A few herbs and shrubs are known to have naturally endowed medicinal properties. There are many such species from the plant kingdom that medical sciences are aware of. Black cohosh is one among them. It is a woodland-based herb and is considered as a potent medicine. People often confuse white cohosh or blue cohosh which is completely different types of herbs as compared to black cohosh. The medicinal properties of black cohosh are not observed in both the above variants. Black cohosh is used for the treatment of a wide range of clinical conditions; this herb may however cause a few side effects. It is essential to know more about the likely adverse effects before starting to use this herb.
Herbs such as black cohosh work to enhance the powers of your immune system. Once your immune system is boosted, your ability to withstand infections or other clinical conditions stands improved. This herb is widely used as a natural remedy for a few maladies.
Uses of black cohosh
The main benefit of black cohosh is this herb can decrease inflammation or internal stresses. A few active chemicals found in this herb are known to work on your brain; medical studies link the functioning of these chemicals with another well-known transmitting chemical known as serotonin. This herb also has a few ingredients that can enhance the health of your nerves.
Apart from serotonin, this herb is also known to mirror the female sex hormone, estrogen. The effects of this herb on this front are not universal though. It is only in a few people this herb works like this female sex hormone. Also, in such people – this herb may reduce estrogen levels in some organs while boosting the presence of this sex hormone in a few other organs. Owing to its similarities with estrogen, it is used for the treatment of discomforts associated with menopause. As an extended benefit, this herb is also used for treating memory lapses, hot-flashes, weakening of bones and a few autoimmune conditions like cancers (especially, in the breasts), arthritis – both rheumatoid and osteoarthritis. However, most of these above claims are not fully ascertained and evidenced through scientific research.
You need to remember that this herb is known to trigger a few undesired side effects and some adverse reactions. Hence, it is a safe practice to talk to a qualified herbal medicine specialist or a pharmacist before using this herbal supplement.
Side effects of black cohosh
This herb is widely considered as safe for use among adults. Its dosages can be taken for a period of 9 to 12 months. It is important to take the dosages under needful guidance and supervision of a specialist in herbal medicines or supplements. This drug is taken orally as instructed by your treating physician.
Minor reactions or side effects triggered by the use of this herb are abdominal problems such as indigestion or nausea; you may also experience cramping of abdominal muscles, spots on the vaginal region, increase in body weight as well as excessive bleeding. Users of black cohosh have also noticed frequent episodes of headache or migraines, hives or rashes on skin, etc. Other likely side effects include hypotension (i.e., a spell of decreased blood pressure level), sweating profusely as well as heavy feeling in your lower limbs, etc.
When this herb is used in very large amounts, it may lead to fits, convulsions or seizures, eyesight related problems and erratic heartbeats. You are advised to discontinue the usage of black cohosh upon experiencing signs of jaundice – such as pain in abdominal region as well as yellowing of skin or eyes.
People with liver conditions and their use of black cohosh
Those who are living with hepatic dysfunction – especially, cirrhosis of the liver or inflammation (hepatitis) are advised to take added levels of precaution. This is because of a few instances wherein this herb is known to have caused possible damages to the liver. It is hence highly recommended to check the functioning of your liver on a regular basis. Also, stay aware of the likely symptoms of liver damage; these include discoloration of eyes as well as skin, discharge of darkened urine and being excessively tired. If you are noticing one or more of these side effects, it is advised to stop taking this herb. It is always a safe practice to contact your treating physician and /or pharmacist.
As this herb may cause damages to your fetus, it is not recommended for pregnant women. Those who are planning to become pregnant or women who are already pregnant must keep away from this herbal drug. Those who used it during pregnancy may witness miscarriages or other related conditions. Women who have medical conditions that are likely to be affected by estrogen must not take this herb; such conditions include fibroids, cancers in the uterine tract or ovaries as well as conditions like endometriosis. Women who took black cohosh while having hormone-sensitive disorders may find their medical condition turning worse in most cases.
People living with blood clotting problems – mainly due to inadequate availability of protein “S” – must refrain from taking black cohosh. The odds of developing blood clots are high when people with such conditions take this herbal drug.
