Herbal Monograph
Blue cohosh
Caulophyllum thalictroides (L.) Michx.
Berberidaceae (Barberry family)
Potent uterine tonic and emmenagogue from Native American tradition — practitioner-only herb requiring expert dosing and strict pregnancy avoidance.
Overview
Plant Description
Erect, glabrous, glaucous perennial herb, 30-90 cm tall, arising from a thick, knotty, yellowish-brown rhizome with extensive matted rootlets. Stem single, smooth, unbranched below the inflorescence, purplish at base becoming green above, covered with a whitish-blue waxy bloom (hence 'blue' cohosh). Leaves typically 2 (sometimes 3): one large, sessile, triternately compound leaf near the top of the stem (appearing as a single massive leaf divided into 27 leaflets), and one smaller leaf subtending the inflorescence. Leaflets 2-5 cm long, oblong to obovate, 2-5 lobed at apex, thin, glabrous, glaucous beneath, resembling leaves of meadow-rue (Thalictrum — hence the species epithet 'thalictroides'). Flowers small, 8-12 mm, yellowish-green to purplish-brown, in a terminal racemose panicle appearing before leaves are fully expanded (April-May). Six sepals petaloid; six small, gland-like petals (nectaries) opposite the sepals; six stamens. Fruit distinctive: the ovary wall ruptures early, exposing 2 naked seeds that develop into deep blue, berry-like structures (actually exposed seeds with a fleshy blue seed coat) on stout stalks, 6-8 mm diameter, resembling blueberries. Seeds contain the alkaloid methylcytisine and are considered toxic.
Habitat
Rich, moist, deciduous hardwood forests. Prefers deep, humus-rich, well-drained soils in dappled shade to full shade. Found on moist slopes, ravines, stream banks, and cove forests. Often associated with rich mesic forests containing sugar maple, basswood, tulip poplar, and beech. Altitude range: 100-1,500 m. Does not tolerate dry, exposed, or disturbed sites.
Distribution
Native to eastern North America, from Manitoba and New Brunswick south to Alabama, Georgia, and South Carolina, west to Missouri and Nebraska. Most abundant in the Appalachian Mountains, Great Lakes region, and Ohio River Valley. Scattered and uncommon at the southern and western limits of its range. Not commercially cultivated at scale; most commercial supply is wild-harvested.
Parts Used
Rhizome and root (Caulophylli rhizoma)
Preferred: Tincture of fresh or recently dried rhizome; decoction of dried rhizome
The rhizome with attached roots is the primary medicinal part recognized in the Eclectic and Native American traditions, as well as in modern Western herbal practice. The dried rhizome contains the key bioactive saponins (caulosaponin, caulosides) and alkaloids (methylcytisine, magnoflorine). Quality rhizome should be firm, hard, and knotty with a yellowish cross-section and slightly acrid taste. Fresh rhizome is preferred by some practitioners for tincture preparation.
Key Constituents
Triterpene saponins (caulosaponins)
The triterpene saponins are considered the primary bioactive constituents responsible for blue cohosh's uterine-stimulating activity. Caulosaponin in particular stimulates uterine smooth muscle contraction, providing the pharmacological basis for the traditional use in facilitating labor and treating menstrual irregularities. The saponins also contribute to the anti-inflammatory, antispasmodic (at low doses — stimulatory at higher doses via oxytocic mechanism), and cytotoxic activities. The vasoconstrictive property of caulosaponin is clinically important: it may constrict fetal coronary arteries, contributing to the neonatal toxicity cases reported with late-pregnancy use.
Quinolizidine and isoquinoline alkaloids
The alkaloid fraction, particularly N-methylcytisine, contributes significantly to blue cohosh's pharmacological activity and toxicological profile. N-methylcytisine is a nicotinic receptor agonist that stimulates smooth muscle contraction (including uterine and vascular smooth muscle), increases blood pressure, and affects cardiac function. The combination of nicotinic alkaloid activity (N-methylcytisine) with oxytocic saponin activity (caulosaponin) creates a potent uterine-stimulating effect but also elevates the risk profile considerably compared to herbs that work through a single mechanism. The alkaloid content is the primary reason for the Class 3 safety classification and the strict contraindication during pregnancy without qualified supervision.
