THE evening primrose plant has a history of traditional healing and it was only in the 1970s that the oil from its seeds was found to benefit a host of conditions including atopic eczema, premenstrual syndrome, breast pain, diabetic neuropathy, dry skin and brittle nails.
A panacea or snake oil? Snake oil it certainly is not as there are more than 400 research papers which agree that the underlying causes of the conditions that are helped by evening primrose oil are all linked to abnormal essential fatty acid metabolism.
Essential fatty acids are components of every cell, to provide energy, to insulate the nerves and maintain the integrity of cell membranes. The World Health Organization recommends that at least 3% of our daily calorie intake should be in the form of essential fatty acids. Children, pregnant and nursing mothers require a higher intake of 5% daily.
Evening primrose oil works by supplying essential fatty acids in the form of gamma-linolenic acid (GLA) and linoleic acid. The essential fatty acids in the oil are converted into physiologically-active substances called prostaglandins. There are at least fifty prostaglandins that have been identified so far and new ones are being discovered each year. Prostaglandins are required for the function of virtually every system in the body such as regulation of blood pressure, pain, inflammation, blood clotting, hormonal production and their actions.
Each prostaglandin has a role to play and if these chemicals are not synthesised in the right amounts and in the proportions required, clinical findings show that they are linked to a host of health problems. The body has to receive a constant and balanced supply of essential fatty acids in order to produce the right prostaglandins as they are needed. Prostaglandin E1 (PGE1) derived from evening primrose oil seems to have the most desirable properties and is obtained from the conversion of GLA.
A common disease of childhood, atopic eczema is a skin condition characterised by dry, scaly, red and itchy patches. Eczema patients commonly have a defect in the conversion of essential fatty acid into prostaglandins, but fortunately this can be overcome by supplying large quantities of GLA. The usage of evening primrose oil for treating atopic eczema is well documented and it is approved for use in the United Kingdom as an eczema medication.
In one study, very young children with atopic eczema were given 3gm evening primrose oil each day for 28 days, followed by clinical evaluations every seven days. While none of the children showed complete recovery within that period, there was a significant improvement in symptoms including the redness, lesions and reduction in the thickness and scaling of the skin. All of the children showed a dramatic improvement in skin itch and were able to cut down on the use of antihistamine. These results were reproduced in trials on adults with atopic eczema that further support the therapeutic application of evening primrose oil for this condition. Atopic eczema cannot be cured, but evening primrose oil treatment is regarded an excellent form of long term management of the condition as it is relatively free of risks compared to topical steroid creams.
Premenstrual syndrome (PMS) is a very common condition that affects most women and approximately 10% experiences severe physical and psychological symptoms that impair their daily lives. Physical symptoms include fluid retention, weight gain, swollen ankles, legs and fingers, breast pain, bloating, skin problems and food cravings. Lack of concentration, irritability, lethargy, depression and mood swings are psychological manifestations of PMS.
Eight clinical investigations on over 200 women with PMS, using between six to eight capsules of 500mg evening primrose oil found that the oil significantly improved both physical and psychological symptoms of PMS.
Breast pain or mastalgia associated with PMS affects up to 70% of the female population at some time in their lives. Studies show that women with severe breast pain consumed more saturated fats in their diet and they have much more lower than normal levels of essential fatty acid metabolites especially gamma-linolenic acid in their bodies.
Once breast cancer or other breast disorders are ruled out, evening primrose oil is usually prescribed as the first line of treatment for mastalgia. In one trial, 3g of evening primrose oil taken daily was shown to produce clinically significant improvements in 58% of patients with cyclical mastalgia (linked to the menstrual cycle) and 38% of patients with non-cyclical breast pain.
Nerve damage in diabetes is referred to as diabetic neuropathy and the symptoms vary depending on which nerve is affected. Diabetic neuropathy develops gradually over a number of years and causes loss of sensation, muscle weakness especially at the ankle, resulting in an uncoordinated gait. If sensation is lost, a minor injury to the foot, such as a stubbed toe may go unnoticed. In diabetes, wound healing is slow due to poor blood supply and this may lead to infection. If left untreated, the infection may spread to the bone which may call for drastic measures such as a toe amputation.
People who have diabetes are less able, than healthy individuals, to convert linoleic acid to GLA and Prostaglandin E1. Since GLA and its metabolites are important in the maintenance of normal cell membrane structure, a lack of GLA may contribute to stiff and inept cell membranes that affect the rate of conduction of nerve impulses. Slow conduction of nerve impulses means impaired sensation, muscle weakness, muscle wasting, loss of tendon reflexes in the limbs and other symptoms linked to diabetic neuropathy.
GLA is also important for the blood flow supplying nerves. When the levels of essential fatty acids are reduced in red blood cell membranes, they become stiff and sticky and highly inefficient in delivering oxygen and nutrients to the nerve cells. Nerve cells are then starved of oxygen and nutrients, leading to further nerve damage. Diabetics have rigid red blood cells and viscous blood.
Fiocchi, A, Sala, M, Signoroni, P, et al., 1994, ‘The efficacy and safety of gamma-linolenic acid in the treatment of infantile atopic dermatitis’, The Journal of International Medical Research, vol. 22, pp. 24-32.
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, Switzerland, vol. 15, no. 1, pp. 20-5.
O’Brien, PMS, Massil, H, 1990, Premenstrual Syndrome: Clinical Studies on Essential Fatty Acids. Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, NY, pp. 423-545.
Gately, CA, 1994, ‘Drug therapy of mastalgia. What are the options?’ Drugs, vol. 48, pp. 709-716.
Cameron, NE, Cotter, MA, 1997, `Metabolic and vascular factors in the pathogenesis of diabetic neuropathy’, Diabetes, Sep, vol. 46, suppl. 2, pp31-7, (ISSN: 0012-1797).
Keen, H, Payan,J, Allawi, J, Walker, J, Jamal, GA, Weir, Henderson, L, Bissessar, EA, Watkins, PJ, Sampson, M, et al, 1993, `Treatment of diabetic neuropathy with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter Trial Group’, Diabetes Care, Jan, vol. 16, no. 1, pp. 8-15.
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