Butterbur (Petasites hybridus)
What it is
One of the few herbal supplements with strong evidence for migraine prevention. AAN and AHS guidelines previously recommended 150 mg per day based on trials showing a 48 percent reduction in migraine frequency. However, raw butterbur contains pyrrolizidine alkaloids that cause liver damage. Only PA-free certified extracts (like Petadolex) are safe. Product was withdrawn from German market in 2009 over quality concerns. Use only PA-free brands.
Dose
75 mg PA-free extract twice daily for migraine prevention; ONLY use certified PA-free products
Time of day & tips
Take with food. Only use PA-free certified products. Twice daily with meals. Avoid if you have ragweed allergy — possible cross-reaction.
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