Black Cohosh
Black cohosh is also known as black snakeroot (as the name appeared in the U.S. Pharmacopoeia in the year 1820), bugwort, columbine-leaved leontice, tall bugbane, cordate rattle top, rattleroot, macrotys, papoose root, and battleweed. Its Latin name is Actaea racemosa or Cimicifuga racemosa. Macrotys actaeoides is also a synonym for the drug (Frostburg State University, frostburg.edu). It belongs to the Ranunculaceae (buttercup) family (Kinghorn A 2). The plant was first described in 1690 in Phytographia by Leonard Plukenet as Christopheriana facie. Later in 1751, it was named as Actaea racemosa by Linnaeus. However, the name was later changed into Macrotrys racemosa, then named as Macrotys racemosa, and finally changed into Cimicifuga racemosa. This name was used until botanists found different genera, Actaea, Souliea, and Cimicifuga. With the passage of time, all the species of the last two genera were incorporated into Actaea (Kinghorn A 46).
Figure 1: Black cohosh (Source: mass.gov)
Black cohosh is a perennial herb native to North America and found in different areas ranging from central Georgia to south of Ontario, and west to Arkansas and Missouri (Kinghorn A 2). Presently, near 28 different species of Actaea are distributed across the Northern Hemisphere. Eight species are endemic to North America while the other 20 species are found mostly in Asia. Three species are also found in Europe (Kinghorn A 46). It is found in many American gardens due to its attractive, deeply-cut burgundy leaves (Ni n.p.).
Important Constituents of the herb
Black cohosh constitutes minimum 20 triterpene glycosides (saponins) of the cycloartane type including 23-epi-26-deoxyactein, actein, cimicifugoside, and cimiracemoside A. Among the other important constituents of black cohosh are aromatic acids including isoferulic, ferulic, and acyl caffeic acids; resins including cimicifugin; fatty acids, and tannins. In spite of the earlier reports, the plant has no substantial amount of isoflavones (Bone, and Mills 428).
Pharmacology of black cohosh
The actual working of black cohosh in the body is not clear. It is commonly suggested that black cohosh has an estrogenic activity, but studies are showing conflicting results in this regard. Although most of the studies are unable to show that extracts of black cohosh contain compounds that work on estrogen receptors (ERα and ERβ), it has several pharmacological effects showing its estrogen-like activity such as protection from menopausal bone loss and lowering of luteinizing hormone (LH) levels (Bone, and Mills 428).
Some other mechanisms of actions of the herb have also been reported such as dopaminergic, serotonergic, and opioid receptor activity (Bone, and Mills 428). Black cohosh is thought to work by inhibiting the activity of hypothalamus in the brain – an area having thermoregulatory effects, and increasing the availability of serotonin, a brain neurotransmitter involved in sleep, depression, and memory (Hobbs, and Keville 15). Researchers have found that propanol extracts of the herb could inhibit the effects of subreceptors of serotonin including 1A, 1D and 7, which are present in the hypothalamus. Inhibition of serotonin-1A receptor shows a hypothermic effect that could present a decrease in vasomotor symptoms. Some serotonin receptors are found to terminate directly on the LH releasing hormone (LhRh) resulting in the inhibition of LH secretion. It is important to note that hot flashes are represented by decreased levels of estrogen as well as a rise in LH and FSH (follicle-stimulating hormone) levels, and black cohosh has shown LH inhibitory activity in-vivo. Researchers have also isolated Nώ–methylserotonin from Actaea racemosa that is involved in potentiating the serotonergic factors associated with regulatory effects of the symptoms of menopause. This compound has a high affinity for serotonin-7 receptors resulting in increased level of serotonin, thereby leading to mood changes that can help in alleviating the symptoms of depression (Frostburg State University, frostburg.edu). These activities of the herb have an important role in enhancing the effects of black cohosh. In addition to these activities, anti-inflammatory activity of black cohosh has also been found in-vitro that is helpful in some other uses of the herb (Bone, and Mills 428).
Use of the Medicine
Black cohosh is best known for its use in a number of gynecological disorders. Since pre-Columbian times, it has a history of use in Native Americans for the problems such as premenstrual syndrome, menstrual pains, menopause, and other such gynecological problems. In the Native America, people used to put a kettle having a hot decoction of the roots of black cohosh in a hole in the ground while placing the rheumatic limbs over the steam to give relief to the affected area. It was also used in emergency medicine for the treatment of snakebites. In that case, the herb was broken into smaller pieces and applied to the wound, while giving some juice to be taken orally (Frostburg State University, frostburg.edu).
At the turn of the 19th century, it was a commonly used uterine tonic. It was also used to diminish false pains during labor, and maintain and elevate true pains. People also used black cohosh to give relief from pain, and facilitate in calming the nervous system after labor, i.e. the drug results in mild sedative effects on the nerves, thereby giving relief from the pain. By the year 1876, John King, an eclectic physician, also suggested the use of cramp bark along with black cohosh for the delayed or painful periods (Hobbs, and Keville 15).
