GLA (Gamma-Linolenic Acid) Beneficial for Diabetic Neuropathy

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GLA (Gamma-Linolenic Acid) Beneficial for Diabetic Neuropathy

 

GLA -(Gamma-Linolenic Acid)

 

Supplement Forms / Alternate Names-

 

Omega-6 Fatty Acids; Sources of GLA include Black Currant Seed Oil,

Borage Oil, Evening Primrose Oil

 

Principal Proposed Use-

• Diabetic Neuropathy

 

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What Is the Scientific Evidence for GLA (Gamma-Linolenic Acid)?

 

---

-- GLA (gamma-linolenic acid) is one of the two main 'types' of

essential fatty acids.

 

These are " good " fats that are as necessary for your health as

vitamins.

 

Specifically, GLA is a Therapuetic omega-6 fatty acid. (For more

information on the other major category of essential fatty acids,

omega-3,

see the article on fish oil.)

 

The body uses essential fatty acids to make various prostaglandins

and leukotrienes.

These substances *influence* inflammation and pain; some of them

increase

symptoms, while others decrease them.

 

Taking GLA may swing the balance over to the more " favorable "

prostaglandins and leukotrienes,

making it 'helpful' for diseases that involve inflammation.

---

-

 

-Requirements/Sources

 

The body ordinarily makes all the GLA it needs from linoleic acid,

an omega-6 essential fatty acid found in many foods. In certain

 

circumstances, however, the body may not be able to convert linoleic

 

acid to GLA efficiently.

 

These include advanced age, diabetes, high alcohol intake, eczema,

 

cyclic mastitis, viral infections, excessive saturated fat intake,

elevated cholesterol levels,

and deficiencies of vitamin B6, zinc, magnesium, biotin, or calcium.

 

In such cases, taking GLA supplements may make up for a genuine

deficiency.

 

Very little GLA is found in the diet.

 

Borage oil is the richest supplemental source (17 to 25% GLA),

 

followed by black currant oil (15 to 20%)

 

and evening primrose oil (7 to 10%).

 

Borage and evening primrose are the most common sources.

 

 

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--

 

-Therapeutic Dosages-

 

Diabetic neuropathy is typically treated with about 400 to 600 mg

daily

(about 4 to 6 g of evening primrose or 2 to 3 g of borage oil),

 

and rheumatoid arthritis may require as much as 2,000 to 3,000 mg

(best

obtained from purified GLA).

 

GLA should be taken with food. Full benefits are said

to take more

than 6 months to develop, so be patient.

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--

 

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Therapeutic Uses

Evening primrose oil appears to be effective for diabetic

neuropathy,

a complication of diabetes. This condition, which develops in many

 

people with diabetes, consists of pain and/or numbness due to

 

progressive nerve damage.

 

 

---

--

 

-What Is the Scientific Evidence for

GLA (Gamma-Linolenic Acid)?

 

Diabetic Neuropathy-

 

Diabetic neuropathy is a gradual degeneration of nerves caused by

 

diabetes. There is some evidence that GLA can be helpful, if you

give

 

it long enough to work. In one double-blind, placebo-controlled

study,

 

111 people with mild diabetic neuropathy received either 480 mg

daily

 

of GLA or placebo.51 After 12 months, the group taking GLA was doing

 

significantly better than the placebo group.

 

Good results were seen in a smaller study as well.

 

In addition, numerous studies in animals have found that evening

 

primrose oil can protect nerves from diabetes-induced nerve injury.

 

There is preliminary evidence that GLA may be more effective for

this

 

condition when combined with alpha lipoic acid.

 

 

 

 

 

Rheumatoid Arthritis-

 

According to many studies, fish oil, a source of omega-3 essential

 

fatty acids, definitely improves symptoms of rheumatoid arthritis. A

 

few studies suggest that GLA may also work.

 

One double-blind study followed 56 people with rheumatoid arthritis

 

for 6 months.66 Participants received either 2.8 g daily of GLA or

 

placebo.

 

The group taking GLA experienced significantly fewer symptoms than

the

 

placebo group, and the improvements grew over time.

