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Can Feverfew at the First Sign of Migraine Prevent the Pain?

The medicinal herbs feverfew and butterbur can prevent migraine. Taking feverfew at the first sign of migraine stops the headache.

Migraine headaches make life miserable for many sufferers. As a result, they are eager to find any treatment that can ease the pain and reverse the nausea, photophobia and other symptoms that may accompany migraine. Whether they utilize an over-the-counter approach such as aspirin, prescription medication like sumatriptan or some other therapy, most people find that their preferred remedy works best if taken at the very first sign of migraine. Some readers have found this also applies to certain herbal medicines, particularly feverfew and butterbur.

Butterbur and Feverfew as Preventive Medicine:

Q. I had debilitating migraines periodically from about age 12 until my mid-fifties. Ordinary OTC painkillers did not help at all once the headache began.

I tried an herbal remedy, a capsule that contained feverfew, butterbur and something else. The directions were to take it every day and this would lessen the incidence of migraine. It worked for me, but eventually my source went out of business. Is there anything else you recommend?

A. Feverfew (Tanacetum parthenium) and butterbur (Petasites hybridus) have long been used for migraine prevention (StatPearls, July 8, 2021). 

Recent research demonstrates that the active compounds in butterbur root extract inhibit calcitonin gene-related peptide (Journal of Headache Pain, April 13, 2021).  New prescription migraine medications like erenumab (Aimovig), fremanezumab (Ajovy) and galcanezumab (Emgality) work through the same mechanism.

MigreLief for Migraine:

MigreLief is a popular combination medicine sold over the counter for migraines. It contains riboflavin, magnesium and feverfew extract. Feverfew extract reduces brain inflammation and inhibits dopamine release (Molecules, Dec. 23, 2020).  Presumably, these actions explain its ability to ease migraine pain. Like other medicines or remedies to treat migraines, it probably works best at the first sign of migraine.

Taking Feverfew at the First Sign of Migraine:

Q. I’ve had migraines since I was 12 years old. About 35 years ago I read that taking feverfew at the first sign of migraine would give quick relief.

I discovered that if I take one feverfew and two ibuprofen capsules as soon as I notice the visual disturbance I get before the headache, the migraine itself never develops! This remedy has worked like a miracle for me. It has also worked for my daughter and several of my friends.

A. Scientific studies tend to support your experience, although most have examined feverfew as a preventative rather than a treatment. One review found strong evidence for butterbur (Petasites) and moderate evidence for feverfew (MIG-99) as well as NSAIDs like ibuprofen (Neurology, Apr. 24, 2012). In conclusion, all of these work best if taken before the pain begins or at the very first sign of migraine.

How Does Feverfew Work Against Migraines?

There is even a fascinating description of the mechanism. Parthenolide, the active ingredient in feverfew, blocks the TRPA1 channels that often trigger migraine (Pain, Dec. 2013). Such transient receptor potential channels work to help nerves sense painful stimuli throughout the body. You can learn more about them by listening to our interview with neuroscientist Bruce Bean. It is Show 1054: The Scientific Explanation for a Weird Remedy

Learn More About What to Take at the First Sign of Migraine:

Other migraine sufferers might want to know more about feverfew, butterbur and other approaches to preventing these debilitating headaches. Some readers recommend inducing an ice-cream headache at the first sign of migraine. Hypothetically, this too would be working through TRP channels. In this case, TRPM8 channels that sense cold might have the power to reverse the development of a migraine headache. We have written about brain freeze as a remedy in our eGuide to Headaches and Migraines. We included more information on non-drug approaches and remedies along with the pros and cons of medications. You may also wish to listen to Show 1133: How Can You Overcome Migraine Headaches?

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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  • Din L & Lui F, "Butterbur." StatPearls, July 8, 2021.
  • Kleeberg-Hartmann J et al, "Petasin and isopetasin reduce CGRP release from trigeminal afferents indicating an inhibitory effect on TRPA1 and TRPV1 receptor channels." Journal of Headache Pain, April 13, 2021. DOI: 10.1186/s10194-021-01235-5
  • Holland S et al, "Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults." Neurology, Apr. 24, 2012. doi: 10.1212/WNL.0b013e3182535d0c
  • Materazzi S et al, "Parthenolide inhibits nociception and neurogenic vasodilatation in the trigeminovascular system by targeting the TRPA1 channel." Pain, Dec. 2013. DOI: 10.1016/j.pain.2013.08.002
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