Wise Mind Herbs

The information on this page has been prepared with reference to published scientific literature, not by a medically qualified expert. It is not medical advice. Any decision to use a supplement or herb-based product is your responsibility. Consult a suitably qualified medical professional, especially if you have underlying conditions. Remember, nothing is for everyone, and not everything sold is what it claims to be. Some things work for some people, some of the time.

Feverfew - Tanacetum parthenium

Feverfew (Tanacetum parthenium, formerly Chrysanthemum parthenium) is a flowering plant in the Asteraceae family that has been used medicinally for centuries. Known by several common names including bachelor's buttons, featherfew, featherfoil, and midsummer daisy, it should not be confused with German chamomile (Matricaria chamomilla) or Roman chamomile (Chamaemelum nobile), despite some visual similarities.

Image source and license: https://commons.wikimedia.org/wiki/File:Mutterkraut_(Tanacetum_parthenium)_auf_dem_Wochenmarkt_in_M%C3%BCnster,_Westfalen.jpg.
Modified by Peter Jorgensen.

Conditions with Scientific Evidence for Efficacy

The strongest scientific evidence supports feverfew's use for the following conditions:

• Migraine prevention: Multiple clinical trials have demonstrated efficacy in reducing migraine frequency and severity
• Rheumatoid arthritis: Moderate evidence for anti-inflammatory effects and symptom reduction
• Fever reduction: Limited clinical evidence despite traditional use (hence the name)
• Menstrual pain: Some studies suggest benefit due to anti-inflammatory properties

Bioactive Compounds

The primary bioactive compounds in feverfew include:

• Parthenolide: The main sesquiterpene lactone responsible for anti-inflammatory and antimigraine effects
• Flavonoids: Including apigenin and luteolin
• Volatile oils: Including camphor and chrysanthenyl acetate

Recommended Dosages

Based on clinical studies, recommended dosages for feverfew are:

• For migraine prevention: 50-125 mg daily of dried leaf extract standardized to contain 0.2-0.4% parthenolide
• Fresh leaves: 2-3 leaves (approximately 50 mg) daily, though parthenolide content can vary significantly
• Commercial preparations: 100-300 mg capsules of freeze-dried leaf, taken 1-2 times daily

Most clinical trials have used preparations standardized to at least 0.2% parthenolide content. Products with lower parthenolide concentrations have shown inconsistent results in trials.

Side Effects and Risks

While generally considered safe for short-term use in recommended dosages, feverfew can cause:

• Oral irritation and ulcers (especially with chewing fresh leaves)
• Gastrointestinal disturbances including nausea, vomiting, and abdominal pain
• "Post-feverfew syndrome": Withdrawal symptoms including rebound headaches, anxiety, and insomnia when stopping after long-term use
• Allergic reactions, particularly in those with known allergies to other members of the Asteraceae family
• Blood-thinning effects, potentially increasing bleeding risk

Contraindications

Feverfew should be avoided by:

• Pregnant women (may stimulate uterine contractions)
• Breastfeeding women (insufficient safety data)
• Children under 2 years (insufficient safety data)
• Individuals with blood clotting disorders or taking anticoagulant medications
• Patients scheduled for surgery (discontinue at least 2 weeks before)
• People with allergies to plants in the Asteraceae family

High-Dose Studies and Knowledge Gaps

Studies involving doses above the recommended therapeutic range (>125 mg standardized extract or >0.4% parthenolide) are limited. The few existing studies suggest:

• No clear additional benefit at higher doses for migraine prevention
• Increased incidence and severity of side effects, particularly oral irritation and gastrointestinal distress
• Potential hepatotoxicity at very high doses in animal studies, though human data is lacking

Significant knowledge gaps exist regarding:

• Long-term safety (most studies lasted <6 months)
• Optimal formulation and standardization methods
• Mechanisms of action beyond parthenolide's effects
• Potential drug interactions, especially with anticoagulants and antiplatelet medications

Commercial Pharmaceutical Products

Few regulated pharmaceutical products containing feverfew exist globally. Notable examples include:

• MigraHeal® (standardized feverfew extract, 0.4% parthenolide, available in some European countries)
• MIG-99® (proprietary CO2 feverfew extract used in several European clinical trials)
• Tanacet® (standardized feverfew product used in some UK clinical studies)

In the United States and most countries, feverfew is primarily available as a dietary supplement rather than a regulated pharmaceutical product.

Conclusion

The strongest evidence supports feverfew's use for migraine prevention, with moderately strong evidence for anti-inflammatory benefits. Standardization of products to contain consistent parthenolide levels appears crucial for efficacy. While generally safe at recommended doses, potential side effects and interactions warrant caution, particularly in certain populations. More rigorous clinical research is needed, especially regarding long-term safety and optimal dosing strategies.

References

Johnson, E. S., Kadam, N. P., Hylands, D. M., & Hylands, P. J. (1985). Efficacy of feverfew as prophylactic treatment of migraine. Br Med J (Clin Res Ed), 291(6495), 569-573.

O'Neill, L. A., Barrett, M. L., & Lewis, G. P. (1987). Extracts of feverfew inhibit mitogen‐induced human peripheral blood mononuclear cell proliferation and cytokine mediated responses: a cytotoxic effect. British journal of clinical pharmacology, 23(1), 81-83.

Pfaffenrath, V., Diener, H. C., Fischer, M., Friede, M., & Henneicke-von Zepelin, H. H. (2002). The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis—a double-blind, multicentre, randomized placebo-controlled dose-response study. Cephalalgia, 22(7), 523-532.

Pareek, A., Suthar, M., Rathore, G.S. and Bansal, V., 2011. Feverfew (Tanacetum parthenium L.): A systematic review. Pharmacognosy reviews, 5(9), p.103.