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black cohosh

 
Dictionary: black cohosh
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n.
An eastern North American perennial herb (Cimicifuga racemosa) having large, pinnately compound leaves and racemes of small white flowers. Also called black snakeroot.


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Drug Info: Black Cohosh, Cimicifuga racemosa
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Brand names: Combination 5W™Olivias Secret™One-A-Day® Menopausal HealthPregnancy-6™Remifemin™Remifemin™ Plus

Chemical formula:



Black Cohosh Root Extract Oral tablet

What is this medicine?

BLACK COHOSH (blak  KOH hosh) or Cimicifuga racemosa is a dietary supplement. It is being promoted to help support female health problems, like the symptoms of menopause (hot flashes). Black cohosh is also promoted to ease menstrual pain or pre-menstrual syndrome (PMS). The FDA does not recognize black cohosh as being safe or effective for any use at this time, and warns against its use in pregnancy.
 
This supplement may be used for other purposes; ask your health care provider or pharmacist if you have questions.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:
•cancer
•endometriosis or uterine fibroids
•high blood pressure
•infertility
•kidney disease
•liver disease
•menstrual changes or irregular periods
•unusual vaginal or uterine bleeding
•an unusual or allergic reaction to black cohosh, soybeans, tartrazine dye (yellow dye number 5), other medicines, foods, dyes, or preservatives
•pregnant or trying to get pregnant
•breast-feeding

How should I use this medicine?

Take this herb by mouth with a glass of water. Follow the directions on the package labeling, or talk to your health care professional. Do not use for longer than 6 months without the advice of a health care professional. Do not use if you are pregnant or breast-feeding. Talk to your obstetrician-gynecologist or certified nurse-midwife.

This herb is not for use in children under the age of 18 years.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

If you miss a dose, use it as soon as you can. If it is almost time for your next dose, use only that dose.

What may interact with this medicine?

•female hormones, like estrogens or progestins and birth control pills
•fertility treatments
•medicines for blood pressure
•medicines for diabetes

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medicine?

Since this herb is derived from a plant, allergic reactions are possible. Stop using this herb if you develop a rash. You may need to see your health care professional, or inform them that this occurred. Report any unusual side effects promptly.

If you are taking this herb for menstrual or menopausal symptoms, visit your doctor or health care professional for regular checks on your progress. You should have a complete check-up every 6 months. You will need a regular breast and pelvic exam while on this therapy. Follow the advice of your doctor or health care professional.

If you have any reason to think you are pregnant, stop taking this herb at once and contact your doctor or health care professional.

Herbal or dietary supplements are not regulated like medicines. Rigid quality control standards are not required for dietary supplements. The purity and strength of these products can vary. The safety and effect of this dietary supplement for a certain disease or illness is not well known. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:
•Always read product labels and follow directions.
•Natural does not mean a product is safe for humans to take.
•Look for products that include USP after the ingredient name. This means that the manufacturer followed the standards of the US Pharmacopoeia.
•Supplements made or sold by a nationally known food or drug company are more likely to be made under tight controls. You can write to the company for more information about how the product was made.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:
•allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue
•difficulty breathing, shortness of breath, or wheezing
•easy bruising
•fast heartbeat, slow heartbeat, or palpitations
•headache
•high blood pressure
•severe nausea or vomiting
•unusually weak or tired

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):
•heartburn
•mild upset stomach

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medicine?

Keep out of the reach of children.

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees C). Throw away any unused herb after the expiration date.

Last updated: 12/10/2003 2:08:00 PM

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Alternative Medicine Encyclopedia: Black Cohosh
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Description

Black cohosh (Cimicufuga racemosa) is a member of the Ranunculaceae family. Its nicknames of squawroot and snakeroot denote its Algonquian heritage and differentiate it from the common snake root plant (Aristolochia serpentaria). It should also not be confused with blue cohosh (Caulophyllum thalictroides); their only similarity is that both are roots.

Black cohosh grows from a gnarled black root, hence its name; it has a smooth stem and big multiple leaves with jagged edges. In summer, white flowers develop from what are called racemes. These flowers emit a stinky odor. The plant, which can grow to 9 ft (1 m) tall, is a native North American plant found on hills and in forests located at high levels. It is found from Ontario, Canada to Maine to the southern states of Georgia and Missouri.

