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Black cohosh

Category: Medicines - plant based



Introduction and description


Actaea racemosa (black cohosh, black bugbane, black snakeroot, fairy candle; syn. Cimicifuga racemosa) is a species of flowering plant of the family Ranunculaceae.

It is native to eastern North America from the extreme south of Ontario to central Georgia, and west to Missouri and Arkansas.

It grows in a variety of woodland habitats, and is often found in small woodland openings.

The roots and rhizomes have long been used medicinally by Native Americans, and extracts from these plant materials possess analgesic, sedative, and anti-inflammatory properties.

Today, black cohosh extracts are being studied as effective treatments for symptoms associated with menopause.



Black cohosh is a herbaceous perennial that produces large, compound leaves from an underground rhizome, reaching a height of 25–60 cm (9.8–23.6 in). The basal leaves are up to 1 m (3 ft 3 in) long and broad, forming repeated sets of three leaflets having a coarsely toothed (serrated) margin.

It bears tall tapering racemes of white midsummer flowers on wiry black-purple stems, 75–250 cm (30–98 in) tall, forming racemes up to 50 cm (20 in) long.

The flowers have no petals or sepals, and consist of tight clusters of 55-110 white, 5–10 mm (0.20–0.39 in) long stamens surrounding a white stigma. The flowers have a distinctly sweet, fetid smell that attracts flies, gnats, and beetles. Their mildly unpleasant, medicinal smell at close range gives the plant its common name "Bugbane".

The fruit is a dry follicle 5–10 mm (0.20–0.39 in) long, with one carpel, containing several seeds. 


The plant produces a stout, blackish rhizome (creeping underground stem), cylindrical, hard and knotty, bearing the remains of numerous stout ascending branches.  The straight, stout, dark brown roots which are given off from the under surface of the rhizome are bluntly quadrangular and furrowed. In transverse section, they show several wedge-shaped bundles of porous, whitish wood. A similar section of the rhizome shows a large dark-coloured, horny pith, surrounded by a ring of numerous pale wedges of wood, alternately with dark rays, outside which is a thin, dark, horny bark.

A bit of history

The Native American Indians used Black Cohosh extensively in their medicine and the European settlers who came to the U.S. continued the medicinal usage of Black Cohosh.  So useful was it that the settlers even sent seeds back to Europe for use in ‘physicke gardens’.  The plant appeared in the U.S. Pharmacopoeia in 1830 under the name “black snakeroot”.

In 1844, A. racemosa gained popularity when a doctor called John King, used it to treat rheumatism and nervous disorders. It was widely used in the mid-nineteenth century for a variety of maladies related to the female reproductive system, including endometritis, amenorrhea, dysmenorrhea, menorrhagia, sterility, severe after-birth pains, and for increased breast milk production.

The plant species has a history of taxonomic uncertainty dating back to Carl Linnaeus, who — on the basis of morphological characteristics of the inflorescence and seeds —placed the species into the genus Actaea. This designation was later revised by Thomas Nuttall reclassifying the species to the genus Cimicifuga, however, recent data from morphological and gene phylogeny analyses demonstrate that black cohosh is more closely related to species of the genus Actaea than to other Cimicifuga species. So the plant has been renamed Actaea racemosa just as Linnaeus originally intended. Blue cohosh (Caulophyllum thalictroides), despite its similar common name belongs to another family, the Berberidaceae, and is therefore not closely related to black cohosh.



A. racemosa grows in dependably moist, fairly heavy soil.  It makes a very pleasant garden plant.  The drying seed heads stay handsome in the garden for many weeks, for example, and its deeply cut leaves, burgundy coloured in the variety "atropurpurea", add interest to gardens, wherever summer heat and drought do not make it die back, which make it a popular garden perennial. It has gained the Royal Horticultural Society's Award of Garden Merit.

It should be sown as soon as the season will permit. It flowers in June or early in July, but according to Mrs Grieve “does not perfect seed in England”, though it thrives well in moist shady borders and is perfectly hardy. It may thrive better in the rest of Europe.

