Butterbur: Benefits, side effects, and risks

Butterbur is a plant extract that some people use as an alternative remedy. However, research into the health benefits of butterbur is limited and there are potential risks of using it, including liver toxicity.

Butterbur comes from a shrub that grows in Europe, Asia, and parts of North America.

Some proponents suggest it may be useful for treating migraine, hay fever, asthma, and more. However, studies evaluating its efficacy and safety for most of these purposes are lacking. Many health organizations advise against using it due to the potential health risks.

This article explores the potential health benefits of butterbur. It also looks at the risks and side effects of this herbal supplement.

The scientific name for the butterbur plant is Petasites hybridus. It grows best in wet marshland, damp forest soil, or on riverbanks.

The term butterbur may come from the fact that people traditionally used its large leaves to wrap butter and stop it from melting in summer.

Butterbur extract comes from the leaf, roots, or bulb of the plant.

The use of butterbur to treat ailments goes back to the Middle Ages.

In the past, the American Academy of Neurology (AAN) recommended butterbur in the treatment of migraine to help reduce the frequency of episodes. This is because previous research suggested it may be a safe and effective treatment for migraine.

However, in 2015, the AAN retracted this guidance due to the potential risk of liver toxicity.

This is because some butterbur products contain chemicals called pyrrolizidine alkaloids (PAs). These chemicals can damage the liver, cardiovascular system, and lungs and may also be carcinogenic (cancer-causing).

Additionally, while the National Center for Complementary and Integrative Health (NCCIH) notes that people should only consider butterbur products that have been processed to remove PAs and are labeled or certified as PA-free, some products may claim to be PA-free when they are not.

The NCCIH also highlights that further research into the safety of long-term butterbur use is necessary.

A 2022 review sponsored by the manufacturers of a butterbur extract-based medication called Petadolex found that, in comparison to a placebo, the medication may significantly reduce migraine attack frequency. The review authors noted that there were no reports of relevant abnormal liver function.

Based on older research, the NCCIH has previously noted an association between the medication and liver damage in some people.

This section explores the other modern uses of butterbur and whether any scientific evidence is available to support them.

The NCCIH notes there is no scientific evidence to support the use of butterbur for:

Some people use butterbur to help treat allergic rhinitis, commonly known as hay fever.

An older 2009 review suggested that while there is some evidence that butterbur may help treat this condition, high quality research is lacking. The study authors noted that further large-scale high quality studies are necessary to determine the safety and efficacy of using butterbur for this purpose.

A 2018 review noted that butterbur may have a neuroprotective effect in mice with Alzheimer’s disease.

However, animal studies have many limitations, and their findings are not always applicable to humans. Therefore, further research into this topic is necessary.

As with any natural remedy, a person should speak with a doctor before taking butterbur, as it may interact with medications they are taking or cause other adverse effects.

Additionally, people should note that the Food and Drug Administration (FDA) does not regulate the quality or sale of butterbur, so it does not undergo the same rigorous testing as medications for specific health conditions.

People may wish to consider the following points before taking butterbur.

While some studies have suggested that butterbur may have potential health benefits, wide-scale high quality research is lacking in most cases. Further research into the safety and efficacy of butterbur is necessary.

Older studies have suggested that butterbur may be beneficial for people with migraine. However, as of 2015, the AAN has recommended against taking butterbur to treat migraine. This is due to the risk of liver toxicity.

The NCCIH suggests that it is only safe to take butterbur products certified as “PA-free,” as they undergo processes to remove the dangerous chemicals.

However, it also notes that there may still be a risk of liver toxicity, even if a person uses butterbur products labeled as “PA-free.”

Side effects of butterbur can include:

The NCCIH notes that butterbur may also cause liver toxicity. Symptoms of liver toxicity can include:

Liver toxicity can be life threatening, so if a person experiences any of the symptoms above, they should contact a doctor immediately.

Butterbur may cause an allergic reaction in people who are sensitive or allergic to other plants, such as:

Previous research suggested butterbur is effective in treating migraine. However, since 2015, the AAN has recommended against taking butterbur for this purpose due to the risk of liver toxicity.

Based on current research, there is little evidence to support the use of butterbur to treat other health conditions.

People should always speak with a doctor before trying any alternative remedies. In many cases, the potential risks outweigh the proposed benefits.