General Description

Feverfew (Tanacetum parthenium) is a composite plant cultivated in flower gardens throughout Europe and the United States. The name feverfew is a corruption of the word febrifuge, signifying its fever-dispelling properties.

Chemical Composition

The major active chemicals in the plant have been hypothesized to be sesquiterpene lactones, principally parthenolide. However, many investigators have found evidence of other active constituents, including both lipophilic compounds (like sesquiterpene lactones) and hydrophilic compounds, although their exact identity has not been determined.^1–3 The flowering herb also contains 0.02% to 0.07% volatile oils (L-camphor, L-borneol, terpenes, and miscellaneous esters).^4,5 Various compounds in the volatile oil have shown pharmacologic activity.⁶

History and Folk Use

Feverfew has been used for centuries as a febrifuge and for the treatment of migraines and arthritis. Other historic uses of feverfew have been in the treatment of anemia, earache, dysmenorrhea, dyspepsia, trauma, and intestinal parasites.⁴ It has also been used as an abortifacient and in gardens to control noxious pests (its pyrethrin component is an effective insecticide and herbicide).

Pharmacology

Feverfew has demonstrated some remarkable pharmacologic effects in experimental studies. Extracts of feverfew have been shown to inhibit the synthesis of compounds that promote inflammation, including inflammatory prostaglandins, leukotrienes, and thromboxanes. No adverse effects reported for feverfew mimic those of aspirin or nonsteroidal antiinflammatory drugs (NSAIDs), suggesting that the effects of feverfew are in some way distinct from those of the drugs. Inhibition of phospholipase A₂ is more like the effects of corticosteroids.⁷

Feverfew also has favorable effects on the behavior of blood platelets in vitro,^7,8 including inhibition of platelet aggregation and the secretion of inflammatory and allergic mediators like histamine and serotonin. Parthenolide components also exert a tonic effect on vascular smooth muscle.⁹

The combined effect on smooth muscle and platelets is probably responsible for feverfew’s effect in preventing and treating migraine headaches.

Clinical Applications

Feverfew has been used for centuries to relieve fever, migraines, and arthritis. The only condition with confirmed scientific documentation at present is in the prevention and treatment of migraine headache.

Migraine Headache

Physician John Hill, in his book The Family Herbal (1772), noted, “In the worst headache this herb exceeds whatever else is known.” A 1983 survey found that 70% of 270 migraine sufferers who had eaten feverfew daily for prolonged periods claimed that the herb decreased the frequency and/or intensity of their attacks.¹⁰