ArticleCase reports in gastrointestinal medicine2014
Black cohosh and liver toxicity: is there a relationship?
Article in Case reports in gastrointestinal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- The Effectiveness of Non-Soy Oral Herbal Supplements for Menopausal Symptoms: A Systematic Review.Nutrients · 2026Pooled it
- Herbal Medicines and Drugs Interactions: Cytochrome P450 Responsibility.Current medicinal chemistry · 2026Review
- Review of black cohosh-induced toxicity and adverse clinical effects.Journal of environmental science and health. Part C, Toxicology and carcinogenesis · 2025Review
- Article
- Mechanistic Evaluation of Black Cohosh Extract-Induced Genotoxicity in Human Cells.Toxicological sciences : an official journal of the Society of Toxicology · 2021Article
- Modulation of steroidogenesis by Actaea racemosa and vitamin C combination, in letrozole induced polycystic ovarian syndrome rat model: promising activity without the risk of hepatic adverse effect.Chinese medicine · 2021Article
- Herb-Induced Liver Injury by Cimicifuga racemosa and Thuja occidentalis Herbal Medications for Fertility.Case reports in gastrointestinal medicine · 2021Article
- Assessment of acute, 14-day, and 13-week repeated oral dose toxicity of Tiglium seed extract in rats.BMC complementary and alternative medicine · 2018Article
- Naturally Occurring Nrf2 Activators: Potential in Treatment of Liver Injury.Oxidative medicine and cellular longevity · 2016Review
- RUCAM in Drug and Herb Induced Liver Injury: The Update.International journal of molecular sciences · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Herbal supplements are commonly used by patients for various problems. It is a well-known fact that most patients do not tell their physicians about the use of herbal supplements unless they are specifically asked. As a result, sometimes important information regarding drug side effects is missed in history taking. During our literature search, we found several retrospective studies and other meta-analyses that claim a lacking or weak link between black cohosh use and hepatotoxicity. We present a case of a 44-year-old female who developed subacute liver injury demonstrated on a CT scan and liver biopsy within a month of using the drug to resolve her hot flashes and discuss a possible temporal and causal association between black cohosh use and liver disease. Since the patient was not taking any other drugs, we concluded that the acute liver injury was caused by the use of black cohosh. We agree with the United States Pharmacopeia recommendations that a cautionary warning about hepatotoxicity should be labeled on the drug package.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.