Feverfew is an ancient herb claimed to help with migraines, soothe skin irritation, and protect against UV radiation-induced skin damage. Preliminary research suggests this plant may also help with pain, anxiety, and depression. Read on to discover why this old remedy is now modern medicine.
What Is Feverfew?
Feverfew (Tanacetum parthenium) is a plant from the daisy family (Compositae or Asteraceae). It is also known as featherfew, bachelor’s buttons, or wild chamomile [1, 2].
Feverfew is native to the Balkans but now grows all over the world, including the Americas [1].
Also known as ‘‘medieval aspirin’’, this plant has been traditionally used as a treatment for fever, rheumatism, arthritis, toothache, psoriasis, insect bites, asthma, stomachache, headaches, infertility, tinnitus, dizziness, nausea, vomiting, menstrual problems and migraine [3].
The plant contains active compounds such as [1, 3]:
- Sesquiterpene lactones (mainly parthenolide, 85% of total sesquiterpene lactones ): parthenolide decreases inflammation and may even help fight cancer
- Volatile oils (such as camphor), which are antibacterial
- Flavonoids, which have antioxidant, anti-inflammatory, and antibacterial properties
Mechanisms
Parthenolide is the main active compound of feverfew and is found in the leaves [1].
Feverfew and parthenolide:
- Reduce serotonin release by platelets and white blood cells and block serotonin receptors. During a migraine attack, increased serotonin release may cause inflammation and stimulate nerves, causing pain [4, 5, 6, 7].
- Inhibit phospholipase A and prostaglandin formation and reduce blood clots, which decreases inflammation. Additionally, prostaglandins also cause blood vessels to widen (vasodilation), which contributes to migraine [4, 8, 9, 1].
- Block NF-kB (the master-regulator of inflammation), decrease inflammatory cytokines (TNF-alpha, IL-1beta, IL-2, IL-4, IL-6, IL-17A, IFN-gamma) and messengers (nitric oxide and PGE2) [3, 10, 11, 12].
- Increase Nrf2/ARE activation, possibly protecting against oxidative stress [13].
- Increase p53 and decrease VEGF. This may cause cell death in cancer cells [3, 14].
Snapshot
Proponents
- May help reduce the severity and frequency of migraine attacks
- Potential to improve skin disorders
Skeptics
- Insufficient evidence for most benefits
- May cause some adverse effects and withdrawal-like symptoms
- Not safe for children younger than 2 years old and pregnant and breastfeeding women
- May cause allergic reactions
- May interact with blood thinners
Health Benefits
Possibly Effective
Migraines
Feverfew has been historically used as a “natural aspirin” for headaches and migraines.
In 3 clinical trials on almost 400 people, feverfew extract reduced the number and severity of the attacks, the number of attacks requiring bed rest, and the frequency of vomiting. [15, 16, 17].
In another trial on 69 women with frequent migraines, the combination of feverfew and acupuncture had better effects on pain management and quality of life than either of these strategies alone [18].
Combinations of feverfew and ginger (LipiGesic and Gelstat) were also effective in 2 trials on 89 people. Similarly, another combination of feverfew and willow extract (Mig-RL) prevented migraine attacks and reduced their intensity in a small trial on 12 people [19, 20, 21].
In a small trial on 17 people, capsules with freeze-dried feverfew prevented the worsening of headaches, nausea, and vomiting but caused a withdrawal-like syndrome with migraine symptoms and joint stiffness when they switched from feverfew to placebo [22].
However, feverfew extract (standardized to 0.5 mg parthenolide) did not improve migraine symptoms in a trial on 50 people [23].
In another trial on 49 people, feverfew combined with riboflavin and magnesium had no benefit over riboflavin alone at preventing migraine attacks [24].
Parthenolide, the active ingredient of feverfew, blocked pain signals in rodent nerves (trigeminal neurons), which may be the mechanism by which it reduces migraine pain [25].
All in all, although some mixed results exist, the evidence suggests that feverfew (both alone and in combination with other herbal extracts) may help reduce the severity and frequency of migraine attacks. You may discuss with your doctor if it may be helpful in your case. Follow your doctor’s recommendations and never use feverfew in place of what your doctor recommends or prescribes.
Insufficient Evidence
Skin Health
Health and beauty companies use parthenolide-depleted feverfew in a variety of topical products.
Parthenolide can cause skin irritation (contact dermatitis), but parthenolide-depleted feverfew may help with redness/blotchiness, roughness, razor burns, and UV damage without causing this unwanted effect [26].