Other constituents
The non-alkaloid, non-saponin constituents contribute to the overall physicochemical properties of preparations (taste, solubility) but are not considered primary bioactive agents.
Herbal Actions
Stimulates or increases menstrual flow
Blue cohosh is one of the strongest emmenagogues in Western herbal practice. The oxytocic saponin caulosaponin and the nicotinic alkaloid N-methylcytisine both stimulate uterine smooth muscle contraction. This dual mechanism makes blue cohosh particularly effective for promoting menstrual flow in amenorrhea and oligomenorrhea, but also makes it potentially dangerous in pregnancy (uterine overstimulation, fetal toxicity). The emmenagogue action is the primary traditional and modern clinical application. In Eclectic medicine, blue cohosh was specifically indicated for atonic uterine conditions with sluggish or absent menses.
[1, 5]Relieves smooth muscle spasm
Paradoxically, blue cohosh exhibits both antispasmodic and oxytocic activity depending on dose and uterine state. At lower doses and in the context of dysmenorrhea (painful, cramping menses), the smooth muscle relaxant activity of magnoflorine and the overall toning effect may reduce excessive cramping. At higher doses, the oxytocic effect of caulosaponin dominates. The Eclectic physicians described blue cohosh as acting to 'coordinate uterine contractions' — reducing inefficient, painful cramping while promoting effective, rhythmic contraction. This biphasic action requires careful dosing and practitioner expertise.
[5, 6]Reduces inflammation
The triterpene saponins (caulosides) and the alkaloid magnoflorine demonstrate anti-inflammatory activity in preclinical models. Blue cohosh was traditionally used by Native Americans for rheumatic and arthritic complaints. The anti-inflammatory mechanism involves saponin-mediated modulation of inflammatory pathways. This action is secondary to the uterine/reproductive applications but supports the historical use for joint pain.
[7]Increases urine production and output
Mild diuretic activity noted in traditional sources. Blue cohosh was occasionally used for urinary tract complaints and fluid retention. The diuretic action is modest and secondary to the primary reproductive applications.
[5]Promotes perspiration
Mild diaphoretic activity. Blue cohosh was sometimes included in Eclectic formulas for febrile conditions to promote perspiration. This is a minor, supportive action.
[5]Promotes the discharge of mucus from the respiratory tract
The saponin content provides mild expectorant activity via irritation of gastric mucosa and reflex stimulation of bronchial secretions. Blue cohosh was occasionally used for bronchial conditions in Eclectic medicine, though this was never a primary indication.
[6]Therapeutic Indications
Reproductive System
Amenorrhea and oligomenorrhea (absent or scanty menses)
The primary traditional indication. Blue cohosh was the Eclectic and Native American herb of choice for promoting menstrual flow in amenorrhea, particularly when associated with cold, atonic uterine conditions. The dual mechanism of oxytocic saponins and nicotinic alkaloids provides a strong physiological basis. Eclectic physicians prescribed it for 'suppressed menses from cold, debility, or atony.' No modern clinical trials exist for this indication, but the pharmacological rationale is well-established.
[5, 6]Dysmenorrhea (painful menstruation)
Blue cohosh was used by Eclectic physicians for dysmenorrhea characterized by cramping, bearing-down pains, and irregular uterine contractions. The specific indication was spasmodic dysmenorrhea in the context of uterine atony — the 'cramp that won't organize.' Small doses were used to coordinate uterine contractions, reducing inefficient cramping. Distinguished from congestive dysmenorrhea (better suited to Viburnum species). Often combined with Viburnum prunifolium (black haw) or Actaea racemosa (black cohosh) for comprehensive menstrual pain management.
