Borage

botanical

What is it

Borage (Borago officinalis) is a herbaceous flowering plant native to the Mediterranean region. While the leaves and flowers have been used traditionally in cooking and herbal medicine, the most studied product is borage seed oil, which is one of the richest natural sources of gamma-linolenic acid (GLA), typically containing 20-26% GLA.

How it works

Borage's primary therapeutic constituent is gamma-linolenic acid (GLA), an omega-6 fatty acid. The body converts GLA to dihomo-gamma-linolenic acid (DGLA) and then to anti-inflammatory series 1 prostaglandins (PGE1). This pathway is normally fed by linoleic acid, but the conversion to GLA can be impaired by aging, diabetes, alcohol, and other factors, making direct GLA supplementation potentially beneficial. Borage leaves and aerial parts also contain mucilaginous compounds, tannins, and small amounts of pyrrolizidine alkaloids (PAs). PAs can be hepatotoxic at sufficient exposure, which has led to regulatory concerns about consuming borage leaves and teas in significant amounts. Borage seed oil intended for supplements is typically processed to remove or minimize PA content.

Evidence for 5 uses

AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.

Rheumatoid arthritis

Grade B

Good evidence

Several randomized trials have shown that borage seed oil (1.4-2.8 g/day of GLA) reduces joint pain, tenderness, and morning stiffness in rheumatoid arthritis. Effects develop over 1-3 months.

Atopic dermatitis (eczema)

Grade C

Moderate evidence

Studies of borage seed oil in adults and children with atopic dermatitis have shown mixed results. Some studies show improvement in skin barrier function and symptoms; others show no benefit. Newer meta-analyses are less supportive than early studies.

Diabetic neuropathy

Grade C

Moderate evidence

Limited studies have shown improvements in nerve conduction with GLA supplementation in diabetic neuropathy. Effects are modest.

PMS / cyclic mastalgia

Grade D

Mixed evidence

GLA-containing oils have been tried for PMS symptoms and breast pain with mixed evidence. Newer studies are less supportive than older ones.

Respiratory inflammation / ARDS

Grade D

Mixed evidence

Studies of borage and fish oil combinations in acute respiratory distress syndrome have shown inconsistent results.

3 commercial forms

Borage seed oil softgels (standardized)

Standardized to GLA content; processed to remove PAs

The standard supplement form. Look for products certified PA-free or with very low PA content.

Borage seed oil (bottled liquid)

Same fatty acid profile

Less common; oxidation risk requires refrigeration.

Borage leaves / flowers (culinary)

Different bioactives; contains PAs

Used as a garnish or in small amounts in traditional cooking. Daily significant consumption is not recommended due to PA content.

Dosage

For borage seed oil, doses range from 1000-3000 mg per day, providing approximately 240-720 mg of GLA. Some clinical conditions have used higher doses under medical supervision. Borage leaves should be used sparingly and primarily for culinary garnishing due to PA concerns; daily consumption of borage tea is generally discouraged.

When and how to take it

Take borage seed oil with meals to enhance absorption and reduce gastrointestinal upset. Effects on inflammatory conditions develop over weeks to months. Daily consistency matters more than specific timing. Avoid taking with bedtime if you notice sleep disturbance.

Safety

Borage seed oil is generally well tolerated. Possible side effects include nausea, bloating, soft stools, and headache. The main safety concern is pyrrolizidine alkaloid (PA) content; choose products certified as PA-free or low-PA. Borage seed oil's GLA may have mild antiplatelet effects, increasing bleeding risk at high doses.

Who should be cautious

Avoid in pregnancy and breastfeeding due to potential PA exposure and uterine-stimulating effects of borage. People with liver disease should avoid borage leaves and teas. People taking anticoagulants, with bleeding disorders, with epilepsy (theoretical concern about lowered seizure threshold from phenothiazine interactions), or scheduled for surgery within 2 weeks should consult a clinician.

Interactions

Borage seed oil may interact with anticoagulants and antiplatelet medications, potentially increasing bleeding risk. It may interact with phenothiazine medications (theoretical lowering of seizure threshold) and NSAIDs. Theoretical interactions with CYP450 enzymes affecting drug metabolism.

Frequently asked questions

How is borage seed oil different from evening primrose oil?⌄

Both provide GLA, but borage seed oil has a much higher GLA concentration (20-26% vs ~10% in evening primrose), meaning smaller doses are needed. Borage carries pyrrolizidine alkaloid concerns that evening primrose does not.

Are borage leaves safe to eat?⌄

Small amounts as garnish are traditional and probably safe. Daily consumption of large amounts of leaves or borage tea is discouraged due to pyrrolizidine alkaloid content and potential liver toxicity.

Will borage seed oil help my arthritis?⌄

Studies show benefit in rheumatoid arthritis at GLA doses of 1.4-2.8 g/day (equivalent to several capsules of borage oil). Effects develop over weeks. Discuss with your rheumatologist.

Can I take borage oil with my blood thinner?⌄

Borage oil may have additive antiplatelet effects. Discuss with your clinician; bleeding risk should be monitored.

How do I know if my borage oil is safe?⌄

Look for products certified as PA-free or 'pyrrolizidine alkaloid-free.' Reputable manufacturers process the oil to remove these toxins.

References

  • Borage (Wikidata) — Wikidata link

Track Borage with Pilora

Set up dose reminders, check interactions, and join the community in the Pilora iPhone app.

Coming to App Store

Disclaimer: These statements have not been evaluated by the FDA. This page is educational, not a substitute for personalized medical advice. Evidence grades are AI-assisted assessments — talk to your doctor before starting any new supplement, especially if you're pregnant, breastfeeding, on medications, or managing a chronic condition.