Feverfews name is a corruption of the word febrifuge, from its traditional use of dispelling fevers.
Despite its name, it's not actually the best herb for this. Or even a very good one in fact. What it does excel at is treating migraine headaches. It's the only herb used in European phytotherapy that is specific for treating migraine headaches.
For this use it's the best around, and is suggested to be especially beneficial for the sort of migraines that are alleviated by adding warmth to the head. It's one of the few herbs readily accepted by modern medicine for this purpose as well.
The reason it is so effective at treating migraines has so far eluded scientists studying the plant, however, there are a few strong theories.
- Emmenagogue (high doses)
- A general tonic herb
Mainly the leaves are used
Equivalent to 1 fresh leaf 1-3 times per day
For migraine: 1 - 2 ml/day of standardized leaf and flower extract (containing a minimum of 0.2% parthenolide. Higher doses may be required for acute treatment of migraine or for inflammatory conditions [6, 8].
Liquid extract (1:1):
0.7-2 ml/day 
For Migraine: A higher dose is often necessary but doses can vary a lot depending on the quality of the extract. Regular doses in this range can take months to have an effect, therefore it may be more beneficial to use higher doses from the start. .
50 - 150 mg 1-2 times/day of dried leaf preparations [6, 8]
- Particularly the kind eased by adding warmth to the head 
- Tension headaches
- Painful periods
- Sluggish menstrual flow
- Atonic dyspepsia
- Nervous debility
- Tanecetum parthenium
- Chrysanthemum parthenium
- Febrifuge plant
- Santa Maria
- Wild chamomile
Traditionally feverfew was used as a decoction with sugar or honey to treat coughs, wheezing, and difficulty breathing . It was used as a warm infusion to purge choler, treat colds/flus, fever, cleanse the kidneys, stimulate menstruation, and expel parasitic worms . It was decocted to treat wheezing, coughs, and difficulty breathing . A cold infusion was used as a tonic, and for opium overdoses .
Topically, the herb was used by bruising and heating with a little oil, and applied for conditions such as wind and colic. The tincture was also used topically to treat pain and swelling from insect and animal bites to offer fast relief . As a poultice it was used to reduce pain and inflammation of the bowel, and for wind or colic conditions .
It was described by Dioscorides as useful for "all hot inflammations" ,
There was very little reference to feverfews actions on migraine headaches , despite this being one of the main uses of this plant today.
In South America, the Kallaway Indians of the Andes mountains used feverfew for treating conditions such as colic, kidney pain, morning sickness, and stomach aches . In other areas of South and Central America feverfew was used to support digestion, as a cardiotonic, emmenagogue, antispasmodic, menstrual tonic, treating earaches, and in the form of an enema for worms .
Feverfew is an aromatic perennial herb, growing to a height of around 70 cm. The leaves are light green, and ovate with pinnatifid lobed or toothed leaflets [1, 8].
The flowers resemble that of chamomiles.
Habitat Ecology, and Distribution:
Feverfew is native to the Balkan Peninsula, and can now also be found in Australia, Europe, China, Japan, and North Africa, United states, and Canada. It is usually found growing along roadsides, in fields, and waste areas. .
Harvesting Collection, and Preparation:
The parthenolide content from feverfew varies greatly depending on the growing conditions. This is important because this is suggested to be one of the main constituents responsible for feverfews ability to reduce the severity of and/or prevent migraine headaches. This is why it is suggested that a standardized extract of feverfew should be used, containing at least a 0.2% parthenolide content (per 125mg dried feverfew leaf equivalent) .
The leaves (and sometimes stems) are collected during, or after flowering .
[1, 3-6, 8, 10-14]
- Sesquiterpene lactones 
- Also contains: artecanin, artemorin, balchanin, canin, costunolide, 10-epicanin, epoxyartemorin, 1-beta-hydroxyarbusculin, 3-beta-hydroxycostunolide, 8-alpha-hydroxyestagiatin, 8-beta hydroxyreynosinn, 3-beta-hydroxyparthenolide, manolialide, reynosin, santamarine, epoxysantamarine, secotanaparthenolide A, secotanaparthenolide B, tanaparthin-alpha-peroxide, and 3,4-beta-epoxy-8-deoxycumambrin B .
