Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Butterbur (Petasites hybridus) has a history of traditional use for respiratory conditions, but there is also scientific evidence supporting its use for sinus health, particularly in the context of allergic rhinitis (hay fever). Several randomized controlled trials have evaluated standardized butterbur extracts (such as Petadolex) for their ability to reduce symptoms of allergic rhinitis, which commonly affects the sinuses. A notable study published in the British Medical Journal in 2002 found that butterbur extract was as effective as cetirizine, a common antihistamine, in reducing symptoms of hay fever, but with fewer sedative effects. The beneficial effects are believed to be due to butterbur's content of petasin and isopetasin, compounds with anti-inflammatory and antispasmodic properties. Butterbur reduces leukotriene synthesis, which can help decrease inflammation in nasal passages.

However, most clinical research supports its use specifically for allergic rhinitis rather than for all types of sinus issues. Safety concerns also exist: raw butterbur contains pyrrolizidine alkaloids (PAs), which are toxic to the liver, so only PA-free extracts should be used. While there's reasonable evidence for its use in allergic rhinitis affecting the sinuses, more research is needed to confirm benefits for other sinus-related conditions. Thus, butterbur is supported by both historical use and moderate-quality scientific evidence, justifying a mid-range evidence rating.

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