While many substances deemed "natural" are purported to be effective in treating headache, it is important to emphasize that "natural" and safe are not synonymous. Cyanide and strychnine both o ccur in nature but are quite poisonous. In medical school we were taught that the definition of a drug without side effects is a drug that has not been tested adequately, and it's true that the closer you look, the more likely you will find that any product ("natural" or otherwise) can produce some type of untoward reaction. Because "natural" products and dietary supplements are not subjected to the same level of scrutiny required for prescription medications, extrava*gant claims of benefit may be made on behalf of agents that lack a scientific basis for those claims and, worse, may produce serious adverse effects (witness the recent withdrawal from the market of OTC medications containing ephreda or phenylprophylnolamine).

There are several "natural" agents that have been tested for their safety and effectiveness in treating headache. While feverfew initially appeared promising as a treatment for headache, more recent studies have demonstrated little evidence of benefit. Even worse, feverfew apparently can cause "rebound" headache. Magnesium, riboflavin (vitamin B2) and petasites appear to have more efficacy and are discussed in some detail in Appendix 3.