Black/Blue CohoshLiver Disease

The changing view of black cohosh and liver toxicity

 This is the third review in the past year that has come to the same conclusion.

This time, researchers from the Johann Wolfgang Goethe-University, in Hanau, Germany evaluated the relationship between suspected liver toxicity in 9 patients treated with black cohosh (Actaea racemosa and Cimicifuga racemosa).

First, the details.

  • The authors evaluated 9 cases with suspected liver toxicity associated with using black cohosh.
  • The updated Council for International Organizations of Medical Sciences scale was used to assess the likelihood that liver damage was caused by black cohosh.

And, the results.

  • In 8 of 9 patients the likelihood of their liver disease being due to black cohosh was negative or unlikely.
  • In only 1 case was it possible that 2 months of taking black cohosh was responsible, although the brand and dose were unknown.
  • Other possible causes in this case included gallstones and fatty liver.
  • Cotreatment with synthetic drugs and herbal or other dietary supplements was reported in 5 of 9 patients.

The bottom line?
The authors concluded, “Due to this lack of significant circumstantial evidence, the present study shows little, if any, hepatotoxic risks by the use of black cohosh in the analyzed cases.”

Over the past 2 years there has been a shift in the assessment of risk for liver toxicity with taking black cohosh. Reading backward through the summaries linked here illustrates this change in thinking.

4/4/09 22:06 JR

Hi, I’m JR

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.