Podcast 260: Herbalists’ Views on the Top-Selling Herbs (Part 8): Milk Thistle & Black Cohosh

5 September, 2025

Herbs #22 and 23 on the top-selling herbs list for 2023 were milk thistle and black cohosh.

Today we continue our series on commercially popular herbs, and share our views as herbalists on the actions, benefits, and applications of these.

Milk thistle is widely known as an excellent herb for the liver, and this is a case where the common wisdom is correct. It’s one of the safest herbs out there, and fortunately, it is also widely available and inexpensive. Hepatoprotective and even able to regenerate damaged liver tissue, it is at the same time a very gentle and benign plant. But don’t try to make tea with it!

Black cohosh’s reputation is as a remedy for PMS and menopausal symptoms, and often this is attributed to phytoestrogenic activity or constituents. The reality is murky – and has remained so despite decades of argument and investigation on both sides of the claim. Regardless, black cohosh can often help. We find it best to view the herb through the lens of its action as a relaxant. If PMS or menopause are showing up with lots of tension, it’s worth a try and most likely to help. But we can also apply that action much more broadly, for injuries, spasms, and (certain kinds of) headaches.

22. Milk Thistle – Silybum marianaum

23. Black Cohosh – Actaea racemosa

Previous episode in this series:

If all you’d heard (before today) about black cohosh was that it’s “good for menopause”, you might want to check out our Reproductive Health course! We discuss the whole range of human reproductive variability and herbal medicines to support all kinds of people. We even bust a few reproductive-health myths and herban legends. (Hint: vitex is not “a miracle herb for all women”!)

Reproductive Health

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Episode Transcript

Ryn (00:14):
Hi, I’m Ryn. And I’m here at Commonwealth Holistic Herbalism in Boston, Massachusetts and on the internet everywhere, thanks to the power of the podcast. Okay. So, as you might have guessed, today we’re going to be continuing on with our series about the top-selling herbs in the commercial context. So, products made of herbs and sold as supplements in grocery stores,, and pharmacies and Amazon, and online shops of all kinds. The goals of this series, just to refresh, are to get you informed about herbs that are popular, that people are taking very frequently. Because in your work, whether it’s a hobby or a career, as an herbalist you’re going to encounter these very regularly. And so it’s good to be informed about them. Also because there’s often a pretty large gap between the way that the practicing herbalist or the traditional herbalist thinks about these plants and the way that they are presented and advertised in the commercial world. So, that’s why we’re doing it, and we’re going to carry on today.

Ryn (01:19):
In this episode we’re going to be discussing milk thistle and black cohosh, two herbs which are very popular and very well-known in the herbalism community and the alternative health community more broadly and for good reason as we’ll see. Before I jump in, I want to just remind you that I’m not a doctor. I’m an herbalist. I’m a holistic health educator. And so the ideas discussed in this podcast don’t constitute medical advice. No state or federal authority licenses herbalists in the United States, and these discussions are for educational purposes only. I want to remind you that good health doesn’t mean the same thing for everyone. Good health doesn’t exist as a single objective standard. It’s influenced by your individual needs, experiences, and goals. So, I’m not trying to present a single, dogmatic right way that you must adhere to to get healthy or to stay that way. Everyone’s body is different. And so the things that I’m talking about here may or may not apply directly to you. But my hope is that they’re going to give you some new information to think about and some new ideas to experiment with and to research a little bit further. Finding your way to better health is both your right and your own personal responsibility. That doesn’t mean that you’re alone on the journey, and it doesn’t mean that you’re to blame for your current state of health. But it does mean that when you’re considering any course of action, whether it’s discussed on the internet or prescribed by a physician, that’s always your choice to make. All right.

