black cohosh

Botanical name
Cimicifuga racemosa
Parts used and where grown
Black cohosh is a shrub-like plant native to the eastern deciduous forests of North America, ranging from southern Ontario to Georgia, north to Wisconsin and west to Arkansas. The dried root and rhizome are used medicinally.1 When harvested from the wild, the root is black in color. Cohosh, an Algonquin Indian word meaning “rough,” refers to the plants gnarly root structure.2
Black cohosh has been used in connection with the following conditions (refer to the individual health concern for complete information):
Science Ratings - Health Concerns
*** - Menopause
* - Dysmenorrhea (painful menstruation)
* - Osteoporosis
* - Premenstrual syndrome
*** - Reliable and relatively consistent scientific data showing a substantial health benefit.
** - Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
* - For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
Historical or traditional use (may or may not be supported by scientific studies)
Native Americans valued the herb and used it for many conditions, ranging from gynecological problems to rattlesnake bites. Some 19th century American physicians used black cohosh for fever, menstrual cramps, arthritis, and insomnia.3
Active constituents
Black cohosh contains several ingredients, including triterpene glycosides (e.g., acetin and 27-deoxyactein) and isoflavones (e.g., formononetin). Other constituents include aromatic acids, tannins, resins, fatty acids, starches, and sugars. As a woman approaches menopause, the signals between the ovaries and pituitary gland diminish, slowing down estrogen production and increasing luteinizing hormone (LH) secretions. Hot flashes can result from these hormonal changes. Earlier animal studies4 5 and a human clinical trial6 suggested that black cohosh had some estrogen activity in the body and also decreased LH secretions. However, more recent animal studies7 and a clinical trial8 have found no estrogen activity for black cohosh extracts. Further clinical trials are needed to determine whether black cohosh has significant estrogenic actions in the body.
Small German clinical trials support the usefulness of black cohosh for women with hot flashes associated with menopause.9 10 A review of eight clinical trials found black cohosh to be both safe and effective for symptomatic relief of menopausal hot flashes.11 Other symptoms which improved included night sweats, insomnia, nervousness, and irritability. A clinical trial compared the effects of 40 mg versus 130 mg of black cohosh in menopausal women with complaints of hot flashes.12 While hot flashes were reduced equally at both amounts, there was no evidence of any estrogenic effect in any of the women. Although further trials are needed, this trial suggests that black cohosh is best reserved only for the symptomatic treatment of hot flashes associated with menopause and is not thought to be a substitute for hormone replacement therapy in menopausal and postmenopausal women.
A recent study suggests black cohosh may protect animals from osteoporosis.13 Human studies have not confirmed this action.
How much is usually taken?
Black cohosh can be taken in several forms, including crude, dried root or rhizome (300–2,000 mg per day), or as a solid, dry powdered extract (250 mg three times per day). Standardized extracts of the herb are available. The recommended amount is 20–40 mg twice per day.14 The best researched extract provides 1 mg of deoxyactein per 20 mg of extract. Tinctures can be taken at 2–4 ml three times per day.15 Black cohosh can be taken for up to six months, and then it should be discontinued.16
Are there any side effects or interactions?
Black cohosh should not be used by pregnant or breast-feeding women.17 Very large amounts (over several grams daily) of this herb may cause abdominal pain, nausea, headaches, and dizziness.
There is one case report of a woman developing autoimmune hepatitis while using black cohosh.18 A cause–effect relationship is in doubt, however, because the hepatitis did not resolve after black cohosh was discontinued. A few cases have also been reported in which severe liver failure was attributed to the use of black cohosh.19 While a cause–effect relationship is difficult to prove, and while such a side effect appears to be rare, people taking black cohosh should be alert to signs of possible liver disease, such as nausea, loss of appetite, fatigue, and tan-colored urine. Black cohosh is not a substitute for hormone replacement therapy during menopause.
At the time of writing, there were no well-known drug interactions with black cohosh.

