The authors of this article reviewed 69 cases in which black cohosh (Cimicifuga racemosa) herb was suspected of having caused liver disease.  Included were 11 published reports and 58 regulatory health agency reports.  The authors have doubts about whether the diseases were actually caused by black cohosh, and in general, the evidence was considered to be of poor quality.

There were a number of inconsistencies in reported data.  Often there was uncertainty about which black cohosh supplement was used; and, it was not disclosed why the patient was taking black cohosh in some cases.  There was lack of evidence about how long the person took black cohosh in relationship to the onset of liver disease.  There was inadequate reporting of alcohol use, other medications used, and reporting of results of reuse of black cohosh by the patients at a later date, etc.

CONCLUSION:  The cases of suspected liver disease secondary to black cohosh use were not convincing to the authors.  Better evaluation of future cases of suspected hepatotoxicity due to black cohosh is needed at the time of occurrence.  (Unfortunately, the full article is not available for free.  This summary is based on the author’s abstract only.)

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PMID: 20216279.

Summary #596.