#22 Milk Thistle: Silymarin Constituents

Ryn (02:40):
So, milk thistle, black cohosh. We start with the milk thistle. Silybum marianum is the botanical name for that one. It has had other botanical names in the past. If you look into some of the older herbalism literature, you might find it under the name Carduus marianus. But it’s the same plant and easy to find. So, what can one say about milk thistle? One can say liver, liver, liver, liver, liver, liver, liver, liver, liver. And that’s milk thistle. Yeah. It’s an herb that has profound effects, and they are all centered on the liver and on antioxidant effects that it can convey there. Milk thistle is one of the most reliable, most widely accessible, and safest herbs out there in the world and particularly in commercial herbalism. So, I’m always very happy to see this one as a top seller. And it regularly is. You can look back several years, and you’ll find it always somewhere in the list. Rarely up at the top, but somewhere in the mid-range you tend to find that one.

Ryn (03:47):
Okay, so in the contemporary world, you go to the shop, you go to the website. What are you going to find? Milk thistle products there are nowadays most often going to be an extract inside of the capsule. So, we take the milk thistle seeds, we use a solvent and a process to extract the chemistry we want from them. We distill that down or concentrate it down and put it into a capsule. You will find various levels of concentration in the products. Four to one is really common. You’ll see 9:1 sometimes. And then you’ll see some products that are describing themselves as a 30:1 concentrate or a 30:1 extract. Those, I think, are more frequently written in a different way, though more frequently those ones are going to be presenting themselves as being standardized for silymarin content. And if it says standardized to 80% silymarin, that’s essentially the same with a couple caveats. It’s essentially the same as a 30:1 concentrate. Okay. Silymarin is definitely the most famous chemistry that’s in milk thistle. And as often is the case here, It’s not a single constituent. It’s actually a group that we can kind of refer to by that name, silymarin. If you want to get super specific about it, it includes a number of related flavonoid compounds, individuals that have names like silybin, silydianin, silychristin. But they’re generally referred to as the group as silymarin. Yeah. Some products I found in a review are labeled silymarin instead of being labeled milk thistle. But then when you read the supplement facts label carefully, you’ll see that what it really contains is an 80% silymarin standardized extract of milk thistle. And so it would contain some other things alongside. That’s an interesting case where something is presenting itself as an isolate, but it actually is more of a concentrated extract than an isolate of a single chemical.

Ryn (05:47):
Yeah. I have also found at least one trademarked milk thistle extract. You can compare this to the BioPerine, the trademarked black pepper extract that I’ve mentioned in previous episodes in this series. This happens with a variety of herbs. It happens with ashwagandha. It happens with black pepper. And there’s a few other cases where this occurs. And so this is one of those situations where somebody is preparing a particular type of extract of the silymarin or the milk thistle and then selling that to other product makers so they can include it in their formula, or white label it and put it in their own product. That one is and there are a few other varieties that are also made this way, but they’re focused on making the milk thistle extracts more bioavailable by conjugating them with what are called phospholipids. This is essentially a strategy that’s used to bypass the fact that things which are water soluble and things which are fat soluble or difficult to absorb at the same time, or there can be differing bioavailability for each of them. And you can structure it so that your body isn’t going to break down the silymarin. It’s going to pass a little bit deeper into the system, be absorbed into circulation, and then kind of release the silymarin at that point. And then it can go out and do its jobs. And in this case, the release is going to occur right there in the liver, the first stop after absorption through the intestine. And so it can go to work right away.

More Than Just Encapsulated Powder

Ryn (07:18):
It’s rare nowadays to find a supplement of milk thistle that’s simply an encapsulation of the milk thistle powder. These used to be a lot more common. It used to be the kind of default of what you would get with a milk thistle capsule you buy at the shop. Nowadays, almost everybody’s moved in the direction of making the extract and encapsulating that because it’s believed to have greater potency. And it’s a realistic expectation for that to occur. You will find some products that do that thing where they combine the raw powder with the extract, and they put both of those together. This is a strategy that I really quite like. I think I mentioned this in previous episodes of the series. Because what it does is allow you to present a replicable, a consistent amount of that target constituent, the one you set your standard to achieve. But it also allows you to have the complete complement of constituents that are found in the actual plant material itself.

