Borage Oil
Borage oil is the richest natural source of gamma-linolenic acid (GLA) — 20–26% by weight, ~2.5× evening primrose oil. Best evidence: rheumatoid arthritis joint pain (modest, 6+ months). Older data also support diabetic neuropathy. Cochrane has rejected the eczema use. Always choose PA-free certified product.
Quick decision guide
May help most
Adults with rheumatoid arthritis seeking an adjunct to standard DMARDs; people with mild diabetic neuropathy at early stages; people whose endogenous delta-6-desaturase is impaired by aging, diabetes, or atopy.
Common dosing range
1–3 g borage oil/day delivering 240–720 mg GLA. RA trials used 1.4–2.8 g GLA/day (= ~6–12 g borage oil).
When to expect effects
8–12 weeks minimum; full RA effect at 6 months.
Watch out for
Pyrrolizidine alkaloid contamination if untested; choose PA-free certified products.
Evidence snapshot
What is it
Borage oil is extracted from the seeds of the borage plant (Borago officinalis) and contains the highest natural concentration of gamma-linolenic acid (GLA), an omega-6 fatty acid. Typical borage oil contains 20-26% GLA, compared to evening primrose oil at 8-10%.
Is it worth it for you?
Use this as a quick fit check, not a diagnosis.
Worth considering if…
Probably skip if…
Evidence at a glance
| Goal | Effect | Best fit | Time |
|---|---|---|---|
Rheumatoid arthritis (adjunct) Good Evidence | Moderate reduction in joint pain, morning stiffness, tender joint count at GLA ≥1.4 g/day over 6 months | Adults with established RA on stable DMARD therapy seeking an adjunct; able to commit to 6 months at GLA ≥1.4 g/day | 8–12 weeks for early signs; 6 months for maximum effect |
Mild diabetic neuropathy Limited Evidence | Significant improvements in 13/16 nerve conduction and clinical parameters at 480 mg GLA/day over 1 year (1993 trial) | Early/mild diabetic neuropathy with good glycemic control | Months — Keen used 1 year |
Atopic dermatitis (eczema) Mixed Evidence | No benefit vs placebo in pooled RCT data | None — Cochrane review concluded against effectiveness | Not relevant — no benefit shown |
Premenstrual syndrome / cyclical mastalgia Mixed Evidence | Inconsistent; not significantly better than placebo in modern reviews | Adults wanting a low-risk trial for cyclical breast tenderness; expect modest at best | 2–3 menstrual cycles to assess |
Cardiovascular biomarkers Mixed Evidence | Inconsistent small biomarker changes; no hard endpoint data | None established for borage specifically | Not established |
Rheumatoid arthritis (adjunct)
- Effect
- Moderate reduction in joint pain, morning stiffness, tender joint count at GLA ≥1.4 g/day over 6 months
- Best fit
- Adults with established RA on stable DMARD therapy seeking an adjunct; able to commit to 6 months at GLA ≥1.4 g/day
- Time
- 8–12 weeks for early signs; 6 months for maximum effect
Mild diabetic neuropathy
- Effect
- Significant improvements in 13/16 nerve conduction and clinical parameters at 480 mg GLA/day over 1 year (1993 trial)
- Best fit
- Early/mild diabetic neuropathy with good glycemic control
- Time
- Months — Keen used 1 year
Atopic dermatitis (eczema)
- Effect
- No benefit vs placebo in pooled RCT data
- Best fit
- None — Cochrane review concluded against effectiveness
- Time
- Not relevant — no benefit shown
Premenstrual syndrome / cyclical mastalgia
- Effect
- Inconsistent; not significantly better than placebo in modern reviews
- Best fit
- Adults wanting a low-risk trial for cyclical breast tenderness; expect modest at best
- Time
- 2–3 menstrual cycles to assess
Cardiovascular biomarkers
- Effect
- Inconsistent small biomarker changes; no hard endpoint data
- Best fit
- None established for borage specifically
- Time
- Not established
Evidence for 5 uses
AI-assisted evidence assessment — talk to your doctor before relying on any single supplement.
Rheumatoid arthritis (adjunct)
Disease adjunctThe 2011 Cochrane review (Cameron et al.) included 22 herbal RA studies (2 specifically borage oil) and concluded GLA-rich oils — evening primrose, borage, and blackcurrant seed oil — produced moderate reductions in pain, morning stiffness, and joint tenderness over 6–12 weeks, with greatest benefit at GLA doses >1.4 g/day for 6 months. Some patients reduced NSAID use. Borage oil delivers GLA more efficiently per softgel than evening primrose oil because of its higher GLA content. Modern biologics dramatically outperform any GLA effect, but borage is a reasonable low-risk adjunct.
Bottom line: Real but modest. An adjunct to DMARDs/biologics, not a replacement. Requires high doses (≥1.4 g GLA/day) and patience (6 months).