false unicorn

Botanical name
Chamaelirium luteum
Parts used and where grown
False unicorn is native to Mississippi and continues to grow primarily in the southern part of the United States. The roots of false unicorn are most commonly used in herbal medicine.
False unicorn has been used in connection with the following conditions (refer to the individual health concern for complete information):
Science Ratings - Health Concerns
* - Dysmenorrhea (painful menstruation)
*** - Reliable and relatively consistent scientific data showing a substantial health benefit.
** - Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
* - For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
Historical or traditional use (may or may not be supported by scientific studies)
The medicinal use of false unicorn root is based in traditional Native American herbalism. It was recommended for many women’s health conditions, including dysmenorrhea (painful menstruation) and other irregularities of menstruation, as well as to prevent miscarriages.1 False unicorn was also used as a remedy for morning sickness.
Active constituents
Steroidal saponins are generally credited with providing false unicorn root’s activity.2 However, modern investigations have not confirmed this, and no research exists about the medical applications of this herb.
How much is usually taken?
False unicorn root tincture, 1/2–1 teaspoon (2–5 ml) three times per day, is sometimes recommended .3 The dried root, 1/4–1/2 teaspoon (1–2 grams) three times per day, is also used.
Are there any side effects or interactions?
No adverse effects have been reported with the use of false unicorn. Although false unicorn has been used historically for nausea and vomiting of pregnancy and to prevent miscarriages, its actions as a possible uterine tonic make its use during pregnancy potentially unsafe.
At the time of writing, there were no well-known drug interactions with false unicorn.

blue cohosh

Botanical name
Caulophyllum thalictroides
Parts used and where grown
Blue cohosh grows throughout North America. The roots of this flower are used medicinally. Blue cohosh is not related to black cohosh (Cimicifuga racemosa). However, both herbs are primarily used to treat women’s health problems.
Blue cohosh has been used in connection with the following conditions (refer to the individual health concern for complete information):
Science Ratings - Health Concerns
* - Amenorrhea (lack of menstruation)
* - Dysmenorrhea (painful menstruation)
*** - Reliable and relatively consistent scientific data showing a substantial health benefit.
** - Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
* - For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
Historical or traditional use (may or may not be supported by scientific studies)
Native Americans are believed to have used blue cohosh flowers to induce labor and menstruation.1 Blue cohosh is a traditional remedy for lack of menstruation. It is considered an emmenagogue (agent that stimulates menstrual flow) and a uterine tonic. No clinical trials have validated this traditional use. It has also been used traditionally to treat painful periods (dysmenorrhea). Early 20th century physicians in the United States who treated with natural remedies (known as Eclectic physicians) used blue cohosh for these same purposes and also to treat kidney infections, arthritis, and other ailments.
Active constituents
A saponin from blue cohosh called caulosaponin is believed to stimulate uterine contractions.2 Several other alkaloids may be active in this herb. However, current research about the active constituents of blue cohosh is insufficient.
How much is usually taken?
Blue cohosh is generally taken as a tincture and should be limited to no more than 1–2 ml taken three times per day. The whole herb (300–1,000 mg per day) is sometimes used. Blue cohosh is generally used in combination with other herbs.
Are there any side effects or interactions?
Large amounts of blue cohosh can cause nausea, headaches, and high blood pressure. Blue cohosh should only be used under medical supervision and in limited amounts. Using blue cohosh during pregnancy has been brought into question by reports of an infant developing a stroke and another infant being born with congestive heart failure.3 4 Safety studies need to be completed to determine whether blue cohosh is safe to use during pregnancy.
At the time of writing, there were no well-known drug interactions with blue cohosh.
Source: www.cncahealth.com