Adverse reactions when co-administered with other drugs
Black cohosh may alter the efficacy levels of a few drugs, if co-administered. So, it is a good practice to inform your medical team about the drugs you presently take. You need to prepare a list of all currently consumed medicines and share this list with your treating physician. As you are making this list of drugs, ensure to add over the counter (OTC) drugs, prescription meds, vitamins, protein supplements, dietary aids as well as other herbal supplements, if any.
Black cohosh is also likely to interact with a few chemotherapeutic drugs such as cisplatin; this drug is widely administered as part of cancer care. Your treating doctor may recommend discontinuation of black cohosh while taking such chemo drugs. Similarly, intake of black cohosh along with a few types of statins – especially, atorvastatin, simvastatin, pravastatin, lovastatin, etc. – can lead to likely damage of the liver. Also, a few drugs may change the way your liver works; these are erythromycin and a few other drugs like isoniazid, phenytoin and similar forms of muscle relaxants. Black cohosh must not be taken along with any of the aforesaid drugs.
Those who are taking drugs to reduce blood pressure levels (antihypertensive meds) need to stay careful while using this herb. This is mainly because – the herb can decrease your blood pressure levels. Hence, while co-administered with antihypertensive drugs, you may witness a severe drop in blood pressure levels. Common signs of hypotension are a throbbing headache, excessive sweating, fainting or passing out.
If you are taking drugs which require the liver for processing them, your doctor may advise to take more caution. For example, drugs such as substrates of cytochrome or medications like fluoxetine, tramadol, donepezil, etc. are metabolized with the help of liver enzymes. This herb is known to slow down the breaking down of these drugs by liver and in general, may reduce the efficacy of drugs that are dependent on liver’s actions. An extended list of such liver-dependent drugs includes generic drugs (and branded formulations) such as amitriptyline, codeine, meperidine, etc.
Safe dosage levels of black cohosh
This herb does not come under the purview of the food and drug administration (FDA). As the manufacture of this herbal medicine remains largely unregulated, the active ingredients in each brand may vary. It is a safe practice to buy drugs which are certified by external testing and regulatory agencies such as US pharmacopeia, Consumer Labs and similar others.
Use of black cohosh is more pronounced among women who desire to manage the typical signs of menopause; these signs include dryness of vagina, mood shifts, night sweating, hot-flashes, etc. It is also used as a natural substitute for hormone replacement requirement or therapies (i.e., HRT). The herb is used for treating irregular menstrual cycles and associated syndromes. Its dosages are taken over a period of 8 to 11 months. The most commonly administered dosage level is 30 to 120 milligrams (mg); this dose is taken on a daily basis.
Key ingredients of black cohosh
This herb is known to contain tannins, highly volatile oils, flavonoids, glycosides of the triterpene genre as well as a few variants of phenolic acids. Of these, tannins possess capabilities to resist autoimmune conditions like cancers. Oils with high volatility that are present in this herb are observed to keep chronic maladies at bay. The types of phenolic acids present in this herb are rich in antioxidants; most of them are known to have anti-inflammatory properties.
Mechanism of action of this herb is largely unknown to modern sciences. It is postulated that it functions as a stimulator of the female sex hormone, estrogen. On the other hand, there are also other possible mechanisms – such as its ability to activate receptors of brain chemicals like serotonin; one other theory indicates the presence of anti-inflammatory agents as a possible reason for its medicinal properties.
Other possible uses of black cohosh
The herb is currently being studied for a few other possible applications; these include – treatment of diabetes, reduction of anxiety, boosting of bone health, management of fibroids – especially in the uterine region, etc. In some animal studies, administration of black cohosh has reduced the quantum of blood glucose. However, more substantive evidence is needed to conclude a direct association with management of diabetes mellitus. On fibroids of uterine channel, clinical studies reveal a greater linkage between intake of black cohosh and effective management of such uterine cysts or fibroids.
In sum, use of black cohosh may trigger a few side effects. Common among such side effects are cramping of muscles, increase in body weight, bleeding, indigestion and nausea. Most of these side effects may disappear once your body gets used to the active ingredients of this herbal medicine. But, if you notice one or more these adverse side effects to persist, you are advised to consult your treating doctor or the pharmacist without any delay.
Education: Master’s in Nursing (MSN) from Johns Hopkins University. Experience: 7 years writing for online health portals and nursing journals, specializing in patient education and chronic illness management.
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