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Evening Primrose Oil

Uses

Evening primrose oil (EPO), comes from the seeds of the evening primrose plant. Like black currant seed oil and borage oil, EPO contains gamma linolenic acid (GLA), a fatty acid that the body converts to a hormone-like substance called prostaglandin E1 (PGE1).

What Are Star Ratings?

This supplement has been used in connection with the following health conditions:

Used for Why
2 Stars
Eczema
Adults: 500 to 1,000 mg a day of GLA; children: proportionately less, according to body weight
Supplementing with evening primrose oil can supply anti-inflammatory fatty acids that are missing in many people with eczema.

Researchers have reported that people with eczema do not have the normal ability to process fatty acids, which can result in a deficiency of gamma-linolenic acid (GLA). GLA is found in (EPO), borage oil, and black currant seed oil. Some, but not all, double-blind trials have shown that EPO is useful in the treatment of eczema. An analysis of nine trials reported that the effects for reduced itching were most striking. Much of the research uses 12 pills per day; each pill contains 500 mg of EPO, of which 45 mg is GLA. Smaller amounts have been shown to lack efficacy.

2 Stars
Fibrocystic Breast Disease
3 grams daily
Taking evening primrose oil may help alleviate symptoms.

In double-blind research, (EPO) has reduced symptoms of FBD, though only slightly. One group of researchers reported that EPO normalizes blood levels of fatty acids in women with FBD. However, even these scientists had difficulty linking the improvement in lab tests with an actual reduction in symptoms. Nonetheless, most reports continue to show at least some reduction in symptoms resulting from EPO supplementation. Based on this research, many doctors recommend a trial of 3 grams per day of EPO for at least six months to alleviate symptoms of FBD.

2 Stars
Osteoporosis (Fish Oil)
6 grams daily
Fish oil combined with evening primrose oil (EPO) may improve calcium absorption and promote bone formation.

A preliminary trial found that elderly women with osteoporosis who were given 4 grams of fish oil per day for four months had improved calcium absorption and evidence of new bone formation. Fish oil combined with (EPO) may confer added benefits. In a controlled trial, women received 6 grams of a combination of EPO and fish oil, or a matching placebo, plus 600 mg of calcium per day for three years. The EPO/fish oil group experienced no spinal bone loss in the first 18 months and a significant 3.1% increase in spinal bone mineral density during the last 18 months.

2 Stars
Premenstrual Syndrome
3 to 4 grams daily
Women with PMS may have impaired conversion of linoleic acid to gamma linolenic acid (GLA). Evening primrose oil contains GLA and may reduce PMS symptoms.

Women with PMS have been shown to have impaired conversion of linoleic acid (an essential fatty acid) to gamma linolenic acid (GLA). Because a deficiency of GLA might, in theory, be a factor in PMS and because (EPO) contains significant amounts of GLA, researchers have studied EPO as a potential way to reduce symptoms of PMS. In several double-blind trials, EPO was found to be beneficial, whereas in other trials it was no more effective than placebo.

Despite these conflicting results, some doctors consider EPO to be worth a try; the amount usually recommended is 3–4 grams per day. EPO may work best when used over several menstrual cycles and may be more helpful in women with PMS who also experience breast tenderness or fibrocystic breast disease.

2 Stars
Rheumatoid Arthritis
540 to 1,100 mg daily of GLA
Evening primrose oil appears to be an effective treatment for people with rheumatoid arthritis. It contains gamma linolenic acid, which is converted in part to an anti-inflammatory substance.

Oils containing the omega-6 fatty acid gamma linolenic acid (GLA)—borage oil, black currant seed oil, and (EPO)—have been reported to be effective in the treatment for people with RA. Although the best effects have been reported with use of borage oil, that may be because more GLA was used in borage oil trials (1.1–2.8 grams per day) compared with trials using black currant seed oil or EPO. The results with EPO have been mixed and confusing, possibly because the placebo used in those trials (olive oil) may have anti-inflammatory activity. In a double-blind trial, positive results were seen when EPO was used in combination with fish oil. GLA appears to be effective because it is converted in part to prostaglandin E1, a hormone-like substance known to have anti-inflammatory activity.

