+ Indications

• Migraines
• Tension headaches
• Dizziness
• Tinnitus
• Fever
• Nervous debility
• Painful periods
• Sluggish menstrual flow
• Arthritis
• Parasites
• Coughs
• Colds
• Atonic dyspepsia
  

+ Contraindications

• Warfarin
• Mouth ulceration

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].

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:

1. Inhibiting serotonin release from platelet triggers (which is thought to lead to a complex chain reaction leading to migraine attacks) [1, 8].
2. 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].
3. Decrease of vascular smooth muscle spasm [1, 17].
4. 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].
• 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]. *