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Blue Cohosh (Caulophyllum thalictroides)
A herb traditionally used to induce labour, and a serious teratogen. This entry exists so that blue cohosh can be SCREENED — it is never recommended, and there is no dose at which it is appropriate in pregnancy or breastfeeding.
Research compound — not a dietary supplement
Blue Cohosh is a research compound, not a regulated dietary supplement. It is sold for research or off-label use. The evidence below is largely preclinical (animal and in-vitro) or early-stage, so no evidence score is assigned. This page is provided for transparency and education — it is not a recommendation to use. Consult a qualified healthcare provider, and be aware that purity, dosing, and legal status vary by jurisdiction.
What the evidence says
Blue Cohosh doesn't have enough studies with structured effect-size data yet to pool a verdict. Browse the studies below for individual findings.
Most evidence is from medium-quality studies published 2014–2014.
Based on 1 study
Confidence
Very low confidenceScores at the floor because there is no controlled human evidence of benefit for any use. What literature exists is toxicological — mechanism-of-harm work and case reports of severe neonatal outcomes after maternal use.
Blue cohosh (Caulophyllum thalictroides) has a long history of use by North American midwives to induce or augment labour. It contains quinolizidine alkaloids — principally N-methylcytisine, a nicotinic agonist — together with glycosides that disrupt mitochondrial respiration.
Case reports describe severe neonatal outcomes after maternal use, including myocardial infarction, congestive heart failure, stroke and profound perinatal distress.
It is carried here as a screenable entry rather than as an option: it is flagged `researchCompound`, has no goal mappings, and is excluded from every recommendation flow. The purpose is that a reader who scans a product or types the name is told what it is, instead of being told it could not be identified.
N-methylcytisine is a nicotine-like alkaloid; it is the constituent behind the cardiovascular effects reported in exposed newborns.
Blue cohosh extract disrupts cellular respiration and mitochondrial membrane potential in vitro — the mechanism screened for in drugs that later carry black-box warnings.
Avoid — the alkaloids are teratogenic and maternal use is linked to serious neonatal complications, including myocardial infarction and stroke in the newborn.
Avoid — the alkaloids are pharmacologically active and there is no safety data for the nursing infant.
Avoid — never give this herb to a child.
N-methylcytisine is a nicotinic agonist; effects may add to those of nicotine-containing products.
Reported cardiovascular effects may oppose or exaggerate blood-pressure treatment.
Tip: Do not take this herb
Tip: Seek urgent medical care
The current evidence for Blue Cohosh is insufficient to assign an evidence score, based on 1 indexed study. A herb traditionally used to induce labour, and a serious teratogen. This entry exists so that blue cohosh can be SCREENED — it is never recommended, and there is no dose at which it is appropriate in pregnancy or breastfeeding. Representative study: PMID 24328138.
The commonly studied dose of Blue Cohosh is No appropriate dose. This entry exists so the herb can be screened, not taken.. Individual needs vary — start at the lower end of the range and adjust based on how you respond.
Timing is flexible for Blue Cohosh — consistent daily use matters more than the time of day. No dose is appropriate; no timing guidance is given.
Blue Cohosh should be used with caution — talk to a healthcare provider before taking it. The most commonly reported side effects are nausea, vomiting, headache, chest pain and tachycardia. Use caution if any of these apply to you: Pregnancy — do not take; the alkaloids are teratogenic and linked to serious neonatal complications; Breastfeeding — do not take; Anyone trying to conceive.
Comfrey
Too few graded studiesA traditional poultice herb containing unsaturated pyrrolizidine alkaloids, which are hepatotoxic and carcinogenic. This entry exists so that comfrey can be SCREENED — it is never recommended, and internal use has caused fatal hepatic veno-occlusive disease.
Pennyroyal
Too few graded studiesA mint-family herb used historically as an abortifacient, and a documented cause of fatal liver failure. This entry exists so that pennyroyal can be SCREENED — it is never recommended, and the oil in particular has no safe dose.
Psyllium Husk
Likely helpsGel-forming soluble fiber that lowers LDL cholesterol, regulates blood sugar, and promotes digestive regularity.
St. John's Wort
Mixed evidenceModulates serotonin, dopamine, and norepinephrine; studied for mood, with trials in mild-to-moderate depression comparing it to SSRIs — requires drug-interaction caution.
Reviewed by Dr. Baher Al Hakim · Last reviewed August 2026 · evidence from 1 study · how we score · editorial policy
This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult a qualified healthcare provider before starting, stopping, or changing any supplement or medication.