Supplement·Interactions·Reviewed June 9, 2026
Black Cohosh interactions.
Black Cohosh has 6 documented interactions in the NutriStack database: 4 that need timing or caution and 2 that work synergistically. The full list, with what each pairing does, is below.
Black Cohosh at a glance.
A quick, data-grounded summary. The full table is below.
Black Cohosh has 6 documented interactions in the NutriStack database: 4 that need timing or caution and 2 that work synergistically. The full list, with what each pairing does, is below.
Everything that interacts with black cohosh.
Every supplement and medication in the NutriStack database with a documented interaction with this substance, highest-severity first. Open any pair for the mechanism and sources.
| Substance | Interaction | What happens |
|---|---|---|
| 5-HTP | Caution | On their own, supplemental 5-HTP can already raise serotonin levels, and Black Cohosh has measurable serotonergic pharmacology plus at least one... |
| Estradiol | Caution | Black cohosh (Cimicifuga racemosa) is used for menopausal symptoms and has mild estrogenic and serotonergic activity. Combining it with prescribed... details → |
| Green Tea Extract | Caution | Concentrated Green Tea Extract is one of the botanicals most consistently linked to liver injury in the US Drug-Induced Liver Injury Network, and... |
| St. John's Wort | Caution | Both herbs carry independent hepatic safety signals, so combining them can complicate monitoring and attribution if liver enzymes rise or symptoms... |
| Calcium | Synergy | Calcium complements black cohosh in the menopausal setting by supporting bone density, which black cohosh does not address while it relieves... |
| Vitamin D3 | Synergy | Pairing black cohosh for menopausal vasomotor symptoms with vitamin D3 addresses a complementary need, since postmenopausal women face elevated bone... |
The full black cohosh profile.
Benefits, dosing by goal, forms, and the cited evidence for this supplement.
Common black cohosh questions.
Quick answers drawn from the table above.
What interacts with Black Cohosh?
In the NutriStack database, Black Cohosh has 6 documented interactions with other supplements and medications. The most notable include 5-HTP, Estradiol, Green Tea Extract, St. John's Wort, and Calcium.
What works well with Black Cohosh?
Black Cohosh pairs synergistically with Calcium and Vitamin D3 in the NutriStack database. Synergy still depends on dose and timing; open any pair for the detail.
Can you take Black Cohosh with 5-HTP?
NutriStack classifies the Black Cohosh and 5-HTP pairing as caution: On their own, supplemental 5-HTP can already raise serotonin levels, and Black Cohosh has measurable serotonergic pharmacology plus at least one published case of... Do not combine 5-HTP with Black Cohosh if you also take any SSRI, SNRI, MAOI, tramadol, triptan, or other serotonergic medication. If using both...
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