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Evening primrose oil

Also listed as: Oenothera biennis; Sun drop

Overview
Plant Description
What's It Made Of?
Medicinal Uses and Indications
Available Forms
 
How to Take It
Precautions
Possible Interactions
Supporting Research

Overview

Evening primrose is a wildflower that grows throughout the U.S. Although Native Americans used the seeds for food and made poultices from the whole plant to heal bruises, evening primrose oil (EPO) has only recently been used as medicine. European settlers took the root back to England and Germany, where it was eaten as food.

Evening primrose oil is found in the plant's seeds and is high in the essential fatty acid gamma-linolenic acid (GLA). Essential fatty acids -- such as omega-6, found in EPO, and omega-3, found in fish oil -- are used as building blocks for a number of molecules in the body. Your body needs a balance of omega-6 and omega-3 fatty acids for good health. In addition to evening primrose oil, GLA is found in borage oil and black currant oil.

Today, EPO is used to relieve PMS symptoms and some arthritis-related conditions, although there is not a lot of scientific evidence about using EPO for those conditions. The strongest evidence for EPO is for treating eczema.

Plant Description

A circle of leaves grows close to the ground around evening primrose stems after the first year it is planted. Flowers bloom after sunset, June through September, or on overcast days during the second year. The leaves grow on both sides of the stem at alternating levels. This monograph focuses on the seed from which the oil is extracted.

What's It Made Of?

Oil is extracted from the seeds and prepared as medicine using a chemical called hexane. The seeds have up to 25% essential fatty acids including linoleic acid (LA) and gamma-linolenic acid (GLA). Both LA and GLA belong to the omega-6 family of fatty acids. The body needs a balance of omega-6 and omega-3 fatty acids (found in fish oil) to stay healthy. Most North Americans get too much omega-6 fatty acids in their diet. However, there are different types of omega-6 fatty acids. Some are more healthy, such as those found in evening primrose oil.

Other sources of GLA include spirulina (a blue-green algae), borage, hemp, and black currant oils.

Medicinal Uses and Indications

EPO is used mostly to relieve the itchiness causes by certain skin conditions, such as eczema and dermatitis. It is also used to ease breast tenderness from premenstrual syndrome (PMS) or other causes. Some of the uses for EPO include:

Eczema

Eczema symptoms include redness and scaling in addition to itching. More than 30 human studies report the benefits of EPO for eczema and dermatitis. A study of 1,207 patients found that EPO helped relieve symptoms from skin conditions, including itching, crusting, edema (fluid, swelling), and redness. EPO can be used in children and adults with skin conditions.

Premenstrual syndrome (PMS)

Many women throughout the world take EPO to reduce symptoms of PMS, although there isn’t any real scientific evidence that it works. In one review of 10 studies that used EPO to treat PMS, only two were well designed. Both of those studies found that EPO had no effect on PMS symptoms. Better studies are needed to know for sure.

Rheumatoid arthritis (RA)

Although a few studies have found that people with RA who took EPO felt better, the studies were hampered by poor design and high drop-out rates. Also, there wasn’t any evidence that taking EPO actually helped slow down the joint damage that happens with RA. Rheumatoid arthritis should be treated with conventional medications, to slow down or stop permanent joint damage.

Raynaud’s phenomenon

One small study suggests that taking EPO may help reduce symptoms in some people with Raynaud’s phenomenon. But the study found no difference in hand temperature between people who took EPO and those who took placebo. More studies are needed.

Diabetic peripheral neuropathy

Diabetic peripheral neuropathy is a nerve condition where people with diabetes have numbness, tingling, pain, burning, or lack of sensation in their feet and legs. Two studies have found that GLA may help reduce symptoms of diabetic neuropathy.

Breast pain

Although there is not a lot of scientific evidence, EPO is widely used to treat breast pain (mastalgia) in a number of European countries. A few studies have found that EPO seemed to help, but they have not been well-designed studies. Other studies show no benefit.

Menopausal symptoms

Although EPO has gotten popular for treating hot flashes, there is no scientific evidence that it actually helps.

Available Forms

EPO is available as an oil or in capsules. EPO products should be kept in the refrigerator and out of direct sunlight to prevent the oil from becoming rancid. Generally, high-quality oil will be certified as organic by a reputable third party, packaged in light-resistant containers, refrigerated, and marked with a freshness date.

EPO should be standardized to contain 8% gamma-linolenic acid.

