Studies suggest that a standardized extract of butterbur (Petasites hybridus) is a powerful migraine-preventive agent. Butterbur has been used for more than 2,000 years for conditions ranging from gastric disorders to allergies.16-19 A specialized butterbur root extract has been available in Germany as a prescription remedy since 1988. More than half a million German citizens have used this remarkable plant extract for health concerns such as migraine prevention and allergies.18 The good news is that this standardized butterbur extract is now also readily available in the United States as a dietary supplement.
Butterburs headache-preventive capabilities likely stem from its anti-inflammatory and spasmolytic (muscle-relaxant) effects.17 It contains active components known as isopetasin, oxopetasin, and petasin, which induce smooth muscle relaxation, particularly in cerebral blood vessel walls. Research indicates that petasin inhibits the proinflammatory lipoxygenase (LOX) enzyme, while both petasin and isopetasin exert highly potent anti-inflammatory effects by inhibiting leukotriene synthesis.
Butterbur extract has also been reported to inhibit cyclooxygenase-2 (COX-2) activity, which relieves pain and inflammation. In addition, butterbur petasins decrease the intracellular concentration of calcium, thus offsetting calcium-induced vasoconstriction, which also helps explain the herbs anti-inflammatory and spasmolytic effects. (1)
What is butterbur?
Butterbur is an herb. People use the leaf, root, and bulb to make medicine. Some butterbur preparations contain chemicals called pyrrolizidine alkaloids (PAs), which can damage the liver and cause other serious harm. Only butterbur products that are certified and labeled PA-free should be used
What research shows
In a recent study, German and American researchers gave adult migraine sufferers either a 75-mg dose or a placebo twice a day. After 4 months, researchers found that butterbur reduced migraines by 48%; the placebo reduced them by 26%. (Migraines often respond to a placebo; on average, about a third of patients respond to sugar pills.)
A new German study of 108 children with recurrent migraines showed similar results: 10- to 17-year-olds got 50 mg of butterbur twice a day; 6- to 9-year-olds took half as much. After 4 months, both groups reported less pain, and 77% had halved the number of migraines they usually got.
Other studies have been just as persuasive. In Scotland, the Asthma & Allergy Research Group at the University of Dundee reported that butterbur and Allegra were equally effective in attenuating the nasal response . . . and in improving nasal symptoms for patients who were allergic to dust mites.29
A large open-label study in 508 patients with seasonal allergic rhinitis who supplemented with butterbur extract for two weeks found that 90% of participants reported improvements in symptoms such as sneezing, nasal congestion, watery eyes, itchy eyes and nose, and red eyes.
According to LEF.org Butterbur root should never be consumed directly from the plant, since it contains compounds called pyrrolizidine alkaloids that have may have hepatotoxic and carcinogenic effects.17
However, extracts that are prepared for human use are processed to remove these alkaloids. An independent evaluation of data gathered from various trials concluded that commercially marketed butterbur root extract is entirely safe for human consumption.26 A standardized butterbur extract has been used by more than half a million German citizens since its introduction in 1988, and the safety data are excellent.18
A dosage of 50-75 mg of standardized butterbur extract twice daily for up to four months has demonstrated efficacy in migraine prevention,17 while 50 mg twice daily has been used in the management of allergic rhinitis.17
No instances of overdose with butterbur have been reported in the scientific literature,17 but anyone who has a known allergy to plants in the Asteraceae family, such as ragweed or daisies, should consume butterbur with caution.