[5, 6]Uterine atony and pelvic congestion
Blue cohosh was considered the premiere Eclectic remedy for 'chronic uterine disease dependent on atony' — characterized by heavy, dragging sensations in the pelvis, leucorrhea, bearing-down pain, and a general sense of pelvic congestion with poor muscular tone. The Eclectic materia medicas describe its action as 'increasing the tonicity and contractility of the uterine muscle.' Used in the intermenstrual period as a uterine tonic.
[5]Labor preparation and augmentation (historical — now contraindicated without expert supervision)
Historically the most well-known use: blue cohosh was widely used by Native American midwives and later by Eclectic physicians as a partus praeparator (labor preparation agent) taken in the final 2-4 weeks of pregnancy, and during labor to strengthen and coordinate contractions. This use continued into the late 20th century among lay midwives. However, MODERN SAFETY ASSESSMENT HAS SHIFTED: multiple case reports of neonatal toxicity (myocardial infarction, congestive heart failure, seizures, multi-organ hypoxic injury) temporally associated with maternal blue cohosh use in late pregnancy have been published. The mechanism involves N-methylcytisine-mediated vasoconstriction of fetal coronary arteries and caulosaponin-induced uterine overstimulation. THIS USE IS NOW CONTRAINDICATED except under the supervision of a qualified practitioner experienced in botanical obstetrics who can carefully manage dosing and timing.
[1, 2, 3]Musculoskeletal System
Rheumatic and arthritic conditions
Blue cohosh root was used by multiple Native American tribes (Cherokee, Ojibwe, Menominee) for rheumatic pain, joint stiffness, and arthritis. The anti-inflammatory saponins provide pharmacological support for this use. Not a primary modern indication but historically significant. Often combined with other anti-rheumatic herbs in formulation.
[7]Urinary System
Urinary tract conditions (cystitis, urinary retention)
Minor traditional indication. Blue cohosh was occasionally used by Eclectic physicians for chronic cystitis and urinary retention associated with pelvic congestion and atony. The diuretic and antispasmodic actions support this use. Not a primary modern application.
[5]Nervous System
Nervous excitability with reproductive involvement
The Eclectic physicians described blue cohosh as useful for 'nervous excitability dependent upon uterine wrongs' — anxiety, irritability, and nervous tension arising from reproductive system dysfunction. This is a secondary, supportive indication. Blue cohosh was not considered a primary nervine but rather a reproductive tonic that secondarily calmed the nervous system by resolving the underlying reproductive pathology.
[6]Energetics
Temperature
warm
Moisture
dry
Taste
Tissue States
cold/depression, atrophy/deficiency, wind/tension
Blue cohosh is warming and drying in energetic quality. The bitter taste reflects the alkaloid content; the astringent quality reflects the saponins and tannins. In vitalist energetics, blue cohosh is specifically indicated for cold, atonic, deficient reproductive tissue — the 'cold womb' with scanty or absent menses, bearing-down sensations, and poor uterine tone. It is contraindicated in hot, excess, or inflammatory reproductive conditions (active infection, excessive bleeding). The warming, stimulating quality drives stagnant blood and fluids, promoting flow where there is stasis. In traditional Native American classification systems, blue cohosh was considered a 'women's herb' with warm, activating energy.
Traditional Uses
Native American medicine
- Cherokee: root decoction as a partus praeparator for labor induction and to ease childbirth; for rheumatism, colic, cramps, sore throat, and urinary conditions
- Ojibwe (Chippewa): root used to suppress profuse menstruation and as a labor aid
- Menominee: root tea for pulmonary troubles, cramps, and fever; valued as a woman's medicine
- Meskwaki (Fox): root used for genitourinary conditions and as a general tonic
- Potawatomi: root decoction for urinary and reproductive conditions
- Omaha-Ponca: root used to induce labor and as a fever remedy
- Multiple tribes used the blue seeds decoratively and in ceremonies
"Blue cohosh was one of the most important Native American women's herbs, used by numerous eastern woodland tribes for reproductive conditions, particularly labor preparation and facilitation. The name 'papoose root' directly references this obstetric use. Ethnobotanical surveys by Daniel Moerman document use by at least 8 tribal groups. The plant's association with women's medicine was so strong that it was among the first Native American remedies adopted into colonial American practice."
