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Feverfew Herb Extract

Also known as: Feverfew, featherfew, Tanacetum parthenium

Overview

Feverfew, scientifically known as Tanacetum parthenium L., is a perennial herb widely recognized for its traditional use in the prevention of migraine headaches. This herbal supplement is typically derived from the dried leaves or extracts of the plant. Its primary application is as a prophylactic agent to reduce the frequency and severity of migraine attacks. Feverfew contains several bioactive compounds, most notably parthenolide, which are believed to be responsible for its therapeutic effects. Research on feverfew's efficacy for migraine prevention is moderately mature, with multiple randomized controlled trials (RCTs) and systematic reviews supporting its use. While the quality of evidence is mixed, it generally indicates some efficacy with a favorable safety profile. It is not typically used for acute migraine treatment but rather for long-term prevention.

Benefits

The primary and most well-researched benefit of feverfew is the prevention of migraine attacks. Systematic reviews and meta-analyses consistently indicate that feverfew may reduce both the frequency and severity of migraine episodes when compared to a placebo. While the exact quantitative effect sizes vary across studies, several randomized controlled trials have shown statistically significant reductions in migraine frequency and intensity, although some studies report more modest effects. Beyond its primary role in migraine prevention, some evidence suggests that feverfew may also help alleviate associated symptoms such as nausea and photophobia, though the data supporting these secondary effects are less robust. The benefits are most consistently observed in adults with episodic migraine. It's important to note that the therapeutic effects of feverfew are generally not immediate; benefits are typically observed after several weeks of continuous daily supplementation.

How it works

Feverfew's mechanism of action is primarily attributed to its ability to inhibit inflammatory mediators and modulate serotonin release, both of which are key factors in the pathophysiology of migraines. Parthenolide, a sesquiterpene lactone, is considered the main active compound. It works by inhibiting prostaglandin synthesis, which reduces inflammation, and by inhibiting platelet aggregation, which can contribute to vascular changes during migraines. Additionally, parthenolide may inhibit the release of vasoactive neuropeptides, such as substance P, further contributing to its anti-migraine effects. The oral bioavailability of parthenolide can vary, which is why standardized extracts are often used to ensure consistent delivery of the active compounds.

Side effects

Feverfew is generally considered safe, with most reported adverse effects being mild and transient. The most common side effects, occurring in over 5% of users, include mouth ulcers, general gastrointestinal discomfort, and mild nausea. Less common side effects, affecting 1-5% of users, may include allergic reactions and mild dizziness. Rare side effects, occurring in less than 1% of users, involve hypersensitivity reactions. While no major drug interactions or contraindications have been firmly established, caution is advised for individuals taking anticoagulant medications due to feverfew's potential effects on platelet aggregation. It is also generally recommended to avoid feverfew during pregnancy and lactation, as its safety in these populations has not been well-established through sufficient research. Users should discontinue use if they experience any significant adverse reactions and consult a healthcare professional.

Dosage

Effective dosages of feverfew, as observed in clinical trials, typically range from 50 mg to 150 mg of feverfew extract daily. It is crucial that the extract is standardized to contain 0.2-0.4% parthenolide, which is considered the primary active compound. The minimum effective dose is generally around 50 mg per day. Feverfew is commonly administered as a dried leaf capsule or a standardized extract. For optimal efficacy, consistent daily dosing is important. The duration of treatment in studies usually ranges from 4 to 12 weeks, as benefits are typically observed after several weeks of continuous use. There are no specific upper limits or safety thresholds widely established beyond these therapeutic ranges, but adherence to recommended dosages is advised.

FAQs

Is feverfew effective for acute migraine treatment?

No, evidence primarily supports feverfew's use for the prevention of migraine headaches, not for the acute treatment of an ongoing migraine attack.

How soon can benefits be expected?

Benefits from feverfew supplementation are typically not immediate. Users can generally expect to observe effects after 4 to 8 weeks of continuous daily use.

Is feverfew safe long-term?

Feverfew is generally considered safe for long-term use, but most clinical trial data extends only up to 3 months. Longer-term safety data are more limited.

Can feverfew be combined with other migraine medications?

Feverfew can often be combined with other migraine medications. However, it is always advisable to consult a healthcare provider due to potential interactions, especially with anticoagulant drugs.

Research Sources

https://www.cambridge.org/core/journals/public-health-nutrition/article/efficacy-and-safety-of-feverfew-tanacetum-parthenium-l-an-update-of-a-systematic-review/58D33D08C23C4F4C9625DBD3470A43C0 – This systematic review of 6 RCTs found that the majority of trials favored feverfew over placebo for migraine prevention, with only mild and transient adverse effects. It highlights the heterogeneity in preparations and small sample sizes in some trials as limitations, but generally supports feverfew's efficacy.
https://pubmed.ncbi.nlm.nih.gov/25892430/ – This Cochrane systematic review and meta-analysis concluded that feverfew monopreparations showed some efficacy in reducing migraine frequency and were generally safe and well-tolerated. It noted the risk of bias in some included trials and variable parthenolide content as potential limitations.
https://pubmed.ncbi.nlm.nih.gov/14973986/ – This systematic review of double-blind RCTs indicated that evidence supports feverfew's efficacy for migraine prevention. However, it cautioned that the evidence was not conclusively beyond reasonable doubt due to small sample sizes and methodological variability across studies.