Feverfew grows widely across Europe and North America. The leaves are used in herbal medicine.
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3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Standardized herbal extract delivering 250 mcg of parthenolide per day
Feverfew is the most frequently used herb for the long-term migraine prevention. Continuous use of feverfew may reduce the severity, duration, and frequency of migraine headaches.
The most frequently used herb for the long-term prevention of migraines is feverfew.1 Four double-blind trials have reported that continuous use of feverfew leads to a reduction in the severity, duration, and frequency of migraine headaches,2 , 3 , 4 , 5 although one double-blind trial found feverfew to be ineffective.6
Studies suggest that taking standardized feverfew leaf extracts that supply a minimum of 250 mcg of parthenolide per day is most effective. Results may not be evident for at least four to six weeks. Although there has been recent debate about the relevance of parthenolide as an active constituent,7 it is best to use standardized extracts of feverfew until research proves otherwise.
A double-blind study found that a combination of feverfew and ginger may be effective for acute treatment of migraines. In that study, 63% of patients taking the herbal preparation experienced pain relief within 2 hours, whereas only 39% taking placebo experienced relief, a statistically significant difference. The product used in this study was a proprietary preparation called LipiGesic M (PuraMed BioScience, Inc., Schofield, WI). The liquid from 1-unit dose applicator was administered sublingually, held under the tongue for 60 seconds, and then swallowed. A second dose was given 5 minutes later. If pain persisted after 1 hour, a second treatment of 2-unit doses could be given.8
Feverfew was mentioned in Greek medical literature as a remedy for inflammation and for menstrual discomforts. Traditional herbalists in Great Britain used it to treat fevers, rheumatism, and other aches and pains.
Feverfew contains a range of compounds known as sesquiterpene lactones. Over 85% of these are a compound called parthenolide. In test tube studies, parthenolide prevents excessive clumping of platelets and inhibits the release of certain chemicals, including serotonin and some inflammatory mediators.9 , 10 Feverfew’s parthenolide content was originally thought to account for the anti-migraine action of this herb, but this has been a matter of recent debate.11
According to three double-blind trials with migraine patients, feverfew reduces the severity, duration, and frequency of migraine headaches.12 , 13 , 14 These successful studies employed dried, powdered leaves. One negative study used an alcohol extract suggesting the dried leaf preparation is superior.15
Feverfew leaf products with at least 0.2% parthenolide content are generally used. Standardized leaf extracts may contain up to 0.7% parthenolide. Herbal products in capsules or tablets providing at least 250 mcg of parthenolide per day may be taken.16 It may take four to six weeks before benefits are noticed. Feverfew is useful for decreasing the severity and incidence of migraines. However, it is not an effective treatment for an acute migraine attack.
Certain medicines interact with this supplement.
Although there are no documented cases of feverfew (Tanacetum parthenium) interacting with warfarin in humans, feverfew has been shown to interfere with certain aspects of blood clotting in test tube studies.17 , 18 , 19
Taken as recommended, standardized feverfew causes minimal side effects. Minor side effects include gastrointestinal upset and nervousness. Chewing feverfew leaves has been reported to cause canker sores.20 Feverfew is not recommended during pregnancy or breast-feeding and should not be used by children under the age of two years.
1. Volger BK, Pittler MH, Ernst E. Feverfew as a preventive treatment for migraine: a systematic review. Cephalagia 1998;18:704–8.
2. Murphy JJ, Hepinstall S, Mitchell JR. Randomized double-blind placebo controlled trial of feverfew in migraine prevention. Lancet 1988;2:189–92.
3. Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J (Clin Res Ed) 1985;291:569–73.
4. Palevitch D, Earon G, Carasso R. Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: A double-blind placebo-controlled study. Phytother Res 1997;11:508–11.
5. Diener HC, Pfaffenrath V, Schnitker J, et al. Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention - a randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia2005;25:1031–41.
6. De Weerdt CJ, Bootsma HPR, Hendriks H. Herbal medicines in migraine prevention. Phytomed icine 1996;3:225–30.
7. Awang DVC. Parthenolide: The demise of a facile theory of feverfew activity. J Herbs Spices Medicinal Plants 1998;5:95–8.
8. Cady RK, Goldstein J, Nett R, et al. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache 2011;51:1078–86
9. Makheja AN, Bailey JM. A platelet phospholipase inhibitor from the medicinal herb feverfew (Tanacetum parthenium). Prostagland Leukotrienes Med 1982;8:653–60.
10. Heptinstall S, White A, Williamson L, Mitchell JR.. Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leukocytes. Lancet 1985;1:1071–4.
11. Awang DVC. Parthenolide: The demise of a facile theory of feverfew activity. J Herbs Spices Medicinal Plants 1998;5:95–8.
12. Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J 1985;291:569–73.
13. Murphy JJ, Heptinstall S, Mitchell JRA. Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet 1988;2:189–92.
14. Palevitch D, Earon G, Carasso R. Feverfew(Tanacetum parthenium) as a prophylactic treatment for migraine: A double-blind placebo-controlled study. Phytother Res 1997;11:508–11.
15. De Weerdt CJ, Bootsma HPR, Hendriks H. Herbal medicines in migraine prevention. Phytomed 1996;3:225–30.
16. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 91–5.
17. Heptinstall S, Groenewegen WA, Spangenberg P, Loesche W. Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. J Pharm Pharmacol 1987;39:459–65.
18. Heptinstall S, Groenewegen WA, Spangenberg P, Losche W. Inhibition of platelet behaviour by feverfew: a mechanism of action involving sulphydryl groups. Folia Haematol Int Mag Klin Morphol Blutforsch 1988;115:447–9.
19. Loesche W, Mazurov AV, Voyno-Yasenetskaya TA, et al. Feverfew—an antithrombotic drug? Folia Haematol Int Mag Klin Morphol Blutforsch 1988;115:181–4.
20. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 91–5.
Last Review: 11-07-2012
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