BLACK COHOSH

OTHER NAME(S):

Actaea macrotys, Actaea racemosa, Actée à Grappes, Actée à Grappes Noires, Actée Noire, Aristolochiaceae Noire, Baie d’actée, Black Cohosh, Baneberry, Black Aristolochiaceae, Black Snakeroot, Bugbane, Bugwort, Cimicaire à Grappes, Cimicifuga, Cimicifuga Racemosa, Cimicifuge, Cohosh Negro, Cohosh Noir, Cytise, Herbe aux Punaises, Macrotys, Phytoestrogen, Phytoestrogène, Racine de Serpent, Racine de Squaw, Racine Noire de Serpents, Rattle Root, Rattle Top, Rattlesnake Root, Rattleweed, Rhizoma Cimicifugae, Sheng Ma, Snakeroot, Squaw Root.<br/><br/>

Overview

Overview Information

Black cohosh is an herb. The root of this herb is used for medicinal purposes. Black cohosh was first used for medicinal purposes by Native American Indians, who introduced it to European colonists. Black cohosh became a popular treatment for women’s health issues in Europe in the mid-1950s.

Since that time, black cohosh has commonly been used to treat symptoms of menopause, premenstrual syndrome (PMS), painful menstruation, acne, weakened bones (osteoporosis), and for starting labor in pregnant women.

Black cohosh has also been tried for a lot of additional uses, such as anxiety, rheumatism, fever, sore throat, and cough, but it is not often used for these purposes these days.

Some people also apply black cohosh directly on the skin. This is because there was some thought that black cohosh would improve the skin’s appearance. Similarly, people used black cohosh for other skin conditions such as acne, wart removal, and even the removal of moles, but this is seldom done anymore.

Black cohosh also goes by the name “bugbane” because it was once used as an insect repellent. It is no longer used for this purpose. Frontiersmen had said that black cohosh was useful for rattlesnake bites, but no modern researchers have tested this.

Do not confuse black cohosh with blue cohosh or white cohosh. These are unrelated plants. The blue and white cohosh plants do not have the same effects as black cohosh, and may not be safe.

How does it work?

The root of black cohosh is used for medicinal purposes. Black cohosh root contains several chemicals that might have effects in the body. Some of these chemicals work on the immune system and might affect the body’s defenses against diseases. Some might help the body to reduce inflammation. Other chemicals in black cohosh root might work in nerves and in the brain. These chemicals might work similar to another chemical in the brain called serotonin. Scientists call this type of chemical a neurotransmitter because it helps the brain send messages to other parts of the body.

Black cohosh root also seems to have some effects similar to the female hormone, estrogen. In some parts of the body, black cohosh might increase the effects of estrogen. In other parts of the body, black cohosh might decrease the effects of estrogen. Estrogen itself has various effects in different parts of the body. Estrogen also has different effects in people at different stages of life. Black cohosh should not be thought of as an “herbal estrogen” or a substitute for estrogen. It is more accurate to think of it as an herb that acts similar to estrogen in some people.

Uses

Uses & Effectiveness?

Possibly Effective for

  • Menopausal symptoms. Research shows that taking some black cohosh products can reduce some symptoms of menopause. However, the benefits are only modest. Black cohosh might lessen the frequency of hot flashes. Most of this research is for a specific commercial black cohosh product, Remifemin. The benefits may not occur with all products that contain black cohosh.

    Research using black cohosh products other than Remifemin have not always shown benefits for menopausal symptoms. Some of these studies show that these other black cohosh products do not reduce hot flashes or menopausal symptoms any better than a sugar pill (“placebo”).

    Some women take black cohosh for hot flashes related to breast cancer treatment. Women with breast cancer should not use black cohosh without talking to their cancer specialist or other health provider. Some early research suggested that black cohosh might reduce hot flashes in breast cancer patients, but more recent and higher quality research shows that black cohosh does not reduce hot flashes in women with breast cancer. Also, there is some question as to whether black cohosh is safe for women with breast cancer. It is important for a woman with breastcancer to discuss any use of black cohosh with her health provider before using it.

Insufficient Evidence for

  • Breast cancer. One study suggests that taking black cohosh supplements is linked to a deceased risk of breast cancer. However, other research has found no link. One study found that taking black cohosh might increase survival in women already diagnosed with breast cancer.
  • Heart disease. Early research shows that taking 40 mg of a specific black cohosh extract (CR BNO 1055) daily does not lower the risk of heart disease in postmenopausal women.
  • Mental function. Early research suggests that taking 128 mg of black cohosh daily for 12 months does not improve memory or attention in postmenopausal women.
  • Infertility. Some early research suggests that taking black cohosh plus clomiphene citrate can increase pregnancy rates in infertile women compared to clomiphene citrate alone. Other research shows that taking black cohosh with clomiphene results in pregnancy rates that are similar to those found when clomiphene is taken with another fertility drug.
  • Induction of labor. Some people report that black cohosh can help start labor. As many as 45% of nurse-midwives use black cohosh to start labor in pregnant women at term. Despite its common use, there is no reliable scientific evidence that black cohosh works for this purpose.
  • Migraine headache. Early research shows that taking 50 mg of black cohosh plus soy isoflavones and dong quai daily for 24 weeks can reduce the occurrence of menstrual migraines.
  • Osteoarthritis. Early research suggests that taking a specific product containing black cohosh (Reumalex) twice daily for 2 months improves pain, but not joint function, in people with osteoarthritis.
  • Weak bones (Osteoporosis). Evidence regarding the benefit of black cohosh for treating or preventing osteoporosis is unclear. Some early research shows that taking a specific black cohosh product (CR BNO 1055, Klimadynon/Menofem, Bionorica AG) daily for 12 weeks increases markers of bone formation in postmenopausal women. However, other research shows that taking the same black cohosh extract does not improve bone mineral density. It is not known if these black cohosh products can reduce the risk of bone fractures.
  • Rheumatoid arthritis. Early evidence suggests that taking a specific product containing black cohosh (Reumalex) twice daily for 2 months improves pain, but not joint function, in people with rheumatoid arthritis.
  • Acne.
  • Anxiety.
  • Bug bites.
  • Cough.
  • Fever.
  • Mole removal.
  • Painful menstruation.
  • Premenstrual syndrome (PMS).
  • Rheumatism.
  • Snake bite.
  • Sore throat.
  • Wart removal.
More evidence is needed to rate black cohosh for these uses.

Side Effects

Side Effects & Safety

Black cohosh is POSSIBLY SAFE when taken by mouth appropriately by adults for up to one year.

Black cohosh can cause some mild side effects such as stomach upset, cramping, headache, rash, a feeling of heaviness, vaginal spotting or bleeding, and weight gain.