Black cohosh contains several components, as outlined by James F. Balch, MD and Phyllis A. Balch, CNC in their book Prescription for Nutritional Healing, Second Edition:

General Use

Black cohosh has a history of usage for women's health problems, dating back to the Algonquian natives living in the Ohio Valley. However, according to Michael Castleman in The Healing Herbs, the Algonquians also boiled the roots in water and drank the concoction for fatigue, arthritis, sore throat, and a typical occurrence of that time, rattlesnake bites. The Eclectic doctors of the 1800s also recommended black cohosh for what they called "hysterical" diseases, i.e. female reproductive diseases as well as fevers, rashes, sleeplessness and malaria. A popular patent medicine company of the same era, the Lydia E. Pinkham's Vegetable Compound, sold a potion containing black cohosh for menstrual complaints.

Today, black cohosh is still used for gynecological problems from menstruation to menopause, with several studies over the past 40 years backing up this pattern of usage. Michael T. Murray, ND, a well-known natural medicine author, outlines some of this research regarding menopause in his paper Hormone Replacement Therapy vs. Black Cohosh in Menopause. Growing numbers of menopausal women are turning to black cohosh rather than allopathic treatment to manage their symptoms. A 2002 study of menopausal women in the San Francisco Bay area found that women taking black cohosh and other herbal remedies for their symptoms reported higher satisfaction with their treatment than women receiving conventional allopathic therapy.

The most famous research was a 1982 open study in which 629 women took 80 mg of black cohosh over a period of six to eight weeks. Over 80% of the women experienced relief from several menopausal symptoms—hot flashes, perspiration, headaches, vertigo, heart palpitations, irritability, sleep disturbances and depression. A later random study focused on 60 women under 40 years of age who had hysterectomies, with one ovary remaining. The women were either given black cohosh or hormone replacement therapy (HRT) of estrogen or estrogen-progestin combinations. Although the HRT met with better results, the study concluded that black cohosh was a favorable natural alternative for post hysterectomy.

A 1998 German clinical study showed that black cohosh has good therapeutic results in treating symptoms of menopause and also that black cohosh did not show any hormone-like activity as previously thought. A second German study, published in 2002, reported that black cohosh has antiestrogenic effects.

Because the collective results of a number of studies show synthetic hormone replacement therapy, which contains estrogen, increases breast cancer risk by 1–30%, black cohosh is being considered as an alternative. A 1998 study at the University of Bridgeport in Connecticut reviewed eight previous studies of black cohosh as treatment for menopausal symptoms. This study stated that black cohosh is a safe alternative to estrogen replacement therapy (ERT) for women where ERT is contraindicated or declined. Some contraindicated conditions from ERT include a history of estrogen-dependent cancer, unidentified uterine bleeding, liver disease, gallbladder disease, endometriosis, uterine fibroids and fibrocystic breast disease.

In a 1999 in vitro study at the New York College of Osteopathic Medicine, several herbs, including black cohosh, hops, and vitex, were shown to inhibit the growth of T-47D cells. The study concluded that these herbs may be useful in preventing breast cancer.

A 1999-2000 study at Cedars-Sinai Hospital in Los Angeles, California, focused on the efficacy and safety of several traditional phytomedicines, including black cohosh root extract, to treat women's gynecological conditions, such as PMS and menopause. This study concluded that both dong quai and black cohosh are safe to use to relieve menopausal symptoms, but only black cohosh showed efficacy. The study stated that information regarding safety for use during pregnancy and lactation is still small in amount and suggested pharmacists study scientific literature to help decide the value of recommending these herbs for use.

A 1999 national survey of 500 midwives belonging to the American College of Nurse-Midwives and 48 nurse-midwife education programs was undertaken by the West Virginia University School of Medicine. The purpose was to determine if colleges were educating their students in the use of herbs to stimulate labor. Of the 172 surveys returned, 90 used herbal preparations and 82 did not. Herbal usage was broken down as: black cohosh (45%), evening primrose oil (60%), blue cohosh (64%), and castor oil (93%). Those who used these herbs did so because they are natural, and those who refrained from using them cited the lack of sufficient research about the safety.

Black cohosh can sometimes bring relief from tinnitus (ringing in the ears) as James A. Duke, Ph.D. relates in The Green Pharmacy. He refers to a professional flutist who suffered this condition for many years and a black cohosh tincture caused his tinnitus to decrease considerably.

Black cohosh can also decrease blood pressure by "opening the blood vessels in the limbs (peripheral vasodilation)" according to a study referred to by Michael Castleman in The Healing Herbs. A person with hypertension should first consult a physician.

Other possible benefits of black cohosh are to alleviate muscle spasms, reduce neuralgia pain, and relieve bronchial infections by stopping the compulsion to cough. Black cohosh has also been recommend as a glandular tonic.

