Can You Take Black Cohosh and Vitamin B3 Together?

Use extra care with this pair

The short answer

Black Cohosh may trigger autoimmune hepatitis, while high-dose niacin causes dose-dependent hepatotoxicity. This combination, potentially used by menopausal women managing both symptoms and cholesterol, warrants liver monitoring.

How to arrange timing

Monitor liver function when combining. Use the lowest effective niacin dose (immediate-release form preferred).

Reference

Reference noted for this combination: Mahady GB et al., Menopause 2008; Guyton JR, Am J Cardiol 1998

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.