Take butterbur extract (Petasites hybridus)

What to Do

Take a PA-free butterbur extract (such as Petadolex) 50-75mg twice daily during allergy season. Only use products certified free of pyrrolizidine alkaloids (PAs).

Why It Works

Butterbur has the strongest clinical evidence of any herbal allergy remedy. A landmark Swiss RCT found butterbur equivalent to cetirizine for allergic rhinitis symptoms, without causing drowsiness. It inhibits leukotriene synthesis and blocks histamine receptors. Multiple systematic reviews rate the evidence as moderate-to-good.

Tips

• Never use raw butterbur — it contains liver-toxic PAs that must be removed during extraction
• Look for "PA-free" or "Petadolex" on the label
• Takes 1-2 weeks of consistent use for full effect
• Not recommended during pregnancy or for children without physician guidance