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| Actaea racemosa | ||||||||||||||
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| Actaea racemosa (L.) Nutt. |
Actaea racemosa (Black cohosh, Black bugbane or Black snakeroot or Fairy candle; syn. Cimicifuga racemosa) is a member of the family Ranunculaceae, native to eastern North America from the extreme south of Ontario south to central Georgia, and west to Missouri and Arkansas. It grows in a variety of woodland situations, and is often found in small woodland openings.
It is a glabrous herbaceous perennial plant, producing large, compound leaves from an underground rhizome, growing 0.25-0.6 m (7-18 in) tall. The basal leaves are up to 1 m (39 in.) long and broad, tripinnately compound, the leaflets with a coarsely toothed margin. The flowers are produced in late spring and early summer on a tall stem, 0.75-2.5 m (2½–8 ft) tall, in racemes up to 50 cm (20 in) long; they have no petals or sepals, only a tight cluster of 55-110 white stamens 5-10 mm long surrounding the white stigma. The flowers have a distinctly sweet smell. The fruit is a dry follicle 5-10 mm long containing several seeds.
Cimicifuga has been recently placed in the Actea genus due to new phylogenetic evidence based on DNA similarities. Blue cohosh (Caulophyllum thalictroides), despite its similar common name, is a plant of another genus.
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Herbal use
Black cohosh has been included in herbal compounds or dietary supplements marketed to women as remedies for the symptoms of premenstrual tension, menopause and other gynecological problems. However, its usage for treating these ailments is controversial, with a recent study conducted with a large group of participants and a range of black cohosh formulations casting doubt on its efficacy, since biological effects of some black cohosh preparations were not performing better than placebo. [1] Study design and dosage of black cohosh preparations play a role in clinical outcome,[2] 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.[3]
It was thought that black cohosh contained estrogen-like compounds, but recent research suggests that its biological effects may in part be due to binding to serotonin receptors. [1] Native Americans used black cohosh to treat gynecological and other disorders, including sore throats, kidney problems, and depression. Black cohosh has also been used as an abortifacient (see side effects).
Like most plants, black cohosh contains a very large number of organic compounds with biological activity. [2] 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, [3] suggesting that application of black cohosh-produced compounds may aid treatments of this common ailment in humans.
Side effects
Black cohosh should not be used during pregnancy or lactation due to possible health risks. There is a case report of neurological complications in a post-term baby after labor induction with a mixture of black cohosh and blue cohosh during a home birth.[4] Other cases of adverse outcomes experienced by neonates born to women who reportedly used blue cohosh to induce labor have been published in peer-reviewed journals.[5]
Black cohosh produces endometrial stimulation. Since black cohosh increases blood flow to the pelvic area, its use is not recommended during menses as it may increase or prolong bleeding.[6] Because of the possible estrogenic action, it should be used with caution after six months.[7] Additionally, black cohosh contains tannin, which inhibits iron absorption.[8] This, considered with possible effects of enhancing menstrual bleeding, gives good cause to monitor iron stores when taking black cohosh.
No studies have been published on long-term safety in humans.[9] However concerns arise that, in humans, because of its estrogen-like effects, long-term use may promote metastasis of estrogen-sensitive cancer tissue via stimulation of cells in the endometrium or breast. Black cohosh increased metastasis of cancer to the lungs (but did not cause an increased incidence of breast cancer) in an experiment done on mice (which was never published and the lung tumors were never biopsied, just observed.)NIH.pdf
The liver damage reported in a few individuals using black cohosh has been severe, but large numbers of women have taken the herb for years without reporting adverse health effects.[10] See the NIH link above for thorough discussion of the liver issue. While studies of black cohosh have not proven that 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 of some individuals and should not be used without medical supervision.[11]
Aside from pregnancy complications, increased menstrual bleeding, anemia, and rare but serious hepatic dysfunction, reported direct side-effects also include dizziness, diarrhea, nausea, and occasional gastric discomfort. Additional possible side effects include headaches, seizures, vomiting, sweating, constipation, low blood pressure, slow heartbeats, weight problems.[12]
Garden use
Cimicifuga 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 burgundy, deeply cut leaves add interest to American gardens, wherever summer heat and drought do not make it die back, which make it a popular garden perennial.
External links
- Flora of North America: Cimicifuga racemosa
- Missouri plants: Cimicifuga racemosa (detailed photos)
- Chemical background of black cohosh.
- Article on a recent study of Black cohosh
- National Institutes of Health (NIH) "Workshop on the Safety of Black Cohosh in Clinical Studies" November 2004 Large .pdf file addresses rare liver toxicty issues, lung mets in the mouse study from 2003, and concludes that there was NO COMPETENT EVIDENCE to support concerns about safety with respect to use of black cohosh in breast cancer patients as long as they are being followed by their doctors.
- Australian Adverse Drug Reactions Bulletin, April 2006, Noted 49 cases of live toxicity worldwide have been associated with the use of black cohosh. 4 Cases in the group required liver transplants. Serious cases of liver toxicity have been reported with use for less than a month. Listed as Do Not Use in Worst Pills Best Pills, August 2006, p63
- Cimicifuga racemosa entry in Drugs and Medicines of North America by Lloyd and Lloyd, 1884-1887
References
- ^ 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.
- ^ a b Viereck V, Emons G, Wuttke W (2005). "Black cohosh: just another phytoestrogen?". Trends Endocrinol Metab. 16: :214–221. doi:. PMID 15927480.
- ^ 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 TNFalpha signaling pathways". Chemistry & Biology 14: :860–869. doi:. PMID 17656322.
- ^ Gunn TR, Wright IM: The use of black and blue cohosh in labour. New Zealand Medical Journal 109: 410-411, 1996. [PubMed abstract]
- ^ Finkle RS, Zarlengo KM: Blue cohosh and perinatal stroke. New England Journal of Medicine 351: 302-303, 2004; Jones TK, Lawson BM: Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. Journal of Pediatrics 132: 550-552, 1998
- ^ http://www.stalkingthewild.com/sh/black_cohosh.html | Black Cohosh / Cimicuga racemosa / Herbal Relief For Women, by Phyllis D. Light, RH, LMT Women experiencing "abnormal uterine bleeding" are excluded from enrollment in a 2006 clinical trial to determine whether black cohosh may reduce menstrual anxiety | http://www.clinicaltrials.gov/ct/show/NCT00120458
- ^ The Complete German commission E Monographs recommends a use duration of not longer than 6 months.
- ^ http://www.fammed.ouhsc.edu/ocfmr/journal/Herbal/herbal.htm | 1°Care Exchange -- A Reader-Directed Journal from the Oklahoma Center for Family Medicine Research / Volume 1, Number 1 January 1999.
- ^ Questions and Answers About Black Cohosh and the Symptoms of Menopause | url=http://ods.od.nih.gov/factsheets/BlackCohosh.asp
- ^ Workshop on the Safety of Black Cohosh in Clinical Studies | url=http://nccam.nih.gov/news/pastmeetings/blackcohosh_mtngsumm.pdf#summary
- ^ Australian Therapeutic Goods Administration alert | url=http://www.tga.gov.au/cm/blkcohosh.htm
- ^ http://www.intellihealth.com/IH/ihtIH/WSSAN283/8513/31402/346466.html?d=dmtContent | Black Cohosh (Cimicifuga racemosa)
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- This page was last modified on 6 October 2008, at 18:11.
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