[7]
Eclectic medicine (19th-20th century American)
- Primary remedy for uterine atony, amenorrhea, and dysmenorrhea
- Partus praeparator — taken for 2-4 weeks before expected delivery to tone the uterus and facilitate labor
- During labor to strengthen weak, irregular, or inefficient contractions
- Treatment of after-pains (postpartum uterine cramping)
- For leucorrhea and chronic uterine inflammation associated with atony
- Combined with Actaea racemosa (black cohosh) as the 'cohosh combination' for comprehensive reproductive support
- Minor use for rheumatism, bronchitis, and nervous conditions secondary to reproductive disorders
"The Eclectic physicians (1830s-1930s) adopted blue cohosh directly from Native American practice and made it a cornerstone of their gynecological materia medica. Felter and Lloyd (1898) in King's American Dispensatory describe it as acting upon 'the reproductive organs of the female, being a uterine tonic and antispasmodic.' Finley Ellingwood (1919) wrote that its specific indications were 'reflex conditions, depending upon uterine wrongs' with 'false pains, severe paroxysmal after-pains, dysmenorrhea.' It was one of the most frequently prescribed herbs in Eclectic obstetric practice."
Modern Western herbal medicine
- Uterine tonic for amenorrhea and oligomenorrhea in the context of cold, atonic conditions
- Dysmenorrhea (usually in combination with other antispasmodic herbs)
- Endometriosis support (in combination formulas, low dose, under practitioner supervision)
- Rarely used for labor preparation in modern practice due to safety concerns — restricted to experienced botanical midwives/herbalists
- Pelvic congestion and bearing-down sensations
- Almost always used in combination rather than as a simple (single herb)
"Modern Western herbalists retain blue cohosh in the materia medica but use it with significantly more caution than the Eclectics due to the published case reports of neonatal toxicity and the better understanding of its nicotinic alkaloid pharmacology. Most modern herbalists restrict its use to non-pregnant reproductive conditions (amenorrhea, dysmenorrhea, uterine atony) and always in formulation rather than as a single herb. The American Herbalists Guild and most herbal training programs classify it as a practitioner-level herb requiring careful dosing."
Modern Research
Neonatal toxicity case reports
Multiple case reports of severe neonatal adverse events temporally associated with maternal blue cohosh use in late pregnancy.
Findings: Jones and Lawson (1998) reported the case of a newborn with acute myocardial infarction, congestive heart failure, and shock following maternal ingestion of blue cohosh to induce labor. Finkel and Zarlengo (2004) reported a neonate with severe multi-organ hypoxic injury, seizures, and renal failure after maternal blue cohosh use. Additional case reports describe neonatal stroke and severe perinatal complications. The proposed mechanism involves N-methylcytisine-mediated coronary artery vasoconstriction in the fetus (fetal coronary arteries may be particularly sensitive to nicotinic agonists) combined with caulosaponin-induced uterine hyperstimulation causing placental hypoperfusion.
Limitations: Case reports cannot establish causation. Confounding factors may exist (other supplements, obstetric complications). The dose, preparation, and timing of blue cohosh use were variably documented. However, the pharmacological plausibility (known nicotinic agonist and oxytocic constituents) and the temporal association across multiple independent cases support a causal relationship.
Cytotoxic and antiproliferative activity
In vitro studies investigating the cytotoxic potential of blue cohosh saponins.
