Can You Take Black Cohosh and Kava Together?

Use extra care with this pair

The short answer

Both Black Cohosh and Kava are independently associated with hepatotoxicity. Black Cohosh may trigger autoimmune hepatitis, while Kava causes direct hepatocellular damage. Their combination may compound liver injury risk.

How to arrange timing

Consider avoiding concurrent use. If both are needed, periodic liver function monitoring (ALT, AST) is advisable. Discontinue immediately if symptoms of liver injury appear.

Reference

Reference noted for this combination: Mahady GB et al., Menopause 2008; Teschke R., Ann Intern Med 2010; 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.