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Head-to-head evidence comparison — which supplement is right for you?
Butterbur vs Cocoa Flavanols: Cocoa Flavanols has the stronger overall evidence (5 vs 6/10); the best pick depends on your goals. Take the 60-second quiz for a pick tailored to your goals.
Cocoa Flavanols wins 2 of 3 categories. Both are solid choices — the best pick depends on your specific goals.
Verdict
Mostly mechanism / observational
Top outcomes
Verdict
Mostly mechanism / observational
0 of 1 studies with measurable effects showed benefit.
Top outcomes
50-75mg PA-free standardized extract twice daily for migraine prophylaxis (≈100-150mg/day); allergic rhinitis similar
with-meals
Certified PA-free standardized extract
500-750mg cocoa flavanols daily (COSMOS used 500mg; endothelial benefit peaked near 710mg)
any
Standardized cocoa flavanol extract (epicatechin-standardized)
1-3 months
2-6 weeks
Variable
2-8 weeks
Acute to 8 weeks
Years
Throughout use
Petasites hybridus root (butterbur) is an effective preventive treatment for migraine.
Neurology (2004) · Rct · n=245
75mg twice-daily cut migraine frequency 48% vs 26% placebo
Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: a systematic review.
Phytomedicine : international journal of phytotherapy and phytopharmacology (2006) · Systematic review
Effective for migraine prophylaxis
Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.
BMJ (Clinical research ed.) (2002) · Rct · n=125
Comparable to cetirizine for allergic rhinitis symptoms
Effect of cocoa flavanol supplementation for the prevention of cardiovascular disease events: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial.
Am J Clin Nutr (2022) · Rct · n=21442
21,442 older US adults, 500mg flavanols/day, median 3.6 years, double-blind placebo-controlled
Effect of cocoa on blood pressure.
Cochrane Database Syst Rev (2017) · Meta analysis
Cochrane meta-analysis of flavanol-rich cocoa vs control
Dose-response relationship between cocoa flavanols and human endothelial function: a systematic review and meta-analysis of randomized trials.
Food Funct (2019) · Meta analysis
15 articles, 18 intervention arms pooled
Cocoa Flavanols has a higher evidence score (5/10 vs 6/10) and wins in 2 of 3 categories.
No known interactions between Butterbur and Cocoa Flavanols have been documented in our database. However, always consult a healthcare provider before combining supplements.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.