BORAGE: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Borage is a plant. Its flowers and leaves, as well as the oil from its seeds are used as medicine.

Borage seed oil is used for skin disorders including eczema (atopic dermatitis), red, itchy rash on the scalp (seborrheic dermatitis), and a type of skin condition called neurodermatitis. It is also used for rheumatoid arthritis (RA), swelling of the gums, stress, premenstrual syndrome (PMS), diabetes, attention deficit-hyperactivity disorder (ADHD), acute respiratory distress syndrome (ARDS), alcoholism, pain and swelling (inflammation), asthma, and for preventing heart disease and stroke. Borage oil is sometimes added to infant formula in small amounts to provide fatty acids needed to promote development of preterm infants.

Borage flower and leaves are used for fever, cough, and depression.

Borage is also used for a hormone problem called adrenal insufficiency, for "blood purification," to increase urine flow, to prevent inflammation of the lungs, as a sedative, and to promote sweating. Borage is also used to increase breast milk production and to treat bronchitis and colds.

Borage is applied to the skin for red, itchy rash on the scalp of infants (seborrheic dermatitis) and is also used in a dressing to soften the skin.

In foods, borage is eaten in salads and soups.

In manufacturing, borage is used in skin care products.

How does it work ?

Borage seed oil contains a fatty acid called gamma linolenic acid (GLA). GLA seems to have anti-inflammatory effects. Borage flower might have an antioxidant effect.

Uses & Effectiveness

Possibly Effective for

Improving the function of the lungs in critically ill patients. There is some evidence that borage seed oil, when taken by mouth in combination with eicosapentaenoic acid (EPA), might reduce the number of days spent in the intensive care unit (ICU) and the length of time a breathing machine is needed by patients with acute respiratory distress syndrome (ARDS).
Growth and development in premature infants. Infant formula supplemented with fatty acids from borage oil and fish oils seems to improve growth and development of the nervous system in infants born early, especially boys.
Rheumatoid arthritis (RA). There is some evidence that taking borage seed oil in combination with conventional painkilling or anti-inflammatory medications might help decrease symptoms of RA after six weeks of treatment. The improvement appears to last for up to 24 weeks. Improvement is measured as a decrease in the number and severity of tender and swollen joints.

Possibly Ineffective for

Itchy, red skin (eczema). Taking borage seed oil by mouth does not seem to improve eczema in adults or children.

Insufficient Evidence for

Asthma. Early research suggests that taking borage oil daily for 12 months does not improve asthma symptoms.
A dental condition called periodontitis. Early research suggests that taking borage oil daily for 12 weeks improves gum inflammation but does not reduce plaque in people with periodontitis.
A skin condition in infants called seborrheic dermatitis. There is some evidence that topical application of borage seed oil might be helpful for infantile seborrheic dermatitis, a condition that causes a red, itchy rash on the scalp. It seems to heal the condition within 1 to 3 weeks.
Premenstrual syndrome (PMS).
Diabetes.
Attention deficit-hyperactivity disorder (ADHD).
Alcoholism.
Heart disease.
Stroke.
Fever.
Cough.
Depression.
Dry skin.
Arthritis.
Pain relief.
Inflamed veins (phlebitis).
Menopausal disorders.
Fluid retention.
Other conditions.

More evidence is needed to rate the effectiveness of borage for these uses.

Side Effects

Borage seed oil is POSSIBLY SAFE when taken by mouth or applied to the skin appropriately.

Borage seed oil is LIKELY UNSAFE when products containing a dangerous chemicals called pyrrolizidine alkaloids (PAs) are taken by mouth. Borage plant parts including the leaf, flower, and seed can contain PAs. PAs can damage the liver or cause cancer, especially when used in high doses or for a long time. Only use products that are certified and labeled PA-free.

Special Precautions and Warnings

Pregnancy and breast-feeding: Borage seed oil is LIKELY UNSAFE during pregnancy and while breast-feeding. It is important to avoid borage products that might contain pyrrolizidine alkaloids (PAs). PAs are a risk to the mother because they can cause serious liver disease and might cause cancer. PAs are also a risk to the infant because they might cause birth defects and they can pass into breast milk. Researchers are not sure if borage products that are certified PA-free are safe during pregnancy and breast-feeding. It is best to stay safe and avoid using borage.