Findings: Cauloside glycosides demonstrated cytotoxic activity against several cancer cell lines in vitro. The triterpenoid saponins showed antiproliferative effects, suggesting potential for further investigation in oncological research. However, this remains a preclinical observation with no clinical translation.
Limitations: In vitro studies only. Cytotoxic activity in cell cultures does not translate to clinical anticancer utility without extensive further development. Systemic toxicity of the alkaloids limits any potential therapeutic window.
[4]
Pharmacological characterization of N-methylcytisine
Studies characterizing the nicotinic receptor agonist activity of N-methylcytisine (caulophylline), the principal alkaloid of blue cohosh.
Findings: N-methylcytisine acts as a partial agonist at nicotinic acetylcholine receptors (nAChRs), with selectivity for alpha-4-beta-2 subtypes (similar to cytisine and varenicline). The pharmacological profile includes vasoconstriction, smooth muscle stimulation, ganglionic stimulation, and catecholamine release. In isolated uterine tissue preparations, both N-methylcytisine and caulosaponin independently stimulate contraction, with additive effects when combined.
Limitations: Pharmacological characterization studies, not clinical trials. Doses used in pharmacological studies may differ from those achieved with traditional preparations. The relative contribution of alkaloid vs. saponin activity in human clinical use remains unclear.
[4]
Survey of midwifery use patterns
Surveys examining the patterns of blue cohosh use among American midwives.
Findings: Multiple surveys of certified nurse-midwives and lay midwives found that blue cohosh was one of the most commonly used herbal preparations for labor induction, used by 45-64% of midwife respondents in some surveys. Most midwives combined it with black cohosh. The surveys revealed wide variation in dosing, timing of administration, and preparation type, highlighting the lack of standardized protocols and the potential for both underdosing (inefficacy) and overdosing (toxicity).
Limitations: Survey data with self-reported use. No efficacy or safety outcomes measured. Lack of controlled comparison. Reflects historical practice patterns that have shifted since the publication of neonatal toxicity case reports.
[9]
Estrogenic activity screening
In vitro evaluation of blue cohosh extract for estrogenic activity.
Findings: Blue cohosh root extract demonstrated weak estrogenic activity in estrogen receptor binding assays and in MCF-7 cell proliferation assays. The estrogenic effect was modest compared to isoflavone-containing plants (soy, red clover) and is not considered a primary mechanism of action. The uterotonic effects are primarily mediated by the saponin/alkaloid pathways rather than estrogen receptor activation.
Limitations: In vitro assays only. Weak activity may not be clinically significant at typical doses. The relative contribution of estrogenic activity to the overall reproductive effects of blue cohosh is uncertain.
[4]
Preparations & Dosage
Tincture
Strength: 1:5 dried root in 60% ethanol; or 1:2 fresh root in 75% ethanol
Macerate dried blue cohosh rhizome and root in 60% ethanol menstruum. Ratio 1:5 for dried root. For fresh root (preferred by some practitioners), use 1:2 in 75% ethanol. Macerate for 4-6 weeks with regular agitation. Press and filter. The tincture should be dark brownish-amber.
0.5-1 mL, 3 times daily. Start at the lower end and increase cautiously. Maximum: 3 mL per day.
3 times daily between meals.
Short-term use (2-4 weeks) for acute reproductive conditions. Reassess if no response. Not for long-term continuous use.
Not recommended for pediatric use.
Tincture is the most common modern preparation form. The relatively high alcohol percentage (60%) is needed to adequately extract both the alkaloids and the saponins. Blue cohosh tincture is almost always used in combination with other herbs rather than as a simple — common partners include Actaea racemosa (black cohosh), Viburnum prunifolium (black haw), Mitchella repens (partridgeberry), and Dioscorea villosa (wild yam). Solo use at full dose is not recommended due to the narrow therapeutic window.
