Feverfew is a medicinal herb commonly used in self-treatment for conditions such as migraine. The feverfew herb has a long history of use in traditional and folk medicine, especially among Greek and early European herbalists. The primary active ingredients in feverfew are the sesquiterpene lactones; other plants containing this chemical compound include artichoke, sunflower, lettuce, spinach, and ginkgo biloba. Sesquiterpene lactones consist of several different varieties. The one of central importance in feverfew is parthenolide (Tanacetum parthenium) which occurs naturally in this plant. In fact, many feverfew-containing products specify the content of parthenolide as it is central to its pharmacologic mechanisms and biological effects.
Feverfew’s mode of action does not appear to be limited to a single mechanism. Plant extracts can affect a wide variety of physiologic pathways; some of these mechanisms include inhibition of prostaglandin synthesis, decrease of vascular smooth muscle spasm, and blockage of platelet secretion.
A proposed mechanism of action involves parthenolide specifically binding to and inhibiting IκB kinase complex (IKK)β. IKKβ plays an important role in pro-inflammatory cytokine-mediated signaling.
Further, feverfew appears to be an inhibitor of prostaglandin synthesis, creating an anti-inflammatory effect. Specifically, tanetin, a lipophilic flavonoid found in the leaf, flower, and seed of feverfew, blocks prostaglandin synthesis. Aqueous extracts do not contribute to feverfew’s anti-inflammatory activity, but do prevent the release of arachidonic acid and inhibit in vitro aggregation of platelets.
Feverfew supplements are available fresh, freeze-dried, or dried and can be purchased in capsule, tablet, or liquid extract forms. Feverfew supplements with clinical studies contain a standardized dose of parthenolide. Feverfew supplements should be standardized to contain at least 0.2% parthenolide.
Feverfew may alter the effects of some prescription and non-prescription medications. If you are currently being treated with any of the following medications, you should consult first with your healthcare provider.
- Blood-thinning medications– Feverfew may inhibit the activity of platelets (a substance that plays a role in blood clotting), so individuals taking blood-thinning medications (such as aspirin and warfarin) should consult a healthcare provider before taking this herb.
Adverse reactions of using feverfew include oral ulcers, hypersensitivity, and post-feverfew syndrome. Contraindications for feverfew are pregnancy, breastfeeding, and allergies to chamomile or tansy.
By: Dr. Sandy Cho. MD
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- Saranitzky E, White CM, Baker EL, Baker WL, Coleman Cl. Feverfew for migraine prophylaxis: a systematic review. J Diet Suppl 2009;6(2):91-103.
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