There is one thing which deserves noting.  Black cohosh is a chelating agent

If grown on unadulterated soil it can chelate us - meaning it can help rid us of metals like aluminium that cause dementia and destroy the blood brain barrier, leading to any number of problems  related to brain damage.  BUT, if the ground on which Black Cohosh is grown is in any way polluted with lead, aluminium or other heavy metals, it will take them up in its roots

This may be why some over the counter products sold in tablet form have been accused of being 'adulterated'.  They were not deliberately adulterated, they were adulterated by virtue of the fact they were grown on polluted soil.

Medicinal use


Dr Duke’s analysis, which we have provided below, shows that Black cohosh, via its chemical constituents, has a large range of activity.  It is anti-viral, anti-bacterial and anti-parasitical.  The researchers have not yet caught up with the herbalists in determining which parasites, which viruses and which bacteria, but no doubt that will come in time and as often happens simply confirm what the herbalists already know, but give it more scientific foundation.

It is the rhizome that has been traditionally used in medicine and it is collected in the autumn after the fruit has formed and the leaves have died down.  It is then cut into pieces and dried. It has only a faint, disagreeable odour, but a bitter and acrid taste.  

Native Americans used black cohosh to treat gynaecological disorders and Black cohosh is at last beginning to be recommended by doctors [in the UK and Europe at least]  for women suffering from the menopause, premenstrual tension and pain and other gynaecological problems.  One observation shows that the triterpenes have an impact here.

But, the key here is to use the entire plant.  Some ‘extracts’ are just this – extracts - and it is clear from looking at the papers that it is the entire plant that is key to success – the combination of chemicals.  This will be apparent when you look at the analysis from Dr Duke, showing the variety of activity.   If we look at Mrs Grieve’s analysis and medicinal usages, no mention is made of menopause, instead the emphasis is in the anti-pathogenic activity – anti-viral and anti-bacterial

Mrs Grieve’s herbal
The root of this plant is much used in America in many disorders, and is supposed to be an antidote against poison and the bite of the rattlesnake. The fresh root, dug in October, is used to make a tincture. In small doses, it is useful in children's diarrhoea. In the paroxyms of consumption, it gives relief by allaying the cough, reducing the rapidity of the pulse and inducing perspiration. In whooping-cough, it proves very effective. The infusion and decoction have been given with success in rheumatism. In infantile disorders, it is given in the form of syrup. It is said to be a specific in St. Vitus' Dance of children. Overdoses produce nausea and vomiting.

Overdoses produce nausea and vomiting – in effect at too high a dose it becomes a poison.


 It is also clear from looking at the papers that there are some vendors selling so called ‘Black Cohosh’ whose contents are not Black Cohosh at all.  In Europe, the contents of herbal medicines is to a certain extent regulated, in the US, it is not.  The Cochrane Collaboration, using US based products, concluded that there was insufficient evidence to support its use for menopausal symptoms, in total contrast to the European studies that found – using European produced and controlled medicines that it was effective.

This means that if you are based in the US, it is probably better to grow your own plants in the garden.

There have been a number of somewhat unsubstantiated statements claiming liver damage and even increased risk of womb damage from Black Cohosh.  But on looking at the sources it is clear that there may be, shall we say, monetary reasons why some of these reports are coming out.

There is a risk from overdose.  But this is true of all things ingested – too much and you poison yourself and thus risk liver damage.  The main risk that has been identified which is absolutely genuine is again the quality of the products for sale and the unregulated nature of this area:  

Herb induced liver injury (HILI) is a particular challenge that also applies to purported cases caused by black cohosh (BC), an herb commonly used to treat menopausal symptoms. We analyzed and reviewed all published case reports and spontaneous reports of initially alleged BC hepatotoxicity regarding quality of case details and causality assessments.
Shortcomings of data quality were more evident in spontaneous reports of regulatory agencies compared to published case reports, but assessments with the scale of CIOMS (Council for the International Organizations of Sciences) or its updated version revealed lack of causality for BC in all cases.
The applied causality methods are structured, quantitative, and liver specific with clear preference over an ad hoc causality method or the liver unspecific Naranjo scale.
Reviewing the case data and the reports dealing with quality specifications of herbal BC products, there is general lack of analysis with respect to authentication of BC in the BC products used by the patients.
In one regulatory study, there was a problem of BC authentication in the analysed BC products, and other reports addressed the question of impurities and adulterants in a few BC products.
It is concluded that the use of BC may not exert an overt hepatotoxicity risk, but quality problems in a few BC products were evident that require additional regulatory quality specifications.
PMID:  21677326


Because the vast majority of black cohosh materials are harvested from plants growing in the wild,  a recurring concern regarding the safety of black cohosh-containing dietary supplements is mis-identification of plants causing unintentional mixing-in (adulteration) of potentially harmful materials from other plant sources.

