If you deal with migraines or seasonal allergies, you may have heard about butterbur. It’s an herbal extract that some people use to cut migraine frequency or ease hay fever symptoms. That said, raw butterbur contains pyrrolizidine alkaloids (PAs) — compounds that can damage the liver — so the big rule is: only use PA‑free, standardized extracts and talk to your doctor first.
Clinical trials using a PA‑free, standardized butterbur root extract showed fewer migraine attacks for some users. In simple terms, people in those trials had fewer headaches per month compared with placebo. For seasonal allergic rhinitis, butterbur has reduced nasal symptoms in some studies, acting more like a non‑sedating antihistamine for certain users. Results aren’t guaranteed for everyone, but there’s real clinical evidence that a properly processed extract can help.
Safety is the most important part. Don’t use whole plant products or anything that doesn’t explicitly say “PA‑free.” Common study doses were 50–75 mg twice daily of a PA‑free, standardized root extract (look for Petasites hybridus on the label). Try a product consistently for at least 2–3 months to see if it helps. If you notice jaundice, dark urine, severe abdominal pain, or unusual fatigue, stop and see a doctor right away — those can be signs of liver problems.
A few practical points: avoid butterbur if you are pregnant, breastfeeding, or have known liver disease. If you take other medications or have chronic conditions, check with your clinician before starting. People with allergies to ragweed, chrysanthemums, marigolds, or daisies may react to butterbur, so be cautious if you have those sensitivities.
When buying, look for these boxes checked: the label says “PA‑free,” the product is a standardized extract (mentions petasin or standardized amount), and there’s third‑party testing or a reputable manufacturer. Trusted seals include third‑party labs like USP, NSF, or Independent ConsumerLab results—these reduce risk of contaminated or mislabeled supplements.
Side effects are usually mild but can include stomach upset, burping, or tiredness. Serious liver injury is rare but has been linked to PA contamination in unprocessed products — that’s why PA‑free matters. Also, don’t assume “natural” equals safe; quality and processing determine risk.
Want to try butterbur? Pick a PA‑free, standardized product, use the dose shown in trials (50–75 mg twice daily unless your provider advises otherwise), give it a couple of months, and keep an eye on any odd symptoms. Ask your doctor for a liver check if you plan long‑term use or have risk factors. That way you get the possible benefit without unnecessary risk.
