Actaea racemosa (black cohosh, black bugbane, black snakeroot, fairy candle; syn.

Cimicifuga racemosa)
is a species of flowering plant of the family Ranunculaceae. It is native to eastern North America from
the extreme south of Ontario to central Georgia, and west to Missouri and Arkansas. It grows in a variety
of woodland habitats, and is often found in small woodland openings. The roots and rhizomes have long
been used medicinally by Native Americans. Extracts from these plant materials are thought to possess
analgesic, sedative, and anti-inflammatory properties. Black cohosh extracts are being studied as
treatments for symptoms associated with menopause.[1]

Contents

1 Description

2 Taxonomy

3 Cultivation

4 Medicinal uses

4.1 Historical use

4.2 Contemporary use

4.3 Side effects

4.4 Bioactive compounds

5 See also

6 Chemical constituents

7 References

8 External links

Description

Actaea racemosa inflorescence

Black cohosh is a smooth (glabrous) herbaceous perennial plant that produces large, compound leaves
from an underground rhizome, reaching a height of 25–60 cm (9.8–23.6 in).[2][3] The basal leaves are
up to 1 m (3 ft 3 in) long and broad, forming repeated sets of three leaflets (tripinnately compound)
having a coarsely toothed (serrated) margin. The flowers are produced in late spring and early summer
on a tall stem, 75–250 cm (30–98 in) tall, forming racemes up to 50 cm (20 in) long. The flowers have no
petals or sepals, and consist of tight clusters of 55–110 white, 5–10 mm (0.20–0.39 in) long stamens
surrounding a white stigma. The flowers have a distinctly sweet, fetid smell that attracts flies, gnats, and
beetles.[2] The fruit is a dry follicle 5–10 mm (0.20–0.39 in) long, with one carpel, containing several
seeds.[4]

Taxonomy

The plant species has a history of taxonomic uncertainty dating back to Carl Linnaeus, who — on the
basis of morphological characteristics of the inflorescence and seeds — had placed the species into the
genus Actaea. This designation was later revised by Thomas Nuttall reclassifying the species to the genus
Cimicifuga. Nuttall's classification was based solely on the dry follicles produced by black cohosh, which
are typical of species in Cimicifuga.[4] However, recent data from morphological and gene phylogeny
analyses demonstrate that black cohosh is more closely related to species of the genus Actaea than to
other Cimicifuga species. This has prompted the revision to Actaea racemosa as originally proposed by
Linnaeus.[4] Blue cohosh (Caulophyllum thalictroides), despite its similar common name belongs to
another family, the Berberidaceae, and is therefore not closely related to black cohosh.

Cultivation

A. racemosa grows in dependably moist, fairly heavy soil. It bears tall tapering racemes of white
midsummer flowers on wiry black-purple stems, whose mildly unpleasant, medicinal smell at close
range gives it the common name "Bugbane". The drying seed heads stay handsome in the garden for
many weeks. Its deeply cut leaves, burgundy colored in the variety "atropurpurea", add interest to
gardens, wherever summer heat and drought do not make it die back, which make it a popular garden
perennial. It has gained the Royal Horticultural Society's Award of Garden Merit.[5]

Medicinal uses

Historical use

Native Americans used black cohosh to treat gynecological and other disorders, including sore throat,
kidney problems, and depression.[3] Following the arrival of European settlers in the U.S. who continued
the medicinal usage of black cohosh, the plant appeared in the U.S. Pharmacopoeia in 1830 under the
name “black snakeroot”. In 1844 A. racemosa gained popularity when John King, an eclectic physician,
used it to treat rheumatism and nervous disorders. Other eclectic physicians of the mid-nineteenth
century used black cohosh for a variety of maladies, including endometritis, amenorrhea,
dysmenorrhea, menorrhagia, sterility, severe after-birth pains, and for increased breast milk
production.[6]
Contemporary use

Black cohosh is used today mainly as a dietary supplement marketed to women as remedies for the
symptoms of premenstrual tension, menopause and other gynecological problems.[3] A meta-analysis
of contemporary evidence supports these claims,[1] but the Cochrane Collaboration concluded that
there is insufficient evidence to support its use for menopausal symptoms.[7] Study design and dosage
of black cohosh preparations play a role in clinical outcome.[8] An in vitro investigation with pure
compounds found in black cohosh identified some beneficial effects of these compounds on
physiological pathways underlying osteoporosis.[9]

Side effects

According to Cancer Research UK: "Doctors are worried that using black cohosh long term may cause
thickening of the womb lining. This could lead to an increased risk of womb cancer." They also caution
that people with liver problems should not take it as it can damage the liver,[10] although a 2011 meta-
analysis of research evidence suggested this concern may be unfounded.[11]

Studies on human subjects who were administered two commercially available black cohosh
preparations did not detect estrogenic effects on the breast.[12]

No studies exist on long-term safety of black cohosh use in humans.[13] In a transgenic mouse model of
cancer, black cohosh did not increase incidence of primary breast cancer, but increased metastasis of
pre-existing breast cancer to the lungs.[14]

Liver damage has been reported in a few individuals using black cohosh,[3] but many women have taken
the herb without reporting adverse health effects,[15] and a meta-analysis of several well-controlled
clinical trials found no evidence that black cohosh preparations have any adverse effect on liver
function.[11] Although evidence for a link between black cohosh and liver damage is not conclusive,
Australia has added a warning to the label of all black cohosh-containing products, stating that it may
cause harm to the liver in some individuals and should not be used without medical supervision.[16]
Other studies conclude that liver damage from use of black cohosh is unlikely,[17] and that the main
concern over its safe use is lack of proper authentication of plant materials and adulteration of
commercial preparations with other plant species.[18]

Reported direct side-effects also include dizziness, headaches, and seizures; diarrhea; nausea and
vomiting; sweating; constipation; low blood pressure and slow heartbeats; and weight problems.[19]
Because the vast majority of black cohosh materials are harvested from plants growing in the wild,[3] a
recurring concern regarding the safety of black cohosh-containing dietary supplements is mis-
identification of plants causing unintentional mixing-in (adulteration) of potentially harmful materials
from other plant sources.[3]

Black Cohosh can interact with estrogens, progestins and birth control pills, as well as fertility
treatments.[20]