Ryn (08:17):
The brand Oregon’s Wild Harvest makes a number of different products this way. They have a milk thistle that’s made that way, and I think it’s a really nice approach. It’s a good balance between the two extremes. Yeah. You will also find tinctures or liquid extracts like a glycerite of milk thistle available. I think it’s really worth being clear that you can tincture your own milk thistle at home. You’re going to want to do that in relatively high alcohol. But you’re not going to get anything from putting milk thistle seeds in a jar and pouring glycerin on top of them. When you find a product that is a milk thistle extract in a liquid form, and it says the major ingredient is glycerin, this is a case where what was done was first an alcohol extraction of those constituents. And then boiling away the alcohol while replacing it with the glycerin so that the finished product is the milk thistle extractives suspended in the glycerin. So, it’s not one that you can easily prepare at home. Okay.

Ryn (09:16):
Many products from milk thistle are going to combine that herb together with others. Generally with other liver herbs, often with bitter herbs and liver stimulants like dandelion or blessed thistle. That’s fine. But there are certain cases where you might not want to have any degree of direct liver stimulation involved and just be protecting and soothing and cooling the liver. So, if there was a case where somebody had a highly inflammatory problem in the liver itself. And it was maybe even swollen and feels hot to the touch and very tender when you reach under. Then we might not even want to include any liver stimulants alongside and just stick to the hepatoprotectives. Just stick to the milk thistle in this case. Yeah. But I will say in the majority of cases where we’re working with a liver issue we want both a little bit of stimulation and a bunch of protection. And one of these milk thistle-dandelion or milk thistle-blessed thistle combination products, they can do the job really nicely. All right. One of the nice things about milk thistle is that it’s apparently very easy to make an effective product. I’ve rarely encountered a milk thistle supplement that was ineffective. Even old school capsules of milk thistle seed powder have been helpful for people with liver pathology, liver inflammation, issues like that. Although let’s be clear, the modern extracts are more potent, right? They are more powerful. And it’s maybe even worth saying that there are highly purified, pharmaceutical-grade versions of milk thistle extract, which are used in very extreme cases of poisoning. There are certain mushrooms that can poison you so thoroughly that one bite could eventually kill you. And in those cases, one of the ways to rescue such a person is an intravenous injection or sometimes intraperitoneal injection of a purified silymarin complex.

Ryn (11:10):
So, what I want to raise here is just that if you know somebody was eating a destroying angel mushroom, you’re not going to save their life by giving them a spoonful of milk thistle seeds, right? There is a difference in potency and concentration between these different preparations of the remedy. Yes. But again, even products that are just like a homemade capsule of milk thistle powder, and you take a few capsules each day, that can be helpful. You might need to take quite a lot of them in comparison to a more modern, concentrated, smaller package product. Yeah. Okay.

Liver Support & Ways to Take This Herb

Ryn (11:46):
All of these products are marketed for liver stuff, right? Like I said before, liver support, antioxidant activity, and then things that connect to the liver, like our good old friend detox. And even I’ve seen products labeled for cleanse support. So, while I have some hesitations around the language of cleansing or the kind of over application of the word detox, it is phrasing that catches people’s attention. And physiologically, these are fairly sound claims, let’s say, in this particular case of milk thistle. The scientific evidence for benefits here is quite clear. The tradition of application and many, many, many, many reports of benefit here are very clear. And it basically comes down to the fact that milk thistle will protect your liver from oxidative damage and help it recover from past damage, even to the degree of regeneration of new healthy liver tissue. So, that’s pretty fantastic. And you can see the connection to words like cleanse or detox. Your liver is a major organ responsible for those jobs in the body. I get hung up on the topic because I don’t want people to think of detox as a time-bound thing that you have to go and do. You have to go and do the cleanse. You have to take the liver flush. You have to do a long fast or whatever other methods people have for cleansing themselves. In fact, internal cleansing, internal detoxification is an ongoing process not only in your liver but throughout your body all the time. And there are ways that we can enhance that, ways that we can make it more efficient like working with milk thistle, right? But I want people to be clear that it is an ongoing process. It is a natural process and not something you have to force. Yeah.

