Doctors have renewed warnings about black cohosh, after a US woman developed acute liver injury after taking the herbal supplement for menopausal symptoms.

The 50-year-old had been feeling well until two months earlier, when she started experiencing fatigue, nausea, itching and yellowing of the skin, write doctors from the University of Mississippi Medical Centre in Jackson.

She had asthma, COPD, type 2 diabetes and iron deficiency anaemia but no personal or family history of liver disease, they reported.

Her medications included carvedilol 12.5 mg two times per day, famotidine 20 mg/day, salbutamol and formoterol–budesonide inhalers.