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Herbs for Health: Migraine Headaches and Feverfew

By Steven Foster
October/November 1995
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Few chronic ailments result in as many trips to medical practitioners in search of relief as the migraine headache. As many as one in eight people suffers at some time from migraines, experiencing the sensation of having a Mack truck drive through the head: pounding, seething pain, often accompanied by nausea and vomiting, that makes it difficult to get through the day, go to sleep, or relate to fellow human beings. Of the many herbs that have been called upon over the centuries to counteract the painful, often debilitating symptoms of migraines, the most thoroughly researched has been feverfew (Tanacetum parthenium).

Historical Uses

While headaches—migraine or otherwise—are often a result of the stress of modern life, they are certainly nothing new to human experience, nor is the use of feverfew as a treatment. John Goodyer’s 1655 translation of the materia medica of Dioscorides (the first-century Greek physician who served as a physician in the Roman army) states that feverfew is good for “melancholicall”; we’d call it “headaches”.

Gerard’s Herball, first published in 1597, advises: “Feverfew dried and made into pou­der, and two drams of it taken with honie or sweet wine, purgeth by siege melancholy and flegme, whereforre it is very good for them that are giddie in the head, or which have the turning called Vertigo, this is a swimming and turning in the head. Also it is good for such as be melancholike, sad, pensive, and without speech.”

Similarly, the seventeenth-century English herbalist Ni­cholas Culpeper, whose English Physician Enlarged is the most widely printed English-language herbal of all time, observed the use of feverfew for headache: “It is very effectual for all pains in the head coming of a cold cause, the herb being bruised and applied to the crown of the head; as also for the Vertigo, that is a sunning or swimming of the head.”

Modern Studies

In the past decade, references to feverfew as a migraine remedy have assumed a new emphasis. Several articles published in British medical journals have catapulted feverfew into recognition as one treatment for prevention of symptoms associated with migraines. Adopting an unusual approach, researchers in two studies bypassed animal studies and instead sought human volunteers who were already using feverfew for self-treatment of migraine. Seventeen volunteers participated in a double-blind study by Johnson and coworkers conducted in 1985 at the City of London Migraine Clinic in collaboration with the Chelsea College of the University of London. Nine of them received a placebo, and this group reported a significant increase in the frequency and severity of migraines and associated symptoms such as nausea and vomiting. The eight patients who continued to ingest feverfew reported no change in their migraines.

Of seventy-two participants in a study by Murphy and coworkers in 1988, fifty-nine were assessed at the end of the randomized, double-blind, pla­cebo-controlled trial. In those who took feverfew, the researchers observed a significant reduction in the mean number and severity of migraine headaches, as well as a reduction in vomiting. The greater number of participants in this trial compared to the 1985 study lent support for the claim that feverfew prevents migraines.

Suspected Cause

Abnormal behavior of blood platelets has been implicated in the development of migraines. During a migraine attack, platelets release the hormone serotonin, which constricts blood vessels. The use of serotonin antagonists (substances that inhibit the release of serotonin) has been proposed in the effort to prevent migraines; feverfew has been shown in laboratory studies to fall into this category. Its effectiveness as a serotonin antagonist has been positively correlated with the parthenolide content in freeze-dried or air-dried whole feverfew leaf. (Parthenolide is thought to be the primary active component in feverfew.) In a 1991 report published in the Journal of Natural Products, Awang and his colleagues proposed 0.2 percent parthenolide in a daily dose of 250 mg of feverfew leaf as the least amount needed to ensure an effective feverfew product, a proposal that Canadian regulatory authorities have since adopted.

After reports of British ­clinical trials were published in the scientific and popular literature, many products containing feverfew appeared on the market in North America. Researchers initially found that none contained as much as 0.1 percent par­thenolide, let alone the 0.2 percent proposed by Awang. Since then, however, manufacturers have been able to obtain higher-parthenolide dried feverfew leaf and thus produce feverfew remedies with a higher par­thenolide content. Consumers who purchase feverfew products should check the parthenolide content on the label.

Migraine sufferers who want to cultivate feverfew and harvest the leaves from their own gardens will find the plant easy to grow and use. The leaf has been proven the most efficacious part of the plant for preventing migraines; most modern herbals suggest eating two large, fresh leaves or three or four small ones daily. The fresh leaf has been reported to cause mouth ulcers in more than 11 percent of feverfew users surveyed; the problem is not as common among those taking standardized feverfew products.

Other Herbs for Other Headaches

Several herbs have traditionally been used to relieve milder headaches. Among these are several species of willow, the dried bark of which is generally taken as a tea. White willow (Salix alba) is the spe­cies most commonly mentioned in the literature. Willow owes its effectiveness as an analgesic to the presence of salicin precursor compounds in the bark. As the bark tea enters the intestine, the alkaline intestinal fluid transforms these precursors into salicin. Microorganisms in the intestine further convert it into saligenin. Absorbed by the intestine into the blood and liver, saligenin is oxidized to form salicylic acid, which has similar properties to acetylsalicylic acid (aspirin). The former produces fewer side effects but lacks aspirin’s blood-thinning capability.

Salicin precursors occur at concentrations less than 1 percent and as high as 11 percent in willows, depending upon the species. Calculating how much willow bark tea to take for a headache can be problematical. In Herbs of Choice, Varro E. Tyler explains that if your willow bark is very low in salicin precursors, you may have to drink nearly 5 quarts of willow bark tea to get the therapeutic equivalent of two aspirins; if the bark is high in the compounds, about 3 cups will do. For commercial products, the German health authorities have established a dosage of willow bark equivalent to 60 to 120 mg of salicin content unless prescribed otherwise.

Several members of the mint family, including lavender (Lavandula angustifolia) and peppermint (Mentha ¥ piperita), have been used as for the treatment of headaches. They are usually taken by drinking teas made of the leaves. Components of the lavender and mint volatile oils have been shown to reduce muscle spasms, which cause some headaches, including tension headaches. To date, no human clinical studies confirming these traditional uses have taken place, but the search for relief can be expected to continue.

References

• Awang, D.V.C., et. al. J. Nat. Prod. 1991, 54:1516.
• Culpeper, N. The English Physician Enlarged. Dublin: H. Colbert, 1787.
• Foster, S. Feverfew. Austin, Texas: American Botanical Council, 1991.
• Gunther, R. T. The Greek Herbal of Dioscorides. New York: Hafner, 1934; reprinted 1968.
• Heptinstall, S., et. al. J. Pharm. Pharmacol. 1992, 44:391.
• Johnson, E. S., et. al. British Med. J. 1985, 291:589.
• Johnson, T. The Herball, or Generall Historie of Plantes. 1633; reprinted New York: Dover, 1975.
• Murphy, J. J., et. al. The Lancet 1988 (23 July):(ii)189.
• Pattichis, K., et. al. Eur. J. Pharmacol. 1995, 292:173–177.
• Bradley, P. R., ed. British Herbal Compendium, 1. Bournemouth, England: British Herbal Medicine Association, 1992.
• Tyler, V. E. Herbs of Choice: The Therapeutic Use of Phytomedicinals. Binghamton, New York: Pharmaceutical Products Press, 1994.
• Weiss, R. F. Herbal Medicine (translated from German by A. R. Meuss). Beaconsfield, England: Beaconsfield, 1988.


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