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Evening Primrose Oil

Evening Primrose Oil

Uses

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

This supplement has been used in connection with the following health conditions:

Used for Why
3 Stars
Type 2 Diabetes
4 grams daily
Learn More
Supplementing with 4 grams of evening primrose oil per day for six months has been found in double-blind research to improve nerve function and to relieve pain symptoms of diabetic neuropathy.1
2 Stars
Eczema
Adults: 500 to 1,000 mg a day of GLA; children: proportionately less, according to body weight
Learn More

Researchers have reported that people with eczema do not have the normal ability to process fatty acids, which can result in a deficiency of gamma-linolenic acid (GLA).2 GLA is found in evening primrose oil (EPO), borage oil , and black currant seed oil. Some,3 , 4 , 5 but not all,6 , 7 , 8 , 9 double-blind trials have shown that EPO is useful in the treatment of eczema. An analysis of nine trials reported that the effects for reduced itching were most striking.10 Much of the research uses 12 pills per day; each pill contains 500 mg of EPO, of which 45 mg is GLA. Smaller amounts have been shown to lack efficacy.11

2 Stars
Fibrocystic Breast Disease
3 grams daily
Learn More

In double-blind research, evening primrose oil (EPO) has reduced symptoms of FBD,12 , 13 though only slightly.14 One group of researchers reported that EPO normalizes blood levels of fatty acids in women with FBD.15 However, even these scientists had difficulty linking the improvement in lab tests with an actual reduction in symptoms. Nonetheless, most reports continue to show at least some reduction in symptoms resulting from EPO supplementation.16 , 17 Based on this research, many doctors recommend a trial of 3 grams per day of EPO for at least six months to alleviate symptoms of FBD.

2 Stars
Osteoporosis (Fish Oil)
6 grams daily
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A preliminary trial found that elderly women with osteoporosis who were given 4 grams of fish oil per day for four months had improved calcium absorption and evidence of new bone formation.18 Fish oil combined with evening primrose oil (EPO) may confer added benefits. In a controlled trial, women received 6 grams of a combination of EPO and fish oil, or a matching placebo, plus 600 mg of calcium per day for three years.19 The EPO/fish oil group experienced no spinal bone loss in the first 18 months and a significant 3.1% increase in spinal bone mineral density during the last 18 months.

2 Stars
Premenstrual Syndrome
3 to 4 grams daily
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Women with PMS have been shown to have impaired conversion of linoleic acid (an essential fatty acid) to gamma linolenic acid (GLA).20 Because a deficiency of GLA might, in theory, be a factor in PMS and because evening primrose oil (EPO) contains significant amounts of GLA, researchers have studied EPO as a potential way to reduce symptoms of PMS. In several double-blind trials, EPO was found to be beneficial,21 , 22 , 23 , 24 whereas in other trials it was no more effective than placebo.25 , 26

Despite these conflicting results, some doctors consider EPO to be worth a try; the amount usually recommended is 3–4 grams per day. EPO may work best when used over several menstrual cycles and may be more helpful in women with PMS who also experience breast tenderness or fibrocystic breast disease .27

2 Stars
Rheumatoid Arthritis
540 to 1,100 mg daily of GLA
Learn More

Oils containing the omega-6 fatty acid gamma linolenic acid (GLA)— borage oil,28 , 29 , 30 black currant seed oil,31 and evening primrose oil (EPO)32 , 33—have been reported to be effective in the treatment for people with RA. Although the best effects have been reported with use of borage oil, that may be because more GLA was used in borage oil trials (1.1–2.8 grams per day) compared with trials using black currant seed oil or EPO. The results with EPO have been mixed and confusing, possibly because the placebo used in those trials (olive oil) may have anti-inflammatory activity. In a double-blind trial, positive results were seen when EPO was used in combination with fish oil.34 GLA appears to be effective because it is converted in part to prostaglandin E1, a hormone-like substance known to have anti-inflammatory activity.

2 Stars
Skin Ulcers
1,500 mg with each meal
Learn More

A preliminary report suggested that evening primrose oil improves blood flow to the legs and heals or reduces the size of venous leg ulcers.35 No controlled research has further investigated this claim.

