Health Canada warns of black cohosh liver damage risk

Black cohosh, also known as Actaea racemosa or Cimicifuga racemosa, is a herbal remedy that is often used to relieve menopausal and premenstrual symptoms. Common names for it include black snakeroot, black bugbane and rheumatism weed.

Health Canada said that there have been a number of international case reports of liver damage suspected to be associated with the use of black cohosh, including three case reports in Canada and one published case of death in the US. Most of these cases involved other medical problems and the use of other medications that may have contributed to the liver damage. The quality of the black cohosh products involved in these cases is not known.

While case reports of liver damage are rare and the link between black cohosh and liver toxicity is unclear, the regulator is taking a precautionary approach and is currently reviewing the safety and effectiveness of black cohosh.

In the meantime, Health Canada is advising consumers and healthcare practitioners that consumers should exercise caution in the use of products containing black cohosh, and consult a healthcare practitioner if they have concerns about its use.

In addition, the regulator has advised consumers to discontinue the use of products containing black cohosh and consult a physician if they have unusual fatigue, weakness, loss of appetite, or if they develop symptoms suggestive of liver injury such as yellowing of the skin or whites of the eyes, dark urine or abdominal pain.

Health Canada also said that it will advise Canadian healthcare practitioners and consumers if further precautionary measures are necessary.