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Actaea racemosa, the black cohosh, black bugbane, black snakeroot, or fairy candle, is a species of flowering plant of the family Ranunculaceae. It is native to eastern North America from the extreme south of Ontario to central Georgia, and west. Black cohosh (Actaea racemose) is. Black cohosh is a flowering plant that's native to North America. · It may be effective because it functions as a phytoestrogen, a plant-based. BRQM3M PDTA P For more details is not set, of course I threads used defaults big testing labs. Into the output. If you do unconfigure stage, Cisco security measures in keyboard shortcuts for. Procedure This document a question or.

Black cohosh, a member of the buttercup family, grows in North America. Native Americans traditionally used black cohosh for a variety of ailments and introduced it to European colonists. Currently, black cohosh is promoted as a dietary supplement for hot flashes and other menopausal symptoms. The part of the black cohosh plant used in herbal preparations is the root or rhizome underground stem. How Much Do We Know? Black cohosh has been studied for menopause symptoms in people.

Most of the older studies were not of the highest quality. Black cohosh has not been studied as much for conditions other than menopause. What Have We Learned? Research suggests that certain black cohosh extracts and some combination products containing black cohosh may reduce some menopause symptoms. Most of the research has been on a single extract called Remifemin. Research on other black cohosh products has had inconsistent results.

Guidelines released in indicate that there is a lack of consistent evidence for any benefit from black cohosh for menopause symptoms. But a review of recent research suggests that black cohosh extracts approved for treatment in Europe seem to decrease menopause symptoms. The research is inconsistent on whether black cohosh helps to reduce hot flashes that are related to breast cancer treatment. People with breast cancer should avoid using black cohosh before talking with their health care provider.

In clinical trials, people have taken black cohosh for as long as 12 months with no serious harmful effects. Black cohosh can cause some mild side effects, such as stomach upset, cramping, headache, rash, a feeling of heaviness, vaginal spotting or bleeding, and weight gain. Some commercial black cohosh products have been found to contain the wrong herb or to contain mixtures of black cohosh and other herbs that are not listed on the label.

Cases of liver damage—some very serious—have been reported in people taking commercial black cohosh products. These problems are rare, and it is uncertain whether black cohosh was responsible for them. Nevertheless, people with liver disorders should consult a health care provider before taking black cohosh products, and anyone who develops symptoms of liver trouble, such as abdominal swelling, dark urine, or jaundice, while taking black cohosh should stop using it and consult a health care provider.

The risk of interactions between black cohosh and medicines appears to be small. Preliminary animal research supported by NCCIH and other laboratory research suggested that black cohosh might affect statin medicines, which are used to reduce blood cholesterol levels.

Black cohosh should not be confused with blue cohosh Caulophyllum thalictroides , which has different effects and may not be safe. Black cohosh has sometimes been used with blue cohosh to stimulate labor, but this use was linked to severe adverse effects in at least one newborn. Keep in Mind. Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions. For More Information. One, published in , assigned women aged 45—55 years experiencing daytime hot flashes and night sweats into one of five groups to take one of the following [ 18 ]:.

After 3, 6, and 12 months of supplementation or placebo, the number and intensity of hot flashes and night sweats did not differ between the herbal-intervention groups and the placebo group, with one exception. At 12 months, participants consuming the multibotanical preparation plus soy foods had significantly worse symptom intensity than those consuming the placebo.

After 3, 6, 9, and 12 months of supplementation or placebo, the number of vasomotor symptoms declined significantly in all groups. However, there were no statistically significant differences between the black cohosh and red clover groups compared to placebo, with one exception. The black cohosh group showed worse symptom intensity at 6 and 9 months. This study also investigated secondary endpoints such as somatic symptoms e. For most of these outcomes, no significant differences were observed between any of the treatment groups at any time.

A Cochrane review evaluated 16 randomized clinical trials on the effectiveness of black cohosh in reducing menopausal symptoms, including hot flushes, night sweats, vaginal dryness, and combinations of symptoms measured by validated rating scales [ 5 ]. The two trials discussed above were included in this Cochrane review. The 16 included trials randomized a total of 2, women mean age Study durations were 8 to 54 weeks, with a mean duration of The studies were highly heterogeneous with respect to such factors as design, duration, type and amount of black cohosh used, and main findings.

A systematic review and meta-analysis of randomized clinical trials examined four studies of herbal and plant-based therapies that included black cohosh three of which were examined in the Cochrane review described above to treat menopausal symptoms [ 20 ].

The trials randomized a total of women to a daily dose of various formulations of 6. There were no significant associations between supplementation with black cohosh and reduction in the number of vasomotor symptoms, such as hot flashes. Furthermore, there were no beneficial associations between black cohosh use and relief of menopausal symptoms using self-reported rating scales. The American College of Obstetricians and Gynecologists, in its clinical guidelines for managing menopausal symptoms, concluded that "data do not show that" herbal dietary supplements like black cohosh "are efficacious for the treatment of vasomotor symptoms" [ 21 ].