Preparations

Black cohosh may be taken in capsule, extract, tea, or tincture.

To make a tea, boil 1/2 tsp powdered black cohosh root for each cup (250 ml) of water for 30 minutes. After it cools, it can be sipped with lemon and honey to mask its bitter taste.

One teaspoon of black cohosh tincture can be taken on a daily basis. Ten to 30 drops of extract mixed in water can be taken daily. Two to five capsules (40 mg/capsule) may be taken daily. The German Commission E recommends taking two 20-mg capsules daily, one in the morning and one at night. These tablets are available under the name Remifemin, a black cohosh extract. A 2002 German study found that these standard dosages are effective for most women and that there is no therapeutic benefit from higher dosages.

Precautions

Black cohosh should not be used during pregnancy except at the time of birth. It should also not be taken by those with a chronic disease, or women taking birth control pills or HRT. Children under 12 years and adults over 62, should start with lower dosages.

The German Commission E recommends taking black cohosh for six months at a time only. However, recent studies with animals show no toxicity problems. It is always best to first consult a health care practitioner.

Side Effects

An overdose (over 900 mg/day) could cause dizziness, nausea and vomiting, diarrhea, pain in the abdomen, headaches, joint pains, and a lowered heart rate. These conditions could also appear sometimes when taking low dosages of black cohosh. Large dosages can also cause poisoning symptoms.

Interactions

Women taking black cohosh should not take it together with birth control pills; HRT; such sedatives as diazapam; or blood pressure medications.

Resources

Books

Balch, James F., MD, and Phyllis A. Balch. CNC. Prescription for Nutritional Healing, second edition. Avery Publishing Group, 1997.

Castleman, Michael. The Healing Herbs. Rodale Press, 1991.

Duke, James A., PhD. The Green Pharmacy. Rodale Press, 1997.

Heinerman, John. Heinerman's Encyclopedia of Healing, Herbs & Spices. Prentice Hall, 1996.

Landis, Robin, with Karta Pukh Singh Khalsa. Herbal Defence. Warner Books, Inc. 1997.

Mindle, Earl. Earl Mindell's Herb Bible. Simon & Schuster, 1992.

Murray, Michael, ND. Encyclopedia of Nutritional Supplements. Prima Publishing, 1996.

Murray, Michael, ND. The Healing Power of Herbs, second edition. Prima Publishing, 1995.

Rothenberg, Mikel, MD, and Charles Chapman. Dictionary of Medical Terms, third edition. Barron's Educational Series, 1994.

Periodicals

Kam, I. W., C. E. Dennehy, and C. Tsourounis. "Dietary Supplement Use Among Menopausal Women Attending a San Francisco Health Conference." Menopause 9 (January-February 2002): 72-78.

Liske, E., W. Hanggi, H. H. Henneicke-von Zepelin, et al. "Physiological Investigation of a Unique Extract of Black Cohosh (Cimicifugae racemosae rhizoma): A 6-month Clinical Study Demonstrates No Systemic Estrogenic Effect." Journal of Women's Health and Gender-Based Medicine 11 (March 2002): 163-174.

Stengler, Angela, ND and Mark Stengler, ND. "Black Cohosh." Natural Factors Research Information (September 10, 1998).

Tyler, Varro E., PhD, ScD. "Honest Herbalist: Five Herbs That Ease Menopause." Prevention Magazine (March 1999).

Zierau, O., C. Bodinet, S. Kolba, et al. "Antiestrogenic Activities of Cimicifuga racemosa Extracts." Journal of Steroid Biochemistry and Molecular Biology 80 (January 2002): 125-130.

Other

Hardy, M. L. Herbs of special interest to women [Abstract]. Cedars-Sinai Integrative Medicine Medical Group, Cedars-Sinai Hospital, Los Angeles, CA. 2000.

Lieberman, S. A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause [Abstract]. University of Bridgeport, Connecticut, USA. 1998.

McFarlin B.L, M.H. Gibson, J. O'Rear, and P. Harman. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice [Abstract]. West Virginia University School of Medicine, Department of Obstetrics and Gynecology, Morgantown, 1999.

[Article by: Sharon Crawford; Rebecca J. Frey, PhD]

Wikipedia: Actaea racemosa
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Actaea racemosa

Scientific classification
Kingdom: Plantae
Division: Magnoliophyta
Class: Magnoliopsida
Order: Ranunculales
Family: Ranunculaceae
Genus: Actaea
Species: C. racemosa
Binomial name
Actaea racemosa
(Nutt.) L.

