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Black Cohosh
(Cimicifuga racemosa)
Description
Not to be confused with blue cohosh, a herb that is potentially
toxic to the heart, black cohosh is used primarily to treat
women’s health problems. Black cohosh has been approved
by Germany’s Commission E for the treatment of Menopause,
dysmenorrhea, and PMS.
Herbal Uses
In addition to women’s
health problems, Native Americans traditionally used the herb
to treat Arthritis, Fatigue, and snakebite. In the late nineteenth
century, black cohosh became the main ingredient in the extremely
popular treatment for menstrual Cramps known as Lydia Pinkham’s
Vegetable Compound. Black cohosh was also a popular treatment
in Europe for women’s problems, arthritis, and high
blood pressure.
Suggested Intakes
Standardised extract, containing
1 mg of 27-deoxyacteine per tablet, 1 or 2 tablets twice daily.
Supplemental Uses
Modern research suggests
that black cohosh mimics the effects of estrogen. The herb
appears to display oestrogen-like action, binding to oestrogen
receptors in the body (2). The herb appears to inhibit the
pituitary hormone LH, the levels of which rise dramatically
during Menopause (3-5).
Menopause:
Studies show that menopausal women experience significant
improvement in the following symptoms after using black cohosh
for 4 to 6 weeks: Hot Flushes, sweating, Headache, vertigo,
heart palpitations, Tinnitus, Nervousness, irritability, sleep
disturbance, Anxiety, vaginal dryness, and Depression. The
best evidence demonstrating the benefits of black cohosh came
from a double-blind study showing that black cohosh was more
effective than oestrogen in relieving menopausal symptoms
(6). However, there is no evidence indicating that black cohosh
prevents Osteoporosis or heart disease, two significant benefits
of oestrogen.
Menstrual disorders:
Black cohosh can be mildly effective for treating PMS and
dysmenorrhea.
Safety and Precautions
Aside from occasional mild
gastrointestinal distress, black cohosh does not appear to
produce any side effects. Studies involving rats demonstrate
no significant toxicity with excessive and prolonged administration
(7).
Black cohosh is not recommended
for adolescents or pregnant or nursing women due to hormonal
activity.
Women with breast cancer
history, patients with liver or kidney disease, and young
children should be cautious with black cohosh since safety
has not been established.
Interactions and Contra-Indications
Black cohosh may interfere
with drugs for high-blood pressure or diabetes (8). However,
no such incidents have been reported.
Transitioning from 0.625
mg of daily oestrogen to black cohosh is generally successful.
However, transitioning from higher dosages of oestrogen may
result in breakthrough Hot Flushes and other symptoms. Consult
with a doctor before stopping oestrogen therapy.
References
1.Jones TK, et al.
Profound neonatal congestive heart failure caused by maternal
consumption of blue cohosh herbal medication. J Pediatr 132:
550-552, 1998.
2. The Complete German Commission E Monographs. Eds. Blumenthal
M, et al. Boston: American Botanical Council, 1998.
3. Jarry H, et al. II. Endocrine effects of constituents of
Cimicifuga racemosa. 1. The effect on serum levels of pituitary
hormones in ovariectomized rats. Planta Med 1: 46-49, 1985.
4. Jarry H, et al. The endocrine effects of constituents of
Cimicifuga racemosa. 2. In vitro binding of constituents to
estrogen receptors. Planta Med 4: 316-319, 1985.
5. Duker EM, et al. Effects of extracts from Cimicifuga racemosa
on gonadotropin release in menopausal women and ovariectomized
rats. Planta Med 57(5): 420-424, 1991.
6.Stoll W. Phytopharmacon influences atrophic vaginal epithelium.
Double-blind study: Cimicifuga vs. estrogenic substances.
Therapeuticum 1: 23-31: 1987.
7. Korn WD. Six-month oral toxicity study with Remifemin-granulate
in rats followed by an 8-week recovery period. Hannover, Germany:
International Bioresearch, 1991.
8. Newall C. Herbal medicines: A guide for health-care professionals.
London: Pharmaceutical Press, 1996: 80.
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