Evening Primrose Oil, Now Gathering Respect for its Support of Healthful Cellular Functioning, Is of Special Interest for CFS and FM Patients

A growing body of research indicates supplementation with the nutrient evening primrose oil can be beneficial for individuals with compromised cellular metabolism. For example, a new study conducted at Hammersmith Hospital in the UK concludes that supplementation with evening primrose oil plus fish oil may offer a nutrient-based “avenue” for support of proper cellular functioning in some patients with Chronic Fatigue Syndrome.1 This tends to corroborate the findings of two earlier placebo controlled trials at Glasgow University, which found “marked” easing of some symptoms in 85 percent of CFS patients who received evening primrose oil supplementation.2

Other scientific trials suggest that the nutritional value of evening primrose oil may be of special interest to Fibromyalgia patients.3

What is evening primrose oil?

It is a nearly-unique direct dietary source of a particular omega-6 essential fatty acid – gamma linolenic acid (GLA) – derived from the seeds of a wildflower originating in the Americas. “Essential” means GLA is a nutrient considered crucial for healthful cellular functioning, which like most vitamins must be derived from food sources because the body cannot manufacture it from scratch. Borage oil and black current oil are the only other commonly available supplemental sources of GLA.

GLA-containing evening primrose oil, and the plant’s roots and leaves too, were traditionally considered healthful and medicinal foods by Native Americans, and then by European herbalists, beginning in the 16th century. In England evening primrose oil was known as “The King’s Cure-All.” The FDA has not tested or approved evening primrose oil for marketing in the U.S. as a food additive or drug, though it is marketed as a supplement across the globe.

Additionally, based on extensive recent research, GLA is known to offer beneficial nutritional support for many individuals with “disordered fatty acid metabolism.”

The new wave of research

“An explosion of fatty acid studies appearing in medical research has led us into a new era in our approach to resolving disease,” writes Patricia Kane, PhD, in “It’s All in the Fat: The Role of Essential Fatty Acids in Health.”4 One widely accepted finding of all the recent research is that both omega-6 essential fatty acids and omega-3 essential fatty acids are crucial in the diet – ideally in a ratio of four parts or less omega-6 to one part omega-3. Unfortunately modern diets mostly tip the balance unhealthily to more like 11-to-1 or even 30-to-1.

Why the focus on balance?

Based on today’s still-unfolding understanding of metabolic processes at the cellular level, as detailed in the University of Maryland Medical Center’s Medical Reference:5

n Most of the omega-6 essential fatty acids (including the linoleic-acid-rich corn, sunflower, and soybean oils commonly used in dressings and cooking) tend to promote the “inflammatory response” – without which our bodies could not fight infections or heal injuries. Temporary swelling and fever are the signs of infection-fighting and healing processes at work.6

n The omega-3 essential fatty acids tend to balance the inflammatory response by supporting an anti-inflammatory action. The omega-3’s are plentiful, for example, in flax seed, oily fish, leafy green vegetables, nuts, fruits, and the lean meat and eggs of animals fed on omega-3 rich grains and greens. This anti-inflammatory response/balance is needed to avoid chronic inflammation and pain. (Omega-9 essential fatty acids, plentiful in a few foods such as olive oil – as in “the Mediterranean diet” – also support anti-inflammatory action.)

n Importantly, even when dietary intake of omega-6 essential fatty acids far outbalances the omega-3 intake, our bodies normally metabolize some of the omega-6 linoleic acid (LA) to produce GLA. This is the same gamma-linolenic acid that rare nutrients such as evening primrose oil can provide directly – and GLA is a maverick in the omega-6 essential fatty acid family, in that it also can support a balancing anti-inflammatory action. GLA accomplishes this by playing a role in the production of various hormone-like substances called “prostaglandins.” These are known to help inflammation, aid in digestion, regulate hormones in the menstrual cycle, and much more. Nursing infants receive the benefits of GLA as a component of breast milk if the mother is healthy and well nourished, and in Japan, for example, GLA in the form of evening primrose oil is a standard component of infant formulas to make it more like breast milk.

n But sometimes the body’s ability to convert omega-6 LA to GLA as needed is compromised. When this happens, control of inflammatory influences at the cellular level becomes less efficient. The crucial step in the metabolization of essential fatty acids for use by the cells is called “delta-6 desaturation,” writes Neeyah Ostrom, author of several books examining metabolic function in Chronic Fatigue Syndrome.7 But blockage of this step – disordered fatty acid metabolism – is known to be associated with a variety of adverse factors.

1. Modern food processing methods change the structure of omega-6 LA fatty acid to “trans fatty acids,” and these “actually block the normal conversion process,” explains holistic health journalist Marilyn Brown.8 Trans fats are oils that have been treated with hydrogen gas to prolong shelf life, and are used in scores of foods, from cookies, frostings, and chips to margarine and microwave popcorn.

2. Other factors that may result in disordered fatty acid metabolism, according to Neenyah Ostrom’s review of the literature, include a release of significant amounts of the hormones adrenaline and hydrocortisone during stress; aging; certain conditions such as diabetes; and high alcohol intake. Additionally, she explains, “this metabolic step has also been shown to be reduced in people who have certain forms of eczema, hypertension, high cholesterol levels, and viral infections.”

