-IBIS-1.7.0-
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Cimicifuga racemosa (Black Cohosh)
Botanicals

definition

botanical name(s): Cimicifuga racemosa

synonyms: black cohosh, black snakeroot, rattleweed

part(s) used: rhizome, roots.

qualities: bitter, pungent, warm, dry.

affinities: hypothalamic-pitutuitary-gonadal axis, lungs, reproductive tract, smooth and striated muscle.

actions: Emmenogogue, hormonal and utero-ovarian tonic (estrogen mimetic, LH suppressive), antirheumatic, antitussive, sedating nervine, antispasmodic.

dosage:

» tincture: (Fresh 1:2, Dry 1:5) 0.5-2ml twice daily or T.I.D

» Standardised Extract: Standardised to triterpenes as 27-desoxyactein. 20mgm twice daily

(Manufacturers preparations may vary)

therapy:

» Menopausal symptoms, PMS symptoms, dysmenorrhea hypertension, spasmodic rheumatic conditions, bronchitis, pertussis, hypertension.

» Depression, deep gloom, associated with menstrual cycle (Boericke, 1927)

» spastic parametropathy; conditions based on estrogen deficiency; puberty; pregnancy, menopause; menopausal depression (Weiss, 1988);

»intercostal myalgia; chorea; tinnitus aurium (Bradley, 1992)

specific indications:

» menopausal symptoms, dysmennorrhea.

» Eclectic Specifcic indications: see footnote.-

constituents:

» triterpene glycosides (including Actein, cimicifugoside, 27 desoxyactein)

» Isoflavones (including formononetin).

» Aromatic acids (including isoferulic, salicylic)

pharmacology:

» Cimicifuga extracts have been shown to reduce LH levels in vivo- animal studies. They also bind competitvely to estrogen receptors in rat uteri (Jarry, 1985)

clinical trials: In a clinical trial of 110 menopausal women, standardised Cimicifuga (Remifemin) after two months at 8mg daily reduced LH but did not change FSH levels (Duker, 1991). In another group of hysterectomized women, Cimicifuga extract gave similar climacteric symptom releif as estriol, conjugated estrogen, and estrogen-getagen combinations, (Lehmann, 1988).

AHPA Botanical Safety Rating: 2b, 2c.

toxicity: 2

Cimicifuga has minimal to mild toxicity. Occasional side effects of gastro-intestinal disturbance, and frontal headache are reported. SInce long term studies are lacking, Commission E recommends duration of treatment not to exceed six months. (Blumenthal et al. 1997)

contraindications:

» pregnancy until end of 3rd trimester when it is considered partus preparator by midwife herbalists. It may also be used to prevent threatened miscarriage, however this is only recommended for obsterically experienced herbalists or herbally experienced midwives.

» lactation (Brinker, 1998)

Note:

Eclectic Medicine and Cimifuga: Cimicifuga was an important Eclectic medication and played a key role in the history of eclectic theraputics as Macrotys, which at one time was prepared, like Podophyllum, as a solid extract by the "resinoid" faction of the Eclectics. Later it became an important Specific Medication.

Specific Indications: heavy, tensive, aching pain (Scudder); pain characterized as rheumatic: dull, tensive, intermittent, drawing, and seeming as if dependent upon a contracted state of the muscular fibers; soreness of muscular tissues, as if one had been pounded or bruised; stiff neck; aching of whole body from colds; the onset of fevers, or from muscular exertion; lumbago; bruised feeling of muscles of the forehead, with stiffness of the ocular muscles; soreness and stiffness of the throat with sense of muscular drawing in the pharynx and fauces; muscular pains in the loins, thigh, or back, of a drawing character; deep-seated boring and tensive pains; rheumatoid dyspepsia: dull, aching pain and tenderness in stomach and bowels, with tendency to metastasis, and aggravated by food and drink, the stomach feeling as if painfully contracting upon a hard body or lump; the soreness and aching pains of abdominal gripe, when of rheumatoid type; sore, bruised sensation in the respiratory tract; chronic muscular rheumatism; ovarian pains of a dull aching character; dragging pains in the womb, with sense of soreness; the dull tensive pains incident to reproductive disorders of the female; false pains; after-pains; weak, irregular uterine contractions during labor; irregular, scanty, or delayed menstruation, with dull pain and muscular soreness; chorea, with amenorrhea; rheumatism of the uterus (Felter, p. 466)

muscular aching and pains of la grippe; rheumatic endocarditis; diaphragmatic rheumatism, pleurodynia, intercostal neuralgia; gastralgia, enteralgia, mediastinal pain, pain in the orbits and ears, when acute and rheumatoid in nature; acute muscular pain; headache; eye-strain; atony of the reproductive tract; amenorrhea; dysmenorrhea; uterine subinvolution; leukorrhea; reflex mammary pains during gestation; ovaralgia; ovarian neuralgia; hysteria; spasmodic asthma; pertussis

footnotes

General Reference, Snow J, 1996. Cimicifuga racemosa Monograph. Protocol Journal of Botanical Medicine. 1(4):17-19

Boericke, W., 1927.Pocket Manual of Homeopathic Materia Medica and Repertory. B. Jain Publishers Pvt. Ltd., New Delhi.

Bradley. P.R. 1992. Black Cohosh Monograph British Herbal Compendium. 34-36. BHMA.

Blumenthal, M., Gruenwald, J., Hall, T., & Riggins, CW, (eds.). 1998. German Commission E Monographs: Therapeutic Monographs on Medicinal Plants for Human Use. Austin, TX: American Botanical Council.

Brinker, F. 1998 Herb Contraindications and Drug Interactions. 2nd edition. In Press. Eclectic Institute Inc, Sandy, OR.

Duker EM et al. 1991. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Med 57(5):420-4

ABSTRACT: Remifemin is an ethanolic extract of the rhizome of Cimicifuga racemosa (C.r.) and is used to relieve climacteric hot flushes. In the present study the effects of this preparation on LH and FSH secretion of menopausal women were investigated. After an 8 weeks treatment, LH but not FSH levels were significantly reduced in patients receiving the Cimicifuga extract. To further characterize the endocrinologically active principles of this plant extract, a lipophilic extract of C.r. was prepared and subjected to Sephadex chromatography. Fractions obtained were tested for their ability to reduce LH secretion in ovariectomized (ovx) rats and to compete in vitro with 17 beta-estradiol for estrogen receptor binding sites. Three types of endocrinologically active compounds were obtained: (1) Constituents which were not ligands for the estrogen receptor but suppress LH release after chronic treatment, (2) constituents binding to the estrogen receptor and also suppressing LH release, and (3) compounds which are ligands for the estrogen receptor but without an effect of LH release. It is concluded that the LH suppressive effect of C.r. extracts observed in menopausal women and ovx rats is caused by at least three different synergistically acting compounds.

Felter, H.W. 1922. The Eclectic Materia Medica, Pharmacology and Therapeuticsreprinted, Eclectic Institute, Sandy OR, 1983.

Jarry H., et al. 1985. Studies of the endocrine effects of the contents of Cimicifuga racemosa 2. In vitro binding of the compounds to Estrogen receptors. Planta Medica 4;316-319.

Lehmann W.E., Reidel H.H. 1988 Zentralbatt fuer Gynakologie 110:610-618 (Quoted in Snow, 1996)

Weiss, R.F., 1988 Herbal Medicine p319. AB Arcanum, Beaconsfield, UK.