Borage Oil And Fish Oil
Also known as: Fish oil, marine oil, borage oil, polyunsaturated fatty acids (PUFAs), omega-3 fatty acids, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), gamma-linolenic acid (GLA), Fish Oil and Borage Oil
Overview
Fish oil, rich in omega-3 fatty acids EPA and DHA, is derived from oily fish, while borage oil, abundant in the omega-6 fatty acid GLA, is extracted from the seeds of the borage plant. Both are essential fatty acid supplements known for their anti-inflammatory properties. Fish oil is widely used for cardiovascular health, inflammation reduction, and joint pain relief, with a moderate to high level of research maturity. Borage oil is primarily utilized for its anti-inflammatory effects, particularly in skin disorders and rheumatoid arthritis, though its research maturity is moderate with fewer large-scale studies. When combined, these oils offer synergistic benefits, especially in managing inflammatory conditions. The body cannot synthesize these essential fatty acids, making dietary intake or supplementation crucial. They are available in various forms, including capsules and specialized enteral formulas for clinical use.
Benefits
Fish oil and borage oil, particularly in combination, offer several evidence-based benefits. Fish oil significantly reduces arthritis pain, with studies showing an approximate 8% improvement on a visual analog scale (VAS) for pain in rheumatoid arthritis patients, corresponding to a standardized mean difference (SMD) of -0.24. This effect is small to moderate but statistically significant. In critically ill patients (e.g., with sepsis or ARDS), enteral formulas containing both fish oil and borage oil have been associated with reductions in mortality, ventilator days, and ICU length of stay, although results can vary. Fish oil also helps reduce inflammatory markers and improve joint function in rheumatoid arthritis. Borage oil, through its GLA content, contributes to anti-inflammatory effects, and some trials suggest modest benefits in mastalgia and rheumatoid arthritis, especially when combined with fish oil. The time course for benefits in arthritis studies typically ranges from 3 to 6 months, while in ICU settings, benefits are observed during acute administration.
How it works
Fish oil's primary mechanism involves its omega-3 fatty acids, EPA and DHA, which modulate inflammatory pathways by competing with arachidonic acid, thereby reducing the production of pro-inflammatory eicosanoids. Borage oil's GLA is converted in the body to dihomo-gamma-linolenic acid (DGLA), which can then produce anti-inflammatory prostaglandins. Both oils exert their effects by interacting with immune cells, modulating cytokine production, and altering membrane fluidity. They target key molecular pathways such as cyclooxygenase (COX), lipoxygenase (LOX), and nuclear factor kappa B (NF-κB), all of which are central to inflammatory responses. Both oils are absorbed in the small intestine, and their bioavailability can be enhanced when consumed with meals containing fat.
Side effects
Fish oil and borage oil are generally well tolerated at recommended doses. Common side effects, affecting more than 5% of users, are typically mild gastrointestinal symptoms. These include a fishy aftertaste, nausea, or diarrhea for fish oil, and mild GI discomfort for borage oil. Uncommon side effects (1-5% frequency) for fish oil include a possible increased bleeding risk, particularly at high doses, due to its inhibitory effect on platelet aggregation. Rare side effects (less than 1%) can include allergic reactions, especially in individuals with fish allergies. Fish oil may interact with anticoagulant medications like warfarin, potentially increasing the risk of bleeding; borage oil may have additive effects in this regard. Contraindications include bleeding disorders or impending surgery. Safety data for pregnant and breastfeeding individuals are limited, so consultation with a healthcare provider is advised before use in these populations.
Dosage
For anti-inflammatory effects, the minimum effective dose for fish oil is typically at least 1 gram per day of combined EPA and DHA. For borage oil, studies commonly use around 1-3 grams per day of GLA. Optimal dosage ranges are generally 1-3 grams per day of EPA+DHA for fish oil and 1-3 grams per day of GLA for borage oil. The maximum safe dose for fish oil is generally considered up to 3 grams per day of EPA+DHA; higher doses should only be taken under medical supervision. Both oils are best taken with meals to enhance absorption and minimize gastrointestinal side effects. For critically ill patients, specialized enteral formulas containing these oils are used. For general supplementation, capsules or softgels are common. No specific cofactors are required, but antioxidants may help protect the polyunsaturated fatty acids from oxidation.
FAQs
Are fish oil and borage oil safe to take together?
Yes, fish oil and borage oil are often combined due to their synergistic anti-inflammatory effects, making them safe to take together.
How long until effects are seen?
For chronic conditions like arthritis pain, benefits from fish oil and borage oil supplementation may become noticeable after several weeks to a few months of consistent use.
Can these oils replace medications?
No, fish oil and borage oil are considered adjuncts to treatment and should not replace prescribed medications or therapies without consulting a healthcare professional.
Do these oils help with cardiovascular health?
Fish oil has strong evidence supporting its benefits for cardiovascular health, while borage oil's impact on cardiovascular health is less established.
Is there a risk of bleeding?
At high doses, particularly with fish oil, there is an increased risk of bleeding due to its effects on platelet aggregation; caution is advised, especially if taking anticoagulants.
Research Sources
- https://www.criticalcarenutrition.com/docs/4.1b(i)%20EN_Fish%20Oils%20Borage%20Oils%20and%20other%20AOX_March2021v2.pdf – This systematic review and meta-analysis examined the effects of enteral fish oil/borage oil formulas in critically ill patients, including those with sepsis and ARDS. It found that these formulas reduced mortality, ventilator days, and ICU length of stay, despite some heterogeneity across studies. The research highlights the clinical relevance of these oils in acute care settings.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5295086/ – This systematic review and meta-analysis, involving 30 RCTs, investigated the impact of fish oil on arthritis pain. It concluded that fish oil modestly but significantly reduces arthritis pain (SMD -0.24, p=0.007), with a stronger effect observed in rheumatoid arthritis patients. The study noted some heterogeneity in the included trials but provided robust evidence for pain reduction.
- https://www.painphysicianjournal.com/current/pdf?article=MzEwMQ%3D%3D&journal=100 – This systematic review of RCTs explored the benefits of fish oil and borage oil in rheumatoid arthritis and mastalgia. It indicated that both oils, and their combined use, show modest benefits in reducing pain and inflammation. The review acknowledged that some trials had small sample sizes and variable controls, but overall supported the anti-inflammatory potential of these supplements.