Decoction
Strength: 1-3 g dried root per 300 mL water
Add 1-3 g of dried, sliced blue cohosh rhizome and root to 300 mL of cold water. Bring to a gentle boil and simmer for 15-20 minutes. Strain. The resulting decoction is bitter and somewhat acrid in taste.
60-120 mL (one-quarter to one-half cup) of the decoction, 2-3 times daily.
2-3 times daily.
Short-term use only (1-2 weeks). Reassess after 1 cycle for menstrual conditions.
Not recommended.
Decoction is the traditional Native American and Eclectic preparation form. The hard, woody rhizome requires decoction (simmering) rather than simple infusion to extract the active constituents. This was the primary form used by Native American midwives. Felter and Lloyd recommended the decoction at the dose of 'a wineglassful' (approximately 60-90 mL) repeated as needed.
[5]
Capsule / Powder
Strength: Crude dried root powder, 300-500 mg per capsule
Dried, powdered blue cohosh rhizome and root encapsulated. Less commonly used than tincture due to difficulty standardizing dose and the preference for liquid preparations in clinical practice.
300-500 mg of dried root powder per capsule; 1-2 capsules, 2-3 times daily. Maximum 1.5 g dried root per day.
2-3 times daily with meals.
Short-term use (2-4 weeks).
Not recommended.
Capsule form is available commercially but less preferred by herbalists who favor tincture for its dosing flexibility and faster onset. The capsule form makes it harder to titrate dose, which is important given blue cohosh's narrow therapeutic window. If using capsules, choose products from reputable manufacturers that verify botanical identity (Caulophyllum thalictroides, not Actaea racemosa, which is sometimes confused in commerce).
[1]
Glycerite
Strength: 1:5, 60-75% glycerin
Macerate dried blue cohosh rhizome in 60-75% vegetable glycerin. Alcohol-free alternative, though glycerin is less efficient at extracting the full alkaloid and saponin profile.
2-4 mL, 2-3 times daily.
2-3 times daily.
Short-term use.
Not recommended.
Glycerite form is less potent than tincture due to glycerin's inferior extraction of alkaloids and saponins compared to ethanol. Suitable only when alcohol is strictly contraindicated. Dose may need to be increased relative to tincture to achieve comparable effects.
[8]
Safety & Interactions
Class 3
To be used only under supervision of a qualified practitioner (AHPA Botanical Safety Handbook)
Contraindications
Blue cohosh is absolutely contraindicated during pregnancy without expert supervision. The nicotinic alkaloid N-methylcytisine can cause fetal coronary artery vasoconstriction leading to myocardial ischemia and infarction. The oxytocic saponin caulosaponin can cause uterine hyperstimulation, leading to placental hypoperfusion, fetal distress, and premature labor. Multiple case reports document neonatal myocardial infarction, multi-organ hypoxic injury, seizures, congestive heart failure, and stroke temporally associated with maternal blue cohosh use. The alkaloid anagyrine is a known teratogen in livestock. The traditional use as a labor-preparation herb is NOT safely replicated outside of experienced practitioner supervision with careful dose titration. AHPA BSH Class 2a applies (not for use in pregnancy).
N-methylcytisine has vasoconstrictive and hypertensive effects via nicotinic receptor stimulation and catecholamine release. Patients with hypertension, coronary artery disease, heart failure, or arrhythmias should not use blue cohosh due to the risk of exacerbating cardiovascular symptoms.
Patients with documented hypersensitivity to Berberidaceae plants (including Berberis, Mahonia) should avoid blue cohosh.
