Evening_Primrose_Oil.jpg

Photo copyright Steven Foster

Evening Primrose Oil

Also indexed as: Black Currant Seed Oil, EPO, Oenothera biennis, Starflower

What does it do? Evening primrose oil (EPO), black currant seed oil, and borage oil contain gamma linolenic acid (GLA), a fatty acid that the body converts to a hormone-like substance called prostaglandin E1 (PGE1). PGE1 has anti-inflammatory properties and may also act as a blood thinner and blood vessel dilator.

The anti-inflammatory properties of EPO have been studied in double-blind research with people suffering from rheumatoid arthritis. Some, but not all, studies have reported that EPO supplementation provides significant benefit to these people.1

GLA, the primary active ingredient in EPO, has anticancer activity in test tube studies2 and in some,3 but not all,4 animal studies. Injecting GLA into tumors has caused regression of cancer in people in preliminary research.5 Very preliminary evidence in people with cancer suggested “marked subjective improvement,”6 though not all studies find GLA helpful.7

EPO has been reported to lower cholesterol levels in people in some,8 but not all,9 research.

EPO supplementation has been shown to improve skin itching, redness and dryness associated with kidney dialysis.10 11

Linoleic acid, a common fatty acid found in nuts and seeds and most vegetable oils (including EPO), should theoretically be converted to PGE1. But many things can interfere with this conversion, including disease, the aging process, saturated fat, hydrogenated oils, blood sugar problems, and inadequate vitamin C, magnesium, zinc, and B vitamins. Supplements that provide GLA circumvent these conversion problems, leading to more predictable formation of PGE1.12

Where is it found? EPO is found primarily in supplements. Its presumed active ingredient, GLA, can also be found in black currant seed oil and borage oil supplements. However, it is not known whether the effects of these three oils in the body are the same.

Evening primrose oil has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating Health Concerns
3Stars Diabetes
2Stars Eczema
Fibrocystic breast disease
Osteoporosis (in combination with fish oil)
Premenstrual syndrome (PMS)
Rheumatoid arthritis
Skin ulcers
1Star Alcohol withdrawal
Atherosclerosis
Attention deficit disorder
Intermittent claudication
Irritable bowel syndrome (IBS)
Multiple sclerosis
Raynaud’s disease
Scleroderma
Sjogren’s syndrome
Tardive dyskinesia
3Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1Star An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Who is likely to be deficient? Those with premenstrual syndrome,13 diabetes,14 scleroderma,15 Sjogren’s syndrome,16 tardive dyskinesia,17 eczema,18 and other skin conditions19 can have a metabolic block that interferes with the body’s ability to make GLA. In preliminary research, supplementation with EPO has helped people with these conditions.20 21 22 23 24

There is evidence that alcoholics may be deficient in GLA, and a double-blind study suggested that alcohol withdrawal may be facilitated with EPO supplementation.25 Many people in Western societies may be at least partially GLA-deficient as a result of aging, glucose intolerance, high dietary fat intake, and other problems. People with deficiencies would presumably benefit from supplemental GLA intake from EPO, black currant seed oil, or borage oil.

How much is usually taken? Although many people may have inadequate levels of GLA, the optimal intake for this nutrient remains unknown. Researchers often use 3,000–6,000 mg of EPO per day, which provides approximately 270–540 mg of GLA.

Are there any side effects or interactions? EPO has been reported to exacerbate symptoms of temporal lobe epilepsy, which can sometimes be mistaken for schizophrenia.26 27

Other nutrients are needed by the body, along with EPO, to make PGE1. Consequently, some experts suggest that magnesium, zinc, vitamin C, niacin, and vitamin B6 should be taken along with EPO.

Are there any drug interactions? Certain medications may interact with evening primrose oil. Refer to the drug interactions safety check for a list of those medications.

