Liver failure associated with  the use of black cohosh for menopausal symptoms

Chow, Elizabeth C-Y; Teo, Marcus; Ring, John A; Chen, John W

doi:10.5694/j.1326-5377.2009.tb02294.x

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In reply: Teschke questions the temporal sequence in our reported case1 by raising an ambiguity in dates. We wish to clarify: when the patient first presented on 23 May 2006, lethargy, arthralgia and nausea had been present for only about 3 weeks. This was well after the dose increase in black cohosh in March 2006. As such, the dose escalation definitely preceded the patient’s symptoms and liver failure.

Department of Gastroenterology and Hepatology, Flinders Medical Centre, Adelaide, SA.

Correspondence: elizabeth.chow@fmc.sa.gov.au

1. Chow ECY, Teo M, Ring JA, Chen JW. Liver failure associated with the use of black cohosh for menopausal symptoms. Med J Aust 2008; 188: 420-422. <MJA full text>
2. Joy D, Joy J, Duane P. Black cohosh: a cause of abnormal postmenopausal liver function tests. Climacteric 2008; 11: 84-88.
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5. Australian Government Department of Health and Ageing Therapuetic Goods Administration. Required advisory statements for medicine labels. Proposed update 3.1, consultation document. Canberra: Australian Government, 2007. http://www.tga.gov.au/meds/drrasmlupd3-1.pdf (accessed Oct 2008).
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