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Updated: Jun 24, 2026
11:38
High Content Screening Analysis to Evaluate the Toxicological Effects of Harmful and Potentially Harmful Constituents (HPHC)
Published on: May 10, 2016
Black cohosh hepatotoxicity: quantitative causality evaluation in nine suspected cases
Rolf Teschke1, Ruediger Bahre, Johannes Fuchs
1Department of Internal Medicine II, Division of Gastroenterology and Hepatology, Klinikum Hanau, Teaching Hospital of the Johann Wolfgang Goethe-University Frankfurt/Main, Hanau, Germany. rolf_teschke@klinikum-hanau.de
Menopause (New York, N.Y.)
|April 3, 2009
Summary
Black cohosh (Actaea racemosa) use is unlikely to cause liver damage in most women. A review of nine cases found minimal evidence of hepatotoxicity linked to this popular herbal remedy for menopausal symptoms.
Area of Science:
- Herbal medicine research
- Toxicology
- Hepatology
Background:
- Black cohosh (Actaea racemosa) is widely used for menopausal symptom relief.
- Concerns exist regarding potential rare hepatotoxicity associated with its use.
Observation:
- Nine cases of suspected liver injury linked to black cohosh were evaluated.
- Causality was assessed using the Council for International Organizations of Medical Sciences scale.
- Data quality, alternative diagnoses, and confounding factors influenced causality assessments.
Findings:
- Hepatotoxicity was excluded or deemed unlikely in eight out of nine cases.
- Causality was possible in only one case, with confounding factors like cholelithiasis and fatty liver present.
- Comedication with other substances was reported in five cases.
Implications:
- The study suggests a low risk of hepatotoxicity from black cohosh in the analyzed cases.
- Further research with higher quality data is needed to definitively establish safety profiles.
- This evidence supports cautious but continued use of black cohosh for menopausal symptoms.
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