References:

1. Joe LA, Hart LL. Evening primrose oil in rheumatoid arthritis. Ann Pharmacother 1993;27:1475–7 [review].

2. Dippneaar N, Booyens J, Fabbri D, Katzeff IE. The reversibility of cancer: evidence that malignancy in melanoma cells is gamma linolenic acid deficiency-dependent. S Afr Med J 1982;62:505–9.

3. Pritchard GA, Mansel RE. The effects of essential fatty acids on the growth of breast cancer and melanoma. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine. Horrobin DF (ed). New York: Alan R Liss, 1990, 379–90.

4. Lee JH, Sugano M. Effects of linoleic and gamma-linolenic acid on 7,12-dimethylbenz(a)anthracene-induced rat mammary tumors. Nutr Rep Int 1986;34:1041.

5. Naidu MRC, Das UN, Kshan A. Intratumoral gamma-linolenic acid therapy of human gliomas. Prostaglandins Leukot Essent Fatty Acids 1992;45:181–4.

6. Van der Merwe CF, Booyens J. Oral gamma-linolenic acid in 21 patients with untreatable malignancy. An ongoing pilot open clinical trial. Br J Clin Pract 1987;41:907–15.

7. McIllmurray MB, Turkie W. Controlled trial of gamma linolenic in Duke’s C colorectal cancer. Br Med J 1987;294:1260.

8. Ishikawa T, Fujiyama Y, Igarashi O, et al. Effects of gammalinolenic acid on plasma lipoproteins and apolipoproteins. Atherosclerosis 1989;75:95–104.

9. Boberg M, Vessby B, Selinus I. Effects of dietary supplementation with n-6 and n-3 long-chain polyunsaturated fatty acids on serum lipoproteins and platelet function in hypertriglyceridaemic patients. Acta Med Scand 1986;220:153–60.

10. Yoshimoto-Furuie K, Yoshimoto K, Tanaka T, et al. Effects of oral supplementation with evening primrose oil for six weeks on plasma essential fatty acids and uremic skin symptoms in hemodialysis patients. Nephron 1999;81:151–9.

11. Tamimi NA, Mikhail AI, Stevens PE. Role of gamma-linolenic acid in uraemic pruritus. Nephron 1999;83:170–1 [letter].

12. Horrobin DF. The importance of gamma-linolenic acid and prostaglandin E1 in human nutrition and medicine. J Holistic Med 1981;3:118–39.

13. Horrobin DF, Manku M, Brush M, et al. Abnormalities in plasma essential fatty acid levels in women with pre-menstrual syndrome and with non-malignant breast disease. J Nutr Med 1991;2:259–64.

14. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

15. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren’s syndrome. Med Hypotheses 1984;14:233–47.

16. Horrobin DF, Campbell A. Sjogren’s syndrome and the sicca syndrome: the role of prostaglandin E1 deficiency. Treatment with essential fatty acids and vitamin C. Med Hypotheses 1980;6:225–32.

17. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 333–43.

18. Manku MS, Horrobin, DF, Morse NL, et al. Essential fatty acids in the plasma phospholipids of patients with atopic eczema. Br J Derm 1984;110:643.

19. Horrobin DF. Essential fatty acids in clinical dermatology. J Am Acad Dermatol 1989;20:1045–53.

20. Mansel RE, Pye JK, Hughes LE. Effects of essential fatty acids on cyclical mastalgia and noncyclical breast disorders. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 557–66.

21. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

22. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren’s syndrome. Med Hypotheses 1984;14:233–47.

23. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine. Horrobin DF (ed). New York: Alan R Liss, 1990, 333–43.

24. Schalin-Karrila M, Mattila L, Jansen CT, et al. Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987;117:11–9.

25. Glen AIM, Glen EMT, MacDonnell LEF, et al. Essential fatty acids in the management of withdrawal symptoms and tissue damage in alcoholics, presented at the 2nd International Congress on Essential Fatty Acids, Prostaglandins and Leukotrienes, London, Zoological Society. March 24–7, 1985, [abstract 53].

26. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6:375–9.

27. Holman CP, Bell AFJ. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orthomol Psychiatr 1983;12:302–4.