Gamma-Linolenic Acid (GLA)
1. Identity: Chemical Names, Structure, and Natural Sources
Chemical Identity
Gamma-linolenic acid (GLA, cis-6, cis-9, cis-12-octadecatrienoic acid) is a conditionally essential fatty acid of the n-6 family. It is a polyunsaturated fatty acid (PUFA) with three cis (Z) double bonds — the first from the methyl end being at the omega-6 (ω-6) position — classified in shorthand as 18:3n-6. Its molecular weight is 278.4296 g/mol, molecular formula C₁₈H₃₀O₂, and its IUPAC name is (6Z,9Z,12Z)-octadeca-6,9,12-trienoic acid (CAS registry number 506-26-3; PubChem 5280933).
Gamma-linolenic acid was first isolated by Heiduschka A. and Luft K. in 1919 from the seed oil of Oenothera biennis (evening primrose). Its structure was first proposed by Eibner A. and Luft K. in 1927 and later confirmed by Riley J.P. in 1949. GLA was synthesized in 1961 by Osbond J.M. et al. The compound is also known by several synonyms: gamolenic acid (its International Nonproprietary Name), cis-6,cis-9,cis-12-octadecatrienoic acid, and 18:3n-6. Gamma-linolenic acid is an isomer of alpha-linolenic acid, but whereas alpha-linolenic acid belongs to the omega-3 series, GLA is strictly an omega-6 fatty acid.
Natural Plant Sources
GLA is widely distributed in the plant kingdom in trace amounts and is not present in major commercial vegetable seed oils. It is present in seeds of many species belonging to families Aceraceae, Boraginaceae, Cannabinaceae, Liliaceae, Onagraceae, Ranunculaceae, Saxifragaceae, and Scrophulariaceae. A very limited number of plant sources have been commercialized in the last 30 years as a source of GLA, mainly in the health food industry and to a limited extent in pharmaceutical, pet food, and cosmetic industries. These include oils of borage, black currant, evening primrose, and recently hemp.
GLA is found in certain plant seed oils, notably evening primrose oil and borage oil, where it constitutes about 8–10% and 20–23% of total fatty acids, respectively. Borage oil is the richest supplemental source (17 to 25 percent GLA), followed by black currant oil (15 to 20 percent) and evening primrose oil (7 to 10 percent). Beyond seed oils, spirulina lipid contains 18–21% GLA; however, only 7.8% of spirulina is lipid by dry mass, so the overall GLA content by dry mass is closer to 1.23%. According to the USDA Standard Release, GLA is present in hemp seeds (1.34% by mass), some vegetable oil products (0.59% in soft margarine), and some meats (0.1% in chicken skin). GLA is found in moderate amounts in human breast milk, making it a significant natural source during infancy.
Some fungi and algae form GLA-rich lipid stores, examples being strains of Rhizopus, Mortierella, Mucor, and Spirulina.
Common Forms and Preparations
Evening primrose oil supplements come as softgels, capsules, and liquids, and are also added to creams and ointments for topical application. The seed oil of the evening primrose (EPO) has been widely used commercially as a component of foods, as a nutritional supplement, as an ingredient of cosmetic, skin care and hair care products, and as a pharmaceutical. GLA can also be obtained in more concentrated forms via purified preparations from borage or black currant seed oil, which allow higher per-capsule doses than those achievable from evening primrose oil alone.
2. Traditional and Historical Use
Native American Traditions
Many Native American groups used evening primrose medicinally, including the Anishinaabe, Cherokee, Iroquois, Ojibwas, and Potawatomi. Many groups used tea from the plant to improve energy levels and aid in weight loss. They also made a poultice from the plant to treat bruises, piles, and boils. They chewed the roots and rubbed them onto the muscles to improve strength. The plant was also sometimes used internally to treat bowel and menstrual pain.
