Borage Extract
Also known as: Borage, starflower, Borage extract, Borage oil, Borago officinalis
Overview
Borage extract, derived from the seeds of the Borago officinalis plant, is a botanical supplement primarily valued for its high concentration of gamma-linolenic acid (GLA), an omega-6 fatty acid. It is commonly used for its potential anti-inflammatory properties and has been investigated for various conditions, including skin disorders like atopic eczema, cyclic mastalgia (breast pain), and its immune-modulatory effects in severe inflammatory states such as critical illness and COVID-19. While some research supports its efficacy for specific uses, such as cyclic mastalgia, evidence for other applications like atopic eczema is mixed or inconclusive. The research maturity for borage extract is moderate, with several randomized controlled trials and some systematic reviews, though more high-quality studies are needed to fully establish its benefits and optimal usage across all potential indications.
Benefits
Borage extract offers several potential benefits, primarily due to its GLA content: * **Cyclic Mastalgia (Breast Pain):** Strong evidence supports its efficacy. A clinical study demonstrated statistically significant improvements in pain severity and quality of life measures (work, sleep, sexual activity) in women with cyclic breast pain after 90 days of treatment, with p-values <0.01 across measures. This indicates a robust benefit in reducing cyclic mastalgia symptoms. * **Critical Illness/Inflammation:** Moderate evidence suggests a potential role in reducing inflammation. Systematic reviews and meta-analyses of enteral formulas containing both fish oil and borage oil have indicated a potential reduction in mortality and decreased ventilator days in critically ill patients with sepsis or acute lung injury. However, it's important to note that these studies involved multi-ingredient formulas, making it difficult to isolate the specific effect of borage oil alone. * **COVID-19:** Preliminary, low-quality evidence exists. An early study explored borage syrup in ICU COVID-19 patients, measuring inflammatory cytokines. While promising, detailed efficacy outcomes and statistical significance were not provided, and more robust research is needed to confirm any benefit. * **Atopic Eczema:** Limited to no evidence of benefit. A well-powered randomized controlled trial found no significant benefit of borage oil over placebo in reducing eczema severity, despite earlier, smaller studies suggesting some efficacy. Current high-quality evidence does not support its use for atopic eczema.
How it works
Borage oil's primary mechanism of action stems from its active component, gamma-linolenic acid (GLA). Once ingested, GLA is metabolized in the body to dihomo-gamma-linolenic acid (DGLA). DGLA serves as a precursor for the synthesis of anti-inflammatory eicosanoids, specifically certain prostaglandins and leukotrienes. These compounds play a crucial role in modulating inflammatory pathways within the body. By influencing these pathways, borage oil may reduce the production of pro-inflammatory cytokines and modulate overall immune responses. This anti-inflammatory and immune-modulatory effect is believed to be responsible for its potential benefits in inflammatory conditions and its investigated role in systemic inflammation.
Side effects
Borage extract is generally considered well-tolerated in clinical trials, with common side effects being mild and infrequent. No significant adverse events were reported in studies investigating its use for mastalgia and eczema. However, caution is advised for individuals taking anticoagulant medications due to the potential for omega-6 fatty acids to increase bleeding risk, although this interaction has not been widely reported with borage oil specifically. Safety during pregnancy and lactation has not been well-established, and therefore, its use in these populations should be approached with caution and under medical supervision. There are no major drug interactions or contraindications widely reported in the reviewed literature, but individuals with pre-existing liver conditions should consult a healthcare professional before use, as some traditional uses of borage leaves (not the oil) have been associated with hepatotoxicity due to pyrrolizidine alkaloids, which are typically removed from purified borage oil.
Dosage
Effective dosages of borage extract vary depending on the condition being addressed and the concentration of GLA in the product. For cyclic mastalgia, studies have shown benefit with treatment lasting 90 days, though specific daily GLA dosages were not fully detailed. In studies for atopic eczema, a dose of 920 mg GLA daily (often administered as 4 capsules twice daily for adults) was used for 12 weeks, but this regimen showed no significant benefit. For severe COVID-19 patients in preliminary studies, a borage syrup providing 20 mg/ml GLA was administered at 5 ml for 5 days. Optimal dosing for specific indications remains to be definitively established, and longer durations, typically 3 months or more, may be necessary for chronic conditions to observe effects. Absorption of borage oil is generally enhanced when taken with meals that contain fat.
FAQs
Is borage extract effective for eczema?
Current high-quality evidence, including a well-powered randomized controlled trial, does not support the efficacy of borage extract for treating atopic eczema.
Is it safe for long-term use?
Borage extract is generally considered safe with mild side effects. However, long-term safety data are limited, and caution is advised, especially regarding potential interactions with anticoagulants.
Can it reduce inflammation in critical illness?
Some evidence from studies using combined enteral formulas containing borage oil suggests a potential benefit in reducing inflammation and improving outcomes in critical illness, but the isolated effect of borage oil requires further study.
Does it help with breast pain?
Yes, evidence from clinical studies supports the efficacy of borage extract in significantly reducing symptoms of cyclic mastalgia (breast pain).
Research Sources
- https://www.scirp.org/journal/paperinformation?paperid=56886 – This clinical trial investigated the effect of borage extract on cyclic mastalgia. It reported statistically significant improvements in pain severity and quality of life measures (work, sleep, sexual activity) after 90 days of treatment, with p-values <0.01, indicating efficacy in reducing cyclic breast pain.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC292992/ – This randomized, double-blind, placebo-controlled trial (n=151) evaluated borage oil for atopic eczema. It found no significant benefit of borage oil (920 mg GLA daily) over placebo in reducing eczema severity after 12 weeks (p=0.45), suggesting limited efficacy for this condition.
- https://www.criticalcarenutrition.com/docs/4.1b(i)%20Fish%20Oils%20Borage%20Oils%20March%208%202021.pdf – This systematic review/meta-analysis examined enteral formulas containing fish oil and borage oil in critically ill patients. It indicated potential for mortality reduction and decreased ventilator days in patients with sepsis or acute lung injury, though the effect of borage oil alone was unclear due to combined interventions.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9705573/ – This preliminary clinical study explored borage syrup in severe COVID-19 ICU patients. It measured inflammatory cytokines (TNF, IL-6, IL-8) but did not provide detailed efficacy outcomes or statistical significance, indicating early-stage research.
Supplements Containing Borage Extract
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