PDR for Herbal Medicines

92/BLACK CATNIP PDR FOR HERBAL MEDICINES

Thyagarajan SP, Subramanian S, Thirunalasundari T,

Venkateswaran PS, Blumberg BS, Effect of Phyllanthus amarus

on chronic carriers of hepatitis B virus. Lancet, 2:764-6, 1988

Oct 1.

Thyagarajan SP, Subramanian S, Thirunalasundari T,

Venkateswaran PS, Blumberg BS, In vitro effect of Phyllanthus

amarus on hepatitis B virus. Indian J Med Res, 2:71-3, 1991

Mar.

Cimicifuga racemosa

TRADE NAMES

Black Cohosh (available from a number of manufacturers)

and sometimes sold as Black Cohosh Root, Black Cohosh

Power, Wild Countryside Black Cohosh, NuVeg Black

Cohosh Root, Remifemin

DESCRIPTION

Medicinal Parts: The medicinal part is the fresh and dried

root.

Flower and Fruit: The inflorescence is a long-peduncled,

drooping raceme, 30 to 90 cm long with white flowers.

There are 3 to 8 petals without nectaries, and the sepals

enclose the flower bud.

Leaves, Stem and Root: The plant grows 1 to 1.5 m high. It is

leafy, with a sturdy, blackish rhizome, which is cylindrical,

tough and knotty. The straight, strong, dark brownish roots

sprout from the underground rhizome and are roughly

quadrangular and grooved. The transverse root section shows

wedge-shaped bundles of white wood. The rhizome section

shows a large black medulla surrounded by a ring of paler,

woodier wedges. The leaves are double-pinnate, smooth and

crenate-serrate.

Habitat: Black Cohosh is native to Canada and the U.S.; it is

cultivated in Europe.

Production: The medicinally used part of die plant consists

of the dried rhizome of Cimicifuga racemosa with attached

roots.

Other Names: Black Snake Root, Rattleroot, Rattleweed,

Squaw Root, Bugbane, Bugwort, Cimicifuga, Richweed

ACTIONS AND PHARMACOLOGY

COMPOUNDS

Triterpenes : triterpene glycoside, including actein, 27-deox-

yactein, cimifugoside

Quinolizidine alkaloids: cytisine, methyl cytisine

Phenylpropane derivatives: including isoferulic acid

EFFECTS

The active ingredients in the root are the triterpine glycosides

such as cimifugaside, 27-deoxyactein and the actein. The

increase in luteinizing hormone (LH) that occurs as estrogen

levels decrease is implicated as the cause of menopausal

symptoms. Compounds of the rootstock of Cimicifuga

racemosa bind to the estrogen receptor where it selectively

suppresses LH secretion with no effect on FSH. The result is

an estrogenic effect, which will decrease climacteric symp-

toms such as hot flashes, diaphoresis and psychological

disturbances (Duker, 1991; Lehmann-Wilenbrock, 1988).

There have been conflicting reports stating Cimicifuga

racemosa has no estrogen-like action (Einer-Jensen, 1996;

Liske, 1998). The herb did not appear to have an effect on

levels of LH, FSH, sex hormone-binding globulin (SHBG),

prolactin and estradiol in a study that concluded the

therapeutic effects seen are not attributable to estrogenic or

other endocrine-system effects (Liske, 1998).

The improvement in premenstrual symptoms, dysmenorrhea

and menopause may be due to the relaxing of uterine tissue

(Tyler, 1997).

CLINICAL TRIALS

A placebo-control, open study was conducted to determine

the effects of commercially available Cimicifuga racemosa

extract (Remifemin) on LH and FSH secretion in 110

menopausal women. After 2 months of therapy with 8 mg

daily of the drug, FSH levels in the Remifemin treatment

group and placebo group were similar. LH secretion was

significantly reduced in the Remifemin treatment group,

which points to the estrogenic effect of Cimicifuga racemosa

preparations (Duker, 1991).

Sixty hysterectomized patients, under 40 years of age, with

at least one intact ovary were involved in a study to

determine the effect of Cimicifuga racemosa extract (Rem-

ifemen 8 mg), estriol (1 mg), conjugated estrogens (1.25 mg)

and an estrogen-gestagen product on menopausal symptoms.

The evaluation of menopausal symptoms was determined by

the Kupperman-Index. The study also included evaluation of

the trophic disorders of the genitals, including FSH and LH

serum concentration measurement. There was a significant

decrease in menopausal symptoms determined by the Kup-

perman-Index in all treatment groups. There was a moderate

decline in the serum gonadotropin concentration in each

group, with no significant therapeutic difference between the

groups. Cimicifuga racemosa was as effective as the estrogen

products in decreasing menopausal symptoms in young

patients who have undergone a hysterectomy (Lehmann-

Willenbrock, 1988).

In an open study including 50 patients with menopausal

complaints, the effect of Cimicifuga racemosa extract

Black Cohosh