* Black cohosh has been identified as one of the herbs as having the most potential for causing liver toxicities by the Journal of Gastroenterology.
This herb is best known for alleviation of menopause symptoms although studies have yielded mixed results on black cohosh’s efficacy.
Attention for Liver Disease: Patients with liver disease are strongly advised to avoid black cohosh. There have been more than 30 reports of hepatotoxicity linked to black cohosh use. Reports of severe hepatitis, dea th and liver failure requiring transplant surgery. Experts do not know if the problem was due solely to black cohosh or contaminants. Because it appears to interact with cytochrome p-450 metabolized substances (see Cytochrome P-450), do not take black cohosh during HCV treatment.
Safety Information: Black cohosh has a long list of reported adverse events; hepatotoxicity is the biggest safety concern. Black cohosh has estrogenic properties but only weakly so. Researchers are concerned about the possibility of cancer or use of cancer drugs interacting with this herb. Gastric discomfort is the most common side effect. Those with history of stroke or thromboembolism should avoid black cohosh. Cardiovascular and neurological (seizures) adverse events were reported by a very small number of patients taking black cohosh, although the link between the two is not solidly established. Black cohosh should not be taken by women who are pregnant or breastfeeding. No safety information is available for children.
Interactions: Black cohosh may interact with any cytochrome p-450 metabolized substances (see Cytochrome P-450). Anyone with hormone-sensitive malignancies or those taking drugs such as tamoxifen or HRT may want to avoid or use cautiously. May interact with hormones, NSAIDs, anti-androgenic, and anticoagulant drugs.
Lab Notes: May lower blood pressure and interfere with liver function tests.
Note: If you decide to take black cohosh despite the warnings, do so with a full glass of water. Blue cohosh is not the same as black cohosh – do not substitute one for the other.