Tori Hudson, ND
Tori Hudson, ND, program director of the Institute of Women’s Health and Integrative Medicine, and author of the Women’s Encyclopedia of Natural Medicine (McGraw-Hill).
Black cohosh has become popular among women looking to relieve menopause symptoms, in particular hot flashes — but the herb itself has been used since the 19th century for various ailments. Of late, though, published reports have suggested that black cohosh may not be totally safe. The journal Cancer Research reported a study from Duquesne University in Pittsburgh in which female mice with a genetic predisposition for breast cancer ate food laced with black cohosh throughout their lives. Though these mice were not found to develop more breast cancer, the ones that did get the disease were more likely to have it spread to their lungs. Yet another caution was a committee report from the US Pharmacopeia suggesting a “possible” link between taking black cohosh and liver damage.
To help sort out the facts, I called Tori Hudson, ND, who specializes in women’s health and is the program director of the Institute of Women’s Health and Integrative Medicine. Dr. Hudson is also author of the Women’s Encyclopedia of Natural Medicine. She told me she doesn’t find the studies worrisome, noting she finds black cohosh “very helpful” to about 75% of women suffering menopausal symptoms and that it typically provides a 50% reduction in hot flashes. She had several specific criticisms of the cancer study. First, the mice ate cohosh their entire adult life, whereas women typically take it for anywhere from a few months to a few years. She also pointed out that there is other research saying it actually inhibits estrogen-receptor positive breast cancer cells. Dr. Hudson told me that a new study published in the journal Phytomedicine, funded by the National Institutes of Health and the Susan G. Komen Breast Cancer Foundation, reported certain fractions of black cohosh were able to reduce breast cancer cell proliferation by more than 50% in lab tests.
As for liver toxicity, the report actually did not find that black cohosh caused liver damage or that there was any unfavorable information about the herb. Nevertheless, the committee decided to add a cautionary statement to the product — apparently a “just in case” strategy. Dr. Hudson says women taking black cohosh should stop if they develop dark urine, jaundice or abdominal pain, all of which are symptoms of possible liver problems. She adds that for her patients who have liver disease and take black cohosh, she monitors their liver function through a routine blood test for liver enzymes and considers other herbal alternatives to treat their menopausal symptoms.