Feverfew (Tanacetum parthenium L.) belongs to the family Asteraceae (daisies) and is a daisy-like perennial plant found commonly in gardens and along roadsides. The name stems from the Latin word febrifugia, meaning “fever reducer”. Feverfew is native to Europe and Asia Minor, but has been naturalized in many parts of the world. It is a perennial herb that grows up to 60 cm tall, with yellow-green leaves and white flowers.
Traditional medicine
According to a book titled “Herbs and Healers from the Ancient Mediterranean through the Medieval West”, feverfew was used in ancient Roman and Greek medicine for various purposes, such as:
- Reducing fever, hence its name derived from the Latin word febrifugia.
- Treating menstrual disorders, such as amenorrhea (absence of menstruation) and dysmenorrhea (painful menstruation).
- Relieving headaches, especially those caused by heat or sun exposure.
- Healing wounds and ulcers, both internally and externally.
- Alleviating inflammation and pain in joints and muscles.
- Repelling insects and snakes.
Dioscorides, a Greek physician who lived in the first century AD, was the first to describe feverfew in his work “De Materia Medica”, which was a comprehensive encyclopedia of herbal medicine.
From “De Materia Medica”, description of the herb called ARTEMISIA MONOKLONOS, which seems to be the most likely description of Tanacetum parthenium:
Artemisia is of two types: polyclonos and monoclonos. It mainly grows in places near the sea and is an herbaceous plant similar to absinthe, but larger and with larger leaves. There is a type that thrives with larger leaves and stems and another smaller one, with small, thin, white flowers with a strong odor; it blooms in summer. Some (in parts of the Mediterranean) call Artemisia monoclonos a small herb with a thin stem, extremely small, abundant in reddish-yellow flowers. The scent of this one is sweeter than the other. Both warm and relieve. Boiled, they are good to put in women’s baths to eliminate menstrual flow, as an abortifacient, for the closure and inflammation of the uterus, the breaking of kidney stones, and the obstruction of urine. A lot of herb applied in the lower part of the intestine induces menstrual flow and the juice (mixed together with myrrh and applied) extracts as many things from the uterus as the bath; three teaspoons of filaments are given to drink to get out the same things. If someone has Artemisia while traveling, it dissolves fatigue and if worn on the feet it keeps away poisonous beasts and demons. After blood has hardened around the joints, take the larger branches with rosaceum and (having boiled them in a pot) rub the whole body of the sick person with this while going to sleep. It greatly helps congestion of women’s uterus and soothes slow painful urination. It is also called toxetesia, ephesia, anactorios, sozusa, lea or lycophrys; Magi call it sanguis hominis, it is also called chrysanthemon, Romans call it salentia, some serpyllum, others herba regia, rapium, tertanageta or artenisia; Gauls call it ponem and Dacians zuoste.
Feverfew is not a common herb in traditional Chinese medicine or Ayurveda, but it has some similarities and uses with other herbs in these systems. According to some sources, feverfew is:
- Known as Xiao Bai Ju in Chinese, and is used to tonify yin, clear heat, clear wind heat, clear liver heat, and calm. It is mainly used for migraine, headaches, nausea, vomiting, menstrual disorders, fever, dizziness, arthritis, anxiety, and red, itchy skin disorders.
- Similar to chamomile (Matricaria chamomilla; babunah) in Ayurveda, which is also used for reducing fever, inflammation, pain, and spasms, and treating headache, migraine, nausea, vomiting, menstrual disorders, anxiety, insomnia, and skin conditions. Chamomile is considered a sattvic herb that balances all three doshas (vata, pitta, and kapha).
Migraine
Migraine is a common and debilitating neurological disorder that affects millions of people worldwide. It is characterized by recurrent attacks of moderate to severe headache, often accompanied by nausea, vomiting, sensitivity to light and sound, and other symptoms. Migraine can have a significant impact on the quality of life and productivity of sufferers, as well as a high economic burden on the health care system.
There are many treatments available for migraine, such as medications, behavioral therapies, and complementary and alternative medicine. However, some people may not respond well to these treatments, experience adverse effects, or prefer natural remedies. One of the most popular herbal remedies for migraine prevention is feverfew (Tanacetum parthenium L.).
What are the active ingredients and mechanism of action of feverfew?
Feverfew contains several bioactive substances, including sesquiterpene lactones, flavonoids, and volatile oils. The main active ingredients of feverfew are sesquiterpene lactones, especially parthenolide, which are responsible for most of its pharmacological effects. Sesquiterpene lactones are compounds that have anti-inflammatory, anti-allergic, anti-tumor, and anti-microbial properties. Parthenolide is the most abundant and potent sesquiterpene lactone in feverfew.
The exact mechanism of action of feverfew for migraine prevention is not fully understood, but several hypotheses have been proposed. One of them is that parthenolide inhibits the release of serotonin and other inflammatory mediators from platelets and leukocytes, which are involved in the pathogenesis of migraine. Another hypothesis is that parthenolide modulates the activity of nuclear factor-kappa B (NF-κB), a transcription factor that regulates the expression of genes related to inflammation and pain. A third hypothesis is that parthenolide blocks the activation of transient receptor potential ankyrin 1 (TRPA1), a channel protein that mediates nociception and neurogenic inflammation. Other bioactive substances in feverfew, such as flavonoids, have also been shown to have anti-inflammatory and antioxidant properties. These substances work by scavenging free radicals and reducing oxidative stress in the body.
What is the evidence for the efficacy of feverfew for migraine prevention?
Several clinical trials have been conducted to evaluate the efficacy and safety of feverfew for migraine prevention. In a double-blind placebo-controlled pilot study of sublingual feverfew and ginger in the treatment of migraine, at 2 hours, subjects receiving feverfew/ginger showed statistically significant reduction of pain and headache. One study demonstrated significant efficacy of the combination of Tanacetum parthenium and Salix alba (white willow) in reducing not only the frequency of migraine attacks, but also the intensity and duration of pain. In another study, treatment with T. parthenium was associated with a reduction in the mean number and severity of migraine attacks; the duration of individual attacks remained unchanged.