Black cohosh is also gaining popularity among European doctors to give relief from hot flashes as well as from the conditions that are caused by the absence of estrogen as, for example, depression during menopause. It is considered as one of the most promising herbs for the problems related to menopause, but it must be taken for such a time period in which it remains effective (Hobbs, and Keville 15). Although further studies are required in establishing the efficacy of black cohosh in the treatment of these disorders, but short-term use of the drug is effective in their treatment (Ni n.p.).
Black cohosh has also shown anti-cancer effects. The extracts of the herb help in slowing down the growth of estrogen-dependent tumors. Methanol extracts can also promote the activity of genes that can promote apoptosis of breast cancer cells. Similar apoptotic as well as cytotoxic effects have been found on prostate carcinoma cells (Frostburg State University, frostburg.edu).
Some other problems that are usually treated with the help of black cohosh include mood and sleep disorders, vaginal dryness, night sweets, and hot flashes. It can also help in reducing the inflammation, treatment of arthritis, and muscular pain (Hobbs, and Keville 15). It can also treat some of the problems of the respiratory system, relieve ringing in ear, and relax the central nervous system (Hobbs, and Keville 15). Tincture of the herb can be used to treat coughs, and sometimes to help a restless baby sleep. In the Traditional Chinese Medicine, sheng ma (a black cohosh related species also known as foetid bugbane) is used for the treatment of prolapse of the uterus, shortness of breath, fatigue, anxiety, and headaches (Hobbs, and Keville 15).
Black cohosh was also used for a wide range of other disorders in the later parts of the 19th century. Those disorders include cholera, delirium tremens (alcohol withdrawal), fits, periodical convulsions, epilepsy, asthma, nervous excitability, and spasmodic afflictions, cough, consumption, ulcers, neuralgia, and scrofula. Root and rhizome of the drug were also used for the treatment of measles, small pox, and scarlet fever. It was also mentioned to have insect repelling properties, particularly when leaves were applied on the skin. That insect repelling property also resulted in the name Cimicifuga, which is obtained from “cim” - a bug, and “fugo” - to drive away (Frostburg State University, frostburg.edu).
Parts of the Herb commonly used
The root as well as rhizome of the herb, harvested in the fall, is most commonly used for health related benefits (Ni n.p.).
Figure 2: Actaea racemosa rhizome and roots. (Frostburg State University, frostburg.edu)
Preparation of the herb as a medicine
Black cohosh can be used in the form of tea, tincture, solid extract, or capsule (Ni n.p.). Tincture of the herb can be prepared by soaking the root in alcohol (Frostburg State University, frostburg.edu). According to a report of American Botanical Council, black cohosh extract was among 10 best-selling dietary supplements in the drug, food, and mass market in the U.S. in the year 2011. During that time, it showed sales of more than $10 million (Kinghorn A 2). It was also used in decoction, and as a gargle it can help in relieving sore throats (Frostburg State University, frostburg.edu).
Standard dose of the medicine
In the form of tincture, it is advised to take 30 to 60 drops, 2 to 3 times daily. In the form of tea, it is advised to take a cup of tea of black cohosh, 2 times daily. In this form, it can also be combined with other herbs. In the form of capsules having standardized extracts, it is advised to take 3 capsules two times daily. However, in some menopausal women, at least twice the amount is required (Hobbs, and Keville 15).
Availability of the Herb
Black cohosh can be obtained through health food stores, herbal specialty stores, and through internet (Ni n.p.).
Cautions or Recommended avoidances
It is important to note that the name of blue cohosh is almost similar to that of black cohosh but they must not be confused for the same thing as both of them are used for completely different kinds of disorders (Ni n.p.).
It is also important to note that the use of black cohosh can result in stomach discomfort and headaches. It is also considered as an unsafe drug for women during pregnancy (Ni n.p.). It can also result in liver problems. Last but not the least, high doses of herbs have to be avoided in general as they can result in adverse events (Hobbs, and Keville 15).
Works Cited
Bone, K., and S. Mills. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Elsevier Health Sciences UK, 2013. Print.
Frostburg State University. " Black Cohosh – Actaea racemosa L.". Frostburg State University, n.d. Web. 20 May. 2016 <http://www.frostburg.edu/fsu/assets/File/ACES/actaea%20racemosa-%20final.pdf>.
Hobbs, C., and K. Keville. Women's Herbs, Women's Health. Book Publishing Company, 2007. Print.
Kinghorn A, D., H. Falk, and J. Kobayashi. Progress in the Chemistry of Organic Natural Products 99. Springer International Publishing, 2014. Print.
Ni, Mao Shing. The Natural Health Dictionary: Your Comprehensive a-to Z Guide for Healing with Herbs, Nutrition, Supplements, and Secret Remedies. Ask Dr. Mao, 2011. Print.