Rosacea
In a small trial on 8 people, topical parthenolide-depleted feverfew reduced skin redness caused by an irritant. Concentrations of 0.5%, 0.75%, and 1.0% reduced redness by 28%, 39%, and 68%, respectively [11].
Topical parthenolide-depleted feverfew also reduced skin inflammation (dermatitis) in mice [11].
Migraine is more common in people with rosacea. Both are inflammatory conditions that cause problems in areas innervated by the trigeminal nerve. A study in rodents showed that parthenolide targets the trigeminal nerve, which may explain why feverfew may help with both conditions [27, 25].
UV damage
A small trial on 12 people found that parthenolide-deprived feverfew reduced redness caused by UVB radiation. It helped by reducing UV-induced free radical (hydrogen peroxide) formation, blocking inflammatory cytokine (IL-1alpha) release, and increasing DNA repair enzymes [28].
Parthenolide-deprived feverfew also reduced skin thickening caused by UV damage in rodents [28].
Two small clinical trials and some animal studies are clearly insufficient to support the use of feverfew in people with these skin conditions. Larger, more robust clinical trials are needed to validate these preliminary results.
Animal and Cell Research (Lack of Evidence)
No clinical evidence supports the use of feverfew for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based research, which should guide further investigational efforts. However, the studies should not be interpreted as supportive of any health benefit.
Anti-Inflammatory
Feverfew has been used as a natural anti-inflammatory remedy for millennia. The Greek doctor Pedanius Dioscorides used it for “all hot inflammations and hot swellings” [29].
In mice with hepatitis, parthenolide, a component of feverfew, decreased the inflammatory cytokines IFN-gamma, TNF-alpha, IL-17A, IL-1beta, and IL-6, and improved liver function [12].
Additionally, parthenolide reduced brain inflammation by decreasing IL-17, TNF-alpha, and IFN-gamma levels in mice with multiple sclerosis [30].
Parthenolide improved colon inflammation in mice with inflammatory bowel disease (IBD) by blocking NF-κB and decreasing TNF-alpha and IL1-beta [31].
It also reduced inflammation by blocking NF-kappaB activation in mice with cystic fibrosis [32].
In rats with arthritis, parthenolide reduced joint inflammation [33].
In a study in skin cells, parthenolide reduced inflammation by blocking NF-κB [34].
Feverfew may reduce inflammation even when devoid of parthenolide. Parthenolide-depleted feverfew blocked the release of inflammatory molecules nitric oxide, PGE2, TNF-alpha, IL-2, IL-4, and IFN-gamma from white blood cells. It also improved skin inflammation (dermatitis) in mice [11].
This means that feverfew has components, other than parthenolide, that may effectively reduce inflammation.
Antioxidant
Feverfew is a known antioxidant capable of breaking down free radicals such as ferric, oxygen, hydroxyl, and peroxynitrates [28].
Parthenolide-depleted feverfew is a stronger antioxidant than Vitamin C. In human cells, it protected against cigarette smoke-induced oxidative damage [28].
Parthenolide also protected rats against toxin-induced oxidative stress and liver damage [35].
Pain
Parthenolide reduced inflammation and pain-causing prostaglandins by inhibiting prostaglandin synthase (PHS) in animal and cell-based studies [36, 37, 38].
In mice, feverfew reduced acute chemically-induced pain without causing sleepiness or changes in behavior [39].
Feverfew flower extract reduced acute, inflammatory, joint, and neuropathic pain in rodents. It was also effective against chemotherapy-induced pain. However, the leaf extract was much less potent [40].
Anxiety and Depression
Feverfew extract reduced anxiety and depression in mice [41].
Drug Intoxication
In rats, parthenolide blocked the effects of cocaine on dopamine-sensitive neurons (in the ventral tegmental area of the brain) [42].
Blood Clots
In cell-based studies, parthenolide increased platelet production but decreased their activation, possibly preventing blood clots [43, 44].
Allergies
Feverfew extract blocked histamine release from allergy-causing mast cells [45].
Antibacterial
Feverfew essential oil inhibits the growth of harmful bacteria in cell-based studies [46].
Oil made from the flowering stage has the strongest antibacterial activity due to its high content of camphor [46].
Possibly Ineffective
Cancer
Parthenolide delayed the development of skin tumors and decreased their number in mice exposed to UVB radiation [47].
This compound also damaged or killed multiple cancer cell types, including leukemia, lymphoma, multiple myeloma, liver, breast, lung, colon, skin, bladder, and brain cancer in test tubes [48, 49, 50, 51, 52, 53, 54, 55, 14, 56, 57, 58].
