Butterbur: A way to head off migraines?
If you suffer from migraine headachesas do some 30 million Americansyou may still be searching for an effective treatment, or better yet a preventive. Conventional medicines often fail to relieve the debilitating pain or head off new attacks, and many people turn to alternative/complementary practices, including herbal remedies.
One herb that has some research behind it is butterbur root (Petasites hybridus), a shrub-like plant in the daisy family, native to Europe, North Africa and Southwestern Asia. Also called purple butterbur, its extracts have been used to treat migraines in Europe for decades.
Butterbur is sold in the U.S. under the trademark Petadolex (developed in Europe), though many other butterbur products are available from other supplement makers. There may be real benefits to butterburbut there are also some caveats.
What the research shows about butterbur and migraines
A few clinical trials suggest that butterbur may decrease the frequency, duration and intensity of migraines. For example, in a 2004 study in Neurology of more than 200 migraine sufferers, those who took Petadolex (150 milligrams a day in split doses) for four months reported a 48 percent decrease in frequency of headaches, compared to 26 percent in those given a placebo.
Another paper that year, in European Neurology, found reduced frequency of migraines in people taking a lower dose (100 milligrams) for three months. Butterbur may also be effective in children, according to a 2007 study in the European Journal of Pain.
Several professional groups discuss butterbur as a potential migraine preventive. The American Academy of Neurology classifies it as an effective drug for this use. And the Natural Standard, which evaluates complementary and alternative therapies, gives butterbur a "B," saying there is "good scientific evidence" behind it. Still, these and other experts cite the need for more studies and concern about the lack of long-term safety data.
When taken regularly, the herb is thought to reduce migraine attacks by inhibiting pro-inflammatory substances in the body and by reducing spasms in the smooth muscle of blood vessel walls in the brain. There's no evidence that it helps after a migraine develops or that it helps with other kinds of headaches.
Before you use butterbur to treat migraines
Butterbur may cause mild intestinal symptomsmostly burping, but also nausea and stomach pain. Of more concern, naturally occurring chemicals in butterbur called pyrrolizidine alkaloids are toxic to the liver and have been found to cause cancer in lab animals. They must be processed out to make the supplement safe.
Petadolex is made in Germany, where it's regulated as a drug by the government; it is purified to contain no detectable levels of alkaloids. But you can't be sure about other butterbur products, even if they claim to be free of alkaloids.
You shouldn't use butterbur if you are pregnant or nursing or if you are allergic to related plants including daisies, marigolds, ragweed and chrysanthemums. Interactions with calcium channel blockers and some other drugs taken for heart disease are theoretically possiblethough none have been reported.
Bottom line about butterbur and migraines
If you get migraines, and conventional preventive strategies haven't worked, butterbur may be worth a try. Petadolex is the safest option. If you see no improvement within four to six months, stop taking it. A month's supply is not cheap (costs about $50).
Source: Originally published in The University of California, Berkeley Wellness Letter (May 2011)