2 Stars
Skin Ulcers
1,500 mg with each meal
A preliminary report suggested that evening primrose oil improves blood flow to the legs and heals or reduces the size of venous leg ulcers.

A preliminary report suggested that improves blood flow to the legs and heals or reduces the size of venous leg ulcers. No controlled research has further investigated this claim.

1 Star
Alcohol Withdrawal
Refer to label instructions
In a double-blind study of alcoholics in a detox program, supplementing with EPO led to greater improvement than did placebo in some parameters of liver function.

Alcoholics may be deficient in a substance called prostaglandin E1 (PGE1) and in gamma-linolenic acid (GLA), a precursor to PGE1. In a double-blind study of alcoholics who were in a detoxification program, supplementation with 4 grams per day of (containing 360 mg of GLA) led to greater improvement than did placebo in some, but not all, parameters of liver function.

1 Star
Atherosclerosis
Refer to label instructions
Taking evening primrose oil has been shown to lower cholesterol in double-blind research. Lowering cholesterol levels should in turn reduce the risk of atherosclerosis.

Though low levels (2 grams per day) of appear to be without action, 3–4 grams per day have lowered cholesterol in double-blind research. Lowering cholesterol levels should in turn reduce the risk of atherosclerosis.

Preliminary research shows that chondroitin sulfate may prevent atherosclerosis in animals and humans and may also prevent heart attacks in people who already have atherosclerosis. However, further research is needed to determine the value of chondroitin sulfate supplements for preventing or treating atherosclerosis.

1 Star
Attention Deficit–Hyperactivity Disorder
Refer to label instructions
A deficiency of several essential fatty acids has been observed in some children with ADHD. In one study, children who received evening primrose oil showed minor improvements.

A deficiency of several essential fatty acids has been observed in some children with ADHD compared with unaffected children. One study gave children with ADHD supplements in an attempt to correct the problem. Although a degree of benefit was seen, results were not pronounced. In a 12-week double-blind study, children with ADHD were given either a placebo or a fatty-acid supplement providing daily: 186 mg of eicosapentaenoic acid (EPA), 480 mg of docosahexaenoic acid (DHA), 96 mg of gamma-linolenic acid (GLA), 864 mg of linoleic acid, and 42 mg of arachidonic acid. Compared with the placebo, the fatty-acid supplement produced significant improvements in both cognitive function and behavioral problems. No adverse effects were seen. In a preliminary trial, supplementation with approximately 400 mg of flaxseed oil and 25 mg of vitamin C, each twice a day for three months, was associated with an improvement of symptoms in children with ADHD.

1 Star
Chronic Obstructive Pulmonary Disease
Refer to label instructions
Evening primrose oil contains gamma-linolenic acid, a type of omega-3 fatty acid that has been linked to reduced risk of COPD.

A greater intake of the omega-3 fatty acids found in fish oils has been linked to reduced risk of COPD, though research has yet to investigate whether fish oil supplements would help people with COPD. In a double-blind trial, people with COPD received a fatty acid supplement (providing daily 760 mg of GLA [gamma-linolenic acid], 1,200 mg of ALA [alpha-linolenic acid], 700 mg of EPA [eicosapentaenoic acid], and 340 mg of DHA [docosahexaenoic acid]) or a placebo (80% palm oil and 20% sunflower oil) during an eight-week rehabilitation program. Compared with the placebo, the fatty acid supplement significantly improved exercise capacity. While two of the fatty acids supplied in this supplement (EPA and DHA acid) are found in fish oil, it is not known which components of the supplement were most responsible for the improvement. Gamma-linolenic acid is found in , black currant seed oil, and borage oil; alpha-linolenic acid is found in flaxseed oil and other oils.

1 Star
Intermittent Claudication
Refer to label instructions
In a preliminary trial, supplementing with evening primrose oil led to a 10% increase in exercise tolerance in people with intermittent claudication.

Caution: One study showed a slightly increased risk of vascular surgery among people with intermittent claudication who took beta-carotene supplements. Until more is known, people with intermittent claudication wishing to use beta-carotene supplements should first consult with their doctor.

