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Feverfew; Tanacetum parthenium

Proposed Uses: Migraine Headaches; Osteoarthritis; Rheumatoid Arthritis

Feverfew leaves have long been used medicinally to improve childbirth, promote menstruation, induce abortions, relieve rheumatic pain, and treat severe headaches.

In Mideieval times there was a widespread belief among herbalists that feverfew could lower fevers. After a while they noticed that it didn't work, and then angrily rejected feverfew as a useless herb. Feverfew remained out of fashion until  the late 1970s.

At that time, the wife of the chief medical officer of the National Coal Board in England suffered from serious migraine headaches. When workers in the industry learned of this fact, a miner suggested she try a folk treatment he had used. She followed his advice and chewed feverfew leaves. The results were dramatic: her migraines disappeared almost completely.

Dr. E. Stewart Johnson of the London Migraine Clinic subsequently experimented with feverfew in his practice, and seemed to observe good results.

Feverfew is primarily used for the prevention of migraine headaches. For this purpose, it is taken daily. There has been no formal investigation of feverfew as a treatment for migraines that have already started, although one double-blind study evaluating feverfew as a preventive agent did find hints of possible symptom-reducing benefits.

It is important to remember that 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.

Feverfew is sometimes recommended for osteoarthritis or rheumatoid arthritis, but there is no evidence at all that it works.

Five studies have been performed to evaluate feverfew's effectiveness as a preventive treatment for migraines. The best of the positive trials used a feverfew extract made by extracting the herb with liquid carbon dioxide. Two other trials that used whole feverfew leaf also found it effective; however two studies that used feverfew extracts did not find benefit.

Two other studies used whole feverfew leaf, and found benefit. Unfortunately, this trial did not report whether there was any change in the frequency of migraines; it is possible, therefore, that this study actually showed a symptom-reducing effect rather than a preventive benefit.

One study using an alcohol extract failed to find benefit.

Dosage
The tested liquid-carbon-dioxide feverfew extract is taken at a dose of 6.25mg 3x daily. To replicate the dosage of feverfew used in the two positive studies of whole leaf described above, take 80 to 100mg of powdered whole feverfew leaf daily.

Safety Issues
Animal studies suggest that feverfew is essentially nontoxic.13 In one 8-month study, there were no significant differences in side effects between the treated and control groups. There were also no changes in measurements on blood tests and urinalysis.

In a survey involving 300 people, 11.3% reported mouth sores from chewing feverfew leaf, occasionally accompanied by general inflammation of tissues in the mouth. A smaller percentage reported mild gastrointestinal distress. However, mouth sores do not seem to occur in people who use encapsulated feverfew leaf powder, the usual form.

In view of its use as a folk remedy to promote abortions, feverfew should probably not be taken during pregnancy.

Because feverfew might inhibit the activity of blood-clotting cells known as platelets, it should not be combined with strong anticoagulants, such as Coumadin (warfarin) or heparin, except on medical advice. Feverfew might also increase the risk of stomach problems if combined with anti-inflammatory drugs such as aspirin.

Safety in young children, pregnant or nursing women, or those with severe kidney or liver disease has not been established.

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