Gammalinolenic acid + rheumatoid arthritis
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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Gamma-linolenic acid (GLA) is an essential fatty acid (EFA). It is in the omega-6 group that is found primarily in plant-based oils.
EFAs must be obtained from food. EFAs are essential for the regulation of a number of metabolic functions.
Linoleic acid (LA), another omega-6 fatty acid, is found in cooking oils and processed foods and converted to GLA after it is ingested. GLA is then broken down to either arachidonic acid (AA) or another form of GLA called DGLA.
GLA is found in the plant seed oils of evening primrose, black currant, borage, and fungal oils. Spirulina (often called blue-green algae) also contains GLA.
GLA supplements are derived from evening primrose oil (EPO) as well as black currant seed and borage seed oils. The GLA supplements are often packaged in oil-containing capsules. EPO has been the most researched source of GLA.
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.
The average North American diet provides more than 10 times the necessary amount of linoleic acid and tends to contain too much omega-6 fatty acids compared to omega-3 fatty acids, another important class of EFAs. For optimum health, the ratio of omega-6 to omega-3 fatty acids should be between 1:1 and 4:1. The typical North American diet ranges from 11:1 to 30:1. This imbalance contributes to the development of chronic disorders such as heart disease, cancer, asthma, arthritis, and depression.
Linoleic acid and arachidonic acid (AA) promote inflammation. In contrast, GLA may actually reduce inflammation.
Much of the GLA ingested is not converted to AA, but rather to DGLA. DGLA competes with AA and prevents the inflammatory effects that AA would otherwise cause. Having adequate amounts of certain nutrients, such as magnesium, zinc, and vitamins C, B3, and B6 helps to promote the conversion of GLA to DGLA rather than AA.
The evidence supporting the use of omega-3 fatty acids to reduce inflammation and prevent diseases is stronger than the information regarding use of GLA for these purposes. Two important omega-3 fatty acids include eicosopentaenoic acid (EPA) and docosahexaenoic acid (DHA), both found in fish and fish oils.
Some preliminary information indicates that GLA, from evening primrose oil, borage oil, or black currant seed oil, may diminish joint pain, swelling, and morning stiffness. GLA may also allow for reduction in the amount of pain medication used by those with rheumatoid arthritis.
One option is to try GLA to see if it is safe for and then monitor symptoms to see if they improve.
• The recommended dosage for rheumatoid arthritis is 1,400 mg per day of GLA or 3,000 mg of EPO.
• Studies have suggested that up to 2,800 mg of GLA per day is well tolerated.
Because of the potential for side effects and interactions with medications, dietary supplements should be taken only after conferring with your physician.
Omega-6 supplements, including GLA and EPO, should not be used in patients with seizure disorders because there have been reports of these supplements inducing seizures.
Borage seed oil, and possibly other sources of GLA, should not be used during pregnancy because they may be harmful to the fetus and induce early labor.
Doses of GLA greater than 3,000 mg per day should be avoided because, at that point, the balance favors the production of AA over DGLA.
If you are currently being treated with any of the following medications, you should not use GLA without first talking to your healthcare provider.
Theoretically, use of NSAIDs, such as ibuprofen, together with borage oil or other GLA containing supplements may counteract the effects of the supplement.
Individuals taking a class of medications called phenothiazines (such as chlorpromazine, fluphenazine, perphenazine, promazine, and thioridazine) to treat schizophrenia should not take EPO because it may interact with these medications and increase the risk of seizures. The same may be true for other GLA containing supplements.
Arthritis Rheum. 1996 Nov;39(11):1808-17.
gamma-Linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial.
Zurier RB, Rossetti RG, Jacobson EW, DeMarco DM, Liu NY, Temming JE, White BM, Laposata M.
University of Massachusetts Medical Center, Worcester 01655-0335, USA.
OBJECTIVE: To assess the clinical efficacy and adverse effects of gamma-linolenic acid (GLA), a plant seed oil-derived unsaturated fatty acid that suppresses inflammation and joint tissue injury in animal models, in the treatment of active rheumatoid arthritis (RA). METHODS: Fifty-six patients with active RA were randomized to treatment groups in a 6-month, double-blind trial of GLA versus placebo. This was followed by a 6-month, single-blind trial during which all patients received GLA. Patients were treated with 2.8 gm/day of GLA as the free fatty acid or with sunflower seed oil (placebo) administered in identical capsules. RESULTS: Treatment with GLA for 6 months resulted in statistically significant and clinically relevant reductions in the signs and symptoms of disease activity in patients with RA. Overall meaningful responses (at least 25% improvement in 4 measures) were also better in the GLA treatment group (14 of 22 patients versus 4 of 19 in the placebo group; P = 0.015). During the second 6 months, both groups exhibited improvement in disease activity. Thus, patients taking GLA during the entire study showed progressive improvement during the second 6 months. In this group, 16 of 21 patients showed meaningful improvement at 12 months compared with study entry. CONCLUSION: GLA at doses used in this study is a well-tolerated and effective treatment for active RA. GLA is available as a component of several plant seed oils and is usually taken in far lower doses than were used in this trial. It is not approved in the United States for the treatment of any condition, and should not be viewed as therapy for any disease. Further controlled studies of its in RA are warranted.
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