Feverfew Overview

Originally native to the Balkans, this relative of the common daisy was spread by deliberate planting throughout Europe and the Americas. Feverfew's feathery and aromatic leaves have long been used medicinally to improve childbirth, promote menstruation, induce abortions, relieve rheumatic pain, and treat severe headaches.

Contrary to popular belief, feverfew is not used for lowering fevers. Actually, according to one source, "feverfew" is a corruption of the name "featherfoil." ¹ Featherfoil became featherfew and ultimately feverfew. In a weird historical reversal, this name then led to a widespread belief among herbalists that feverfew could lower fevers. After a while they noticed that it didn't work, and then angrily rejected feverfew as a useless herb! Feverfew remained out of fashion until a serendipitous event occurred in the late 1970s.

At that time, the wife of the chief medical officer of the National Coal Board in England suffered from serious migraine headaches. When workers in the industry learned of this fact, a sympathetic miner suggested she try a folk treatment he had used. She followed his advice and chewed feverfew leaves. The results were dramatic: her migraines disappeared almost completely.

Her husband was impressed, too. He used his high office to gain the ear of a physician who specialized in migraine headaches, Dr. E. Stewart Johnson of the London Migraine Clinic. Johnson subsequently experimented with feverfew in his practice and seemed to observe good results. This led to the studies described below.

Five meaningful double-blind, placebo-controlled studies have been performed to evaluate feverfew's effectiveness as a preventive treatment for migraines. The best of the positive trials used a feverfew extract made by extracting the herb with liquid carbon dioxide. Two other trials that used whole feverfew leaf also found it effective; however, two studies that used feverfew extracts did not find benefit.

In a well-conducted 16-week, double-blind, placebo-controlled study of 170 people with migraines, use of a feverfew extract at a dose of 6.25 mg 3 times daily resulted in a significant decrease in headache frequency as compared to the effect of the placebo treatment. ² In the treatment group, headache frequency decreased by 1.9 headaches per month, as compared to a reduction of 1.3 headaches per month in the placebo group. The average number of headaches per month prior to treatment was 4.76 headaches. The extract used in this study was made utilizing liquid carbon dioxide.

A previous study using the same extract had failed to find benefit, but it primarily enrolled people with less frequent migraines. ³ Two other studies used whole feverfew leaf and found benefit. The first followed 59 people for 8 months. ⁴ For 4 months, half received a daily capsule of powdered feverfew leaf; the other half took placebo. The groups were then switched and followed for an additional 4 months. Treatment with feverfew produced a 24% reduction in the number of migraines and a significant decrease in nausea and vomiting during the headaches. A subsequent double-blind study of 57 people with migraines found that use of feverfew leaf could decrease the severity of migraine headaches. ⁵ Unfortunately, this trial did not report whether there was any change in the frequency of migraines; it is possible, therefore, that this study actually showed a symptom-reducing effect rather than a preventive benefit.

One study using an alcohol extract failed to find benefit. ⁶

The tested liquid-carbon-dioxide feverfew extract is taken at a dose of 6.25 mg 3 times daily. To replicate the dosage of feverfew used in the two positive studies of whole leaf described above, take 80 to 100 mg of powdered whole feverfew leaf daily.

1. Castleman M. The Healing Herbs: The Ultimate Guide to the Curative Power of Nature's Medicines. Emmaus, PA: Rodale Press; 1991:173-176.
2. Diener H, Pfaffenrath V, Schnitker J, et al. Efficacy and safety of 6.25 mg t.i.d. feverfew CO-extract (MIG-99) in migraine prevention - a randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia. 2005;25:1031-41.
3. Pfaffenrath V, Diener HC, Fischer M, Friede M, Henneicke-von Zepelin HH, Investigators. The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis--a double-blind, multicentre, randomized placebo-controlled dose-response study. Cephalalgia. 22(7):523-32.
4. Murphy JJ, Heptinstall S, Mitchell JR. Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet. 2(8604):189-92.
5. Palevitch D, Earon G, Carasso R. Feverfew ( Tanacetum parthenium ) as a prophylactic treatment for migraine: a double-blind, placebo-controlled study. Phytother Res. 1997;11:508-511.
6. De Weerdt CJ, Bootsma HPR, Hendriks H. Herbal medicines in migraine prevention. Randomized double-blind, placebo-controlled crossover trial of a feverfew preparation. Phytomedicine. 1996;3:225-230.