Liver failure and black cohosh

The 51-year old woman, reported in the latest issue of The Medical Journal of Australia, had been using black cohosh at a dose of 20 mg per day, on and off for three years, according to the severity of her menopausal symptoms.

She had suffered from nausea, lethargy and aching joints for two months. During the previous two months she had suffered particularly bad menopausal symptoms and had increased the dose of black cohosh to 20 mg twice a day - the manufacturer's maximum recommended dose. She had acute hepatitis, which was as a result of taking black cohosh, and needed a liver transplant.

Black cohosh is available over the counter and is used worldwide by millions of women to control menopausal symptoms. It is generally thought to be safe, but over the past 10 years there have been seven cases of severe liver failure as a result of its use. Most authorities now recommend that warnings against liver failure be placed on black cohosh preparations and that women taking the product should have their liver function monitored.