1 Star
Irritable Bowel Syndrome and PMS
Refer to label instructions
In one trial, women with IBS who experienced worsening symptoms before and during their menstrual period were helped by taking evening primrose oil.

In one trial, women with IBS who experienced worsening symptoms before and during their menstrual period were helped by taking enough (EPO) to provide 360–400 mg of gamma linolenic acid (GLA) per day. In that trial more than half reported improvement with EPO, but none was helped in the placebo group. The effects of EPO in other groups of IBS sufferers have not been explored.

1 Star
Multiple Sclerosis
Refer to label instructions
The omega-6 fatty acids found in such oils as evening primrose oil (EPO) may be beneficial. When people with MS were given EPO, their hand grip improved in one study.

The omega-6 fatty acids, found in such oils as (EPO) and sunflower seed oil, also may be beneficial. When people with MS were given 4 grams of EPO for three weeks, their hand grip improved. In a review of three double-blind trials, two of the trials reported that linoleic acid reduced the severity and length of relapses. When the data were re-examined, it was found that taking linoleic acid decreased disability due to MS in all three trials. According to these researchers, taking linoleic acid while following a diet low in animal fat and high in polyunsaturated fat may be even more beneficial. Amounts used in these trials were approximately 17 to 23 grams of linoleic acid per day, provided by 26 to 35 grams of sunflower seed oil.

1 Star
Raynaud’s Disease
Refer to label instructions
Fatty acids in evening primrose oil (EPO) inhibit the formation of prostaglandins, which promote blood vessel constriction. One study found that supplementing with EPO reduced the number and severity of attacks.

Fatty acids in (EPO) inhibit the formation of biochemical messengers (prostaglandins) that promote blood vessel constriction. A double-blind trial of 21 people with Raynaud’s disease found that, compared with placebo, supplementation with EPO reduced the number and severity of attacks despite the fact that blood flow did not appear to increase. Researchers have used 3,000–6,000 mg of EPO per day.

1 Star
Scleroderma
Refer to label instructions
People with scleroderma can have a metabolic block that interferes with the body’s ability to make GLA, the main constituent of evening primrose oil. In preliminary research, supplementing with EPO has helped people with several skin conditions.

People with scleroderma, and other skin conditions can have a metabolic block that interferes with the body’s ability to make GLA, the main constituent of evening primrose oil. In preliminary research, supplementation with EPO has helped people with several skin conditions.

1 Star
Sjogren’s Syndrome
Refer to label instructions
People with Sjogren’s syndrome can have a metabolic block that interferes with the body’s ability to make GLA, the main constituent of evening primrose oil. In preliminary research, supplementing with EPO has helped people with several skin conditions.

People with Sjogren’s syndrome, and other skin conditions can have a metabolic block that interferes with the body’s ability to make GLA, the main constituent of evening primrose oil. In preliminary research, supplementation with EPO has helped people with several skin conditions.

1 Star
Tardive Dyskinesia
Refer to label instructions
Several people have experienced improvement while taking evening primrose oil.

Several people have experienced an improvement in TD while taking (EPO). In a double-blind study, however, supplementing with EPO (12 capsules per day) resulted only in a minor, clinically insignificant improvement.

1 Star
Type 1 Diabetes
Refer to label instructions
Evening primrose oil may relieve nerve pain in those with type 1 diabetes.
Supplementing with evening primrose oil providing 360–480 mg of gamma-linolenic acid per day for six months has been found in double-blind research to improve nerve function and relieve pain in people with diabetic nerve damage (neuropathy). However, one of the investigators involved in these clinical trials was subsequently found by the professional conduct committee of the General Medical Council (United Kingdom) to have falsified the results of his research. In the absence of more recent clinical trials, it is not clear whether evening primrose oil or GLA is of any value for patients with diabetic neuropathy.
1 Star
Type 2 Diabetes
4 grams daily
Preliminary research suggests evening primrose oil may be helpful for preventing and treating diabetic neuropathy.
Evening primrose oil is a source of the anti-inflammatory omega-6 fatty acid gamma linolenic acid (GLA). Animal research suggests evening primrose oil and GLA may be helpful for preventing and treating diabetic neuropathy. Supplementing with 4 grams of evening primrose oil per day for six months was found in a double-blind trial to improve nerve function and to relieve pain symptoms of diabetic neuropathy. However, the principal investigator who conducted these clinical trials was subsequently found by the professional conduct committee of the General Medical Council (United Kingdom) to have falsified the results of the research. Therefore, it is not clear whether evening primrose oil or GLA is of any value for patients with diabetic neuropathy.

