Oil Of Borage
Also known as: Borage oil, Oil of Borage, Borago officinalis oil, Borago officinalis Seed Oil
Overview
Borage oil is extracted from the seeds of the *Borago officinalis* plant and is primarily used as a source of gamma-linolenic acid (GLA), an omega-6 fatty acid. GLA is believed to possess anti-inflammatory properties, leading to its traditional use for skin conditions like eczema and other inflammatory diseases. Borage oil also contains other fatty acids such as linoleic acid and oleic acid. Research on borage oil is moderately mature, with several randomized controlled trials (RCTs) and systematic reviews available, particularly focusing on eczema treatment. However, the overall quality of evidence is mixed, with some high-quality systematic reviews indicating limited efficacy for certain indications. Pharmaceutical-grade borage oil is purified to remove pyrrolizidine alkaloids, which can be hepatotoxic.
Benefits
The most studied benefit of borage oil is its potential to improve symptoms of eczema (atopic dermatitis). However, a Cochrane systematic review found no significant improvement in global eczema symptoms compared to placebo. This indicates no clinically meaningful benefit over placebo. Emerging research suggests that borage oil combined with syrup may improve clinical outcomes and reduce ICU stay length in COVID-19 ICU patients, possibly due to its anti-inflammatory effects, but this evidence is preliminary and from a single study with a relatively small sample size. No strong evidence supports benefits in specific populations for eczema or other inflammatory conditions based on current systematic reviews. Effect sizes for eczema symptom improvement are statistically non-significant and clinically negligible.
How it works
Borage oil is rich in gamma-linolenic acid (GLA), which is metabolized to dihomo-gamma-linolenic acid (DGLA), a precursor to anti-inflammatory eicosanoids. The proposed mechanism involves modulation of inflammatory pathways, potentially reducing pro-inflammatory cytokines and improving skin barrier function. GLA absorption is generally good, but conversion efficiency to DGLA varies among individuals. The oil also contains other fatty acids such as linoleic acid and oleic acid, which may contribute to its biological effects.
Side effects
Borage oil is generally well tolerated in oral doses used in clinical trials. Mild gastrointestinal discomfort has been reported but is uncommon. Uncommon side effects include headache and mild skin reactions. Rare side effects include potential for liver toxicity due to pyrrolizidine alkaloids in unrefined oils, but pharmaceutical-grade borage oil is purified to remove these compounds. No significant drug interactions have been reported in clinical trials, but caution is advised with anticoagulants due to a theoretical bleeding risk from fatty acid effects. It should be avoided in pregnancy and breastfeeding due to insufficient safety data. Limited data exists for special populations; caution is advised in individuals with liver disease due to potential hepatotoxicity from impurities.
Dosage
No established effective dose for eczema exists due to a lack of demonstrated efficacy. GLA doses around 200-300 mg/day from borage oil have been used in trials. Up to 3 grams/day of borage oil is generally considered safe in short-term use. It is usually administered orally in divided doses with meals. Pharmaceutical-grade, purified borage oil capsules are preferred to avoid pyrrolizidine alkaloid contamination. Fatty acid absorption is enhanced with dietary fat intake. No specific cofactors are required, but overall nutritional status may influence fatty acid metabolism.
FAQs
Does borage oil effectively treat eczema?
Current high-quality evidence shows no significant benefit over placebo for eczema symptom relief.
Is borage oil safe for long-term use?
Generally safe if pharmaceutical-grade and free of toxic alkaloids, but long-term safety data are limited.
Can borage oil help with other inflammatory conditions?
Preliminary data suggest potential benefits in inflammatory states like COVID-19 ICU patients, but more research is needed.
Are there any risks of liver damage?
Risk is associated with unrefined oils containing pyrrolizidine alkaloids; purified oils are considered safe.
How long before effects are seen?
No significant effects have been demonstrated in clinical trials for eczema over weeks to months.
Research Sources
- https://www.cochrane.org/CD004416/SKIN_oral-evening-primrose-oil-and-borage-oil-eczema – This Cochrane systematic review and meta-analysis of 27 RCTs (8 on borage oil) with 1596 participants found no significant improvement in eczema symptoms with borage oil compared to placebo. The studies varied in duration, mostly weeks to months, and the risk of bias was low in most studies, but heterogeneity in outcome measures was noted. The overall conclusion was that there is high-quality evidence indicating borage oil is not effective for eczema.
- https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2022.975937/full – This randomized controlled trial examined the effect of borage syrup in COVID-19 ICU patients. The study found that the addition of borage syrup improved outcomes and reduced ICU stay length, possibly via the anti-inflammatory effects of GLA. However, this is a single study with a small sample size, and the findings are preliminary, requiring replication in larger trials.
- https://pubmed.ncbi.nlm.nih.gov/23633319/ – This citation refers to the Cochrane review, which is a systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of oral evening primrose oil and borage oil for eczema. The review concluded that there was no significant benefit of these oils compared to placebo for improving eczema symptoms. The high-quality evidence suggests that these oils are not effective treatments for eczema.
- https://highvalleydermatology.com/eczema/ – This is a general information page about eczema. It does not provide specific research on borage oil, but it offers context on eczema as a condition. The page discusses various treatment options and management strategies for eczema, but it does not focus on the efficacy of borage oil.
- https://consensus.app/search/how-has-borage-improved-patient-outcomes/yNeu-u-GTsKddQQxtjcnZA/ – This is a search result aggregator that summarizes research findings related to borage oil and patient outcomes. It confirms the lack of significant benefit of borage oil in eczema symptom relief compared to placebo, reinforcing the findings of the Cochrane review. The aggregated data suggests that borage oil is not an effective treatment for eczema based on current evidence.