Actaea racemosa (black cohosh, black bugbane or black snakeroot or fairy candle; syn. Cimicifuga racemosa) is a plant of the family Ranunculaceae. It is native to eastern North America from the extreme south of Ontario south to central Georgia, and west to Missouri and Arkansas. The plant grows in a variety of woodland habitats, and is often found in small woodland openings. The roots and rhizomes of black cohosh have long been used medicinally by Native Americans. Extracts from these plant materials are thought to possess analgesic, sedative, and anti-inflammatory properties. Today, black cohosh preparations (tinctures or tablets of dried materials) are used chiefly to treat symptoms associated with menopause.

Contents

General features and taxonomy

Black cohosh is a smooth (glabrous), herbaceous perennial plant that produces large, compound leaves from an underground rhizome, reaching a height of 0.25-0.6 m (7-18 in).[1][2] The basal leaves are up to 1 m (39 in) long and broad, forming repeated sets of three leaflets (tripinnately compound) having a coarsely toothed (serrated) margin. The flowers are produced in late spring and early summer on a tall stem, 0.75-2.5 m (2½–8 ft) tall, forming racemes up to 50 cm (20 in) long. The flowers have no petals or sepals, and consist of tight clusters of 55-110 white, 5-10 mm long stamens surrounding a white stigma. The flowers have a distinctly sweet, fetid smell that attracts flies, gnats, and beetles.[1] The fruit is a dry follicle 5-10 mm long, with one carpel, containing several seeds.

The plant species has a history of taxonomic uncertainty dating back to Carl Linnaeus, who—based on 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.[3] However, recent data from morphological and gene phylogeny analyses demonstrate that black cohosh is more closely related to species of the genus Actaea than to other Cimicifuga species. This has prompted the revision to Actaea racemosa as originally proposed by Linnaeus.[3] Blue cohosh (Caulophyllum thalictroides), despite its similar common name, is a plant of another genus and not closely related to black cohosh.

Medicinal uses

Native Americans used black cohosh to treat gynecological and other disorders, including sore throats, kidney problems, and depression.[2] Black cohosh has also been used as an abortifacient.[citation needed]

Black cohosh is used as dietary supplement marketed to women as remedies for the symptoms of premenstrual tension, menopause and other gynecological problems.[2] However, its usage for treating these ailments is controversial, with some studies casting doubt on its efficacy. [4] Study design and dosage of black cohosh preparations play a role in clinical outcome,[5] and recent investigations with pure compounds found in black cohosh have identified some beneficial effects of these compounds on physiological pathways underlying age-related disorders like osteoporosis.[6]

Because of some physiological effects of black cohosh extracts, it was originally thought these extracts contained estrogenic compounds.[2] Recent research, however, suggests that these physiological effects may be due to black cohosh compounds that bind and activate serotonin receptors, [7] and a derivative of serotonin with high affinity to serotonin receptors has been identified in black cohosh.[8]

Like most plants, black cohosh contains many organic compounds with biological activity.[5] Complex biological molecules, such as triterpene glycosides (e.g. cycloartanes), have been shown to reduce cytokine-induced bone loss (osteoporosis) by blocking osteoclastogenesis in in vitro and in vivo models.[6]

Side effects

Studies on human subjects who were administered two commercially available black cohosh preparations did not detect estrogenic effects on the breast.[9]

No studies exist on long-term safety of black cohosh use in humans.[10] In a transgenic mouse model of cancer, black cohosh did not increase incidence of primary breast cancer, but increased metastasis of pre-existing breast cancer to the lungs. [11].

Liver damage has been reported in a few individuals using black cohosh,[2] but many women have taken the herb without reporting adverse health effects.[12] While studies of black cohosh have not conclusively shown the herb causes liver damage, Australia has added a warning to the label of all products containing black cohosh, stating that it may cause harm to the liver in some individuals and should not be used without medical supervision.[13]

Reported direct side-effects also include dizziness, headaches, and seizures; diarrhea; nausea and vomiting; sweating; constipation; low blood pressure and slow heartbeats; and weight problems.[14]

Because the vast majority of black cohosh materials are harvested from plants growing in the wild,[2] a recurring concern regarding the safety of black cohosh-containing dietary supplements is mis-identification of plants causing unintentional mixing-in (adulteration) of potentially harmful materials from other plant sources.[2]

Garden use

Actaea racemosa grows in dependably moist, fairly heavy soil. 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 American gardens, wherever summer heat and drought do not make it die back, which make it a popular garden perennial.

