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Feverfew
Up to 125mg /day of dried leaf standardized to minimum of 0.2% parthenolide is suggested. Used traditionally for headaches, extremely well tolerated. Proposed mechanisms of action vary from inhibiting platelet aggregation, decreasing inflammatory promotors (i.e., prostaglandins or serotonin) or by dampening vascular reactivity. 50 to 82 mg per day was found to be more effective than placebo in three of five trials, but variation among formulations makes dosage recommendation difficult, and study quality was mixed (10). Beneficial effects may take weeks to develop. Aphthous ulcers and gastrointestinal irritation are common side effects. Rebound headache can ensue from abrupt cessation of feverfew. It is not recommended during pregnancy due to prolongation of bleeding times (1).
Butterbur
50 mg three times a day for a month, then 50 mg twice a day (4). Butterbur has been shown to reduce migraine attack by 50% in trials, for at least 4 months duration. The extract was standardized to 15% of the marker molecules (petasins). Excessive belching can be a side effect.
Ginger
Can use tea, or 1 gram powdered four times daily. Ginger is especially helpful for headaches with nausea. An easily prepared tea is as follows:
Approximately 1 inch coarsely chopped ginger root (most groceries have this)
Put in 1 quart jar, fill with boiling water
Steep >10 minutes
Strain out ginger, add honey to taste
Can refrigerate remaining tea to enjoy cold, or reheat in microwave as needed
Valerian (Valeriana Officinalis)
Use up to 250mg tid.(1). Also available in tinctures and dried root for tea. Valerian is specially helpful with anxiety and tension headaches, due to its sedative properties. It should not be used before operating machinery/driving. Some patients have a paradoxical effect: anxiety and restlessness.
Kava Kava (Piper Methysticum)
150 or 200 mg 1 hour before sleep. Kava Kava helps insomnia, agitation and tension. It is a traditional beverage of the southeast Pacific Islands and produces an intoxicating effect. Sedation can cause interference with activities, and patients should be cautioned not to drive.
Other herbs traditionally used for headaches:
Dong quai (Angelica sinensis)
Devil's claw (Harpagophytum procumbens)
Ginkgo biloba (Ginkgo biloba)
Jamaica dogwood (Piscidia erythrina/Piscidia piscipula)
Lavender (Lavandula angustifolia)
Linden (Tilia cordata/platypus ) flowers
Peppermint (Mentha x piperita)
Willow bark (Salix spp.)
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