BLACK COHOSH (cimicifuga racemosa): Hot Flushes - What are the Options??

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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.

_________________

JoAnn Guest

mrsjoguest

DietaryTipsForHBP

www.geocities.com/mrsjoguest/Genes

 

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Posted: Mon Feb 07, 2005 3:32 pm Post subject: Hot Flushes- What are the

options?

 

--

 

Hot Flushes- What are the options?

JoAnn Guest

Dec 23, 2004 19:36 PST

 

Hot Flushes- What are the options?

 

http://www.weightcontroldoctor.com/healthtopics/a-z/hotflushes.asp

 

Hot flushes are the single most common symptom associated with

menopause. They consist of a sudden sensation of heat which rises

usually from the chest up over the neck and face. The face may

actuallybecome quite red and sweaty.

 

They last from a few seconds to several minutes and may occur just a few

times a year or fifteen to twenty times

a day! You may find yourself feeling hot and flustered while those

around you are cool, calm and collected as they complain when you

open windows and turn off heaters.

 

The flushes can occur at night as well,but you may only be aware of them

after waking drenched with perspiration.

 

What causes them?

 

Hot flushes are due to a rapid dilatation of blood vessels on the

surface of the skin, which results from the fact that the body's

thermostat, situated in the area of the brain known as the

'hypothalamus', does not function at all well without the presence

of estrogen.

 

The lack of estrogen is of course the hallmark of menopause.

 

Nearly 80 percent of menopausal women are troubled with hot flushes

and in 70 percent of this group the flushes will last, on average, for

five years.

 

They vary in severity between different women and may be

associated with heart palpitations, dizziness and strange crawling

or itching sensations under the skin.

 

Books

" HRT The Real Truth - balance your hormone naturally and swing from

the chandeliers! " This is Dr Cabot's new book which covers all aspects

of natural hormone replacement.

 

Treatment & General Recommendations

A simple treatment at the time of a hot flush is to apply cold water

compresses to the face. It is wise to avoid foods and situations

that will make you hot such as caffeine(coffee,pop) alcohol, cigarette

smoking, big meals, emotional exertion, electric blankets and sitting in

direct sunlight. Wear cotton clothing if possible, which allows your

skin to breathe.

 

Also see chapter 19 " Relief of the symptoms of menopause " in the

book HRT - The Real Truth "

 

Diet

Numerous plants contain natural estrogenic substances which, though

weak in potency and only present in small amounts, are capable of

exerting a mild estrogenic effect when eaten regularly.

 

These foods include -

cabbage, carrots, green beans, peas, pumpkin,

organic potato, alfalfa, parsley, olives, extra virgin olive oil,

garlic, beetroot, rice, oats, split peas, chick peas, organic soya

bean, kidney beans, lima beans, barley, rye, apples,

cherries, plums, rhubarb, sesame seeds,sunflower seeds,

wheat and baker's yeast. Drink two liters of water daily.

---

FROM: Altern Med Rev 2003 (Aug); 8 (3): 284–302 ~ FULL TEXT

Philp HA

---

Hot flashes are a common experience for menopausal women, with an

85-percent incidence in the West. With the increased knowledge of

side ffects attributable to conventional treatment options, more women

areexploring natural alternatives.

 

Although more definitive research is necessary, several natural

therapies show promise in treating hot flashes without the risks

associated with conventional therapies.

Non-gmo Soy and other phytoestrogens, black cohosh, evening primrose

oil, vitamin E, the bioflavonoid " hesperidin " with vitamin C,

ferulicacid, acupuncture treatment, and regular aerobic exercise have

beenshown effective in treating hot flashes in menopausal women.

 

Medical Abstract Title:

http://www.enzy.com/abstracts/display.asp?id=2256

 

---

 

Medical Abstract Title:

 

Black Cohosh: Efficacy, Safety, and Use in Clinical and Preclinical

Applications

Author:

McKenna DJ, Jones K, Humphrey S, Hughes K

Source:

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

Abstract:

Actaea racemosa L (formerly Cimicifuga racemosa [L] Nutt)(Ranunculaceae),

commonly known as black cohosh, is an herb

nativeto 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

menopausalanxiety and depression. Extracts also have been shown to be

usefulforyounger women suffering hormonal deficits following ovariectomy

orhysterectomy, 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 Europeanphytotherapy, " Remifemin " is commonly prescribed as an

effectivealternative to hormone replacement therapy for menopause.

