{"id":14300,"date":"2024-10-22T09:20:11","date_gmt":"2024-10-22T08:20:11","guid":{"rendered":"https:\/\/www.herbalreality.com\/?post_type=herb&p=14300"},"modified":"2025-05-25T08:22:12","modified_gmt":"2025-05-25T07:22:12","slug":"blue-cohosh","status":"publish","type":"herb","link":"https:\/\/www.herbalreality.com\/herb\/blue-cohosh\/","title":{"rendered":"Blue cohosh"},"content":{"rendered":"","protected":false},"featured_media":14307,"parent":0,"menu_order":0,"template":"","meta":{"_acf_changed":false,"footnotes":"","beyondwords_generate_audio":"1","beyondwords_project_id":"47224","beyondwords_content_id":"7dd4a649-b804-49b5-a0e3-ec000e3e28d7","beyondwords_preview_token":"b28c7dbb-d50e-4312-9c96-2a231c546291","beyondwords_player_content":"","beyondwords_player_style":"","beyondwords_language_code":"","beyondwords_language_id":"","beyondwords_title_voice_id":"","beyondwords_body_voice_id":"","beyondwords_summary_voice_id":"","beyondwords_error_message":"","beyondwords_disabled":"","beyondwords_delete_content":"","beyondwords_podcast_id":"","beyondwords_hash":"","publish_post_to_speechkit":"","speechkit_hash":"","speechkit_generate_audio":"","speechkit_project_id":"","speechkit_podcast_id":"","speechkit_error_message":"","speechkit_disabled":"","speechkit_access_key":"","speechkit_error":"","speechkit_info":"","speechkit_response":"","speechkit_retries":"","speechkit_status":"","speechkit_updated_at":"","_speechkit_link":"","_speechkit_text":""},"tags":[],"conditions":[699,696,698],"sustainability":[1576],"sense":[18,16,27],"western_action":[992,996,997,1001,1008,1009,1011,1018,1020,1023],"chinese_action":[],"ayurvedic_action":[],"energetics_action":[1491,1510,1498,1382,1511,1504],"region":[1893],"class_list":["post-14300","herb","type-herb","status-publish","has-post-thumbnail","hentry","conditions-musculoskeletal-system","conditions-nervous-system","conditions-reproductive-system","sustainability-green-sustainability-status","sense-bitter","sense-hot","sense-sweet","western_action-anti-inflammatory","western_action-antirheumatic","western_action-antispasmodic","western_action-bitter","western_action-diuretic","western_action-emmenagogue","western_action-febrifuge","western_action-relaxant","western_action-stimulant","western_action-uterine-tonic","energetics_action-neutralising","energetics_action-acrid","energetics_action-bitter","energetics_action-cool","energetics_action-sweet-taste-chinese","energetics_action-warm-temperature-chinese","region-western-herbs"],"acf":{"last_reviewed":"20241021","herb_author":1235,"banner_text":"Blue cohosh has a wide range of indications for gynaecological conditions","latin_name":"Caulophyllum thalictroides<\/em>","pseudonym_name":"","family_name":"Berberidaceae","herb_summary":"Blue cohosh has a long history of use as a uterine tonic, which may be used for uterine inflammation and menstrual pain. It can also be useful in the treatment of conditions in the musculoskeletal system.","key_benefits":"Uterine tonic\r\nDysmenorrhoea\r\nAmenorrhoea \r\nAnti-rheumatic\r\nFebrifuge","how_does_it_feel":"Blue cohosh is a bitter woodland plant that shares a genus with <\/span>barberry<\/span><\/a>, <\/span>goldenseal<\/span><\/a>, and <\/span>Oregon grape root<\/span><\/a>. It has a less pungent and acrid taste profile than that these related species. The tincture and decoction also have slight sweet taste.<\/span>","hdif_image_1":14310,"hdif_image_2":14308,"hdif_image_3":14307,"hdif_video":"","sense":[18,16,27],"what_can_i_use_it_for":"[caption id=\"attachment_14308\" align=\"alignright\" width=\"600\"]\"Blue Blue cohosh (Caulophyllum thalictroides<\/em>)[\/caption]\r\n\r\nHistorically, blue cohosh well esteemed by herbalists and midwives for helping to support the uterine function during late pregnancy and labour. There is some controversy surrounding the safety of this herb due to a small number of case reports relating to foetal distress and toxicity (2). Therefore, it is not recommended for use during pregnancy unless under the care and guidance of a qualified medical herbalist (3).<\/span>\r\n\r\nBlue cohosh is an important Native American medicine used for a range of female reproductive conditions. It has a notable tonic effect upon the uterine tissues. It can be used for dysmenorrhoea (menstrual pain) particularly where it is caused by poor uterine tone. It is sometimes used for young women at the commencement of menstrual cycle to help bring about healthy and regular cycles (4).