Ryn (13:37):
Milk thistle is a really gentle herb. You know, it’s not forceful in these actions. So, if people are going to be buying detox herbs, I’d rather it be milk thistle than something much more intense, right, than wormwood, or black walnut concentrates, or something like that. Yeah. Now, if you’d like to make your own remedies with this, you can take the milk thistle seeds, and you can grind them into a powder. And then just put a spoonful of that into food. It’s a great way to take it. It’s quite effective. And in the context of a meal, you actually do get an increase, an improvement in bioavailability and absorption of what the milk thistle has to offer. If you were to compare that to just stirring the powder into water and slugging it down on an empty stomach between meals or something like that, it’s better to take milk thistle together with food. So, taking it just in food is fine. It’s a nutty kind of a flavor. It’s pretty benign and blends with a lot of things. So, that’s a great way to take it. Some people like to take that powder and put it into a smoothie. If you don’t mind a little bit of grittiness in there, or you’ve got other powders in there already, that’s a fine way to do it. Similar reasons. And like I said before, you can tincture this in moderate to high alcohol. Generally anything higher than 60%, 75% is where you’re going to aim for. I know some folks prefer to go all the way to 95% with it. But somewhere in that span is where you’re going to get a decent effect.

Ryn (14:59):
If you are working with those seeds, like you’re going to make powder out of them and take that, it is better to leave them whole and to keep them in the fridge. And then to powder or to grind each day’s batch fresh that day rather than grinding up a whole bunch of it and then leaving it. The worst would be to leave it in an open container on the counter in a hot environment that also had a lot of humidity, right? That’s bad news for any herb, right? But milk thistle is a plant with a high concentration of oils and fatty substances, things that can go rancid on oxygen exposure. The seed packet itself protects these things to some extent. And so it’s better to wait to break those open until the last moment that you can. Yep. So yeah, grind them fresh each day, and you’re going to be all set. Because these constituents are also fatty in nature, they’re not going to extract into water. So, I can’t see any good rationale for making milk thistle tea, doing a decoction or something with that. I suppose, unless what somebody means is I ground the milk thistle seeds to a powder, and then I put them into my tea. And then I drink it, and I consume the powder. Okay. That’ll get you what you’re aiming for. I mean, there will be some distribution of it into the water, but it’s just not the optimal method. So, I wouldn’t recommend that.

Safety Profile & Other Thistles

Ryn (16:18):
Okay. One other comment on milk thistle is the safety profile, right? I mentioned earlier that this is one of the safest herbs available. And it has no clinically significant drug interactions. It has no serious adverse effects. Occasionally you’ll see reference to one or two. But when you see reference to drug interactions with this plant, in my experience every time I’ve seen one, they’re always theoretical rather than being based on case reports, or real-world situations, or a randomized trial where it’s a direct intervention study to see if an interaction develops. A lot of times when you look at the claims like that, what it really boils down to is this herb does stuff to the liver. This drug is metabolized in the liver. Eh, maybe they interact, right? So, I don’t find that to be very compelling. And again, practically speaking you don’t see oh, the antibiotic didn’t work because of that milk thistle. Or oh, the heart medication didn’t function the way it was supposed to. These things just don’t happen. So again, a very safe herb, not having interactions. And on its own, not also having adverse effects if you take too much, right? It’s hard to take too much milk thistle. If you take a very high dose, you could get loose stool. But you could probably say a very similar thing about any seed. You could probably say the same thing about sunflower seeds. So, I don’t think that that really stands out in any particular way. Since a lot of medications put stress on the liver, and since many chronic health issues come along with a greater degree of inflammatory strain or inflammatory load on the liver as well, it’s really handy that milk thistle can be freely recommended in this way.