There is also some concern that black cohosh may be associated with liver damage. It is not known for sure if black cohosh actually causes liver damage. Researchers are studying this. Until more is known, people who take black cohosh should watch for symptoms of liver damage. Some symptoms that may suggest liver damage are yellowing of the skin and eyes (jaundice), unusual fatigue, or dark urine. If these symptoms develop, black cohosh should be stopped and a health provider should be contacted. People who take black cohosh should talk with their health provider about getting tests to make sure their liver is working well.

Special Precautions & Warnings:

Pregnancy or breast-feeding: Black cohosh is POSSIBLY UNSAFE when used during pregnancy or breast-feeding. Since black cohosh acts somewhat like a female hormone it might increase the risk of miscarriage.

Breast cancer: There is some concern that black cohosh might worsen existing breast cancer. Women who have breast cancer or who have had breast cancer in the past, and women at high-risk for breast cancer, should avoid black cohosh.

Hormone-sensitive conditions, including endometriosis, fibroids, ovarian cancer, uterine cancer, and others: Black cohosh acts somewhat like the female hormone, estrogen, in the body. There is some concern that it could worsen conditions that are sensitive to female hormones. Do not take black cohosh if you have a condition that could be affected by female hormones. These conditions include ovarian cancer, uterine cancer, endometriosis, fibroids, and other conditions.

Liver disease: Some reports suggest that black cohosh might cause liver damage. It is not known for sure if black cohosh is the cause of liver damage in these cases. Until more is known, people with liver disease should avoid taking black cohosh.

Kidney transplant: Taking a product containing black cohosh plus alfalfa has been linked to a report of kidney transplant rejection. It is not known if black cohosh is the cause of this rejection. Until more is known, people who have received a transplant should avoid black cohosh.

Protein S deficiency: People with a condition called protein S deficiency have an increased risk of blood clots. Due to the hormone-like effects of black cohosh, there is some concern that black cohosh might also increase the risk of blood clots. There is a report linking blood clots in someone with protein S deficiency after taking black cohosh along with several other herbal products. Until more is known, people with protein S deficiency should avoid black cohosh.

Interactions

Interactions?

Moderate Interaction

Be cautious with this combination

!
  • Atorvastatin (Lipitor) interacts with BLACK COHOSH

    There is concern that black cohosh might harm the liver. Taking black cohosh with atorvastatin (Lipitor) might increase the chance of liver damage. However, there is not enough scientific information to know if this is an important concern. Before taking black cohosh talk to your healthcare provider if you take atorvastatin (Lipitor).

  • Cisplatin (Platinol-AQ) interacts with BLACK COHOSH

    Cisplatin (Platinol-AQ) is used to treat cancer. There is some concern that black cohosh might decrease how well cisplatin (Platinol-AQ) works for cancer. Do not take black cohosh if you are taking cisplatin (Platinol-AQ).

  • Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates) interacts with BLACK COHOSH

    Some medications are changed and broken down by the liver.<br /> Black cohosh might decrease how quickly the liver breaks down some medications. Taking black cohosh along with some medications that are change by the liver can increase the effects and side effects of your medication. Before taking black cohosh talk to your healthcare provider if you take any medications that are changed by the liver.<br /> Some medications that are changed by the liver include amitriptyline (Elavil), clozapine (Clozaril), codeine, desipramine (Norpramin), donepezil (Aricept), fentanyl (Duragesic), flecainide (Tambocor), fluoxetine (Prozac), meperidine (Demerol), methadone (Dolophine), metoprolol (Lopressor, Toprol XL), olanzapine (Zyprexa), ondansetron (Zofran), tramadol (Ultram), trazodone (Desyrel), and others.

  • Medications that can harm the liver (Hepatotoxic drugs) interacts with BLACK COHOSH

    There is concern that black cohosh might harm the liver. Taking black cohosh along with medication that might also harm the liver can increase the risk of liver damage. Do not take black cohosh if you are taking a medication that can harm the liver.<br /> Some medications that can harm the liver include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid (INH), methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan), itraconazole (Sporanox), erythromycin (Erythrocin, Ilosone, others), phenytoin (Dilantin), lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), and many others.

Dosing

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • Menopausal symptoms: 20-80 mg once or twice daily.
  • Weak bones (Osteoporosis): 40 mg daily.

View References

REFERENCES:

