Borage: Benefits, Side Effects and Dosage

Borage (Borago officinalis), commonly known as starflower, has gained attention in both herbal medicine and nutritional circles for its rich composition, especially its oil, which is packed with gamma-linolenic acid (GLA). Used traditionally in Europe and the Middle East and now found worldwide, borage has been investigated for its potential to support skin health, modulate inflammation, and even provide antibacterial benefits. However, like all botanicals, it's important to weigh its benefits against possible side effects and understand optimal dosing for safe use. In this article, we dive deep into the science-backed benefits, risks, and recommended dosages of borage, helping you make informed decisions about its role in wellness.

Benefits of Borage

Borage offers a unique profile of nutrients and phytochemicals, making it a sought-after herb in both traditional and modern therapies. Whether consumed as an oil, tea, or extract, its potential applications are broad, ranging from skin conditions to metabolic and cardiovascular support.

Benefit	Application	Key Compound/Action	Source(s)
Skin health	Atopic dermatitis, dry skin	Gamma-linolenic acid (GLA)	1, 2, 3
Anti-inflammatory	Arthritis, multiple sclerosis	GLA, linoleic acid	3
Antibacterial	Infectious diseases, flu	Flower extract	4
Metabolic support	Diabetes, heart health	Fatty acid composition	3

Table 1: Main Benefits of Borage

Skin Health and Atopic Dermatitis

One of the most researched uses of borage is for improving skin barrier function, especially in conditions like atopic dermatitis and eczema. Borage seed oil is particularly rich in GLA—a rare omega-6 fatty acid that is a direct precursor to anti-inflammatory compounds in the body 1 2 3. Clinical trials on borage oil supplementation for atopic dermatitis show mixed but promising results: while some studies report significant improvements in skin symptoms, others show only minor or no effects. However, most studies agree that borage oil is well-tolerated in the short term and may offer small benefits, especially for individuals with mild or moderate skin issues seeking alternative therapies 1 2.

In elderly populations, supplementing with GLA-rich borage oil improved skin barrier function, as evidenced by decreased transepidermal water loss (TEWL) and reductions in itch and dry skin complaints 2. This effect is likely due to the direct incorporation of GLA and its metabolites into cell membranes, bypassing potential enzymatic deficiencies associated with aging.

Anti-inflammatory and Metabolic Effects

Beyond the skin, borage's high GLA and linoleic acid content has led to its use in managing inflammatory conditions such as arthritis, multiple sclerosis, and even metabolic disorders like diabetes 3. GLA is metabolized into dihomo-γ-linolenic acid (DGLA), which can be further converted into anti-inflammatory eicosanoids. This pathway is particularly relevant for individuals with inflammatory or autoimmune conditions, although robust clinical evidence for these applications is still developing.

Antibacterial Properties

Borage is not just valued for its fatty acids. Extracts from borage flowers, especially those of Iranian origin, have demonstrated antibacterial activity against pathogens like Staphylococcus aureus 4. This supports traditional uses of borage for infectious diseases, flu, and fever. The antibacterial action is heat-stable, suggesting that even teas or infusions retain some of these properties.

Potential Support for Heart and Blood Sugar Health

Traditional and some experimental studies suggest that borage may play a role in supporting heart health and managing blood sugars, likely due to its overall fatty acid profile 3. However, these uses are less well-supported by large-scale clinical trials and should be approached as supplementary to standard care.

Side Effects of Borage

While borage has a long tradition of safe use in food and medicine, certain risks and side effects need to be considered, especially when using concentrated extracts or oils.

Side Effect	Description	Severity/Notes	Source(s)
Pyrrolizidine alkaloids (PAs)	Potential for liver toxicity	Minimal in refined oil, concern with whole plant	6
Neurological issues	Status epilepticus (rare)	Isolated case, possible contamination or high dose	7
Hematological changes	Altered blood parameters	High doses, animal studies	9
GI discomfort	Mild digestive issues	Generally rare	1
Platelet function	No adverse effect at standard dose	Monitored in trials	8, 10

Table 2: Key Side Effects of Borage

Pyrrolizidine Alkaloids (PAs) and Liver Safety

One major safety concern with borage and other members of the Boraginaceae family is the presence of pyrrolizidine alkaloids (PAs), compounds known to be potentially hepatotoxic (damaging to the liver) if consumed in significant quantities over time. However, systematic reviews of case reports found no reliable evidence linking borage to PA-induced liver toxicity in humans, especially when using commercial borage oils which are typically refined to remove PAs 6. It's still prudent to ensure any borage supplement or oil is PA-free or compliant with safety standards, especially for long-term use.

