Butterbur works as well as antihistamine for seasonal allergies
For millions of Americans, seasonal allergies bring sneezing, runny nose, itchy and watery eyes, and itchy throat. Antihistamines provide relief for many of these allergy symptoms, but many also tend to cause drowsiness. A recent study in the British Medical Journal suggests that butterbur extract—available wherever natural remedies are sold—relieves symptoms as well as an antihistamine and does not cause drowsiness. Butterbur is a plant with large, heart-shaped leaves and stalks of reddish flowers native to Europe, Asia and North America. It has been used to relieve asthma, allergies, headaches, and smooth muscle spasms.
About the study
Between June 1999 and June 2000, researchers in Switzerland recruited 125 men and women aged 18 years or older who had seasonal allergic rhinitis for at least the previous two years. At the start of the study, each participant had a full medical examination and skin allergy tests to confirm his or her allergy to pollen. In addition, participants answered a medical outcome questionnaire called the short-form 36 health survey (SF-36), on which they rated their physical functioning, energy and vitality, general health, and the like.
Sixty-one participants were given butterbur for two weeks and 64 participants were given the non-sedating antihistamine cetirizine (Zyrtec) for two weeks. All participants were told not to take other medications during the study period. At the end of the two weeks, each participant again had a full medical examination and answered the SF-36 survey. Participants' exposure to pollen during the two weeks was verified by checking the pollen count in their areas via the regional pollen count service's online database.
The researchers then compared the SF-36 scores of participants in the butterbur and cetirizine groups.
SF-36 scores improved similarly in both groups from the start of the study to the end of the 2-week study period. This improvement was seen in individual measures within the SF-36 survey, as well as in the overall SF-36 scores for participants in each group.
Although cetirizine is considered a non-sedating antihistamine, the SF-36 scores indicated that people taking cetirizine may be more likely to report drowsiness and fatigue than people taking butterbur.
There are limitations to this study that are worth noting. First, the SF-36 score provides information about improvements in the general health of the allergy-suffering participants, but it does not address improvements in specific allergy symptoms—sneezing, runny nose, itchy eyes, etc. Second, researchers asked patients if they were taking the study medication but did not test their blood or nasal fluid to confirm this. Third, we cannot be certain that participants refrained from taking medications or herbs that may have affected their health during the study period. In an effort to reduce the chance of participants taking other allergy drugs if they were unsatisfied with the study medication, the authors limited the study period to two weeks. This study was funded by Zeller Herbal Remedies Ltd. Interpretation of the results was determined by the investigators of the Petasites Study group.
How does this affect you?
Should you take butterbur rather than an antihistamine for relief of seasonal allergy symptoms? That remains to be seen. Unfortunately, this study did not measure the affects of butterbur and cetirizine on allergy symptoms. The findings of this study do suggest that people taking butterbur and people taking cetirizine may experience similar improvements in general health during the allergy season; and butterbur does not seem to cause drowsiness or fatigue. And because, cetirizine is purported to be a non-sedating antihistamine, people taking butterbur might experience even less drowsiness than with sedating antihistamines, such as those that contain diphenhydramine (for example, Benadryl or Tylenol PM).
Before you consider taking an herbal remedy for relief of allergies, talk to your doctor. Choosing an herbal remedy requires the same amount of research and medical advice as choosing a medication.
Schapowal A, on behalf of the Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.
British Medical Journal . January 21, 2002;324:144-146.
Last reviewed Jan 22, 2002 by ]]>Richard Glickman-Simon, MD]]>
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