Drug Interactions
| Drug / Class | Severity | Mechanism |
|---|---|---|
| Oxytocin (Pitocin) and other uterotonic agents (Uterotonic drugs) | major | Additive uterotonic effect. Blue cohosh's caulosaponin and N-methylcytisine both stimulate uterine contraction. Combined with pharmaceutical uterotonics (oxytocin, misoprostol, methylergonovine), there is significant risk of uterine hyperstimulation, tetanic contraction, uterine rupture, or fetal distress. |
| Nicotine (patches, gum, e-cigarettes) and nicotinic receptor agonists (varenicline/Chantix, cytisine) (Nicotinic agonists) | moderate | Additive nicotinic receptor stimulation. N-methylcytisine and nicotine both act on nAChRs. Combined use could potentiate cardiovascular effects (hypertension, tachycardia) and gastrointestinal effects (nausea). |
| Antihypertensive medications (ACE inhibitors, beta-blockers, calcium channel blockers, diuretics) (Antihypertensives) | moderate | Antagonistic interaction. N-methylcytisine's vasoconstrictive and hypertensive effects may counteract the blood pressure-lowering effects of antihypertensive medications. |
| Cardiac glycosides (digoxin) (Cardiac glycosides) | moderate | Potential for additive cardiac effects. N-methylcytisine can affect cardiac rhythm through nicotinic stimulation and catecholamine release. Combined with digoxin (a narrow therapeutic index drug), there is theoretical risk of arrhythmia. |
| Anticoagulants and antiplatelet agents (warfarin, aspirin, clopidogrel) (Anticoagulants / Antiplatelets) | minor | Blue cohosh's emmenagogue action increases menstrual blood flow. Combined with anticoagulants, there is potential for increased menstrual bleeding. |
Pregnancy & Lactation
Pregnancy
unsafe
Lactation
insufficient data
PREGNANCY: CONTRAINDICATED. Blue cohosh poses serious risks to the fetus and neonate. N-methylcytisine causes fetal coronary artery vasoconstriction; caulosaponin causes uterine hyperstimulation; anagyrine is a teratogen in animal models. Published case reports document neonatal myocardial infarction, multi-organ hypoxic injury, congestive heart failure, and seizures. The AHPA Botanical Safety Handbook classifies it as Class 2a (not for use in pregnancy). Despite the historical traditional use as a partus praeparator, modern evidence clearly demonstrates unacceptable risk for unsupervised use during pregnancy. LACTATION: Insufficient data. No studies on excretion of alkaloids or saponins into breast milk. Given the toxicological profile of N-methylcytisine (nicotinic agonist) and its low molecular weight (favoring transfer into milk), avoidance during lactation is recommended as a precautionary measure.
Adverse Effects
References
Monograph Sources
- [1] Gardner Z, McGuffin M (eds.). American Herbal Products Association's Botanical Safety Handbook, Second Edition: Caulophyllum thalictroides. CRC Press, Boca Raton (2013)
Clinical Studies
- [2] Jones TK, Lawson BM. Profound neonatal congestive heart failure caused by maternal consumption of blue cohosh herbal medication. J Pediatr (1998) ; 132 : 550-552 . PMID: 9544922
- [3] Finkel RS, Zarlengo KM. Blue cohosh and perinatal stroke. N Engl J Med (2004) ; 351 : 302-303 . PMID: 15254290
- [4] Betz JM, Andrzejewski D, Troy A, Casey RE, Obermeyer WR, Page SW, Bhatt RV. Gas chromatographic determination of toxic quinolizidine alkaloids in blue cohosh (Caulophyllum thalictroides). Phytochem Anal (2005) ; 9 : 232-236
Traditional Texts
- [5] Felter HW, Lloyd JU. King's American Dispensatory, 18th Edition: Caulophyllum. Ohio Valley Company, Cincinnati (1898)
- [6] Ellingwood F. American Materia Medica, Therapeutics and Pharmacognosy: Caulophyllum. Ellingwood's Therapeutist, Chicago (1919)
- [7] Moerman DE. Native American Ethnobotany. Timber Press, Portland, OR (1998)
- [8] Hoffmann D. Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press, Rochester, VT (2003)
- [9] Romm A. Botanical Medicine for Women's Health. Churchill Livingstone/Elsevier, St. Louis (2010)
Last updated: 2026-03-23 | Status: published
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