Black Cohosh

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Overview of Black Cohosh

Black cohosh, otherwise known as cimicifuga racemosa, is a plant from the buttercup family that grows in the woodlands of Ontario, Georgia, Arkansas and Wisconsin. This herb is then used for different purposes, but is best known for its use as an herbal supplement to decrease the side effects of menopause. This should not be confused with blue cohosh, which has different properties, treatments, and side effects.

Often times black cohosh and blue cohosh will be used in conjunction to induce labor, but they are very different compounds. It is still not completely understood how black cohosh works its magic, so to speak. Further, it is not yet been determined in the United States that it truly does relieve these symptoms, as clinical studies have not proven this conclusively to date. Regardless, this is still a widely regarded herbal supplement that is recommended by many physicians as well as many users who hail its benefits.

History of Black Cohosh

As this root is grown mainly in North America, black cohosh was initially identified for its helpful effects by the Native Americans. Cohosh actually is a Native American word that means "knobby rough roots". The Native Americans used it for multiple treatments, including what they referred to as "female symptoms" as well as depression, snake bites and kidney problems. This herb was also used as an abortifacient which is a substance that induces abortion.

Over the 19th century use lessened, but has risen again in popularity, especially in Europe. Around the 1950s testing began to try to understand the effects of black cohosh, but to no avail. Initially it was thought that it contained phytoestrogen, or estrogen-like compounds (and some still do believe this theory). Further research has shown that it is more likely that the biological effects (less depression, better sleeping) are contributed to binding with serotonin receptors.

Although the studies are still being conducted to scientifically prove that this supplement alleviates all of these symptoms, many alternative medicinal physicians and patients still place their faith in black cohosh. This is certainly not to say this is only a path for those that choose alternative and herbal medicines; it simply implies that until it is conclusively proven to work, it will not be endorsed by some physicians.

Benefits of Black Cohosh

The most widely known use of black cohosh is to lessen the symptoms of menopause: hot flashes, night sweats, and depression. However, it is thought to have many other benefits outside of the "female problems". Its antispasmodic properties may explain why this herb reduces the cramping that often accompanies a woman's menstrual cycle.

Some believe it helps with all the PMS (Premenstrual Symptoms). In the form of black cohosh tea, it has shown mild sedative and anti-inflammatory benefits. Further, it can help with congestion, cough and aches and pains. Finally, black cohosh is also a great source of pantothenic acid and Vitamin A.

Healthy Claims of Black Cohosh

The main "claim to fame" of black cohosh relates to the relief of menopausal symptoms. This herb is said to relieve night sweats, lessen frequency of hot flashes, lessen the intensity of hot flashes, reduce headaches and slow mood swings, among other things.

However, the scientific evidence is still lacking to prove this claim correct. While many case studies have been done, often times the placebo group will have the same or nearly the same results as the group taking the actual black cohosh supplement.

Further, some studies show that black cohosh relieves menopausal symptoms while others do not. These inconsistencies have placed seeds of doubt in physicians, consumers and the public in general. To remedy some of the inconsistent results, a 12 month random and placebo controlled study is currently in progress at Columbia University of New York.

Further, the long term effects of taking this supplement have not yet been studied. Some cases have actually been tied to liver disease, prompting Britain and Australia to require its manufacturers to put a warning on the label of their brand of supplements.

Recommended Daily Allowance of Black Cohosh

Most studies have shown the best recommended daily allowance of black cohosh to contain 1 mg of terpene glycosides per 20 mg tablet. This is often referred to as the brand name of Remifemin and should be taken twice a day, for a maximum period for 4 to 8 weeks. If it is taken in its dry root powder form, the dosage will vary between 40 to 200 mg. It is particularly important to take the recommended daily allowance, as large doses of black cohosh can be toxic.

Bottom line, this herbal supplement should not be taken longer than for 6 months. The studies are not conclusive, and these are simply the short term studies. To this date, no studies have been done to observe the effects past 6 months when taking this supplement.

Potential Adverse Effects of Black Cohosh

Adverse side effects of taking black cohosh are infrequent, but include headaches, dizziness, gastrointestinal discomfort, nausea and vomiting. However, some studies are now indicating more serious adverse effects for those with personal or family histories of breast cancer and for those that are pregnant.

For those that either currently have breast cancer or even have it in their family history, some studies have shown this herbal supplement as dangerous. For those undergoing chemotherapy, this drug has been shown to increase the intensity of the chemotherapy in some cases, making it very dangerous to the patient.

In general, it is unknown how black cohosh affects the body, but many believe it has to do with estrogen levels or the ability of this herb to mimic estrogen levels. This is the hypothesis for why black cohosh may have negative effects on estrogen based cancers such as breast and endometrial.

It is not recommended that pregnant women take black cohosh for a few reasons. First, this herb has shown in some cases to terminate early pregnancies. Second, this herb can actually help to induce labor during the end of pregnancy. Third, there have been few studies done on the effects of the supplement during the pregnancy.

Liver damage has been reported in a number of individuals using this supplement, although it has not been proven that it is a direct result from taking black cohosh. Another word of warning is that certain studies indicate that taking this supplement can reduce bone mass, leading to osteoporosis. This is certainly something to take into consideration, especially if black cohosh is being taken to alleviate menopausal symptoms as osteoporosis is a big concern for women during that time period.

As this herb is sold as a dietary supplement in the United States, the FDA (Food and Drug Administration) is not required to approve it through research and clinical studies. Unfortunately, this means that manufacturers do not have to make this supplement under a certain consistency that has been proven to be safe.

In laymen's terms, this means that the amount of the herb contained in the supplement will vary as well as the other substances that are added. In Germany, there is a regulatory group for herbs called Commission E. This group has officially approved this supplement to prevent menopausal symptoms. However, this regulatory group has different standards and studies it requires that differs greatly from the FDA.

This supplement should not be taken in conjunction with certain drugs because of its different effects. It should not be taken with aspirins or other blood-thinning drugs because of its theorized effect of increasing bleeding. It also should not be taken with other hormone drugs (i.e. birth control) as it potentially contains estrogen-like substances. Finally, because black cohosh may lower blood pressure it should not be taken with drugs that alter blood pressure. With all this said, the studies for black cohosh and all of these prescription drugs have also not been conclusively proven. These warnings should simply be taken into consideration when deciding whether to take this herbal supplement.

Summary of Black Cohosh

This controversial and potent herbal supplement has been used for hundreds of years. It has mainly been used over the years for what used to be referred to as "female problems" but now are simply called menopausal and premenstrual symptoms.

Black cohosh also is said to have the benefits of an anti-inflammatory, soothing for muscle pains and aches including arthritis, a mild sedative, and can reduce coughing and congestion. While studies are yet to conclusively prove the effects of this herbal supplement, many people continue to use it with the caution of only utilizing it for a maximum of 6 months.

Further, anyone with certain conditions or already taking certain medications should be cautioned against adding this into their diet. Black cohosh remains a potentially helpful supplement, but will benefit more people once studies conclusively prove the claims of its proponents. As always, it is best to consult your physician before adding black cohosh or any SSRI or mood enhancement supplements to your diet.