 

 

 

 

 

 

 

Other Proposed Uses-

 

• GLA Alone:; Attention Deficit, Kidney Stones; PMS; Raynaud's

 

Phenomenon; Rheumatoid Arthritis; Ulcerative Colitis; Weight Loss;

and

 

Many Others; In Combination with Fish Oil:; Attention Deficit and

 

Hyperactivity Disorder (ADHD); Huntington's Disease; Osteoporosis

 

 

-Requirements/Sources-

 

 

 

The body ordinarily makes all the GLA it needs from linoleic acid,

an omega-6 essential fatty acid found in foods.

 

In certain circumstances, however, the body may not be able to

convert

 

linoleic acid to GLA efficiently.

 

These include advanced age, diabetes,

high alcohol intake, eczema, cyclic mastitis, viral infections,

 

excessive saturated fat intake,

elevated cholesterol levels,

and deficiencies of vitamin B6, zinc, magnesium, biotin, or calcium.

 

In such cases, taking GLA supplements may make up for a genuine

 

deficiency.

 

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--

 

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Safety Issues

 

Over 4,000 people have taken GLA or evening primrose oil in

scientific

 

studies, and no significant adverse effects have ever been noted.

 

 

 

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--

 

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References

 

1. Horrobin DF. Nutritional and medical importance of gamma-

linolenic

 

acid. Prog Lipid Res. 1992;31:163–194.

 

2. Horrobin DF. The use of gamma-linolenic acid in diabetic

neuropathy.

 

Agents Actions Suppl. 1992;37:120–144.

 

3. Horrobin DF, Stewart C. Evening primrose oil in atopic eczema.

 

Lancet. 1990;335:864–865.

 

4. Horrobin DF, Manku MS, Brush M, et al. Abnormalities in plasma

 

essential fatty acid levels in women with premenstrual syndrome and

 

with nonmalignant breast disease. J Nutr Med. 1991;2:259–264.

 

5. Manku MS, Horrobin DF, Morse NL, et al. Essential fatty acids in

the

 

plasma phospholipids of patients with atopic eczema. Br J Dermatol.

 

1984;110:643–648.

 

6. Pye JK, Mansel RE, Hughes LE. Clinical experience of drug

treatments

 

for mastalgia. Lancet. 1985;2:373–377.

 

7. Pashby NL, Mansel RE, Hughes LE, et al. A clinical trial of

evening

 

primrose oil in mastalgia [abstract]. Br J Surg. 1981;68:801.

 

8. Mansel RE, Gateley CA, Harrison BJ, et al. Effects and

tolerability

 

of n-6 essential fatty acid supplementation in patients with

recurrent

 

breast cysts—a randomized double-blind placebo-controlled trial. J

Nutr

 

Med. 1990;1:195–200.

 

9. Mansel RE, Harrison BJ, Melhuish J, et al. A randomized trial of

 

dietary intervention with essential fatty acids in patients with

 

categorized cysts. Ann N Y Acad Sci. 1990;586:288–294.

 

10. Drug Evaluations Annual. Vol 2. Milwaukee, Wis.: American

Medical

 

Association; 1991.

 

11. Budeiri D, Li Wan Po A, Dornan JC. Is evening primrose oil of

value

 

in the treatment of premenstrual syndrome? Control Clin Trials.

 

1996;17:60–68.

 

12. Keen H, Payan J, Allawi J, et al. Treatment of diabetic

neuropathy

 

with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter

Trial

 

Group. Diabetes Care. 1993;16:8–15.

 

13. Jamal GA, Carmichael H. The effect of gamma-linolenic acid on

human

 

diabetic peripheral neuropathy: a double-blind placebo-controlled

 

trial. Diabet Med. 1990;7:319–323.

 

14. Morse PF, Horrobin DF, Manku MS, et al. Meta-analysis of

 

placebo-controlled studies of the efficacy of Epogam in the

treatment

 

of atopic eczema. Relationship between plasma essential fatty acid

 

changes and clinical response. Br J Dermatol. 1989;121:75–90.