Bleeding disorders: There is some concern that borage seed oil might prolong bleeding time and increase the risk of bruising and bleeding. If you have a bleeding disorder, use borage with caution.

Liver disease: Borage products containing hepatotoxic pyrrolizidine alkaloids (PA) might make liver disease worse.

Surgery: Borage might increase the risk of bleeding during and after surgery. Stop taking borage at least 2 weeks before a scheduled surgery.

Interactions

Moderate Interaction

Be cautious with this combination

Medications that increase the breakdown of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers) interacts with BORAGE
Borage is broken down by the liver. Some chemicals that form when the liver breaks down borage seed oil can be harmful. Medications that cause the liver to break down borage seed oil might enhance the toxic effects of chemicals contained in borage seed oil.

Some of these medicines include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs) interacts with BORAGE
Borage seed oil might slow blood clotting in some people. Borage seed oil contains GLA (gamma linolenic acid). GLA is the part of borage seed oil that might slow blood clotting. Taking borage seed oil along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
Phenothiazines interacts with BORAGE
Taking supplements containing gamma linolenic acid, such as borage, with phenothiazines might increase the risk of having a seizure in some people.
Some phenothiazines include chlorpromazine (Thorazine), fluphenazine (Prolixin), trifluoperazine (Stelazine), thioridazine (Mellaril), and others.

Dosing

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

For rheumatoid arthritis (RA): 4.5-7.2 grams of borage seed oil daily for up to 24 weeks.

CHILDREN

BY MOUTH:

For growth and development in premature infants: Infant formula containing borage oil and fish oils has been used. Borage oil and fish oil have been added to the formula to provide 0.9 grams of gamma linolenic acid, 0.1 grams of eicosapentaenoic acid, and 0.5 grams of docosahexaenoic acid per 100 grams of fat (13745).

View References

REFERENCES:

Bahmer, F. A. and Schafer, J. [Treatment of atopic dermatitis with borage seed oil (Glandol)--a time series analytic study]. Kinderarztl.Prax. 1992;60(7):199-202. View abstract.

Bard, J. M., Luc, G., Jude, B., Bordet, J. C., Lacroix, B., Bonte, J. P., Parra, H. J., and Duriez, P. A therapeutic dosage (3 g/day) of borage oil supplementation has no effect on platelet aggregation in healthy volunteers. Fundam.Clin.Pharmacol. 1997;11(2):143-144. View abstract.

Barre, D. E. and Holub, B. J. The effect of borage oil consumption on the composition of individual phospholipids in human platelets. Lipids 1992;27(5):315-320. View abstract.

Borrek, S., Hildebrandt, A., and Forster, J. [Gamma-linolenic-acid-rich borage seed oil capsules in children with atopic dermatitis. A placebo-controlled double-blind study]. Klin.Padiatr. 1997;209(3):100-104. View abstract.

Christophe, A., Robberecht, E., Franckx, H., De Baets, F., and van de, Pas M. Effect of administration of gamma-linolenic acid on the fatty acid composition of serum phospholipids and cholesteryl esters in patients with cystic fibrosis. Ann.Nutr Metab 1994;38(1):40-47. View abstract.

Demmelmair, H., Feldl, F., Horvath, I., Niederland, T., Ruszinko, V., Raederstorff, D., De Min, C., Muggli, R., and Koletzko, B. Influence of formulas with borage oil or borage oil plus fish oil on the arachidonic acid status in premature infants. Lipids 2001;36(6):555-566. View abstract.

Dooper, M. M., van Riel, B., Graus, Y. M., and M'Rabet, L. Dihomo-gamma-linolenic acid inhibits tumour necrosis factor-alpha production by human leucocytes independently of cyclooxygenase activity. Immunology 2003;110(3):348-357. View abstract.

Harbige, L. S. and Fisher, B. A. Dietary fatty acid modulation of mucosally-induced tolerogenic immune responses. Proc Nutr Soc 2001;60(4):449-456. View abstract.

Kapoor, R. and Klimaszewski, A. Efficacy of borage oil in patients with atopic eczema. Br J Dermatol 2000;143(1):200-201. View abstract.

Martens-Lobenhoffer, J. and Meyer, F. P. Pharmacokinetic data of gamma-linolenic acid in healthy volunteers after the administration of evening primrose oil (Epogam). Int.J Clin Pharmacol Ther. 1998;36(7):363-366. View abstract.