Ryn (18:02):
And I do know herbalists who are like anybody on pharmaceuticals, give them some milk thistle. You know, rubrics like that are often too general to be very intelligent, very useful. But in this case, that one’s not too far off base, honestly. You could do worse. So, I have some links for you in the show notes. One is our brief profile on milk thistle. One is the profile from those folks over at Herbal Reality. I’ve referenced them a bunch in this series. They’re doing good work over there. They do have indeed realistic monographs about these plants. So, I like that. And then I also have a link to the monograph from Ms. Maud Grieve from 1931 in her book, A Modern Herbal. And the reason I wanted to include that one for you is that in that entry, she’s actually writing under the general heading of thistles. And so you see milk thistle alongside blessed thistle, and Scotch thistle, and I think five or six others all right after each other. And so it’s very cool actually to compare what they were writing about in 1931 about the actions, the applications, and the plant parts, and everything among many different thistles next to each other. It’s worth saying that other thistles in the contemporary herbalism world, the most common other one is blessed thistle, Cnicus benedictus. They do have some of the hepatoprotective activity that we get from milk thistle. With the other ones, we tend to be working with the leaves. And in historical practice we do see people working with milk thistle leaves as well.

Ryn (19:35):
You have to carve off the spines, and you can make tea out of them. People also eat them as food once you separate out all the spiny and rough parts and everything. And in that regard, the milk thistle leaf is very similar to blessed thistle leaf. It’s really the seed of milk thistle where it stands out in adding on that pronounced hepatoprotective and liver regenerative capacity. The leaves of basically all the thistles are going to be bitter. They’re going to be liver stimulants. They’re going to be digestive stimulants the way any bitter is. And also the way any bitter is, they’re going to have benefits in terms of inflammation, and hormonal coordination, and stuff like that. That just comes from our exposure to bitter flavors. Yeah. So, if you want to expand your thistle materia medica, you can do that. Yeah. All right.

#23 Black Cohosh: Triterpene Glycosides & Several Names

Ryn (20:23):
Let’s move on. Let’s talk about black cohosh. So, Actaea racemosa is the contemporary name for this plant. I’ll have a note about a couple of other names you might find it under in historical context. But currently Actaea racemosa, that’s the botanical for that one. The market presentation for black cohosh might be one you’re already familiar with, right? You might be thinking yeah, Ryn, I know. PMS, menopause, okay fine. And really the market presentation for this one is entirely confined to quote unquote, female reproductive issues. Women’s health is like a rubric that’s being used for that very frequently. And it’s sold as a reproductive support remedy. You know, that’s people who are being compliant with the labeling laws here in the US. And people who are less compliant might call it a PMS cure, a menopause fix, an herbal estrogen. You know, that last one comes around too. And on that last note, the question about whether black cohosh possesses literal phytoestrogen compounds, or whether it exerts some kind of effect in the body that’s mediated through estrogen release, or whether its effects are due to other actions entirely has been a debate in herbal worlds and in plant science world as well, plant constituent chemistry world.

Ryn (21:46):
It’s been an ongoing debate for decades, and it’s been a seesaw swinging back and forth, right, one side and then the other. Even just within the span of my career I’ve seen rounds of new evidence coming out about no, black cohosh doesn’t really have any phytoestrogenic activity at all. Or well, maybe it kind of does if you count through this pathway. If you include that, then you could say it does. The thing I want to come away with for you today is that it doesn’t really matter that much. That in general, the applications, the reasons we’re going to choose black cohosh are not tightly tied to specifically altering the level or the activity of estrogen in your body. That it’s not necessary to achieve the goals that we can turn to this herb to help us with. So, all that said, when we look at supplements for black cohosh, we will find that many of them are standardized. And that they’re standardized to a defined level, usually 2.5%, of a constituent group called triterpene glycosides. This is a type of constituent found in a lot of different plants, right? Triterpene glycosides is a group. There’s a certain set of that group found in black cohosh. But it’s a big group, and there are many members of it that are not in black cohosh but are in other plants, right? Many of those plants are known for their impacts on hormone production, or hormone receptivity, or other elements of endocrine activity within the body. And so when you see triterpene glycosides in a plant, you can sort of predict that we’re going to have some kind of an impact on endocrine function one way or the other. So, that’s me acknowledging that there is some rationale to this idea that the majority of black cohosh’s action is coming through a hormonal mediation. What I would put on the other side would be that the fact that it contains triterpene glycosides doesn’t tell us therefore, it acts as phytoestrogen, right? Not every member in that group has that kind of action. And also that they have broader activity than just changing the level or the receptivity of a given hormone. These kind of glycosides have a lot of actions in our system. They’re diffuse. They’re diverse. Yeah.

