St Johns Wort & Black Cohosh - anyone taken this long term??? Risks??

[paganmolloy]

I've been taking this for a good few months now and it's been a revelation for me. Been feeling great, no migraines, calm and positive, no erratic mood swings. Only thing was my poos were not that solid however this didn't bother me at all as Ive always been prone to constipation and going regularly every morning after breakfast was a bit of a bonus.

However I wonder about this side effect and read the leaflet in the packet. It listed it as a possible side effect but I didn't seem to have any others. Nonetheless I wondered if long term use was good or bad and emailed the manufacturers. They came back stating that they would generally recommend 8 weeks on 2 weeks off and they were not recommended for consistent long term use. Also that if my symptoms didn't improve after 3 months then I should stop and see a GP. None of this is mentioned on the leaflet.

I've stopped taking it three days ago and already feel a migraine coming on, lethargic, just had a nap for an hour and generally feeling rubbish.

Has anybody any experience of taking this? The ones I've used are Menomood or Holland & Barrett Menopause Mood Relief. I cannot seem to find anything on internet regarding long term use, just not to use if taking other medicines or a history of certain ailments, none of which apply to me so I thought I was perfectly fine to take this indefinitely.

I was tempted to buy this myself but the potential liver issues of Black Cohosh have put me off so far so will be interested in any replies. I've been taking sage for 2 weeks now and my hot flushes aren't as bad - could of course be doing to background hormonal changes of course. So difficult to now what to do for the best.

I took Black Cohosh for a while - and thought it worked - but really is was only my natural cycle coming and going. Once peri-menopause was really set in and my oestrogen levels had plunged to a lower level for a long time the flushes and sweats stayed and worsened so I chucked it and started HRT - 10+ years ago - and never looked back. Depends what your cycle is doing - if you are hardly getting any periods, getting flushes and sweats, and are not medically unable to take HRT - then why not give it a whirl? After all it is more "natural" (ie it is replacing hormones that your body is deficient in - if you take the right ones ie body-identical hormones) than herbal products - which haven't been properly tested long term anyway as far as I know, and also evidence for their efficacy is limited. I've never taken St John's Wort.

A friend of mine took Black Cohosh, had catastrophic liver failure and almost died, months in hospital and was on the transplant list for a time. A year on and she's still very ill, her liver is essentially toast, and will be life-limiting.

It's a rare side-effect, but wouldn't touch the stuff after what happened to her.

Crikey, that does sound alarming. I think I'd rather have hot flushes.

Jings, alarming indeed

As I said above - no need even to have hot flushes if you take HRT

Menopause isn’t only hot flashes unfortunately! It is the long term consequences for our health due to the loss of estrogen that make me worry and no only because of the obvious symptoms.

This is a good guide to side effects and risks of Black Cohosh.

www.webmd.com/vitamins/ai/ingredientmono-857/black-cohosh

It's a good idea to do your own research online before using anything OTC because herbs can have as many side effects as prescribed drugs. 'Natural' doesn't = safe sometimes. Herbs can be toxic even though they are sold as 'safe'. There is an ongoing government discussion to restrict the sale of herbs for this reason (I don't agree with that by the way but it's in the pipeline.)

SJW is for moods and BC is more for hot flushes but in the link, the evidence it helps is quite weak.

I'm only going from personal experience and since using this particular tablet which contains 300mg SJW and 6.4mg Black Cohosh, I've not suffered from migraines and felt altogether much better. I stopped taking it on Monday and now I have a stinking migraine.

My concern is that there was nothing on the leaflet to say that it wasn't for long term use - all the research I've done, I can find nothing on long term use, just to stop it if I had any of the side effect symptoms. As I had no side effects (other than regular poos which for me was a bonus), I presumed it was ok to take it indefinitely. I'm due another gyn appointment in the next few weeks so will be quizzing the doctor.

i've not suffered from migraines and felt altogether much better. I stopped taking it on Monday and now I have a stinking migraine.

You shouldn't rely on an OTC herb to control migraines. Have you seen a specialist about your migraines?

The reason you won't find anything on the leaflets is that herbs are not regulated like medicines . The manufacturers have a duty of care but as these are not licensed drugs I doubt they have to list every single side effect and also the herbs have not undergone clinical trials like other drugs.

Black cohosh has been linked to liver reactions for a long time.
Maybe you need to decide which is your main problem; SJW is for moods, BC is more for hot flushes. Both have risks if they are taken alongside other prescribed drugs (especially SJW) so it's not as easy as take some herbs and everything's fine.

My migraines are why I'm an outpatient at the local women's health clinic. They are hormonal. When I first was referred I was basically screaming for a full hysterectomy to stop this hell that was happening (my migraines last for 4 days exactly every time the hormones play up and at the time they were playing up a lot more than monthly).

I'm on a wait and see how it goes with options of mirena, HRT and something that would stop my ovaries working and put me into menopause. I was feeling great that SJW/BC seemed to be helping me. I do not take any other drugs nor have a medical history that would suggest taking it was a risk.