  • Innis, S. M. Perinatal biochemistry and physiology of long-chain polyunsaturated fatty acids. J Pediatr 2003;143(4 Suppl):S1-S8. View abstract.
  • Innis, S. M., Adamkin, D. H., Hall, R. T., Kalhan, S. C., Lair, C., Lim, M., Stevens, D. C., Twist, P. F., Diersen-Schade, D. A., Harris, C. L., Merkel, K. L., and Hansen, J. W. Docosahexaenoic acid and arachidonic acid enhance growth with no adverse effects in preterm infants fed formula. J.Pediatr. 2002;140(5):547-554. View abstract.
  • Innis, S. M., Akrabawi, S. S., Diersen-Schade, D. A., Dobson, M. V., and Guy, D. G. Visual acuity and blood lipids in term infants fed human milk or formulae. Lipids 1997;32(1):63-72. View abstract.
  • Innis, S. M., Gilley, J., and Werker, J. Are human milk long-chain polyunsaturated fatty acids related to visual and neural development in breast-fed term infants? J Pediatr 2001;139(4):532-538. View abstract.
  • Innis, S. M., Nelson, C. M., Rioux, M. F., and King, D. J. Development of visual acuity in relation to plasma and erythrocyte omega-6 and omega-3 fatty acids in healthy term gestation infants. Am J Clin Nutr 1994;60(3):347-352. View abstract.
  • Jans, L. A., Giltay, E. J., and Van der Does, A. J. The efficacy of n-3 fatty acids DHA and EPA (fish oil) for perinatal depression. Br J Nutr 2010;104(11):1577-1585. View abstract.
  • Jensen, C. L., Voigt, R. G., Llorente, A. M., Peters, S. U., Prager, T. C., Zou, Y. L., Rozelle, J. C., Turcich, M. R., Fraley, J. K., Anderson, R. E., and Heird, W. C. Effects of early maternal docosahexaenoic acid intake on neuropsychological status and visual acuity at five years of age of breast-fed term infants. J Pediatr 2010;157(6):900-905. View abstract.
  • Jensen, C. L., Voigt, R. G., Prager, T. C., Zou, Y. L., Fraley, J. K., Rozelle, J. C., Turcich, M. R., Llorente, A. M., Anderson, R. E., and Heird, W. C. Effects of maternal docosahexaenoic acid intake on visual function and neurodevelopment in breastfed term infants. Am J Clin Nutr 2005;82(1):125-132. View abstract.
  • Johnson, E. J. and Schaefer, E. J. Potential role of dietary n-3 fatty acids in the prevention of dementia and macular degeneration. Am J Clin Nutr 2006;83(6 Suppl):1494S-1498S. View abstract.
  • Johnson, E. J., Chung, H. Y., Caldarella, S. M., and Snodderly, D. M. The influence of supplemental lutein and docosahexaenoic acid on serum, lipoproteins, and macular pigmentation. Am J Clin Nutr 2008;87(5):1521-1529. View abstract.
  • Johnson, E. J., McDonald, K., Caldarella, S. M., Chung, H. Y., Troen, A. M., and Snodderly, D. M. Cognitive findings of an exploratory trial of docosahexaenoic acid and lutein supplementation in older women. Nutr Neurosci 2008;11(2):75-83. View abstract.
  • Jorgensen, M. H., Hernell, O., Lund, P., Holmer, G., and Michaelsen, K. F. Visual acuity and erythrocyte docosahexaenoic acid status in breast-fed and formula-fed term infants during the first four months of life. Lipids 1996;31(1):99-105. View abstract.
  • Jude, S., Martel, E., Vincent, F., Besson, P., Couet, C., Ogilvie, G. K., Pinault, M., De, Chalendar C., Bougnoux, P., Richard, S., Champeroux, P., Crozatier, B., and Le Guennec, J. Y. Dietary long-chain n-3 fatty acids modify blood and cardiac phospholipids and reduce protein kinase-C-delta and protein kinase-C-epsilon translocation. Br J Nutr 2007;98(6):1143-1151. View abstract.
  • Judge, M. P., Harel, O., and Lammi-Keefe, C. J. A docosahexaenoic acid-functional food during pregnancy benefits infant visual acuity at four but not six months of age. Lipids 2007;42(2):117-122. View abstract.
  • Judge, M. P., Harel, O., and Lammi-Keefe, C. J. Maternal consumption of a docosahexaenoic acid-containing functional food during pregnancy: benefit for infant performance on problem-solving but not on recognition memory tasks at age 9 mo. Am J Clin Nutr 2007;85(6):1572-1577. View abstract.
  • Jumpsen, J. A., Brown, N. E., Thomson, A. B., Paul Man, S. F., Goh, Y. K., Ma, D., and Clandinin, M. T. Fatty acids in blood and intestine following docosahexaenoic acid supplementation in adults with cystic fibrosis. J Cyst.Fibros. 2006;5(2):77-84. View abstract.
  • Kelley, D. S., Siegel, D., Fedor, D. M., Adkins, Y., and Mackey, B. E. DHA supplementation decreases serum C-reactive protein and other markers of inflammation in hypertriglyceridemic men. J Nutr 2009;139(3):495-501. View abstract.
  • Kelley, D. S., Siegel, D., Vemuri, M., and Mackey, B. E. Docosahexaenoic acid supplementation improves fasting and postprandial lipid profiles in hypertriglyceridemic men. Am J Clin Nutr 2007;86(2):324-333. View abstract.
  • Kelley, D. S., Taylor, P. C., Nelson, G. J., and Mackey, B. E. Dietary docosahexaenoic acid and immunocompetence in young healthy men. Lipids 1998;33(6):559-566. View abstract.
  • Kelley, D. S., Taylor, P. C., Nelson, G. J., Schmidt, P. C., Ferretti, A., Erickson, K. L., Yu, R., Chandra, R. K., and Mackey, B. E. Docosahexaenoic acid ingestion inhibits natural killer cell activity and production of inflammatory mediators in young healthy men. Lipids 1999;34(4):317-324. View abstract.
  • Kennedy, D. O., Jackson, P. A., Elliott, J. M., Scholey, A. B., Robertson, B. C., Greer, J., Tiplady, B., Buchanan, T., and Haskell, C. F. Cognitive and mood effects of 8 weeks' supplementation with 400 mg or 1000 mg of the omega-3 essential fatty acid docosahexaenoic acid (DHA) in healthy children aged 10-12 years. Nutr Neurosci 2009;12(2):48-56. View abstract.
  • Kew, S., Mesa, M. D., Tricon, S., Buckley, R., Minihane, A. M., and Yaqoob, P. Effects of oils rich in eicosapentaenoic and docosahexaenoic acids on immune cell composition and function in healthy humans. Am J Clin Nutr 2004;79(4):674-681. View abstract.
  • Khedr, E. M., Farghaly, W. M., Amry, Sel, and Osman, A. A. Neural maturation of breastfed and formula-fed infants. Acta Paediatr. 2004;93(6):734-738. View abstract.
  • Kim, J. G. and Parthasarathy, S. Oxidation and the spermatozoa. Semin.Reprod.Endocrinol 1998;16(4):235-239. View abstract.
