Feverfew (Tanacetum parthenium ), a member of the sunflower family, has been used for centuries in European folk medicine as a remedy for headaches, arthritis, and fevers. The term feverfew is adapted from the Latin word febrifugia or "fever reducer."

Feverfew is also used to treat menstrual irregularities, labor difficulties, skin conditions, stomach aches, and asthma.

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.

Feverfew products usually consist of dried feverfew leaves, but all parts of the plant that grow above ground may also be used for medicinal purposes. The migraine-relieving activity of feverfew is believed to be due to parthenolide, an active compound that helps relieve smooth muscle spasms. In particular, it helps prevent the constriction of blood vessels in the brain (one of the leading causes of migraine headaches). Parthenolide also inhibits the actions of compounds that cause inflammation and may inhibit cancer cell growth.

Health care providers primarily use feverfew to treat and prevent certain headaches, arthritis, and other painful disorders.

Migraine Headaches

Feverfew gained popularity in Great Britain in the 1980s as an alternative to conventional medications for migraine headaches. A survey of 270 migraine sufferers in Great Britain revealed that more than 70% of individuals felt substantially better after ingesting an average of 2 - 3 fresh feverfew leaves daily. Several controlled human trials have been conducted using feverfew for migraine prevention and treatment. Overall, these studies suggest that feverfew taken daily as dried leaf capsules may reduce the incidence of attacks in patients who experience long-term migraine headaches.

• A clinical study used a combination of feverfew with Salix alba (white willow). White willow contains components similar to aspirin. The product was given twice daily for 12 weeks. The frequency of migraine attacks and the pain intensity and duration were significantly reduced in patients taking the combination.
• Another study found that a carbon dioxide extract of feverfew decreased the frequency of migraine attacks from 4.76 per month to 1.9 per month. A 3 month study in 49 subjects found that a combination of feverfew with magnesium and vitamin B2 provided a 50% decrease in migraine attacks.
• Some studies in humans have not been positive. Whether feverfew helps improve migraine pain depends on which feverfew supplement you take. Talk to your health care provider.

Arthritis

Although many laboratory tests and case reports demonstrate anti-inflammatory properties of feverfew, a human study concluded that feverfew was no more effective than placebo in improving symptoms of rheumatoid arthritis. Until further studies are conducted, it appears that the safety and effectiveness of feverfew in people with osteoarthritis or rheumatoid arthritis has yet to be scientifically proven.

Feverfew supplements are available fresh, freeze-dried, or dried and can be purchased in capsule, tablet, or liquid extract forms. Feverfew supplements with clinical studies contain a standardized dose of parthenolide (the active compound in feverfew). Feverfew supplements should be standardized to contain at least 0.2% parthenolide.

Pediatric

Feverfew should not be used in children under 2 years of age.

In older children, adjust the recommended adult dose to account for the child's weight. Most herbal dosages for adults are calculated on the basis of an average of 150 lb (70 kg) adult. Therefore, if the child weighs 50 lb (20 - 25 kg), the appropriate dose of feverfew for this child would be 1/3 of the adult dosage.

Adult

For migraine headaches: Take 100 - 300 mg, up to 4 times daily, standardized to contain 0.2 - 0.4% parthenolides. Feverfew may be used to prevent or stop a migraine headache. Feverfew supplements may also be carbon dioxide extracted. For these, take 6.25 mg, 3 times daily, for up to 16 weeks.

For inflammatory conditions (such as arthritis): 120 - 60 drops, 2 times daily of a 1:1 w/v fluid extract, or 60 - 120 drops 2 times daily of 1:5 w/v tincture.

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and that 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, flatulence, diarrhea, nausea, vomiting, and nervousness. Mouth ulcers, loss of taste, and swelling of the lips, tongue, and mouth may occur in some individuals who chew raw feverfew leaves. Rarely, allergic reactions to feverfew have also been reported. In fact, people with allergies to chamomile, ragweed, or yarrow will likely be allergic to feverfew and, therefore, should not take it.

Feverfew may increase the tendency to bleed, especially in individuals who have bleeding disorders or take blood-thinning medications, such as aspirin or warfarin. Do not use feverfew if you have bleeding disorders or are taking blood-thinning medications unless you are under the supervision of a doctor. Storage of the prepared extract is also important. At normal temperatures, some constituents in feverfew can degrade from capsules.

Pregnant and nursing women as well as children under 2 years of age should not take feverfew.

Do not abruptly stop taking feverfew if you have used it for more than 1 week. A withdrawal syndrome characterized by rebound headache, anxiety, fatigue, muscle stiffness, and joint pain may occur.

Feverfew may alter the effects of some prescription and nonprescription medications. If you are currently being treated with any of the following medications, you should not use feverfew without first talking to your health care provider.

Blood-thinning medications -- Feverfew may inhibit the activity of platelets (a substance that plays a role in blood clotting), so individuals taking blood-thinning medications (such as aspirin and warfarin) should consult a health care provider before taking this herb.

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