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

    This blog ran from 2006 to 2016 and was 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, 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.

  • Recent Posts

  • Recent Comments

    What we know about black cohosh

    A continuing education article on Medscape presents a nice summary on the use of black cohosh to treat the symptoms of menopause.

    Current use

    • It’s an alternative to hormonal therapy to treat hot flashes, mood disturbances, sweating, heart palpitations, and vaginal dryness.
    • Supporting evidence is mixed, especially beyond 6 months of treatment.
    • Most studies use the black cohosh product Remifemin (Schaper & Brümmer).

    What we know.

    • Black cohosh is well tolerated for up to 6 months.
    • Side effects include rash and gastrointestinal symptoms, headache, nausea, dizziness, seizures, sweating, or constipation.
    • Low blood pressure has been reported.
    • Hepatitis and liver toxicity have been reported.
    • There are reports of interactions with drugs that are metabolized via the CYP450 liver enzyme system.
      • CYP450 enzymes account for almost half of the elimination of commonly used drugs, although that does not mean they are all significantly affected.
    • Use with salicylates and medicine associated with bleeding risk, including anticoagulants or herbs such as garlic and ginkgo biloba, is not recommended.

    What we don’t know.

    • The mechanism of its action is not known.
    • Safety during pregnancy and breastfeeding is not known.
    • The effect of black cohosh with estrogens, evening primrose oil, soy, and other products that have purported estrogenic properties is not known.

    Now you know.

    2/14/08 15:10 JR

    Leave a Comment

    You must be logged in to post a comment.