- Polyacetylene compounds
- Volatile oils 
- amphor (56.9%)
- Camphene (12.7%)
- p-cymene (5.2%)
- Bornyl acetate (4.6%)
- Also contains: tricylene, α-thujene, α-pinene, β-pinene, α-phellandrene, α-terpinene, γ-terpinene, chrysantheone, pinocarvone, borneol, terpinen-4-ol, ρ-cymen-8-ol, α-terpineol, myrtenal, carvacrol, eugenol, trans-myrtenol acetate, isobornyl 2-methyl butanoate, and caryophyllene oxide .
- Decaffeoylquinnic acids
- Flavonoids [10-14]
- Also contains: 6-hydroxykaempferol 3,6-dimethyl ether, 6-hydroxykaempferol 3,6,4′-trimethyl ether (tanetin), quercetagetin 3,6-dimethyl ether, quercetagetin 3,6,3′-trimethyl ether (accompanied by isomeric 3,6,4′-trimethyl ether), luteolin (also luteolin 7-glucuronide), chrysoeriol, santin, and centaureidin [10-14].
The parthenolide content of feverfew is associated with much of its therapeutic actions, especially in migraine treatment. This chemical however will vary greatly in different plant samples. It is suggested that it can be improved by harvesting the plant in the afternoon, and after a single water stress event. It is also noted that varieties with a light green/yellow leaf color yield higher concentrations of parthenolide. .
Pharmacology and Medical Research:
Some of the antisecretory, anti-allergenic, and antihistamine activity of feverfew acts on the mast cells by inhibiting the release of histamine. Parthenolide was found to inhibit rat peritoneal mast cell degranulation and release of histamine, as well as inhibited passive cutaneous anaphylaxis in mice. These effects were noted to be dose dependant (meaning that a higher dose will increase or improve this activity). . The mechanism of action has been suggested to involve the mediation of calcium entry into mast cells .
The anti-inflammatory actions of feverfew is mainly via an inhibition of NF-kB activation, and inhibition of prostaglandin biosynthesis . Parthenolide specifically binds to and inhibitsthe IkB kinasecomplex, which plays an important role in the pro-inflammatory cytokine mediated signalling .
Feverfew is considered the best herbal treatment for migraines . It is best used as a long term treatment, rather than for immediate relief. In the 1980's, due to widespread media coverage for the use of feverfew as a "cure" for migraines, a few doctors took it upon themselves to observe the effect of this herb on their patients and submitted their results to an online journal. In one double-blind, placebo controlled clinical trial investigating these effects, feverfew was found to produce a significant reduction in migraine headache frequency compared to the control group. [6, 7].
The mechanism of action for this is reported to be through inhibiting the secretion of granular contents from blood platelets and neutrophils such as prostaglandins, and histamine. The constituents suggested to be responsible are mainly the sesquiterpene lactones; 3-beta-hydroxy-parthenolide, secotanapartholide A, canin, and artecanin. .
Although the above theories stand to reason as to how feverfew acts on migraine headaches, much of the mechanisms of action for this condition remains elusive to science. Therefore it is hard to pinpoint how chemicals such as those contained wihin feverfew truly work within the body for this condition. Currently, the suggestions for feverfews possible mechanism of action(s) on treating migraine headaches includes:
- Inhibiting serotonin release from platelet triggers (which is thought to lead to a complex chain reaction leading to migraine attacks) [1, 8].
- Anti-inflammatory activity in migraines due mainly to the partenolide content. This differs from other anti-inflammatory drugs because of how specific parthenolide is on how it inhibits NF-kB through a variety of biochemical pathways .
