Loading…
We use essential cookies (authentication, your saved goals/stack) by default. With your permission we’ll also enable privacy-respecting analytics (Vercel Web Analytics, anonymous load-time metrics) and error-replay diagnostics (Sentry — DOM snapshots only when an error fires) so we can fix bugs faster. Learn more about cookies
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
Too few graded studies
Top outcomes
Verdict
Too few graded studies
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 (in the cited migraine trial, 50 mg twice daily did not beat placebo and 75 mg twice daily did)
With meals
Certified PA-free standardized extract
200-500 mg cocoa flavanols daily (COSMOS used 500 mg a day). A cited dose-response meta-analysis put the peak endothelial benefit near 710 mg, above the highest dose in the cited trials.
Any time of day
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
245 adults with migraine took Petasites extract 75 mg twice daily, 50 mg twice daily, or placebo for 4 months.
Effectiveness of Petasites hybridus preparations in the prophylaxis of migraine: a systematic review.
Phytomedicine : international journal of phytotherapy and phytopharmacology (2006) · Systematic review · n=293
Two randomised trials with 293 patients (60 and 233), both of the proprietary extract Petadolex. Results were described, not pooled, because they were heterogeneous.
Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis.
BMJ (Clinical research ed.) (2002) · Rct · n=125
125 patients with hay fever were randomised to butterbur Ze339 four times daily (61) or cetirizine once daily (64) for two weeks.
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 documented interaction was found in the data searched. This does not establish that this exact combination is safe.
The right pick depends on your goals. Answer a few quick questions for a personalised recommendation — or dig into the full evidence on each.