Web site: "Information
About Herbs, Botanicals and Other Products"
URL: http://www.mskcc.org/aboutherbs
© 2003 Memorial Sloar-Kettering Cancer Center
(Monograph)
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Full Text |
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Barrie Cassileth
and K. Simon Yeung
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Borage
(Borago officinalis)
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| Clinical Summary |
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Oil
derived from the plant. Used as a source of gamma-linoleic acid (GLA) and
to treat rheumatoid arthritis; routinely consumed as an alternative to
evening primrose oil. Limited clinical data support claims made for borage
oil. One study shown borage oil has no overall efficacy in atopic eczema.
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.
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| Scientific Name |
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Borago
officinalis
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| Also Known As |
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Bee
plant, bee bread, borage seed oil, ox’s tongue, starflower oil
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| Purported Uses |
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• Arthritis
• Chest
congestion
• Cough
• Depression
• Infantile
seborrheic dermatitis
• Menopausal
symptoms
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Constituents
[1] |
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• Alkaloids:
Contains small amounts of many pyrrolizidine types, especially amabiline
(hepatotoxin)
• Fatty
acids: Linoleic acid gamolenic acid (GLA), oleic and saturated fatty acids
• Mucilages:
Glucose, galactose and arabinose
• Acids:
Acetic, lactic, malic and silicic
• Tannins
• Saponins
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| Mechanism Of Action [3], [10] |
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Borage's seed
oils seem to be responsible for its action. The GLA from the seeds may
have anti-inflammatory properties. GLA can be converted to the
prostaglandin precursor dihomo-GLA, which has anti-inflammatory activity.
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.
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Warnings
[2] |
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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).
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Contraindications
[9] |
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Pregnancy:
Preliminary studies suggest borage oil has a teratogenic effect
and that its prostaglandin E agonist action may cause premature labor.
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| Adverse Reactions |
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Common:
Constipation may occur after administration.
Rare: Hepatotoxicity has been reported following chronic
administration.
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Drug Interactions
[6], [ 9] |
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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.
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| Literature Summary And Critique |
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Henz
BM, et al. Double-blind,
multicentre analysis of the efficacy of borage oil in patients with atopic
eczema. Br
J Dermatol
1999;140:685-8.
A
double-blind, multicenter study of borage oil (23% GLA) in 167
adults with stable atopic eczema of moderate severity. Patients were
randomized to take daily either 500 mg of borage oil-containing capsules
or the bland lipid miglyol as a placebo over a 24-week period. Primary
endpoint was amount of rescue medication (topical
diflucortolone-21-valerate cream) used until response; secondary endpoint
was clinical improvement. Patients taking borage oil experienced small but
insignificant clinical improvements compared to placebo; a subgroup
excluding noncompliant patients and those who failed to show increased
erythrocyte dihomo-gamma-linolenic acid levels showed a significant
benefit.
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Leventhal
LJ, et al. Treatment
of rheumatoid arthritis with gammalinoleic acid. Ann Intern Med
1993;119:867-73.
A
randomized, double-blind, placebo-controlled, 24-week trial of 37 patients
with rheumatoid arthritis and active synovitis. The treatment group
receiving gammalinoleic acid (GLA) 1.4 g experienced a 36% reduction in
the number of tender joints and a 28% reduction in swollen joints. The
placebo group did not show significant improvement in any measure. No
significant adverse effects were reported.
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Pullman-Mooar
S, et al. Alteration of the cellular fatty acid profile and the production
of eicosanoids in human monocytes by gamma-linolenic acid. Arthritis
Rheum
1990;33:1526-33.
In an uncontrolled trial, borage seed oil 1.1 g was given to 7 healthy
patients and seven patients with rheumatoid arthritis for 12 weeks.
Eighty-five percent of the arthritic group experienced relief, possibly
due to the GLA in the borage oil.
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| References |
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[1] Newell
CA, et al. Herbal Medicine: A Guide for Healthcare Professionals. London:
Pharmaceutical Press; 1996. |
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[2] Tyler
V. Herbs of Choice, the Therapeutical Use of Phytomedicinals. Binghamton:
Pharmaceutical Press; 1994. |
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[3] Pierce
A. The American Pharmaceutical Association Practical Guide to Natural
Medicines. New York: The Stonesong Press Inc; 1999. 270. |
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[4] Hoffman
D. The Herb Users Guide: The Basic Skills of Medical Herbalism.
Wellingborough: Thorsons, 1987. |
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[5]
Tollesson
A, Frithz A. Borage oil, an effective new treatment for infantile
seborrhoeic dermatitis. Br J Derm 1993;129:95. |
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[6]
Brinker F. Herb Contraindications and Drug Interactions, 3rd
ed. Sandy (OR): Eclectic Medical Publications; 2001. |
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[7]
Leventhal
LJ, et al. Treatment
of rheumatoid arthritis with gamma-linolenic acid. Ann
Intern Med
1993;119:867-73. |
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[8]
Pullman-Mooar
S, et al. Alteration of the cellular fatty acid profile and the production
of eicosanoids in human monocytes by gamma-linolenic acid. Arthritis
Rheum 1990;22:1526-33. |
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[9]
Kast
RE, Borage oil reduction of rheumatoid arthritis activity may be medicated
by increased cAMP that suppresses tumor necrosis factor-alpha.
International Immunopharmacology 2001;2197-99. |
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[10]
Belch
JJ, Hill A. Evening primrose oil and borage oil in rheumatologic
conditions. Am J Clin Nutr 2000;71(suppl):352S-6S. |
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[11]
Henz
BM, et al. Double-blind,
multicentre analysis of the efficacy of borage oil in patients with atopic
eczema. Br J Dermatology 1999;140:685-8.
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| Written |
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10/26/2001 |
| Updated |
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11/01/2002
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