blessed thistle

Common name
St. Benedict Thistle
Botanical name
Cnicus benedictus
Parts used and where grown
Although native to Europe and Asia, blessed thistle is now cultivated in many areas of the world, including the United States. The leaves, stems, and flowers are all used in herbal preparations.
Blessed thistle has been used in connection with the following conditions (refer to the individual health concern for complete information):
Science Ratings - Health Concerns
* - Indigestion and heartburn
* - Poor appetite
*** - Reliable and relatively consistent scientific data showing a substantial health benefit.
** - Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
* - For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
Historical or traditional use (may or may not be supported by scientific studies)
Folk medicine used blessed thistle tea for digestive problems, including gas, constipation, and stomach upset. This herb was also used—like its well-known relative, milk thistle1 —for liver and gallbladder diseases.
Active constituents
The sesquiterpene lactones, such as cnicin, provide the main beneficial effects of blessed thistle in the treatment of indigestion. The bitterness of these compounds stimulates digestive activity, including the flow of saliva and secretion of gastric juice, which leads to improved appetite and digestion.2 Some pharmacological evidence suggests that blessed thistle may also have anti-inflammatory properties.3
How much is usually taken?
The German Commission E monograph recommends 4–6 grams of blessed thistle per day.4 Alternatively, tincture (1/2 teaspoon [2 ml] three times per day) may be used. Approximately 1/2 teaspoon (2 grams) of the dried herb can also be added to 1 cup (250 ml) of boiling water and steeped 10 to 15 minutes to make a tea. Three cups can be drunk each day.
Are there any side effects or interactions?
Blessed thistle is generally safe and is not associated with side effects. Anyone with allergies to plants in the daisy family should use blessed thistle cautiously.
At the time of writing, there were no well-known drug interactions with blessed thistle.

evening primrose oil

Also indexed as
Black Currant Seed Oil, EPO, Oenothera biennis
Introduction
Evening primrose oil (EPO), comes from the seeds of the evening primrose plant. Like black currant seed oil and borage oil, EPO contains gamma linolenic acid (GLA), a fatty acid that the body converts to a hormone-like substance called prostaglandin E1 (PGE1).
Where is it found?
EPO is found primarily in supplements. Its presumed active ingredient, GLA, can also be found in black currant seed oil and borage oil supplements. However, it is not known whether the effects of these three oils in the body are the same.
Evening primrose oil has been used in connection with the following conditions (refer to the individual health concern for complete information):
Science Ratings - Health Concerns
*** - Type 1 diabetes
*** - Type 2 diabetes
** - Eczema
** - Fibrocystic breast disease
** - Osteoporosis (in combination with fish oil)
** - Premenstrual syndrome (PMS)
** - Rheumatoid arthritis
** - Skin ulcers
* - Alcohol withdrawal
* - Atherosclerosis
* - Attention deficit disorder
* - Chronic obstructive pulmonary disease
* - Intermittent claudication
* - Irritable bowel syndrome (IBS)
* - Multiple sclerosis
* - Raynaud’s disease
* - Scleroderma
* - Sjogren’s syndrome
* - Tardive dyskinesia
*** - Reliable and relatively consistent scientific data showing a substantial health benefit.
** - Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
* - For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
Who is likely to be deficient?
Those with premenstrual syndrome,1 diabetes,2 scleroderma,3 Sjogren’s syndrome,4 tardive dyskinesia,5 eczema,6 and other skin conditions7 can have a metabolic block that interferes with the body’s ability to make GLA. In preliminary research, supplementation with EPO has helped people with these conditions.8 9 10 11 12
There is evidence that alcoholics may be deficient in GLA, and a double-blind study suggested that alcohol withdrawal may be facilitated with EPO supplementation.13 Many people in Western societies may be at least partially GLA-deficient as a result of aging, glucose intolerance, high dietary fat intake, and other problems. People with deficiencies would presumably benefit from supplemental GLA intake from EPO, black currant seed oil, or borage oil.
How much is usually taken?
Although many people may have inadequate levels of GLA, the optimal intake for this nutrient remains unknown. Researchers often use 3,000–6,000 mg of EPO per day, which provides approximately 270–540 mg of GLA.
Are there any side effects or interactions?
EPO has been reported to exacerbate symptoms of temporal lobe epilepsy, which can sometimes be mistaken for schizophrenia.14 15
Other nutrients are needed by the body, along with EPO, to make PGE1. Consequently, some experts suggest that magnesium, zinc, vitamin C, niacin, and vitamin B6 should be taken along with EPO.
Drug Interactions
Certain medicines interact with evening primrose oil: Some interactions may increase the need for evening primrose oil (+), other interactions may be negative (-) and indicate evening primrose oil should not be taken without first speaking with your physician or pharmacist, others may require further explanation (?). Refer to the individual drug article for specific details about an interaction.
Note: The following list only includes the generic or class name of a medicine. To find a specific brand name, use the Medicines index.
Tamoxifen (+)
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