Borage is a flowering herb used for both food and medicine, prized mainly as one of the richest plant sources of gamma-linolenic acid (GLA), a fatty acid that helps regulate inflammation in the body. The oil pressed from borage seeds contains 18 to 26% GLA, roughly two to three times more than evening primrose oil, its closest competitor. This high GLA concentration is what drives most of borage’s therapeutic uses, from easing joint pain to supporting skin health.
Culinary Uses
The entire borage plant is edible. Its leaves, flowers, and stalks all taste like cucumber, making it a natural fit in salads, cold drinks, and light summer dishes. Borage leaves work well mixed into yogurt, cream cheese spreads, or alongside shellfish. The stalks can be cooked like any other vegetable.
One practical note: borage leaves grow increasingly fuzzy and prickly as the plant matures, so they’re best picked young and chopped finely. The bright blue, star-shaped flowers are mild enough to use as a garnish on cocktails, desserts, or salads.
Joint Pain and Rheumatoid Arthritis
The most studied medical use of borage oil is for rheumatoid arthritis. GLA gets converted in the body into compounds that dial down inflammation, and clinical trials have shown that daily oral supplementation produces a small but meaningful reduction in rheumatoid arthritis symptoms. Studies using doses of 1.4 grams and 2.8 grams of GLA per day both found statistically significant improvements. The higher dose corresponds to roughly 6 to 11 grams of borage oil daily, depending on GLA concentration.
The mechanism appears to involve suppressing tumor necrosis factor-alpha, one of the key proteins that drives joint inflammation. For people already managing RA with conventional medication, borage oil is sometimes used as a complementary approach, though it works gradually rather than providing immediate relief.
Skin Conditions and Eczema
Borage oil has a long history of use for skin disorders, and there’s a biological rationale for it. GLA helps maintain the skin’s moisture barrier, and people with eczema often have trouble converting dietary fats into GLA on their own. Animal studies have demonstrated that GLA from borage oil can reverse abnormal skin cell overgrowth.
The human evidence is more mixed. A double-blind trial of 160 adults with moderate atopic eczema tested 500 mg of borage oil capsules daily against a placebo over 24 weeks. The overall results did not reach statistical significance. However, a subgroup of patients whose blood levels of GLA actually rose during the study did show meaningful improvement, suggesting that the oil works when it’s properly absorbed but that not everyone absorbs it equally well. The treatment was well tolerated across the board, with no significant safety concerns.
Lung Inflammation in Critical Care
In hospital settings, borage oil has been studied as part of specialized feeding formulas for patients with acute respiratory distress syndrome (ARDS), a severe form of lung inflammation. When combined with fish oils and antioxidants in a continuously administered tube-feeding formula, the combination was associated with shorter time on ventilators, shorter ICU stays, and in some analyses, a 32% reduction in 28-day mortality compared to standard high-fat formulas.
Canadian clinical practice guidelines from 2013 recommended considering this combination for patients with acute lung injury. One important caveat: giving the same oils as a bolus supplement rather than through continuous feeding showed no effect on mortality, suggesting the delivery method matters as much as the ingredients.
How Borage Compares to Evening Primrose Oil
Evening primrose oil is the better-known GLA supplement, but borage oil delivers significantly more GLA per capsule. Evening primrose oil contains 7 to 10% GLA, while borage oil ranges from 18 to 26%, with some analyses putting it as high as 38%. In practical terms, you’d need two to three evening primrose capsules to match the GLA in a single borage oil capsule of the same size. For people specifically seeking GLA supplementation, borage oil is the more concentrated option.
Typical Dosages
Clinical trials have used borage seed oil at 1 to 3 grams per day for adults and around 1 gram per day for children. For eczema specifically, adult doses of 2,000 to 4,000 mg per day (delivering 400 to 1,000 mg of GLA) have been studied. Children with atopic dermatitis have been given 1,000 to 2,000 mg per day, providing 240 to 480 mg of GLA. Most commercially available capsules contain 1,000 mg of borage oil, so typical supplementation falls in the one-to-three-capsule range.
Safety and Drug Interactions
Borage oil is generally well tolerated, but it carries a few specific risks worth knowing about.
- Blood thinners: Borage oil can increase bleeding time. In a small study of patients taking GLA supplements for several months, 9 out of 12 had significantly prolonged bleeding. If you take warfarin or similar anticoagulants, this interaction is worth discussing with a pharmacist.
- Liver health: The borage plant contains small amounts of pyrrolizidine alkaloids, compounds that can be toxic to the liver. Most commercial borage oil supplements are certified “PA-free,” meaning these compounds have been removed during processing. People taking medications that already stress the liver (such as certain antifungals or anabolic steroids) should be especially cautious.
- NSAIDs: Common anti-inflammatory drugs like aspirin and ibuprofen may blunt the effects of borage oil by interfering with the same prostaglandin pathways that GLA uses to reduce inflammation. Taking both together could mean the borage oil does less than expected.
- Seizure risk: At least one case report links borage oil to status epilepticus in a previously healthy woman after just one week of use. This is a rare event, but it has been documented.
The raw borage plant, including teas or tinctures made from leaves and stems, carries a higher risk of pyrrolizidine alkaloid exposure than refined seed oil. If you’re using borage medicinally rather than as an occasional salad ingredient, the processed seed oil is the safer form.