See also

Triterpenoids

References

  1. ^ a b Richo Cech (2002). Growing at-risk medicinal herbs. Horizon Herbs. pp. 10–27. 
  2. ^ a b c d e f g Predny ML, De Angelis P, Chamberlain JL (2006). accessed 2009-08-24 Black cohosh (Actaea racemosa): An annotated Bibliography. 99. http://www.treesearch.fs.fed.us/pubs/26166 accessed 2009-08-24. 
  3. ^ a b Compton JA, Culham A, Jury SL (1998). "Reclassification of Actaea to include Cimicifuga and Souliea (Ranunculaceae): Phylogeny inferred from morphology, nrDNA ITS, and epDNA trnL-F sequence variation". Taxon 47: 593-634. http://www.jstor.org/pss/1223580. 
  4. ^ Newton KM, Reed SD, LaCroix AZ, Grothaus LC, Ehrlich K, Guiltinan J (2006). "Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial". Ann Intern Med. 145: 869-879. PMID 17179056. http://www.annals.org/cgi/content/full/145/12/869. 
  5. ^ a b Viereck V, Emons G, Wuttke W (2005). "Black cohosh: just another phytoestrogen?". Trends Endocrinol Metab. 16: 214–221. doi:10.1016/j.tem.2005.05.002. PMID 15927480. 
  6. ^ a b Qiu SX, Dan C, Ding LS, Peng S, Chen SN, Farnsworth NR, Nolta J, Gross ML, Zhou P (2007). "A triterpene glycoside from black cohosh that inhibits osteoclastogenesis by modulating RANKL and TNFα signaling pathways". Chemistry & Biology 14:  :860–869. doi:10.1016/j.chembiol.2007.06.010. PMID 17656322. 
  7. ^ Burdette JE, Liu J, Chen SN, Fabricant DS, Piersen CE, Barker EL, Pezzuto JM, Mesecar A, Van Breemen RB, Farnsworth NR, Bolton JL (2003). "Black cohosh acts as a mixed competitive ligand and partial agonist of the serotonin receptor". J Agric Food Chem 51: 5661-5670. doi:10.1021/jf034264r. PMID 12952416. 
  8. ^ Powell SL, Gödecke T, Nikolic D, Chen SN, Ahn S, Dietz B, Farnsworth NR, van Breemen RB, Lankin DC, Pauli GF, Bolton JL (2008). "In vitro serotonergic activity of black cohosh and identification of N(omega)-methylserotonin as a potential active constituent". J Agric Food Chem 56: 11718-11726. doi:10.1021/jf803298z. PMID 19049296. 
  9. ^ Ruhlen RL, Haubner J, Tracy JK, Zhu W, Ehya H, Lamberson WR, Rottinghaus GE, Sauter ER (2007). "Black cohosh does not exert an estrogenic effect on the breast". Nutr Cancer 59:  :269-277. PMID 18001221. 
  10. ^ Questions and Answers About Black Cohosh and the Symptoms of Menopause | url=http://ods.od.nih.gov/factsheets/BlackCohosh.asp
  11. ^ Davis VL, Jayo MJ, Ho A, Kotlarczyk MP, Hardy ML, Foster WG, Hughes CL (2008). "Black cohosh increases metastatic mammary cancer in transgenic mice expressing c-erbB2". Cancer Res 68:  :8377-8383. PMID 18922910. 
  12. ^ Workshop on the Safety of Black Cohosh in Clinical Studies | url=http://nccam.nih.gov/news/pastmeetings/blackcohosh_mtngsumm.pdf#summary
  13. ^ Australian Therapeutic Goods Administration alert | url=http://www.tga.gov.au/cm/blkcohosh.htm
  14. ^ http://www.intellihealth.com/IH/ihtIH/WSSAN283/8513/31402/346466.html?d=dmtContent | Black Cohosh (Cimicifuga racemosa)

External links


This entry is from Wikipedia, the leading user-contributed encyclopedia. It may not have been reviewed by professional editors (see full disclaimer)

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Dictionary. The American Heritage® Dictionary of the English Language, Fourth Edition Copyright © 2007, 2000 by Houghton Mifflin Company. Updated in 2009. Published by Houghton Mifflin Company. All rights reserved.  Read more
Drug Info. Gold Standard. Copyright © 2008 by Gold Standard. All rights reserved.  Read more
Alternative Medicine Encyclopedia. Encyclopedia of Alternative Medicine. Copyright © 2005 by The Gale Group, Inc. All rights reserved.  Read more
Wikipedia. This article is licensed under the Creative Commons Attribution/Share-Alike License. It uses material from the Wikipedia article "Actaea racemosa".  Read more