1 Star
Alcohol Withdrawal
Refer to label instructions
Learn More

Alcoholics may be deficient in a substance called prostaglandin E1 (PGE1) and in gamma-linolenic acid (GLA), a precursor to PGE1.36 In a double-blind study of alcoholics who were in a detoxification program, supplementation with 4 grams per day of evening primrose oil (containing 360 mg of GLA) led to greater improvement than did placebo in some, but not all, parameters of liver function.37

1 Star
Atherosclerosis
Refer to label instructions
Learn More

Though low levels (2 grams per day) of evening primrose oil appear to be without action,38 3–4 grams per day have lowered cholesterol in double-blind research.39 Lowering cholesterol levels should in turn reduce the risk of atherosclerosis.

Preliminary research shows that chondroitin sulfate may prevent atherosclerosis in animals and humans and may also prevent heart attacks in people who already have atherosclerosis.40 , 41 However, further research is needed to determine the value of chondroitin sulfate supplements for preventing or treating atherosclerosis.

1 Star
Attention Deficit–Hyperactivity Disorder
Refer to label instructions
Learn More

A deficiency of several essential fatty acids has been observed in some children with ADHD compared with unaffected children.42 , 43 One study gave children with ADHD evening primrose oil supplements in an attempt to correct the problem.44 Although a degree of benefit was seen, results were not pronounced. In a 12-week double-blind study, children with ADHD were given either a placebo or a fatty-acid supplement providing daily: 186 mg of eicosapentaenoic acid (EPA), 480 mg of docosahexaenoic acid (DHA), 96 mg of gamma-linolenic acid (GLA), 864 mg of linoleic acid, and 42 mg of arachidonic acid. Compared with the placebo, the fatty-acid supplement produced significant improvements in both cognitive function and behavioral problems.45 No adverse effects were seen. In a preliminary trial, supplementation with approximately 400 mg of flaxseed oil and 25 mg of vitamin C, each twice a day for three months, was associated with an improvement of symptoms in children with ADHD.46

1 Star
Chronic Obstructive Pulmonary Disease
Refer to label instructions
Learn More

A greater intake of the omega-3 fatty acids found in fish oils has been linked to reduced risk of COPD,47 though research has yet to investigate whether fish oil supplements would help people with COPD. In a double-blind trial, people with COPD received a fatty acid supplement (providing daily 760 mg of GLA [gamma-linolenic acid], 1,200 mg of ALA [alpha-linolenic acid], 700 mg of EPA [eicosapentaenoic acid], and 340 mg of DHA [docosahexaenoic acid]) or a placebo (80% palm oil and 20% sunflower oil) during an eight-week rehabilitation program. Compared with the placebo, the fatty acid supplement significantly improved exercise capacity.48 While two of the fatty acids supplied in this supplement (EPA and DHA acid) are found in fish oil, it is not known which components of the supplement were most responsible for the improvement. Gamma-linolenic acid is found in evening primrose oil , black currant seed oil, and borage oil; alpha-linolenic acid is found in flaxseed oil and other oils.

1 Star
Intermittent Claudication
Refer to label instructions
Learn More

Caution: One study showed a slightly increased risk of vascular surgery among people with intermittent claudication who took beta-carotene supplements.49 Until more is known, people with intermittent claudication wishing to use beta-carotene supplements should first consult with their doctor.

1 Star
Irritable Bowel Syndrome and PMS
Refer to label instructions
Learn More

In one trial, women with IBS who experienced worsening symptoms before and during their menstrual period were helped by taking enough evening primrose oil (EPO) to provide 360–400 mg of gamma linolenic acid (GLA) per day.50 In that trial more than half reported improvement with EPO, but none was helped in the placebo group. The effects of EPO in other groups of IBS sufferers have not been explored.

1 Star
Multiple Sclerosis
Refer to label instructions
Learn More

The omega-6 fatty acids, found in such oils as evening primrose oil (EPO) and sunflower seed oil, also may be beneficial. When people with MS were given 4 grams of EPO for three weeks, their hand grip improved.51 In a review of three double-blind trials, two of the trials reported that linoleic acid reduced the severity and length of relapses.52 When the data were re-examined, it was found that taking linoleic acid decreased disability due to MS in all three trials. According to these researchers, taking linoleic acid while following a diet low in animal fat and high in polyunsaturated fat may be even more beneficial. Amounts used in these trials were approximately 17 to 23 grams of linoleic acid per day, provided by 26 to 35 grams of sunflower seed oil.

