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butterbur

What Is It?
Health Benefits
Forms
Dosage Information
Guidelines for Use
General Interaction
Possible Side Effects
Cautions
References
Evidence Based Rating Scale


What Is It?

The modern name for the butterbur herb comes from the use in early farming communities of Europe and North America of its large leaves to keep their butter fresh in warm weather. Butterbur leaves are among some of the largest in Europe, sometimes reaching three feet in diameter. Butterbur hails from the plant genus Petasites, which is derived from the Greek word petasos, a term used for the large felt hats worn by Greek fishermen.

Modern day herbal butterbur preparations contain a mix of the leaves, flowers, stems, and roots of this plant. These parts contain the bioactive components petasin, isopetasin, and neopetasin, which scientists believe may be responsible for the spasmolytic (muscle spasm reducing) and anti-inflammatory properties of Petasites officianalis. Current research suggests that the herb may also help prevent the pain and suffering of migraine headaches, seasonal allergies, and airway disorders. Traditionally, butterbur has also been used to treat gastrointestinal conditions and skin wounds.

Health Benefits

During the bubonic plague, butterbur was called plague flower due to its ability to protect against infection. Today butterbur is indicated for the treatment and prevention of a myriad of conditions, including:  

  • Prevention of migraine headaches. Research from a study on 245 adult migraine sufferers showed a 48% decrease in migraine frequency over four months. 68% of the people who took butterbur suffered 50% less migraine attacks overall. These benefits persisted 3 months after the study ended (1). Other studies have shown butterbur to be effective in preventing migraine headaches in children and adolescents (2). As the most common side effect experienced was mild stomach complaint, butterbur may be a safe treatment for the excruciating pain and disability associated with migraine headaches.
  • Treatment of seasonal allergies. The runny nose, sneezing, watery eyes, and inflamed sinuses that accompany the change of seasons significantly diminish the quality of personal and work life. A multicenter study of 168 allergy suffers found that butterbur significantly reduced the bothersome allergic symptoms (3). The doctors concluded that butterbur is effective and well tolerated. Other studies have shown similar benefits (4-6). Some doctors even recommend butterbur as a first line treatment for seasonal allergies, instead of or combined with conventional drugs. When compared to a conventional antihistamine cetirizine (Zyrtec), butterbur was found to work as well and to have fewer side effects.(7).
  • Help control asthma attacks. Recent research results suggest that butterbur may be a beneficial adjunctive treatment to conventional asthma medications. Preliminary trials show that butterbur, when administered with conventional corticosteroid inhaler medications, helped reduce airway inflammation in both children and adults (8,9). More research is necessary to confirm these results in larger-scale trials. Since asthma is a serious condition, you should not begin any supplement routine without first discussing the implications with your doctor.
  • Treat gastric ulcers. A small body of research supports butterbur as an effective treatment for treating stomach ulcers Two studies show that butterbur encourages a balance of anti-inflammatory chemistry in the stomach that may promote the healing of gastric ulcers. (10,11). Future studies of adequate size and duration are needed to demonstrate possible clinical benefits.

Forms

    • capsule
    • liquid

Dosage Information

  • For migraine prevention: 50 mg twice a day.
  • For treatment of seasonal allergies: 50-75 mg twice a day
  • For adjunctive asthma therapy: 25-50 mg twice a day

Look for capsules and tinctures that have been standardized to contain a consistent amount of petasin. Many formulations contain 8 mg of petasin per capsule.

Be sure to check out our Dosage Recommendations Chart for Butterbur, which lists therapeutic dosages for specific ailments at a glance.

Guidelines for Use

  • Look for a butterbur product certified free of unsaturated pyrrolizidine alkaloids (UPA). UPA-free butterbur products have been shown to be safe when used for up to 12 weeks.

General Interaction

  • If you are taking any anticholinergic drugs (drugs that block acetylcholine, including some anti-depressants, medications for overactive bladder, etc.), talk to your doctor before supplementing your diet with butterbur. Butterbur may intensify the actions of these medications.
  • You should also avoid butterbur if you are currently taking any of the following herbs: alkanna, borage, gravel root, hemp agrimony, hound’s tongue, comfrey, coltsfoot, dusty miller, or most species of ragwort, as it may combine with them to cause adverse interactions.

Possible Side Effects

  • The most common side effects experienced with butterbur supplementation are mild stomach upset, itchy eyes, and diarrhea.

Cautions

  • When purchasing a butterbur preparation, look for a product that is certified free of unsaturated pyrrolizidine alkaloids (UPA). UPAs have been shown to harm liver function when administered over time. Ask your doctor to recommend a reputable UPA-free butterbur distributor if you are unsure about where to purchase these products.
  • Do not take butterbur if you are pregnant or breastfeeding. Studies have not been conducted on the safety of butterbur in fetal and infant development.

References

  1. Lipton RB, Gobel H, Einhaupl KM, Wilks K, Mauskop A. Petasites hybridus root (butterbur) is an effective preventive treatment for migraine. Neurology. 2004 Dec 28;63(12):2240-4.
  2. Pothmann R, Danesch U. Migraine prevention in children and adolescents: results of an open study with a special butterbur root extract. Headache. 2005 Mar;45(3):196-203.
  3. Schapowal A; Petasites Study Group. Butterbur Ze339 for the treatment of intermittent allergic rhinitis: dose-dependent efficacy in a prospective, randomized, double-blind, placebo-controlled study. Arch Otolaryngol Head Neck Surg. 2004 Dec;130(12):1381-6
  4. Lee DK, Gray RD, Robb FM, Fujihara S, Lipworth BJ. A placebo-controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis. Clin Exp Allergy. 2004 Apr;34(4):646-9.
  5. Lee DK, Carstairs IJ, Haggart K, Jackson CM, Currie GP, Lipworth BJ. Butterbur, a herbal remedy, attenuates adenosine monophosphate induced nasal responsiveness in seasonal allergic rhinitis. Clin Exp Allergy. 2003 Jul;33(7):882-6.
  6. Brattstrom A. A newly developed extract (Ze 339) from butterbur (Petasites hybridus L.) is clinically efficient in allergic rhinitis (hay fever). Phytomedicine. 2003;10 Suppl 4:50-2.
  7. Schapowal A; Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ. 2002 Jan 19;324(7330):144-6.
  8. Lee DK, Haggart K, Robb FM, Lipworth BJ. Butterbur, a herbal remedy, confers complementary anti-inflammatory activity in asthmatic patients receiving inhaled corticosteroids. Clin Exp Allergy. 2004 Jan;34(1):110-4.
  9. Danesch UC. Petasites hybridus (Butterbur root) extract in the treatment of asthma--an open trial. Altern Med Rev. 2004 Mar;9(1):54-62.
  10. Brune K, Bickel D, Peskar BA. Gastro-protective effects by extracts of Petasites hybridus: the role of inhibition of peptido-leukotriene synthesis. Planta Medica. 1993;59:494-496.
  11. Bickel D, Roder T, Bestmann J, et al. Identification and characterization of inhibitors of peptido-leukotriene-synthesis from Petasites hybridus. Planta Medica. 1994;60:318-322.

Evidence Based Rating Scale

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

Condition

Rating

Explanation

 

 

 

 

 

 

 

Allergies - seasonal/hay fever

 

 

 

 

 

 

 

 

 

 

Large high quality studies have shown benefit. Some studies have shown equal benefit to that of conventional medications. Well tolerated treatment for allergies; long history of traditional use for this indication.

 

 

Date Published: 01/06/2007
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