Native Americans used the leaves and bark of evening primrose as a sedative and astringent; it was given for stomach and liver complaints as well as disorders of the female reproductive system. The Flambeau Ojibwe tribe soaked the whole plant in warm water to make a poultice for healing bruises and to overcome skin problems. Evening primrose was used by Native Americans to heal wounds, bruises, and to soothe swollen skin; they would eat the leaves to help with sore throats and stomach issues.
Introduction to Europe and Early Modern Use
In the 17th century, evening primrose was introduced to European botanical gardens as an ornamental, and its oil became a popular folk remedy, earning the plant one of its common names, "King's Cure-All." The Cherokee, Iroquois, Ojibwas, and Potawatomi were among several Native American tribes that used evening primrose for both food and medicinal purposes; they ate the cooked greens when young, made a tea for overfatness, and a hot root poultice for piles. The bark and leaves are astringent and sedative and were used for the treatment of gastrointestinal disorders, whooping cough, and asthma.
It is important to note that traditional uses concerned the whole plant — leaves, roots, bark, and stems — not the isolated fatty acid. GLA was first isolated in 1919 from the oil of the evening primrose plant, a wildflower with a long history of use in folk remedies including as a treatment for pain, swelling, skin disorders, and menstrual pain. The connection between these traditional uses and GLA specifically was only recognized in the 20th century, once the chemistry and biochemistry of the fatty acid had been established.
3. Key Constituents, Biochemistry, and Mechanisms of Action
Endogenous Biosynthesis and the Role of Δ6-Desaturase
The human body produces GLA from linoleic acid (LA). This reaction is catalyzed by Δ6-desaturase (D6D), an enzyme that allows the creation of a double bond on the sixth carbon counting from the carboxyl terminus. Dietary GLA bypasses the rate-limiting Δ6 desaturation step and is quickly elongated to DGLA by elongase, with only a very limited amount being desaturated to arachidonic acid (AA) by Δ5 desaturase.
A lack of GLA can occur when there is a reduction in the efficiency of the D6D conversion (for instance, as people grow older or when there are specific dietary deficiencies) or in disease states wherein there is excessive consumption of GLA metabolites. Factors known to reduce D6D activity include aging, diabetes, nutritional deficiencies (particularly of zinc, magnesium, and vitamins B6 and C), high intake of trans-fatty acids, and excessive alcohol consumption.
The GLA → DGLA → Eicosanoid Pathway
GLA may be elongated to dihomo-gamma-linolenic acid (DGLA) by an elongase enzyme. Δ5-desaturase can then metabolize dihomo-gamma-linolenic acid to arachidonic acid. DGLA is the precursor of the prostaglandin PGH1, which in turn forms PGE1 and the thromboxane TXA1. Both PGE1 and TXA1 are anti-inflammatory; TXA1 induces vasodilation and inhibits platelet aggregation, modulating (reducing) the pro-inflammatory properties of thromboxane TXA2. PGE1 has a role in regulation of immune system function. Unlike arachidonic acid and EPA, DGLA cannot yield leukotrienes; however, it can inhibit the formation of pro-inflammatory leukotrienes from arachidonic acid.
Upon stimulation, DGLA can be converted by inflammatory cells to 15-(S)-hydroxy-8,11,13-eicosatrienoic acid (15-HETrE) and prostaglandin E1. This is noteworthy because these compounds possess both anti-inflammatory and antiproliferative properties. DGLA can be converted to PGE1 via the cyclooxygenase pathway and/or converted to 15-HETrE via the 15-lipoxygenase pathway. 15-HETrE is capable of inhibiting the formation of AA-derived 5-lipoxygenase (pro-inflammatory) metabolites.
Anti-inflammatory mediators such as prostaglandin E1 (PGE1) and 15-HETrE, originating from GLA metabolism, are crucial in regulating fever, smooth muscle contraction, and immune modulation. GLA also influences COX and LOX activity by promoting the synthesis of anti-inflammatory molecules, thereby contributing to immune regulation.
