Black cohosh grows in open woods at the edges of dense forests from Ontario, Canada to Tennessee and west to Missouri. This perennial grows to 2.5 m and is topped by a long plume of white flowers. The term “black” refers to the dark color of the rootstalk. The name “cohosh” comes from an Algonquian word meaning “rough,” referring to the feel of the rhizome.
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Black cohosh can harm your liver. Stop using this product and call your doctor at once if you have signs of liver problems, such as:
nausea, loss of appetite, upper stomach pain;
itching, tired feeling;
dark urine, clay-colored stools; or
jaundice (yellowing of the skin or eyes).
Common side effects may include:
stomach pain or upset;
vaginal bleeding or spotting;
On the basis of clinical studies, the currently recommended daily dose of black cohosh is a 40% to 60% methanol or isopropranolol extract of 40 to 80 mg herb standardized to contain 1 mg of the triterpene 27-deoxyactein per 20 mg tablet. Therapeutic effects generally begin after 2 weeks, with maximum effects usually seen within 8 weeks.