine. Herbalists most frequently recommend it to lower cholesterol and blood sugar, support tissue regeneration, alleviate nervousness or insomnia, boost immunity, reduce menstrual disorders, support cancer therapy, relieve arthritic joint pain, assist with burns, asthmatic bronchitis, prostatitis, or glaucoma.

Animal and human research confirms that Danshen relieves circulatory problems by lowering platelet activity (noticeable within two days!). Studies show Danshen components dissolve fibrin, a key protein in blood clot formation, and relax blood vessels, especially near the heart. Other studies indicate vascular protective effects and mild improvements in heart contractility and a reduction in heart rate.

Further animal studies demonstrate that Danshen's ingredients significantly inhibit the development of liver fibrosis (formation of scar tissue that impairs liver function). These compounds also enhance blood flow through the liver, reducing exposure of the tissue to harmful substances, and may protect kidney tissue from diabetes-induced damage. Ongoing research in China is examining their efficacy for severe pancreatic inflammation.

In the US, a second phase of clinical testing is underway for a patented medication containing a Danshen extract, ginseng, and borneol, marketed as a cardiotonic based on TCM principles and pending FDA approval.

Active compounds in Danshen have been shown to help regulate abnormal cell growth in various types of tumors by affecting the cell cycle and promoting apoptosis (programmed cell death). This mode of action may also underpin some vascular protective effects.

Some studies suggest Danshen compounds can inhibit replication of certain HIV strains, acting as a natural antiretroviral. Other research indicates a neuroprotective action via dopamine release and antioxidant properties—including bone-stimulating effects. Salvianolic acid B supports tissue regeneration and reversal of renal fibrosis in damaged kidneys.

Salvianolic acid A optimizes coronary arterial blood flow and reduces coagulation, improves microcirculation, and protects cardiac cells from vascular flow disturbances and ischemia, with noted protective effects against free radicals and homocysteinemia.

Another major compound, salvianolic acid B, contributes to cardiac protection, prevents LDL oxidation, and inhibits platelet aggregation. It can also limit water retention and stress protein levels, reduce nitric oxide production, and offers protective benefits against cerebral ischemia.

Tanshinone IIA reduces myocardial infarction size and cellular hypertrophy by affecting angiotensin II, acts as a strong antioxidant in cardiac mitochondria, and is under study in China for treating angina pectoris and other cardiovascular concerns.

Safety and Precautions: Drugs such as digoxin, warfarin, heparin, anticoagulants, blood thinners, and acetylsalicylic acid work via different mechanisms but can increase bleeding risk if combined with Danshen. Use should therefore be discussed with a physician or pharmacist. Similar caution is advised for those on antihypertensive therapy. TCM also warns against combining Red Sage with blood-thinning medications or using it before surgery. Due to insufficient safety data, Danshen is not recommended during pregnancy or breastfeeding.

Active Compounds

Key compounds in Red Sage include water-soluble and lipid-soluble constituents: salvianolic acid, rosmarinic acid, tanshinone I, tanshinone IIA, dihydrotanshinone, cryptotanshinone, beta-sitosterol, baicalin, vitamin E, and tannins. Tanshinone IIA is considered the most promising for ongoing research. The root contains approximately 80 compounds—50 water-soluble, 30 lipid-based.

Traditional Dosage

Recommended dosage varies by source. Herbalist guides suggest boiling 9–10 grams of dried root for 15–30 minutes in 500 ml of water (adding water as needed), or infusing 2 teaspoons of dried root in 250 ml cold water for 5 minutes, then boiling for 5 minutes, followed by a 5-minute infusion. Drink this decoction 2–3 times per day, ideally 30 minutes before meals.

For homemade tinctures: Soak finely chopped dried root in plain vodka at a 1:4 weight ratio for about 10 days. Use 10–20 drops 2–3 times daily to support immunity, circulation, and cardiovascular function.