Re: Bl. Cohosh
I take flaxseed oil softgels too. Great stuff!
---------- Original Message ----------------------------------
From: "SallyAnn" <firstname.lastname@example.org>
Date: Tue, 12 Aug 2003 19:58:35 -0400
>Herbs for Hot Flashes: New Attention, Mixed Results
>By LESLIE BERGER
>erry Heaton will not find out for at least another year whether the pills she
>tried for hot flashes were just blanks or really black cohosh, the much
>ballyhooed Native American remedy for women's ailments.
>As a participant in a federally financed study at Columbia University who
>dutifully recorded the frequency and severity of her hot flashes over 12
>months, Ms. Heaton, a 56-year-old retired airline employee, could see that her
>menopausal symptoms were diminishing. She was definitely sleeping better.
>Yet, toward the end of the year, Ms. Heaton, a Manhattan resident, was still
>having mild anxiety attacks. So she wondered whether she had taken a placebo
>"I believe it was the black cohosh because I felt it was helping me," Ms.
>Heaton said. "But I don't know for sure."
>Neither do experts, who are still identifying black cohosh's crucial
>ingredient and sorting out how the flowering herb works, not to mention trying
>to confirm whether it really does work significantly better than placebos.
>Stunned by the string of negative studies about hormone replacement, including
>research released last week that emphasized the risk of heart attacks and
>breast cancer, millions of menopausal women are searching for safe
>substitutes. Their quest for relief from hot flashes, night sweats and other
>symptoms has coincided with the first wave of results from studies begun over
>the last several years of popular herbs and other nonpharmaceutical
>But to the dismay of enthusiasts of alternative medicines, the evidence of the
>benefits has been limited and mixed. As a result, experts are urging caution
>in using products that are just beginning to be understood, are of
>inconsistent quality and are sold in nontraditional ways.
>"The first thing we tell women about the alternatives is that it's really
>important to realize that a product is not necessarily safe just because it's
>`natural,' " said Amy Allina, policy and program director for the National
>Women's Health Network in Washington. "The same questions we ask about drugs
>should be asked of natural remedies too. Why are you taking it? What are the
>risks associated with it? Are there studies proving it's effective for the
>purpose you're taking it?"
>Last year, Dr. Adriane J. Fugh-Berman, an expert in women's health at George
>Washington University, and Dr. Fredi Kronenberg, a professor of physiology at
>Columbia, surveyed scientific studies on complementary and alternative
>treatments for menopausal symptoms. Most of the tests have focused on hot
>flashes, the most common and concrete symptom that drives women to seek
>Their review, published in The Annals of Internal Medicine, found that in 10
>clinical trials of five herbs and one herbal mixture tested for hot flashes,
>just black cohosh has shown a beneficial effect.
>In most of the studies, the improvements for black cohosh were not drastically
>different than for those taking hormone replacements or placebos, the review
>noted. There is still no published information on the long-term safety of
>black cohosh because none of the completed studies lasted more than six
>months, their review said.
>A more recent article, in the journal Menopause, cites the growing body of
>evidence that black cohosh is safe. But the author, Dr. Tieraona Low Dog, said
>she did not recommend using it for longer than six months.
>"Take it for six months, then re-evaluate," said Dr. Low Dog, an assistant
>professor at the University of New Mexico.
>Despite the caveats, black cohosh had $59 million in sales last year, a more
>than fivefold increase from 1998, according to The Nutrition Business Journal,
>a trade publication in San Diego.
>The Chinese herbs dong quai and ginseng showed no benefit for hot flashes, the
>survey in The Annals of Internal Medicine found. Neither did oil of evening
>primrose or red clover, another Indian folk remedy.
>One of the most recent studies, published last month in The Journal of the
>American Medical Association, found that the effects of two brands of red
>clover on hot flashes were just slightly better than that of the placebo.
>In urging a cautious approach, Dr. Fugh-Berman cited the roller coaster ride
>of the hormone replacement therapies that the herbs could in theory replace.
