Rethinking Blue Cohosh

By Lorinda Sorensen, ND

Many herbal books reference will list blue cohosh (Caulophyllum thalictroides) as beneficial for the uterus, often called it an emmenagogue or uterine stimulant, but occasionally even as an uterine tonic. It is an ingredient in ‘Mother’s cordial,’ a combination formula for preparation of labor (partus preparator). There have been several adverse effects reported when blue cohosh has been ingested perinatally, including increased meconium, fetal tachycardia, neonatal congestive heart failure, and perinatal stroke. While it is not clear in some case whether these were related to the pregnancy and would have occurred without the use of the herb, there is evidence in rats and Japanese rice fish that N-methylcytisine is teratogenic. N-methylcytisine, which closely resembles nicotine in its ability to stimulate intestinal activity, raises respiration, and elevates blood pressure. While this alkaloid is thought to be responsible for toxicity issues, some saponins from blue cohosh can interfere with cell membranes. The constituents’ cauloside A and cauloside C were shown to impair mitochondrial function by disrupting membrane integrity in T47D cells, which were chosen since they respond predictably to mitochondrial stress. While this report is very limited, when considering the implications of mitochondrial stress as a factor in many pathological organ and tissue states – such as with various metabolic disease – clinicians should ask themselves if there is a better and possibly safer option to choose instead of blue cohosh

Datta S, Mahdi F, Ali Z, Jekabsons MB, Khan IA, Nagle DG, Zhou YD. Toxins in botanical dietary supplements: blue cohosh components disrupt cellular respiration and mitochondrial membrane potential. J Nat Prod. 2014 Jan 24;77(1):111-7. doi: 10.1021/np400758t. Epub 2013 Dec 11. PubMed PMID: 24328138;

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