<\/span>\r\n\r\nBlue cohosh is used for conditions of the <\/span>musculoskeletal system<\/span><\/a>. It has anti-rheumatic and anti-inflammatory actions, which may be applied for spasmodic muscular and rheumatic pains as well as for rheumatism in the small joints of the hands and feet (2). It also has muscular relaxant properties, which may be useful for muscle tension and cramps (1,2).<\/span>\r\n\r\nDue to its relaxant effect on smooth muscle, blue cohosh may relieve bronchial spasms associated with <\/span>bronchitis<\/span><\/a>, asthma and whooping cough (4). Its specific activities make it a choice herb for <\/span>colds and flus<\/span><\/a> that are characterised by congestion, coldness, aching joints and a fever (2).<\/span>","into_the_heart_of":"[caption id=\"attachment_14306\" align=\"alignright\" width=\"600\"]\"Blue Blue cohosh (Caulophyllum thalictroides<\/em>)[\/caption]\r\n\r\nBlue cohosh is sweet, acrid, bitter and pungent in taste. It is considered to be warm and dry energetically with restorative and decongesting qualities. It also has a moderating effect on the tissues due to its ability to relax and stimulate the smooth muscles (2).<\/span>\r\n\r\nIt primarily acts upon the female <\/span>reproductive system<\/span><\/a> and is best applied where there is uterine atony or vascular constriction and tension which results in congestion. It is a relaxing remedy which may be useful for other conditions classified by tension and constriction in the body, particularly muscular tension (1,4).<\/span>\r\n\r\nIt promotes perspiration and dispels wind-cold, which may be identified by coldness in the extremities, aches and pains in the joints. Blue cohosh can also be considered as a systemic nervous relaxant that helps to address both smooth and striated muscular pain and spasm in cases of nervous tension and high neuromuscular tone (2).<\/span>\r\n\r\nAlthough blue cohosh is not a traditional Chinese herb, in the principles of traditional Chinese medicine it is believed to activate <\/span>qi <\/span><\/i>(relating to vital energy or life force that is thought to guide physical, spiritual and mental processes), release constraint and relax nervous tension and irritability. It is specific for nervous deficiency that presents with emotional and physical tensions. It modifies the tensions in the musculoskeletal system, reducing inflammation and spasm. It is considered to have both relaxant and stimulating qualities. As a stimulant it may be used to address weak and cold tissue conditions. As a relaxant it may apply to both tension and constriction (2).<\/span>","tradtional_uses":"[caption id=\"attachment_14309\" align=\"alignright\" width=\"600\"]\"Blue Blue cohosh (Caulophyllum thalictroides<\/em>)[\/caption]\r\n\r\nBlue cohosh was an important remedy for gynaecological, obstetric and neuromuscular conditions used by native American tribes from where this plant\u2019s use originates (2). The eclectic and physiomedical physicians of the nineteenth century adopted the use of blue cohosh due to its reputed effectiveness.\u00a0<\/span>\r\n\r\nIt was recommended only in small doses as a uterine tonic during the last five weeks of pregnancy. An eclectic physician, John William Fyfe wrote that \u201cas a measure preparatory to confinement [delivery], this agent, when used for two or three weeks previous to labor is of much service to the childbearing woman. It so acts upon that part of the nervous system which control the uterus and pelvic region that there is perfect coordination of muscular powers or contractions. Through this kindly action blue cohosh becomes an efficient remedy for atonic or irritable false pains, and release or cures many manifestations of uterine irritation (4)\u201d.<\/span>\r\n\r\nOne of the most notable obstetric writers of the early 20th century, Finley Ellingwood described blue cohosh as a tonic. His understanding of blue cohosh was that it should be used in the last weeks of pregnancy to prolong gestation until the foetus is fully developed, preventing labour until the uterus reaches superior tonicity (4).<\/span>","what_practioners_say":"[caption id=\"attachment_14310\" align=\"alignright\" width=\"600\"]\"Blue Blue cohosh (Caulophyllum thalictroides<\/em>)[\/caption]\r\n