Grow your own.

Clinical trials on effects of Actaea racemosa (black cohosh) extracts on menopausal symptoms have yielded .. positive results. Two recent studies showed excellent efficacy against classic menopausal complaints and osteoprotective properties, and extracts were deemed safe ….Furthermore, several studies suggest that A. racemosa might help control psychic problems typically found during menopausal transition.  PMID:  15927480

Chemical constituents and activity

By only using the root of Black cohosh it is clear that a number of key medicinal properties of the plant are being overlooked.  In addition to the antibiotic, antiviral and antiparasitic action, as well as the chelating ability and some antifungal activity outlined below for each chemical, in general we can summarise the other activities as follows, according to Dr Duke.



The majority of the activities of the plant are achieved via external application and not via ingestion.  For example there are chemicals in this plant that can act as a spermicide [kills sperm] and helps with verrucas [a wart  caused by the human papillomavirus (HPV)]. 

The plant is also antivaginitic.  Vaginitis is an inflammation of the vagina and there are three kinds - bacterial vaginitis, candiasis which is fungal and trichomoniasis which is parasitic.  It can also help with ear infections.

The plant is both an expectorant and a mucolytic.  Expectorants reduce the thickness or viscosity of bronchial secretions thus increasing mucus flow that can be removed more easily through coughing. Mucolytics break down the chemical structure of mucus molecules. The mucus becomes thinner and can be removed more easily through coughing. Here breathing the fumes of the plant steeped in hot water for example, may help.

But there also appear to be chemicals in the plant itself that help when ingested.  Actein, for example is a natural vasodilator.  There are the natural pain killers such as salicyclic acid [aspirin] which can help with pain- including period pain.



Rather unusually for many plants, the root of Black cohosh contains Vitamin C.  Vitamin C has a vast amount of activity helping with bacterial infection, viral infection, allergies, cataracts, eczema, ‘thick blood’, diabetes, depression and so on.  It can help with heavy metal poisoning. 

It is also Anticlimacteric [500-5,000 mg/day] – helps with the menopause. 

In effect it is the vitamin C in Black cohosh that is doing a lot of the work for which the plant is best known.  The Vitamin C is also helping with the plant's reputed claims to alleviate the pain of endometriosis, a condition resulting from the appearance of endometrial tissue outside the womb and causing pelvic pain.

The root also contains β-Carotene, a precursor form of vitamin A.  Again, it is this vitamin that provides some of the other Black cohosh activity.  Both vitamin C and beta carotene help in healing chronic infection of the cervix with the sexually transmitted human papillomavirus (HPV).  In effect there is anti-viral activity.  Here we also have action against acne, psoriasis, arthritis, asthma, cancer, tumours and …….alleviation of PMS.

There are many more vitamins and a very good supply of essential minerals with their own health giving activities in the root. During winter one can well see that this plant must have been a life giving staple food – not just a pure medicine to the Native Americans.  In some senses we have been completely mis-reading this plant.  The root is both food and medicine because it contains many essential vitamins and minerals, but the plant as a whole is a medicine.

But there is one chemical in the root worthy of note.  According to Cooper-Driver, G. A. [in Chemical substances in plants toxic to animals, pp. 213-47 in CRC Handbook of Naturally Occurring Food Toxicants],  one chemical in the root Formononetin is an abortifacient - an agent (as a drug) that induces abortion.  This same chemical according to Merck’s 11th Edition is ‘Estrogenic’ in effect a chemical mimicking  Estrogen [phytoestrogen]  - the primary female sex hormone responsible for development and regulation of the female reproductive system.  So the root does indeed contain a natural form of HRT.

