Blue cohosh, scientific name Caulophyllum thalictroides, is a perennial flowering plant that grows in moist forest regions throughout the eastern United States. The plant grows up to 3 ft (1 m) tall, and its greenish yellow flowers turn into small blue berries in autumn. The root of the plant, harvested in the fall, is the part that is used medicinally, and has a bittersweet flavor. Blue cohosh is a plant that has long been believed to conform to the doctrine of signatures, which is an ancient idea that the physical shape of plants gives a clue to their medicinal uses. Blue cohosh has branches that are arranged like limbs in spasm, and the herb has been used to treat muscle spasms. It should not be confused with an unrelated herb, black cohosh.
Blue cohosh was widely used by Native Americans to treat a variety of conditions, ranging from parasites to nervous disorders. The Native Americans referred to the herb as squaw root or papoose root, because of its effectiveness in treating female problems, inducing childbirth and easing the pain of labor. Other common names for the herb are beechdrops, blue ginseng, yellow ginseng, and blueberry root.
Blue cohosh contains several important minerals, including potassium, magnesium, calcium, iron, silicon and phosphorus. An active ingredient has been isolated from the herb called caulosaponin, a chemical that has been shown to increase blood flow to the uterus and reduce uterine contractions. Blue cohosh has been shown to be an emmenagogue, which means it helps to bring about menstruation, and to be an anti-spasmodic, or a substance which reduces muscle spasms.
General use
Blue cohosh is recommended as a general tonic for gynecological problems, specifically for the uterus. Blue cohosh is used for menstrual problems, such as amenorrhea (absence of menstrual cycles) and dysmenorrhea (painful periods), and to reduce the pain of menstrual cramps. During pregnancy, it can be used when there is a threat of miscarriage, and to reduce false labor pains. Used just before childbirth, it is reputed to ease pain and facilitate the birthing process. A 1999 survey of the use of herbal preparations among nurse-midwives found that blue cohosh was the herb most commonly used to stimulate labor contractions.
Blue cohosh's antispasmodic properties enable it to be used in some cases of asthma, colic, and nervous coughs. Blue cohosh is also used to reduce pain in some cases of rheumatoid arthritis.
Blue cohosh is also used in homeopathy. The homeopathic remedy made from blue cohosh is called Caulophyllum, and is recommended for menstrual cramps, PMS, dysmenorrhea, and support during childbirth. Homeopaths may also prescribe Caulophyllum for gout, rheumatism, false labor pains, and gonorrhea.
Preparations
Blue cohosh is available as dried root, capsules, and in tinctures (liquid extracts). To prepare a tea, one ounce of the root can be added to one pint of water and steeped for half an hour. Two tablespoons of the tea can be taken every two to three hours. The root can be ground into powder, and 3-9 g (0.11-0.32 oz) of it can be taken several times per day. For the herbal tincture, the recommended dosage is 5-10 drops per dose.
The homeopathic remedy Caulophyllum is available in tablet, liquid dilution, or tincture form in a wide variety of potencies.
Precautions
Blue cohosh should be avoided during the first trimester (three months) of pregnancy, except for cases where miscarriage is threatened. During the remainder of pregnancy, the herb should be used under medical supervision.
Blue cohosh has a reputation in folk medicine as an abortifacient, or drug used to terminate a pregnancy. It should never be used for this purpose, as it can cause serious harm to both mother and fetus. The compound in blue cohosh that causes the uterus to contract is a glycoside known as caulosaponin. This compound causes the blood vessels in the heart to constrict, thus having a toxic effect on heart muscle.
The caulosaponin in blue cohosh has potentially toxic effects in humans. The earliest case report of harm from a mother's use of blue cohosh was published in 1998. The infant developed congestive heart failure shortly after birth. In the summer of 2002, the New York City Poison Control Center reported the case of a 21-year-old woman who developed abdominal cramps, heavy sweating, rapid heartbeat, and nausea after taking blue cohosh in an attempt to induce an abortion.
The side effects of blue cohosh resemble those of nicotine. Blue cohosh has been reported to cause chest pains, nausea and vomiting, headaches, convulsions, excessive thirst, and general weakness.
Symptoms of an overdose of blue cohosh resemble those of nicotine poisoning. They may include muscle weakness, convulsions, violent stomach cramps, headache, loss of coordination, and heart failure.
Interactions
Several herbs are frequently used with blue cohosh in formulas for improving menstrual problems, including false unicorn root, chasteberry tree, angelica, and rue. To reduce the risk of miscarriage during pregnancy, blue cohosh may be combined with false unicorn root and cramp bark. As a general tonic to strengthen the uterus, blue cohosh can be taken with false unicorn root, motherwort, and yarrow.
With regard to prescription medications, blue cohosh interferes with the effectiveness of nittrates and calcium channel blockers (drugs given to treat high blood pressure and heart disease). It opposes the activity of drugs given to control diabetes. Blue cohosh should not be used together with prescription diuretics as it can intensify their effects and cause a loss of potassium from the body.
Hutchens, Alma R. Indian Herbology of North America. Boston, MA: Shambhala, 1991.
Keville, Kathi. Herbs: An Illustrated Encyclopedia. New York: Friedman/Fairfax, 1994.
PERIODICALS
HerbalGram (a quarterly journal of the American Botanical Council and Herb Research Foundation). P.O. Box 144345, Austin, TX 78714-4345. (800) 373-7105. <http://www.herbalgram.org.>
Jones, T. K., and B. M. Lawson. "Profound Neonatal Congestive Heart Failure Caused by Maternal Consumption of Blue Cohosh Herbal Medication." Journal of Pediatrics 132 (March 1998): 550-552.
Martin, P. "Homeopathic Induction. Beyond Cimicifuga and Caulophyllum." Midwifery Today with International Midwife (Fall 2002): 28-30.
McFarlin, B. L., M. H. Gibson, J. O'Rear, and P. Harman. "A National Survey of Herbal Preparation Use by Nurse-Midwives for Labor Stimulation. Review of the Literature and Recommendations for Practice." Journal of Nurse Midwifery 44 (May-June 1999): 205-216.
Rao, R. B., and R. S. Hoffman. "Nicotinic Toxicity from Tincture of Blue Cohosh (Caulophyllum thalictroides) Used as an Abortifacient." Veterinary and Human Toxicology 44 (August 2002): 221-222.
Smith, C. A. "Homoeopathy for Induction of Labour." Cochrane Database Systems Review 2001: CD003399.
ORGANIZATIONS
American Academy of Clinical Toxicology. 777 East Park Drive, P. O. Box 8820, Harrisburg, PA 17105. (717) 558-7750. <www.clintox.org>.
Herb Research Foundation. 1007 Pearl Street, Boulder, CO 80302.(303) 449-2265.
National Center for Homeopathy. 801 N. Fairfax St., Suite 306, Alexandria, VA 22314. (703) 548-7790.