- Decrease of vascular smooth muscle spasm [1, 17].
- Blockage of platelet granule secretion [1, 18].
Toxicity and Contraindications:
- Except for a few susceptible individuals, feverfew is a safe herb and is suitable for long term use .
- Do not use more than 1.5 ml/day of 1:5 tincture while pregnant 
- Caution advised if there are allergies to other members of the Asteraceae family
- Fresh leaves have been reported to cause mouth ulcers in some individuals 
- May interact with aspirin or other anticoagulant drugs due to a similar mechanism of action.
Still compiling research.
- May be synergistic with Gingko biloba for migraine headache.
Recent Blog Posts:
- Pareek, A., Suthar, M., Rathore, G., & Bansal, V. (2011). Feverfew (Tanacetum parthenium L.): A systematic review. Pharmacognosy Reviews, 5(9), 103. doi:10.4103/0973-7847.79105
- Chavez M, Chavez P. (1999). Feverfew. Hosp Pharm. 34:436–61.
- Setty AR, Sigal AH. (2005). Herbal medications commonly used in the practice of rheumatology: Mechanisms of action, efficacy, and side effects. Semin Arthritis Rheum. 34:773–84.
- Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Edinburgh [u.a.: Churchill Livingstone. (Pg. 219-221)
- A Modern Herbal. (1931). Feverfew. Retrieved from http://www.botanical.com/botanical/mgmh/f/feverf10.html
- Hoffmann, D. (2003). Medical herbalism: The science and practice of herbal medicine. Rochester, VT: Healing Arts Press. (Pg. 5587)
- Johnson ES, Kadam NP, Hylands DM. (1985). Efficacy of feverfew as prophylactic treatment of migraine. British medical journal (Clinical research Ed.) 291:569-573
- Bone K, Mills S. (2013). Principles and Practice of Phytotherapy. Elsevier health. China. (Pg. 566-575)
- Akpulat H, Tepe B, Sokmen A, Daferera D, Polissiou M. (2005). Composition of the essential oils of Tanacetum argyrophyllum (C. Koch) Tvzel. var. argyrophyllum and Tanacetum parthenium (L.) Schultz Bip. (Asteraceae) from Turkey. Biochem Syst Ecol. 33:511–6.
- Williams CA, Harborne JB, Eagles J. (1999). Variations in lipophilic and polar flavonoids in the genus Tanacetum. Phytochemistry. 52:1301–6.
- Williams CA, Harborne JB, Geiger H, Hoult JR. (1999). The flavonoids of Tanacetum parthenium and T. vulgare and their anti-inflammatory properties. Phytochemistry. 51:417–23.
- Williams CA, Hoult JR, Harborne JB, Greenham J, Eagles J. (1995). A biologically active lipophilic flavonol from Tanacetum parthenium. Phytochemistry. 38:267–70.
- Long C, Sauleau P, David B. (2003). Bioactive flavonoids ofTanacetum parthenium revisited. Phytochemistry. 64:567–9.
- Hall I, Lee K, Starnes C, Sumida Y, Wu R, Waddell T. (1979). Anti-inflammatory activity sesquiterpene lactones and related compounds. J Pharm Sci. 68:537–42.
- Kwok BH, Koh B, Ndubuisi MI, Elofsson M, Crews CM. (2001). The anti-inflammatory natural product parthenolide from the medicinal herb feverfew directly binds to and inhibits IkappaB kinase. Chem Biol. 8:759–66.
- Hayes NA, Foreman JC. (1987). The activity of compounds extracted from feverfew on histamine release from rat mast cells. J Pharm Pharmacol. 39:466–70.
- Barsby RW, Salan U, Knight DW, Hoult JR. (1992). Feverfew extracts and parthenolide irreversibly inhibit vascular responses of the rabbit aorta. J Pharm Pharmacol. 44:737–40.
- Heptinstall S, White A, Williamson L, Mitchell JR. (1985). Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet. 1:1071–4.