Leukotriene Inhibition
When acting on GLA, arachidonate 5-lipoxygenase produces no leukotrienes, and the conversion by the enzyme of arachidonic acid to leukotrienes is inhibited. This dual action — generating anti-inflammatory series-1 prostaglandins through one arm, while simultaneously suppressing pro-inflammatory leukotriene synthesis through another — provides GLA with a distinctive anti-inflammatory mechanism that distinguishes it from most other omega-6 fatty acids.
Membrane Incorporation
Recent studies demonstrate that dietary GLA increases the content of its elongase product, DGLA, within cell membranes without concomitant changes in arachidonic acid (AA). GLA and DGLA increased in serum lipids of subjects supplemented with 3.0 and 6.0 g/d; GLA supplementation with 3.0 and 6.0 g/d also resulted in an enrichment of DGLA in neutrophil phospholipids but no change in GLA or AA levels. This preferential enrichment of DGLA — rather than its conversion to pro-inflammatory AA — is considered a key mechanism underlying GLA's clinical effects.
4. Scientific Evidence by Area of Use
4.1 Inflammatory and Autoimmune Conditions: Rheumatoid Arthritis
The most thoroughly studied clinical application of GLA is in rheumatoid arthritis (RA). To assess the clinical efficacy and adverse effects of GLA, a plant seed oil-derived unsaturated fatty acid that suppresses inflammation and joint tissue injury in animal models, 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 g/day of GLA as the free fatty acid or with sunflower seed oil (placebo) administered in identical capsules.
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). Patients taking GLA during the entire study showed progressive improvement during the second 6 months; 16 of 21 patients showed meaningful improvement at 12 months compared with study entry.
GLA at doses used in this study was described as 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. An earlier trial by Leventhal et al. (1993, Annals of Internal Medicine) at the University of Pennsylvania also examined borage seed oil at approximately 1,100 mg GLA/day and reported reductions in synovitis. However, the overall evidence base for GLA in RA consists of a limited number of relatively small trials, and longer-term, larger confirmatory studies have not been completed.
4.2 Skin and Dermatological Conditions: Atopic Dermatitis (Eczema)
Atopic dermatitis (AD) has been related to a deficiency of delta-6-desaturase, an enzyme responsible for the conversion of linoleic acid to gamma-linolenic acid (GLA). As a result of reduced enzyme activity of delta-6-desaturase, high levels of LA and low levels of GLA have been observed in AD patients. This provided a compelling mechanistic rationale for supplementation trials.
One open study included 21 patients with AD, to whom EPO (4–6 g) was administered daily for 12 weeks. A significant increase in plasma GLA and DGLA levels and a decrease in the objective SCORAD were observed 4 and 12 weeks after initiation of EPO treatment. GLA is reportedly efficacious for treating transepidermal water loss (TEWL) and epidermal hyper-proliferation. In one study, GLA-containing food was given to adults with dry skin or mild atopic dermatitis; beneficial effects on the TEWL index were recognized, and the efficacy of GLA was statistically significant especially in subjects with pro-inflammatory features.
A number of studies tested GLA-rich oils for treating atopic dermatitis. Initially, trials from the 1980s and 1990s indicated that GLA-rich oils could be useful for relieving symptoms. Multiple studies showed that GLA supplementation (at durations of at least four weeks) could reduce dermatitis symptoms in both children and adults, providing relief from itchiness and redness. These benefits appeared to be due to the generation of anti-inflammatory GLA metabolites improving skin barrier function.
However, the overall evidence picture for eczema is mixed. GLA has been widely marketed for addressing eczema, but current research suggests that it may not provide significant benefits for this condition. A meta-analysis of 27 studies on improvement of atopic dermatitis symptoms yielded mixed/negative results. The licensed evening primrose oil products marketed specifically for atopic eczema in the United Kingdom (Epogam and Efamast) were withdrawn from clinical use in 2002 after re-evaluation of the benefit/risk ratio. The current scientific consensus characterizes the evidence as mixed.
