Herbalists' Views on the Top-Selling Herbs (Part 8): Milk Thistle & Black Cohosh

Herbs #22 and 23 on the top-selling herbs list for 2023 were milk thistle and black cohosh.

Today we continue our series on commercially popular herbs, and share our views as herbalists on the actions, benefits, and applications of these.

Milk thistle is widely known as an excellent herb for the liver, and this is a case where the common wisdom is correct. It’s one of the safest herbs out there, and fortunately, it is also widely available and inexpensive. Hepatoprotective and even able to regenerate damaged liver tissue, it is at the same time a very gentle and benign plant. But don’t try to make tea with it!

Black cohosh’s reputation is as a remedy for PMS and menopausal symptoms, and often this is attributed to phytoestrogenic activity or constituents. The reality is murky – and has remained so despite decades of argument and investigation on both sides of the claim. Regardless, black cohosh can often help. We find it best to view the herb through the lens of its action as a relaxant. If PMS or menopause are showing up with lots of tension, it’s worth a try and most likely to help. But we can also apply that action much more broadly, for injuries, spasms, and (certain kinds of) headaches.

22. Milk Thistle – Silybum marianaum

• Milk Thistle: Herb of the Week
• Milk Thistle at Herbal Reality
• Milk Thistle in A Modern Herbal, M. Grieve, 1931 – presented in this text alongside multiple other thistles, which allows for close comparisons among them.

23. Black Cohosh – Actaea racemosa

• Wuttke, W., Seidlová-Wuttke, D. Black cohosh (Cimicifuga racemosa) is a non-estrogenic alternative to hormone replacement therapy. Clin Phytosci 1, 12 (2015). doi: 10.1186/s40816-015-0013-0.
• Mohapatra S, Iqubal A, Ansari MJ, Jan B, Zahiruddin S, Mirza MA, Ahmad S, Iqbal Z. Benefits of Black Cohosh (Cimicifuga racemosa) for Women Health: An Up-Close and In-Depth Review. Pharmaceuticals (Basel). 2022 Feb 23;15(3):278. doi: 10.3390/ph15030278. PMID: 35337076; PMCID: PMC8953734.
• Black Cohosh at Herbal Reality
• Cimicifuga in King’s American Dispensatory, 1898 – has an impressively long list of indications and applications for this remedy.

If all you’d heard (before today) about black cohosh was that it’s “good for menopause”, you might want to check out our Reproductive Health course! We discuss the whole range of human reproductive variability and herbal medicines to support all kinds of people. We even bust a few reproductive-health myths and herban legends. (Hint: vitex is not “a miracle herb for all women”!)

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