  • Kimura, S., Saito, H., Minami, M., Togashi, H., Nakamura, N., Ueno, K., Shimamura, K., Nemoto, M., and Parvez, H. Docosahexaenoic acid attenuated hypertension and vascular dementia in stroke-prone spontaneously hypertensive rats. Neurotoxicol.Teratol. 2002;24(5):683-693. View abstract.
  • Koch, C., Dolle, S., Metzger, M., Rasche, C., Jungclas, H., Ruhl, R., Renz, H., and Worm, M. Docosahexaenoic acid (DHA) supplementation in atopic eczema: a randomized, double-blind, controlled trial. Br J Dermatol 2008;158(4):786-792. View abstract.
  • Koletzko, B., Beblo, S., Demmelmair, H., and Hanebutt, F. L. Omega-3 LC-PUFA supply and neurological outcomes in children with phenylketonuria (PKU). J Pediatr Gastroenterol Nutr 2009;48 Suppl 1:S2-S7. View abstract.
  • Koletzko, B., Larque, E., and Demmelmair, H. Placental transfer of long-chain polyunsaturated fatty acids (LC-PUFA). J Perinat.Med 2007;35 Suppl 1:S5-11. View abstract.
  • Kris-Etherton, P. M., Taylor, D. S., Yu-Poth, S., Huth, P., Moriarty, K., Fishell, V., Hargrove, R. L., Zhao, G., and Etherton, T. D. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 2000;71(1 Suppl):179S-188S. View abstract.
  • Kroes, R., Schaefer, E. J., Squire, R. A., and Williams, G. M. A review of the safety of DHA45-oil. Food Chem Toxicol. 2003;41(11):1433-1446. View abstract.
  • Lagarde, M., Bernoud, N., Brossard, N., Lemaitre-Delaunay, D., Thies, F., Croset, M., and Lecerf, J. Lysophosphatidylcholine as a preferred carrier form of docosahexaenoic acid to the brain. J.Mol.Neurosci. 2001;16(2-3):201-204. View abstract.
  • Lapillonne, A., Brossard, N., Claris, O., Reygrobellet, B., and Salle, B. L. Erythrocyte fatty acid composition in term infants fed human milk or a formula enriched with a low eicosapentanoic acid fish oil for 4 months. Eur J Pediatr 2000;159(1-2):49-53. View abstract.
  • Larque, E., Demmelmair, H., Berger, B., Hasbargen, U., and Koletzko, B. In vivo investigation of the placental transfer of (13)C-labeled fatty acids in humans. J Lipid Res 2003;44(1):49-55. View abstract.
  • Larque, E., Krauss-Etschmann, S., Campoy, C., Hartl, D., Linde, J., Klingler, M., Demmelmair, H., Cano, A., Gil, A., Bondy, B., and Koletzko, B. Docosahexaenoic acid supply in pregnancy affects placental expression of fatty acid transport proteins. Am J Clin Nutr 2006;84(4):853-861. View abstract.
  • Lauritzen, L., Jorgensen, M. H., Olsen, S. F., Straarup, E. M., and Michaelsen, K. F. Maternal fish oil supplementation in lactation: effect on developmental outcome in breast-fed infants. Reprod.Nutr Dev. 2005;45(5):535-547. View abstract.
  • Lee, J. Y., Plakidas, A., Lee, W. H., Heikkinen, A., Chanmugam, P., Bray, G., and Hwang, D. H. Differential modulation of Toll-like receptors by fatty acids: preferential inhibition by n-3 polyunsaturated fatty acids. J Lipid Res 2003;44(3):479-486. View abstract.
  • Lien, E. L. Toxicology and safety of DHA. Prostaglandins Leukot.Essent.Fatty Acids 2009;81(2-3):125-132. View abstract.
  • Llorente, A. M., Jensen, C. L., Voigt, R. G., Fraley, J. K., Berretta, M. C., and Heird, W. C. Effect of maternal docosahexaenoic acid supplementation on postpartum depression and information processing. Am.J.Obstet.Gynecol. 2003;188(5):1348-1353. View abstract.
  • Lloyd-Still, J. D., Powers, C. A., Hoffman, D. R., Boyd-Trull, K., Lester, L. A., Benisek, D. C., and Arterburn, L. M. Bioavailability and safety of a high dose of docosahexaenoic acid triacylglycerol of algal origin in cystic fibrosis patients: a randomized, controlled study. Nutrition 2006;22(1):36-46. View abstract.
  • Lopez-Alarcon, M., Bernabe-Garcia, M., Del, Prado M., Rivera, D., Ruiz, G., Maldonado, J., and Villegas, R. Docosahexaenoic acid administered in the acute phase protects the nutritional status of septic neonates. Nutrition 2006;22(7-8):731-737. View abstract.
  • Lopez-Alarcon, M., Furuya-Meguro, M. M., Garcia-Zuniga, P. A., and Tadeo-Pulido, I. [The effect of docosahexaenoic acid on the loss of appetite in pediatric patients with pneumonia]. Rev Med Inst.Mex.Seguro.Soc 2006;44(1):5-11. View abstract.
  • Lukiw, W. J. and Bazan, N. G. Docosahexaenoic acid and the aging brain. J Nutr 2008;138(12):2510-2514. View abstract.
  • Lukiw, W. J. Docosahexaenoic acid and amyloid-beta peptide signaling in Alzheimer's disease. World Rev Nutr Diet 2009;99:55-70. View abstract.
  • Lukiw, W. J., Cui, J. G., Marcheselli, V. L., Bodker, M., Botkjaer, A., Gotlinger, K., Serhan, C. N., and Bazan, N. G. A role for docosahexaenoic acid-derived neuroprotectin D1 in neural cell survival and Alzheimer disease. J Clin Invest 2005;115(10):2774-2783. View abstract.
  • Maki, K. C., Van Elswyk, M. E., McCarthy, D., Hess, S. P., Veith, P. E., Bell, M., Subbaiah, P., and Davidson, M. H. Lipid responses to a dietary docosahexaenoic acid supplement in men and women with below average levels of high density lipoprotein cholesterol. J Am Coll Nutr 2005;24(3):189-199. View abstract.
  • Maki, K. C., Van Elswyk, M. E., McCarthy, D., Seeley, M. A., Veith, P. E., Hess, S. P., Ingram, K. A., Halvorson, J. J., Calaguas, E. M., and Davidson, M. H. Lipid responses in mildly hypertriglyceridemic men and women to consumption of docosahexaenoic acid-enriched eggs. Int.J.Vitam.Nutr.Res. 2003;73(5):357-368. View abstract.
  • Makrides, M., Gibson, R. A., McPhee, A. J., Collins, C. T., Davis, P. G., Doyle, L. W., Simmer, K., Colditz, P. B., Morris, S., Smithers, L. G., Willson, K., and Ryan, P. Neurodevelopmental outcomes of preterm infants fed high-dose docosahexaenoic acid: a randomized controlled trial. JAMA 1-14-2009;301(2):175-182. View abstract.
  • Makrides, M., Gibson, R. A., McPhee, A. J., Yelland, L., Quinlivan, J., and Ryan, P. Effect of DHA supplementation during pregnancy on maternal depression and neurodevelopment of young children: a randomized controlled trial. JAMA 10-20-2010;304(15):1675-1683. View abstract.
  • Makrides, M., Gibson, R. A., Udell, T., and Ried, K. Supplementation of infant formula with long-chain polyunsaturated fatty acids does not influence the growth of term infants. Am J Clin Nutr 2005;81(5):1094-1101. View abstract.