1 Star
Raynaud’s Disease
Refer to label instructions
Learn More

Fatty acids in evening primrose oil (EPO) inhibit the formation of biochemical messengers (prostaglandins) that promote blood vessel constriction. A double-blind trial of 21 people with Raynaud’s disease found that, compared with placebo, supplementation with EPO reduced the number and severity of attacks despite the fact that blood flow did not appear to increase.53 Researchers have used 3,000–6,000 mg of EPO per day.

1 Star
Scleroderma
Refer to label instructions
Learn More

People with scleroderma,54 and other skin conditions can have a metabolic block that interferes with the body’s ability to make GLA, the main constituent of evening primrose oil. In preliminary research, supplementation with EPO has helped people with several skin conditions.55 , 56 , 57 , 58 , 59

1 Star
Sjogren’s Syndrome
Refer to label instructions
Learn More

People with Sjogren’s syndrome,60 and other skin conditions can have a metabolic block that interferes with the body’s ability to make GLA, the main constituent of evening primrose oil. In preliminary research, supplementation with EPO has helped people with several skin conditions.61 , 62 , 63 , 64 , 65

1 Star
Tardive Dyskinesia
Refer to label instructions
Learn More

Several people have experienced an improvement in TD while taking evening primrose oil (EPO).66 In a double-blind study, however, supplementing with EPO (12 capsules per day) resulted only in a minor, clinically insignificant improvement.67

1 Star
Type 1 Diabetes
See Learn More for details
Learn More
Supplementing with 4 grams of evening primrose oil per day for six months has been found in double-blind research to improve nerve function and to relieve pain symptoms in people with diabetic nerve damage (neuropathy).68 However, the principal investigator who conducted these clinical trials was subsequently found by the professional conduct committee of the General Medical Council (United Kingdom) to have falsified the results of the research.69 Therefore, it is not clear whether evening primrose oil or GLA is of any value for patients with diabetic neuropathy.

How It Works

How to Use It

Although many people may have inadequate levels of GLA, the optimal intake for this nutrient remains unknown. Researchers often use 3,000–6,000 mg of EPO per day, which provides approximately 270–540 mg of GLA.

Where to Find It

EPO is found primarily in supplements. Its presumed active ingredient, GLA, can also be found in black currant seed oil and borage oil supplements. However, it is not known whether the effects of these three oils in the body are the same.

Possible Deficiencies

Those with premenstrual syndrome ,70 diabetes ,71 scleroderma,72 Sjogren’s syndrome,73 tardive dyskinesia ,74 eczema ,75 and other skin conditions76 can have a metabolic block that interferes with the body’s ability to make GLA. In preliminary research, supplementation with EPO has helped people with these conditions.77 , 78 , 79 , 80 , 81

There is evidence that alcoholics may be deficient in GLA, and a double-blind study suggested that alcohol withdrawal may be facilitated with EPO supplementation.82 Many people in Western societies may be at least partially GLA-deficient as a result of aging, glucose intolerance, high dietary fat intake, and other problems. People with deficiencies would presumably benefit from supplemental GLA intake from EPO, black currant seed oil, or borage oil.

Interactions

Interactions with Supplements, Foods, & Other Compounds

Other nutrients are needed by the body, along with EPO, to make PGE1. Consequently, some experts suggest that magnesium , zinc , vitamin C , niacin , and vitamin B6 should be taken along with EPO.

Interactions with Medicines

As of the last update, we found no reported interactions between this supplement and medicines. It is possible that unknown interactions exist. If you take medication, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a supplement with your doctor or pharmacist.

Side Effects

Side Effects

EPO has been reported to exacerbate symptoms of temporal lobe epilepsy , which can sometimes be mistaken for schizophrenia .83 , 84

References

1. Jamal GA, Carmichael H. The effect of gamma-linolenic acid on human diabetic peripheral neuropathy: a double-blind placebo-controlled trial. Diabet Med 1990;7:319–23.

2. Manku MS, Horrobin DF, Morse NL, et al. Essential fatty acids in the plasma phospholipids of patients with atopic eczema. Br J Dermatol 1984;110:643–8.

