BLACK COHOSH

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BLACK COHOSH

(black cohosh root)

http://www.raysahelian.com/blackcohosh.html

Black cohosh (cimicifuga racemosa), also known as snakeroot, bugbane and rattle weed, is native to eastern North America, and has historically been used by Native Americans for a variety of female conditions. Black cohosh contains a variety of phytoestrogens.

The German Comminssion E has approved black cohosh for the treatment of menopausal symptoms, premenstrual syndrome, and dysmenorrhea, however they recommend treatment be limited to 6 months.

Studies with black cohosh root have shown inconsistent results in reducing hot flashes in postmenopausal women. However, a survey of women done at the University of San Francisco published in Feb 2002 indicated that women who use a combination of herbal remedies and estrogen were more satisfied in the outcome of their symptoms compared to women who used estrogen alone or herbs alone.

The supplements used were black cohosh, ginkgo, and organic soy.

At this time there is debate in the herbal community on the role and effectiveness of black cohosh in treating female conditions. However, historically black cohosh has been used to treat some symptoms of menopause.

Black Cohosh active ingredients

Black cohosh root contains triterine glycosides such as cimifugaside, 27-deoxyactein and actein.

Black Cohosh additional research

Black cohosh has a non-estrogenic, or estrogen-antagonistic effect on human breast cancer cells. This leads to the conclusion that black cohosh treatment may be a safe, natural remedy for menopausal symptoms in breast cancer.

Chemicals within black cohosh can protect against cellular DNA damage caused by reactive oxygen species by acting as antioxidants.

Black cohosh has anti-allergy properties.

Black Cohosh dosage and availability

Black cohosh is sold either by itself, or combined with other herbs and nutrients. The dosage of black cohosh extract used in the majority of clinical studies has been based on the level of a key marker, 27-deoxyactein. The recommended dosage for the relief of menopausal symptoms is one tablet of 20 mg taken twice daily, or one 40 mg capsule daily, with benefits hopefully seen in one to three months.

Black Cohosh Extract , 40 mg, 90 Capsules - Natural Factors

Natural Support for Menopause Symptoms

 

Natural Factors Black Cohosh Extract capsules contain extract standardized to 2.5% triterpene glycosides.

Containing valuable phytoestrogen, Black Cohosh has been used for a number of feminine conditions and recently been recognized for its ability to support menopause symptoms naturally.

Suggested Usage: 1 capsule, 1- 2 times per day preferably before meals or as directed by a health care professional.

PhysicianFormulas.com

Plus: Subscribe to our free Supplement Research Update newsletter. Once or twice a month we email a brief abstract of several studies on various supplements and natural medicine topics, and their practical interpretation by Ray Sahelian, M.D.

Black Cohosh: What is the opinion of the medical establishment?

The field of hormone or herbal therapy during or after menopause is very complicated and there is no consensus within the medical community regarding the best option for long term therapy. The medical community seems to be shifting its viewpoint on hormone replacement. It appears that most traditional doctors now prefer using low doses of hormones for a brief period of time to treat menopausal symptoms, but prefer not to continue hormone replacement therapy indefinitely as in the past. Black cohosh is not well known in the medical community.

Black Cohosh Research Update

In vivo Effects of Black Cohosh and Genistein on Estrogenic Activity and Lipid Peroxidation in Japanese Medaka (Oryzias latipes).

J Herb Pharmcother. 2003;3(3):33-50.

This study was designed to assay the estrogenic activities and the antioxidant potential of ethanol extracts from the herbal dietary supplement black cohosh (Cimicifuga racemosa) relative to the natural phytoestrogen genistein. The in vivo mechanisms of action of these two natural products have not been completely elucidated, and Japanese medaka (Oryzias latipes) provides a useful organism for initial in vivo screening of natural products. While both genistein and estradiol altered ovarian and testicular steroid release and decreased circulating testosterone levels in males, neither black cohosh total extract (75-30,000 ng/fish), cimiracemoside A, 25-O-methyl-cimigenoside, actein, nor 26-deoxy-actein caused any differences in estrogenic activity compared to control fish. To assess antioxidant potential, animals were treated with natural products then challenged with 2-acetylaminofluorene (2-AAF) to induce lipid peroxidation (LPO) in the liver. Neither the total ethanol extracts from black cohosh nor its individual components showed an inhibitory effect in 2-AAF induced LPO. However, genistein manifested potent antioxidative activity in the LPO assay, with similar potency to a high dose of á-tocopherol. In contrast to genistein, black cohosh did not exhibit traditional estrogenic effects nor significant in vivo anti-oxidant potential in this fish model system.