  • Makrides, M., Neumann, M. A., Simmer, K., and Gibson, R. A. A critical appraisal of the role of dietary long-chain polyunsaturated fatty acids on neural indices of term infants: a randomized, controlled trial. Pediatrics 2000;105(1 Pt 1):32-38. View abstract.
  • Makrides, M., Neumann, M. A., Simmer, K., and Gibson, R. A. Dietary long-chain polyunsaturated fatty acids do not influence growth of term infants: A randomized clinical trial. Pediatrics 1999;104(3 Pt 1):468-475. View abstract.
  • Makrides, M., Simmer, K., Goggin, M., and Gibson, R. A. Erythrocyte docosahexaenoic acid correlates with the visual response of healthy, term infants. Pediatr.Res. 1993;33(4 Pt 1):425-427. View abstract.
  • Malcolm, C. A., Hamilton, R., McCulloch, D. L., Montgomery, C., and Weaver, L. T. Scotopic electroretinogram in term infants born of mothers supplemented with docosahexaenoic acid during pregnancy. Invest Ophthalmol.Vis.Sci. 2003;44(8):3685-3691. View abstract.
  • Marangell, L. B., Suppes, T., Ketter, T. A., Dennehy, E. B., Zboyan, H., Kertz, B., Nierenberg, A., Calabrese, J., Wisniewski, S. R., and Sachs, G. Omega-3 fatty acids in bipolar disorder: clinical and research considerations. Prostaglandins Leukot.Essent.Fatty Acids 2006;75(4-5):315-321. View abstract.
  • Martins, J. G. EPA but not DHA appears to be responsible for the efficacy of omega-3 long chain polyunsaturated fatty acid supplementation in depression: evidence from a meta-analysis of randomized controlled trials. J Am Coll Nutr 2009;28(5):525-542. View abstract.
  • Mazurak, V. C., Lien, V., Field, C. J., Goruk, S. D., Pramuk, K., and Clandinin, M. T. Long-chain polyunsaturated fat supplementation in children with low docosahexaenoic acid intakes alters immune phenotypes compared with placebo. J Pediatr Gastroenterol Nutr 2008;46(5):570-579. View abstract.
  • McNamara, R. K., Able, J., Jandacek, R., Rider, T., Tso, P., Eliassen, J. C., Alfieri, D., Weber, W., Jarvis, K., DelBello, M. P., Strakowski, S. M., and Adler, C. M. Docosahexaenoic acid supplementation increases prefrontal cortex activation during sustained attention in healthy boys: a placebo-controlled, dose-ranging, functional magnetic resonance imaging study. Am J Clin Nutr 2010;91(4):1060-1067. View abstract.
  • McNamara, R. K., Jandacek, R., Rider, T., Tso, P., Dwivedi, Y., and Pandey, G. N. Selective deficits in erythrocyte docosahexaenoic acid composition in adult patients with bipolar disorder and major depressive disorder. J Affect.Disord 2010;126(1-2):303-311. View abstract.
  • Mebarek, S., Ermak, N., Benzaria, A., Vicca, S., Dubois, M., Nemoz, G., Laville, M., Lacour, B., Vericel, E., Lagarde, M., and Prigent, A. F. Effects of increasing docosahexaenoic acid intake in human healthy volunteers on lymphocyte activation and monocyte apoptosis. Br J Nutr 2009;101(6):852-858. View abstract.
  • Meyer, B. J., Hammervold, T., Rustan, A. C., and Howe, P. R. Dose-dependent effects of docosahexaenoic acid supplementation on blood lipids in statin-treated hyperlipidaemic subjects. Lipids 2007;42(2):109-115. View abstract.
  • Michael-Titus, A. T. Omega-3 fatty acids and neurological injury. Prostaglandins Leukot.Essent.Fatty Acids 2007;77(5-6):295-300. View abstract.
  • Mickleborough, T. D., Tecklenburg, S. L., Montgomery, G. S., and Lindley, M. R. Eicosapentaenoic acid is more effective than docosahexaenoic acid in inhibiting proinflammatory mediator production and transcription from LPS-induced human asthmatic alveolar macrophage cells. Clin Nutr 2009;28(1):71-77. View abstract.
  • Miller, C., Yamaguchi, R. Y., and Ziboh, V. A. Guinea pig epidermis generates putative anti-inflammatory metabolites from fish oil polyunsaturated fatty acids. Lipids 1989;24(12):998-1003. View abstract.
  • Milte, C. M., Coates, A. M., Buckley, J. D., Hill, A. M., and Howe, P. R. Dose-dependent effects of docosahexaenoic acid-rich fish oil on erythrocyte docosahexaenoic acid and blood lipid levels. Br J Nutr 2008;99(5):1083-1088. View abstract.
  • Mischoulon, D., Best-Popescu, C., Laposata, M., Merens, W., Murakami, J. L., Wu, S. L., Papakostas, G. I., Dording, C. M., Sonawalla, S. B., Nierenberg, A. A., Alpert, J. E., and Fava, M. A double-blind dose-finding pilot study of docosahexaenoic acid (DHA) for major depressive disorder. Eur Neuropsychopharmacol. 2008;18(9):639-645. View abstract.
  • Mitmesser, S. H. and Jensen, C. L. Roles of long-chain polyunsaturated fatty acids in the term infant: developmental benefits. Neonatal Netw. 2007;26(4):229-234. View abstract.
  • Moore, S. A. Polyunsaturated fatty acid synthesis and release by brain-derived cells in vitro. J Mol Neurosci 2001;16(2-3):195-200. View abstract.
  • Moore, S. A., Hurt, E., Yoder, E., Sprecher, H., and Spector, A. A. Docosahexaenoic acid synthesis in human skin fibroblasts involves peroxisomal retroconversion of tetracosahexaenoic acid. J.Lipid Res. 1995;36(11):2433-2443. View abstract.
  • Mori, T. A., Bao, D. Q., Burke, V., Puddey, I. B., and Beilin, L. J. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension 1999;34(2):253-260. View abstract.
  • Mori, T. A., Watts, G. F., Burke, V., Hilme, E., Puddey, I. B., and Beilin, L. J. Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men. Circulation 9-12-2000;102(11):1264-1269. View abstract.
  • Mori, T. A., Woodman, R. J., Burke, V., Puddey, I. B., Croft, K. D., and Beilin, L. J. Effect of eicosapentaenoic acid and docosahexaenoic acid on oxidative stress and inflammatory markers in treated-hypertensive type 2 diabetic subjects. Free Radic.Biol Med 10-1-2003;35(7):772-781. View abstract.
  • Mucke, L. and Pitas, R. E. Food for thought: essential fatty acid protects against neuronal deficits in transgenic mouse model of AD. Neuron 9-2-2004;43(5):596-599. View abstract.
  • Mukherjee, P. K., Chawla, A., Loayza, M. S., and Bazan, N. G. Docosanoids are multifunctional regulators of neural cell integrity and fate: significance in aging and disease. Prostaglandins Leukot.Essent.Fatty Acids 2007;77(5-6):233-238. View abstract.