Mills, D. E., Prkachin, K. M., Harvey, K. A., and Ward, R. P. Dietary fatty acid supplementation alters stress reactivity and performance in man. J Hum.Hypertens. 1989;3(2):111-116. View abstract.

Palombo, J. D., DeMichele, S. J., Boyce, P. J., Lydon, E. E., Liu, J. W., Huang, Y. S., Forse, R. A., Mizgerd, J. P., and Bistrian, B. R. Effect of short-term enteral feeding with eicosapentaenoic and gamma-linolenic acids on alveolar macrophage eicosanoid synthesis and bactericidal function in rats. Crit Care Med 1999;27(9):1908-1915. View abstract.

Pittler, M. H., Verster, J. C., and Ernst, E. Interventions for preventing or treating alcohol hangover: systematic review of randomised controlled trials. BMJ 12-24-2005;331(7531):1515-1518. View abstract.

Rosenstein, E. D., Kushner, L. J., Kramer, N., and Kazandjian, G. Pilot study of dietary fatty acid supplementation in the treatment of adult periodontitis. Prostaglandins Leukot.Essent.Fatty Acids 2003;68(3):213-218. View abstract.

Rossetti, R. G., Seiler, C. M., DeLuca, P., Laposata, M., and Zurier, R. B. Oral administration of unsaturated fatty acids: effects on human peripheral blood T lymphocyte proliferation. J Leukoc.Biol 1997;62(4):438-443. View abstract.

Tollesson, A. and Frithz, A. Transepidermal water loss and water content in the stratum corneum in infantile seborrhoeic dermatitis. Acta Derm.Venereol 1993;73(1):18-20. View abstract.

van Gool, C. J., Thijs, C., Henquet, C. J., van Houwelingen, A. C., Dagnelie, P. C., Schrander, J., Menheere, P. P., and van den brandt, P. A. Gamma-linolenic acid supplementation for prophylaxis of atopic dermatitis--a randomized controlled trial in infants at high familial risk. Am J Clin Nutr 2003;77(4):943-951. View abstract.

Westman, E. C., Yancy, W. S., Jr., Olsen, M. K., Dudley, T., and Guyton, J. R. Effect of a low-carbohydrate, ketogenic diet program compared to a low-fat diet on fasting lipoprotein subclasses. Int J Cardiol. 6-16-2006;110(2):212-216. View abstract.

Ziboh, V. A. and Fletcher, M. P. Dose-response effects of dietary gamma-linolenic acid-enriched oils on human polymorphonuclear-neutrophil biosynthesis of leukotriene B4. Am J Clin Nutr 1992;55(1):39-45. View abstract.

Ziboh, V. A., Naguwa, S., Vang, K., Wineinger, J., Morrissey, B. M., Watnik, M., and Gershwin, M. E. Suppression of leukotriene B4 generation by ex-vivo neutrophils isolated from asthma patients on dietary supplementation with gammalinolenic acid-containing borage oil: possible implication in asthma. Clin.Dev.Immunol. 2004;11(1):13-21. View abstract.

Bamford JTM, Ray S, Musekiwa A, et al. Oral evening primrose oil and borage oil for eczema. Cochrane Database of Systematic Reviews 2013,4: CD004416.

Bandoniene D, Murkovic M. The detection of radical scavenging compounds in crude extract of borage (Borago officinalis L.) by using an on-line HPLC-DPPH method. J Biochem Biophys Methods 2002;53:45-9. View abstract.

Barre DE. Potential of evening primrose, borage, black currant, and fungal oils in human health. Ann Nutr Metab 2001;45:47-57. View abstract.

Belch J, Hill A. Evening primrose oil and borage oil in rheumatologic conditions. Am J Clin Nutr 2000;71:352S-6S. View abstract.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. View abstract.

da Costa Hime LFC, Carvalho Lopes CM, Roa CL, et al. Is there a beneficial effect of gamma-linolenic acid supplementation on body fat in postmenopausal hypertensive women? A prospective randomized double-blind placebo-controlled trial. Menopause. 2021;28(6):699-705. View abstract.

DeLuca P, Rothman D, Zurier RB. Marine and botanical lipids as immunomodulatory and therapeutic agents in the treatment of rheumatoid arthritis. Rheum Dis Clin North Am 1995;21:759-77. View abstract.

