| Actaea racemosa | |
|---|---|
 | |
| Inflorescence | |
Scientific classification | |
| Kingdom: | Plantae |
| Clade: | Tracheophytes |
| Clade: | Angiosperms |
| Clade: | Eudicots |
| Order: | Ranunculales |
| Family: | Ranunculaceae |
| Genus: | Actaea |
| Species: | A. racemosa |
| Binomial name | |
| Actaea racemosa | |
| Synonyms[1] | |
Synonymy
| |
Actaea racemosa, theblack cohosh,black bugbane,black snakeroot,rattle-top, orfairy candle (syn.Cimicifuga racemosa), is aspecies offlowering plant of thefamilyRanunculaceae. It isnative 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.
Theroots andrhizomes are used intraditional medicine byNative Americans.[2] Itsextracts are manufactured asherbal medicines ordietary supplements.[3] Most dietary supplements containing black cohosh are not well-studied or recommended for safe and effective use in treatingmenopause symptoms or any disease.[3][4] A thorough literature profiling suggests thatCimicifuga racemosa is more efficient compared to a placebo in treating vasomotor symptoms resulting from natural menopause. The present review clearly encapsulates the use of CR extract for effective and safe therapy to alleviate menopausal symptoms.[5]
The plantspecies has a history of taxonomic uncertainty.Carl Linnaeus, on the basis of morphological characteristics of theinflorescence and seeds, placed the species into the genusActaea. This designation was later revised byThomas Nuttall reclassifying the species to the genusCimicifuga. Nuttall's classification was based solely on the dry follicles produced by black cohosh, which are typical of species inCimicifuga.[6] However, recent data from morphological andgenephylogeny analyses demonstrate that black cohosh is more closely related to species of the genusActaea than to otherCimicifuga species. This has prompted the revision toActaea racemosa as originally proposed by Linnaeus.[6] Blue cohosh (Caulophyllum thalictroides), despite its similar common name belongs to anotherfamily, theBerberidaceae, is not closely related to black cohosh, and may be unsafe if used together.[2]
Black cohosh is a smooth (glabrous)herbaceousperennial plant that produces large,compound leaves from an undergroundrhizome, reaching a height of 25–60 cm (9.8–23.6 in).[7][8] The basalleaves 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.
Theflowers are produced in late spring and early summer on a tall stem, 75–250 cm (30–98 in) tall, formingracemes up to 50 cm (20 in) long. The flowers have nopetals orsepals, and consist of tight clusters of 55–110 white, 5–10 mm (0.20–0.39 in) longstamens surrounding a white stigma. The flowers have a distinctly sweet, fetid smell that attracts flies,gnats, and beetles.[7]
Thefruit is a dryfollicle 5–10 mm (0.20–0.39 in) long, with onecarpel, containing severalseeds.[6]
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, superficially maple-like leaves, burgundy colored in the variety "atropurpurea",[9] 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 theRoyal Horticultural Society'sAward of Garden Merit.[10]
The plant was Virginia Native Plant Society's 2017 wildflower of the year.[11]
Native Americans used black cohosh in the belief it could treatgynecological and other disorders.[3][8][12] The plant appeared in theU.S. Pharmacopoeia under the name "black snakeroot" during the year 1830.[3] In the 19th century, the root was used to treat snakebite, inflamed lungs, and pain from childbirth.[13]
Extracts from the underground parts of the plant — the rhizome (Cimicifugae racemosae rhizoma) and the root (Cimicifugae racemosae radix) — are used inherbal medicine.[2] The rhizomes and roots contain varioussaponins (triterpene saponins and triterpene glycosides, such as actein) as well as cimifugic acids and other phenolcarboxylic acids.[3][4]
In most European countries, China, Malaysia, Thailand, Argentina and some other countries, black cohosh products are available as herbal products which have been approved by regulatory authorities ensuring reliable pharmaceutical quality, safety and efficacy for the relief of menopausal complaints such as hot flushes and profuse sweating.[4] In the U.S., India, and some other countries, black cohosh is used as adietary supplement marketed mainly to women for treating menopausal symptoms and other gynecological problems.[8][14] Meta-analyses of contemporary evidence support these claims on menopausal complaints only for products holding a marketing authorization for this indication,[15] whereas there is nohigh-quality scientific evidence to support such uses for other products.[2][3][16]
Black cohosh does not prevent or treat cancer. Some people attempt to manage the side effects of breast cancer treatments using black cohosh supplements, but there is no good evidence this has any benefit.[17]
There is a lack of long term safety information for black cohosh.[17]
The Herbal Medicinal Product Committee (HMPC) at the European Medicines Agency (EMA) has summarized the adverse drug reactions of herbal medicines made from cimicifuga with mentioning allergic skin reactions (urticaria, itching, exanthema), facial oedema and peripheral oedema, and gastrointestinal symptoms (i.e. dyspeptic disorders, diarrhoea).[4]
Black cohosh does not show harmful effects onendometrium[18] or breast cancer survivors.[19] In contrast, such studies have not been published for dietary supplements made from black cohosh.[3][12][2] Most black cohosh materials are harvested from the wild. Lack of proper authentication andadulteration of commercial preparations by other plant species are risk factors in dietary supplements[8][20] and a critical matter of quality control in herbal medicinal products holding a marketing authorization. Very high doses of black cohosh may causenausea, dizziness, visual effects, a lower heart rate, and increased perspiration.[12]
Worldwide, some 83 cases of liver damage, includinghepatitis,liver failure, and elevatedliver enzymes, have been associated with using black cohosh, although acause-and-effect relationship remains undefined.[3] The clinical picture is similar to an autoimmune hepatitis with centrilobular liver cell necrosis, which can be treated with corticosteroids.[21] Package leaflets of phytomedicines made from black cohosh caution that people with liver problems should not take it,[2][17]
In 2007, the Australian Government warned that black cohosh may cause liver damage, although rarely, and should not be used without medical supervision.[22] Other studies concluded that liver damage from use of black cohosh is unlikely.[23][24][25]
But millions of women have taken black cohosh without reportingadverse health effects,[2] and ameta-analysis ofclinical trials found no evidence that black cohosh preparations had adverse effects on liver function.[26]
The rhizomes and roots of black cohosh (Cimicifuga racemosa rhizoma) contain diversephytochemicals, particularlytriterpeneglycosides, such as actein and cimicifugoside, cimicifugin,caffeic acid, varioussaponins, andphenolic acids.[3][4][27][28]
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