3. Schalin-Karrila M, Mattila L, Jansen CT, et al. Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987;117:11–9.

4. Lovell CR, Burton JL, Horrobin DF. Treatment of atopic eczema with evening primrose oil. Lancet 1981;I:278 [letter].

5. Wright S, Burton JL. Oral evening-primrose oil improves atopic eczema. Lancet 1982;ii:1120–2.

6. Skogh M. Atopic eczema unresponsive to evening primrose oil (linoleic and gamma-linolenic acids). J Am Acad Dermatol 1986;15:114–5.

7. Bamford JTM, Gibson RW, Renier CM. Atopic eczema unresponsive to evening primrose oil (linoleic and gamma-linolenic acids). J Am Acad Dermatol 1985;13:959–65.

8. Hederos CA, Berg A. Epogam evening primrose oil treatment in atopic dermatitis and asthma. Arch Dis Child 1996;75:494–7.

9. Whitaker DK, Cilliers J, de Beer C. Evening primrose oil (Epogam) in the treatment of chronic hand dermatitis: disappointing therapeutic results. Dermatology 1996;193:115–20.

10. 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.

11. Berth-Jones J, Graham-Brown RAC. Placebo-controlled trial of essential fatty acid supplementation in atopic dermatitis. Lancet 1993;341:1557–60.

12. Mansel RE, Pye JK, Hughes LE. Effects of Essential fatty acids on cyclical mastalgia and noncyclical breast disorders. In Omega-6 essential fatty acids: Pathophysiology and roles in clinical medicine. New York: Alan R Liss, 1990, 557–66.

13. Preece PE, Hanslip JI, Gilbert L, et al. Evening primrose oil (EFAMOL) for mastalgia. In: Clinical Uses of Essential Fatty Acids, ed. DF Horrobin, Montreal: Eden Press, 1982, 147–54.

14. Mansel RE, Harrison BJ, Melhuish J, et al. A randomized trial of dietary intervention with essential fatty acids in patients with categorized cysts. Ann NY Acad Sci 1990;586:288–94.

15. Gateley CA, Maddox PR, Pritchard GA, et al. Plasma fatty acid profiles in benign breast disorders. Br J Surg 1992;79:407–9.

16. Harding C, Harvey J, Kirkman R, Bundred N. Hormone replacement therapy-induced mastalgia responds to evening primrose oil. Br J Surg 1996;83(Suppl 1):24 [abstract # Breast 012].

17. Pye JK, Mansel RE, Hughes LE. Clinical experience of drug treatments for mastalgia. Lancet 1985;ii:373–7.

18. Van Papendorp DH, Coetzer H, Kruger MC. Biochemical profile of osteoporotic patients on essential fatty acid supplementation. Nutr Res 1995;15:325–34.

19. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging 1998;10:385–94.

20. 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;2:259–64.

21. Puolakka J, Makarainen L, Viinikka L, Ylikorkola O. Biochemical and clinical effects of treating the premenstrual syndrome with prostaglandin synthesis precursors. J Reprod Med 1985;30:149–53.

22. Ockerman PA, Bachrack I, Glans S, Rassner S. Evening primrose oil as a treatment of the premenstrual syndrome. Rec Adv Clin Nutr 1986;2:404–5.

23. Massil H, O’Brien PMS, Brush MG. A double blind trial of Efamol evening primrose oil in premenstrual syndrome. 2nd International Symposium on PMS, Kiawah Island, Sep 1987.

24. Casper R. A double blind trial of evening primrose oil in premenstrual syndrome. 2nd International Symposium on PMS, Kiawah Island, Sep 1987.

25. Khoo SK, Munro C, Battisutta D. Evening primrose oil and treatment of premenstrual syndrome. Med J Aust 1990;153:189–92.

26. Collins A, Cerin A, Coleman G, Landgren B-M. Essential fatty acids in the treatment of premenstrual syndrome. Obstet Gynecol 1993;81:93–8.

27. McFayden IJ, Forrest AP, Chetty U, Raab G. Cyclical breast pain - some observations and the difficulties in treatment. Br J Clin Pract 1992; 46:161–4.

28. Pullman-Mooar S, Laposata M, Lem D, et al. Alteration of the cellular fatty acid profile and the production of eicosanoids in human monocytes by gamma-linolenic acid. Arthritis Rheum 1990;33:1526–33.

29. Leventhal LJ, Boyce EG, Zurier RB. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Intern Med 1993;119:867–73.

30. Zurier RB, Rossetti RG, Jacobson EW, et al. Gamma-linolenic acid treatment of rheumatoid arthritis. A randomized, placebo-controlled trial. Arthritis Rheum 1996;39:1808–17.

