Plant Part Used

Root/rhizome

Introduction

Black cohosh has made a name for itself in many parts of the world. The hairy roots of this plant have been used in Chinese medicine for centuries as a remedy for conditions such as headache, non-eruptive measles, gingivitis, and other disorders. Native Americans used it as a remedy for painful menses, problematic childbirth, arthritic problems, and as an antidote for snakebite. Some physicians in America at the turn of the century relied on preparations of black cohosh for many problems, including rheumatism and female complaints.

Interactions and Depletions

Interactions

• Estrogen and estrogen-like medications

Dosage Info

Dosage Range

20-40mg (equivalent to 1mg-2mg of 27-deoxyactein), 2 times daily (standardized extract).

Most Common Dosage

40mg (equivalent to 2mg of 27-deoxyactein), 2 times daily (standardized extract).

Standardization

[span class=doc]Standardization represents the complete body of information and controls that serve to enhance the batch to batch consistency of a botanical product, including but not limited to the presence of a marker compound at a defined level or within a defined range.[/span]

The most current available medical and scientific literature indicates that this dietary supplement should be standardized to 1mg of triterpene glycosides calculated as 27-deoxyactein.

Reported Uses

Scientists have been studying black cohosh’s ability to mimic the effects of the hormone estrogen on the body. (1) This may have applications in the support of women going through menopause. In fact, clinical studies have reported positive effects on menopausal and post-menopausal complaints when using standardized extracts of black cohosh. (2) , (3) , (4) , (5) One study has suggested that black cohosh may have a component that produces a hormonal balancing effect in the female reproductive system. (6) Other studies which were designed to show the estrogen-like activity of black cohosh and the benefit of it on the symptoms associated with menopause have had disappointing results. The results showed little to no estrogen activity and no benefit over a placebo in improving certain menopausal symptoms. (7) , (8) , (9) , (10) Another concluded that an extract improved menopausal symptoms but demonstrated no estrogen-like activity. (11)

The root has also shown promise in the management of rheumatoid arthritis and headache. It is believed that some of the active components in black cohosh can have an anti-inflammatory effect. (12)

The compounds, known as phytoestrogens, in black cohosh have been shown to decrease the growth of certain types of breast cancer, (13) , (14) but may enhance the growth of others. (15) Please discuss the use of black cohosh for cancer with a qualified healthcare professional.

Toxicities & Precautions

Introduction

[span class=alert]Be sure to tell your pharmacist, doctor, or other health care providers about any dietary supplements you are taking. There may be a potential for interactions or side effects.[/span]

General

This dietary supplement is considered safe when used in accordance with proper dosing guidelines. (16) , (17)

Black cohosh is recommended to be taken for 6 months followed by a blood hormone level.

Health Conditions

Scientific studies have reported that certain ingredients contained in this dietary supplement act similar to the body's natural hormone estrogen. If you have or are susceptible to hormonally related cancers, such as breast, ovarian and prostate, talk to your doctor before taking this dietary supplement. (18)

Side Effects

Side effects are possible with any dietary supplement. Large doses of this dietary supplement may cause nausea, vomiting, and headache. (19) Tell your doctor if these side effects become severe or do not go away.

Pregnancy/ Breast Feeding

This dietary supplement should not be used if you are pregnant. (20)

This dietary supplement should not be used if you are breast-feeding an infant without first consulting a physician.

Age Limitations

Use black cohosh for the management of female hormonal functions under the supervision of a physician who is familiar with alternative therapies.

This supplement should not be used in children unless recommended by your physician.

References

1. Jarry H, et al. The Endocrine Effects of Constituents of Cimicifuga racemosa. 2. In Vitro Binding of Constituents to Estrogen Receptors. Planta Med. Aug1985;4:316-19.
2. View Abstract: Lieberman S. A Review of the Effectiveness of Cimicifuga racemosa (black cohosh) for the Symptoms of Menopause. J Womens Health. Jun1998;7(5):525-29.
3. Jarry H, et al. The Endocrine Effects of Constituents of Cimicifuga racemosa. 2. In Vitro Binding of Constituents to Estrogen Receptors. Planta Med. Aug1985;4:316-19.
4. View Abstract: Dog TL, Powell KL, Weisman SM. Critical evaluation of the safety of Cimicifuga racemosa in menopause symptom relief. Menopause. Jul2003;10(4):299-313.
5. View Abstract: Treatment of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Menopause. 2004 Jan-Feb;11(1):11-33.
6. View Abstract: Koeda M, et al. Studies on the Chinese Crude Drug "Shoma." IX. Three Novel Cyclolanostanol Xylosides, Cimicifugosides H-1, H-2 and H-5, from Cimicifuga Rhizome. Chem Pharm Bull. Tokyo. May1995;43(5):771-76.
7. View Abstract: Liu J, Burdette JE, Xu H, Gu C, van Breemen RB, Bhat KP, et al. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem. May2001;49(5):2472-9.
8. View Abstract: Jacobson JS, Troxel AB, Evans J, Klaus L, Vahdat L, Kinne D, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. J Clin Oncol. May2001;19(10):2739-45.
9. View Abstract: Willhite LA, O'Connell MB. Urogenital atrophy: prevention and treatment. Pharmacotherapy. Apr2001;21(4):464-80.
10. View Abstract: Onorato J, Henion JD. Evaluation of triterpene glycoside estrogenic activity using LC/MS and immunoaffinity extraction. Anal Chem. Oct2001;73(19):4704-10.
11. View Abstract: Liske E, et al. Physiological investigation of a unique extract of black cohosh (Cimicifugae racemosae rhizoma): a 6-month clinical study demonstrates no systemic estrogenic effect. J Womens Health Gend Based Med. Mar2002;11(2):163-74.
12. Shibata M, et al. Pharmacological Studies on the Chinese Crude Drug "Shoma" III. Central Depressant and Antispasmodic Actions of Cimicifuga rhizoma, Cimicifuga simplex Wormsk. Yakugaku Zasshi. Nov1980;100(11):1143-50.
13. View Abstract: Dixon-Shanies D, Shaikh N. Growth Inhibition of Human Breast Cancer Cells by Herbs and Phytoestrogens. Oncol Rep. Nov1999;6(6):1383-7.
14. View Abstract: Einbond LS. Growth inhibitory activity of extracts and purified components of black cohosh on human breast cancer cells. Breast Cancer Res Treat. 2004 Feb;83(3):221-31.
15. View Abstract: Liu Z, Yang Z, Zhu M, Huo J. Estrogenicity of black cohosh (Cimicifuga racemosa) and its effect on estrogen receptor level in human breast cancer MCF-7 cells. Wei Sheng Yan Jiu. Mar2001;30(2):77-80.
16. View Abstract: McKenna DJ, Jones K, Humphrey S, Hughes K. Black cohosh: efficacy, safety, and use in clinical and preclinical applications. Altern Ther Health Med. May2001;7(3):93-100.
17. View Abstract: Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause. Jan2003;10(1):58-64.
18. View Abstract: Wade C, Kronenberg F, Kelly A, Murphy PA. Hormone-modulating herbs: implications for women's health. J Am Med Womens Assoc. 1999;54(4):181-3.
19. PDR for Herbal Medicines, 2nd ed. Montvale, NJ: Medical Economics Company; 2000:93.
20. View Abstract: McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J Nurse Midwifery. May1999;44(3):205-16.