Will butterbur help migraines?

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DEAR DR. GOTT: I have vestibular migraines and my neurologist who specializes in migraines, put me on to an herbal supplement called butterbur. Apparently it has been reported on and recommended in neuro journals. My doctor routinely “prescribes” the use of this supplement. It needs to be processed in such a way as to eliminate the plant’s toxic qualities so one would want to watch for that.

Also, it can be pretty pricey depending on brand and store. I make it a practice to buy from Swanson’s Vitamins online which seems to be a quality company. Under their house branding, they have butterbur for approximately $4.00 for 60 of the 75 mg capsules.

The good report is that butterbur works for me. I have had two or three minor migraines since beginning the 150 mg daily dose my physician recommends. I have talked with two others who use it and they report positive results, as well. One woman said it worked for her for awhile then quit working. So far I’m okay on it and going into my third year taking 75 mg am and 75 mg pm.

Thank you for the mention of the noise sensitivity component of this sort of migraine. That explains an episode I had after a family dinner in a very large, very loud restaurant.

I appreciate your column and am so glad you’re online with it. Thank you.

DEAR READER: Butterbur (also known petasites or purple butterbur) is a shrub which commonly grows in wet, marshy areas in Europe and parts of Asia and North America. It’s name is attributed to the past practice of using the leaves to wrap butter during warm weather.

Historically the plant was used in the treatment of a cough, fever, anxiety, pain, headaches, and gastrointestinal and urinary tract problems. Today, it is most commonly used to treat migraines, asthma, allergic skin reactions and nasal allergies. According to the NCCAM (National Center for Complementary and Alternative Medicine), there is some evidence that butterbur is helpful in treating migraines and allergy symptoms, such as itchy eyes and nasal allergies; however, there is no evidence to support the effectiveness in treating asthma or allergic skin reactions.

Butterbur is usually found in tablet form but the extract is occasionally used as a topical remedy. It is important to only use butterbur that is labeled or certified PA-free. PAs (pyrrolizidine alkaloids) can caused liver damage and resulting serious illness.

Side effects can include allergy, headache, belching, asthma, fatigue, drowsiness, itchy eyes, and gastrointestinal issues, the very same maladies the supplement/extract is taken to correct! It is vital that anyone interested in trying butterbur do so only under the supervision of a physician. It is also important that all your physicians know about every medication, supplement and herbal remedy you are taking, as some can interact and cause potentially serious reactions.

I am passing along your letter in the hopes that other migraine sufferers may be helped. Thank you for sharing.