Their name comes from the Greek phyto ("plant") and estrogen, the hormone which gives fertility to female mammals. The word "estrus" - Greek οίστρος - means "sexual desire", and "gene" - Greek γόνο - is "to generate". It has been hypothesized that plants use phytoestrogens as part of their natural defence against the overpopulation of herbivore animals by controlling female fertility

 Dr. Duke's Phytochemical and Ethnobotanical Databases; Chemicals and their Biological Activities in: Cimicifuga racemosa (L.) NUTT. (Ranunculaceae) -- Black Cohosh, Black Snakeroot

ACETIC-ACID Plant: Antibacterial 5,000 ppm ; Antisalmonella; FungicideProtisticide [Kills any member of the kingdom protista, a single-celled endo-organism]
ASCORBIC-ACID Root 21 ppm;
BETA-CAROTENE Root 2.4 ppm;
BUTYRIC-ACID Plant: Nematistat 880 ug/ml [a chemical that immobilises, disorients or disrupts the host finding or feeding behavior of nematode worms, which includes roundworms and threadworms]
CALCIUM Root 5,970 ppm;
CHROMIUM Root 18 ppm;
COBALT Root 38 ppm;
FIBER Root 119,000 ppm;
FORMIC-ACID Plant: Acaricide [a substance poisonous to mites or ticks];
FORMONONETIN Root: see above
GALLIC-ACID Plant: Antiadenovirus; Antibacterial; Antiescherichic; Antiflu; Antiherpetic; AntiHIV; Antileishmanic; AntiMRSA; Antipolio; Antistaphylococcic; Antiviral; Bacteristat ; Gram(+)icide MIC=1,000 ug/ml; Gram(-)icide
Root 380 ppm;
MAGNESIUM Root 1,740 ppm;
MANGANESE Root 14 ppm;
PALMITIC-ACID Plant:  Nematicide
Root 2,080 ppm;
POTASSIUM Root 10,300 ppm;
RIBOFLAVIN Root 0.65 ppm;
SALICYLIC-ACID Plant: Antibacterial
SILICON Root 27 ppm;
TANNIC-ACID Plant: Antibacterial; Antidote For Heavy Metals; Antigingivitic; Antiherpetic; AntiHIV IC90=200 ug/ml ; Antipolio; Antiviral
TANNIN Root: Anthelmintic; Antibacterial; Antidysenteric; Antihepatotoxic; AntiHIV; Antiviral; Chelator
THIAMIN Root 58 ppm;
TIN Root: Antibacterial; Taenicide [A medicine that destroys tapeworms]
ZINC Root:

References and further reading

  • Richo Cech (2002). Growing at-risk medicinal herbs. Horizon Herbs
  • "Actaea racemosa". Royal Horticultural Society.
  • Avula B, Wang YH, Smillie TJ, Khan IA (March 2009). "Quantitative determination of triterpenoids and formononetin in rhizomes of black cohosh (Actaea racemosa) and dietary supplements by using UPLC-UV/ELS detection and identification by UPLC-MS". Planta Med. 75 (4): 381–6. doi:10.1055/s-0028-1088384. PMID 19061153.
  • Santti, R., Makela, S., Strauss, L., Korman, J., Kostian, M. L. 1998. Phytoestrogens: Potential Endocrine Disruptors in Males. Toxicol Ind Health, 14:
  • Kroes, B.H., et al. 1991. Anti-Inflammatory Activity of Gallic Acid. Planta Medica
  • Okuda, T., Yoshida, T., and Hatano, T. Antioxidant Effects of Tannins and Related Polyphenols. Phenolic Compounds in Food and Their Effects on Health
  • Pizzorno, J.E. and Murray, M.T. 1985. A Textbook of Natural Medicine. John Bastyr College Publications, Seattle, Washington
  • Tan, G.T., Pezzuto, J.M., Kinghorn,* A.D., Hughes, S.H. Evaluation Of Natural Products As Inhibitors Of Human Immunodeficiency Virus Type 1 (HIV-1) Reverse Transcriptase. Journal of Natural Products, 54(1)
  • Jeffery B. Harborne and H. Baxter, eds. 1983. Phytochemical Dictionary. A Handbook of Bioactive Compounds from Plants. Taylor & Frost, London
  • Duke, James A. 1992. Handbook of phytochemical constituents of GRAS herbs and other economic plants.
  • Duke, James A. 1992. Handbook of biologically active phytochemicals and their activities.

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