Tanacetum parthenium - Feverfew

Description

This composite plant has numerous, small, daisy-like inflorescences, consisting of yellow heads and white rays. The central floret is nearly flat (not conical like chamomile). The stems are hairy, about .3 - .7 m tall; leaves alternate, downy with short hairs or nearly smooth — about 10 cm long and 5 cm wide, bipinnafided, with serrated margins, petioles flat above and convex beneath. Feverfew has a bitter smell, being particularly disliked by bees. Pyrethrum, an alternative genus name, is derived from the Greek pur (fire), due to the hot taste of the root. Feverfew is thought to be a corruption of the word febrifuge, from its tonic and fever dispelling properties.

Parts Used

All aerial parts, but mostly the leaves.

Constituents

This plant is rich is sesquiterpene lactones (with a-methylenebutyrolactone structures) specifically parthenolide (0.1 - 0.9%), others including, 3-beta-hydroxyparthenolide, seco-tanapartholides A & B, canin (chrysartemin A), artecanin, epoxyartemorin and others. There are several other sesquiterpenes that are more volatile, such as camphor, farnesene and germacrene as well as monoterpene volatile oils such as pinene, bornyl acetate and bornyl angelate. There is only one species of Feverfew, but the main constituent — parthenolide — varies greatly in the various biotypes. There are some biotypes, e.g. those from Mexico and East Serbia, which have no sesquiterpenes. The Canadian Health Protection Branch states that the concentration should be no less than 0.2 % parthenolides to be recognized for migraine claims. Accurate assaying of this herb is therefore very important.(1-5) Published assay methods include parthenolide analysis by HPLC, sesquiterpene lactone identification by infrared spectroscopy.

Mode of Action

The most well-studied use of Feverfew is its ability to stop or reduce migraine. The exact mechanism has not been worked out, yet what is known is that Feverfew inhibits blood platelet aggregation and secretory activity in platelets and polymorphonuclear leucocytes. The migraine prophylactic action is thought to be due to a serotonin (5-HT) antagonist action, inhibiting its release into the blood, thus reducing platelet aggregation. This might be due to neutralizing of sulphydryl (thio) groups on specific enzymes that are fundamental to platelet aggregation and secretion. This mechanism is thought to be due to the a-methylenebutyrolane group as this group is known to have anti-inflammatory action. Serotonin is the most important vasoactive amine mediating vascular headaches, while also acting to lower pain threshold. Feverfew has been shown to inhibit prostaglandin biosynthesis, interfering with the action PA2 at the beginning of the arachidonic acid cascade rather than at the cyclo-oxygenase stage. Parthenolide has been shown to markedly interfer with both contractile and relaxant mechanism in blood vessels.(6,7) One authority (D Awang) now feels that parthenolide is not the active constituent, or at least not the sole active ingredient, as one study showed no clinical results for migraine when there was adequate amounts of pathenolide.(8)

The anti-inflammatory action of Feverfew has been demonstrated in clinical settings continuously. This is probably due to inhibition of the release of damaging material from white blood cells in the inflamed area. The inflammatory action of Feverfew has been disputed in a double-blind study on rheumatoid arthritis patients. This study showed little effect. In this study, patients took only small amounts of Feverfew (75 mg dried herb) along with ASA, which may have reduced the effectiveness of Feverfew. The amount of parthenolides varies greatly between ecotypes. Some ecotypes have no parthenolides. This herb depends on the parthenolides as well as possibly other constiuents for its mode of action. Feverfew, therefore, should only be used for the above conditions when these active constituents are of a guaranteed potency.

Therapeutic action

Aperient, febrifuge, carminative, bitter, stimulating emmenagogue, tonic, nervine.

Energetics

Holmes describes it as bitter and a bit pungent with cool and dry properties; with secondary characteristics of restoring, stimulating and relaxing. It enters into the Spleen, Liver, Kidney, Bladder, Chong and Ren meridians. Holmes also suggests Feverfew can be used for treating liver Qi stagnation. It is also used for nervous ailments when there is damp/cold obstruction. (9) Tierra lists Feverfew as bitter, cool and affecting the Stomach and Liver meridian.(10)

Folklore

This herb has been used since the time of Dioscorides (78 A.D.) for fevers, coughs, colds and for wheezing. Gerard (1597) described it as hot and dry noting that it ``cleanseth, purgeth or scoureth, openeth and fully performeth all that bitter things can do``. John Quincy (1719) used it as an emmenagogue, considering it a `hystericks` for the uterus as well as giddiness. We find scattered uses throughout the ages but few are as specific as what Culpeper said ``it is very effectual for pain in the head``.(11) It has a long history being used for migraine and arthritis as well as nervousness and lowness of spirit due to female complaints. Some of the uses that have been recorded are anemia, earaches, dysmenorrhea, dyspepsia, trauma, and intestinal parasites. The tincture of the extract relieves the pain and swelling caused by insect bites. Feverfew has been used in the garden to control noxious pests, but can also inhibit bees from pollinating nearby plants.(12-14)

Dosage

(may vary due to sesquiterpene content)
Dried leave or infusion - 1 - 2 g
Tincture (1:5, 25% ethanol) - 4 - 6 ml
Fluid extract (1:1) - 1 - 2.0 ml
Powder solid extract (4:1) - 100 - 500 mg

Toxicity and Contraindications

There has been no toxicity found in the studies observed. This herb has been used for centuries without ill-effect. Some sensitive people have been known to get mouth ulcerations from chewing the fresh leaves. Skin rashes have also been noticed in some sensitive pickers. This herb is contraindicated in the last stage of pregnancy, even though some caution is appropriate for its use throughout the whole pregnancy, because of its ability to inhibit arachidonic acid (necessary for uterine contractions).

Official Recognition and Medical References

UK - No product license granted
France - Accepted for specific indications ( No. 90/22 bis)
Canada - DIN available if parthenolide content is above 0.2%
PDR for Herbal Medince - p. 1171
Escop - March 96

References

1. Bradley, P.R., British Herbal Compendium (Volume 1), British Herbal Medicine Association, Bournemouth, Dorset, U.K., 1992, p. 96.
2. Murray M; The Healing Power of Herbs; Prima; Rocklin CA; 1992, p. 188
3.Tyler, V.E., Herbs of Choice , Pharmaceutical Products Press, New York, NY, 1994, p. 126.
4.Duke, J.A. CRC Handbook of Medicinal Herbs, CRC Press, Boca Raton, FL, 1985, p. 118.
5. Awang, D.V.C., Feverfew , Pharm. J. and Can Pharm J 1989, p. 122, 266-270.
6. ESCOP Monographs on the Medincinal Uses of Plant Medicne ; Tanaceti parthenii Herba; March 1996.
7. Leung, A.Y. and S. Foster, Encyclopedia of Common Natural Ingredients: Used in Food, Drugs, and Cosmetics, John Wiley & Sons, Inc., New York, 1996, p. 246.
8.Awang D; Parthenolide: The Demise of a Facile Theory of Feverfew Activity; Journal of Herbs, Spice and Medicinal Plants; Vol 5(4) 1998, 95-98.
9. Holmes, P., The Energetics of Western Herbs (2 volumes), Artemis Press, Boulder, CO, 1989, p. 283.
10. Tierra, M., Planetary Herbology, Lotus Press, Sante Fe, NM, 1988, p. 159.
11. Holmes, P., The Energetics of Western Herbs (2 volumes), Artemis Press, Boulder, CO, 1989, p. 283.
12. Grieve, M. A Modern Herbal , Jonathan Cape Ltd., London, 1931, p. 310.
13. Murray, Ibid
14. Duke, J.A. Ibid.