Feverfew for acute headaches: does it work?

We often hear in naturopathic circles that feverfew is great for preventing recurrent headaches, but not so effective at treating a headache once it's begun. My own clinical experience, however, has shown me that feverfew can be very effective in the treatment of acute headaches.

Case #1.

A 14 year-old female called the office in June, 1995, complaining of a sudden onset of visual symptoms that consisted of "weird lights" flashing in her eyes followed by acute head pain. She had no previous history of migraines. I recommended she take 30 drops of feverfew every 15 minutes for 4 doses and call back if she was no better within the hour. I was her a few days later at which time she told me she'd experienced immediate relief of her symptoms within 2 doses of the feverfew.

Case #2

A 33 year-old female I first saw in May of 1995 came in complaining of daily headaches since moving from British Columbia two months earlier. She was also experiencing irregular bowel movements, mild acne, and lower energy than usual. The headaches were dull, but once every two weeks she would get a severe headache. She was given feverfew 30 drops twice a day and instructed to increase the dose to 60 drops every 15 minutes for acute headache. I also placed her on a homeopathic remedy, Natrum muriaticum, which fit her general symptoms and is a good remedy for headaches. She also received a lipotrophic factors formula (Eclectic Institute) as I felt her bowel irregularity, increased acne, and headaches suggested some need for liver support. On her return visit she reported a decrease in the number of headaches which had gone from daily to every 3-4 days. This might be attributed to the feverfew or the Natrum muriaticum.

She also reported increased energy, a decrease in her acne and more regularity with her bowels. She said that when headaches did occur, she took 60 drops of the feverfew tincture every 15 minutes and that the headache would usually be gone in three doses. She reported that the tincture did not work as well for really severe headaches, but that it did lessen the pain significantly. This is consistent with reports from other patients, some of whom tell me that once the headache has gotten really severe, nothing seems to completely eradicate the pain, but that feverfew, taken often enough, works as well as ibuprofen in lessening the intensity of the headache.

Case #3

A 45-year-old woman with chronic fatigue and fibromylagia first came to see me in October of 1994. She said she'd had headaches for as long as she could remember and suffered from head pain 90% of the time. Severe headaches, when they came, were usually left-sided, with throbbing sharp pains "like a lightening bolt" shooting from the neck to the front of the head. They were often preceded by an aura of flashing lights. She was given Natrum muriaticum homeopathically, as well as the following tincture:

Taraxacum (dandelion root) 3 parts

Glycyrrhiza (licorice root) 2 parts

Eleutherococcus (eleuthero root, "Siberian ginseng") 2 parts

Silybum (milk thistle seed) 1 part

To be taken 30 drops three times a day for liver and adrenal support. Feverfew was given in a dose of 30 drops three times a day with instructions to increase her dose to 60-120 drops every 15 minutes in case of acute headaches. On return visit 2 weeks later, she reported that the headaches were still constant, but less severe, and that if she took the feverfew 4-6 times a day, it seemed to lessen the pain. Her energy was slightly better. I increased her feverfew to 60 drops three times a day, and on return visit she said she felt the consistently increased dosage was helping her and that the headaches were occurring with less frequency. By January of 1995, her headaches were down to 1-2 per week, occurring only when under stress, and lasting only 1-2 days rather than the 5-9 days previously. By April, she said she could go over a week without a headache, but that about once a week she still experienced pretty severe headaches. At that times she reported that 1 tsp of feverfew tincture repeated every 30-60 minutes helped with some relief after the first dose and complete relief in two doses. When I spoke with her recently, I shared with her that most practitioners feel that feverfew is hot helpful for acute headaches but only for preventing headaches. Her response was dramatic.

"Well!" she said. "those doctors should talk to the people who take feverfew!"

Case #4

A 35 year-old female first seen in October 1994 came in complaining of "headaches and weird digestion" for 4-5 years. She stated that she had a tendency to get diarrhea after eating lettuce, spicy or fatty foods, or raw broccoli or onion. She would also get diarrhea and rumbling if she was anxious. Headaches occurred once per week and could be quite severe with throbbing pain and a feeling like her "head would explode." She was placed on homeopathic Lycopodium, and feverfew 30 drops twice a day. She was also given a tincture:

Taraxacum (dandelion) 3 parts

Avean (oats) 1 part

Eleutherococcus (Siberian ginseng) 2 parts

Silybum (milk thistle seed) 2 parts

The eleutherococcus was given as a general tonic for her adrenals as she was under a lot of stress, and the avena was given as a nutritive nerve tonic. The taraxacum and silybum were given for liver support, as colon symptoms such as she was experiencing often stress the liver. On follow-up visit 4 weeks later, she reported that her gastrointestinal symptoms were better almost immediately with the homeopathic Lycopodium, and that she had only has 2 headaches since her first visit, which were totally alleviated by feverfew 30 drops given once then repeated one hour later. She still gets occasional headaches and reports that 30 drops of feverfew in 1 or 2 doses stops the pain every time.

Because feverfew is such a strong bitter, it is well-indicated for gastric or "bilious headaches." It also has a strong reputation for being helpful in migraine headache, and as some of the previous cases illustrate, it does not often fail us here even in acute pain. These days, I usually combine feverfew with lavender, a relaxing nervine which really softens the harsh warrior energy of the feverfew.

Comment

Feverfew is one of my pet-peeve herbs. It is a perfect example of an herb whose uses have been reduced because of scientific research. Traditionally is has been used in both acute and chronic headache, in fevers, in menstrual complaints, and in arthritis. It is a warming, pungent, diaphoretic herb, stimulating circulation, and thus breaking up "stagnant-blood", whether accumulated in the head, the joints, or the uterus. It also has a strong effect on an "irritable" nervous system, in the language of the Eclectic physicians of the last century. Dr. William Cook (1869) recommends it for conditions after exposure to cold, including "when the menstrual secretion has been choked from exposure," and for symptoms of "hysteria,' (read PMS). Ever since recent research into its effect on migraine headache, it has been pidgeonholed as a "migraine" herb, and its potential gynecological uses have been lost from view. Because it is a warming, pungent herb, presumably it could make conditions of true inflammation worse.

My only comment on these specific cases is that the dose of eleuthero root is low in the cases where it is used. The use of eleuthero root as a tonic and adaptogen was learned from the Russians after they did screening research on Aralia family plants looking for ginseng analogues. The root bark (but not the root) of eleutherococcus was used in traditional Chinese medicine, interchangeably with at least thirteen other plants that have had the same Chinese name wu jia pi. The root bark is not used as a tonic, but as a wind-damp-dispersing herb for treatment of arthritis. The Russian research discovery, and the subsequent Russian product that is widely popular as an adaptogen in Russia today, is a 1:1 tincture of the whole root in 30% alcohol. The dose is 2-20 ml/day for thirty days. Many of its famed benefits will be lost with lower doses, weaker tinctures, or shorter periods of use. The only product I know of that uses the Russian specifications is one by HerbPharm, which then uses vacuum technology to concentrate it to double strength.

Medical Herbalism.

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By Deborah Frances

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