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Herbs & Supplements

Actea racemosa
Scientific Name: Black Cohosh
Other Names: Cimicifuga racemosa

References

Albertazzi P. A review of non-hormonal options for the relief of menopausal symptoms. Treat Endocrinol. 2006;5(2):101-113.

Amato P, Christophe S, Mellon PL. Estrogenic activity of herbs commonly used as remedies for menopausal symptoms. Menopause. 2002;9(2):145-150.

Amato P, Marcus DM. Review of alternative therapies for treatment of menopausal symptoms. Climacteric. 2003;6(4):278-284.

Anon. Cimicifuga racemosa. Monograph. Alternative Medicine Review. 2003;8(2):186-189.

Anon. The use of black cohosh to treat symptoms of menopause. Fertility and Sterility. 2004;81(Suppl 2):27-34.

Anon: Black cohosh. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. May 1998.

Anon: Blue cohosh. In: DerMarderosian A, Beutler JA, eds. Facts and Comparisons: The Review of Natural Products. St. Louis, MO, Facts and Comparisons. January 2003.

Blumenthal M, Gruenwald J, Hall T, Rister RS, eds. The Complete German Commission E Monographs. Austin, Texas: American Botanical Council; 1998.

Bodinet C, Freudenstein J. Influence of Cimicifuga racemosa on the proliferation of estrogen receptor-positive human breast cancer cells. Breast Cancer Research and Treatment. 2002;76(1):1-10.

Boekhout AH, Beijnen JH, Schellens JH. Symptoms and treatment in cancer therapy-induced early menopause. Oncologist. 2006;11(6):641-654.

Borrelli F, Izzo AA, Ernst E. Pharmacological effects of Cimicifuga racemosa. Life Sciences. 2003;73(10):1215-1229.

Brinker F. Herb Contraindications and Drug Interactions. Sandy, Oregon: Eclectic Institute, 1997.

Burdette JE, Liu J, Chen SN, et al. Black cohosh acts as a mixed competitive ligand and partial agonist of the serotonin receptor. Journal of Agricultural and Food Chemistry. 2003;51(19):5661-5670.

Burke BE, Olson RD, Cusack BJ. Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomedicine and Pharmacotherapy. 2002;56(6):283-288.

Carroll DG. Nonhormonal therapies for hot flashes in menopause. American Family Physician. 2006;73(3):457-464.

Dog TL, Powell KL, Weisman SM. Critical evaluation of the safety of Cimicifuga racemosa in menopause symptom relief. Menopause. 2003;10(4):299-313.

Dugoua J-J, Seely D, Perri D, Koren G, Mills E. Safety and efficacy of black cohosh (cimicifuga racemosa) during pregnancy and lactation. Canadian Journal of Clinical Pharmacology. 2006;13(3):e257-e261.

Duker EM, Kopanski L, Jarry H, Wuttke W. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Medica. 1991;57(5):420-424.

Ehrlich M, Rao J, Pabby A, Goldman MP. Improvement in the appearance of wrinkles with topical transforming growth factor beta(1) and l-ascorbic acid. Dermatologic Surgery. 2006;32(5):618-625.

Einbond LS, Shimizu M, Xiao D, et al. Growth inhibitory activity of extracts and purified components of black cohosh on human breast cancer cells. Breast Cancer Research and Treatment. 2004;83(3):221-231.

Frei-Kleiner S, Schaffner W, Rahlfs VW, Bodmer Ch, Birkhauser M. Cimicifuga racemosa dried ethanolic extract in menopausal disorders: a double-blind placebo-controlled clinical trial. Maturitas. 2005;51(4):397-404.

Garita-Hernandez M, Calzado MA, Caballero FJ, et al. The growth inhibitory activity of the Cimicifuga racemosa extract Ze 450 is mediated through estrogen and progesterone receptors-independent pathways. Planta Medica. 2006;72(4):317-323.

Geller SE, Studee L. Botanical and dietary supplements for menopausal symptoms: what works, what does not. Journal of Womens Health (Larchmont). 2005;14(7):634-649.

Geller SE, Studee L. Botanical and dietary supplements for mood and anxiety in menopausal women. Menopause. 2007;14(3 Pt 1):541-549.

Geller SE, Studee L. Contemporary alternatives to plant estrogens for menopause. Maturitas. 2006;55(Suppl 1):S3-S13.

