Dr. HingHau Tsang's Crusade on Nutrition
Dr. HingHau Tsang's Crusade on Nutrition
Newsletter #104
--- Butterbur - medicinal herb for migraine, irritable bladder and more
Butterbur has been used medicinally for centuries in Europe, northern Africa, southwestern Asia and North America to treat plague, fever, whooping cough, asthma, stomach cramps, painful menstrual cramps and skin wounds.
Butterbur (Petasides hybridus) is a perennial shrub usually found in wet, marshy ground, damp forests, and adjacent to rivers or streams. The plant can grow to a height of three feet. Its downy leaves can attain a diameter of three feet, making it the largest of all indigenous floras. It is sometimes referred to as "umbrella leaves" due to the size of its foliage. The genus name, Petasites, is derived from the Greek word petasos - the felt hat worn by shepherds. Butterbur is attributed to the large leaves being used to wrap butter during warm weather.
Mechanisms of Action
Extracts of Petasites hybridus are prepared from the rhizomes, roots, and leaves. The active constituents of Petasites have an antispasmodic effect on vascular walls and appear to have an affinity for cerebral blood vessels. Petasites' ability to reduce smooth muscle spasm suggests it may be a useful therapeutic tool in treating migraine headaches, urinary disorders, menstrual cramps as well as other liver or gastrointestinal disorders associated with smooth muscle spasm. The anti-inflammatory properties of butterbur extracts are primarily due to the petasin content and are attributed to inhibition of lipoxygenase activity and down-regulation of leukotriene synthesis.
Clinical Applications of Butterbur
Currently, butterbur are used for prophylactic treatment of migraines headache, Asthma/Bronchitis, Hay Fever (Allergic Rhinitis). It has also been used successfully in treating irritable bladder, urinary tract spasms and other gastrointestinal Disorders
Clinical Studies
Migraine Headache -
Butterbur Extract (Petadolex) Effective in Migraine PreventionIn a study published in the December 28, 2004 issue of the journal Neurology - a proprietary standardized extract of the root of butterbur was effective in preventing migraines in a randomized, placebo-controlled clinical trial of 245 migraine sufferers. This randomized, double-blind, placebo controlled trial was carried out in nine medical centers, including the Departments of Neurology and Epidemiology and Population Health at the Albert Einstein College of Medicine, Bronx, NY; the New York Headache Center, New York, NY; Innovative Medical Research, a Division of Advance PCS, Baltimore, MD; and the Pain Clinic and Christian Albrechts University Kiel and Charite, Department of Neurology, Humboldt University Berlin, Germany. The results of this trial concluded that the use of the proprietary butterbur extract in migraine patients (ages 18 to 65) helped to reduce the occurrence of migraines by an average of 48% during the four months of the trial. This compared to a reduction of only 26% in the group that received a placebo. The herbal extract effects took place early in the trial and lasted throughout. The researchers noted that the efficacy for the butterbur extract was equivalent to the levels of effectiveness shown for conventional pharmaceutical anti-migraine drugs.
Two other double-blind, placebo controlled, clinical studies involved a total of 128 patients using standardized Petasites extract for 12 weeks also demonstrated its effectiveness as a prophylactic treatment for migraines.The results of the two studies showed a significant reduction (as much as 60%) in frequency of migraine attacks compared to placebo. Other improvements included a reduction in the number of days with migraines per month, a decrease in migraine-associated symptoms, and diminished duration and intensity of pain. No adverse reactions were reported in either study. Butterbur extract's high degree of efficacy and excellent tolerability accentuates its value in the prophylactic treatment of migraines.
Butterbur Extract (Petadolex) May Help Children and Adolescents with Migraines
Butterbur root extract shows a potential as an effective and well-tolerated migraine prophylaxis also for children and teenagers."
Pothmann R, Danesch U. Migraine prevention in children and adolescents: results of an open study with a special butterbur root extract. Headache. 2005 Mar;45(3):196-203. This recent study was conducted in five pediatric clinics and 13 medical practices and included a total of 108 subjects. The open-label study included 29 children (ages 6-9 years) and 79 adolescents (10-17 years) who had suffered from migraines for at least 1 year. Depending on age, patients were treated with 50 to 150 mg of the butterbur root extract known as Petadolex for 4 months. The number of migraine attacks in children and adolescents were substantially reduced by the use of the butterbur root extract. After 4 months of treatment, the rate of attacks fell from 9.4 to 4.0 in the 6-9 year olds treated with butterbur and 9.7 to 5.8 in the butterbur-treated 10-17 year olds. Ninety-one percent of patients reported they felt substantially or at least slightly improved after taking the herbal extract for the length of the study.
