Butterbur
Also known as: Petasites hybridus
Overview
Butterbur is an herb most commonly known for its use in migraine prevention, although it is falling out of favor due to the risk of liver toxicity in commercial formulations. Its name comes from its large hat-like leaves which historically were used to wrap butter to protect it from the weather. Butterbur typically grows in North America, Asia, and Europe within wet marsh areas or close to rivers or streams.
Benefits
There are a few different proposed mechanisms for how butterbur helps to prevent migraine. First, the butterbur constituents petasin and isopetasin have been shown to reduce the constriction of blood vessels and decrease neuron excitation by inhibiting L-type voltage-gated calcium channels (which relax the smooth muscles that control the diameter of blood vessels). Additionally, independent of petasin content, butterbur extract has been shown to inhibit COX-2 enzymes, which produce inflammation-causing prostaglandins. Finally, some research suggests that butterbur root extract reduces the sensation of pain by acting on two types of ion channels that are also triggered by spicy food (TRPA1 and TRPV1).
How it works
Butterbur is most known for its use in migraine prevention, and several expert societies recommended it in the past but have since retracted their recommendation due to safety concerns. Butterbur has also been used for allergic rhinitis and asthma. For intermittent allergic rhinitis, taking 50 mg of butterbur extract containing 8 mg of petasins 2–3 times daily for 2 weeks reduced symptoms of runny nose, sneezing, and itching compared to a placebo. Small studies have suggested that it may be comparable to cetirizine or fexofenadine, but larger studies are needed to be sure. Studies of butterbur in asthma have been too short and too low-quality to draw conclusions.
Side effects
Most clinical studies have used 50–150 mg of butterbur extract daily in divided doses. For migraine prevention, dosages of 50–150 mg daily taken by mouth have been used. Note that if you use butterbur on a daily basis, it is important to monitor for signs of liver toxicity. For allergic rhinitis, 50 mg of butterbur extract two to three times daily seems to have some benefit.
Dosage
Common side effects of butterbur include burping, stomach upset, and headache, as well as allergic reactions, including itchy eyes and wheezing. People with allergies to ragweed and daisies (common causes of seasonal allergic rhinitis) may have allergic cross-reactivity to butterbur. Butterbur contains pyrrolizidine alkaloids, which are known to be toxic to the liver, and there have been rare reports of liver toxicity with butterbur use.
FAQs
What is butterbur?
Butterbur (Petasites hybridus) is an herb most commonly known for its use in migraine prevention, although it is falling out of favor due to the risk of liver toxicity. Its name comes from its large hat-like leaves which historically were used to wrap butter to protect it from the weather. Butterbur typically grows in North America, Asia, and Europe within wet marsh areas or close to rivers or streams.
What are butterbur’s main benefits?
Butterbur is most known for its use in migraine prevention, and several expert societies recommended it in the past but have since retracted their recommendation due to safety concerns. Butterbur has also been used for allergic rhinitis and asthma. For intermittent allergic rhinitis, taking 50 mg of butterbur extract containing 8 mg of petasins 2–3 times daily for 2 weeks reduced symptoms of runny nose, sneezing, and itching compared to a placebo. Small studies have suggested that it may be comparable to cetirizine or fexofenadine, but larger studies are needed to be sure. Studies of butterbur in asthma have been too short and too low-quality to draw conclusions.
What are butterbur’s main drawbacks?
Common side effects of butterbur include burping, stomach upset, and headache, as well as allergic reactions, including itchy eyes and wheezing. People with allergies to ragweed and daisies (common causes of seasonal allergic rhinitis) may have allergic cross-reactivity to butterbur. Butterbur contains pyrrolizidine alkaloids, which are known to be toxic to the liver, and there have been rare reports of liver toxicity with butterbur use.
Can butterbur cause liver toxicity?
There is a small risk that butterbur can cause liver toxicity, especially when used with hepatotoxic (toxic to the liver) medications, like acetaminophen, or in people with pre-existing liver conditions. Liver toxicity is likely caused by the known hepatotoxins pyrrolizidine alkaloids (PAs), which are supposed to be removed when the herb is processed for commercial dietary supplement use. However, a 2012 study that tested 21 commercial butterbur supplements found that only 7 of the supplements contained no PAs, while another 7 contained toxic levels of PAs. This might explain why there have been reports of hepatotoxicity in people taking commercial butterbur supplements that are supposed to be free of PAs.
How does butterbur work?
There are a few different proposed mechanisms for how butterbur helps to prevent migraine. First, the butterbur constituents petasin and isopetasin have been shown to reduce the constriction of blood vessels and decrease neuron excitation by inhibiting L-type voltage-gated calcium channels (which relax the smooth muscles that control the diameter of blood vessels). Additionally, independent of petasin content, butterbur extract has been shown to inhibit COX-2 enzymes, which produce inflammation-causing prostaglandins. Finally, some research suggests that butterbur root extract reduces the sensation of pain by acting on two types of ion channels that are also triggered by spicy food (TRPA1 and TRPV1).
Supplements Containing Butterbur
Butterbur Extra
Vitanica
Migravent
Vita Sciences
Petadolex
Nature's Way
Extra Strength Continence Max
Solaray
Migraine Prevention Formula
Dr. Knowles
My Brain!
Eu Natural
Migra-Tension Ez
Indiana Botanic Gardens
Butterbur Extract 75 mg
Nutricost
MigraSoothe
Thompson
