Butterbur: Ancient Remedy, Practical Uses (September 2024)

A surprising number of people use butterbur to prevent migraines and ease seasonal allergy symptoms. In September 2024 we published a clear look at what butterbur does, how people used it for centuries, and practical safety steps you can take before trying it.

What butterbur is and how it works

Butterbur (Petasites hybridus) is a plant that’s been used historically for pain and breathing problems. Modern extracts target two main uses: migraine prevention and relief from allergic rhinitis (hay fever). Clinical trials using standardized, PA-free extracts reported fewer migraine attacks and reduced nasal symptoms compared to placebo. That’s why some healthcare providers consider it an option when other treatments aren’t working well.

The active compounds often named are petasin and isopetasin. They seem to reduce inflammation and spasms in blood vessels and airways, which explains the benefit for headaches and congestion. The results in trials were noticeable for people who stuck with a regular dose over several weeks.

Safe use, dosing, and picking a product

Safety matters more than hype. Raw butterbur contains pyrrolizidine alkaloids (PAs), which can damage the liver. Always choose a product labeled "PA-free" or "pyrrolizidine-alkaloid free." Some brands used in clinical studies, for example Petadolex, make PA-free extracts. That doesn’t guarantee total safety, but it cuts the biggest known risk.

Typical trial doses were in the range of 50–75 mg taken twice daily of a standardized PA-free extract. People often start at the lower end, watch for side effects (stomach upset, tiredness, or allergic reaction), and track symptoms for 6–12 weeks to judge benefit. Don’t use butterbur if you’re pregnant, breastfeeding, or have known liver disease. Also check with your doctor if you’re on other medicines.

Practical buying tips: buy from reputable brands that state PA-free and show extract strength on the label; prefer standardized extracts (they’ll list petasin content); look for third-party testing or a quality seal; and avoid homemade or foraged preparations.

If you try butterbur, keep a simple diary: dose, day, headache frequency/intensity or allergy symptoms, and any side effects. That gives you and your clinician data to decide if it helps. The September piece focused on providing these exact steps so readers can make safer, more useful choices when considering butterbur.