 

15. Berth-Jones J, Graham-Brown RA. Placebo-controlled trial of

 

essential fatty acid supplementation in atopic dermatitis. Lancet.

 

1993;341:1557–1560.

 

16. Hederos CA, Berg A. Epogam evening primrose oil treatment in

atopic

 

dermatitis and asthma. Arch Dis Child. 1996;75:494–497.

 

17. Henz BM, Jablonska S, van de Kerkhof PC, et al. Double-blind,

 

multicentre analysis of the efficacy of borage oil in patients with

 

atopic eczema. Br J Dermatol. 1999;140:685–688.

 

18. Whitaker DK, Cilliers J, de Beer C. Evening primrose oil

(Epogam)

 

in the treatment of chronic hand dermatitis: disappointing

therapeutic

 

results. Dermatology. 1996;193:115–120.

 

19. Tamimi NA, Mikhail AI, and Stevens PE. Role of gamma-linolenic

acid

 

in uraemic pruritus [letter]. Nephron. 1999;83:170–171.

 

20. Yoshimoto-Furuie K, Yoshimoto K, Tanaka T, et al. Effects of

oral

 

supplementation with evening primrose oil for six weeks on plasma

 

essential fatty acids and uremic skin symptoms in hemodialysis

 

patients. Nephron. 1999;81:151–159.

 

21. Zurier RB, Rossetti RG, Jacobson EW, et al. gamma-Linolenic acid

 

treatment of rheumatoid arthritis. A randomized, placebo-controlled

 

trial. Arthritis Rheum. 1996;39:1808–1817.

 

22. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid

 

arthritis with blackcurrant seed oil. Br J Rheumatol. 1994;33:847–

852.

 

23. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid

 

arthritis with gammalinolenic acid. Ann Intern Med. 1993;119:867–

873.

 

24. Rothman D, DeLuca P, Zurier RB. Botanical lipids: Effects on

 

inflammation, immune responses, and rheumatoid arthritis. Semin

 

Arthritis Rheum. 1995;25:87–96.

 

25. Belch JJ, Shaw B, O'Dowd A, et al. Evening primrose oil (Efamol)

as

 

a treatment for cold-induced vasospasm (Raynaud's phenomenon). Prog

 

Lipid Res. 1986;25:335–340.

 

26. Belch JJ, Shaw B, O'Dowd A, et al. Evening primrose oil (Efamol)

in

 

the treatment of Raynaud's phenomenon: a double-blind study. Thromb

 

Haemost. 1985;54:490–494.

 

27. Haslett C, Douglas JG, Chalmers SR, et al. A double-blind

 

evaluation of evening primrose oil as an antiobesity agent.

IntJObes.

 

1983;7:549–553.

 

28. Garcia CM, Carter J, Chou A. Gamma linolenic acid causes weight

 

loss and lower blood pressure in overweight patients with family

 

history of obesity. SwedJBiolMed. 1986;4:8–11.

 

29. Kenny FS, Pinder SE, Ellis IO, et al. Gamma linolenic acid with

 

tamoxifen as primary therapy in breast cancer. Int J Cancer.

 

2000;85:643–648.

 

30. Greenfield SM, Green AT, Teare JP, et al. A randomized

controlled

 

study of evening primrose oil and fish oil in ulcerative colitis.

 

Aliment Pharmacol Ther. 1993;7:159–166.

 

31. Buck AC, Jenkins A, Lingam K, et al. The treatment of idiopathic

 

recurrent urolithiasis with fish oil (EPA) and evening primrose oil

 

(GLA)—a double blind study. J Urol. 1993;149:253A.

 

32. Tulloch I, Smellie WS, Buck AC. Evening primrose oil reduces

 

urinary calcium excretion in both normal and hypercalciuric rats.

Urol

 

Res. 1994;22:227–230.

 

33. Horrobin DF. Multiple sclerosis: the rational basis for

treatment

 

with colchicine and evening primrose oil. Med Hypotheses.

 

1979;5:365–378.