Gurley B, Hubbard MA, Williams DK, et al. Assessing the clinical significance of botanical supplementation on human cytochrome P450 3A activity: comparison of a milk thistle and black cohosh product to rifampin and clarithromycin. Journal of Clinical Pharmacology. 2006;46(2):201-213.

Gurley BJ, Barone GW, Williams DK, et al. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin pharmacokinetics in humans. Drug Metabolism Disposable. 2006;34(1):69-74.

Gurley BJ, Gardner SF, Hubbard MA, et al. In vivo effects of goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes. Clinical Pharmacology and Therapeutics. 2005;77(5):415-426.

Haimov-Kochman R, Hochner-Celnikier D. Hot flashes revisited: pharmacological and herbal options for hot flashes management. What does the evidence tell us? Acta Obstetrica et Gynecologica Scandinavica. 2005;84(10):972-979.

Hernandez Munoz G, Pluchino S. Cimicifuga racemosa for the treatment of hot flushes in women surviving breast cancer. Maturitas. 2004;44(Suppl 1):S59-S65.

Hostanska K, Nisslein T, Freudenstein J, Reichling J, Saller R. Cimicifuga racemosa extract inhibits proliferation of estrogen receptor-positive and negative human breast carcinoma cell lines by induction of apoptosis. Breast Cancer Research and Treatment. 2004;84(2):151-160.

Huntley A, Ernst E. A systematic review of the safety of black cohosh. Menopause. 2003;10(1):58-64.

Irikura B, Kennelly EJ. Blue Cohosh: a word of caution. Alternative Therapies in Womens Health. 1999;1(10):81-83.

Jacobson JS, Troxel AB, Evans J, Klaus L, Vahdat L, Kinne D, et al. Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer. Journal of Clinical Oncology. 2001;19(10):2739-2745.

Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

Jiang B, Kronenberg F, Balick MJ, Kennelly EJ. Analysis of formononetin from black cohosh (Actaea racemosa). Phytomedicine. 2006 Jul;13(7):477-486.

Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. Journal of Pediatrics. 1998;132(3 Pt 1):550-552.

Kang HJ, Ansbacher R, Hammoud MM. Use of alternative and complementary medicine in menopause. International Journal of Gynaecology [sic] and Obstetrics. 2002;79(3):195-207.

Kim CD, Lee WK, Lee MH, Cho HS, Lee YK, Roh SS. Inhibition of mast cell-dependent allergy reaction by extract of black cohosh (Cimicifuga racemosa). Immunopharmacology and Immunotoxicology. 2004;26(2):299-308.

Kretzschmar G, Nisslein T, Zierau O, Vollmer G. No estrogen-like effects of an isopropanolic extract of Rhizoma Cimicifugae racemosae on uterus and vena cava of rats after 17 day treatment. Journal of Steroid Biochemistry and Molecular Biology. 2005;97(3):271-277.

Kronenberg F, Fugh-Berman A. Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Annals of Internal Medicine. 2002;137(10):805-813.

Lieberman S. A review of the effectiveness of Cimicifuga racemosa (black cohosh) for the symptoms of menopause. Journal of Womens Health. 1998;7(5):525-529.

Liske E, Hanggi W, Henneicke-von Zepelin HH, Boblitz N, Wustenberg P, Rahlfs VW. Physiological investigation of a unique extract of black cohosh (Cimicifugae racemosae rhizoma): a 6-month clinical study demonstrates no systemic estrogenic effect. Journal of Womens Health and Gender Based Medicine. 2002;11(2):163-174.

Liske E. Therapeutic efficacy and safety of Cimicifuga racemosa for gynecologic disorders. Advances in Therapeutics. 1998;15(1):45-53.

Lontos S, Jones RM, Angus PW, Gow PJ. Acute liver failure associated with the use of herbal preparations containing black cohosh. Medical Journal of Australia. 2003;179(7):390-391.

Low Dog T. Menopause: a review of botanical dietary supplements. American Journal of Medicine. 2005;118(12 Suppl 2):98-108.

Lupu R, Mehmi I, Atlas E, et al. Black cohosh, a menopausal remedy, does not have estrogenic activity and does not promote breast cancer cell growth. International Journal of Oncology. 2003;23(5):1407-1412.

Lynch CR, Folkers ME, Hutson WR. Fulminant hepatic failure associated with the use of black cohosh: a case report. Liver Transpl. 2006;12(6):989-992.

