Black cohosh extract is marketed in the United States as a natural form of hormone replacement therapy (HPT) and is used to treat menopause symptoms, such as hot flashes and night sweats.
A new meta-analysis involving more than 1,100 women who used either black cohosh or a comparison substance (inactive placebo or a hormonal medication called tibolone) for three to six months found no evidence black cohosh triggered harmful changes in liver enzymes, an indicator of liver damage.
Before treatment, 37 black cohosh users exhibited abnormally high levels a liver enzyme known as AST but 62 percent of the participants saw AST levels return to normal levels during the course of the treatment.
Meanwhile reports of liver inflammation and liver failure in small number of users have prompted some countries to place a warning label on black cohosh products. In most of those cases, doctors were unable to account for patients' drinking habits or use of medications that might also damage the liver.
Signs of liver toxicity include: abdominal pain, dark urine and/or jaundice (yellowing of the skin), among others.
Patients should remember that deciding to use hormone replacement therapy or a natural alternative is a complicated issue that involves many health factors.
Women who are at the age of menopause should have a discussion with their physician to determine what the best course of action should be. Always speak with your physician before starting any kind of natural remedy.