Evening primrose oil

It is appropriate to begin this entry by introducing the profile of David Horrobin. This gentleman once famously sold evening primrose or borage oil, which he advertised as a cure for almost everything. He claimed that a deficiency of one substance, gamma linolenic acid, was at the root of many – perhaps most – of the diseases of civilization. He was, of course, hounded by pharmaceutical companies, who hailed him as the greatest fraudster of our time – such were the headlines of sponsored articles in the press.

One can begin to wonder whether Horrobin acted honestly, selling a remedy whose effects were not fully proven. One can partially agree with the charges leveled against it – after all, if it weren’t for the restrictions, anyone could sell paint-stained water to cancer patients as a miracle panacea. On the other hand, what the pharmaceutical companies and the people in their service have done, i.e., labeling something not tested as “not working,” is equally dishonest. If we find David’s actions reprehensible, we should also throw the British Medical Journal in the garbage.

A few years passed, the issue dried up a bit, and a number of clinical trials were conducted. The effects were sometimes astonishing. It seems that the “biggest crook” was very much right, and the whole bureaucratic machine at the service of pharmaceutical companies, called “modern medicine” for the sake of disguise, was wrong.

But but, I got worked up. A few words of introduction would be useful – what is this strange substance? Gamma linolenic acid is the “active” form of omega 6, just as popular omega 3 capsules from the drugstore contain the active form of these acids, absent in, for example, flaxseed oil. It is often said that there is a paradox – although omega 6 are considered “bad” and their excess harms, increasing inflammation, but GLA has the opposite effect, quieting these processes. Moreover, it is usually produced in the body from these “bad” omegas.

It is practically not found in food, in any case not in an amount that would be of any significance to our bodies. I’m not sure now, I can’t dig up the research where I read this, but if my memory doesn’t fail me – we produce up to 2 grams of it per day, to get that amount from one of the richest sources – spirulina – we would have to eat about 200 grams of it per day in dried form. This is simply impossible, both for financial reasons and because of the excess of other nutrients from spirulina.

What’s left is production inside the body – and that sometimes fails. Unfortunately, I have to rely on unscientific sources – quite a few “alternative” doctors believe that one of the causes may be infection with the Epstein-Barr virus, which causes mononucleosis and then resides in the body. Inflammation is often pointed to as the cause of problems. An excess of certain fatty acids can block metabolic pathways of metabolism, as can a deficiency of certain vitamins and micronutrients. Feeding a baby from a bottle instead of breastfeeding is also a serious risk factor – human milk contains high amounts of GLA, while infant formula generally does not.

The reasons for the decline in GLA concentrations in the body must probably remain a mystery. What is a fact – and an indisputable one – is the benefits from supplementation in certain conditions.

A placebo-controlled study of rheumatoid arthritis will go first:

https://pubmed.ncbi.nlm.nih.gov/8912502/

Using the specific in question at nearly 3 grams per day for six months significantly improved the condition compared to the placebo group. In the second part of the study, when both groups got the active ingredient – there was continuous improvement in both. Such continuity could mean two things – either the deficiency requires such a long supplementation, which has a scientific justification – only then can one talk about the saturation of cell membranes with gamma linolenic acid, or it acted as a simple anti-inflammatory drug. However, the evenness of the improvement and the gradual progression toward complete recovery make us suspect the first scenario. Most importantly, studies in which low doses were used (less than 500 mg) or for too short a time (less than 6 months) had no effect.

There was a clinical trial for multiple sclerosis:

https://www.ncbi.nlm.nih.gov/pubmed/17922959

And here the improvement was continuous, linear, over successive months the patients gradually progressed towards full recovery – paralysis regressed, tremors disappeared. Small doses had no effect – only the use of 2 to 3 grams of GLA per day gave satisfactory results.

Preliminary cancer studies are very promising – in one of them

https://www.ncbi.nlm.nih.gov/pubmed/6291176

the development of liver cancer was slowed down by 90%. Many other clinical trials confirm high efficacy in some cancers in tissue culture (although in others it is very low or even zero). We should, of course, wait for clinical trials with patients – but I’m afraid they won’t be done within the next millennium. After all, medicine has already had 30 years to test in practice the effect of supplementation on liver cancer – and so far doctors and scientists around the world have not managed to raise money for a bottle of evening primrose oil. The question is whether it is more ethical in this situation to encourage a man who has three months to live to try something that only worked in a test tube, or to tell him that he should wait until someone tests it decently in 30 years?

It is not known whether it works on atopic dermatitis. Studies have given conflicting results, in some it worked very nicely, in others not at all. Instead, it has incredibly high efficacy against diabetic neuropathy:

https://www.ncbi.nlm.nih.gov/pubmed/2159860

I think the two examples: multiple sclerosis and rheumatoid arthritis are enough to show how much potential simple evening primrose oil has. There are many reports of recovery after its use, whether from autoimmune disorders, menstrual pain in women, or even chronic fatigue syndrome. However, solid clinical trials are lacking. They will not be conducted soon; there is no money to be made from selling the oil.

Should it be supplemented? This is the real conundrum. The ideal would be to conduct cell membrane saturation tests to determine whether it makes sense, unfortunately, the cost is extremely high. Healthy people are unlikely to get anything out of it for themselves, although some studies points to reduced cancer risk. However, if someone suffers from chronic conditions that medicine can’t do much about, perhaps the root cause is the body’s blocking of the synthesis of this substance? The problem is that the improvement in health would then be very slow, spread over a year or more, and the therapy is not cheap, so it’s hard to judge whether one is throwing money away. As far as I know, there are no deficiency symptoms that can be observed with the naked eye.

Evening primrose oil contains about 10% GLA, which means you need to drink about 20 ml a day to reach the amount tested in clinical trials. Genetically modified safflower oil contains as much as 40% GLA, making it the richest source – regular safflower oil is worthless. Borage has 20%, which means you need to drink 10 ml a day, but be warned, the taste of borage oil is… hmm… unforgettable. Buy a small bottle first.

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