Cimicifuga racemosa
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''Actaea racemosa'', the black cohosh, black bugbane, black snakeroot, rattle-top, or fairy candle ( syn. ''Cimicifuga racemosa''), is a
species In biology, a species is the basic unit of classification and a taxonomic rank of an organism, as well as a unit of biodiversity. A species is often defined as the largest group of organisms in which any two individuals of the appropriate s ...
of
flowering plant Flowering plants are plants that bear flowers and fruits, and form the clade Angiospermae (), commonly called angiosperms. The term "angiosperm" is derived from the Greek words ('container, vessel') and ('seed'), and refers to those plants th ...
of the
family Family (from la, familia) is a Social group, group of people related either by consanguinity (by recognized birth) or Affinity (law), affinity (by marriage or other relationship). The purpose of the family is to maintain the well-being of its ...
Ranunculaceae Ranunculaceae (buttercup or crowfoot family; Latin "little frog", from "frog") is a family of over 2,000 known species of flowering plants in 43 genera, distributed worldwide. The largest genera are ''Ranunculus'' (600 species), ''Delphinium' ...
. It is
native Native may refer to: People * Jus soli, citizenship by right of birth * Indigenous peoples, peoples with a set of specific rights based on their historical ties to a particular territory ** Native Americans (disambiguation) In arts and entert ...
to eastern North America from the extreme south of Ontario to central Georgia, and west to Missouri and Arkansas. It grows in a variety of woodland habitats, and is often found in small woodland openings. The
root In vascular plants, the roots are the organs of a plant that are modified to provide anchorage for the plant and take in water and nutrients into the plant body, which allows plants to grow taller and faster. They are most often below the sur ...
s and
rhizome In botany and dendrology, a rhizome (; , ) is a modified subterranean plant stem that sends out roots and shoots from its nodes. Rhizomes are also called creeping rootstalks or just rootstalks. Rhizomes develop from axillary buds and grow hori ...
s were used in
traditional medicine Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
by Native Americans. Its
extract An extract is a substance made by extracting a part of a raw material, often by using a solvent such as ethanol, oil or water. Extracts may be sold as tinctures, absolutes or in powder form. The aromatic principles of many spices, nuts, h ...
s are manufactured as
herbal medicines Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern remedies ...
or
dietary supplement A dietary supplement is a manufactured product intended to supplement one's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources or that are synthetic in order ...
s. Most dietary supplements containing black cohosh are not well-studied or recommended for safe and effective use in treating
menopause Menopause, also known as the climacteric, is the time in women's lives when menstrual periods stop permanently, and they are no longer able to bear children. Menopause usually occurs between the age of 47 and 54. Medical professionals often d ...
symptoms or any disease. In contrast, some herbal medicinal products containing black cohosh extract hold a marketing authorization in several states of the European Union are well-studied and recommended for safe and effective use for the relief of menopausal symptoms (i.e. in the years around menopause) such as hot flushes and profuse sweating attacks. Such differentiation between the product types seems to be important.


Taxonomy

The plant
species In biology, a species is the basic unit of classification and a taxonomic rank of an organism, as well as a unit of biodiversity. A species is often defined as the largest group of organisms in which any two individuals of the appropriate s ...
has a history of taxonomic uncertainty.
Carl Linnaeus Carl Linnaeus (; 23 May 1707 – 10 January 1778), also known after his ennoblement in 1761 as Carl von Linné Blunt (2004), p. 171. (), was a Swedish botanist, zoologist, taxonomist, and physician who formalised binomial nomenclature, the ...
, on the basis of morphological characteristics of the
inflorescence An inflorescence is a group or cluster of flowers arranged on a stem that is composed of a main branch or a complicated arrangement of branches. Morphologically, it is the modified part of the shoot of seed plants where flowers are formed o ...
and seeds, placed the species into the genus ''Actaea''. This designation was later revised by
Thomas Nuttall Thomas Nuttall (5 January 1786 – 10 September 1859) was an England, English botany, botanist and zoologist who lived and worked in America from 1808 until 1841. Nuttall was born in the village of Long Preston, near Settle, North Yorkshire, S ...
reclassifying the species to the genus '' Cimicifuga''. Nuttall's classification was based solely on the dry follicles produced by black cohosh, which are typical of species in ''Cimicifuga''. However, recent data from morphological and
gene In biology, the word gene (from , ; "...Wilhelm Johannsen coined the word gene to describe the Mendelian units of heredity..." meaning ''generation'' or ''birth'' or ''gender'') can have several different meanings. The Mendelian gene is a ba ...
phylogeny A phylogenetic tree (also phylogeny or evolutionary tree Felsenstein J. (2004). ''Inferring Phylogenies'' Sinauer Associates: Sunderland, MA.) is a branching diagram or a tree showing the evolutionary relationships among various biological spec ...
analyses demonstrate that black cohosh is more closely related to species of the genus ''Actaea'' than to other ''Cimicifuga'' species. This has prompted the revision to ''Actaea racemosa'' as originally proposed by Linnaeus. Blue cohosh (''
Caulophyllum thalictroides ''Caulophyllum thalictroides'', the blue cohosh, a species of '' Caulophyllum'' (family Berberidaceae) is a flowering plant in the Berberidaceae (barberry) family. It is a medium-tall perennial with blue berry-like fruits and bluish-green foliage ...
''), despite its similar common name belongs to another
family Family (from la, familia) is a Social group, group of people related either by consanguinity (by recognized birth) or Affinity (law), affinity (by marriage or other relationship). The purpose of the family is to maintain the well-being of its ...
, the
Berberidaceae The Berberidaceae are a family of 18 genera of flowering plants commonly called the barberry family. This family is in the order Ranunculales. The family contains about 700 known species, of which the majority are in ''Berberis''. The species i ...
, is not closely related to black cohosh, and may be unsafe if used together.