Nonestrogen treatment modalities for vasomotor symptoms associated with menopause.

Ann Pharmacother. 2004 Sep;38(9):1482-99. Epub 2004 Aug 03.

OBJECTIVE: To systematically review the literature regarding the efficacy and safety of nonestrogen treatments for menopause-associated vasomotor symptoms not due to cancer or chemotherapy. CONCLUSIONS: According to this systematic literature review, postmenopausal vasomotor treatments that have been shown to be safe and effective in short-term use include black cohosh, exercise, gabapentin, medroxyprogesterone acetate, SSRIs (ie, paroxetine hydrochloride), and soy protein. Initial, small reports are suggestive for efficacy in menopausal vasomotor symptoms with megestrol acetate and venlafaxine.

The Cimicifuga (black cohosh) preparation BNO 1055 vs. conjugated estrogens in a double-blind placebo-controlled study: effects on menopause symptoms and bone markers.

Wuttke W, 2003 Mar 14;44 Suppl 1:S67-77. University of Gottingen, Robert-Koch-Strasse 40, 37075 Gottingen, Germany.

OBJECTIVES: In the present study, therapeutic effects of the Cimicifuga racemosa (black cohosh) preparation CR BNO 1055 (Klimadynon/Menofem) on climacteric complaints, bone metabolism and endometrium will be compared with those of conjugated estrogens (CE) and placebo. The question whether black cohosh contains substances with selective estrogen receptor modulator (SERM) activity will be investigated. METHODS: Sixty-two evaluable postmenopausal women were included in the double-blind, randomized, multicentre study, and treated either with (black cohsoh (daily dose corresponding to 40 mg herbal drug), 0.6 mg CE, or matching placebo, for 3 months. Menopausal symptoms were assessed by the menopause rating scale (MRS) and a diary. Levels of CrossLaps (marker of bone degradation) were determined by ELECSYS system and bone-specific alkaline phosphatase (marker of bone formation) by an enzymatic assay. Endometrial thickness was measured via transvaginal ultrasound; vaginal cytology was also studied. The primary efficacy criterion was the change from baseline to end point in the MRS. Change from baseline was analyzed for the secondary variables too. RESULTS: black cohosh proved to be equipotent to CE and superior to placebo in reducing climacteric complaints. Under both verum preparations, beneficial effects on bone metabolism have been observed in the serum. Black cohosh had no effect on endometrial thickness, which was significantly increased by CE. Vaginal superficial cells were increased under CE and black cohosh treatment. CONCLUSION: The results concerning climacteric complaints and on bone metabolism indicate an equipotent effect of black cohosh in comparison to 0.6 mg CE per day. It is proposed that black cohosh contains substances with SERM activity, i.e. with desired effects in the brain/hypothalamus, in the bone and in the vagina, but without exerting uterotrophic effects.

Cimicifuga racemosa (black cohosh) for the treatment of hot flushes in women surviving breast cancer.

Maturitas. 2003 Mar 14;44 Suppl 1:S59-65. Parque Humboldt, Prados del Este, Caracas, Venezuela.

OBJECTIVES: To examine the effect of Cimicifuga racemosa black cohosh (CR BNO 1055) on hot flushes caused by tamoxifen adjuvant therapy in young premenopausal breast cancer survivors. This treatment presents an off-label use of black cohosh. METHODS: Between May 1999 and December 2001, we accrued 136 breast cancer survivors aged 35-52 years. After treatment with segmental or total mastectomy, radiation therapy and adjuvant chemotherapy, participants were in open-label randomly assigned (1-2) to receive tamoxifen 20 mg per day orally (usual-care group; n=46) or tamoxifen (same dose and posology) plus black cohosh (Menofem/Klimadynon, corresponding to 20 mg of herbal drug; intervention group n=90). Duration of treatment was 5 years for tamoxifen, according to international standards for adjuvant therapies, and 12 months for black cohosh. Follow-up included clinical assessment every 2 months; the primary endpoint was to record the number and intensity of hot flushes. RESULTS: Comparing patients assigned to usual-care group with those assigned to intervention group, the number and severity of hot flushes were reduced after intervention. Almost half of the patients of the intervention group were free of hot flushes, while severe hot flushes were reported by 24.4% of patients of intervention group and 73.9% of the usual-care group (P<0.01). CONCLUSIONS: Hot flushes were the most frequent adverse reaction to tamoxifen adjuvant therapy in breast cancer survivors. The combined administration of tamoxifen plus black cohosh for a period of 12 months allowed satisfactory reduction in the number and severity of hot flushes.

