Author: Avon Essiential
Here at Bountiful Breast we have had professional herbalists use our product for their own breast enlargement. Cecily Henderson in the testimonials and photo gallery sections of our website is an herbalist.
Black cohosh has enjoyed a rapid rise in popular use for the amelioration or alleviation of menopausal symptoms. At the same time, the last decade has witnessed a significant expansion of research on the chemistry, pharmacology, and clinical efficacy and safety of this botanical species. As a consequence of the growing body of data on black cohosh, together with the appearance of reports implicating this botanical in cases of liver damage.
Because black cohosh has only recently been brought into cultivation, it is difficult to meet escalating world demand, and much of this botanical is still collected from the wild, where species identification depends on the skill, knowledge, experience, and honesty of the collector and where mistakes might be made. This situation might also tempt a less scrupulous supplier to substitute related but possibly ineffective and potentially harmful species for A racemosa.
The Medical Products Agency in Sweden has received a total of 7 adverse event reports involving hepatotoxicity associated with Remifemin and none for Klimadynon, the only approved black cohosh products in Sweden. A detailed review by a herpetologist found that 4 of the 7 cases were possible associations, but 3 of those were confounded by use of other drugs associated with adverse effects on the liver (e.g., ketoprofen, levothyroxine (thyroid medicine), lamotrigine, tramadol, paracetamol). Other drugs and herbs taken in combination with black cohosh may also induce the same liver toxicity.
In the United Kingdom, the Medicines and Healthcare Products Regulatory Agency has received a total of 26 reports of liver problems. Cases range in severity from abnormal liver function to hepatitis; 1 patient required a liver transplant. As standard causality methods do not transpose well to spontaneous case reports, specific causality categories were not assigned. However, all cases have undergone detailed analysis and consideration by the United Kingdom’s expert advisory committees, which resulted in detailed warnings being added to both licensed and unlicensed products containing black cohosh. The Medicines and Healthcare Products Regulatory Agency continues to monitor for cases of hepatotoxicity suspected to be associated with black cohosh.
The Office of Complementary Medicine, Therapeutic Goods Administration, in Australia reviewed 16 adverse event reports of hepatic injury with concomitant black cohosh received between 2002 and 2006. Although sufficient data were not available to draw conclusions about mechanism of liver toxicity, dose-response relationship, or linkage to a particular product, 3 of the cases were serious, all requiring liver transplants. One patient died. These latter cases prompted a mandate for the use of very strong, detailed warning labels on black cohosh products in Australia. By May 2007, the WHO-UMC had received 43 reports of 66 liver adverse events for black cohosh from 6 countries.
It appears that genetics, what strain of black cohosh, what other medications and herbs are mixed with the plant and what part of the plant are used all play a role in liver toxicity.
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