Can You Take Black Cohosh and Fo-Ti (He Shou Wu) Together?

Use extra care with this pair

The short answer

Both Fo-Ti (He Shou Wu) and Black Cohosh have strong hepatotoxicity evidence. Fo-Ti's anthraquinones cause idiosyncratic liver injury, while Black Cohosh triggers autoimmune hepatitis. Combined use is a notable liver risk.

How to arrange timing

Avoid concurrent use. Both have individually caused severe hepatotoxicity cases. If either is medically necessary, monitor liver enzymes closely.

Reference

Reference noted for this combination: Lei X et al., J Ethnopharmacol 2015; Mahady GB et al., Menopause 2008; LiverTox (NIH/NLM)

Important context

Whether supplements suit you together also depends on dose, product formulation, health conditions, and medication use. Ask a doctor or pharmacist first if you take medication, are pregnant or breastfeeding, or have a chronic condition.