Fatty Acid

Borage Oil

Borago officinalis

Evidence TierCWADA NOT PROHIBITED

tuneTypical Dose

1.4 g daily of gamma-linolenic acid from borage seed oil was used in the main rheumatoid-arthritis RCT

watchEffect Window

Anti-inflammatory symptom changes in rheumatoid-arthritis trials were assessed over months rather than days.

check_circleCompliance

WADA NOT PROHIBITED

Overview

Clinical Summary

Borage oil provides gamma-linolenic acid and has limited evidence for rheumatoid-arthritis symptom reduction, but its eczema evidence is mixed and product purity matters.

Borage oil is mainly used as a gamma-linolenic-acid supplement. The better human evidence is for rheumatoid-arthritis symptom reduction at fairly high GLA doses, while the atopic-dermatitis literature is inconsistent and often disappointing. Safety framing also matters because borage products can vary in pyrrolizidine-alkaloid contamination if they are not well purified.

Borage oil is mainly relevant because it supplies gamma-linolenic acid, which can increase dihomo-gamma-linolenic acid and shift some eicosanoid signaling toward less inflammatory pathways. That mechanism is plausible, but the human benefits are still selective and not uniform across conditions.

Outcomes

What This Is Expected To Influence

Primary Outcomes

  • Possible reduction in rheumatoid-arthritis symptom activity at high GLA doses

Secondary Outcomes

  • Mixed and generally weak evidence for atopic dermatitis
  • Product purity is a meaningful safety qualifier

Safety

Contraindications and Interactions

Contraindications

  • Pregnancy
  • Liver disease

Side effects

  • GI upset
  • Loose stools

Interactions

  • Anticoagulants or antiplatelet drugs
  • Hepatotoxic drugs

Avoid if

  • You cannot verify that the product uses purified seed oil with low pyrrolizidine-alkaloid contamination
  • You are expecting meaningful eczema improvement based on marketing rather than mixed clinical data

Evidence

Study-level References

bor-SRC-001Randomized controlled trial
Sourceopen_in_new

Leventhal LJ, et al. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Intern Med. 1993. doi:10.7326/0003-4819-119-9-199311010-00001. PMID:8214997.

Population: Patients with active rheumatoid arthritis and active synovitis.

Dose protocol: 1.4 g daily gamma-linolenic acid from borage seed oil for 24 weeks

Key findings: Meaningful reductions in tender and swollen joint measures versus placebo in active rheumatoid arthritis.

Notes: Best direct efficacy trial.

Paper content

This is the main efficacy anchor for borage oil. In patients with active rheumatoid arthritis, 1.4 g daily of gamma-linolenic acid from borage seed oil improved several joint-activity measures over 24 weeks compared with placebo.

bor-SRC-002Narrative review
Sourceopen_in_new

Foster RH, Hardy G. Borage oil in the treatment of atopic dermatitis. Am J Clin Dermatol. 2010. doi:10.2165/11536220-000000000-00000. PMID:20579590.

Population: Clinical trials of oral or topical borage oil used for treatment or prevention of atopic dermatitis.

Dose protocol: Mixed oral and topical borage-oil protocols across dermatitis trials

Key findings: Overall data suggest no major clinical effect for atopic dermatitis, though small benefit in some individuals cannot be excluded.

Notes: Best condition-wide eczema review.

Paper content

This review is the best evidence anchor for the eczema literature. It found mixed results and concluded that borage oil is unlikely to have a major clinical effect in atopic dermatitis, though a small benefit in some individual patients cannot be ruled out.

bor-SRC-003Randomized controlled trial
Sourceopen_in_new

Takwale A, 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. doi:10.1136/bmj.327.7428.1385. PMID:14670885.

Population: Adults and children with atopic eczema.

Dose protocol: Adults 920 mg GLA daily and children lower weight-adjusted dosing for 12 weeks

Key findings: No meaningful advantage over placebo on SASSAD or symptom scores.

Notes: Best large negative eczema RCT.

Paper content

This large eczema trial is important because it is clearly negative. Over 12 weeks, oral borage oil did not improve eczema severity, symptoms, or steroid requirements versus placebo.

bor-SRC-004Randomized controlled trial
Sourceopen_in_new

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. doi:10.1039/d1fo01887f. PMID:34606560.

Population: Overweight young adults with a family history of obesity.

Dose protocol: Borage oil providing 880 mg GLA/day for 6 weeks in overweight young adults with family history of obesity.

Key findings: Lowered plasma triglycerides and raised HDL cholesterol. No effect on resting metabolic rate, BMI, total cholesterol, LDL, or glucose.

Notes: Adds a lipid-benefit data point for borage oil beyond the rheumatoid-arthritis evidence. Short duration and small sample limit confidence.

Paper content

This RCT in overweight young adults with a family history of obesity found that 6 weeks of borage oil (880 mg GLA/day) had no effect on resting metabolic rate but significantly lowered plasma triglycerides and raised HDL cholesterol compared to baseline. BMI, total cholesterol, LDL, and glucose were unaffected. Evening primrose oil at a lower GLA dose did not produce the same lipid effects. The results suggest borage oil may offer modest lipid benefits independent of any metabolic rate or weight-loss effect.

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