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" Reader Question: I am taking black cohosh for hot flashes but heard it could damage my liver. Should I stop using it? Although there&amp;#039;s been some debate about whether black cohosh works for hot flashes, it&amp;#039;s generally been thought to be safe. In fact, a North American Menopause Society (NAMS) 2004 position paper recommended it as a nonprescription remedy for hot flash relief. However, recently there have been some cases of people who suffered liver toxicity while taking it. A review of these cases (which occurred in the U.S., Australia, Canada and Europe) was published in the July/August 2008 issue of the journal Menopause. The conclusion: While there is a possible link between black cohosh and liver toxicity, we don&amp;#039;t know if using this supplement actually causes liver toxicity. The authors of the review recommend a label change that would tell consumers to &amp;quot;discontinue use and consult a health care practitioner if you have a liver disorder or develop symptoms of liver trouble, such as abdominal pain, dark urine or jaundice.&amp;quot; Whether or not you keep taking black cohosh is up to you and your doctor. My advice is to get a blood test to make sure your liver is OK, and to get periodically tested as long as you&amp;#039;re taking the supplement to make sure it stays that way. If you notice any signs of liver problems (as indicated by blood tests or the symptoms mentioned above), stop and consider other options. Those include using hormone therapy or certain SSRI antidepressants, drinking soy milk or even making simple lifestyle changes like turning up the fan and sipping cold fluids. I want to hear from you, so e-mail me your questions at dailywd@womansday.com.  Disclaimer: Your seeking information on health related topics and/or Sandra Adamson Fryhofer, MD&amp;#039;s providing such information herein constitutes neither the solicitation of nor the provision of medical advice, services, care or treatment. Communication with Dr. Fryhofer on this website does not create a doctor/patient relationship. For concerns about your own particular medical condition, you should consult your own medical professional, who can examine and evaluate you. Communication on a website is not a substitute for taking an active role in your own medical care and treatment and being personally seen by a physician of choice in your area.  "^^<http://www.w3.org/2001/XMLSchema#string>
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