Mahady GB, Fabricant D, Chadwick LR, Dietz B. Black cohosh: an alternative therapy for menopause? Nutrition in Clinical Care. 2002;5(6):283-289.

Mahady GB. Is black cohosh estrogenic? Nutrition Review. 2003;61(5 Pt 1):183-186.

McFarlin BL, Gibson MH, O'Rear J, Harman P. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. Journal of Nurse Midwifery. 1999;44(3):205-216.

McKenna DJ, Jones K, Humphrey S, Hughes K. Black cohosh: efficacy, safety, and use in clinical and preclinical applications. Alternative Therapies in Health and Medicine. 2001;7(3):93-100.

Minciullo PL, Saija A, Patafi M, Marotta G, Ferlazzo B, Gangemi S. Muscle damage induced by black cohosh (Cimicifuga racemosa). Phytomedicine. 2006;13(1-2):115-118.

Moyad MA. Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women. Urology. 2002;59(4 Suppl 1):20-33.

Newton KM, Reed SD, Grothaus L, et al. The Herbal Alternatives for Menopause (HALT) Study: background and study design. Maturitas. 2005;52(2):134-146.

North American Menopause Society. Treatment of menopause-associated vasomotor symptoms: position statement of The North American Menopause Society. Menopause. 2004;11(1):11-33.

Oerter Klein K, Janfaza M, Wong JA, Chang RJ. Estrogen bioactivity in fo-ti and other herbs used for their estrogen-like effects as determined by a recombinant cell bioassay. Journal of Clinical Endocrinology and Metabolism. 2003;88(9):4077-4079.

Philp HA. Hot flashes--a review of the literature on alternative and complementary treatment approaches. Alternative Medicine Review. 2003;8(3):284-302.

Piersen CE. Phytoestrogens in botanical dietary supplements: implications for cancer. Integrated Cancer Therapy. 2003;2(2):120-138.

Pockaj BA, Gallagher JG, Loprinzi CL, et al. Phase III double-blind, randomized, placebo-controlled crossover trial of black cohosh in the management of hot flashes: NCCTG Trial N01CC1. Journal of Clinical Oncology. 2006;24(18):2836-2841.

Pockaj BA, Loprinzi CL, Sloan JA, et al. Pilot evaluation of black cohosh for the treatment of hot flashes in women. Cancer Investigation. 2004;22(4):515-521.

Raus K, Brucker C, Gorkow C, Wuttke W. First-time proof of endometrial safety of the special black cohosh extract (Actaea or Cimicifuga racemosa extract) CR BNO 1055. Menopause. 2006;13(4):678-691.

Rebbeck TR, Troxel AB, Norman S, et al. A retrospective case-control study of the use of hormone-related supplements and association with breast cancer. International Journal of Cancer. 2007;120(7):1523-1528.

Rice S, Amon A, Whitehead SA. Ethanolic extracts of black cohosh (Actaea racemosa) inhibit growth and oestradiol [sic] synthesis from oestrone [sic] sulphate in breast cancer cells. Maturitas. 2007;56(4):359-367.

Roemheld-Hamm B, Dahl NV. Herbs, menopause, and dialysis. Seminars in Dialysis. 2002;15(1):53-59.

Russell L, Hicks GS, Low AK, Shepherd JM, Brown CA. Phytoestrogens: a viable option? American Journal of Medical Science. 2002;324(4):185-188.

Sakurai N, Wu JH, Sashida Y, et al. Anti-AIDS agents. Part 57: Actein, an anti-HIV principle from the rhizome of Cimicifuga racemosa (black cohosh), and the anti-HIV activity of related saponins. Bioorganic and Medicinal Chemistry Letter. 2004;14(5):1329-1332.

Schonberg MA, Wee CC. Menopausal symptom management and prevention counseling after the Women's Health Initiative among women seen in an internal medicine practice. Journal of Womens Health (Larchmont). 2005;14(6):507-514.

Scott GN. Black cohosh for menopausal symptoms. Detail Document #200714. Pharmacist's Letter/Prescriber's Letter. July 2004.

Seidlova-Wuttke D, Hesse O, Jarry H, Christoffel V, Spengler B, Becker T, Wuttke W. Evidence for selective estrogen receptor modulator activity in a black cohosh (Cimicifuga racemosa) extract: comparison with estradiol-17beta. European Journal of Endocrinology. 2003;149(4):351-362.

