Black Cohosh
Also known as: actaea racemosa, cimicifuga racemosa, black snakeroot
Recommended Dosage
20–40 mg
Traditional herbal remedy primarily used for menopausal symptoms including hot flashes and mood disturbances. Moderate evidence of efficacy. Rare but serious liver toxicity reports warrant caution. Avoid in hormone-sensitive conditions.
Quick Facts
Evidence
Grade C
Studies
1
Interactions
2
Forms
1
Evidence Rating: Grade C — Preliminary
Limited human trials, mostly animal or in-vitro data. Promising but not yet proven in robust human studies.
Interaction Warnings
May have additive estrogenic effects — use caution with hormone-sensitive conditions.
Rare liver injury reports — avoid combining with other hepatotoxic medications.
Important Notes
- Rare reports of liver toxicity — discontinue if abdominal pain, dark urine, or jaundice occur
- Avoid in hormone-sensitive cancers (breast, uterine, ovarian) due to potential estrogenic activity
- Not recommended during pregnancy or breastfeeding
- Typically used for menopausal symptom relief (hot flashes, mood changes)
Clinical Evidence (1 study)
Black cohosh (Cimicifuga racemosa) for menopausal symptoms: a review
Kargozar R et al. (2017) — J Menopausal Med
Black cohosh showed benefit for vasomotor symptoms (hot flashes) and mood disturbances in menopausal women
View on PubMedAlternatives to Consider
These supplements target similar goals and may be worth considering alongside or instead of Black Cohosh.
Vitex (Chasteberry)
Grade BWell-studied herbal remedy for PMS symptoms, particularly mood changes, breast tenderness, and irritability. Works by modulating dopamine and reducing prolactin. Evidence is solid for PMS but takes 2-3 cycles. Avoid with hormonal medications.
Evening Primrose Oil
Grade CRich source of gamma-linolenic acid (GLA), an anti-inflammatory omega-6 fatty acid. Used for skin conditions, PMS, and inflammation. Evidence is moderate. Takes weeks to show effects. Avoid with seizure medications.
Dong Quai
Grade CTraditional Chinese Medicine herb for menstrual and menopausal support, almost always used in combination formulas. Weak evidence as a standalone supplement. Significant blood-thinning properties via coumarins. Photosensitizing. Better studied herbs exist for similar goals.
Related Supplements
Vitex (Chasteberry)
Grade B — Moderate EvidenceWell-studied herbal remedy for PMS symptoms, particularly mood changes, breast tenderness, and irritability. Works by modulating dopamine and reducing prolactin. Evidence is solid for PMS but takes 2-3 cycles. Avoid with hormonal medications.
Magnesium Glycinate
Grade A — Strong EvidenceHighly bioavailable form of magnesium. Strong evidence for sleep quality, muscle relaxation, and stress reduction. Most adults are deficient.
Ashwagandha
Grade A — Strong EvidenceAyurvedic adaptogen with strong clinical evidence for cortisol reduction (15-30%), stress relief, and exercise performance.
Rhodiola Rosea
Grade B — Moderate EvidenceAdaptogenic herb with strong evidence for reducing stress-related fatigue. Comparable to low-dose antidepressants for mild depression.
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⚕️ Important Disclaimer
This information is for educational purposes only. It is not medical advice. Always consult a healthcare provider before starting any supplement regimen, especially if you take medications or have health conditions.
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