However, a study of 12 cancer patients found that feverfew does not contain enough parthenolide to show up in blood tests and may not have any effect against the disease [59].
Rheumatoid Arthritis
In a clinical trial on 41 women with rheumatoid arthritis, chopped feverfew (70-86 mg) wasn’t more effective than the placebo at improving joint pain, mobility, and inflammation [60].
Safety
Side Effects
This list does not cover all possible side effects. Contact your doctor or pharmacist if you notice any other side effects.
Call your doctor for medical advice about side effects. In the US, you may report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada, you may report side effects to Health Canada at 1-866-234-2345.
Studies show that feverfew is generally safe when taken at normal doses, and only caused mild, transient adverse effects (mainly mouth ulceration and gut-related symptoms) in clinical trials [61].
However, it can cause withdrawal-like symptoms if discontinued abruptly [62, 61].
The main potential adverse effects from feverfew ingestion include:
- Mouth sores [63]
- Mouth numbing [19]
- Heartburn [17]
- Nausea/vomiting [63, 19]
- Gas [64]
- Bloating [61]
- Indigestion [17]
- Diarrhea [61, 17]
- Constipation [61]
- Weight gain [17]
- Increased menstrual bleeding [64]
- Post Feverfew Syndrome: withdrawal from feverfew may cause aches, pains, and stiffness in muscles and joints as well as nervousness and fatigue [62, 61]
- Dermatitis, as parthenolide is a skin irritant [65, 66, 3]
Pregnant and breastfeeding women should avoid feverfew, since prostaglandin synthetase inhibitors (such as parthenolide) can harm fetuses and newborns, and trigger uterine contractions. Similarly, feverfew is not recommended in children younger than 2 years old [67, 64, 68].
People allergic to ragweed and other Compositae plants (such as daisies and marigolds) may also be allergic to feverfew [64, 69].
Because it may act as a blood thinner, people with bleeding disorders or a scheduled surgical procedure are advised to avoid feverfew.
Drug Interactions
Supplement/Herb/Nutrient-drug interactions can be dangerous and, in rare cases, even life-threatening. Always consult your doctor before supplementing and let them know about all drugs and supplements you are using or considering.
Feverfew should not be taken along with other blood thinners such as warfarin or aspirin, since it may add to their effects and increase the risk of bleeding [64, 70, 71].
Supplementation
Feverfew supplements have not been approved by the FDA for medical use due to the lack of solid clinical research. Regulations set manufacturing standards for supplements but don’t guarantee that they’re safe or effective. Speak with your doctor before supplementing with feverfew.
Dosage
Because feverfew is not approved by the FDA for any condition, there is no official dose. Users and supplement manufacturers have established unofficial doses based on trial and error. Discuss with your doctor if feverfew may be useful as a complementary approach in your case and which dose you should take.
Feverfew supplements are available fresh, freeze-dried, or dried and can be purchased in capsule, tablet, or liquid extract forms. Those used in clinical studies usually contain a standardized dose of parthenolide [71].
The leaves can be taken either dried or fresh. The typical adult dose is 2-3 leaves/day [1].
For Migraines
- The extract is usually taken in doses of 100-300 mg (standardized to 0.2-0.4% parthenolide), 4x/day [1, 71]
- In cases of CO2-extracted feverfew, the dose is 6.25 mg 3x/day for up to 16 weeks [1]
For Inflammation
- The normal dose for inflammation is 60-120 drops (1:1 w/v fluid extract or 1:5 w/v tincture), 2x/day [1, 71]
For children over 2 years old, you may adjust the dosage proportionally to their weight. Adult doses are based on an average weight of 150 lbs (70 kg). Therefore, a 75 lb child may need half of the adult dose [1].
A variety of skin-care products are available that contain parthenolide-depleted feverfew. Consult the product for usage instructions.
User Reviews
The opinions expressed in this section are solely those of feverfew users, who may or may not have medical or scientific training. Their reviews do not represent the opinions of SelfHacked. SelfHacked does not endorse any specific product, service, or treatment.
Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice from your doctor or other qualified healthcare providers because of something you have read on SelfHacked. We understand that reading individual, real-life experiences can be a helpful resource, but it is never a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare provider.
Many users reported that feverfew helped with their migraines. Many of them claimed that it resolved this condition completely However, a few people complained that feverfew was ineffective and even made their migraines worse.
Feverfew-containing creams were reportedly effective in reducing redness and soothing irritation. However, some users developed skin irritation from using them, probably because they were sensitive to the plant.