Description

Black cohosh is a smooth (glabrous)
herbaceous Herbaceous plants are vascular plants that have no persistent woody stems above ground. This broad category of plants includes many perennials, and nearly all annuals and biennials. Definitions of "herb" and "herbaceous" The fourth edition of t ...
perennial plant A perennial plant or simply perennial is a plant that lives more than two years. The term ('' per-'' + '' -ennial'', "through the years") is often used to differentiate a plant from shorter-lived annuals and biennials. The term is also wide ...
that produces large, compound leaves from an underground
rhizome In botany and dendrology, a rhizome (; , ) is a modified subterranean plant stem that sends out roots and shoots from its nodes. Rhizomes are also called creeping rootstalks or just rootstalks. Rhizomes develop from axillary buds and grow hori ...
, reaching a height of . The basal
leaves A leaf (plural, : leaves) is any of the principal appendages of a vascular plant plant stem, stem, usually borne laterally aboveground and specialized for photosynthesis. Leaves are collectively called foliage, as in "autumn foliage", wh ...
are up to long and broad, forming repeated sets of three leaflets (tripinnately compound) having a coarsely toothed (serrated) margin. The
flower A flower, sometimes known as a bloom or blossom, is the reproductive structure found in flowering plants (plants of the division Angiospermae). The biological function of a flower is to facilitate reproduction, usually by providing a mechani ...
s are produced in late spring and early summer on a tall stem, tall, forming
raceme A raceme ( or ) or racemoid is an unbranched, indeterminate type of inflorescence bearing flowers having short floral stalks along the shoots that bear the flowers. The oldest flowers grow close to the base and new flowers are produced as the s ...
s up to long. The flowers have no
petal Petals are modified Leaf, leaves that surround the reproductive parts of flowers. They are often advertising coloration, brightly colored or unusually shaped to attract pollinators. All of the petals of a flower are collectively known as the ''c ...
s or
sepal A sepal () is a part of the flower of angiosperms (flowering plants). Usually green, sepals typically function as protection for the flower in bud, and often as support for the petals when in bloom., p. 106 The term ''sepalum'' was coined b ...
s, and consist of tight clusters of 55–110 white, long
stamen The stamen (plural ''stamina'' or ''stamens'') is the pollen-producing reproductive organ of a flower. Collectively the stamens form the androecium., p. 10 Morphology and terminology A stamen typically consists of a stalk called the filame ...
s surrounding a white stigma. The flowers have a distinctly sweet, fetid smell that attracts flies,
gnat A gnat () is any of many species of tiny flying insects in the dipterid suborder Nematocera, especially those in the families Mycetophilidae, Anisopodidae and Sciaridae. They can be both biting and non-biting. Most often they fly in large ...
s, and beetles. The
fruit In botany, a fruit is the seed-bearing structure in flowering plants that is formed from the ovary after flowering. Fruits are the means by which flowering plants (also known as angiosperms) disseminate their seeds. Edible fruits in particu ...
is a dry follicle long, with one
carpel Gynoecium (; ) is most commonly used as a collective term for the parts of a flower that produce ovules and ultimately develop into the fruit and seeds. The gynoecium is the innermost whorl of a flower; it consists of (one or more) ''pistils'' ...
, containing several
seed A seed is an embryonic plant enclosed in a protective outer covering, along with a food reserve. The formation of the seed is a part of the process of reproduction in seed plants, the spermatophytes, including the gymnosperm and angiospe ...
s.