Seidlova-Wuttke D, Jarry H, Becker T, Christoffel V, Wuttke W. Pharmacology of Cimicifuga racemosa extract BNO 1055 in rats: bone, fat and uterus. Maturitas. 2003;44(Suppl 1):S39-S50.

Seidlova-Wuttke D, Jarry H, Pitzel L, Wuttke W. Effects of estradiol-17beta, testosterone and a black cohosh preparation on bone and prostate in orchidectomized rats. Maturitas. 2005;51(2):177-186.

Seidlova-Wuttke D, Thelen P, Wuttke W. Inhibitory effects of a black cohosh (Cimicifuga racemosa) extract on prostate cancer. Planta Medica. 2006;72(6):521-526.

Spangler L, Newton KM, Grothaus LC, Reed SD, Ehrlich K, LaCroix AZ. The effects of black cohosh therapies on lipids, fibrinogen, glucose and insulin. Maturitas. 2007 Jun 20;57(2):195-204.

Taylor M. Alternatives to HRT: an evidence-based review. International Journal of Fertility and Womens Medicine. 2003;48(2):64-68.

Tesch BJ. Herbs commonly used by women: an evidence-based review. Disease of the Month. 2002;48(10):671-696.

Uebelhack R, Blohmer JU, Graubaum HJ, Busch R, Gruenwald J, Wernecke KD. Black cohosh and St. John's wort for climacteric complaints: a randomized trial. Obstetrics and Gynecology. 2006;107(2 Pt 1):247-255.

Verhoeven MO, van der Mooren MJ, van de Weijer PH, et al. Effect of a combination of isoflavones and Actaea racemosa Linnaeus on climacteric symptoms in healthy symptomatic perimenopausal women: a 12-week randomized, placebo-controlled, double-blind study. Menopause. 2005;12(4):412-420.

Viereck V, Emons G, Wuttke W. Black cohosh: just another phytoestrogen? Trends in Endocrinology and Metabolism. 2005;16(5):214-221.

Viereck V, Grundker C, Friess SC, et al. Isopropanolic extract of black cohosh stimulates osteoprotegerin production by human osteoblasts. Journal of Bone Mineral Research. 2005;20(11):2036-2043.

Warren BS, Devine CM. Herbal Medicines and breast cancer risk. Fact Sheet #53. Cornell University Program on Breast Cancer and Environmental Risk Factors. Revised November 2004. Available at: http://envirocancer.cornell.edu/factsheet/diet/fs53 /herbal.pdf. Accessed July 14, 2005.

Whiting PW, Clouston A, Kerlin P. Black cohosh and other herbal remedies associated with acute hepatitis. Medical Journal of Australia. 2002;177:440-443.

Winterhoff H, Spengler B, Christoffel V, Butterweck V, Lohning A. Cimicifuga extract BNO 1055: reduction of hot flushes and hints on antidepressant activity. Maturitas. 2003;44(Suppl 1):S51-S58.

Woo KC, Park YS, Jun DJ, et al. Phytoestrogen cimicifugoside-mediated inhibition of catecholamine secretion by blocking nicotinic acetylcholine receptor in bovine adrenal chromaffin cells. Journal of Pharmacology and Experimental Therapeutics. 2004;309(2):641-649.

Wuttke W, Gorkow C, Seidlova-Wuttke D. Effects of black cohosh (Cimicifuga racemosa) on bone turnover, vaginal mucosa, and various blood parameters in postmenopausal women: a double-blind, placebo-controlled, and conjugated estrogens-controlled study. Menopause. 2006;13(2):185-196.

Wuttke W, Seidlova-Wuttke D, Gorkow C. The Cimicifuga preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers. Maturitas. 2003;44(Suppl 1):S67-S77.

Zierau O, Bodinet C, Kolba S, Wulf M, Vollmer G. Antiestrogenic activities of Cimicifuga racemosa extracts. Journal of Steroid Biochemistry and Molecular Biology. 2002;80(1):125-130.

Last Revised July 21, 2007

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Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.

In general, herbal products are not subject to review or approval by the U.S. Food and Drug Administration (FDA). They are not required to be standardized, meaning that the amounts of active ingredients or contaminants they contain may vary between brands or between different batches of the same brand. Not all of the risks, side effects, or interactions associated with the use of herbal products are known because few reliable studies of their use in humans have been done.

This information is provided for your education only. Please share this information with your healthcare provider and be sure that you talk to your doctor and pharmacist about all the prescription and non-prescription medicines you take before you begin to use any herbal product.

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