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Blue Cohosh

Blue Cohosh

Botanical Description & Habitat

Caulophyllum thalictroides


Common Names
Blue ginseng
Papoose root
Women's best friend
Yellow ginseng

Canada, the United States, and eastern Asia; it flourishes near running streams, around swamps, and in other moist places.

Blue cohosh is a perennial plant which has a round, smooth stem growing from a knotty rootstock. The stem grows from 1-3 feet in height. Its leaflets are oval, irregularly lobed, and they have pale undersides. Small greenish-yellow flowers bloom from May to June. Its blue, spherical fruits, which are naked seeds, grow on fleshy stalks; they ripen in August. The seeds are poisonous.

Medicinal Parts
Rhizome and roots - dried, collected in autumn.

Historical Properties & Uses

Blue cohosh is used mainly as an antispasmodic agent for the uterus, relieving cramps and spasms. It is used to stimulate menstrual flow, a use passed into medicine from the Native American Indians.

The plant is also used as a diuretic, diaphoretic, anthelmintic and oxytocic. The berries are poisonous, and hypersensitive persons may be allergic to the plant.

Method of Action

Blue cohosh has good anti-inflammatory activity.

A similar Russian species has been found to have fungicidal activity.

A pharmacological work-up on this herb appears to be lacking. The pharmacological effects of blue cohosh have been attributed to the presence of several glycosides and alkaloids (including caulosaponin and methylcytisine).

Oxytocic effects are attributed to caulosaponin. This substance constricts the coronary vessels, stimulates intestinal contractions or spasms and in high doses produces toxic effects on cardiac muscle tissue of small lab animals.

Methylcytisine produces nicotinic effects (though not nearly as potent), i.e., it elevates blood pressure and stimulates respiration as well as intestinal motility.

Drug Interactions & Precautions

Known Interactions
Diuretics, such as blue cohosh, may potentiate the action of antihypertensive, ganglionic or peripheral adrenergic blocking drugs, tubocurarine and, to a lesser degree, norepinephrine.

Possible Interactions
The oxytocic property of blue cohosh, in conjunction with such vasoconstrictors as ephedrine, methoxamine, phenylephrine or sympathomimetics, may cause severe hypertension. In addition, citrates taken in conjunction with the herb may produce erratic and unpredictable results due to the oxytocic action. It should also be noted this herb and sparteine may have synergistic oxytocic activity.

Blue cohosh may increase the metabolism of digitoxin, oral contraceptives, phenytoin, corticosteroids, fluroxene, methadone, metyrapone, and tetracyclines.

The metabolism of blue cohosh may be increased by barbiturates, ethanol, diazoxide, loxapaine, and vitamin B-6. Conversely, the metabolism of this herb may be decreased by propoxyphene, troleandomycin, aminosalicylic acid, antihistamines, chloramphenicol, disulphiram, halothane, isoniazid, methylphenidate, phenothiazines, sulfa drugs.

By sequestering blue cohosh, mineral oil may reduce the herb's anthelmintic effect. The same may be true, to a lesser extent, of antacids.

The diuretic action of blue cohosh may reduce renal clearance of lithium. The use of diuretics may require dosage adjustments of antidiabetic drugs.

The neuromuscular relaxing action of blue cohosh may be enhanced by the use of certain aminoglycositic antibiotics, such as clindamycin. Prolonged use of this diuretic may affect certain laboratory test results such as electrolytes (especially potassium and sodium), blood urea nitrogen (BUN), uric acid, glucose, and protein bound iodine (PBI).

The antidiabetic ability of blue cohosh may be decreased by concomitant use of acetazolamide, oral contraceptives, corticosteroids, ethanol, dextrothyroxine, epinephrine, glucagon, and marijuana.

The antidiabetic effects of blue cohosh may also be decreased when used in conjunction with phenothiazines, rifampin, thiazide diuretics, and thyroid hormones.

Conversely, the antidiabetic action of blue cohosh may be enhanced when it is used with allopurinol, anabolic steroids, chloramphenicol, clofibrate, fenfluramine, guanethidine, MAOI's, phenylbutazone, probenecid, and phenyramidol.

The antidiabetic action of blue cohosh may also be enhanced when used in conjunction with salicylates, sulfinpyrazone, sulfonamides, and tetracyclines.

Safety Factors & Toxicity

Blue cohosh can be very irritating to mucous surfaces, and may cause contact dermatitis. Blue cohosh berries can be poisonous to small children.

Blue cohosh should not be taken during pregnancy.

Preparation & Administration

Three times a day

Dried tuber and roots
0.3-1 gram

made from 1/4-1/2 tsp of dried tuber and roots

Fluid extract
1:1 in 70% alcohol, 0.5-1 ml

This herb should not be taken during pregnancy.

Note: This Herbal Preparation information is a summary of data from books and articles by various authors. It is not intended to replace the advice or attention of health care professionals.


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Caulophyllum thalictroides

? Southwest School of Botanical Medicine


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