Feverfew
Tanacetum parthenium
Feverfew has an interesting history. This member of the daisy family has been used for centuries to treat headaches, arthritis, and problems with labor and childbirth. Ancient Greek physicians used it to reduce inflammation and treat menstrual cramps. Although it was once used to treat fevers, as its name suggests, it was not very effective. It is now used to prevent migraine headaches, and several scientific studies suggest that it works well for that purpose.
Plant Description
Native to southeastern Europe, feverfew is now widespread throughout Europe, North America, and Australia. Feverfew is a short perennial that blooms between July and October, and gives off a strong and bitter odor. Its yellow-green leaves are alternate (the leaves grow on both sides of the stem at alternating levels), and turn downward with short hairs. The small, daisy-like yellow flowers are arranged in a dense flat-topped cluster.
What is it Made Of?
Feverfew products usually contain dried feverfew leaves, but all parts of the plant that grow above ground may be used. Researchers thought a substance called parthenolide, which helps relieve spasms in smooth muscle tissue, was what made feverfew effective against migraines. However, after more studies researchers are not sure which part of the herb may best treat or prevent migraines.
Parthenolide may also reduce inflammation and may stop cancer cells from growing.
Medicinal Uses and Indications
Feverfew is used mostly to treat and prevent headaches.
Migraine Headaches
Feverfew was popular in the 1980s as a treatment for migraines. A survey of 270 people with migraines in Great Britain found that more than 70% of them felt much better after taking an average of 2 to 3 fresh feverfew leaves daily. Several human studies have used feverfew to prevent and treat migraines. Overall, these studies suggest that taking dried leaf capsules of feverfew every day may reduce the number of migraines in people who have chronic migraines.
One study used a combination of feverfew and white willow (Salix alba), which has chemicals like aspirin. People who took the combination twice a day for 12 weeks had fewer migraines and the pain did not last as long or hurt as much.
Another study found that people who took a special extract of feverfew had fewer migraine attacks per month compared to people who took placebo. A 3-month study with 49 people found that a combination of feverfew, magnesium, and vitamin B2 led to a 50% decrease in migraines.
Not all studies have found that feverfew works for migraines, however. Whether it reduces migraine pain and frequency may depend on which supplement you take. Ask your doctor to help you find out the right formula and dose for your needs.
Rheumatoid Arthritis
Some laboratory tests show that feverfew can reduce inflammation, so researchers thought it might help treat rheumatoid arthritis (RA). However, a human study found that feverfew did not work any better than placebo in improving RA symptoms.
Dermatitis
Preliminary studies suggest that feverfew may help reduce damaged skin cells and inflammation. Other studies show feverfew may help relieve dermatitis and improve the appearance of the skin.
Available Forms
Feverfew supplements are available fresh, freeze-dried, or dried. They can be purchased as capsules, tablets, or liquid extracts. Feverfew supplements used in clinical studies contain a standardized dose of parthenolide. Feverfew supplements should be standardized to contain at least 0.2% parthenolide.
How to Take It
Pediatric
DO NOT give feverfew to children under 2.
For older children, ask your doctor whether feverfew is safe for your child. Your doctor will determine the right dose.
Adult
For migraine headaches: Studies have used 50 to 100 mg daily, standardized to contain 0.2 to 0.35% parthenolides. Feverfew may be used to prevent or stop a migraine headache. Feverfew supplements may also be carbon dioxide extracted. For these, one study used 6.25 mg, 3 times daily, for up to 16 weeks.
Precautions
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.
Side effects from feverfew can include abdominal pain, indigestion, gas, diarrhea, nausea, vomiting, and nervousness. Some people who chew raw feverfew leaves may have mouth sores, loss of taste, and swelling of the lips, tongue, and mouth.
Rarely, allergic reactions to feverfew have been reported. People with allergies to chamomile, ragweed, or yarrow may be allergic to feverfew and should not take it.
Feverfew may increase the risk of bleeding, especially if you take blood-thinning medications, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Ask your doctor before taking feverfew if you take blood thinners.
Pregnant and nursing women, as well as children under 2, should not take feverfew.
If you are scheduled for surgery, tell your doctor if you are taking feverfew. It may interact with anesthesia.
DO NOT abruptly stop taking feverfew if you have used it for more than 1 week. Stopping feverfew too quickly may cause rebound headache, anxiety, fatigue, muscle stiffness, and joint pain.
Possible Interactions
Feverfew may change how prescription and nonprescription medications work. If you take any of the following medications, you should not use feverfew without first talking to your health care provider.
Blood-thinning medications: Feverfew may increase the risk of bleeding. Ask your doctor before taking feverfew if you take blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin.
Medications broken down by the liver: Feverfew can interact with many medications that are broken down by the liver. To be safe, ask your doctor before taking feverfew if you take any prescription medications.
Supporting Research
Bowe WP. Cosmetic benefits of natural ingredients: mushrooms, feverfew, tea and wheat complex. J Drugs Dermatol. 2013;12(9 Suppl):s133-6.