  • Mullen, A., Loscher, C. E., and Roche, H. M. Anti-inflammatory effects of EPA and DHA are dependent upon time and dose-response elements associated with LPS stimulation in THP-1-derived macrophages. J Nutr Biochem 2010;21(5):444-450. View abstract.
  • Neff, L. M., Culiner, J., Cunningham-Rundles, S., Seidman, C., Meehan, D., Maturi, J., Wittkowski, K. M., Levine, B., and Breslow, J. L. Algal docosahexaenoic acid affects plasma lipoprotein particle size distribution in overweight and obese adults. J Nutr 2011;141(2):207-213. View abstract.
  • Nestel, P., Shige, H., Pomeroy, S., Cehun, M., Abbey, M., and Raederstorff, D. The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. Am.J.Clin.Nutr. 2002;76(2):326-330. View abstract.
  • Nobili, V., Bedogni, G., Alisi, A., Pietrobattista, A., Rise, P., Galli, C., and Agostoni, C. Docosahexaenoic acid supplementation decreases liver fat content in children with non-alcoholic fatty liver disease: double-blind randomised controlled clinical trial. Arch Dis Child 2011;96(4):350-353. View abstract.
  • O'Brien, D. M., Kristal, A. R., Jeannet, M. A., Wilkinson, M. J., Bersamin, A., and Luick, B. Red blood cell delta15N: a novel biomarker of dietary eicosapentaenoic acid and docosahexaenoic acid intake. Am J Clin Nutr 2009;89(3):913-919. View abstract.
  • Antoine, C., Liebens, F., Carly, B., Pastijn, A., and Rozenberg, S. Safety of alternative treatments for menopausal symptoms after breast cancer: a qualitative systematic review. Climacteric. 2007;10(1):23-26. View abstract.
  • Boblitz N, Schrader E, Henneicke-von Zepelin HH, and et al. Benefit of a fixed drug combination containing St. John's wort and black cohosh for climacteric patients -- results of a randomised clinical trial (poster presentaion from 6th Annual Symposium on Complementary Health Care, Exeter, England, December 2-4, 1999). Focus Alt Comp Ther (FACT) 2000;5(1):85-86.
  • Booth, N. L., Nikolic, D., van Breemen, R. B., Geller, S. E., Banuvar, S., Shulman, L. P., and Farnsworth, N. R. Confusion regarding anticoagulant coumarins in dietary supplements. Clin Pharmacol.Ther 2004;76(6):511-516. View abstract.
  • Borrelli F, Mascolo N, Russo A, and et al. Cimicifuga racemosa: a systematic review of its clinical and pharmacological effects. 8th Annual Symposium on Complementary Health Care, 6th-8th December 2001 2001;
  • Borrelli, F. and Ernst, E. Black cohosh (Cimicifuga racemosa) for menopausal symptoms: a systematic review of its efficacy. Pharmacol.Res 2008;58(1):8-14. View abstract.
  • Borrelli, F. and Ernst, E. Black cohosh (Cimicifuga racemosa): a systematic review of adverse events. Am J Obstet.Gynecol. 2008;199(5):455-466. View abstract.
  • Borrelli, F. and Ernst, E. Cimicifuga racemosa: a systematic review of its clinical efficacy. Eur J Clin Pharmacol 2002;58(4):235-241. View abstract.
  • Bruno, D. and Feeney, K. J. Management of postmenopausal symptoms in breast cancer survivors. Semin.Oncol. 2006;33(6):696-707. View abstract.
  • Buettner, C., Mukamal, K. J., Gardiner, P., Davis, R. B., Phillips, R. S., and Mittleman, M. A. Herbal supplement use and blood lead levels of United States adults. J.Gen.Intern.Med. 2009;24(11):1175-1182. View abstract.
  • Burdette, J. E., Chen, S. N., Lu, Z. Z., Xu, H., White, B. E., Fabricant, D. S., Liu, J., Fong, H. H., Farnsworth, N. R., Constantinou, A. I., van Breemen, R. B., Pezzuto, J. M., and Bolton, J. L. Black cohosh (Cimicifuga racemosa L.) protects against menadione-induced DNA damage through scavenging of reactive oxygen species: bioassay-directed isolation and characterization of active principles. J Agric.Food Chem 11-20-2002;50(24):7022-7028. View abstract.
  • Carroll, D. G. Nonhormonal therapies for hot flashes in menopause. Am Fam.Physician 2-1-2006;73(3):457-464. View abstract.
  • Centre for Reviews and Dissemination. Complementary and alternative therapies for the management of menopause-related symptoms: a systematic evidence review (;Structured abstract). Database of Abstracts of Reviews of Effects, 2012;(3)
  • Cheema, D., Coomarasamy, A., and El Toukhy, T. Non-hormonal therapy of post-menopausal vasomotor symptoms: a structured evidence-based review. Arch Gynecol.Obstet 2007;276(5):463-469. View abstract.
  • Cimicifuga racemosa - Monograph. Altern.Med Rev 2003;8(2):186-189. View abstract.
  • Daiber W. Menopause symptoms: success without hormones. Arztl Praxis 1983;35:1946-1947.
  • Davis, V. L., Jayo, M. J., Ho, A., Kotlarczyk, M. P., Hardy, M. L., Foster, W. G., and Hughes, C. L. Black cohosh increases metastatic mammary cancer in transgenic mice expressing c-erbB2. Cancer Res 10-15-2008;68(20):8377-8383. View abstract.
  • Einbond, L. S., Shimizu, M., Nuntanakorn, P., Seter, C., Cheng, R., Jiang, B., Kronenberg, F., Kennelly, E. J., and Weinstein, I. B. Actein and a fraction of black cohosh potentiate antiproliferative effects of chemotherapy agents on human breast cancer cells. Planta Med 2006;72(13):1200-1206. View abstract.
  • Einbond, L. S., Soffritti, M., Esposti, D. D., Park, T., Cruz, E., Su, T., Wu, H. A., Wang, X., Zhang, Y. J., Ham, J., Goldberg, I. J., Kronenberg, F., and Vladimirova, A. Actein activates stress- and statin-associated responses and is bioavailable in Sprague-Dawley rats. Fundam.Clin Pharmacol. 2009;23(3):311-321. View abstract.
  • Einbond, L. S., Su, T., Wu, H. A., Friedman, R., Wang, X., Jiang, B., Hagan, T., Kennelly, E. J., Kronenberg, F., and Weinstein, I. B. Gene expression analysis of the mechanisms whereby black cohosh inhibits human breast cancer cell growth. Anticancer Res 2007;27(2):697-712. View abstract.
  • Einbond, L. S., Su, T., Wu, H. A., Friedman, R., Wang, X., Ramirez, A., Kronenberg, F., and Weinstein, I. B. The growth inhibitory effect of actein on human breast cancer cells is associated with activation of stress response pathways. Int J Cancer 11-1-2007;121(9):2073-2083. View abstract.