Cultivation

''A. racemosa'' grows in dependably moist, fairly heavy soil. It bears tall tapering racemes of white midsummer flowers on wiry black-purple stems, whose mildly unpleasant, medicinal smell at close range gives it the common name "Bugbane". The drying seed heads stay handsome in the garden for many weeks. Its deeply cut, superficially maple-like leaves, burgundy colored in the variety "atropurpurea", add interest to gardens, wherever summer heat and drought do not make it die back, which make it a popular garden perennial. It has gained the
Royal Horticultural Society The Royal Horticultural Society (RHS), founded in 1804 as the Horticultural Society of London, is the UK's leading gardening charity. The RHS promotes horticulture through its five gardens at Wisley (Surrey), Hyde Hall (Essex), Harlow Carr (Nort ...
's
Award of Garden Merit The Award of Garden Merit (AGM) is a long-established annual award for plants by the British Royal Horticultural Society (RHS). It is based on assessment of the plants' performance under UK growing conditions. History The Award of Garden Merit ...
. The plant was Virginia Native Plant Society’s 2017 wildflower of the year.


Traditional medicine


History

Native Americans used black cohosh in the belief it could treat
gynecological Gynaecology or gynecology (see spelling differences) is the area of medicine that involves the treatment of women's diseases, especially those of the reproductive organs. It is often paired with the field of obstetrics, forming the combined are ...
and other disorders. Following the arrival of European settlers in the U.S. who continued the use of black cohosh, the plant appeared in the U.S. Pharmacopoeia under the name "black snakeroot". In the 19th century, the root was used to treat snakebite, inflamed lungs, and pain from childbirth.


Herbalism

Extract An extract is a substance made by extracting a part of a raw material, often by using a solvent such as ethanol, oil or water. Extracts may be sold as tinctures, absolutes or in powder form. The aromatic principles of many spices, nuts, h ...
s from the underground parts of the plant — the rhizome (''Cimicifugae racemosae'' rhizoma) and the root (''Cimicifugae racemosae'' radix) — are used in
herbal medicine Herbal medicine (also herbalism) is the study of pharmacognosy and the use of medicinal plants, which are a basis of traditional medicine. With worldwide research into pharmacology, some herbal medicines have been translated into modern remed ...
. The rhizomes and roots contain various
saponin Saponins (Latin "sapon", soap + "-in", one of), also selectively referred to as triterpene glycosides, are bitter-tasting usually toxic plant-derived organic chemicals that have a foamy quality when agitated in water. They are widely distributed ...
s (triterpene saponins and triterpene glycosides, such as actein) as well as cimifugic acids and other phenol
carboxylic acid In organic chemistry, a carboxylic acid is an organic acid that contains a carboxyl group () attached to an R-group. The general formula of a carboxylic acid is or , with R referring to the alkyl, alkenyl, aryl, or other group. Carboxylic ...
s. In most European countries, China, Malaysia, Thailand, Argentina and some other countries, black cohosh products are available as herbal products which have been approved by regulatory authorities ensuring reliable pharmaceutical quality, safety and efficacy for the relief of menopausal complaints such as hot flushes and profuse sweating. In the U.S., India, and some other countries, black cohosh is used as a
dietary supplement A dietary supplement is a manufactured product intended to supplement one's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources or that are synthetic in order ...
marketed mainly to women for treating menopausal symptoms and other gynecological problems. Meta-analyses of contemporary evidence support these claims on menopausal complaints only for products holding a marketing authorization for this indication, whereas there is no high-quality scientific evidence to support such uses for other products.


