Is a Dose of 540 mg a Day of Black Cohosh Safe for Women?

For centuries, Native Americans have included black cohosh in their health treatments for painful joints, sore throat, general discomfort, kidney problems and issues related to the female reproductive system, reports the website Planet Botanic 2. Today, women use it to relieve many of the symptoms associated with menopause, such as hot flashes and mood changes, and proponents claim it is beneficial in the treatment of arthritis. However, there is not enough clinical evidence to support its use for these ailments, and you should consult your physician before beginning any sort of regimen.

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The plant is a member of the buttercup family. Roots and the underground stem of the plant are used either fresh or dried to make teas, infusions, capsules and pills.

Suggested Doses

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The Mayo Clinic notes that "there is no proven effective dose for black cohosh" for either the treatment of arthritis or menopause symptoms; however, the British Herbal Compendium advises taking no more than a total of 40 to 200 mg per day of the dried underground stem in divided doses 2. Traditional dosing of black cohosh has been as much as 1 to 2 g taken three times a day 2. A 540-mg dose falls in between these guidelines--over twice the amount the British Herbal Compendium recommends, but much less than the traditional dose. Susun Weed, an herbal practitioner, states that black cohosh is a tonifying herb that demonstrates a cumulative effect in the body rather than an immediate effect 2. She advises that black cohosh works best when taken in small quantities over an extended period of time 2. Planet Botanic suggests that if you've taken black cohosh for four months and have noticed no change in symptoms, then you should discontinue its use 2.

Safety of Use

Among the black cohosh plant's active substances is a small amount of salicylic acid, a major component of aspirin, although it is not known whether the salicylic acid remains in the commercial forms of the herb 2. The herb could pose a risk for those with aspirin allergies, with tendencies toward bleeding of the stomach or on a blood thinner regimen. Consult a physician before you begin taking the herb.


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Women with known liver disease should avoid black cohosh, and if you experience liver-related symptoms while taking the supplement, such as:

  • abdominal pain
  • dark urine or jaundice
  • discontinue use
  • contact your physician 2

Women who are pregnant or breastfeeding or who have a blood clotting disorder, seizures or high blood pressure should only use black cohosh under the guidance of their health-care practitioner 2. If you are allergic to the buttercup plant or any other plants in the buttercup family, avoid use of black cohosh due to potential allergic reactions 2.

Potential Side Effects

Potential side effects include:

  • constipation
  • lower abdominal discomfort
  • nausea
  • loss of bone mass irregular heartbeat
  • low blood pressure
  • says the Mayo Clinic

High doses may also cause headache, dizziness and perspiration. To date, there has been no evidence to suggest that black cohosh interacts adversely with prescription medications, states the Office of Dietary Supplements from the National Institutes of Health; however, there have been very few studies in this area 2.