Rare Neurological Effects

There is a published case of status epilepticus (a severe and prolonged seizure) in a person who took borage oil for a week 7. While this is an isolated incident, it underscores the importance of using high-quality, standardized products and consulting a healthcare professional before use, especially for individuals with a history of seizures or neurological conditions.

Hematological and Blood Effects

Animal studies have shown that very high doses of borage extract can alter blood parameters such as erythrocyte count, hemoglobin, and hematocrit 9. While these effects have not been replicated in standard human doses, they suggest a possible risk at excessive intake, especially in unsupervised or non-standardized preparations.

Gastrointestinal and Other Minor Effects

Most clinical trials using borage oil report it is well-tolerated, with only occasional mild gastrointestinal symptoms (e.g., upset stomach) 1. Standard supplemental dosages have not been associated with significant side effects in healthy volunteers 8 10.

Platelet Function and Bleeding Risk

Theoretical concerns exist that GLA-rich oils could affect platelet aggregation and bleeding risk. However, human trials using 3 g/day of borage oil found no significant effect on platelet aggregation or increased bleeding risk in healthy adults 8 10. Extremely high doses (far above therapeutic levels) may increase risk, but these are not recommended.

Dosage of Borage

Determining the right dosage of borage is crucial for maximizing benefits while minimizing risks. Different preparations—oil, extract, tea—have varying concentrations of active compounds, making standardized recommendations important.

Preparation	Typical Dose	Main Use	Source(s)
Borage oil	1–3 g/day (containing 240–720 mg GLA)	Skin, inflammation	2, 8, 10
Borage extract	Variable; often not standardized	Experimental, traditional	3, 9
Borage tea	Traditional, unstandardized	General wellness	4

Table 3: Typical Dosages of Borage

Standardized Borage Oil Supplements

Most clinical trials and safety studies have used borage oil at doses of 1–3 grams per day, providing approximately 240–720 mg of GLA 2 8 10. This dosage range has been shown to:

• Improve skin barrier function and reduce symptoms of dry or itchy skin, especially in elderly adults 2.
• Potentially provide anti-inflammatory benefits for mild arthritis or metabolic syndrome, though more research is needed 3.
• Not affect platelet aggregation or blood clotting at this dose, confirming its safety in healthy adults 8 10.

Extracts and Traditional Preparations

Borage extracts (from leaves or flowers) are used in some experimental and traditional settings, but dosages are highly variable and often not standardized 3 5 9. Animal studies have used a range of doses to explore effects on heart and blood parameters, but high doses may carry risks and are not recommended for self-administration 9.

Borage Flower Teas

Traditional use of borage flower tea, especially in Iranian and European herbal medicine, is for general wellness, respiratory infections, and fever 4. Because the concentration of active compounds varies widely, it is difficult to recommend a precise dosage. However, tea preparations are generally considered safe when consumed occasionally as part of a balanced diet, with the caveat to ensure the product is free of pyrrolizidine alkaloids.

Safety Considerations

• Always select PA-free, standardized supplements.
• Start with the lowest effective dose, especially if using for the first time.
• Consult a healthcare provider if you have existing liver, neurological, or hematological conditions, or are taking other medications.
• Avoid high, unregulated doses, especially from non-standardized extracts.

Conclusion

Borage is a versatile botanical with a rich tradition and increasingly robust body of scientific research supporting its health benefits—particularly for skin and mild inflammatory conditions. However, as with any supplement, understanding its side effects and optimal dosage is key for safe and effective use.

Key Takeaways:

• Skin Health: Borage oil, rich in GLA, may help improve skin barrier function and reduce symptoms of mild atopic dermatitis and dry skin, especially in older adults 1 2 3.
• Anti-inflammatory & Antibacterial: Potential benefits exist for inflammatory conditions and as a natural antibacterial agent, but more research is needed for routine use 3 4.
• Side Effects: Generally well-tolerated at standard doses, but rare cases of neurological events and blood changes highlight the importance of product quality and proper dosing 7 9.
• Dosage: 1–3 grams of borage oil per day (providing 240–720 mg GLA) is typical and safe for most adults; avoid high, unregulated doses and ensure products are PA-free 2 8 10.
• Consultation: Always check with a healthcare professional before starting borage supplements, especially if you have pre-existing health conditions or are on medication.

Borage demonstrates promise as a natural supplement for skin and general wellness. With careful selection and appropriate dosing, it can be incorporated safely into a holistic health regimen.