31. Leventahn LJ, Boyce EG, Zuerier RB. Treatment of rheumatoid arthritis with black currant seed oil. Br J Rheumatol 1994;33:847–52.

32. Brzeski M, Madhok R, Capell HA. Evening primrose oil in patients with rheumatoid arthritis and side­effects of non­steroidal anti­inflammatory drugs. Brit J Rheumatol 1991;30:370–2.

33. Jantti J, Seppala E, Vapaatalo H, Isomaki H. Evening primrose oil and olive oil in treatment of rheumatoid arthritis. Clin Rheumatol 1989;8:238–44.

34. Belch JJ, Ansell D, Madhok R, et al. Effects of altering dietary essential fatty acids on requirements for non­steroidal anti­inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study. Ann Rheum Dis 1988;47:96–104.

35. Simpson LO, Hand BI, Olds RJ. Large leg ulcers, Efamol and hyperbaric oxygen. N Z Med J 1986;99:552 [abstract].

36. Horrobin DF. Essential fatty acids, prostaglandins, and alcoholism: an overview. Alcohol Clin Exp Res 1987;11:2–9.

37. Glen I, Skinner F, Glen E, MacDonell L. The role of essential fatty acids in alcohol dependence and tissue damage. Alcohol Clin Exp Res 1987;11:37–41.

38. Boberg M, Vessby B, Selinus I. Effects of dietary supplementation with n-6 and n-3 long-chain polyunsaturated fatty acids on serum lipoproteins and platelet function in hypertriglcyeridaemic patients. Acta Med Scand 1986;220:153–60.

39. Horrobin DF, Manku MS. How do polyunsaturated fatty acids lower plasma cholesterol levels? Lipids 1983;558–62.

40. Morrison LM, Branwood AW, Ershoff BH, et al. The prevention of coronary arteriosclerotic heart disease with chondroitin sulfate A: Preliminary report. Exp Med Surg 1969;27:278–89.

41. Morrison LM, Enrick NL. Coronary heart disease: Reduction of death rate by chondroitin sulfate A. Angiology 1973;24:269–82.

42. Mitchell EA, Aman MG, Turbott SH, Manku M. Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin Pediatr 1987;26:406–11.

43. Stevens LJ, Zentall SS, Deck JL, et al. Essential fatty acid metabolism in boys with attention-deficit hyperactivity disorder. Am J Clin Nutr 1995;62:761–8.

44. 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.

45. Richardson AJ, Puri BK. A randomized double-blind, placebo-controlled study of the effects of supplementation with highly unsaturated fatty acids on ADHD-related symptoms in children with specific learning difficulties. Prog Neuropsychopharmacol Biol Psychiatry 2002;26:233–9.

46. Joshi K, Lad S, Kale M, et al. Supplementation with flax oil and vitamin C improves the outcome of Attention Deficit Hyperactivity Disorder (ADHD). Prostaglandins Leukot Essent Fatty Acids 2006;74:17–21.

47. Shahar E, Folsom AR, Melnick SL, et al. Dietary n-3 polyunsaturated fatty acids and smoking-related chronic obstructive pulmonary disease. Atherosclerosis Risk in Communities Study Investigators. N Engl J Med 1994;331:228–33.

48. Broekhuizen R, Wouters EFM, Creutzberg EC, et al. Polyunsaturated fatty acids improve exercise capacity in chronic obstructive pulmonary disease. Thorax 2005;60:376–82.

49. Törnwall ME, Virtamo J, Haukka JK, et al. The effect of alpha-tocopherol and beta-carotene supplementation on symptoms and progression of intermittent claudication in a controlled trial. Atherosclerosis 1999;147:193–7.

50. Cotterell CJ, Lee AJ, Hunter JO. Double-blind cross-over trial of evening primrose oil in women with menstrually-related irritable bowel syndrome. In Omega-6 Essential Fatty Acids: Pathophysiology and roles in clinical medicine, Alan R Liss, New York, 1990, 421–6.

51. Werbach M. Nutritional Influences on Illness. Tarzana, CA: Third Line Press, 1996, 434 [review].

52. Dworkin RH, Bates D, Millar JH, Paty DW. Linoleic acid and multiple sclerosis: a reanalysis of three double-blind trials. Neurology 1984;34:1441–5 [review].