 

34. Field EJ, Joyce G. Effect of prolonged ingestion of

 

gamma-linolenate by MS patients. Eur Neurol. 1978;17:67–76.

 

35. Bates D. Dietary lipids and multiple sclerosis. Ups J Med Sci

 

Suppl. 1990;48:173–187.

 

36. Horrobin DF. Multiple sclerosis: the rational basis for

treatment

 

with colchicine and evening primrose oil. Med Hypotheses.

 

1979;5:365–378.

 

37. Behan PO, Behan WM, Horrobin D. Effect of high doses of

essential

 

fatty acids on the postviral fatigue syndrome. Acta Neurol Scand.

 

1990;82:209–216.

 

38. Warren G, McKendrick M, Peet M. The role of essential fatty

acids

 

in chronic fatigue syndrome. A case-controlled study of red-cell

 

membrane essential fatty acids (EFA) and a placebo-controlled

treatment

 

study with high dose of EFA. Acta Neurol Scand. 1999;99:112–116.

 

39. Vaddadi K. Dyskinesias and their treatment with essential fatty

 

acids: a review. Prostaglandins Leukot Essent Fatty Acids.

 

1996;55:89–94.

 

40. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-

linolenic

 

acid and eicosapentaenoic acid supplementation in senile

osteoporosis.

 

Aging (Milano). 1998;10:385–394.

 

41. Bassey EJ, Littlewood JJ, Rothwell MC, et al. Lack of effect of

 

supplementation with essential fatty acids on bone mineral density

in

 

healthy pre- and postmenopausal women: two randomized controlled

trials

 

of EfacalW v. calcium alone. Br J Nutr. 2000;83:629–635.

 

42. Richardson AJ, McDaid AM, Calvin CM, et al. Reduced behavioural

and

 

learning problems in children with specific learning difficulties

after

 

supplementation with highly unsaturated fatty acids: a randomized

 

double-blind placebo-controlled trial. Presented at: 2nd Forum of

 

European Neuroscience Societies; July 24–28, 2000; Brighton, United

 

Kingdom.

 

43. Horrobin DF, Manku MS, Brush M, et al. Abnormalities in plasma

 

essential fatty acid levels in women with premenstrual syndrome and

 

with nonmalignant breast disease. J Nutr Med. 1991;2:259–264.

 

44. Horrobin DF, Manku MS, Brush M, et al. Abnormalities in plasma

 

essential fatty acid levels in women with premenstrual syndrome and

 

with nonmalignant breast disease. J Nutr Med. 1991;2:259–264.

 

45. Pye JK, Mansel RE, Hughes LE. Clinical experience of drug

 

treatments for mastalgia. Lancet. 1985;2:373–377.

 

46. Pashby NL, Mansel RE, Hughes LE, et al. A clinical trial of

evening

 

primrose oil in mastalgia [abstract]. Br J Surg. 1981;68:801.

 

47. Mansel RE, Gateley CA, Harrison BJ, et al. Effects and

tolerability

 

of n-6 essential fatty acid supplementation in patients with

recurrent

 

breast cysts—a randomized double-blind placebo-controlled trial. J

Nutr

 

Med. 1990;1:195–200.

 

48. Mansel RE, Harrison BJ, Melhuish J, et al. A randomized trial of

 

dietary intervention with essential fatty acids in patients with

 

categorized cysts. Ann N Y Acad Sci. 1990;586:288–294.

 

49. Kollias J, Macmillan RD, Sibbering DM, et al. Effect of evening

 

primrose oil on clinically diagnosed fibroadenomas. Breast.

 

2000;9:35–36.

 

50. Budeiri D, Li Wan Po A, Dornan JC. Is evening primrose oil of

value

 

in the treatment of premenstrual syndrome? Control Clin Trials.

 

1996;17:60–68.

 

51. Keen H, Payan J, Allawi J, et al. Treatment of diabetic

neuropathy

 

with gamma-linolenic acid. The gamma-Linolenic Acid Multicenter

Trial

 

Group. Diabetes Care. 1993;16:8–15.