Iirritable bladder and urinary tract spasms
Nearly 30 million people in the United States, most of them women, have issues with urinary urgency and frequency. This sudden urge occurs when the smooth muscle of the bladder contracts. Difficulty with bladder control has a profound effect on quality of life - causing social, psychological, occupational, physical and sexual frustrations. Butterbur relaxes the detrusor muscle, which reduces pressure on the bladder and thus relieves the urge to urinate.
Butterbur Extract (Petadolex) has been shown to minimize frequency and the sudden urge to urinate. In a human clinical trial conducted in Germany, 24 women were given butterbur for 8 weeks. After three weeks, 17 women reported a significant reduction in the frequency of urination. Before they began taking butterbur, voiding intervals were 30 to 90 minutes, three weeks later the intervals of 17 of the women were between 90 and 150 minutes. (Bauer, H.W. and U. Danesch. 1995. Therapeutische Aspekte in der Urologie mit Petadolex (Therapeutic aspects in the urology with Petadolex) Presse Symposium München 10/18/95. )
Hay Fever (Allergic Rhinitis)
Butterbur Extract (Petadolex) can relieve hayfever symptoms as effectively as antihistamines.
A Swiss and German study of 330 patients reported in the August 22, 2005 online issue of the journal Phytotherapy Research found that butterbur worked as well as the antihistamine fexofenadine (Allegra) for hayfever symptoms such as sneezing, nasal congestion, runny nose and itching. Butterbur was also effective without causing drowsiness, a common side effect of antihistamines. A smaller study reported similar results in 2002. Some were given pills containing butterbur extract, another group received fexofenadine and a third group received a placebo. The leaves and roots of butterbur contain natural chemicals called petasines, which inhibit the body's production of leukotrienes, components of allergic reactions.
In a 2-week, double-blind, placebo-controlled study of 186 people with intermittent allergic rhinitis, use of butterbur at a dose of three standardized tablets (150mg) daily reduced allergy symptoms as compared to placebo.
Another 2-week, double-blind study of 125 individuals with hay fever compared a standardized butterbur extract against the antihistamine drug certizine (Zyrtec). According to ratings by both doctors and patients, the two treatments proved about equally effective.
Asthma/Bronchitis
Butterbur's effectiveness in treating upper respiratory disorders such as asthma/bronchitis and whooping cough is attributed to the antispasmodic properties of the petasin constituent.
The plant's anti-inflammatory action would also help calm the reactive airways seen in both asthma and bronchitis. A Polish clinical study conducted in 1998 examined the influence of Petasites on lung ventilation and bronchial reactivity in patients suffering from asthma or chronic obstructive bronchitis. The study included three test groups and two control groups. Test Group A exhibited an improvement in forced expiratory volume (FEV1) three hours after an oral dose of 600 mg Petasites extract. Group B experienced a significant decrease in bronchial reactivity two hours after receiving an oral dose of 600 mg Petasites extract. Group C patients were treated for 14 days and received 600 mg of the extract three times daily. Some patients (n=10) were also given corticosteroids due to disease severity. All three groups exhibited a decrease in bronchial reactivity, but the patients in Group C who received no corticosteroids had the most pronounced results. These results indicate Petasites (Butterbur Extract) might be helpful in improving lung ventilation in patients with asthma or chronic obstructive bronchitis.
Gastrointestinal Disorders
Butterbur's use as an antispasmodic for gastrointestinal conditions dates back to the Middle Ages to treat spasms of the digestive tract associated with colic, plague, and bile flow obstruction. A German study conducted in 1993 found Petasites hybridus extracts blocked ethanol-induced gastric damage and reduced ulcerations of the small intestine caused by indomethacin, an anti-inflammatory drug used to treat arthritic conditions. The results of this study were attributed to inhibition of lipoxygenase activity and leukotriene biosynthesis.
Warning
Butterbur contains liver-toxic and possibly carcinogenic components called pyrrolizidine alkaloids.
Be sure to use Butterbur Extract (Petadolex) which is guaranteed to be pyrrolizidine alkaloid (PA) free.
Butterbur should not be used by pregnant or nursing women or people with severe kidney or liver disease.
If you are taking any prescription medications consult your physician before using this product.
Dosage
The adult dosage ranges from 50 mg three times a day with meals.
When used to treat migraines, administration is prophylactic and supplementation should be carried out daily for four to six months and then tapered until migraine incidence begins to increase.
References
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