Ryn (24:08):
In the herbal literature, if we look back into history a bit and try to figure out what have people understood about this plant in the past? How can we compare that to where it’s at now in the present? First off, the names change. So, if you go back a little ways in the literature, you’ll find black cohosh referred to as Cimicifuga racemosa. That’d be the botanical name there. And in some of the eclectic literature from around the 1800s, we find it referred to as macrotys. It turns out that that’s like a slight misspeaking or one would say bastardization of the word macrotrys, which comes from a French author who was writing about the plant, whatever. It was known under that name for a fair number of time in some of the literature that we find really helpful when we’re looking at historical activity with these plants, especially in the US. So, if you really wanted to do some deep digging, search on Actaea racemosa, search on Cimicifuga racemosa, search on macrotys, and put them all together. Yep.

A Fairly Strong Relaxant for Many Types of Tension

Ryn (25:14):
Very often when people are speaking about black cohosh, they’ll say this herb has a really long-term history and ancient practice all the way through to the modern era of being taken as a remedy for women’s ailments, right? And it’s true that indigenous practices with this herb did sometimes include work for such problems. Whether that’s PMS issues, or menopause issues, or troubles throughout pregnancy or during the labor process, there’s applications for this herb there. That’s true. However this wasn’t the only, or even the main, the major indication that would’ve been applied in those contexts. More often the herb was taken for what you might call rheumatic complaints. Today we would translate that into inflammatory issues impacting connective tissue in the body. So, that can be inflammatory joint pain. That can be headaches and migraines. And there can be some other issues that would fall under that rubric as well. And indigenous folks and also the eclectics around the 1800s era, they would also work with black cohosh for itch, for spasmodic cough, and for a variety of emotional and even spiritual troubles as well. And so when we try to look for a unifying feature, there me looking at that from my perspective as an herbalist who focuses on energetics and on perceptible patterns that we can see when we work with an herb. I see it primarily as a relaxant agent, and it’s a fairly strong relaxant agent. It’s an antispasmodic, you can say.

Ryn (27:02):
So, this herb is particularly helpful for patterns of tension. For patterns of tension that have progressed so long that they’re manifesting with spasms, and shaking, and things like that. And one particularly good indication for black cohosh is injuries where there’s like a whiplash kind of a situation. So, with whiplash, you do have damage to connective tissue, maybe even the discs in the spine, things like that. But you also have a reaction on the part of the muscles around the injured area to clamp down tight and to try to restrict your movement. Now, that makes sense in the immediate aftermath of an injury, right? If we hurt something by stretching it too far or moving it too fast in one direction, we don’t want to do that again. We want to keep it in place for a while. But that tension can go on too long, and it can become counterproductive to the healing process. So, if we can release that tension and allow the blood and the fluids and even the cerebral spinal fluid to flow more freely, then we can improve and accelerate the healing and complete the recovery from it. So, with literal whiplash it can be very helpful. But then other injuries that have involved kind of an acute trauma and then a clenching reaction afterwards, black cohosh can be very, very handy there.

Ryn (28:26):
Yeah. Now, another major indication for black cohosh amongst contemporary herbalist is certain kinds of depression. Oftentimes when this is discussed, we’ll hear American herbalists refer to black cloud depression. And there’s often a gesture toward the growth habit of the plant and the black, tangled, muddy root ball that you’ll get when you pull that up. The root is the part of this plant that we’re going to be working with, right? So, it’s like ah, look at this black cloud of the root and think about the feeling of a black cloud hanging around your head. You can’t see the sun, even if you’re kind of looking straight up toward it. And so it’s that feeling of a heaviness, a damp kind of a weight that’s upon you, you know? And I think that’s a pretty decent description of a pattern that black cohosh can help with. But I might also say that if we look for cases of depression where it’s accompanied by tension, physical, mental, emotional tension. That can manifest with stubbornness. That can manifest with an inability to perceive or respond to available options, things like that. Those are also cases where I think black cohosh could be worth a try, and I might include it in a formula or in a protocol for someone.