4.3 Diabetic Neuropathy
GLA has been studied for its possible benefits for diabetic neuropathy. Diabetic patients have abnormalities of essential fatty acid metabolism and therefore may require higher amounts of essential fatty acids. GLA and linoleic acid are both essential components of myelin and the neuronal cell membrane, and GLA has provided positive results in the treatment of experimental diabetes.
Two of three randomized controlled trials showed positive effects of GLA in diabetic neuropathy. Two of the trials demonstrated, with GLA at 360 mg/day for 6 months and 480 mg/day for 1 year, statistically significant improvements in neuropathy scores, nerve conduction velocities, and action potentials. A review of three randomized, controlled trials suggested evening primrose oil might improve symptoms of diabetic neuropathy. Dosages in these trials ranged from 360 to 480 mg GLA daily. Few adverse effects were noted in these trials, and there was no increase in blood glucose levels.
More recently, gamma-linolenic acid derived from evening primrose oil was found noninferior to alpha-lipoic acid for reducing pain in patients with diabetic neuropathy. Nevertheless, the supplement is primarily associated with potential benefits for diabetic neuropathy, although conclusive evidence for its effectiveness remains limited. The evidence is promising but comes from a small number of trials with limited sample sizes.
4.4 Breast Pain (Mastalgia) and Women's Health
Among 10 clinical studies on mastalgia (breast pain), seven showed the priority of evening primrose oil over other treatments. Wide-ranging doses of 0.27 g to 6.48 g GLA per day have been used in clinical studies in mastalgia. However, more recent evidence has tempered earlier enthusiasm. Current research suggests that GLA may not provide significant benefits for cyclic mastalgia.
One randomized, multicenter, controlled double-blind trial tested GLA in combination with other nutrients in women with cyclic breast pain associated with fibrocystic breast changes. Women were randomized to receive a liquid formulation (1 g GLA, 750 μg iodine, and 70 μg selenium) or control formula daily for three cycles. Breast pain scores decreased similarly in both groups (−32.2% experimental vs. −33.1% control, p = 0.64). Nodularity was reduced in the experimental but not the control group. Among women who continued pain medication, the amount was reduced in the experimental group relative to controls. This study did not isolate the effect of GLA alone.
For premenstrual syndrome (PMS) more broadly, study results vary: some show benefit, others do not. The evidence for GLA's effect on menopausal vasomotor symptoms (hot flashes) is similarly mixed and limited.
4.5 Cardiovascular Health
Gamma-linolenic acid has been investigated for potential cardiovascular benefits. Studies indicate that GLA supplementation may help lower blood pressure, improve lipid profiles, and reduce the risk of cardiovascular diseases. These effects are likely mediated through the anti-inflammatory and vasodilatory properties of PGE1, as well as the potential inhibition of platelet aggregation. Preliminary data suggest benefit in some lipid profiles, but robust, large-scale outcome trials in cardiovascular disease are lacking. The mechanistic plausibility via DGLA-derived eicosanoids is well-established; the clinical evidence, however, is sparse.
4.6 Oncology (Adjunct Research)
Gamma-linolenic acid demonstrates promising potential in cancer therapy by selectively inducing apoptosis in cancer cells while sparing normal cells. It has been shown to disrupt the cancer cell cycle and promote cell death. GLA may help prevent inflammatory diseases by converting into dihomo-DGLA, which produces powerful anti-inflammatory agents. Given its anti-inflammatory and immune-modulating effects, GLA holds promise as an adjunct in cancer therapy, although its selective anticancer properties require further investigation. The current evidence in oncology is predominantly preclinical (in vitro and animal models); robust human clinical trial data in oncology are lacking.
4.7 Dry Eye and Sjögren's Syndrome
Preliminary data suggest benefit for ocular surface diseases such as dry eye. GLA's proposed mechanism in this context is the modulation of inflammatory eicosanoids in the lacrimal gland and ocular surface. The evidence base remains small, consisting of preliminary studies only.