 

52. Jamal GA, Carmichael H. The effect of gamma-linolenic acid on

human

 

diabetic peripheral neuropathy: a double-blind placebo-controlled

 

trial. Diabet Med. 1990;7:319–323.

 

53. Stevens EJ, Lockett MJ, Carrington AL, et al. Essential fatty

acid

 

treatment prevents nerve ischaemia and associated conduction

anomalies

 

in rats with experimental diabetes mellitus. Diabetologia.

 

1993;36:397–401.

 

54. Reichert R. Evening primrose oil and diabetic neuropathy. Q Rev

 

Natr Med. 1995;129–133.

 

55. Hounsom L, Horrobin DF, Tritschler H, et al. A lipoic acid-gamma

 

linolenic acid conjugate is effective against multiple indices of

 

experimental diabetic neuropathy. Diabetologia. 1998;41:839–843.

 

56. Cameron NE, Cotter MA, Horrobin DH, et al. Effects of alpha-

lipoic

 

acid on neurovascular function in diabetic rats: Interaction with

 

essential fatty acids. Diabetologia. 1998;41:390–399.

 

57. Morse PF, Horrobin DF, Manku MS, et al. Meta-analysis of

 

placebo-controlled studies of the efficacy of Epogam in the

treatment

 

of atopic eczema. Relationship between plasma essential fatty acid

 

changes and clinical response. Br J Dermatol. 1989;121:75–90.

 

58. Berth-Jones J, Graham-Brown RA. Placebo-controlled trial of

 

essential fatty acid supplementation in atopic dermatitis. Lancet.

 

1993;341:1557–1560.

 

59. Biagi PL, Bordoni A, Hrelia S, et al. The effect of gamma-

linolenic

 

acid on clinical status, red cell fatty acid composition and

membrane

 

microviscosity in infants with atopic dermatitis. Drugs Exp Clin

Res.

 

1994;20:77–84.

 

60. Hederos CA, Berg A. Epogam evening primrose oil treatment in

atopic

 

dermatitis and asthma. Arch Dis Child. 1996;75:494–497.

 

61. Henz BM, Jablonska S, van de Kerkhof PC, et al. Double-blind,

 

multicentre analysis of the efficacy of borage oil in patients with

 

atopic eczema. Br J Dermatol. 1999;140:685–688.

 

62. Berth-Jones J, Graham-Brown RA. Placebo-controlled trial of

 

essential fatty acid supplementation in atopic dermatitis. Lancet.

 

1993;341:1557–1560.

 

63. Whitaker DK, Cilliers J, de Beer C. Evening primrose oil

(Epogam)

 

in the treatment of chronic hand dermatitis: disappointing

therapeutic

 

results. Dermatology. 1996;193:115–120.

 

64. Tamimi NA, Mikhail AI, Stevens PE. Role of gamma-linolenic acid

in

 

uraemic pruritus [letter]. Nephron. 1999;83:170–171.

 

65. Yoshimoto-Furuie K, Yoshimoto K, Tanaka T, et al. Effects of

oral

 

supplementation with evening primrose oil for six weeks on plasma

 

essential fatty acids and uremic skin symptoms in hemodialysis

 

patients. Nephron. 1999;81:151–159.

 

66. Zurier RB, Rossetti RG, Jacobson EW, et al. gamma-Linolenic acid

 

treatment of rheumatoid arthritis. A randomized, placebo-controlled

 

trial. Arthritis Rheum. 1996;39:1808–1817.

 

67. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid

 

arthritis with blackcurrant seed oil. Br J Rheumatol. 1994;33:847–

852.

 

68. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid

 

arthritis with gammalinolenic acid. Ann Intern Med. 1993;119:867–

873.

 

69. Rothman D, DeLuca P, Zurier RB. Botanical lipids: Effects on

 

inflammation, immune responses, and rheumatoid arthritis. Semin

 

Arthritis Rheum. 1995;25:87–96.

 

70. Belch JJ, Shaw B, O'Dowd A, et al. Evening primrose oil (Efamol)

as

 

a treatment for cold-induced vasospasm (Raynaud's phenomenon). Prog

 

Lipid Res. 1986;25:335–340.

