Caulophylle faux-pigamon

Related Terms

Alkaloid, alpha-isolupanine, anagyrine, aporphine, baptifoline, beechdrops, Berberidaceae (family), blue cohosh root, blue ginseng, blueberry, Caulophyllum, Caulophyllum thalictroides Mich., Leontice thalictroides (L.), lupanine, magnoflorine, Mastodynon, N-methylcytisine, papoose root, quinolizidine alkaloids, saponins, scaulophylline, sparteine, squaw root, taspine, thalictroidine, triterpene saponins, yellow ginseng.
Note: Blue cohosh (Caulophyllum thalictroides) should not be confused with black cohosh (Cimicifuga racemosa), an over-the-counter herbal supplement sold as a menopause and menstrual remedy.

Background

Blue cohosh has been used for hundreds of years primarily to help women in the area of childbirth. It was used as a medicinal herb by Native American women to facilitate labor. Today, the herb is most commonly used to stimulate labor and to ease the effects of childbirth.
Modern herbalists often recommend blue cohosh as an emmenagogue to induce menstruation, and as a uterine stimulant and antispasmodic. It is also frequently employed as a diuretic to eliminate excess fluids, as an expectorant to treat congestion, and as a diaphoretic to eliminate toxins by inducing sweating. Traditional herbalists will often combine blue cohosh and black cohosh to effect a more balanced treatment for nerves and to enhance the herbs' antispasmodic effects. Blue cohosh is combined with other herbs to promote their effects in treating bronchitis, nervous disorders, urinary tract ailments, and rheumatism. Blue cohosh is also thought to help pelvic inflammatory disease, endometriosis, erratic menstruation, and retained placenta. In addition, the herb is also believed to relieve ovarian neuralgia (nerve pain).
Although blue cohosh has been indicated for many conditions, all indications lack sufficient scientific data to support their efficacy and safety at this time. More research is needed in these areas before firm conclusions can be drawn.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)
* Key to grades

A: Strong scientific evidence for this use
B: Good scientific evidence for this use
C: Unclear scientific evidence for this use
D: Fair scientific evidence for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Dosing

Adults (18 years and older)
Based on available scientific evidence, there is no proven safe or effective dose for blue cohosh. As a decoction, 4 grams twice daily or 1-3 grams every three to four hours has been used. As a fluid extract, 0.5-1.0 milliliter (1:1 in 70% alcohol) three times daily as a preparation for pregnancy has been used. As an infusion/tea, 2-4 fluid ounces (1oz root to 1 pint boiling water) two to four times daily has been used. Also, 300-1,000 milligrams of the dried whole herb up to three times daily has been used.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Interactions

Interactions with Drugs
Blue cohosh may increase blood glucose levels. Caution is advised when using medications that may lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary.
Blue cohosh may have antispasmodic effects. Individuals using blue cohosh with other drugs with antispasmodic effects should consult with a qualified healthcare professional, including a pharmacist.
Blue cohosh may cause coronary vasoconstriction (decreased blood flow due to constriction of blood vessels), tachycardia (increased heart rate), and possible increases in blood pressure. Individuals taking medications that affect heart rate or blood pressure should consult with a qualified healthcare professional, including a pharmacist.
A constituent of blue cohosh, N-methylcytisine, is similar to nicotine and may lead to nicotinic toxicity. Caution is advised in patients who smoke or use other products containing nicotine.
Blue cohosh may induce labor and should not be used with oxytocin (Pitocin ?).

Attribution

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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Edmunds J. Blue cohosh and newborn myocardial infarction? Midwifery Today Int.Midwife. 1999;(52):34-35.
Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N.Engl.J.Med. 7-15-2004;351(3):302-303.
Ganzera M, Dharmaratne HR, Nanayakkara NP, et al. Determination of saponins and alkaloids in Caulophyllum thalictroides (blue cohosh) by high-performance liquid chromatography and evaporative light scattering detection. Phytochem.Anal. 2003;14(1):1-7.
Gunn TR, Wright IM. The use of black and blue cohosh in labour. N.Z.Med.J. 10-25-1996;109(1032):410-411.
Jhoo JW, Sang S, He K, et al. Characterization of the triterpene saponins of the roots and rhizomes of blue cohosh (Caulophyllum thalictroides). J.Agric.Food Chem. 2001;49(12):5969-5974.
Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J.Pediatr. 1998;132(3 Pt 1):550-552.
Kennelly EJ, Flynn TJ, Mazzola EP, et al. Detecting potential teratogenic alkaloids from blue cohosh rhizomes using an in vitro rat embryo culture. J.Nat.Prod. 1999;62(10):1385-1389.
Lin LT, Liu LT, Chiang LC, et al. In vitro anti-hepatoma activity of fifteen natural medicines from Canada. Phytother Res 2002;16(5):440-444.
Low DT. Blue cohosh and neonatal myocardial toxicity. Journal of the American Herbalists Guild 2001;2(2):9-10.
McFarlin BL, Gibson MH, O'Rear J, et al. A national survey of herbal preparation use by nurse-midwives for labor stimulation. Review of the literature and recommendations for practice. J.Nurse Midwifery 1999;44(3):205-216.
Rao RB, Hoffman RS. Nicotinic toxicity from tincture of blue cohosh (Caulophyllum thalictroides) used as an abortifacient. Vet.Hum.Toxicol. 2002;44(4):221-222.
Reichert R. Neonatal congestive heart failure associated with maternal use of blue cohosh. Quarterly Review of Natural Medicine 1998;Winter:265-267.
Scott CC, Chen KK. The pharmacological action of N-methylcytisine. The Journal of Pharmacology and Experimental Therapuetics 1943;79:334-339.