3. And in particular, “CFS may be associated with persistent viral infections,” which in turn “are likely to impair the ability of the body to biosynthesize omega-3 and omega-6 long-chain fatty acids by inhibiting the delta-6 desaturation” process,1 writes Dr. Basant Puri, the Chronic Fatigue Syndrome researcher who conducted the new study at Hammersmith Hospital. This builds on the theory proposed in earlier studies of CFS and other conditions that “viruses, as part of their attack strategy, may reduce the ability of cells to make 6-desaturated essential fatty acids.” 9,10

Hence the benefit of evening primrose oil supplementation

Evening primrose oil’s ability to deliver GLA directly to the cells becomes highly beneficial when the body’s normal ability to process this crucial substance is compromised. “The direct source of GLA takes the pressure off the body to produce the necessary amount of GLA for optimum health,” writes Marilyn Brown.

But importantly, nutritionists add, the body will still be unable to utilize GLA efficiently to support anti-inflammatory processes if it is deficient in some other essential nutrients. Chief among these required helper nutrients are the mineral magnesium, zinc, and the vitamins C, B-3, and B-6.

How is evening primrose oil produced?

To ensure that the heat- and light-sensitive GLA found in evening primrose oil will be delivered to the cells intact, the oil should be cold-pressed from the plant’s minute seeds11 – which cluster some 500 per flower and require years to mature after a one-night blooming period. The oil from 5,000 or more seeds is needed to fill one capsule of this supplement. Normally, the oil contains about 70 percent omega-6 LA and 9 percent GLA.

Who should not take evening primrose oil supplements?

Evening primrose oil is generally considered safe. It should be taken only in amounts directed on the package, and with food to avoid nausea. However, people with allergies to plants, schizophrenia, epilepsy, or any seizure disorder should never take evening primrose oil. In particular, anyone taking anti-seizure drugs should avoid taking it because it may interfere with the action of these medications. Likewise, evening primrose oil should not be taken by individuals using any of the following prescription and over-the-counter drugs: aspirin, “neuroleptic” agents designed to have a tranquilizing or calming effect, non-steroidal anti-inflammatories (NSAIDs) used for pain relief/reduction of inflammation, or warfarin or other anti-clotting agents.

Overall, as evening primrose oil may affect blood clotting, it should not be taken with any herbal preparations or medications that have an anti-clotting effect.

And finally, because the effect of evening primrose oil supplementation in pregnant and nursing women is not known, these individuals should avoid taking it. Additionally, parents should consult a doctor before offering evening primrose oil to a child, as there is no information regarding appropriate dietary amounts for children.

Note: The information provided here is not intended to diagnose, treat, cure, mitigate, or prevent any disease. If you have a health condition, see your physician for diagnosis and treatment advice. Never make any changes in your nutritional and other health support plans without your physician’s explicit review and consent. It is essential for you and your healthcare providers to work as a mutually-informed team.


1. “Long-chain polyunsaturated fatty acids and the pathophysiology of myalgic encephalomyelitis (chronic fatigue syndrome),” by Basant K. Puri, published online ahead of print August 25, 2006 by the Journal of Clinical Pathology. See the abstract at http://www.immunesupport.com/library/showarticle.cfm?id=7264&T=CFIDS_FM

2. “Evening primrose oil benefits Chronic Fatigue Syndrome (CFS) patients,” adapted from Better Nutrition for Today’s Living and available in the ImmuneSupport.com archive at www.immunesupport.com/library/showarticle.cfm/id/109 – which cites “Effect of high doses of essential fatty acids on the postviral fatigue syndrome,” by P.O. Behan, et al., published in the September 1990 issue of the journal Acta Neurologica Scandinavica.

3. “Evening primrose Oil,” by Tori Hudson, published in the January 2001 issue of the Townsend Letter for Doctors and Patients, http://findarticles.com/p/articles/mi_m0ISW/is_2001_Man/ai_70777287

4. “It’s all in the fat: The role of essential fatty acids in health,” by Patricia Kane, PhD, reproduced with permission November 8, 2003 by ImmuneSupport.com www.immunesupport.com/library/showarticle.cfm/id/5065/

5. See the University of Maryland Medical Center’s free online Medical Reference on Supplements, sections on “Omega-3 Fatty Acids,” “Omega-6 Fatty Acids,” “Gamma-Linolenic Acid (GLA),” and “Eicosapentaenoic Acid (EPA),” at http://www.umm.edu/altmed/ConsLookups/Supplements.html ; “Trans Fats 101,” at http://www.umm.edu/features/transfats.html; and “Omega 3: Implications in Human Health and Disease,” by Jobson Medical Education, August 1, 2001 at http://www.powerpak.com/index.asp?show=lesson&lsn_id=1861&page=courses/1861/lesson.htm

6. “Natural Remedies for Inflammation,” by Jack Challem, published in the November 25, 2000 issue of the newsletter Nutrition Reporter at http://www.nutritionreporter.com/remedies_for_inflammation.html

7. “The benefits of Evening Primrose Oil: Fact or Fiction?” by Neenyah Ostrom, reproduced with permission September 1, 1994, by ImmuneSupport.com at www.immunesupport.com/library/showarticle.cfm/ID/48/T/CFIDS_FM

8. “Evening Primrose Oil – Superfood for the Active Lifestyle,” by Marilyn Brown, in Holistic Health News online, at www.hhnews.com/epo.htm

9. “Post-viral Fatigue Syndrome, viral infections in atopic eczema, and essential fatty acids,” by D.F. Horrobin, published in the March 1990 issue of the journal Medical Hypotheses.

10. “Eicosanoids and essential fatty acid modulation in chronic disease and the Chronic Fatigue Syndrome,” by J.B. Gray and A.M. Martinovic, published in the January 1994 issue of the journal Medical Hypotheses.

11. “The clinical advantages of cold-pressed non-raffinated evening primrose oil over refined preparations,” by B.K. Puri, published in the September 2004 issue of the journal Medical Hypotheses. See the abstract at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14729014&dopt=Abstract

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