Botanical name: Caulophyllum thalictroides
© Steven Foster
Parts used and where grown
Blue cohosh grows throughout North America. The roots of this flower are used medicinally.
Blue cohosh is not related to black
cohosh (Cimicifuga racemosa). However, both herbs are primarily used to
treat women’s health problems.
Blue cohosh has been used
in connection with the following conditions (refer to the individual
health concern for complete information):
Historical or traditional use (may
or may not be supported by scientific studies)
Native Americans are believed to have used blue cohosh flowers to induce labor and
menstruation.1 Blue cohosh is a traditional remedy for lack of menstruation. It is
considered an emmenagogue (agent that stimulates menstrual flow) and a uterine tonic. No
clinical trials have validated this traditional use. It has also been used traditionally to
treat painful periods (dysmenorrhea). Early
20th century physicians in the United States who treated with natural remedies (known as
Eclectic physicians) used blue cohosh for these same purposes and also to treat kidney
infections, arthritis, and other ailments.
A saponin from blue cohosh called caulosaponin is believed to stimulate uterine
contractions.2 Several other alkaloids may be active in this herb. However, current
research about the active constituents of blue cohosh is insufficient.
How much is usually taken?
Blue cohosh is generally taken as a tincture and should be limited to no more than
1–2 ml taken three times per day. The whole herb (300–1,000 mg per day) is
sometimes used. Blue cohosh is generally used in combination with other herbs.
Are there any side effects or interactions?
Large amounts of blue cohosh can cause nausea, headaches, and high blood pressure. Blue cohosh should only be used
under medical supervision and in limited amounts. Using blue cohosh during pregnancy has been brought into question by reports of
an infant developing a stroke and another infant being born with congestive heart failure.3 4
Safety studies need to be completed to determine whether blue cohosh is safe to use during
At the time of writing, there were no well-known drug interactions
with blue cohosh.
1. Castleman M. The Healing Herbs. New York: Bantam Books, 1991,
2. Foster S. Herbal Renaissance. Salt Lake City: Gibbs-Smith
Publisher, 1993, 48–50.
3. Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J
Med 2004 351:302–3.
4. Jones TK, Lawson BM. Profound neonatal congestive heart failure caused
by maternal consumption of blue cohosh herbal medication. J Pediatr