Mode of administration of black cohosh

[Guest guest]

Thanks to all in the group for the recent posts on black cohosh.

 

As a Western herbalist, I learned long ago (early 1980s) that the active

principles in black cohosh are best extracted using alcohol, and should be

administered as a tincture.

 

Since the recent discussions on the list about the efficacy of black cohosh,

I have tried to find the source of the above statement, and have not been

able to confirm what I have held so long in my head.

 

However, the recent posting on the HALT (Herbal Alternatives for Menopause

Symptoms) study showing no efficacy of the 160 mg dose of black cohosh -

which I must assume was in a pill form, and the Wang study showing the

possible route of effect being on the hypothalamic system - which used an

extract form - seem to support the idea that route of administration of

black cohosh (cimicifuga racemosa) is important in efficacy. There were

additional reports by members on this list concerning studies that showed

efficacy for the use of black cohosh extract at lower doses than the HALT

study.

 

I have suggested the used of this herb to women I am treating for hot

flashes as an adjunct to TCM pattern differentiated formulas, if the TCM

formula and acupuncture do not completely control hot flashes to a level

that is acceptable to the patient in a 6-8 week period of time. I always

suggest that they use a tincture form of the herb, and follow the label

instructions for dosage. I carefully add that it takes up to two weeks to

see an effect. I have had a couple patients continue with black cohosh

tincture alone after a course of Chinese Herbal therapy. While the TCM

formulas addresses a host of symptomology, and adverse symptoms from

insomnia to migraines, fatigue, night sweat, restless legs etc improve,

sometimes hot flashes only become less severe. The black cohosh tincture

addition makes a huge difference once the underlying imbalance is addressed.

 

The report on the adverse cutaneous effect of Remifemin (again a pill form

of the herb) makes me think that a tincture is the way to go in

administering black cohosh.

 

The Wang study suggests to me that herbal therapy might well be augmented by

auricular acupuncture that targets the hypothalamus, as it also seems clear

that black cohosh, like any herb, should not be used indefinitely.

 

Valerie Hobbs, Dipl. O.M.