The hybrid BUTTERBUR or bog rhubarb, PETASITES HYBRIDUS = PETASITES OFFICINALIS, ASTERACEAE is a plant native to Eurasia but present in North America.
Butterbur grows in damp and shady places: banks of rivers or streams, swamps, wet meadows.
It is a plant recognizable by its large leaves which appear after the development of the floral stem, it is perennial by its rhizome.
Its very particular aspect makes it an ornamental plant, but it is considered invasive.
Butterbur, has been included in traditional European pharmacopoeia for a very long time.
It is still registered on the B list of the French pharmacopoeia (list of plants whose disadvantages exceed the advantages ).
Butterbur is nevertheless a plant used in herbal medicine in british and german speaking countries mainly to prevent migraine attacks, reduce allergic rhinitis (hay fever) and asthma .
All parts of the plant are medicinal.
PETASITES JAPONICUS , giant or great butterbur, is traditionally eaten (after a special preparation)in Asia.
BUTTERBUR PETASITES HYBRIDUS MIGRAINE HAY-FEVER ALLERGIC RHINITIS ASTHMA DYSMENORRHEA SPASMS PETADOLEX
CHEMICAL COMPOSITION AND PROPERTIES
The main constituents are:
- Sesquiterpenes: the most important are petasin and isopetasin which are used to titrate extracts of butterbur.
- Anti-inflammatory flavonoids like quercetin.
- A small amount of pyrrolizidine alkaloids which are known to be toxic to the liver and which are probably mutagenic (carcinogenic). Butterbur leaves contain a lower percentage of alkaloids than the rhizome.
- Mucilaginous substances and tannins.
- A little essential oil dominated by dodecanal with a floral scent that can remind of lilac.
The anti-migraine properties of butterbur are attributed to sesquiterpenes mainly petasin and isopetasin.
These compounds have an anti-inflammatory effect by probable inhibition of the synthesis of leukotrienes and of the cyclooxygenase enzymes (COX-1 and COX-2) important actors in inflammatory processes because they participate in the synthesis of prostaglandins.
Petasin and isopetasin are also useful for treating other pathologies involving leukotrienes and prostaglandins: bronchial asthma, dysmenorrhea, allergic rhinitis, asthmatic cough of allergic origin.
In addition, the sesquiterpenes of butterbur are antispasmodics of smooth fibers, they can relieve spasms of the biliary and urinary tract and the digestive system.
USES
MIGRAINE PREVENTION
MIGRAINE is a very widespread painful affection which affects for example approximately 10% of the French population: headache sometimes very painful, throbbing, generally on one side (unilateral), appearing by crisis, often preceded by visual disturbances and accompanied by digestive disorders.
Prevention takes place over several months (at least 6 months), so treatment should be as harmless as possible. Butterbur extracts has long been known for their ability to reduce headaches, but the presence of toxic alkaloids reduces their use over time.
A modern extraction process (supercritical CO2) makes it possible to obtain butterbur extracts rich in petasin and containing (according to laboratory indications) no detectable hepatotoxic alkaloid.
There are modern synthetic drugs that manage to alleviate the migraine attack (triptans) but the prevention of these migraine attacks is difficult and requires drugs that have side effects or which in some cases cannot be used ( examples: beta-blockers in asthmatics, anti-inflammatory drugs (NSAIDs) in people with stomach ulcers or gastritis).
The specialty, « PETADOLEX », is marketed in Germany and the USA and can be found on the internet but not in pharmacies in France, at least on the date of publication of this page.
Several double-blind studies show an average preventive effect at a dose of twice 75 mg of extract per day, which is more than what is recommended by the laboratory.
North American migraine specialists consider this petaside extract to be one of the best non-drug preventive treatments for migraine, despite the possible but very low risk of reversible liver problems or more severe hepatitis.
ALLERGIC RHINITIS HAY-FEVER
« Hay fever » is an « allergic » condition but with inflammatory manifestation.
Leukotrienes and prostaglandins play an important role in the production of symptoms: mucosal hypersecretion, mucosal inflammation, vascular congestion.
Treatment with a non-sedating antihistaminic is standard but is often accompanied by a tendency to sleep which can be bothersome or even dangerous when driving.
An alkaloid-free butterbur leaf extract, Ze339 ™, is marketed in Switzerland and a few other countries to treat seasonal allergic rhinitis. It has other trade names: « tesalin », « Zarbee’s Naturals Seasonal Relief ».
The recommended DOSAGE is 20 mg of butterbur leaf extract twice daily
ASTHMA, DYSMENORRHEAS
Asthma or asthmatic cough may also benefit from treatment with butterbur extracts.
Dysmenorrhea is initiated by a release of prostaglandins, and butterbur extracts may also be useful.
DOSAGE: « Petadolex » 50 mg twice a day.
DIGESTIVE BILIARY URINARY SPASMS
The total extracts of butterbur (especially alcoholic tincture of the rhizome) are known for their ability to lift spasms of smooth fibers: hepatic colic, renal colic, digestive spasms.
But we do not recommend them because of the presence of toxic alkaloids.
ABSTRACT
PETASITE, BUTTERBUR, A PLANT AGAINST MIGRAINE AND HAY FEVER
Butterbur is a decorative plant for humid areas which contains anti-inflammatory components active on migraine, hay fever and asthma.
Until now, the presence of toxic alkaloids has limited its use, but modern extraction techniques allow them to be eliminated.
Copyright 2021 : Dr Jean-Michel Hurtel
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