Mild diabetic neuropathy
Disease adjunctKeen 1993 randomized 111 patients with mild diabetic neuropathy to 480 mg/day GLA or placebo for 1 year. 13 of 16 nerve-conduction and clinical parameters significantly improved with GLA vs placebo. The rationale is that diabetes impairs delta-6-desaturase activity, making exogenous GLA important. Subsequent larger trials have been less consistent, and modern neuropathy management (tight glycemic control, alpha-lipoic acid, gabapentinoids for pain) has stronger evidence.
Bottom line: Worth discussing with your endocrinologist as an adjunct for early neuropathy; don't substitute for tight glycemic control.
Atopic dermatitis (eczema)
Supplement benefitThe 2013 Cochrane review (Bamford et al.) pooled 27 RCTs (19 evening primrose, 8 borage oil; 1,596 participants) and found neither oil was more effective than placebo for atopic eczema. Side effects were mild and similar between groups. This was the definitive analysis for the field — earlier individual positive trials did not survive pooled scrutiny. Don't take borage oil for eczema.
Bottom line: Cochrane closed this question — borage oil doesn't help eczema. Topical emollients, corticosteroids, calcineurin inhibitors, and (for AD) the new L-histidine pilot data have better evidence.
Premenstrual syndrome / cyclical mastalgia
Supplement benefitGLA-rich oils (evening primrose more than borage) have a long history of use for breast tenderness and PMS, but modern systematic reviews find no consistent benefit beyond placebo. Mechanistic plausibility via prostaglandin modulation exists; clinical data don't deliver. Small individual studies are positive but pooled evidence is weak.
Bottom line: Plausible but unproven. Worth a 3-cycle trial if you want; don't expect dramatic effects.
Cardiovascular biomarkers
Biomarker supportSmall studies suggest borage oil may modestly improve blood pressure or LDL/HDL ratios, but trials are short, small, and inconsistent. EPA/DHA (fish oil) has dramatically stronger cardiovascular evidence than GLA from borage oil. Borage oil is not a cardiovascular supplement.
Bottom line: Skip borage for heart health — fish oil and Mediterranean dietary fats are better-evidenced.
How it works
How to take it
What to track
Bottom line: For RA: commit to ≥1.4 g GLA/day for 6 months on top of standard DMARDs. For neuropathy: 480 mg GLA/day for 1 year. Only PA-free certified products.
5 commercial forms
Compare the main delivery options and what they’re best suited for.
PA-free borage seed oil softgel (1 g, ~240 mg GLA)
RecommendedThe standard practical format. Softgels protect the oil from oxidation. Reputable brands certify and test for pyrrolizidine alkaloids — this is the single most important quality marker.
Standard; absorbed with dietary fat.
High-GLA borage softgel (1 g, ~300 mg GLA)
Fewer pillsConcentrated to ~30% GLA via molecular distillation. Reduces pill burden at therapeutic doses (4 softgels = ~1.2 g GLA vs 5 standard softgels). Same PA-free certification requirements.
Equivalent on a per-mg-GLA basis.
Cold-pressed liquid borage oil
NicheLiquid form, sometimes preferred by people avoiding gelatin softgels. Faster oxidation — must be refrigerated and used within shelf life. PA-free certification still required.
Same as softgel form; storage matters more.
Evening primrose oil (8–10% GLA)
Lower GLA alternativeDifferent plant (Oenothera biennis), lower GLA content per gram. Requires roughly 2.5× more capsules than borage for the same GLA dose. No PA concern. Bamford 2013 found it equally ineffective for eczema and similar for other GLA uses.
Equivalent on a per-mg-GLA basis; just more capsules.
Blackcurrant seed oil (15–17% GLA)
Middle groundIntermediate GLA content; less commonly tested in trials. Also free of pyrrolizidine alkaloids. Cochrane 2011 included it alongside borage and EPO as GLA-rich oils for RA.
Equivalent on a per-mg-GLA basis.
Safety
Know the common side effects, key cautions, and who should avoid it.
Common side effects
Serious risks
Pyrrolizidine alkaloid (PA) contamination — borage contains hepatotoxic and potentially carcinogenic PAs (notably amabiline). Only use products certified PA-free (<0.5–1 µg/g) by independent testing.
Theoretical mild antiplatelet effect from GLA — could increase bleeding risk with anticoagulants or pre-surgery. Discontinue 1–2 weeks before planned surgery.
Possible seizure-threshold lowering at high doses — case reports of seizures in people on phenothiazine antipsychotics. Avoid in epilepsy without neurologist input.
Who should avoid it
- Pregnant women — borage has been used historically as a galactagogue and uterine stimulant; safety in pregnancy is not established and concentration of PAs in untested oils is concerning. Avoid.