 

http://www.enzy.com/abstracts/display.asp?id=2676

 

---

 

'Vasomotor Symptom' Relief in Postmenopausal Women: A

Multicenter, Double-Blind, Randomized, Placebo-Controlled Study

Author:

Upmalis DH, Lobo R, Bradley L, Warren M, Cone FL, Lamia CA

Source:

Menopause 2000;7:236-242.

Abstract:

 

OBJECTIVE: To determine the safety and efficacy of an organic oral soy

isoflavone extract for relief of menopausal hot flushes.

 

DESIGN: This was a double-blind, randomized, parallel group,

outpatient, multicenter (15 sites) study. A total of 177

postmenopausal

women (mean age = 55 years) who were experiencing five or more hot

flushes per day were randomized to receive either soy isoflavone

extract (total of 50 mg genistin and daidzin per day) or placebo.

 

Physical examinations and endometrial and biochemical evaluations

were

performed upon admission and completion. Body weight, symptoms, and

safety were evaluated at all visits.

 

 

RESULTS: Relief of vasomotor symptoms was observed in both groups.

Decreases in the incidence and severity of hot flushes occurred as

soon

as 2 weeks in the soy group, whereas the placebo group experienced

norelief for the first 4 weeks.

 

Differences between evaluable subjectsinboth groups were statistically

significant over 6 weeks (p = 0.03).

Over 12 weeks, between-group differences approached significance (p

=0.0.

 

Endometrial thickness evaluated by ultrasound, lipoproteins,

bone markers, sex hormone-binding globulin and follicle-stimulating

hormone, and vaginal cytology did not change in either group.

 

 

CONCLUSIONS: Organic Soy isoflavone extract was effective in reducing

frequencyand severity of flushes and did not stimulate the endometrium.

Soy isoflavone extracts provide an attractive addition to the choices

available for relief of hot flushes.

 

--

 

Today's Question

Had Enough Wild Yams?

 

I have been using wild yam cream for the past 12 years. Should I ever stop using

it?

 

-- Elaine Gerber

 

Today's Answer

(Published 06/03/2003)

 

Wild yams (Dioscorea) have been promoted as a source of natural progesterone for

the relief of menopausal symptoms or a host of other female problems ranging

from menstrual cramps to monthly mood swings.

 

Claims for the effectiveness of wild yam cream are based on the fact that wild

yams contain a precursor of steroid hormones called diosgenin.

However, diosgenin itself has no hormonal activity and can’t be converted in the

human body into anything that does.

 

Many women prefer natural progesterone products to synthetic progesterone

(progestins) typically prescribed as part of hormone replacement therapy (HRT).

 

You don’t need progesterone if you’ve had a hysterectomy and no longer have a

uterus. If you do have a uterus, replacing estrogen alone can overstimulate the

uterine lining, raising the risk of endometrial cancer.

 

Adding progesterone protects the uterus.

 

If you have been using wild yam cream in the belief that it is supplying enough

progesterone to offset the effects of estrogen replacement on the uterus, I’m

afraid that you haven’t been getting the protection you need.

 

 

If you have been using wild yam cream and estrogen replacement for 12 years, I

would recommend taking a break from the estrogen and giving up the wild yam

cream.

 

 

If you have hot flashes or other menopausal discomforts, try black cohosh

(Cimifiuga racemosa); I would recommend the standardized product called

" Remifemin " plus 800 IUs of natural vitamin E (or 80mg as mixed tocopherols and

tocotrienols) daily.

 

Two to three daily servings of whole organic soy foods (tofu, tempeh, edamame,

and soy milk) will give you some safe plant estrogens (isoflavones) that may

help relieve symptoms.

_________________

 

JoAnn Guest

mrsjoguest

DietaryTipsForHBP

www.geocities.com/mrsjoguest/Genes

 

 

 

 

AIM Barleygreen

" Wisdom of the Past, Food of the Future "

 

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