FEVERFEW

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Feverfew

Parts used and where grown: Feverfew grows widely across Europe and North America. The leaves are used in herbal medicine.

Feverfew has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Migraine headaches
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Historical or traditional use (may or may not be supported by scientific studies): 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.

Active constituents: 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.^{1 2} 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.³

According to three double-blind trials with migraine patients, feverfew reduces the severity, duration, and frequency of migraine headaches.^{4 5 6} These successful studies employed dried, powdered leaves. One negative study used an alcohol extract suggesting the dried leaf preparation is superior.⁷

How much is usually taken? 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.⁸ 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.

Are there any side effects or interactions? 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.⁹ Feverfew is not recommended during pregnancy or breast-feeding and should not be used by children under the age of two years.

At the time of writing, there were no well-known drug interactions with feverfew.

1. Makheja AN, Bailey JM. A platelet phospholipase inhibitor from the medicinal herb feverfew (Tanacetum parthenium). Prostagland Leukotrienes Med 1982;8:653–60.

2. 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.

3. Awang DVC. Parthenolide: The demise of a facile theory of feverfew activity. J Herbs Spices Medicinal Plants 1998;5:95–8.

4. Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J 1985;291:569–73.

5. Murphy JJ, Heptinstall S, Mitchell JRA. Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet 1988;2:189–92.

6. 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.

7. De Weerdt CJ, Bootsma HPR, Hendriks H. Herbal medicines in migraine prevention. Phytomed 1996;3:225–30.

8. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 91–5.

9. Brown DJ. Herbal Prescriptions for Better Health. Rocklin, CA: Prima Publishing, 1996, 91–5.

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