 

71. Belch JJ, Shaw B, O'Dowd A, et al. Evening primrose oil (Efamol)

in

 

the treatment of Raynaud's phenomenon: a double-blind study. Thromb

 

Haemost. 1985;54:490–494.

 

72. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-

linolenic

 

acid and eicosapentaenoic acid supplementation in senile

osteoporosis.

 

Aging (Milano). 1998;10:385–394.

 

73. Bassey EJ, Littlewood JJ, Rothwell MC, et al. Lack of effect of

 

supplementation with essential fatty acids on bone mineral density

in

 

healthy pre- and postmenopausal women: two randomized controlled

trials

 

of EfacalW v. calcium alone. Br J Nutr. 2000;83:629–635.

 

74. Richardson AJ, McDaid AM, Calvin CM, et al. Reduced behavioural

and

 

learning problems in children with specific learning difficulties

after

 

supplementation with highly unsaturated fatty acids: a randomized

 

double-blind placebo-controlled trial. Presented at: 2nd Forum of

 

European Neuroscience Societies; July 24–28, 2000; Brighton, United

 

Kingdom.

 

75. Haslett C, Douglas JG, Chalmers SR, et al. A double-blind

 

evaluation of evening primrose oil as an antiobesity agent. Int J

Obes.

 

1983;7:549–553.

 

76. Garcia CM, Carter J, Chou A. Gamma linolenic acid causes weight

 

loss and lower blood pressure in overweight patients with family

 

history of obesity. Swed J Biol Med. 1986;4:8–11.

 

77. Horrobin DF. Nutritional and medical importance of gamma-

linolenic

 

acid. Prog Lipid Res. 1992;31:163–194.

 

78. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to

 

differentiate between temporal lobe epilepsy and schizophrenia.

 

Prostaglandins Med. 1981;6:375–379.

 

79. Aman MG, Mitchell EA, Turbott SH. The effects of essential fatty

 

acid supplementation by Efamol in hyperactive children. J Abnorm

Child

 

Psychol. 1987;15:75–90.

 

80. Arnold LE, Kleykamp D, Votolato NA, et al. Gamma-linolenic acid

for

 

attention-deficit hyperactivity disorder: placebo-controlled

comparison

 

to D-amphetamine. Biol Psychiatry. 1989;25:222–228.

 

81. Vaddadi KS, Soosai E, Chiu E, et al. A randomised,

 

placebo-controlled, double blind study of treatment of Huntington's

 

disease with unsaturated fatty acids. Neuroreport. 2002;13:29-33.

 

82. Middleton SJ, Naylor S, Woolner J, et al. A double-blind,

 

randomized, placebo-controlled trial of essential fatty acid

 

supplementation in the maintenance of remission of ulcerative

colitis.

 

Aliment Pharmacol Ther. 2002;16:1131-1135.

 

83. Mansel RE, Pye KJ, Hughes LE. A controlled trial of evening

 

primrose oil (Efamol) in cyclic premenstrual matalgia. Abstract 47.

 

Proceedings of the 2nd International Symposium on Premenstrual,

 

Postpartum, and Meonopausal Mood Disorders; 1987; Kiawah Island, S.

 

84. Preece PE, Hanslip JI, Gilbert L. Evening primrose oil (Efamol)

for

 

mastalgia. In: Horrobin DF, ed. Clinical uses of essential fatty

acids.

 

Montreal: Eden;1982. pp.147–154.

 

85. Blommers J, De Lange-De Klerk ES, Kuik DJ, et al. Evening

primrose

 

oil and fish oil for severe chronic mastalgia: A randomized,

 

double-blind, controlled trial. Am J Obstet Gynecol.

 

2002;187:1389–1394.

 

86. Van Gool CJ, Thijs C, Henquet CJ, et al. Gamma-Linolenic acid

 

supplementation for prophylaxis of atopic dermatitis—a randomized

 

controlled trial in infants at high familial risk. Am J Clin Nutr.

 

2003;77:943–951.

 

 

 

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