Ranunculaceae · rhizome
Black cohosh
Actaea racemosa
Rhizome mapped to conflicting vasomotor-symptom trials. Liver injury is the safety story.
Safety first
Idiosyncratic hepatotoxicity reports. Not estrogen. Postmenopausal bleeding needs workup. Not a hormone-replacement substitute.
Tradition vs trials
Traditional record. Eastern North American gynecologic tradition later industrialized in Germany (Cimicifuga).
Trial literature. Vasomotor trials conflict. EMA/NCCIH-type summaries note liver-injury reports.
Practical ranges
Educational ranges — not a prescription. Culinary use is not an extract.
rhizome extract
German/European products often provide about 40–80 mg extract daily of specified preparations
ESCOP / EMA HMPC / NCCIH — Educational range only — not a prescription. A licensed clinician individualizes product, dose, and duration.
Pregnancy, nursing, children
- Pregnancy. Avoid.
- Nursing. Avoid.
- Children. Insufficient reliable data; avoid unless a clinician directs otherwise.
Contraindications
- liver disease
- unexplained postmenopausal bleeding as sole care
Key interactions
- hepatotoxic drugs · caution
Idiosyncratic liver-injury reports.
- hormonal therapies · note
Not an estrogen; still a clinician conversation in hormone-sensitive disease.