I’ve written here before about migraines. Grace was plagued by migraines during the prodromal phase of the disease onset (that feels like a redundancy). Migraines are the bane of my existence. My neurologist jumps through whatever hoops neurologists jump through in order to try to keep mine in check. I have a “migraineur’s brain” meaning that I have T2 lesions on my brain that show up on an MRI. Migraines cause lesions on the brain. Scary thought. Neurologists call it “scar tissue”. I don’t know about you, but I don’t want scar tissue on my brain. I don’t want Grace having scar tissue on her brain.
What can we migraineurs do about it?
I’m on a shit ton of medication which works prophylactically to prevent migraines, and, even though I still get them, it works 50% of the time in a bad month when stress is sky high and 75% when life is holding. That’s not bad.
Could it be better? Sh’yeah!
I have reached a somewhat desperate state. I went to the emergency room at 2 AM this morning because my migraine was beyond self-help. It was at a 9 or 10 on the pain scale, and, once the barfing starts, it won’t stop. The good people of my local ER were on it, and I was home by 5:30 AM sans any pain at all.
This is no way to live. So, if you live with chronic migraine disease, what can you do? My neurologist puts me on prednisone from time to time in an attempt to arrest a migraine that might feel like sticking around. That didn’t work this time. I’m on prednisone now, and that is not a drug one wants to be on. Side effects, anyone?
Let’s talk about an alternative treatment. Butterbur and feverfew.
In 2012, the American Academy of Neurology (AAN) updated its guidelines on migraine prevention to include complementary treatments. Based on reviews of clinical studies, the AAN recommends:
- Butterbur (Petasites hybridus). Butterbur is a traditional herbal remedy used for many types of ailments, including migraine. The AAN considers butterbur “effective” and recommends it be offered for migraine prevention. Butterbur was the only non-drug treatment ranked by the AAN as having the highest proof of evidence (Level A) for effectiveness. Butterbur may cause an allergic reaction in people who are sensitive to ragweed and related plants.
- Feverfew. Feverfew is another well-studied herbal remedy for headaches. The AAN ranks feverfew as “probably effective” (Level B evidence) and recommends that it be considered for migraine prevention. Pregnant women should not take this herb as it may potentially harm the fetus.
- Riboflavin (Vitamin B2) and Magnesium. Riboflavin and magnesium are the two vitamin and mineral supplments ranked by the AAN as “probably effective”. Vitamin B2 is generally safe, although some people taking high doses develop diarrhea. Magnesium helps relax blood vessels. Some studies have reported a higher rate of magnesium deficiencies in some patients with migraine..
German doctors have been using butterbur as a prophylactic treatment for migraine with great success since the 1980s. It is a widely recommended and known treatment in Germany and other European countries. My neurologist may not know about this nor has she recommended magnesium to me. She has recommended vitamin D due to low vitamin D levels being linked to inflammation.
The thing to note about butterbur is a pesky alkaloid that is toxic to your liver–pyrrolizidine alkaloids. They are indicated on butterbur supplements as PA, and all butterbur supplements should say “PA-free”. I note this because there was a change in a German company’s manufacturing process a few years ago, and their butterbur supplement, Petadolex, suddenly became contaminated with those pesky alkaloids. A review and subsequent testing of the supplement revealed that the hepatoxic alkaloid compounds were still present in the supplement, and Germany removed the supplement from the market; Switzerland banned the sale of all butterbur supplements altogether. There are, however, other companies that produce butterbur supplements other than Weber and Weber, the German-based company who failed the investigation. Oddly enough, you can still buy Weber and Weber’s butterbur supplement on Amazon, so beware.
This is a case of throwing out the baby with the bathwater (Switzerland, I am talking to you). Everyone in the know is aware of hepatoxic alkaloids in butterbur. Why the American Headache Society is attempting to formulate a stance on it is beyond me unless it just doesn’t want anyone taking butterbur at all to prevent litigious action. In the end, you need to be smart. If our doctors have us taking a plethora of drugs in an attempt to manage our pain, then why not look at butterbur as well? Have you read the side effects of these anticonvulsants, steroids, and triptans? Nothing is very good here.
In the meantime, here is an excellent butterbur supplement that is PA-free and also contains feverfew and magnesium. It’s wheat-free, gluten-free, and even vegetarian.
Do some research for yourself if you struggle with migraines. There are complementary treatments. Sometimes we have to be the ones to find them.
Preventing Migraine Pain with Butterbur (great article)