- Breastfeeding women — limited data; transfer of PAs to breast milk is a theoretical concern. Avoid unless PA-free certified and with clinician approval.
- People with epilepsy or on phenothiazine antipsychotics (chlorpromazine, haloperidol-class) without neurologist input.
- People on warfarin, DOACs, or aggressive antiplatelet therapy without prescriber coordination.
- Children — safety and dosing for pediatric use of borage oil are not established; pediatric AD trials in Bamford 2013 showed no benefit.
Pregnancy & breastfeeding
Avoid borage oil in pregnancy. Concerns include possible uterine-stimulant activity and the unresolved risk of pyrrolizidine alkaloid exposure to the fetus. Breastfeeding data are similarly sparse — PA transfer to breast milk is theoretically concerning. If you are pregnant or planning pregnancy, stop borage oil and discuss alternatives with your obstetric provider.
Bottom line: PA-free certification is the single most important quality marker. Avoid in pregnancy, epilepsy, and on aggressive anticoagulation without medical input.
Interactions
Mild antiplatelet effect from GLA could potentiate anticoagulant action. Monitor INR or signs of bleeding; discuss with prescriber before starting.
Additive antiplatelet activity — modest increase in bleeding risk at therapeutic borage doses.
Case reports suggest GLA-rich oils may lower the seizure threshold when combined with phenothiazines. Avoid combination or use only with neurologist supervision.
Theoretical seizure-threshold lowering with GLA-rich oils could destabilize seizure control. Avoid in epilepsy without neurologist input.
GLA's antiplatelet effect adds modestly to NSAID-related GI and bleeding risks at long-term high doses. Probably fine short-term, monitor with chronic combination.
GLA may modulate inflammatory signaling — theoretical interaction with immunosuppressant effect. No clear clinical signal; mention to transplant team.
Food sources
| Food | Amount | %DV |
|---|---|---|
| Borage seed oil (supplement only) | 1 g (~240 mg GLA, 20–24% by weight) | — |
| Evening primrose oil (alternative source) | 1 g (~80–100 mg GLA) | — |
| Blackcurrant seed oil (alternative source) | 1 g (~150–170 mg GLA) | — |
| Hemp seed oil (small amounts of GLA) | 1 Tbsp (~50–100 mg GLA) | — |
| Spirulina (trace GLA from algae) | 1 g (~10–15 mg GLA, varies) | — |
Borage seed oil (supplement only)
- Amount
- 1 g (~240 mg GLA, 20–24% by weight)
- %DV
- —
Evening primrose oil (alternative source)
- Amount
- 1 g (~80–100 mg GLA)
- %DV
- —
Blackcurrant seed oil (alternative source)
- Amount
- 1 g (~150–170 mg GLA)
- %DV
- —
Hemp seed oil (small amounts of GLA)
- Amount
- 1 Tbsp (~50–100 mg GLA)
- %DV
- —
Spirulina (trace GLA from algae)
- Amount
- 1 g (~10–15 mg GLA, varies)
- %DV
- —
Choosing a product
What to look for on the label — and what to be skeptical of.
Look for…
Be skeptical of…
Frequently asked questions
What is the difference between borage oil and evening primrose oil?⌄
Both are sources of GLA. Borage oil has a higher GLA concentration (20-26%) than evening primrose oil (8-10%), meaning smaller doses can deliver equivalent GLA.
Is borage oil safe?⌄
Generally yes, but choose certified PA-free borage oil. Raw borage contains hepatotoxic pyrrolizidine alkaloids that must be removed during oil processing. Avoid during pregnancy.
Does borage oil help arthritis?⌄
Yes, multiple trials show GLA-rich borage oil reduces symptoms of rheumatoid arthritis, including joint pain and stiffness. Effects typically appear after 4-12 weeks of consistent use.
How much GLA should I take?⌄
For arthritis, clinical trials have used 1.4-2.8 grams of GLA per day. For general use, 240-720 mg per day is typical. The borage oil dose to provide these GLA amounts depends on GLA percentage in your product.
Can borage oil cause seizures?⌄
GLA-rich oils may lower the seizure threshold in some people. People with epilepsy should consult a clinician before use, particularly if taking certain anticonvulsants or phenothiazines.
References by claim
Rheumatoid arthritis (adjunct)
Cameron et al., 2011 (Cochrane) — PubMed — Cochrane Database of Systematic Reviews (2011) link
Atopic dermatitis (eczema)
Bamford et al., 2013 (Cochrane) — PubMed — Cochrane Database of Systematic Reviews (2013) link
Mild diabetic neuropathy
Keen et al., 1993 — PubMed — Diabetes Care (1993) link
Track Borage Oil with Pilora
Set up dose reminders, check interactions, and join the community in the Pilora iPhone app.
Coming to App StoreDisclaimer: 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.