53. Belch JJF, Shaw B, O’Dowd A, et al. Evening primrose oil (Efamol) in the treatment of Raynaud’s phenomenon: A double-blind study. Throm Haemost 1985;54(2):490–4.

54. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren’s syndrome. Med Hypotheses 1984;14:233–47.

55. Mansel RE, Pye JK, Hughes LE. Effects of essential fatty acids on cyclical mastalgia and noncyclical breast disorders. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 557–66.

56. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

57. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren’s syndrome. Med Hypotheses 1984;14:233–47.

58. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine. Horrobin DF (ed). New York: Alan R Liss, 1990, 333–43.

59. Schalin-Karrila M, Mattila L, Jansen CT, et al. Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987;117:11–9.

60. Horrobin DF, Campbell A. Sjogren’s syndrome and the sicca syndrome: the role of prostaglandin E1 deficiency. Treatment with essential fatty acids and vitamin C. Med Hypotheses 1980;6:225–32.

61. Mansel RE, Pye JK, Hughes LE. Effects of essential fatty acids on cyclical mastalgia and noncyclical breast disorders. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 557–66.

62. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

63. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren’s syndrome. Med Hypotheses 1984;14:233–47.

64. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine. Horrobin DF (ed). New York: Alan R Liss, 1990, 333–43.

65. Schalin-Karrila M, Mattila L, Jansen CT, et al. Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987;117:11–9.

66. Vaddadi KS. Essential fatty acids and neuroleptic drug-associated tardive dyskinesia: preliminary clinical observations. IRCS Med Sci 1984;12:678.

67. Vaddadi KS, Courtney P, Gilleard CJ, et al. A double-blind trial of essential fatty acid supplementation in patients with tardive dyskinesia. Psychiatr Res 1989;27:313–23.

68. Jamal GA, Carmichael H. The effect of gamma-linolenic acid on human diabetic peripheral neuropathy: a double-blind placebo-controlled trial. Diabet Med 1990;7:319–23.

69. Dyer O. GMC reprimands doctor for research fraud. BMJ 2003;326:730.

70. Horrobin DF, Manku M, Brush M, et al. Abnormalities in plasma essential fatty acid levels in women with pre-menstrual syndrome and with non-malignant breast disease. J Nutr Med 1991;2:259–64.

71. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

72. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren’s syndrome. Med Hypotheses 1984;14:233–47.

73. Horrobin DF, Campbell A. Sjogren’s syndrome and the sicca syndrome: the role of prostaglandin E1 deficiency. Treatment with essential fatty acids and vitamin C. Med Hypotheses 1980;6:225–32.

74. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 333–43.

75. Manku MS, Horrobin, DF, Morse NL, et al. Essential fatty acids in the plasma phospholipids of patients with atopic eczema. Br J Derm 1984;110:643.

76. Horrobin DF. Essential fatty acids in clinical dermatology. J Am Acad Dermatol 1989;20:1045–53.

77. Mansel RE, Pye JK, Hughes LE. Effects of essential fatty acids on cyclical mastalgia and noncyclical breast disorders. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine, ed. DF Horrobin. New York: Alan R Liss, 1990, 557–66.

78. Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care 1993;16:8–15.

79. Horrobin DF. Essential fatty acid metabolism in diseases of connective tissue with special reference to scleroderma and to Sjogren’s syndrome. Med Hypotheses 1984;14:233–47.

80. Vaddadi KS, Gilleard CJ. Essential fatty acids, tardive dyskinesia, and schizophrenia. In Omega-6 Essential Fatty Acids: Pathophysiology and Roles in Clinical Medicine. Horrobin DF (ed). New York: Alan R Liss, 1990, 333–43.

81. Schalin-Karrila M, Mattila L, Jansen CT, et al. Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987;117:11–9.

82. Glen AIM, Glen EMT, MacDonnell LEF, et al. Essential fatty acids in the management of withdrawal symptoms and tissue damage in alcoholics, presented at the 2nd International Congress on Essential Fatty Acids, Prostaglandins and Leukotrienes, London, Zoological Society. March 24–7, 1985, [abstract 53].

83. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6:375–9.

84. Holman CP, Bell AFJ. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orthomol Psychiatr 1983;12:302–4.

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