  • Ernst, E. and Chrubasik, S. Phyto-anti-inflammatories. A systematic review of randomized, placebo-controlled, double-blind trials. Rheum.Dis Clin North Am 2000;26(1):13-27, vii. View abstract.
  • Fugh-Berman, A. and Ernst, E. Herb-drug interactions: review and assessment of report reliability. Br J Clin Pharmacol 2001;52(5):587-595. View abstract.
  • Garita-Hernandez, M., Calzado, M. A., Caballero, F. J., Macho, A., Munoz, E., Meier, B., Brattstrom, A., Fiebich, B. L., and Appel, K. The growth inhibitory activity of the Cimicifuga racemosa extract Ze 450 is mediated through estrogen and progesterone receptors-independent pathways. Planta Med 2006;72(4):317-323. View abstract.
  • Geller, S. E. and Studee, L. Contemporary alternatives to plant estrogens for menopause. Maturitas 11-1-2006;55 Suppl 1:S3-13. View abstract.
  • Genazzani E and Sorrentino L. Vascular action of acteina: active constituent of Actaea racemosa L. Nature 1962;194(4828):544-545.
  • Gingrich, P. M. and Fogel, C. I. Herbal therapy use by perimenopausal women. J Obstet.Gynecol.Neonatal Nurs. 2003;32(2):181-189. View abstract.
  • Grippo, A. A., Hamilton, B., Hannigan, R., and Gurley, B. J. Metal content of ephedra-containing dietary supplements and select botanicals. Am J Health Syst.Pharm 4-1-2006;63(7):635-644. View abstract.
  • Gurley, B. J., Barone, G. W., Williams, D. K., Carrier, J., Breen, P., Yates, C. R., Song, P. F., Hubbard, M. A., Tong, Y., and Cheboyina, S. Effect of milk thistle (Silybum marianum) and black cohosh (Cimicifuga racemosa) supplementation on digoxin pharmacokinetics in humans. Drug Metab Dispos. 2006;34(1):69-74. View abstract.
  • Guttuso, T., Jr. Effective and clinically meaningful non-hormonal hot flash therapies. Maturitas 2012;72(1):6-12. View abstract.
  • Hanna K, Day A O'Neill S Patterson C Lyons-Wall P. Does scientific evidence support the use of non-prescription supplements for treatment of acute menopausal symptoms such as hot flushes? Nutrition & Dietetics 2005;62(4):138-151.
  • He, K., Zheng, B., Kim, C. H., Rogers, L., and Zheng, Q. Direct analysis and identification of triterpene glycosides by LC/MS in black cohosh, Cimicifuga racemosa, and in several commercially available black cohosh products. Planta Med 2000;66(7):635-640. View abstract.
  • Hemachandra, L. P., Madhubhani, P., Chandrasena, R., Esala, P., Chen, S. N., Main, M., Lankin, D. C., Scism, R. A., Dietz, B. M., Pauli, G. F., Thatcher, G. R., and Bolton, J. L. Hops (Humulus lupulus) inhibits oxidative estrogen metabolism and estrogen-induced malignant transformation in human mammary epithelial cells (MCF-10A). Cancer Prev.Res (Phila) 2012;5(1):73-81. View abstract.
  • Hirschberg, A. L., Edlund, M., Svane, G., Azavedo, E., Skoog, L., and von, Schoultz B. An isopropanolic extract of black cohosh does not increase mammographic breast density or breast cell proliferation in postmenopausal women. Menopause. 2007;14(1):89-96. View abstract.
  • Hostanska, K., Nisslein, T., Freudenstein, J., Reichling, J., and Saller, R. Apoptosis of human prostate androgen-dependent and -independent carcinoma cells induced by an isopropanolic extract of black cohosh involves degradation of cytokeratin (CK) 18. Anticancer Res 2005;25(1A):139-147. View abstract.
  • Huang, Y., Jiang, B., Nuntanakorn, P., Kennelly, E. J., Shord, S., Lawal, T. O., and Mahady, G. B. Fukinolic acid derivatives and triterpene glycosides from black cohosh inhibit CYP isozymes, but are not cytotoxic to Hep-G2 cells in vitro. Curr Drug Saf 2010;5(2):118-124. View abstract.
  • Huntley, A. L. and Ernst, E. A systematic review of herbal medicinal products for the treatment of menopausal symptoms. Menopause. 2003;10(5):465-476. View abstract.
  • Johnson, B. M. and van Breemen, R. B. In vitro formation of quinoid metabolites of the dietary supplement Cimicifuga racemosa (black cohosh). Chem.Res Toxicol. 2003;16(7):838-846. View abstract.
  • Julia Molla, M. D., Garcia-Sanchez, Y., Romeu, Sarri A., and Perez-lopez, F. R. Cimicifuga racemosa treatment and health related quality of life in post-menopausal Spanish women. Gynecol.Endocrinol. 2009;25(1):21-26. View abstract.
  • Kanadys, W. M., Leszczynska-Gorzelak, B., and Oleszczuk, J. [Efficacy and safety of Black cohosh (Actaea/Cimicifuga racemosa) in the treatment of vasomotor symptoms--review of clinical trials]. Ginekol.Pol. 2008;79(4):287-296. View abstract.
  • Kang, H. J., Ansbacher, R., and Hammoud, M. M. Use of alternative and complementary medicine in menopause. Int.J Gynaecol.Obstet. 2002;79(3):195-207. View abstract.
  • Kelley, K. W. and Carroll, D. G. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. J.Am.Pharm.Assoc.(2003.) 2010;50(5):e106-e115. View abstract.
  • Kim, C. D., Lee, W. K., Lee, M. H., Cho, H. S., Lee, Y. K., and Roh, S. S. Inhibition of mast cell-dependent allergy reaction by extract of black cohosh (Cimicifuga racemosa). Immunopharmacol Immunotoxicol. 2004;26(2):299-308. View abstract.
  • Kupferer, E. M., Dormire, S. L., and Becker, H. Complementary and alternative medicine use for vasomotor symptoms among women who have discontinued hormone therapy. J Obstet.Gynecol.Neonatal Nurs. 2009;38(1):50-59. View abstract.
  • Li, W., Sun, Y., Liang, W., Fitzloff, J. F., and van Breemen, R. B. Identification of caffeic acid derivatives in Actea racemosa (Cimicifuga racemosa, black cohosh) by liquid chromatography/tandem mass spectrometry. Rapid Commun.Mass Spectrom. 2003;17(9):978-982. View abstract.
  • Liske E and Wüstenberg P. Therapy of climacteric complaints with Cimicifuga racemosa: herbal medicine with clinically proven evidence [poster presentation]. Menopause 1998;5(4):250.
  • Liske E, Wüstenberg P, and Boblitz N. Human-pharmacological investigations during treatment of climacteric complaints with Cimicifuga racemosa (Remifemin): No estrogen-like effects. ESCOP 2001;1:1.
  • Long, L., Soeken, K., and Ernst, E. Herbal medicines for the treatment of osteoarthritis: a systematic review. Rheumatology.(Oxford) 2001;40(7):779-793. View abstract.
