Herbs & Supplements:
Butterbur
Petasites hybridus
Principal Proposed Uses
•
Migraine Headaches (Prevention), Allergies
Other Proposed Uses
•
Pain, Asthma, Ulcer Protection
Butterbur can be found growing along rivers, ditches, and marshy areas in northern Asia, Europe, and parts of North America. It sends up stalks of reddish flowers very early in spring, before producing very large heart-shaped leaves with a furry gray underside. Once the leaves appear, butterbur somewhat resembles rhubarb—one of its common names is bog rhubarb. It is also sometimes referred to as "umbrella leaves" due to the size of its foliage. Other more or less descriptive common names abound, including blatterdock, bogshorns, butter-dock, butterly dock, capdockin, flapperdock, and langwort.
Butterbur is often described as possessing an unpleasant smell, but being malodorous hasn't protected it from harvesting by humans. The plant has a long medicinal history, including use for stomach cramps, whooping cough, and asthma.
Externally, butterbur has been applied as a poultice over wounds or skin ulcerations.
What Is Butterbur Used for Today?
Based on one double-blind trial, butterbur is becoming increasingly popular for preventing migraine headaches.1 For this purpose, it is taken in a special extract form (see Dosage below).
Migraine headaches are usually felt in the forehead or temples, often on one side only and typically accompanied by nausea and a preference for a darkened room. Headache attacks can last from several hours up to a day or more. They are usually separated by completely pain-free intervals.
Individuals with frequent migraine attacks may wish to use medication on a daily basis to prevent them. The herb feverfew has become famous as a natural treatment for this purpose, and butterbur may be helpful as well. However, further study is needed to confirm this potential benefit.
Note: Serious diseases may occasionally first present themselves as migraine-type headaches. For this reason, proper medical diagnosis is essential if you suddenly start having migraines without a previous history, or if the pattern of your migraines changes significantly.
A preliminary double-blind trial suggests that butterbur may be as effective for hay fever as a standard antihistamine drug.14
In addition, there here is some evidence that butterbur has anti-inflammatory and anti-spasmodic effects.2,3 This may make it useful for a variety of other painful conditions, including abdominal pain, tension headaches, back pain, bladder spasms, and gallbladder pain.4,5,6 Butterbur has also been investigated for asthma treatment.7,8 However, the evidence that butterbur actually offers benefits for these conditions is weak to nonexistent.
Very weak evidence also suggests that butterbur might help protect the stomach lining from ulcers.9,10
What Is the Scientific Evidence for Butterbur?
Migraines
Butterbur was tested as a migraine preventive in a double-blind placebo-controlled study involving 60 men and women who experienced at least 3 migraines per month.11 After 4 weeks without any conventional medications, participants were randomly assigned to take either 50 mg of butterbur extract or placebo twice daily for 3 months.
The results were positive: both the number of migraine attacks and the total number of days of migraine pain were significantly reduced in the treatment group as compared to the placebo group. Three out of four individuals taking butterbur reported improvement, as compared to only one out of four in the placebo group. No significant side effects were noted.
However, these results need to be confirmed by an independent laboratory with another properly designed study before butterbur can be considered a proven treatment for migraine prevention.
Hayfever (Allergic Rhinitis)
A two week double-blind study of 125 individuals with hay fever (technically, "seasonal allergic rhinitis") compared a standardized butterbur extract against the antihistamine drug certizine.14 According to ratings by both doctors and patients, the two treatments proved about equally effective. While the lack of a placebo control group diminishes the meaningfulness of this study, these are nonetheless promising results.
Dosage
The usual dosage of butterbur as a migraine preventive is 50 mg twice daily of an extract that has been processed to remove potentially dangerous chemicals called pyrrolizidine alkaloids (see Safety Issues below).
Warning: Use of any butterbur product that still contains these alkaloids is definitely not recommended.
Safety Issues
No side effects from the use of butterbur have been reported. However, as mentioned above, butterbur contains liver-toxic and possibly carcinogenic components called pyrrolizidine alkaloids.12 Fortunately, it is possible to remove these compounds from butterbur products.13
Safety in young children, pregnant or nursing women, or people with severe kidney or liver disease has not been established.
View References
Last reviewed March 2002 by Medical Review Board
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