Common Names: Butterbur, Petasites, Purple Butterbur
Latin Names: Petasites hybridus (also known as Petasites officinalis or Tussilago hybrida)
Background: Butterbur is a shrub that grows in various regions, including Europe, Asia, and North America. It derives its name from its historical use of large leaves to wrap butter in warm weather. In the past, butterbur was employed for various medicinal purposes, such as treating plague, fever, cough, asthma, and skin wounds. More recently, it has gained attention as a dietary supplement for addressing conditions like urinary tract symptoms, stomach upset, headaches (including migraines), allergic rhinitis (hay fever), and other ailments.
How Much Do We Know? There have been a limited number of studies investigating the effects of butterbur on migraines and allergic rhinitis (hay fever) in humans, providing some insights into its potential benefits and risks.
What Have We Learned?
- Migraines: Butterbur has shown promise in reducing the frequency of migraines in both adults and children. In 2012, the American Academy of Neurology recommended its use for migraine prevention. However, this recommendation was revoked in 2015 due to concerns about potential liver toxicity associated with butterbur consumption.
- Allergic Rhinitis: While some studies suggest that butterbur root or leaf extracts may help alleviate symptoms of hay fever (allergic rhinitis), the overall evidence is not conclusive.
- Somatoform Disorders: There is one study indicating that a combination product containing butterbur might have a positive impact on anxiety and depression in individuals with somatoform disorders, which involve physical complaints without a clear physiological basis.
- Other Conditions: Butterbur has not demonstrated significant efficacy in treating conditions such as allergic skin reactions, chronic obstructive bronchitis, insomnia, upset stomach, urinary tract symptoms, asthma, and other health issues.
What Do We Know About Safety?
- Some butterbur products contain pyrrolizidine alkaloids (PAs), which can be harmful to the liver, lungs, and blood circulation and may potentially lead to cancer. Only butterbur products that have undergone processing to remove PAs and are certified as PA-free should be considered safe for use.
- In some countries, concerns about liver toxicity have led to the withdrawal of butterbur products from the market.
- Due to safety concerns, some experts recommend against the use of butterbur for migraine treatment.
- The safety of applying butterbur products to the skin is not well established.
- Studies, including those involving children and adolescents, have suggested that PA-free butterbur products taken orally at recommended doses for up to 16 weeks are generally safe. However, not all products claiming to be PA-free may truly be so. For instance, Petadolex, marketed as a PA-free butterbur product, has been associated with liver damage in some cases, raising questions about its actual PA content. The long-term safety of butterbur use remains uncertain.
- Butterbur products containing PAs should not be used during pregnancy or while breastfeeding, as they may pose risks of birth defects or liver damage. The safety of using PA-free butterbur during pregnancy or while breastfeeding is not well understood.
- PA-free butterbur is typically well tolerated but can lead to side effects such as belching, headache, itchy eyes, diarrhea, breathing difficulties, fatigue, upset stomach, and drowsiness.
- Individuals with sensitivities to plants like ragweed, chrysanthemums, marigolds, and daisies may experience allergic reactions to butterbur.
Keep in Mind: If you plan to use butterbur or give it to your child, it’s important to discuss this with your healthcare provider. They may consider monitoring liver function in individuals using butterbur. Taking an active role in your health and having open discussions with your healthcare providers about complementary health approaches can help ensure well-informed decisions and safe use.