Background

Blue cohosh is a plant. "Cohosh" is from the Algonquin Indian word meaning "rough," and it refers to the appearance of the roots. The root is used to make medicine. Blue cohosh is not a safe plant. However, it still is available as a supplement. Sometimes the supplements do not include warnings.

Blue cohosh is used for stimulating the uterus and starting labor; starting menstruation; stopping muscle spasms; as a laxative; and for treating colic, sore throat, cramps, hiccups, epilepsy, hysterics, inflammation of the uterus, infection of the female organs (pelvic inflammatory disease), over-growth of uterine tissue (endometriosis), and joint conditions.

In foods, the roasted seeds of blue cohosh are used as a coffee substitute.

Safety Safety definitions

Blue cohosh is LIKELY UNSAFE for adults when taken by mouth. It can cause diarrhea, stomach cramps, chest pain, increased blood pressure, increased blood sugar, and other severe side effects.

Special Precautions & Warnings:

Pregnancy and breast-feeding: It is LIKELY UNSAFE to take blue cohosh by mouth during pregnancy. Some of the chemicals in blue cohosh can cause birth defects. When taken by the mother late in pregnancy, blue cohosh can cause severe heart problems in the newborn baby. It can also be toxic to the mother.

Many midwives still use blue cohosh to make childbirth easier, because blue cohosh causes the uterus to contract. But this is a dangerous practice, and it should be avoided.

Heart conditions: There is concern that blue cohosh might worsen some heart conditions. These conditions include chest pain (angina) and high blood pressure. Blue cohosh might cause blood vessels in the heart to become smaller and decrease oxygen flow to the heart. It might also increase blood pressure and cause rapid heartbeat. Don't use blue cohosh if you have a heart condition.

Diabetes: There is some concern that blue cohosh might make diabetes worse. It can raise blood sugar levels in some people who have diabetes.

Diarrhea: Blue cohosh might make diarrhea symptoms worse.

Hormone-sensitive conditions such as breast cancer, uterine cancer, ovarian cancer, endometriosis, or uterine fibroids: Blue cohosh might act like estrogen. If you have any condition that might be made worse by exposure to estrogen, don't use blue cohosh.

Effectiveness

Dosing & administration

The appropriate dose of blue cohosh depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for blue cohosh. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

Interactions with pharmaceuticals

Medications for diabetes (Antidiabetes drugs)

Interaction Rating=Moderate Be cautious with this combination.

Blue cohosh might increase blood sugar. Diabetes medications are used to lower blood sugar. By increasing blood sugar, blue cohosh might decrease the effectiveness of diabetes medications. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.

Medications for high blood pressure (Antihypertensive drugs)

Interaction Rating=Moderate Be cautious with this combination.

Blue cohosh seems to increase blood pressure. By increasing blood pressure blue cohosh might decrease the effectiveness of medications for high blood pressure.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), amlodipine (Norvasc), hydrochlorothiazide (HydroDiuril), furosemide (Lasix), and many others.

Nicotine

Interaction Rating=Moderate Be cautious with this combination.

Blue cohosh contains chemicals that work similarly to nicotine. Taking blue cohosh with nicotine might increase the effects and side effects of nicotine.

Interactions with herbs & supplements

There are no known interactions with herbs and supplements.

Interactions with foods

There are no known interactions with foods.

Action

It is thought that blue cohosh might have effects similar to the hormone estrogen. It also may narrow the vessels that carry blood to the heart that can decrease oxygen in the heart.