Black cohosh: efficacy, safety, and use in clinical and preclinical applications.

Institute for Natural Products Research in Marine, St. Croix, Minn., USA.

Altern Ther Health Med. 2001 May-Jun;7(3):93-100.

Actaea racemosa L (formerly Cimicifuga racemosa [L] Nutt) (Ranunculaceae), commonly known as black cohosh, is an herb native to Eastern North America. Black cohosh has a history of traditional use among Native Americans for the treatment of a variety of disorders, including various conditions unique to women such as amenorrhea and menopause. Contemporary uses of black cohosh are primarily geared toward the treatment of symptoms of menopause, such as hot flashes, and menopausal anxiety and depression. Extracts also have been shown to be useful for younger women suffering hormonal deficits following ovariectomy or hysterectomy, as well as for juvenile menstrual disorders. A number of clinical studies using Remifemin, a standardized extract, have demonstrated efficacy for the alleviation of menopausal complaints. The safety profile of black cohosh is positive, with low toxicity, few and mild side effects, and good tolerability. In European phytotherapy, Remifemin is commonly prescribed as an effective alternative to hormone replacement therapy for menopause.

Black Cohosh Laboratory Studies

Inhibition of mast cell-dependent allergy reaction by extract of black cohosh (Cimicifuga racemosa).

Immunopharmacol Immunotoxicol. 2004 May;26(2):299-308.

Black cohosh (Cimicifuga racemosa) has been used as therapeutics for pain and inflammation in Korean folk medicine. The potential effects of black cohosh extract on mast cell-dependent allergy reaction, however, have not been well elucidated yet. In the present study, we investigated the effect of black cohosh on the allergy reaction using mast cell-dependent in vivo and in vitro models. black cohosh showed no potential of skin sensitization in local lymph node assay. The oral administration of black cohosh significantly inhibited the anti-IgE-induced passive cutaneous anaphylaxis reaction. Black cohosh also showed inhibitory potential on the compound 48/80-induced histamine release from rat peritoneal mast cells. In addition, black cohosh inhibited the IL-4, IL-5 and TNF-alpha mRNA induction by PMA and A23187 in human leukemia mast cells, HMC-1. These results demonstrated that black cohosh has an anti-allergic potential and it may be due to the inhibition of histamine release and cytokine gene expression in the mast cells.

Cimicifuga racemosa (black cohosh) extract inhibits proliferation of estrogen receptor-positive and negative human breast carcinoma cell lines by induction of apoptosis.

Breast Cancer Res Treat. 2004 Mar;84(2):151-60.

Hormone replacement therapy is contraindicated in women with breast cancer. Extracts from the rhizomes of Cimicifuga racemosa (black cohosh), have gained acceptance as a natural alternative for the treatment of menopausal symptoms. In the present study we investigated the antiproliferative activity of black cohosh extracts (isopropanolic and ethanolic) on the estrogen receptor positive MCF-7 and estrogen receptor negative MDA-MB231 breast cancer cells. Down regulation of the proliferative activity and cell killing by isopropanolic and ethanolic extracts occurred in a clear dose-dependent response with a 50% growth inhibitory concentration. Further, the mode of cell death was identified as apoptosis. These results indicate that black cohosh extract exerts no proliferative activity, but kills the estrogen receptor positive MCF-7 as well as estrogen receptor negative MDA-MB231 cells by activation of caspases and induction of apoptosis.

Growth inhibitory activity of extracts and purified components of black cohosh on human breast cancer cells.

Breast Cancer Res Treat. 2004 Feb;83(3):221-31.

The purpose of this study was to determine whether black cohosh contains constituents that inhibit the growth of human breast cancer cells, and therefore might eventually be useful in the prevention or treatment of breast cancer. Black cohosh rhizomes were extracted with methanol/water and fractionated by solvent-solvent partitioning to yield three fractions: hexane, ethyl acetate and water. The ethyl acetate fraction displayed the highest potency in two cell-based assays, growth inhibition and cell cycle analysis. Further studies are in progress to identify the mechanisms by which actein and related compounds present in black cohosh inhibit growth of human breast cancer cells.

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