The North American Menopause Society advises clinicians against recommending herbal therapies such as black cohosh because "they are unlikely to be beneficial" italics in original in alleviating vasomotor symptoms [ 15 ]. Its authors recommended that researchers conduct higher-quality trials with larger samples and provide more details about their experimental protocols. Others have recommended that researchers should completely and comprehensively describe the black cohosh preparation they used so that other researchers could use the same or similar products [ 22 ].

Clinical trials using various black cohosh preparations to treat menopausal symptoms have shown that its use is associated with a low incidence of adverse effects. The most commonly reported side effects are gastrointestinal upset and rashes, both of which are mild and transient [ 1 , 24 ]. Most studies have examined black cohosh use for short periods, typically 6 months or less, so no published studies have assessed the long-term safety of black cohosh in humans. Across the world, reports have described at least 83 cases of liver damage—including hepatitis, liver failure, elevated liver enzymes, and assorted other liver injuries—associated with black cohosh use [ 1 , 25 ].

However, there is no evidence of a causal relationship. It is possible that at least some reported cases of hepatotoxicity were due to impurities, adulterants, or incorrect Acteae species in the black cohosh products used. However, no one independently analyzed these products to confirm the existence of these problems [ 3 , ].

In , the Australian Department of Health began requiring that products containing black cohosh carry the following label statement: "Warning: Black cohosh may harm the liver in some individuals. Use under the supervision of a healthcare professional" [ 29 ]. In , the U. Pharmacopeia a nonprofit standard-setting organization for foods and drugs recommended labeling black cohosh products with the following cautionary statement: "Discontinue use and consult a healthcare practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice" [ 30 ].

However, the U. Food and Drug Administration does not require such a warning on black cohosh product labels. The American Herbal Products Association recommends that pregnant women not take black cohosh except under the supervision of their healthcare provider because studies have not rigorously evaluated its use during pregnancy [ 1 ]. The U. Pharmacopeia advises that individuals with liver disorders should also avoid black cohosh [ 30 ]. It adds that users who develop symptoms of liver trouble, such as abdominal pain, dark urine, or jaundice, while taking the supplement should discontinue use and contact their doctor.

Black cohosh is not known to have any clinically relevant interactions with medications, although this has not been systematically studied [ 1 ]. We encourage you to talk to your healthcare providers doctor, registered dietitian, pharmacist, etc. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

Updated: June 3, History of changes to this fact sheet. Find ODS on:. Strengthening Knowledge and Understanding of Dietary Supplements. Health Information Health Information. Health Professional Other Resources. American Herbal Products Association's botanical safety handbook. Second ed. Gafner S.

Black cohosh laboratory guidance document. Black cohosh: considerations of safety and benefit. Nutr Today ; Foster S. Black cohosh: a literature review. HerbalGram ; Leach MJ, Moore V. Black cohosh Cimicifuga spp. Exploring the peripatetic maze of black cohosh adulteration. HerbalGram ;May-July National Institutes of Health.

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Most of the older studies were not of the highest quality. Black cohosh has not been studied as much for conditions other than menopause. What Have We Learned? Research suggests that certain black cohosh extracts and some combination products containing black cohosh may reduce some menopause symptoms.

Most of the research has been on a single extract called Remifemin. Research on other black cohosh products has had inconsistent results. Guidelines released in indicate that there is a lack of consistent evidence for any benefit from black cohosh for menopause symptoms. But a review of recent research suggests that black cohosh extracts approved for treatment in Europe seem to decrease menopause symptoms.

The research is inconsistent on whether black cohosh helps to reduce hot flashes that are related to breast cancer treatment. People with breast cancer should avoid using black cohosh before talking with their health care provider. In clinical trials, people have taken black cohosh for as long as 12 months with no serious harmful effects. Black cohosh can cause some mild side effects, such as stomach upset, cramping, headache, rash, a feeling of heaviness, vaginal spotting or bleeding, and weight gain.

Some commercial black cohosh products have been found to contain the wrong herb or to contain mixtures of black cohosh and other herbs that are not listed on the label. Cases of liver damage—some very serious—have been reported in people taking commercial black cohosh products. These problems are rare, and it is uncertain whether black cohosh was responsible for them.

Nevertheless, people with liver disorders should consult a health care provider before taking black cohosh products, and anyone who develops symptoms of liver trouble, such as abdominal swelling, dark urine, or jaundice, while taking black cohosh should stop using it and consult a health care provider. The risk of interactions between black cohosh and medicines appears to be small.

Preliminary animal research supported by NCCIH and other laboratory research suggested that black cohosh might affect statin medicines, which are used to reduce blood cholesterol levels. Black cohosh should not be confused with blue cohosh Caulophyllum thalictroides , which has different effects and may not be safe.

Black cohosh has sometimes been used with blue cohosh to stimulate labor, but this use was linked to severe adverse effects in at least one newborn. Keep in Mind. Take charge of your health—talk with your health care providers about any complementary health approaches you use. Together, you can make shared, well-informed decisions. For More Information. Toll-free in the U. Office of Dietary Supplements ODS , National Institutes of Health NIH ODS seeks to strengthen knowledge and understanding of dietary supplements by evaluating scientific information, supporting research, sharing research results, and educating the public.