Safety concerns

The Herbal Medicinal Product Committee (HMPC) at the European Medicines Agency (EMA) has summarized the adverse drug reactions of herbal medicines made from cimicifuga with mentioning allergic skin reactions (urticaria, itching, exanthema), facial oedema and peripheral oedema, and gastrointestinal symptoms (i.e. dyspeptic disorders, diarrhoea). Studies on the long-term safety of using herbal medicines made from black cohosh are available. They do not show harmful effects on breast tissue, endometrium, or breast cancer survivors. In contrast, such studies have not been published for dietary supplements made from black cohosh. Most black cohosh materials are harvested from the wild. Lack of proper authentication and
adulteration An adulterant is caused by the act of adulteration, a practice of secretly mixing a substance with another. Typical substances that are adulterated include but are not limited to food, cosmetics, pharmaceuticals, fuel, or other chemicals, that ...
of commercial preparations by other plant species are risk factors in dietary supplements and a critical matter of quality control in herbal medicinal products holding a marketing authorization. Very high doses of black cohosh may cause
nausea Nausea is a diffuse sensation of unease and discomfort, sometimes perceived as an urge to vomit. While not painful, it can be a debilitating symptom if prolonged and has been described as placing discomfort on the chest, abdomen, or back of the ...
, dizziness, visual effects, a lower heart rate, and increased perspiration. Worldwide, some 83 cases of liver damage, including
hepatitis Hepatitis is inflammation of the liver tissue. Some people or animals with hepatitis have no symptoms, whereas others develop yellow discoloration of the skin and whites of the eyes (jaundice), poor appetite, vomiting, tiredness, abdominal pa ...
, liver failure, and elevated
liver enzyme Liver function tests (LFTs or LFs), also referred to as a hepatic panel, are groups of blood tests that provide information about the state of a patient's liver. These tests include prothrombin time (PT/INR), activated partial thromboplastin tim ...
s, have been associated with using black cohosh, although a cause-and-effect relationship remains undefined. Millions of women have taken black cohosh without reporting adverse health effects, and a
meta-analysis A meta-analysis is a statistical analysis that combines the results of multiple scientific studies. Meta-analyses can be performed when there are multiple scientific studies addressing the same question, with each individual study reporting me ...
of
clinical trial Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietar ...
s found no evidence that black cohosh preparations had adverse effects on liver function. Package leaflets of phytomedicines made from black cohosh caution that people with liver problems should not take it, although a 2011 meta-analysis of research evidence suggested this concern may be unfounded. In 2007, the Australian Government warned that black cohosh may cause liver damage, although rarely, and should not be used without medical supervision. Other studies concluded that liver damage from use of black cohosh is unlikely. The clinical picture is similar to an autoimmune hepatitis with centrilobular liver cell necrosis, which can be treated with corticosteroids.


Phytochemicals and pharmacology

The rhizomes and roots of black cohosh (''Cimicifuga racemosa'' rhizoma) contain diverse
phytochemical Phytochemicals are chemical compounds produced by plants, generally to help them resist fungi, bacteria and plant virus infections, and also consumption by insects and other animals. The name comes . Some phytochemicals have been used as poisons ...
s, particularly various saponins (triterpene saponins/triterpene glycosides such as actein) as well as cimifugic acids and other phenol carboxylic acids. The pharmacologically active substance comprises the total extract. In the past, estrogen-like properties were attributed to preparations from this herbal drug. However, formonetin—a phytoestrogen compound (
isoflavone Isoflavones are substituted derivatives of isoflavone, a type of naturally occurring isoflavonoids, many of which act as phytoestrogens in mammals. Isoflavones are produced almost exclusively by the members of the bean family, Fabaceae (Leguminosae ...
)—could only be detected in methanolic extracts and was not found in ethanolic or isopropanolic cimicifuga extracts. Today, an estrogen-like mechanism of action can be ruled out. Regarding the alleviation of menopausal symptoms, central nervous activity was suspected as early as 2003, and it has since been confirmed with preclinical and clinical data.


See also

*
Caffeic acid Caffeic acid is an organic compound that is classified as a hydroxycinnamic acid. This yellow solid consists of both phenolic and acrylic functional groups. It is found in all plants because it is an intermediate in the biosynthesis of lignin, one ...
*
Ferulic acid Ferulic acid is a hydroxycinnamic acid, an organic compound with the formula (CH3O)HOC6H3CH=CHCO2H. The name is derived from the genus ''Ferula'', referring to the giant fennel ('' Ferula communis''). Classified as a phenolic phytochemical, ferul ...
* List of unproven and disproven cancer treatments *
Phenylpropanoid The phenylpropanoids are a diverse family of organic compounds that are synthesized by plants from the amino acids phenylalanine and tyrosine. Their name is derived from the six-carbon, aromatic phenyl group and the three-carbon propene tail of ...
s *
Triterpenoid Triterpenes are a class of chemical compounds composed of three terpene units with the molecular formula C30H48; they may also be thought of as consisting of six isoprene units. Animals, plants and fungi all produce triterpenes, including squal ...
s


References

{{Taxonbar, from=Q682257 racemosa Flora of North America Plants used in traditional Native American medicine Plants described in 1753 Taxa named by Carl Linnaeus