The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

  • Support this site

    If you found the information here helpful, please consider supporting this site.If you found the information here helpful, please consider supporting this site.

  • Recent Posts

  • Recent Comments

    Differing point of view on black cohosh and liver toxicity

    Drs. Luigi Gori and Fabio Firenzuoli from the Center of Natural Medicine, S. Giuseppe Hospital in Italy think the European Medicines Agency (EMEA) and the Committee on Herbal Medicinal Products (HMPC) erred in their assessment of the risk of liver toxicity to Cimicifugae racemosae rhizoma (black cohosh, root).

    The EMEA and HMPC reviewed 42 reports and reported that the cases were “poorly documented,” and only “two can be considered as possible” and “two can be classified as probable.”

    They concluded, “The HMPC would like to draw the attention of the public to the potential serious hepatic reactions that may occur in patients using herbal medicinal products containing Cimicifugae racemosae rhizoma (black cohosh, root).

    Not so fast say Gori and Firenzuoli.
    “In our opinion it is very important to know the brand, the dose of substance consumed, the type of extract, the content of possible contaminants (wrong plants, pesticides, heavy metals, aflatoxins) before making an official statement about any adverse reaction to a herb-based product.”

    If the preparation investigated contains several substances, no clear connection can be established between adverse reactions and a single herb, unless it is a well-known hepatotoxic substance or it accounts for a very high proportion in the respective remedy.

    They believe, “For the time being, the EMEA statement can, paradoxically, be regarded as the proof that the risk of black cohosh hepatoxicity is small: although every year millions of doses of black cohosh are used worldwide?, no fully documented case of liver adverse reaction has been reported so far. To the contrary, safety of black cohosh can be regarded as sufficiently established by the fact that clinical trials in a total of more than 2,000 participants have not reported any hepatotoxic reactions.

    Hat tip to Jonathan Treasure’s Herblog.

    8/11/07 21:27 JR

    Leave a Comment

    XHTML: Line-breaks are automatic. Available tags are <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <s> <strike> <strong>