Cady RK, Goldstein J, Nett R, Mitchell R, Beach ME, Browning R. A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic™ M) in the treatment of migraine. Headache. 2011 Jul-Aug;51(7):1078-86. doi: 10.1111/j.1526-4610.2011.01910.x.
Chen CF, Leung AY. Gene response of human monocytic cells for the detection of antimigraine activity of feverfew extracts. Can J Physiol Pharmacol. 2007;85(11):1108-15.
Curry EA 3rd, Murry DJ, Yoder C, et al., Phase I dose escalation trial of feverfew with standardized doses of parthenolide in patients with cancer. Invest New Drugs. 2004;22(3):299-305.
De Weerdt CJ, Bootsma HPR, Hendriks H. Herbal Medicines in migraine prevention. Randomized double-blind placebo controlled crossover trial of a feverfew preparation. Phytomedicine. 1996;3:22-230.
Diener HC, Pfaffenrath V, Schnitker J, Friede M, Henneicke-von Zepelin HH. 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. Cephalalgia. 2005;25(11):1031-41.
Ernst E, Pittler MH. The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. [Review] Public Health Nutr. 2000;3(4A):509-514.
Evans RW, Taylor FR. "Natural" or alternative medications for migraine prevention. Headache. 2006;46(6):1012-8.
Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm. 2000;57(13):1221-1227.
Henneicke-von Zepelin HH. Feverfew for migraine prophylaxis. Headache. 2006;46(3):531
Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J. 1985;291:569-573.
Lesiak K, Koprowska K, Zalesna I, Nejc D, Düchler M, Czyz M. Parthenolide, a sesquiterpene lactone from the medical herb feverfew, shows anticancer activity against human melanoma cells in vitro. Melanoma Res. 2010 Feb;20(1):21-34.
Maizels M, Blumenfeld A, Burchette R. A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: a randomized trial. Headache. 2004;44(9):885-90.
Martin K, et al. Parthenolide-depleted Feverfew (Tanacetum parthenium) protects skin from UV irradiation and external aggression. Arch Dermatol Res. 2008;300(2):69-80.
Miller L. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158(20):2200-2211.
Murphy JJ, Heptinstall S, Mitchell JR. Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet. 1988;2:189-192.
Palevitch D, Earon G, Carasso R. Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: a double-blind controlled study. Phytotherapy Res. 1997;11:508-511.
Pareek A, Suthar M, Rathore GS, Bansal V. Feverfew (Tanacetum parthenium L.): A systematic review. Pharmacogn Rev. 2011 Jan;5(9):103-10. doi: 10.4103/0973-7847.79105.
Pattrick M, Heptinstall S, Doherty M. Feverfew in rheumatoid arthritis: a double-blind, placebo controlled study. Ann Rheum Dis. 1989;48:547-549.
Pfaffenrath V, Diener HC, Fischer M, et al. The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis--a double-blind, multicentre, randomized placebo-controlled dose-response study. Cephalalgia. 2002;22(7):523-532.
Pittler MH, Vogler BK, Ernst E. Feverfew for preventing migraine. [Review] Cochrane Database Syst Rev. 2000;(3):CD002286.
Rodriguez KJ, Wong HK, Oddos T, Southall M, Frei B, Kaur S. A purified feverfew extract protects from oxidative damage by inducing DNA repair in skin cells via a P13-kinase-dependent Nrf2/ARE pathway. J Dermatol Sci. 2013;72(3):304-10.
Schiapparelli P, Allais G, Castagnoli Gabellari I, Rolando S, Terzi MG, Benedetto C. Non-pharmacological approach to migraine prophylaxis: part II. Neurol Sci. 2010 Jun;31 Suppl 1:S137-9. Review.
Shrivastava R, Pechadre JC, John GW. Tanacetum parthenium and Salix alba (Mig-RL) combination in migraine prophylaxis: a prospective, open-label study. Clin Drug Investig. 2006;26(5):287-96.
Silberstein SD. Preventive treatment of headaches. Curr Opin Neurol. 2005;18(3):289-92.
Won YK, Ong CN, Shi X, Shen HM. Chemopreventive activity of parthenolide against UVB-induced skin cancer and its mechanisms. Carcinogenesis. 2004;25(8):1449-58.
Wu C, Chen F, Rushing JW, Wang X, Kim HJ, Huang G, Haley-Zitlin V, He G. Antiproliferative activities of parthenolide and golden feverfew extract against three human cancer cell lines. J Med Food. 2006;9(1):55-61.
Yao M, Ritchie HE, Brown-Woodman. A reproductive screening test of feverfew: is a full reproductive study warranted? Reprod Toxicol. 2006;22(4):688-93.
Zhang S, Lin ZN, Yang CF, Shi X, Ong CN, Shen HM. Suppressed NF-kappaB and sustained JNK activation contribute to the sensitization effect of parthenolide to TNF-alpha-induced apoptosis in human cancer cells. Carcinogenesis. 2004;25(11):2191-9.