>Millions of women began taking replacements after studies found an association
>between good health and their use. It was not until vast studies like the
>Women's Health Initiative applied more rigorous methods that the picture began
>"Herbs have not come out looking very good for the treatment of menopausal
>symptoms so far," Dr. Fugh-Berman, an assistant clinical professor of
>medicine, said. "One thing the Women's Health Initiative should have taught us
>all is don't trust observational studies for ascertaining the benefits of
>Even soy, now being sold in pill form, is not the miracle cure originally
>believed, and it may affect the body differently as an extract than as a food,
>several experts said.
>A staple in Asian cuisine for thousands of years, soy foods are considered a
>possible reason for the lower prevalence of menopausal symptoms reported by
>women in China, Japan and Korea.
>The bean has gained popularity on American tables, and its active ingredients,
>a group of plant estrogens known as isoflavones, have been turned into an
>extract that has become the biggest-selling dietary supplement in the
>so-called menopause market. Sales of soy supplements have quadrupled for five
>years, to $102 million last year, according to The Nutrition Business
>But of eight studies of soy or isoflavone supplements that lasted more than
>six weeks, three showed significant improvement in hot flashes, according to
>The Annals survey. The longest study showed no benefit for hot flashes or
>other menopausal symptoms at 24 weeks. Other published results showed only
>All beans contain plant estrogens, not just soy, and eating more of them is a
>harmless way to try to manage menopause, several experts said. But the same
>presumption of safety, they added, cannot be made for extracts sold over the
>counter, many of which are packaged in high concentrations. "Soy foods are
>safe," Dr. Kronenberg said. "Soy extracts remain to be seen."
>Similarly, acupuncture and deep-breathing and relaxation exercises are
>considered benign therapies that have shown benefits in the few studies
>conducted so far. But wild yam cream has proved to be useless. And although
>progesterone cream showed significant improvements in hot flashes in a study
>whose primary focus was bone density, it also caused vaginal spotting in 8 of
>Another complication in the study of alternatives is that hot flashes have
>been extremely responsive to placebos. They seem to improve, at least
>temporarily, with just about any intervention. Most therapies have a placebo
>response rate of 30 percent in clinical trials. The rate with hot flashes is
>40 to 50 percent. Researchers have yet to figure out
>why. "We don't know what causes a hot flash, to this day," said Dr.
>Kronenberg, who has been studying the phenomenon for 15 years.
>In a series of federally financed trials at Columbia, where she is director of
>the Richard and Hinda Rosenthal Center for Complementary and Alternative
>Medicine, Dr. Kronenberg is studying not only black cohosh, but also flax
>seeds and macrobiotic diets.
>Flax, a grain rich in essential fatty acids, vitamin E and plant estrogens, is
>being added to the diets of some participants to see whether it helps hot
>flashes, sleep problems and other menopausal symptoms. One participant, Maria
>Paniagua, 57, a technician for a telephone company, said she felt no changes
>but enjoyed losing some weight. More enthusiastic was Patt Haring, 59, a
>retired teacher with glowing skin who said the night sweats that had been
>driving her crazy improved within weeks after she started following the strict
>macrobiotic diet. "It was really liberating," Ms. Haring said, "to be off all
>those hormones and learn which foods you can eat to heal yourself."
>At the University of Illinois, an expert on medicinal plants, Norman
>Farnsworth, said his laboratory had confirmed that black cohosh acted on the
>hypothalamus, the area of the brain that regulates hormones and body
>temperature, a development that could support the herb's safety.
>Native Americans did not historically use black cohosh for hot flashes, but
>rather as an aid for labor and as an antidepressant, said Dr. Low Dog, who is
>of Indian descent and has been practicing herbal medicine for 25 years.
>"What I find interesting is that its historical use was for melancholy," Dr.
>Low Dog said. "And now studies clearly show it is not estrogenic, but appears
>to be working through the central nervous system. This would be consistent
>with its historical use."
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