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Some effects (e.g., short-term cognitive performance with methylene blue, mild energy effects with NAD+) may be noticed within hours to days

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Although some people may find it helpful, there is a lack of evidence supporting the efficacy of black cohosh for reduction of hot flushes 12 , and the NICE guidelines state Do not offer [] black cohosh to treat menopausal symptoms in women with breast cancer. Lab research has shown that black cohosh can inhibit the two core enzymes that convert tamoxifen to endoxifen, meaning it may reduce the function of tamoxifen