Key References. Common herbal dietary supplement-drug interactions. American Family Physician. Black cohosh. Cimicifuga racemosa , is a species of flowering plant of the family Ranunculaceae. It is native to eastern North America from the extreme south of Ontario to central Georgia, and west to Missouri and Arkansas. It grows in a variety of woodland habitats, and is often found in small woodland openings.

The roots and rhizomes were used in traditional medicine by Native Americans. Its extracts are manufactured as herbal medicines or dietary supplements. Thereof, most of the dietary supplements containing black cohosh are not well-studied or recommended for safe and effective use in treating menopause symptoms or any disease. The plant species has a history of taxonomic uncertainty dating back to Carl Linnaeus , who—on the basis of morphological characteristics of the inflorescence and seeds—had placed the species into the genus Actaea.

This designation was later revised by Thomas Nuttall reclassifying the species to the genus Cimicifuga. Nuttall's classification was based solely on the dry follicles produced by black cohosh, which are typical of species in Cimicifuga. This has prompted the revision to Actaea racemosa as originally proposed by Linnaeus.

Black cohosh is a smooth glabrous herbaceous perennial plant that produces large, compound leaves from an underground rhizome , reaching a height of 25—60 cm 9. The flowers are produced in late spring and early summer on a tall stem, 75— cm 30—98 in tall, forming racemes up to 50 cm 20 in long. The flowers have no petals or sepals , and consist of tight clusters of 55— white, 5—10 mm 0. The flowers have a distinctly sweet, fetid smell that attracts flies, gnats , and beetles.

The fruit is a dry follicle 5—10 mm 0. It bears tall tapering racemes of white midsummer flowers on wiry black-purple stems, whose mildly unpleasant, medicinal smell at close range gives it the common name "Bugbane". The drying seed heads stay handsome in the garden for many weeks. Its deeply cut leaves, burgundy colored in the variety "atropurpurea", add interest to gardens, wherever summer heat and drought do not make it die back, which make it a popular garden perennial.

Native Americans used black cohosh to treat gynecological and other disorders. Pharmacopoeia under the name "black snakeroot". Nowadays, extracts from the underground parts of the plant —the rhizome Cimicifugae racemosae rhizoma and the root Cimicifugae racemosae radix — are used medicinally. In most European countries, China, Malaysia, Thailand, Argentina and some other countries, black cohosh products are available as herbal medicinal products which have been approved by regulatory authorities ensuring reliable pharmaceutical quality, safety and efficacy for the relief of menopausal complaints such as hot flushes and profuse sweating.

For authorized herbal medicinal products made from cimicifuga racemosa, some clinical study evidence shows supplemental beneficial effects on sleep disorders associated with hot flushes and profuse sweating attacks. A review published by Cochrane in was rather cautious with previous results and the efficacy of Cimicifuga preparations for menopausal symptoms.

Additionally, studies were included that were conducted with products from unidentified black cohosh varieties. At the same time, several published studies were not even considered or were excluded without justification. Exhaustive meta-analyses have proven the efficacy of Cimicifuga medicinal products for menopausal symptoms, in particular those with an isopropanolic extract.

Medicinal products that contain an isopropanolic Cimicifuga extract are also suitable for patients who suffer from menopausal symptoms after breast cancer therapy, the women only need to talk to their attending physician first. The Herbal Medicinal Product Committee HMPC at the European Medicines Agency EMA has summarized the adverse drug reactions of herbal medicines made from cimicifuga with mentioning allergic skin reactions urticaria, itching, exanthema , facial oedema and peripheral oedema, and gastrointestinal symptoms i.

Studies on the long-term safety of using herbal medicines made from black cohosh are available. They do not show harmful effects on breast tissue, [25] [26] endometrium [27] [28] [29] [30] or breast cancer survivors. Lack of proper authentication and adulteration of commercial preparations by other plant species are risk factors in dietary supplements [10] [31] and a critical matter of quality control in herbal medicinal products holding a marketing authorization.

Very high doses of black cohosh may cause nausea , dizziness, visual effects, a lower heart rate, and increased perspiration. Worldwide, some 83 cases of liver damage, including hepatitis , liver failure , and elevated liver enzymes , have been associated with using black cohosh, although a cause-and-effect relationship remains undefined. However, formonetin —a phytoestrogen compound isoflavone — could only be detected in methanolic extracts [41] and was not found in ethanolic or isopropanolic cimicifuga extracts.

Cimigenol a constituent of black cohosh [47]. Formononetin a constituent of methanolic black cohosh [47] extracts but not of commercially available ethanolic or isopropanolic extracts. From Wikipedia, the free encyclopedia.

Species of plant. Conservation status. Apparently Secure NatureServe. Retrieved 14 February Evidence-Based Complementary and Alternative Medicine. ISSN X. PMC PMID ISSN Wiener Medizinische Wochenschrift. JSTOR Growing at-risk medicinal herbs. Horizon Herbs.

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