Borage: Benefits, Uses, and Precautions

Borage (Borago officinalis), also known as starflower or bee flower, is a herb harvested mostly for its edible seeds, leaves, and flowers. Different forms of borage include:

• Fresh or dried herbs
• Seed oil supplement
• Skin creams

In traditional medicine, borage is used in the following ways:

• Sedative
• Diuretic
• Seizure treatment
• Kidney disease treatment
• Joint pain relief
• Colds and bronchitis 

The plant is commercially cultivated for borage seed oil extracted from its seeds to be used topically for the hair and skin, and the leaves are often used as dried herbs, as a garnish, and in herbal tea.

According to herbalists, borage contains a high amount of omega-6 fatty acids, which are anti-inflammatory and can be used in health conditions such as:

• Skin disorders 
  • Eczema (atopic dermatitis)
  • Psoriasis
  • Seborrheic dermatitis (red, itchy rash on the scalp)
  • Neurodermatitis 
• Respiratory conditions 
  • Asthma
  • Cough
  • Bronchitis
  • Acute respiratory distress syndrome
• Rheumatoid arthritis
• Swollen gums
• Stress
• Hormonal issues
  • Premenstrual syndrome
  • Menopausal symptoms
• Diabetes and diabetic nerve pain
• Gastrointestinal problems
• Mental health issues
  • Attention-deficit hyperactivity disorder
  • Depression
• Pain and swelling (inflammation)
• Adrenal insufficiency
• Alcoholism

Potential health benefits of borage include the following:

• Alleviates inflammation: Some test-tube and animal studies have reported that borage seed oil can offer protection against oxidative cell damage, which contributes to inflammation. Crushed borage leaves are often used to relieve insect bites and stings to reduce swelling.
• Helps relieve asthma symptoms: Many studies have suggested that borage extract may help relieve asthma symptoms by decreasing inflammation and swelling in the airways.
• Promotes skin health: Borage oil contains a high amount of gamma linoleic acid (GLA), a fatty acid that plays an integral role in maintaining the structure and function of skin cells. Borage also has antioxidant properties that can help promote wound healing and repair the skin’s natural barrier, effectively treating skin infections and conditions such as dermatitis, eczema, psoriasis, acne, and herpes.
• Helps treat arthritis: Borage is rich in essential fatty acids that help relieve pain associated with arthritis and promote joint repair
• Has a relaxing effect: Borage contains niacin or nicotinic acid, which may have positive effects on stress and anxiety.

Using borage oil and borage in high doses can cause health problems such as the following:

• Liver issues: Borage leaves and flowers contain hepatotoxic compounds called pyrrolizidine alkaloids, which can worsen liver disease and cause potential liver damage.
• Bleeding disorders: Borage oil contains 25% gamma linoleic acid (GLA), which may prolong bleeding time and increase the risk of bruising and bleeding. People with bleeding disorders should use borage with caution.
• Seizures: In one study, a few healthy women who took very high doses of borage oil for a week experienced seizures.
• Pregnancy and breastfeeding: Borage products contain pyrrolizidine alkaloids, which can be dangerous to both mother and child. Alkaloid compounds in borage leaves and other plant parts can pass into breast milk, which is unsafe for the baby.
• Blue baby syndrome: Consuming pureed borage, which is high in nitrates, can cause blue baby syndrome, a rare blood disorder in babies that causes the skin to turn blue. 
• Medications: Borage can interact with certain medications, which could lead to serious health problems.
• Surgery: Borage may increase the risk of bleeding during and after surgery. 
• Side effects: Some people may experience side effects with borage such as:
  • Diarrhea
  • Headache
  • Nausea
  • Stomach pain
  • Cramping
• Allergies: Borage can induce allergic reactions in some individuals often noticed by symptoms such as:
  • Skin rash
  • Hives
  • Itching
  • Runny nose
  • Sudden tiredness
  • Dizziness
  • Trouble breathing
  • Throat swelling

People who should avoid or take precautions when using borage or borage oil include those who:

• Are taking blood thinners
• Take medications that can cause liver toxicity such as ketoconazole and anabolic steroids
• Take nonsteroidal anti-inflammatory drugs such as aspirin, COX-2 inhibitors, and ibuprofen.
• Have liver disease
• Are pregnant or breastfeeding
• Are planning to undergo a surgery