Tuesday, July 25, 2006

Warning Regarding Black Cohosh (An OTC Herb)

Across the pond comes news that Black cohosh, an herb popular for relieving hot flashes and other symptoms of menopause may if used regularly be raise the risk of liver damage according to the U.K.'s Medicines and Healthcare products Regulatory Agency.

Black cohosh (known as both Actaea racemosa and Cimicifuga racemosa ), a member of the buttercup family, is a perennial plant that is native to North America. Other common names include black snakeroot, bugbane, bugwort, rattleroot, rattletop, rattleweed, and macrotys. Insects avoid it, which accounts for some of these common names.

The treatment has been used for many years in Europe, and in 2002 women in the USA started using it after a much publicized study fund that hormone replacement therapy using drugs such as Prempro raised a risk of heart attack, stroke, and breast cancer.

Symptoms of liver problems include pain on the right side of the stomach just below the ribs, unexplained nausea, flu-like symptoms, dark urine, and yellowing of eyes or skin.

And this from the NYT:

Almost half of American women seek alternative or complementary treatments for the unpleasant symptoms of menopause. A systematic review of the evidence has found little proof that any of them work.

Three of four trials of the herb black cohosh, a common alternative treatment for menopausal symptoms, showed no improvement, but the studies suffered from poor methodology. The fourth, judged “fair” by the researchers, enrolled 304 women, half of whom took black cohosh and the other half a placebo for 12 weeks. Compared with placebo, there was greater improvement in the treatment group as measured by the participants’ own reports. Dr. Anne Nedrow, the lead author of the review, said the study “did show some benefits, but we had to balance it with studies that showed none.”

None of six trials of traditional Chinese medicinal herbs, three using a combination of medicines, showed a significant benefit over controls for menopausal symptoms.

Studies of biological therapies like kava, primrose oil, guar gum, wild yam cream and red clover showed little or no difference in symptoms between those who used the substances and those given a placebo.

Most of the trials lacked consistent or clear reporting of adverse effects, although one five-year follow-up study of soy indicated that it increased the risk for endometrial hyperplasia, a usually benign thickening of the lining of the uterus that can cause abnormal bleeding. Liver toxicity has been reported with both black cohosh and kava.