Reproductive system<\/span><\/h3>\r\nBlue cohosh has a long history of use in gynaecology and obstetrics. It was once a primary herb for augmenting the labour of childbirth. This effect is understood to result for a tonic effect upon the uterine tissues. Whilst much of the herbal literature is focused on its use as a partus preparator, it is important to note that there is some controversy around its use in pregnancy due to a small number of case reports which suggest a potential for foetal adverse reactions (see Safety) (1).<\/span>\r\n\r\nThe American Herbal Pharmacopeia states that \u201cconcerns based on case reports and mechanistic data about its potential foetal toxicity have caused blue cohosh to fall into disuse, thus potentially eliminating a once very important herb from the materia medica\u201d (1). Matthew Wood also elucidates on the heart-stimulating effects of blue cohosh, suggesting that these effects may be over-stimulating or even damaging to the baby\u2019s heart (4).<\/span>\r\n\r\nSome herbalists still work with blue cohosh to encourage normal and efficient labour in specific circumstances. However, with the lack of conclusive literature surrounding safety, it is important that this herb is only used in the correct dose and timeframe and under supervision of a qualified herbalist (4). Most of the modern literature suggests that it should only be used during the last weeks of pregnancy and in low (drop) doses to help prepare the uterus for birth (2,4).<\/span>\r\n\r\nMathew Wood suggests that it should only be used in drop doses (1\u20137 drops) over a period of time rather than large doses in the final hours (4). It works by increasing the rate of contractions (1,5) in the presence of tissue weakness (4) or poor uterine tone (2,6). It is also sometimes used where labour is slow to start, where the os (opening of the uterus) is rigid or where contractions are weak and feeble (4).\u00a0<\/span>\r\n\r\nIt contains an alkaloid\u00a0called methylcytisine, which is believed to act as a stimulant on the uterus, increasing the rate of contractions during childbirth. In contrast, it also has a traditional use for miscarriage prevention (5,7) in combination with black haw (Viburnum prunifolium) (3); however, this is only relevant to the last two months of pregnancy (4) and it should be noted that some of the literature advises against its use for miscarriage prevention (2). This is another matter that is best managed under the care of a practitioner. It is sometimes also used to assist in the passing of the placenta (6).<\/span>\r\n\r\nAmerican herbalists suggest that the effects of blue cohosh can have considerably different effects on different women. Perhaps this is a prime example of the importance in herbal prescribing that focuses on the individual circumstances, constitutions and tissue states that are being specifically targeted as opposed to treating the symptom or condition (2,6).\u00a0<\/span>\r\n\r\nThe best application of this herb relates to congestion and tension or heaviness in the tissues where there is poor venous circulation. Such cases may present with pain, discomfort and a heavy or full sensation in the pelvic region (6).<\/span>\r\n\r\nBlue cohosh is useful for cervicitis with congestion and poor blood movement within the reproductive organs (6). It is an emmenagogue (a herb that stimulates or increases menstrual flow). It is commonly used to address amenorrhoea, dysmenorrhoea and other conditions associated with uterine atony or congestion. It is sometimes used in combination with <\/span>false unicorn<\/span><\/a>, <\/span>motherwort<\/span><\/a> and <\/span>yarrow<\/span><\/a> where these conditions are caused by weakness in the uterine tissues (7). It is specific for dysmenorrhoea and endometriosis, where there is congestion and prolonged menstrual cycles of more than 30 days (6).<\/span>\r\n\r\nBlue cohosh is believed to have a hormone balancing action via correction of the hypothalamic feedback loop. This is one of the mechanisms by which is may assist in functional secondary amenorrhoea (8).<\/span>\r\n\r\n[caption id=\"attachment_14307\" align=\"alignleft\" width=\"600\"]\"Blue Blue cohosh (Caulophyllum thalictroides<\/em>)[\/caption]\r\n\r\nSome herbalists use blue cohosh to help enhance or restore fertility due to its effects upon the hypothalamic feedback loop with reproductive hormones. Blue cohosh may be corrective where there is luteal malfunction associated with latent of frank hyperprolactinaemia. It may, in this case be used in combination with <\/span>agnus castus<\/span><\/a> and <\/span>false unicorn<\/span><\/a> (8).\u00a0<\/span>\r\n\r\nIt is sometimes used to assist in in fertility issues in older women with speculations that it has oestrogenic activities. This idea is supported by a correlating reaction that some women experience in using blue cohosh \u2014 ovulatory pain and spotting. Spotting and bleeding during ovulation is often experienced by women with high oestrogen or where there is an intolerance to oestrogen (4). The speculation that blue cohosh has oestrogenic activities is likely connected to its physiologically toning effect upon the reproductive system as a whole, which improves the functionality of the ovaries in producing oestrogen. It may, therefore, be of benefit in cases of oestrogen deficiency (2).<\/span>\r\n\r\nFurthermore, blue cohosh has anti-inflammatory and analgesic activities, which may be useful in the relief of pain caused by endometriosis, fibroids, polycystic ovaries and menopausal discomforts (9).<\/span>\r\n