How to Take It

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and that can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.

Pediatric

Ask your doctor before giving EPO to a child.

Adult

Take 2 - 8 grams of EPO daily, standardized to contain 8% GLA. Ask your health care provider to help you determine the right dose for you.

Precautions

EPO is generally safe when used in recommended dosages. Reported side effects are rare and mild, and include nausea, stomach pain, and headache. Stomach pain and loose stools may mean that the dose is too high.

Don’t use omega-6 supplements, including GLA and EPO, if you have epilepsy or another seizure disorder because there have been reports of these supplements bringing on seizures.

Don’t take EPO if you have bleeding problems or a blood disorder.

Pregnant and breastfeeding women should ask their doctors before taking EPO.

Possible Interactions

If you are currently being treated with any of the following medications, you should not use EPO without first talking to your health care provider.

Blood-thinning medications (anticoagulants) -- EPO may raise the risk of bleeding, especially if you take blood-thinners such as aspirin, warfarin (Coumadin), and clopidogrel (Plavix).

Blood pressure medications -- EPO may lower blood pressure in some people, although researchers aren’t sure. If you take medications to treat high blood pressure, ask your doctor before taking EPO.

Phenothizines -- People who take a class of medications called phenothiazines to treat schizophrenia should not take EPO because it may increase the risk of seizures.

Medications to control seizures -- EPO may lower the threshold for seizures, so people who are prone to seizures should not take it.

Antidepressants -- It’s possible, although researchers aren’t sure, that EPO may interact with some antidepressants, including selective serotonin uptake inhibitors such as:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)

Supporting Research

al-Sabanah OA. Effect of evening primrose oil on gastric ulceration and secretion induced by various ulcerogenic and necrotizing agents in rats. Food Chem Toxicol. 1997;35(8):769-775.

Aman MG, Mitchell EA, Turbott SH. The effects of essential fatty acid supplementation by Efamol in hyperactive children. J Abnorm Child Psychol. 1987;15(1):75-90.

Bayles B, Usatine R. Evening primrose oil. Am Fam Physician. 2009 Dec 15;80(12):1405-8.

Barre DE. Potential of evening primrose, borage, black currant, and fungal oils in human health. Annals of Nutrition & Metabolism. 2001;45(2):47-57.

Belch JJ, Hill A. Evening primrose oil and borage oil in rheumatologic conditions. Am J Clin Nutr. 2000;71(1 Suppl):352S-356S.

Burgess J, Stevens L, Zhang W, Peck L. Long-chain polyunsaturated fatty acids in children with attention-deficit hyperactivity disorder. Am J Clin Nutr. 2000; 71(suppl):327S-330S.

Calder PC, Miles EA. Fatty acids and atopic disease. Pediatr Allergy Immunol. 2000;11 Suppl 13:29-36.

Calder PC, Zurier RB. Polyunsaturated fatty acids and rheumatoid arthritis. Curr Opin Clin Nutr Metab Care. 2001;4(2):115-121.

Carroll DG. Nonhormonal therapies for hot flashes in menopause. Am Fam Physician. 2006;73(3):457-64.

Chenoy R, Hussain S, Tayob Y, O'Brien PM, Moss MY, Morse PF. Effect of oral gamolenic acid from evening primrose oil on menopausal flushing. BMJ. 1994;19(308):501-503.

Darlington LG, Stone TW. Antioxidants and fatty acids in the amelioration of rheumatoid arthritis and related disorders. Br J Nutr. 2001;85(3):251-269.

Davies CL, Loizidou M, Cooper AJ, et al. Effect of gamma-linolenic acid on cellular uptake of structurally related anthracyclines in human drug sensitive and multidrug resistant bladder and breast cancer cell lines. Eur J Cancer. 1999;35:1534-1540.

Garcia CM, et al. Gamma linolenic acid causes weight loss and lower blood pressure in overweight patients with family history of obesity. Swed J Biol Med. 1986;4:8-11.

Halat KM, Dennehy CE. Botanicals and dietary supplements in diabetic peripheral neuropathy. J Am Board Fam Pract. 2003;16(1):47-57.

Hederos CA, Berg A. Epogam evening primrose oil treatment in atopic dermatitis and asthma. Arch Dis Child. 1996;75(6):494-497.

Hornych A, Oravec S, Girault F, Forette B, Horrobin DF. The effect of gamma-linolenic acid on plasma and membrane lipids and renal prostaglandin synthesis in older subjects. Bratisl Lek Listy. 2002;103(3):101-7.