DiSilvestro RA, Olivo Marston S, Zimmerman A, Joseph E, Boeh McCarty C. Borage oil intake by overweight young adults: no effect on metabolic rate; beneficial effects on plasma triglyceride and HDL cholesterol readings. Food Funct 2021;12(19):8882-8886. View abstract.

Dodson CD, Stermitz FR. Pyrrolizidine alkaloids from borage (Borago officinalis) seeds and flowers. J Nat Prod 1986;49:727-8.

Dr. Duke's Phytochemical and Ethnobotanical Databases. Available at: https://www.ars-grin.gov/duke/.

Dushianthan A, Cusack R, Burgess VA, Grocott MP, Calder PC. Immunonutrition for acute respiratory distress syndrome (ARDS) in adults. Cochrane Database Syst Rev. 2019;1(1):CD012041. View abstract.

Engler MM, Engler MB, Erickson SK, Paul SM. Dietary gamma-linolenic acid lowers blood pressure and alters aortic reactivity and cholesterol metabolism in hypertension. J Hypertens 1992;10:1197-204. View abstract.

Fan YY, Chapkin RS. Importance of dietary gamma-linolenic acid in human health and nutrition. J Nutr 1998;128:1411-4. View abstract.

Fewtrell MS, Abbott RA, Kennedy K, et al. Randomized, double-blind trial of long-chain polyunsaturated fatty acid supplementation with fish oil and borage oil in preterm infants. J Pediatr 2004;144:471-9. View abstract.

Fisher BAC, Harbige LS. Effect of omega-6 lipid-rich borage oil feeding on immune function in healthy volunteers (abstract). Biochem Soc Trans 1997;25:343S. View abstract.

Food and Drug Administration. FDA Advises Dietary Supplement Manufacturers to Remove Comfrey Products From the Market. July 6, 2001. Available at: https://www.cfsan.fda.gov/~dms/dspltr06.html.

Furse RK, Rossetti RG, Seiler CM, Zurier RB. Oral administration of gammalinolenic acid, an unsaturated fatty acid with anti-inflammatory properties, modulates interleukin-1beta production by human monocytes. J Clin Immunol 2002;22:83-91. View abstract.

Gadek JE, DeMichele SJ, Karlstad MD, et al. Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Enteral Nutrition in ARDS Study Group. Crit Care Med 1999;27:1409-20. View abstract.

Ghasemian M, Owlia S, Owlia MB. Review of Aanti-iInflammatory hHerbal mMedicines. Adv Pharmacol Sci. 2016;2016:9130979. View abstract.

Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty Acids 1994;51:311-6. View abstract.

Hashemian SM, Mortaz E, Shafigh N, et al. Effectiveness of Borage plus syrup on COVID-19 patients in intensive care units. Front Nutr 2022;9:975937. View abstract.

Henz BM, Jablonska S, van de Kerkhof PC, et al. Double-blind, multicentre analysis of the efficacy of borage oil in patients with atopic eczema. Br J Dermatol 1999;140:685-8. View abstract.

Henz BM. Efficacy of borage oil in patients with atopic eczema - reply from author. Br J Dermatol 2000;143:201. View abstract.

Holman CP and Bell AF. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orhtomolecular Psych 1983;12:302-304.

Jung JY, Kwon HH, Hong JS, et al. Effect of dietary supplementation with omega-3 fatty acid and gamma-linolenic acid on acne vulgaris: a randomised, double-blind, controlled trial. Acta Derm Venereol. 2014;94(5):521-5. View abstract.

Kalantar-Zadeh, K., Braglia, A., Chow, J., Kwon, O., Kuwae, N., Colman, S., Cockram, D. B., and Kopple, J. D. An anti-inflammatory and antioxidant nutritional supplement for hypoalbuminemic hemodialysis patients: a pilot/feasibility study. J Ren Nutr 2005;15(3):318-331. View abstract.

Kast RE. Boarge oil reduction of rheumatoid arthritis activity may be mediated by increased cAMP that suppresses tumor necrosis factor-alpha. Int Immunopharmacol 2001;1:2197-9. View abstract.

Langlois PL, D'Aragon F, Hardy G, Manzanares W. Omega-3 polyunsaturated fatty acids in critically ill patients with acute respiratory distress syndrome: A systematic review and meta-analysis. Nutrition. 2019;61:84-92. View abstract.

