Borage

Scientific Name(s): Borago officinalis L.
Common Name(s): Bee fodder, Bee-bread, Borage, Burrage, Common bugloss, Cool tankard, Ox's tongue, Star flower

Medically reviewed by Drugs.com. Last updated on Mar 22, 2022.

Clinical Overview

Use

Borage has been used in European herbal medicine since the Middle Ages, alone and in combination with fish oil for the treatment of rheumatoid arthritis, atopic eczema, and osteoporosis, although clinical evidence to support these uses is limited.

Dosing

Borage seed oil 1 to 3 g/day has been given in clinical trials (1 g/day has been used in children, and up to 3 g/day has been used in adults). The content of gamma-linolenic acid (GLA) is between 20% and 26% of the oil. A 2 g dose of dried herb brewed in 1 cup of boiling water taken 3 times daily has been suggested. Oral doses of 2,000 to 4,000 mg/day (GLA 400 to 1,000 mg) in adults and 1,000 to 2,000 mg/day (GLA 240 to 480 mg) in children with atopic dermatitis have been studied.

Contraindications

Contraindications have not been identified.

Pregnancy/Lactation

Avoid use due to documented adverse effects (pyrrolizidine alkaloids).

Interactions

Because borage contains low concentrations of unsaturated pyrrolizidine alkaloids, which have been associated with hepatotoxic effects, it should not be used with hepatotoxic drugs such as anabolic steroids, phenothiazine, or ketoconazole. Borage may also lower the seizure threshold and should not be used with drugs that can lower the seizure threshold, such as tricyclic antidepressants and phenothiazines. Borage oil should also be used cautiously with any medication that may increase the risk of bleeding.

Adverse Reactions

Borage oil should be used cautiously in patients with epilepsy. A case report describes the development of temporal lobe and gelastic seizures ultimately progressing to status epilepticus in a healthy 41-year-old woman who consumed borage oil 1,500 to 3,000 mg/day for 1 week. Additionally, borage has been reported as the likely cause of several cases of methemoglobinemia in infants in Europe. In patients with rheumatoid arthritis (RA) taking borage, belching and soft stools occurred.

Toxicology

Because borage seeds contain small amounts of unsaturated pyrrolizidine alkaloids, including amabiline, a hepatotoxin, the German Federal Ministry of Health recommends no more than 10 mcg of unsaturated pyrrolizidine alkaloid consumption each day. Another source recommends no more than 1 mcg/day of unsaturated pyrrolizidine alkaloids. Internal use of whole borage leaf is not recommended.

Scientific Family

• Boraginaceae (borage)

Botany

Borage is an annual plant that grows to about 0.6 m in height. The stem and leaves are covered with coarse, prickly hairs, and the flowers are large, star-shaped, and bright blue with contrasting black anthers. It is native to the Mediterranean region but has been widely naturalized in other areas. The fresh plant has a salty flavor and a cucumber-like odor.1

History

Borage leaves have been used as a potherb and in European herbal medicine since the Middle Ages, and were mentioned by Pliny (AD 61), Dioscorides (AD 40), and Galen (AD 129). Borage leaves and flowers were added to wine and lemon juice to make the popular English beverages claret cup and cool tankard. The leaves have been used to treat rheumatism, colds, and bronchitis, as well as to increase lactation in women. Infusions of the leaves have been used to induce sweating and diuresis.2

Chemistry

The leaves and flowers contain mucilage, tannin, and a small amount of essential oil. The seed yields a fix...