Borage

Borage

Borage

Common Names

  • Bee plant
  • bee bread
  • borage seed oil
  • ox's tongue
  • starflower oil

For Patients & Caregivers

Borage may be helpful in treating rheumatoid arthritis, but there is no evidence that it can treat menopausal symptoms, depression, dermatitis or other serious medical conditions.

Borage seeds contain oils that are probably responsible for its medicinal actions. These oils are known to contain the omega-6 fatty acid gamma-linolenic acid (GLA), which is also produced naturally in the body. Scientists have not figured out how exactly borage exerts its effects, but theorize that GLA has anti-inflammatory activity. Chronic inflammation is mediated in part by substances known as prostaglandins and leukotrienes, both by-products of metabolism of arachidonic acid, a fatty acid in cell membranes. GLA is able to reduce the formation of prostaglandins and leukotrienes by replacing arachidonic acid in cell membranes.

Borage also contains mucilage, a sticky mixture of plant sugars, which can act as an expectorant to produce phlegm in patients with coughs.

  • To reduce inflammation and pain associated with arthritis
    A handful of small clinical trials support this use.
  • As an expectorant and to treat coughs
    Laboratory studies support this use, but there is no proof from clinical trials that borage can treat coughs.
  • To treat depression
    No scientific evidence supports this use.
  • To treat infantile seborrheic dermatitis
    Laboratory studies do not support this use.
  • To treat atopic dermatitis (eczema)
    One large clinical trial (described below) does not support this use.
  • To ease menopausal symptoms such as hot flashes, vaginal dryness, sleep disturbances, and mood swings
    No scientific evidence supports this use.
  • Borage oil products should be certified free of toxic compounds called unsaturated pyrrolizidine alkaloids (UPAs), at least no more than 0.5-1 microgram of UPAs per gram of borage oil. The German Federal Health Agency recommends that consumption of UPAs should be limited to no more than 1 microgram daily.
  • You are pregnant (Borage oil may cause birth defects and premature labor).
  • You are taking phenothiazines (In theory, the GLA in borage oil may lower patients’ seizure threshold. Seizures have been reported in patients that have combined phenothiazines with evening primrose oil, which also contains GLA.)
  • You are taking tricyclic antidepressants (In theory, the GLA in borage oil may lower patients’ seizure threshold. Seizures have been reported in patients that have combined tricyclic antidepressants with evening primrose oil, which also contains GLA.)
  • You are regularly taking NSAIDs (such as aspirin, AdvilTM, or cox-2 inhibitors) (In theory, NSAIDs can reduce the effects of borage oil).
  • Constipation
  • Liver damage has occurred in a few patients who took borage oil for prolonged periods of time.

Borage oil products should not be used unless they are certified free of unsaturated pyrrolizidine alkaloids (UPAs) such as amabiline, which can damage the liver. Risk of liver damage increases with length of exposure and cumulative dose.

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For Healthcare Professionals

Borago officinalis

Oil derived from the plant. Recent studies have shown gamma-linoleic acid (GLA) from borage seed oil has some benefits in treating rheumatoid arthritis (7)(9). Studies on borage oil’s effect on skin conditions, such as atopic eczema (11)(12) and infantile seborrheic dermatitis (5), yielded mixed results. Borage oil contains a pyrrolizidine alkaloid, amabiline, which is hepatotoxic. Risk of hepatic damage increases with length of exposure and cumulative dose consumed. Patients should use borage oil certified free of unsaturated pyrrolizidine alkaloids. Borage oil may be unsafe during pregnancy.

  • Arthritis
  • Chest congestion
  • Cough
  • Depression
  • Infantile seborrheic dermatitis
  • Menopausal symptoms

The GLA from the borage seeds may have anti-inflammatory properties. GLA can be converted to the prostaglandin precursor dihomo-gama-linolenic acid (DGLA). DGLA can block the transformation of arachidonic acid to leukotrienes and other prostaglandins (10). GLA can increase cAMP level which suppresses the synthesis of tumor necrosis factor-alpha - an inflammatory mediator linked to rheumatoid arthritis (9). The mucilage constituent has an expectorant-like action and malic acid has a mild diuretic effect. The tannin constituent may have mild astringent and constipating actions.
(3)

Borage contains small amounts of the alkaloid amabiline, which is hepatotoxic. Consumption of 1-2 g of borage seed oil daily can result in an intake of toxic unsaturated pyrrolizidine alkaloids (UPAs) approaching 10 ug. The German Federal Health Agency now specifies consumption of such products should be limited to no more than 1 ug of UPA daily. Borage oil products should be certified free of UPAs (meet criterion of no more than 0.5-1 ug/g).
(2)

Pregnancy: Preliminary studies suggest borage oil has a teratogenic effect and that its prostaglandin E agonist action may cause premature labor.
(9)

Common: Constipation may occur after administration.
Rare: Hepatotoxicity has been reported following chronic administration.

Phenothiazines: Theoretically borage oil may lower the seizure threshold due to its gamma linoleic acid content. Seizures have been documented with evening primrose oil, but not borage oil.
Tricyclic antidepressants: Theoretically, may lower seizure threshold due to gamma linoleic acid content. Seizures have been documented with evening primrose oil, but not borage oil.
NSAIDS: Theoretically concomitant use with borage oil would decrease the effects of borage oil, as NSAIDS interfere with the synthesis of prostaglandin E.
(6)(9)


  1. Newell CA, et al. Herbal Medicine: A Guide for Healthcare Professionals. London: Pharmaceutical Press; 1996.

  2. Tyler V. Herbs of Choice, the Therapeutical Use of Phytomedicinals. Binghamton: Pharmaceutical Press; 1994.

  3. Peirce A. The American Pharmaceutical Association Practical Guide to Natural Medicines. New York: The Stonesong Press Inc; 1999. 270.

  4. Hoffman D. The Herb Users Guide: The Basic Skills of Medical Herbalism. Wellingborough: Thorsons, 1987.

  5. Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical Publications; 2001.

  6. Leventhal LJ, et al. Treatment of rheumatoid arthritis with gamma-linolenic acid. Ann Intern Med 1993;119:867-73.

  7. Belch JJ, Hill A. Evening primrose oil and borage oil in rheumatologic conditions. Am J Clin Nutr 2000;71(suppl):352S-6S.

  8. Takwale A, Tan E, Agarwal S, Barclay G, Ahmed I, Hotchkiss K, Thompson JR, Chapman T, Berth-Jones J. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ. 2003 Dec 13;327(7428):1385.

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