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Rheumatoid Arthritis Symptoms and Treatment

What other names is Borage known by?

Bee Plant, Beebread, Borage Flower, Borage Leaf, Borage Oil, Borage Seed Oil, Borago, Borago officinalis, Borraja, Bourrache, Bourrache Commune, Burage, Burrage, Common Borage, Common Bugloss, Cool Tankard, Feuille de Bourrache, Fleur de Bourrache, Huile de Bourrache, Huile de Graines de Bourrache, Langue de Bœuf, Ox's Tongue, Pain-des-Abeilles, Talewort, Starflower, Starflower Oil.

What is Borage?

Borage is a plant. Its flowers and leaves, as well as the oil from its seeds are used as medicine.

Borage seed oil is used for skin disorders including eczema, seborrheic dermatitis, and neurodermatitis. It is also used for rheumatoid arthritis (RA), stress, premenstrual syndrome (PMS), diabetes, attention deficit-hyperactivity disorder (ADHD), acute respiratory distress syndrome (ARDS), alcoholism, pain and swelling (inflammation), and for preventing heart disease and stroke.

Borage flower and leaves are used for fever, cough, and depression.

Borage is also used for a hormone problem called adrenal insufficiency, for "blood purification," to increase urine flow, to prevent inflammation of the lungs, as a sedative, and to promote sweating. Borage is also used to increase breast milk production and to treat bronchitis and colds.

Borage is applied to the skin for infantile seborrheic dermatitis and is also used in a dressing to soften the skin.

In foods, borage is eaten in salads and soups.

In manufacturing, borage is used in skin care products.

Possibly Effective for...

  • Improving the function of the lungs in critically ill patients. There is some evidence that borage seed oil, when taken by mouth in combination with eicosapentaenoic acid (EPA), might reduce the number of days spent in the intensive care unit (ICU) and the length of time a breathing machine is needed by patients with acute respiratory distress syndrome (ARDS).
  • Growth and development in premature infants. Infant formula supplemented with fatty acids from borage oil and fish oils seems to improve growth and development of the nervous system in infants born early, especially boys.
  • Rheumatoid arthritis (RA).There is some evidence that taking borage seed oil in combination with conventional painkilling or anti-inflammatory medications might help decrease symptoms of RA after six weeks of treatment. The improvement appears to last for up to 24 weeks. Improvement is measured as a decrease in the number and severity of tender and swollen joints.

Possibly Ineffective for...

  • Itchy, red skin (eczema). Taking borage seed oil by mouth does not seem to improve eczema in adults or children.

Insufficient Evidence to Rate Effectiveness for...

  • Asthma. Early research suggests that taking borage oil daily for 12 months does not improve asthma symptoms.
  • A dental condition called periodontitis. Early research suggests that taking borage oil daily for 12 weeks improves gum inflammation but does not reduce plaque in people with periodontitis.
  • Skin conditions in infants. There is some evidence that topical application of borage seed oil might be helpful for infantile seborrheic dermatitis. It seems to heal the condition within 1 to 3 weeks.
  • Premenstrual syndrome (PMS).
  • Diabetes.
  • Attention deficit-hyperactivity disorder (ADHD).
  • Alcoholism.
  • Heart disease.
  • Stroke.
  • Fever.
  • Cough.
  • Depression.
  • Dry skin.
  • Arthritis.
  • Pain relief.
  • Inflamed veins (phlebitis).
  • Menopausal disorders.
  • Fluid retention.
  • Other conditions.
More evidence is needed to rate the effectiveness of borage for these uses.

Rheumatoid Arthritis Symptoms and Treatment

How does Borage work?

Borage seed oil contains a fatty acid called gamma-linolenic acid (GLA). GLA seems to have anti-inflammatory effects. Borage flower might have an antioxidant effect.

Are there safety concerns?

Borage seed oil is POSSIBLY SAFE when taken by mouth or applied to the skin appropriately.

Borage seed oil is LIKELY UNSAFE when products containing a dangerous chemicals called pyrrolizidine alkaloids (PAs) are taken by mouth. Borage plant parts including the leaf, flower, and seed can contain PAs. PAs can damage the liver or cause cancer, especially when used in high doses or for a long time. Only use products that are certified and labeled PA-free.

Special Precautions & Warnings:

Children: Borage see oil is POSSIBLY SAFE when taken by mouth appropriately. Borage seed oil is LIKELY UNSAFE when products containing PA are taken by mouth.

Pregnancy and breast-feeding: Borage seed oil is LIKELY UNSAFE during pregnancy and while breast-feeding. It is important to avoid borage products that might contain pyrrolizidine alkaloids (PAs). PAs are a risk to the mother because they can cause serious liver disease and might cause cancer. PAs are also a risk to the infant because they might cause birth defects and they can pass into breast milk. Researchers are not sure if borage products that are certified PA-free are safe during pregnancy and breast-feeding. It is best to stay safe and avoid using borage.

Bleeding disorders: There is some concern that borage seed oil might prolong bleeding time and increase the risk of bruising and bleeding. If you have a bleeding disorder, use borage with caution.

Liver disease: Borage products containing hepatotoxic pyrrolizidine alkaloids (PA) might make liver disease worse.

Surgery: Borage might increase the risk of bleeding during and after surgery. Stop taking borage at least 2 weeks before a scheduled surgery.

Rheumatoid Arthritis Symptoms and Treatment

Are there any interactions with medications?

Medications that increase the breakdown of other medications by the liver (Cytochrome P450 3A4 (CYP3A4) inducers)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Borage is broken down by the liver. Some chemicals that form when the liver breaks down borage seed oil can be harmful. Medications that cause the liver to break down borage seed oil might enhance the toxic effects of chemicals contained in borage seed oil.

Some of these medicines include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Borage seed oil might slow blood clotting in some people. Borage seed oil contains GLA (gamma linolenic acid). GLA is the part of borage seed oil that might slow blood clotting. Taking borage seed oil along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

Medications used during surgery (Anesthesia)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Borage seed oil might interact with medications used during surgery. Be sure to tell your doctor what natural products you are taking before having surgery. To be on the safe side, you should stop taking borage seed oil at least two weeks before surgery.

NSAIDs (Nonsteroidal anti-inflammatory drugs)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

NSAIDs are anti-inflammatory medications used to decrease pain and swelling. Borage seed oil is also used as an anti-inflammatory medication. Sometimes NSAIDs and borage seed oil are used together for rheumatoid arthritis. However, borage seed oil seems to work in a different way than NSAIDs. Some scientists think that taking NSAIDs along with borage seed oil might decrease the effectiveness of borage seed oil. But it is too soon to know if this is true.

Some NSAIDs include ibuprofen (Advil, Motrin, Nuprin, others), indomethacin (Indocin), naproxen (Aleve, Anaprox, Naprelan, Naprosyn), piroxicam (Feldene), aspirin, and others.

Dosing considerations for Borage.

The following doses have been studied in scientific research:

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  • For rheumatoid arthritis (RA): 1.1 or 1.4 grams of borage seed oil daily for up to 24 weeks.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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