Feverfew
Cochrane-reviewed traditional remedy for migraine prevention: modest but real effect with a stable extract.
Why
Feverfew (Tanacetum parthenium) has been used in European phytotherapy for headache and 'fever' for centuries. The Cochrane review of feverfew for migraine prevention reported a modest reduction in migraine frequency with the stable CO2 extract (MIG-99) versus placebo. Effect is smaller than topiramate or propranolol but the side-effect profile is benign.
How it works
Parthenolide and related sesquiterpene lactones inhibit serotonin release from platelets, dampen prostaglandin and leukotriene synthesis, and inhibit NF-κB, collectively reducing the trigeminovascular inflammatory cascade implicated in migraine.
Expected onset · Prophylactic effect emerges over 6–12 weeks of daily use; not an acute migraine treatment
How to take
Dosage
Stable CO2 extract (MIG-99): 6.25 mg three times daily, the dose used in the larger RCTs. Dried leaf: 50–125 mg daily of a preparation standardised to 0.2–0.4% parthenolide.
Timing
Divided dosing across the day
On the label
Look for the MIG-99 stable CO2 extract or a parthenolide-standardised dried leaf; non-standardised feverfew is highly variable.
Ideal for
Adults with episodic migraine looking for a low-risk prophylactic, especially when standard prophylaxis is declined or not tolerated.
Safety
Evidence
Cochrane 2015 SR (6 RCTs, n=561): the stable MIG-99 CO2 extract reduced migraine frequency more than placebo: modest but consistent direction. Diener 2005 Cephalalgia RCT (n=170): 6.25 mg MIG-99 three times daily significantly reduced migraine frequency over 16 weeks. Effect smaller than first-line prophylactics; favourable safety profile.
Where to get it
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