The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (over 18 years old)
There is no proven effective dose for black cohosh. The British Herbal Compendium recommends 40-200 milligrams of dried black cohosh root daily in divided doses, although traditional doses have been as high as one gram three times daily. As a tincture or liquid, the British Herbal Compendium recommends 0.4-2 milliliters of a (1:10) 60% ethanol tincture daily. Powdered black cohosh root or tea (1-2 grams three times daily) also has been used.
For bone density in postmenopausal women, preparations containing 40 milligrams of black cohosh have been taken by mouth for up to three months.
For breast cancer treatment (menopausal symptoms), 1-4 tablets containing 2.5 milligrams of black cohosh extract have been taken by mouth for six months in addition to tamoxifen. In another study, 20 milligrams of black cohosh was taken by mouth daily for a year. A dose of 20 milligrams of black cohosh has also been given twice daily for 1-6 months.
For heart disease in postmenopausal women, 40 milligrams of black cohosh has been taken by mouth daily for three months, stopped for three months, then taken for three months again.
For infertility, 120 milligrams of black cohosh root has been taken by mouth daily for 12-13 days.
For menopausal symptoms, 6.5-160 milligrams of an alcoholic black cohosh extract, a black cohosh root extract, or other black cohosh formulations has been taken by mouth daily for up to one year in various studies. In some studies, 40 drops of a liquid extract have been taken by mouth once or twice daily for up to 24 weeks. An adjusted dose of black cohosh, starting at 64 milligrams for two weeks increased to 128 milligrams by the fourth week, has been studied.
For mental performance in postmenopausal women, 128 milligrams of ground black cohosh parts has been taken once daily by mouth for one year.
Children (under 18 years old)
There is not enough scientific information to recommend black cohosh in children.
This evidence-based monograph was prepared by The Natural Standard Research Collaboration