Feverfew Summary
Feverfew is quite likely the best herbal treatment for chronic migraine headaches. This condition has many different mechanisms, and is not well understood by medicine even today. There are several major theories as to the pathophysiology of migraine headaches, and feverfew has phytochemicals that address them all.
Despite its name, feverfew is not useful for treating fevers, but has antiallergenic, anti-inflammatory, vasodilating, and antisecretory activities instead.
+ Indications
- Migraines
- Tension headaches
- Dizziness
- Tinnitus
- Fever
- Nervous debility
- Painful periods
- Sluggish menstrual flow
- Arthritis
- Parasites
- Coughs
- Colds
- Atonic dyspepsia
+ Contraindications
- Warfarin
- Mouth ulceration
How Is Feverfew Used?
Feverfew's main use is for migraine headaches, where it excels, especially with recurrent migraines that are characterized by finding relief from applying heat. Feverfew is also useful for female reproductive issues including painful menstruation and sluggish menstrual flow.
Traditional Uses
+ Western Herbal Medicine
Traditionally feverfew was used as a decoction with sugar or honey to treat coughs, wheezing, and difficulty breathing [5]. It was used as a warm infusion to purge choler, treat colds/flus, fever, cleanse the kidneys, stimulate menstruation, and expel parasitic worms [8]. It was decocted to treat wheezing, coughs, and difficulty breathing [8]. A cold infusion was used as a tonic, and for opium overdoses [8].
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 [5]. As a poultice it was used to reduce pain and inflammation of the bowel, and for wind or colic conditions [8].
It was described by Dioscorides as useful for "all hot inflammations" [1],
There was very little reference to feverfews actions on migraine headaches [8], despite this being one of the main uses of this plant today.
+ South American Traditional Medicine
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 [1]. 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 [2].
Herb Details: Feverfew
Herbal Actions:
- Antiinflammatory
- Vasodilator
- Emmenagogue (high doses)
- Aperient
- Carminative
- Bitter
- Antisecretory
- Anthelmintic
- Antiallergic
- Cardiotonic
- Antispasmodic
Part Used
Whole herb
Weekly Dose
- (1:5 Liquid Extract)
7–20 mL - View Dosage Chart
Daily Dose
- (1:5 Liquid Extract)
1 – 3 mL
Family Name
Asteraceae
Distribution
Native to the Balkan Peninsula, and can now also be found in Australia, Europe, China, Japan, and North Africa, United states, and Canada
Constituents of Interest
- Parthenolide
- Thujone
- Apigenin
Common Names
- Feverfew
- Pyrethrum
- Featherfew
- Featherfoil
- Flirtwort
- Tanecetum parthenium
- Chrysanthemum parthenium
- Altamisa
- Nosebleed
- Febrifuge plant
- Santa Maria
- Wild chamomile
- Federfoy
Botanical Information
Feverfew is a member of the Asteraceae family of plants, which is the second largest flowering family only to orchids. Feverfew is further separated into the Anthemideae tribe which is also home to such other medicinal species including the sages and yarrow.
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, & 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. [1].
Harvesting Collection, & 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) [6].
The leaves (and sometimes stems) are collected during, or after flowering [8].
Pharmacology & Medical Research
+ Anti-Allergenic
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). [8]. The mechanism of action has been suggested to involve the mediation of calcium entry into mast cells [16].
+ Antinflammatory
The anti-inflammatory actions of feverfew is mainly via an inhibition of NF-kB activation, and inhibition of prostaglandin biosynthesis [8]. Parthenolide specifically binds to and inhibitsthe IkB kinasecomplex, which plays an important role in the pro-inflammatory cytokine mediated signalling [15].
+ Migraine Headaches
Feverfew is considered the best herbal treatment for migraines [6]. 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. [6].
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 [8].
- Decrease of vascular smooth muscle spasm [1, 17].
- Blockage of platelet granule secretion [1, 18].
Phytochemistry
+ Chemical Breakdown
- Sesquiterpene lactones [3]
- Germacranolides
- Parthenolide
- Guaianolides
- Eudesmanolides
- Articanin
- Santamarin
- 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 [3].
- Germacranolides
- Onoterpenes
- Sesquiterpenes
- Thujone
- Sabinene
- Camphor
- 1,8-Cineole
- Umbellulone
- Monoterpenes
- Polyacetylene compounds
- Volatile oils [9]
- 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 [9].
- Decaffeoylquinnic acids
- Flavonoids [10-14]
- Apigenin
- Diosmetin
- Quercetin
- Jaceidin
- Jaceosidin
- 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. [8]. *
Clinical Applications of Feverfew:
Feverfew is a reliable treatment for migraine headaches. The effects are not immediate, and require gradual long term use to be effective. For this reason it is common to use feverfew alongside pharmaceutical painkillers for symptomatic relief with migraines. After gradual use of feverfew the episodes become shorter, less frequent, and less severe.
Feverfew is also useful for its antiallergenic activities due to its ability to inhibit histamine. Again, this is a long term treatment and will not produce effects after a single dose. For this reason immediate symptomatic relief is often combined with pharmaceutical antihistamines in the early stages of treatment.
Cautions:
Feverfew has been known to cause mouth ulceration.
Do not exceed 1.5 ml/day of 1:5 tincture while pregnant [4]
May interact with aspirin or other anticoagulant drugs due to a similar mechanism of action.
Synergy
May be synergistic with Gingko biloba for migraine headache.
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References:
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Williams CA, Hoult JR, Harborne JB, Greenham J, Eagles J. (1995). A biologically active lipophilic flavonol from Tanacetum parthenium. Phytochemistry. 38:267–70.
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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.
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