Ryn (29:51):
But again, a relaxant first and foremost, right? And able, it seems, to affect both skeletal muscle and smooth muscle. So, that would be things like yeah, your jaw, your neck, your shoulders, your upper back, but also your digestive tract if that’s having spasms. Or this is where we finally get to the reproductive tract again, right? So, if there’s cramping, and spasms, and things happening through there, then this relaxant herb can be very helpful if those are manifesting for you during menstrual symptoms or during menopause symptom times, right? So, despite not necessarily – not necessarily, we can still debate – but not necessarily being phytoestrogenic in nature, this herb can help with common manifestations of menstrual issue, menopausal symptom, and things like that. So, I think that in many cases that’s a fine way to understand why it helps this person and maybe also to help us understand why it didn’t help that person over there, right? They over there were in a state of greater laxity, and they didn’t need any further relaxation, right? We can have menstrual problems that are uncomfortable. And on the one hand, for some person they’re coming from an excess degree of tension. And for somebody else over here, the discomfort, the heaviness, or whatever they’re feeling is coming from excess laxity.

Ryn (31:11):
So, I would just say beware that if we give a strong relaxant like this to somebody who’s already in a state of laxity, it could potentially make their symptoms worse, right? Think about headaches. This is a classic herb for some kinds of headaches, some kinds of migraine. Which kinds? The ones that come with major tension, right? Tension you can feel at the temples, tension around the eyes, tension in the jaw, tension in the back of the neck or up here, right? When that’s the case, black cohosh is likely to help. If the person is having a headache or a migraine, and it’s clear that there’s laxity. That there’s a feeling of heaviness to it, physically speaking now rather than emotionally. Then the black cohosh could potentially make that worse. There’s some people who take this herb, and it gives them a headache. It usually manifests as a headache in the front up around the forehead. But that can be an indicator that hey, black cohosh wasn’t the right herb for you. And if you recommend this herb for someone and want them to try it, I would say start out with a relatively low dose. Scale up. If at some point as you’re doing that, you notice yourself getting frontal headaches. Then hey, that might be an indicator we were on the wrong track. Let’s take a different approach instead. Yep.

At Risk in the Wild & NOT Blue Cohosh

Ryn (32:27):
It’s important to note black cohosh is a threatened species in the wild. It is at risk in wild populations. Now, as always when we say this, I want to acknowledge that this is a very popular herb. It’s highly commercialized, highly cultivated, right? There’s a fair degree of organic cultivation of black cohosh going on. And so when I say it’s threatened, I’m not saying on planet earth we’re running out of black cohosh roots. I’m saying that in the wild there are way fewer than there ever used to be because of overharvesting, including what would fall under the name of poaching, or illegal harvesting, or certainly unethical harvesting practices. So, for those reasons it’s best to purchase or work with products that are made from only organically cultivated material. Remember always that organic certification is at least as important for the certainty it gives us about traceability and about plant matter origins as it is about purity and making it so we don’t have to get exposed to pesticide residues or things like that. Traceability is key, okay. So, when you work with black cohosh, look for organically cultivated. And then you can buy with confidence. But I would actively discourage you from buying wild-crafted black cohosh, unless you really know the person, and you really are sure that they are harvesting it effectively and carefully, right? That can be done. There are people who have botanical sanctuaries in wooded areas, and there’s plenty of black cohosh growing through there. And they’re selective about which ones they harvest and when. This can be done well. This can always be done well, and carefully, and properly. And then also it isn’t always done that way. So, just be thoughtful. All right.