How It Works

How to Use It

Although many people may have inadequate levels of GLA, the optimal intake for this nutrient remains unknown. Researchers often use 3,000–6,000 mg of EPO per day, which provides approximately 270–540 mg of GLA.

Where to Find It

EPO is found primarily in supplements. Its presumed active ingredient, GLA, can also be found in black currant seed oil and borage oil supplements. However, it is not known whether the effects of these three oils in the body are the same.

Possible Deficiencies

Those with premenstrual syndrome,1diabetes,2 scleroderma,3 Sjogren’s syndrome,4tardive dyskinesia,5eczema,6 and other skin conditions7 can have a metabolic block that interferes with the body’s ability to make GLA. In preliminary research, supplementation with EPO has helped people with these conditions.8, 9, 10, 11, 12

There is evidence that alcoholics may be deficient in GLA, and a double-blind study suggested that alcohol withdrawal may be facilitated with EPO supplementation.13 Many people in Western societies may be at least partially GLA-deficient as a result of aging, glucose intolerance, high dietary fat intake, and other problems. People with deficiencies would presumably benefit from supplemental GLA intake from EPO, black currant seed oil, or borage oil.

Interactions

Interactions with Supplements, Foods, & Other Compounds

Other nutrients are needed by the body, along with EPO, to make PGE1. Consequently, some experts suggest that magnesium, zinc, vitamin C, niacin, and vitamin B6 should be taken along with EPO.

Interactions with Medicines

As of the last update, we found no reported interactions between this supplement and medicines. It is possible that unknown interactions exist. If you take medication, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

EPO has been reported to exacerbate symptoms of temporal lobe epilepsy, which can sometimes be mistaken for schizophrenia.14, 15

References

1. Horrobin DF, Manku M, Brush M, et al. Abnormalities in plasma essential fatty acid levels in women with pre-menstrual syndrome and with non-malignant breast disease. J Nutr Med 1991;2:259-64.

2. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

3. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren's syndrome. Med Hypotheses 1984;14:233-47.

4. Horrobin DF, Campbell A. Sjogren's syndrome and the sicca syndrome: the role of prostaglandin E1 deficiency. Treatment with essential fatty acids and vitamin C. Med Hypotheses 1980;6:225-32.

5. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 333-43.

6. Manku MS, Horrobin DF, Morse NL, et al. Essential fatty acids in the plasma phospholipids of patients with atopic eczema. Br J Dermatol 1984;110:643-8.

7. Horrobin DF. Essential fatty acids in clinical dermatology. J Am Acad Dermatol 1989;20:1045-53.

8. Mansel RE, Pye JK, Hughes LE. Effects of essential fatty acids on cyclical mastalgia and noncyclical breast disorders. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 557-66.

9. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

10. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren's syndrome. Med Hypotheses 1984;14:233-47.

11. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine. Horrobin DF (ed). New York: Alan R Liss, 1990, 333-43.

12. Schalin-Karrila M, Mattila L, Jansen CT, et al. Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987;117:11-9.

13. Glen AIM, Glen EMT, MacDonnell LEF, et al. Essential fatty acids in the management of withdrawal symptoms and tissue damage in alcoholics, presented at the 2nd International Congress on Essential Fatty Acids, Prostaglandins and Leukotrienes, London, Zoological Society. March 24-7, 1985, [abstract 53].

14. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6:375-9.

15. Holman CP, Bell AFJ. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orthomol Psychiatr 1983;12:302-4.

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