Herb Profile
Black Cohosh Actaea Racemosa
Actaea racemosa
Black Cohosh (Actaea racemosa) is most studied for menopausal symptoms such as hot flashes, with proposed serotonergic and estrogen receptor modulating activity rather than classical hormonal action.
Last reviewed: •3 sources citedReport a correctionProfile-wide ·B Moderate
Use extra caution — Generally well tolerated; rare suspected hepatotoxicity reports; clinical trials have not consistently shown liver injury Details
- Evidence
- Moderate Evidence
- Typical onset
- Varies by prep
- Safety rating
- High caution
- Best for
- Anti Inflammatory, Hormonal, Inflammatory signaling
- Avoid / review if
- Liver Disease, Pregnancy, Hepatotoxic Drugs (Caution)
Safety
Safety & Cautions
Generally well tolerated; rare suspected hepatotoxicity reports; clinical trials have not consistently shown liver injury
High caution
Caution level: High. Multiple caution categories apply, or the record uses avoid/contraindication language.
- Liver-SensitiveLiver-related caution language appears in the profile.
- Hormonal Activity ContextHormone-adjacent wording is present and should be interpreted carefully.
Detailed safety fields
Pregnancy, breastfeeding, and contraindications
- Liver Disease
- Pregnancy
- Hepatotoxic Drugs (Caution)
Safety classifications
- Liver-Sensitive: Liver-related caution language appears in the profile.
- Hormonal Activity Context: Hormone-adjacent wording is present and should be interpreted carefully.
Full safety note
- Generally well tolerated; rare suspected hepatotoxicity reports; clinical trials have not consistently shown liver injury
Safety labels
- Liver-Sensitive
- Hormonal Activity Context
Evidence
Evidence Summary
Evidence lens
Useful signal, but study design, dose, and population still matter.
ModerateModerate Evidence
Human clinical evidence: Present in source signals
Mechanistic / preclinical: Mechanism mapped — Inflammatory Signaling Modulation · Hormonal Signaling Context · NF KB Modulation
Research maturity: Established research — Long Term Human Evidence May Be Limited.
Safety boundary: Safety note available — Generally well tolerated; rare suspected hepatotoxicity reports; clinical trials have not consistently shown liver injury
This profile cites 3 human studies.
Study design details
Evidence Grade
Grade B: Moderate Evidence
Evaluation of methodological rigor, population reach, and evidence alignment.
- Design Match
- Meta-analysis
- Risk of Bias
- Low
- Consistency
- Not assessed
Strongest recorded design is a meta-analysis, drawn from 3 recorded studies, 2 in people.
How evidence grades work
Each grade reflects the strength and consistency of published human evidence — not marketing claims. Grades are based on study count, design quality, effect size, consistency, and recency.
- Strong
- Multiple RCTs, consistent direction, adequate effect size
- Moderate
- Some RCTs or consistent observational data in humans
- Preliminary / Mixed
- Animal or in-vitro only, or conflicting human data
- Traditional / Theoretical
- Traditional use only; no controlled human trials
Clinical Study Summaries (5)2 human evidence sources · 0 human trials · Participant totals not consistently reported · Consistency not yet classifiable
Filter by study class
Showing 5 of 5 studies.
What the evidence actually shows
This table contains 5 structured sources, including 2 human evidence sources; 0 are human trials.
| Study | Design | N | Dose | Duration | Population | Outcome | Result & magnitude | Source |
|---|---|---|---|---|---|---|---|---|
Black cohosh extracts in women with menopausal symptoms Meherishi S et al. · Menopause · 2023 Background | Meta-analysis Statistically combines results from multiple eligible studies; confidence still depends on the quality, consistency, and directness of those studies. | — | — | — | — | — | — | PubMed → |
Background | Systematic review Uses a predefined method to find and evaluate relevant studies, but may or may not pool their results statistically. | — | — | — | — | — | Systematic evidence for menopausal symptoms is mixed across black-cohosh preparations. Extract/product identity and symptom endpoint matter, and the evidence does not justify broad estrogen-like or hormone-normalizing claims. | PubMed → |
Background | Narrative review Summarizes selected literature without the full prespecified search and selection methods of a systematic review. | — | — | — | — | — | Safety review evidence highlights uncertainty around causality in reported liver-injury cases and substantial product variability. The correct framing is a provenance-sensitive safety signal, not a universal causal claim or a blanket reassurance. | PubMed → |
Black Cohosh: Health Professional Fact Sheet NIH Office of Dietary Supplements · 2020 Background | Other / unclear The study design is not yet classified clearly enough to infer its place in the evidence hierarchy. | — | — | — | — | — | — | Source → |
LiverTox: Clinical and Research Information on Drug-Induced Liver Injury · 2024 Background | Other / unclear The study design is not yet classified clearly enough to infer its place in the evidence hierarchy. | — | — | — | — | — | — | Source → |
Dosing & Timing
- Dose guidance
- Standardized extract (e.g., 2.5% triterpene glycosides): 20 80 mg/day; variability across products
How Black Cohosh Actaea Racemosa works
Simplified mechanism pathway based on preclinical and pharmacological evidence. Does not confirm clinical efficacy.
Mechanism Pathway — How Black Cohosh Actaea Racemosa Works
CompoundTarget / ReceptorMechanismEffect / Outcome
Mechanisms & biological pathways (preclinical)
- Inflammatory Signaling Modulation
- Hormonal Signaling Context
- NF KB Modulation
Active Compounds
Key constituents studied in Black Cohosh Actaea Racemosa, with full pharmacology and safety profiles.
Compare related active botanicals
Explore botanicals with similar chemistry, effects, or safety considerations in the Botanical Activity Atlas.
Compare & Sourcing
Compare side-by-side tradeoffs or verify active marker guidelines.
Sourcing options
Black Cohosh product picks
Affiliate recommendations for Black Cohosh Actaea Racemosa. Review safety, dose, and product quality before buying.
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Product form & quality guidelines
When sourcing Black Cohosh Actaea Racemosa, verify the label for:
- Standardized extract: Confirm active content percentages on the supplement facts panel (e.g. standardized to specific marker compounds) rather than simple raw herb weights.
- Third-party testing: Look for independent purity labels (USP, NSF, ConsumerLab, or Eurofins) to ensure the product is free from heavy metals, solvents, and contaminants.
- Form bioavailability: Ensure the form matches evidence-supported configurations (e.g. standardized active extracts like bacosides, withanolides, or curcuminoids) for optimal onset and digestion tolerance.
Safety first · Harm reduction
This information is educational and not medical advice. Start low, avoid risky combinations, and consult a licensed clinician before making health decisions—especially if you use medications, have diagnosed conditions, or are pregnant/breastfeeding.
Learn how we evaluate confidence, safety, and intensity on the methodology page.
Founder & Head Researcher · Oak Ridge, TN · Last reviewed August 2026
Editorial Review
Checked against primary sources, cited evidence, and contraindication language before publication. Evidence claims, safety language, and affiliate modules are reviewed independently. Not personal medical advice.
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