Ryn (34:17):
One last note: do not confuse black cohosh with blue cohosh. So, black cohosh, Actaea racemosa. Blue cohosh, Caulophyllum thalictroides. So, you can hear it there. These aren’t in the same genus, right? It’s not Actaea X and Actaea Y. It’s Actaea versus Caulophyllum. And these were never in the same botanical category, right? They’re not botanically related. The similarity in their name cohosh, right, this is based on North American indigenous words describing physical features of the plant. Saying that they are two similar-looking plants. In a sense, it’s kind of like how we have St. John’s wort and motherwort. They’re not related. They’re both worts because wort means that kind of not too tall, not woody green plant that is very common, right? That’s wort. In this case, cohosh means something like rough. And this is usually attributed as being an Algonquin, or Abenaki, or Penobscot word. So, kind of from our neck of the woods up here in New England.

Ryn (35:24):
Now, black and blue cohosh, they are not identical in in medical activity or medicinal activity, let me clarify. The reason they’re often confused is because of the similar name. And also because in the modern context, you might see a product of black cohosh, a product of blue cohosh, and both of them say on the front: supports reproductive health. Okay? But this is one of those cases where that similarity in labeling and claims can be very misleading. These do not support reproductive health in anything like the same way. In fact, whereas black cohosh is a relaxant and can release tension in tissues, blue cohosh can actually stimulate contractions, particularly in the uterus. And blue cohosh has a much narrower window of safe applications. There are a few situations where it might make sense for somebody to work with both of these in the same day. But those essentially all have to do with midwifery. And giving a little bit of black cohosh earlier on to help to relax the cervix and relax tension that’s preventing the birthing process from going on. And then later on after the birth usually, that’s when the blue cohosh would come into play. And that would be used to strengthen those uterine contractions. Oftentimes after labor, after the baby’s come through, the body’s totally exhausted, and it’s hard to get the placenta, the afterbirth out. And a bit of blue cohosh at that point can be very helpful there. You’ve got to do it. You can’t leave that in. It can lead to sepsis and other problems. So, anyway, this is one context in which it might make sense for both of those to have their place, but not at the same time, okay, because they don’t do the same thing. You want to be selective about what effect you’re trying to have and when it makes sense to do that. So, yes, that’s important info. Carry that forward.

Ryn (37:25):
I have links in the show notes for you. I have a couple of scientific studies, one of which is proposing a non-estrogenic mechanism of action for black cohosh to be helpful with menopause symptoms. So, just as a way to demonstrate what I was saying earlier. That it doesn’t have to go through that pathway in order to have a result of relief, okay? There’s another one I put in there. It’s a scientific review, but it’s a fairly modern one, just a few years old. And it gives a pretty good current understanding of what cohosh can do and how it can do it. And then I have a couple of profiles. One of them is from 1898 from the book King’s American Dispensatory. So, this is from kind of its tail end of the period of the eclectic herbalists in the US and their practice. And actually the physiomedicalists kind of competitor school is who this one’s from. But I included this for you because it has an impressively long and involved list of indications and applications for black cohosh as a remedy. And I’d just like you to see that the reasons that those medical-level herbalist practitioners would’ve worked with this herb were much broader than PMS cramps or hot flashes of menopause. Okay? So, you can dig right into there and broaden your view a bit.

Ryn (38:42):
Okay. So, I think that’s it for this episode today. You know, since you’ve got your milk thistle in here, and this can support your liver function. And it can support your clearance of internal waste products, including hormones. There are applications from milk thistle in reproductive health issues. Similarly for black cohosh, whether we take the phytoestrogen thing to be gospel, or heresy, or somewhere in between. We can recognize that there are cases where that can be helpful and worth calling on. So, if you’re interested in that area of study, I would point you toward our course: Reproductive Health. And you can dig in there, and you can learn a lot more about the whole range of human reproductive variability and herbal medicines that can support all kinds of people. Yep. So, I’ll put the link in the show notes for that as well. All right, that’s it for this episode of the Holistic Herbalism Podcast. We will continue on soon. Until then, take care of yourselves. Take care of each other. Drink some tea or grind some seeds into your food, depending on what’s appropriate for the herbs you want to take. All right, everybody. See you again soon. Bye.

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