Horrobin DF. Essential fatty acid metabolism and its modification in atopic eczema. Am J Clin Nutr. 2000;71(1 Suppl):367S-72S.

Horrobin DF. The role of essential fatty acids and prostaglandins in the premenstrual syndrome. J Reprod Med. 1983;28(7):465-468.

Keen H, Payan J, AllawiJ, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. The Gamma-Linolenic Acid Multicenter Trial Group. Diabetes Care. 1993;16(1):8-15.

Kelley KW, Carroll DG. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. J Am Pharm Assoc (2003). 2010 Sep-Oct;50(5):e106-15.

Kenny FS, Pinder SE, Ellis IO et al. Gamma linolenic acid with tamoxifen as primary therapy tn breast cancer. Int J Cancer. 2000;85:643-648.

Kollias J, Macmillan RD, Sibbering DM, Burrell H, Robertson JF. Effect of evening primrose oil on clinically diagnosed fibroadenomas. Breast. 2000;9(1):35-6.

Little C, Parsons T. Herbal therapy for treating rheumatoid arthritis. Cochrane Database Syst Rev. 2001;(1):CD002948.

Menendez JA, del Mar Barbacid M, Montero S, et al. Effects of gamma-linolenic acid and oleic acid on paclitaxel cytotoxicity in human breast cancer cells. Eur J Cancer. 2001;37:402-413.

Morse NL, Clough PM. A meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries? Curr Pharm Biotechnol. 2006;7(6):503-24.

Morse PF, Horrobin DF, Manku MS, et al. Meta-analysis of placebo-controlled studies of the efficacy of Epogram in the treatment of atopic eczema: relationship between plasma essential fatty changes and treatment response. Br J Dermatol. 1989;121(1):75-90.

Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukot Essent Fatty Acids. 2007;77(2):101-3.

Pruthi S, Wahner-Roedler DL, Torkelson CJ, Cha SS, Thicke LS, Hazelton JH, Bauer BA. Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study. Altern Med Rev. 2010 Apr;15(1):59-67.

Rosolowich V, Saettler E, Szuck B, et al., Mastalgia. J Obstet Gynaecol Can. 2006;28(1):49-57.

Senapati S, Banerjee S, Gangopadhyay DN. Evening primrose oil is effective in atopic dermatitis: a randomized placebo-controlled trial. Indian J Dermatol Venereol Leprol. 2008 Sep-Oct;74(5):447-52.

Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999;70(3 suppl):560S-569S.

Stonemetz D. A review of the clinical efficacy of evening primrose. Holist Nurs Pract. 2008;22(3):171-4.

Thompson L, Cockayne A, Spiller RC. Inhibitory effect of polyunsaturated fatty acids on the growth of Helicobacter pylori: a possible explanation of the effect of diet on peptic ulceration. Gut. 1994;35(11):1557-1561.

Whitaker DK, Cilliers J, de Beer C. Evening primrose oil (Epogam) in the treatment of chronic hand dermatitis: disappointing therapeutic results. Dermatology. 1996;193(2):115-120.

Whelan AM, Jurgens TM, Naylor H. Herbs, vitamins and minerals in the treatment of premenstrual syndrome: a systematic review. Can J Clin Pharmacol. 2009 Fall;16(3):e407-29. Epub 2009 Oct 29. Review.

Williams HC. Evening primrose oil for atopic dermatitis. BMJ. 2003;327(7428):1358-9.

Worm M, Henz BM. Novel unconventional therapeutic approaches to atopic eczema. Dermatology. 2000;201(3):191-195.

Yoon S, Lee J, Lee S. The therapeutic effect of evening primrose oil in atopic dermatitis patients with dry scaly skin lesions is associated with the normalization of serum gamma-interferon levels. Skin Pharmacol Appl Skin Physiol. 2002;15(1):20-5.


Review Date: 7/26/2011
Reviewed By: A.D.A.M. Editorial Team: David Zieve, MD, MHA, and David R. Eltz. Previously reviewed by Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Uses of this Herb
Alcoholism
Atherosclerosis
Attention deficit hyperactivity disorder
Breast cancer
Cirrhosis
Diabetes
Eczema
Hypercholesterolemia
Menopause
Peptic ulcer
Premenstrual syndrome
Rheumatoid arthritis
Ulcerative colitis
Drugs that Interact
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