  • Loprinzi, C. L., Barton, D. L., Sloan, J. A., Novotny, P. J., Dakhil, S. R., Verdirame, J. D., Knutson, W. H., Kelaghan, J., and Christensen, B. Mayo Clinic and North Central Cancer Treatment Group hot flash studies: a 20-year experience. Menopause. 2008;15(4 Pt 1):655-660. View abstract.
  • Low, Dog T. Menopause: a review of botanical dietary supplements. Am J Med 12-19-2005;118 Suppl 12B:98-108. View abstract.
  • Lundstrom, E., Christow, A., Kersemaekers, W., Svane, G., Azavedo, E., Soderqvist, G., Mol-Arts, M., Barkfeldt, J., and von, Schoultz B. Effects of tibolone and continuous combined hormone replacement therapy on mammographic breast density. Am J Obstet.Gynecol. 2002;186(4):717-722. View abstract.
  • Lundstrom, E., Hirschberg, A. L., and Soderqvist, G. Digitized assessment of mammographic breast density--effects of continuous combined hormone therapy, tibolone and black cohosh compared to placebo. Maturitas 2011;70(4):361-364. View abstract.
  • Maclennan, A. H. Evidence-based review of therapies at the menopause. Int.J Evid.Based.Healthc. 2009;7(2):112-123. View abstract.
  • Mahady, G., Low, Dog T., Sarma, D. N., and Giancaspro, G. I. Suspected black cohosh hepatotoxicity--causality assessment versus safety signal. Maturitas 10-20-2009;64(2):139-140. View abstract.
  • Mazaro-Costa, R., Andersen, M. L., Hachul, H., and Tufik, S. Medicinal plants as alternative treatments for female sexual dysfunction: utopian vision or possible treatment in climacteric women? J.Sex Med. 2010;7(11):3695-3714. View abstract.
  • McBane, S. E. Easing vasomotor symptoms: Besides HRT, what works? JAAPA. 2008;21(4):26-31. View abstract.
  • McKenna, D. J., Jones, K., Humphrey, S., and Hughes, K. Black cohosh: efficacy, safety, and use in clinical and preclinical applications. Altern Ther Health Med 2001;7(3):93-100. View abstract.
  • McKenzie, S. C. and Rahman, A. Bradycardia in a patient taking black cohosh. Med J Aust. 10-18-2010;193(8):479-481. View abstract.
  • Mohamed, M. E. and Frye, R. F. Inhibitory effects of commonly used herbal extracts on UDP-glucuronosyltransferase 1A4, 1A6, and 1A9 enzyme activities. Drug Metab Dispos. 2011;39(9):1522-1528. View abstract.
  • Mohamed, M. F., Tseng, T., and Frye, R. F. Inhibitory effects of commonly used herbal extracts on UGT1A1 enzyme activity. Xenobiotica 2010;40(10):663-669. View abstract.
  • Naser, B. and Liske, E. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust. 1-19-2009;190(2):99. View abstract.
  • Nash LI, Desindes S. Canadian consensus conference on menopause 2006 update. J Obstet Gynaecol Can 2006;28:S69-74.
  • Nedrow, A., Miller, J., Walker, M., Nygren, P., Huffman, L. H., and Nelson, H. D. Complementary and alternative therapies for the management of menopause-related symptoms: a systematic evidence review. Arch Intern.Med 7-24-2006;166(14):1453-1465. View abstract.
  • Nesselhut T, Schellhase C, Dietrich R, and et al. [Investigations into the growth-inhibitive efficacy of phytopharmacopia with estrogen-like influences on mammary gland carcinoma cells] (translated from German). Arch Gynecol Obstet 1993;254:817-818.
  • Newton, K. M., Reed, S. D., LaCroix, A. Z., Grothaus, L. C., Ehrlich, K., and Guiltinan, J. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med 12-19-2006;145(12):869-879. View abstract.
  • Ng, S. S. and Figg, W. D. Antitumor activity of herbal supplements in human prostate cancer xenografts implanted in immunodeficient mice. Anticancer Res 2003;23(5A):3585-3590. View abstract.
  • Nisslein, T. and Freudenstein, J. Effects of an isopropanolic extract of Cimicifuga racemosa on urinary crosslinks and other parameters of bone quality in an ovariectomized rat model of osteoporosis. J Bone Miner.Metab 2003;21(6):370-376. View abstract.
  • Noguchi, M., Nagai, M., Koeda, M., Nakayama, S., Sakurai, N., Takahira, M., and Kusano, G. Vasoactive effects of cimicifugic acids C and D, and fukinolic acid in cimicifuga rhizome. Biol Pharm Bull 1998;21(11):1163-1168. View abstract.
  • Nuntanakorn, P., Jiang, B., Einbond, L. S., Yang, H., Kronenberg, F., Weinstein, I. B., and Kennelly, E. J. Polyphenolic constituents of Actaea racemosa. J Nat Prod 2006;69(3):314-318. View abstract.
  • Nuntanakorn, P., Jiang, B., Yang, H., Cervantes-Cervantes, M., Kronenberg, F., and Kennelly, E. J. Analysis of polyphenolic compounds and radical scavenging activity of four American Actaea species. Phytochem.Anal. 2007;18(3):219-228. View abstract.
  • Onorato, J. and Henion, J. D. Evaluation of triterpene glycoside estrogenic activity using LC/MS and immunoaffinity extraction. Anal.Chem 10-1-2001;73(19):4704-4710. View abstract.
  • Palacio, C., Masri, G., and Mooradian, A. D. Black cohosh for the management of menopausal symptoms : a systematic review of clinical trials. Drugs Aging 2009;26(1):23-36. View abstract.
  • Pang, X., Cheng, J., Krausz, K. W., Guo, D. A., and Gonzalez, F. J. Pregnane X receptor-mediated induction of Cyp3a by black cohosh. Xenobiotica 2011;41(2):112-123. View abstract.
  • Petho A. Climacteric complaints are often helped with black cohosh. Ärztliche Praxis 1987;47:1551-1553.
  • Pierard, S., Coche, J. C., Lanthier, P., Dekoninck, X., Lanthier, N., Rahier, J., and Geubel, A. P. Severe hepatitis associated with the use of black cohosh: a report of two cases and an advice for caution. Eur J Gastroenterol Hepatol. 2009;21(8):941-945. View abstract.
  • Pinkerton, J. V., Stovall, D. W., and Kightlinger, R. S. Advances in the treatment of menopausal symptoms. Womens Health (Lond Engl.) 2009;5(4):361-384. View abstract.
  • Rhyu, M. R., Lu, J., Webster, D. E., Fabricant, D. S., Farnsworth, N. R., and Wang, Z. J. Black cohosh (Actaea racemosa, Cimicifuga racemosa) behaves as a mixed competitive ligand and partial agonist at the human mu opiate receptor. J Agric.Food Chem 12-27-2006;54(26):9852-9857. View abstract.
  • Richardson, M. K. Black cohosh...a cautionary tale! Menopause. 2008;15(4 Pt 1):583. View abstract.

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