4.8 Multiple Sclerosis
In multiple sclerosis patients, evening primrose oil may improve fatigue and quality of life, and along with hemp seed and a diet high in antioxidants, it may improve clinical and immunological parameters. This evidence is early-stage and has not been replicated in large, well-powered trials.
5. Body Systems and Health Areas Associated with GLA
- Immune and Inflammatory System: Modulation of eicosanoid biosynthesis (prostaglandins, leukotrienes, thromboxanes) via the DGLA–PGE1 pathway; inhibition of pro-inflammatory leukotriene formation from arachidonic acid.
- Integumentary System (Skin): Maintenance of skin barrier function; reduction of transepidermal water loss; potential benefit in atopic dermatitis, dry skin, and psoriasis.
- Musculoskeletal System: Anti-inflammatory and joint-protective effects, particularly in rheumatoid arthritis.
- Nervous System: Role as a structural component of myelin and neuronal membranes; potential prevention and amelioration of diabetic peripheral neuropathy.
- Cardiovascular System: Vasodilation via PGE1; inhibition of platelet aggregation; potential effects on blood pressure and lipid profiles.
- Endocrine/Reproductive System: Investigated for cyclic mastalgia, PMS, and menopausal symptoms.
- Ophthalmic: Possible benefit in dry-eye conditions and Sjögren's syndrome.
6. Dosage Forms and Dosages Reported in Studies
GLA is commercially available primarily in the form of softgel capsules of plant seed oils, most commonly evening primrose oil, borage seed oil, and black currant seed oil. Evening primrose oil has been administered orally in clinical trials at doses between 1 and 8 g/day in adults and 2 and 4 g/day in children. The typical content of GLA in the oil is 8% to 10%.
Dosages in published clinical studies vary substantially by indication:
- Rheumatoid arthritis: Patients in the Zurier et al. (1996) trial were treated with 2.8 g/day of GLA as the free fatty acid. In rheumatoid arthritis, doses as high as 2 to 3 thousand mg of GLA have been tried. Doses this high can only be obtained from purified GLA, as one would need impractically high doses of evening primrose oil or borage oil to obtain them.
- Diabetic neuropathy: Two trials demonstrated statistically significant improvements with GLA at 360 mg/day for 6 months and 480 mg/day for 1 year. The dose of 360 mg/day of GLA from EPO may be increased up to 480 mg/day.
- Atopic dermatitis: In one open study, EPO (4–6 g) was administered daily for 12 weeks. In another studied product (EPOGAM® 1000), each capsule contained 80 mg GLA; dosages were two capsules twice daily for patients aged 2–12 years and three capsules twice daily for patients over 12 years.
- Cyclic mastalgia / eczema: The typical dosage is about 200 to 400 milligrams (mg) of GLA daily (approximately 2 to 4 grams of evening primrose oil or 1 to 2 grams of borage oil).
- Healthy humans (metabolic studies): Supplementation of 29 volunteers with GLA in doses of 1.5–6.0 g/day was used to understand in vivo GLA metabolism.
- Mastalgia (combination formula): One multicenter RCT used 1 g GLA per day (with iodine and selenium) for three menstrual cycles.
For diabetic neuropathy, the typical dose is about 400 to 600 mg GLA daily (approximately 4 to 6 g of evening primrose or 2 to 3 g of borage oil).
It is important to distinguish between the dose of the whole oil preparation and the actual delivered GLA dose. Borage oil, as the richest supplemental source, contains 17 to 25 percent GLA, followed by black currant oil at 15 to 20 percent, and evening primrose oil at 7 to 10 percent. Consumers and clinicians should verify the amount of actual GLA per capsule rather than the amount of total oil.
7. Safety Considerations and Drug Interactions
General Tolerability
While GLA is generally well-tolerated by most people, common side effects can include mild digestive issues, headaches, and nausea, especially at higher doses. GLA is generally well tolerated and any reported side effects — such as headache, nausea, diarrhoea, acid reflux and bloating — are usually mild. In one clinical study, the physician confirmed that none of the subjects showed any noteworthy side effects.