Musculoskeletal system<\/span><\/h3>\r\nBlue cohosh is used for debilitated conditions of the <\/span>musculoskeletal system<\/span><\/a> such as rheumatism and idiopathic joint pain (10). It is specific for spasmodic muscular and rheumatic pains, impaired muscular power and for rheumatism of the small joints in the hands and feet (4).<\/span>\r\n\r\nDue to the contents of resins, saponins and volatile oils, blue cohosh also exerts a detoxicant action which may contribute to its effects in addressing chronic rheumatic conditions. It encourages the elimination of metabolic waste from the body through diaphoresis and diuresis. These actions can contribute in a somewhat secondary manner to addressing the inflammation and toxicity often associated with musculoskeletal conditions, whilst also having a direct anti-inflammatory and decongestant effect (2).<\/span>","research":"[caption id=\"attachment_14306\" align=\"alignright\" width=\"600\"]\"Blue Blue cohosh (Caulophyllum thalictroides<\/em>)[\/caption]\r\n\r\nDespite the importance and long standing use of blue cohosh, very little scientific research has been carried out to explore its traditional uses. There are currently no clinical trials, although a small number of in vitro studies that focus on a number of its compounds demonstrate some of its medicinal activities. A small number of these studies have been included below to demonstrate the mechanism of action for some of the medicinal actions of blue cohosh discussed in this monograph.<\/span>\r\n\r\nAnimal studies are not condoned by Herbal Reality, however, for the purpose of including research from which some understanding of therapeutic actions can be evidencec, some animal studies may be referenced within the works included herein.<\/span>\r\n

Anti-inflammatory effect of triterpene saponins isolated from blue cohosh (Caulophyllum thalictroides<\/em>)<\/span><\/h3>\r\nAn <\/span>in vitro<\/span><\/i> study was carried out explore the effects of compounds in blue cohosh on the suppressive expression of iNOS or proinflammatory cytokines. The study methodology used activated microglia with lipopolysaccharide and a number of constituents isolated from blue cohosh. The treatment demonstrated effective suppression of pro-inflammatory processes. The study also demonstrated similar effects in the adrenal glands of mice. The findings suggest that blue cohosh may be able to inhibit the expression of iNOS and proinflammatory cytokines (11).<\/span>\r\n

Triterpene glycosides from the underground parts of Caulophyllum thalictroides<\/em><\/span><\/h3>\r\nAnother study, which set out to investigate the therapeutic activities of triterpene glycosides in blue cohosh, identified an enhancing effect on oestradiol binding to oestrogen receptors <\/span>in vitro<\/span><\/i>. A number of active oxytocic compounds were identified and <\/span>in vitro<\/span><\/i> findings suggest that this demonstrates a positive connection between blue cohosh\u2019s traditional use for increasing uterine tone (12).<\/span>\r\n\r\nThese works afford us a deeper insight into the medicinal activities of this fascinating plant and show it has significant potential beyond many of its current uses.<\/span>","did_you_know":"The genus name comes from the Greek words kaulos meaning a stem and phyllon meaning a leaf. The common name cohosh means \u2018roughly hairy\u2019 (6). <\/span>","additional_information_right":{"illustration":14313},"additional_information_left":{"botany":"Blue cohosh is a perennial plant which grows 1\u20133' tall on strong, upright stems. It has a beautiful and unique foliage which is lacy, alternately-compound, blue-green in colour. The leaves grow from the mid-stem, emerging a smoky blue colour in spring and turning bluish-green as they mature. Young plants are covered with a whitish, waxy bloom. It produces inconspicuous, brownish-green to yellowish-green flowers in spring that are around 1\/2\" in diameter. Each flower has six pointed sepals. Flowers later turn into its erect clusters of blue, fruit-like seeds. The outer seed coating turns fleshy and blue as seeds matures). These resemble small grapes or blueberries. The berry-like seeds are poisonous (17).<\/span>","common_names":"