Larson KM, Roby MR, Stermitz FR. Unsaturated pyrrolizidines from borage (Borago officinalis), a common garden herb. J Nat Prod 1984;47:747-8.

Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Intern Med 1993;119:867-73. View abstract.

Li C, Bo L, Liu W, Lu X, Jin F. Enteral immunomodulatory diet (omega-3 fatty acid, ?-linolenic acid and antioxidant supplementation) for acute lung injury and acute respiratory distress syndrome: An updated systematic review and meta-analysis. Nutrients. 2015;7(7):5572-85. View abstract.

Menendez JA, Colomer R, Lupu R. Omega-6 polyunsaturated fatty acid gamma-linolenic acid (18:3n-6) is a selective estrogen-response modulator in human breast cancer cells: gamma-Linolenic acid antagonizes estrogen receptor-dependent transcriptional activity, transcriptionally represses estrogen receptor expression and synergistically enhances tamoxifen and ICI 182,780 (Faslodex) efficacy in human breast cancer cells. Int J Cancer 2004;10;109:949-54. View abstract.

Menendez JA, del Mar Barbacid M, Montero S, et al. Effects of gamma-linolenic acid and oleic acid on paclitaxel cytotoxicity in human breast cancer cells. Eur J Cancer 2001;37:402-13. View abstract.

Morse PF, Horrobin DF, Manku MS, et al. Meta-analysis of placebo-controlled studies of the efficacy of Epogam in the treatment of atopic eczema. Relationship between plasma essential fatty acid changes and clinical response. Br J Dermatol 1989;121:75-90. View abstract.

Pullman-Mooar S, Laposata M, Lem D. Alteration of the cellular fatty acid profile and the production of eicosanoids in human monocytes by gamma-linolenic acid. Arthritis Rheum 1990;33:1526-33. View abstract.

Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3.

Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.

Rose DP, Connolly JM, Liu XH. Effects of linoleic acid and gamma-linolenic acid on the growth and metastasis of a human breast cancer cell line in nude mice and on its growth and invasive capacity in vitro. Nutr Cancer 1995;24:33-45. . View abstract.

Rothman D, DeLuca P, Zurier RB. Botanical lipids: effects on inflammation, immune responses, and rheumatoid arthritis. Semin Arthritis Rheum 1995;25:87-96. View abstract.

Stedman C. Herbal hepatotoxicity. Semin Liver Dis 2002;22:195-206. View abstract.

Takwale A, Tan E, Agarwal S, et al. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ 2003;327:1385. View abstract.

Theilla M, Singer P, Cohen J, Dekeyser F. A diet enriched in eicosapentanoic acid, gamma-linolenic acid and antioxidants in the prevention of new pressure ulcer formation in critically ill patients with acute lung injury: A randomized, prospective, controlled study. Clin Nutr. 2007;26(6):752-7. View abstract.

Thijs C, van Houwelingen A, Poorterman I, et al. Essential fatty acids in breast milk of atopic mothers: comparison with non-atopic mothers, and effect of borage oil supplementation. Eur J Clin Nutr 2000;54:234-8. View abstract.

Tollesson A, Frithz A, Stenlund K. Malassezia furfur in infantile seborrheic dermatitis. Pediatr Dermatol 1997;14:423-5. View abstract.

Tollesson A, Frithz A. Borage oil, an effective new treatment for infantile seborrhoeic dermatitis. Br J Dermatol 1993;129:95. View abstract.

Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6(4):375-379. View abstract.

van Gool CJ, Zeegers MP, Thijs C. Oral essential fatty acid supplementation in atopic dermatitis-a meta-analysis of placebo-controlled trials. Br J Dermatol 2004;150:728-40. View abstract.

Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. View abstract.

WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.

Wretensjo I. Characterisation of borage oil by GC-MS. Licentiate Thesis, Stockholm University, 2004. Available at: https://www.anchem.su.se/downloads/diss_pdf/i_wretensjo_lic2004.pdf.

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is licensed from Therapeutic Research Center, LLC. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version.
Licensed from Therapeutic Research Center, LLC
Copyright © 1995-2024 by Therapeutic Research Center, LLC. All Rights Reserved.

Conditions

Drugs & Supplements

Well-Being

More

BORAGE - Uses, Side Effects, and More