Loading
Black cohosh is a root extract sold for menopausal hot flushes, and women on tamoxifen or aromatase inhibitors often try it. Placebo-controlled trials in women treated for breast cancer gave mixed results, and rare cases of serious liver injury have been reported.
Black cohosh is used mainly for menopausal symptoms, and the NCI PDQ summary cites a market report placing it among the 15 top-selling herbal supplements in the United States in 2019. Memorial Sloan Kettering's About Herbs summary describes the trials of black cohosh for hot flushes caused by breast cancer treatment as mixed, while noting one report of benefit in menopausal symptoms caused by luteinising hormone-releasing hormone analogues; the NCI PDQ summary concludes that observational and open-label studies suggest benefit but that placebo-controlled trials have not confirmed it. Current laboratory and clinical work on the usual hydroalcoholic extracts does not support the old idea that it acts like oestrogen; serotonin-like activity is better supported. The safety concern is the liver: after reviewing 30 cases of liver injury, the United States Pharmacopeia's expert committee asked for a caution on product labels, and MSK lists case reports of hepatitis resembling autoimmune hepatitis. MSK also lists possible interference with tamoxifen and increased toxicity of doxorubicin and docetaxel in laboratory work, of unknown clinical relevance, and notes poor quality control in several products. Non-hormonal drugs, acupuncture and cognitive behavioural therapy have better evidence for treatment-related hot flushes.
Triterpene glycosides and other constituents appear to act on serotonin, dopamine and GABA signalling rather than on the oestrogen receptor; hormone levels did not change in clinical studies.
Query for this technology: (TITLE:"Black cohosh" OR ABSTRACT:"Black cohosh" OR TITLE:"Actaea racemosa" OR ABSTRACT:"Actaea racemosa" OR TITLE:"Cimicifuga racemosa" OR ABSTRACT:"Cimicifuga racemosa" OR TITLE:"Remifemin" OR ABSTRACT:"Remifemin") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Black cohosh, not a curated reading list.
Shares Hot flushes on hormone therapy, Acupuncture for hot flushes on endocrine therapy, Tamoxifen, Endocrine therapy (SERMs, AIs, SERDs) and the tags complementary, supportive-care.
Shares Asian ginseng (Panax ginseng), Hepatotoxicity (liver enzyme elevation), Evidence-based integrative oncology, Toxicity and quality of life are undervalued and the tags complementary, supportive-care.
Shares Milk thistle (silymarin), Evidence-based integrative oncology, Toxicity and quality of life are undervalued, HR-positive / HER2-negative breast cancer and the tags complementary, supportive-care.
Shares Tamoxifen, Evidence-based integrative oncology, Endocrine therapy (SERMs, AIs, SERDs), Toxicity and quality of life are undervalued and the tags complementary, supportive-care.
Shares Tamoxifen, Evidence-based integrative oncology, Endocrine therapy (SERMs, AIs, SERDs), Toxicity and quality of life are undervalued and the tags complementary, supportive-care.
Shares Milk thistle (silymarin), Evidence-based integrative oncology, Toxicity and quality of life are undervalued and the tags complementary, supportive-care.
Shares Tamoxifen, Evidence-based integrative oncology, Docetaxel, Toxicity and quality of life are undervalued and the tags complementary, supportive-care.
Shares Acupuncture for hot flushes on endocrine therapy, Evidence-based integrative oncology, Toxicity and quality of life are undervalued, HR-positive / HER2-negative breast cancer and the tags complementary, supportive-care.
Every source this page cites, grouped by who published it. Grouping is read from the web address, not assigned by hand.
A source that has moved or gone is reported by the weekly link check. /audit/