Bleeding and Anticoagulant Interactions
Gamma-linolenic acid might slow blood clotting. Taking GLA along with medications that also slow clotting might increase the chances of bruising and bleeding. Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac, ibuprofen, naproxen, dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others. Patients taking antiplatelet agents or anticoagulants should use EPO cautiously or not at all.
Seizure Risk and Phenothiazine Interactions
Taking gamma-linolenic acid with phenothiazines might increase the risk of having a seizure in some people. Some phenothiazines include chlorpromazine (Thorazine), fluphenazine (Prolixin), trifluoperazine (Stelazine), thioridazine (Mellaril), and others. If you have epilepsy or schizophrenia, evening primrose oil may lower your seizure threshold. The same risk applies if you take phenothiazine medications for serious mental health conditions.
Pyrrolizidine Alkaloids in Borage Oil
Uncertified borage oil supplements may contain liver-toxic pyrrolizidine alkaloids (PAs). Some sources of GLA, specifically borage seed oil, can contain compounds called pyrrolizidine alkaloids (PAs). These compounds can be toxic to the liver, especially when consumed in high doses or for prolonged periods. Borage seed oil has the highest GLA potency per capsule but must be labeled PA-free with validated testing to avoid pyrrolizidine alkaloids. Brands that disclose PA testing methods or carry third-party certifications should be favored.
NSAID Interactions
Theoretically, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) may counteract the effect of EPO, since NSAIDs inhibit cyclooxygenase enzymes required for the conversion of DGLA to the anti-inflammatory series-1 prostaglandins that mediate GLA's principal effects.
Potential Interactions with Other Agents
EPO (and by extension, its GLA content) may increase the effectiveness of ceftazidime, chemotherapy agents, and cyclosporine and may interact with phenothiazines, thus causing an increase in seizures.
Special Populations
Information regarding safety and efficacy in pregnancy and lactation is lacking. A case report exists of transient petechiae in a newborn following oral and intravaginal use of evening primrose oil for cervical ripening for a week prior to the infant's birth. GLA should not be taken if a person has a seizure disorder such as epilepsy, a bleeding disorder, or if surgery is planned. It should not be taken during pregnancy. The safety of GLA in babies and younger children has not been established.
Oxidative Stability
As a highly polyunsaturated fatty acid, GLA is prone to oxidative rancidity. High-quality oil (preferably certified organic), packaged in light-resistant containers, refrigerated, and marked with a freshness date should be obtained to avoid rancidity. Rancid or oxidized oils may have altered and potentially harmful biological activity.
8. Overall Evidence Appraisal
Clinical trials show mixed results, with some studies showing benefits for specific conditions while others find no significant effects. Early positive findings have led to the supplement being considered overhyped in some analyses. While GLA is a precursor to anti-inflammatory compounds, its conversion rate in the body can be variable and limited. The anti-inflammatory pathway from GLA to DGLA to PGE1 provides a plausible biological explanation for clinical effects, but "plausible mechanism plus mixed results" is a common pattern in supplement research, and the jury is still out.
The strongest clinical evidence exists for rheumatoid arthritis (several small-to-moderate RCTs with positive findings at high doses) and diabetic neuropathy (two of three RCTs showing benefit at 360–480 mg GLA/day). Evidence for atopic dermatitis is mixed, with early positive trials followed by negative meta-analyses. Evidence for mastalgia, PMS, cardiovascular effects, and most other applications is preliminary, inconsistent, or based on very small studies. Evidence in oncology and neurology remains predominantly preclinical. Overall, evidence suggests that evening primrose oil may be effective for treating rheumatoid arthritis, injection site skin reactions, and diabetic neuropathy, but is lacking to support its use in atopic eczema/dermatitis syndrome, menopausal vasomotor symptoms, mastalgia, or multiple sclerosis.
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