Omega-6 fatty acids are considered essential fatty acids: They are necessary for human health but the body can’t make them -- you have to get them through food. Along with omega-3 fatty acids, omega-6 fatty acids play a crucial role in brain function as well as normal growth and development. Also known as polyunsaturated fatty acids (PUFAs), they help stimulate skin and hair growth, maintain bone health, regulate metabolism, and maintain the reproductive system.

A healthy diet contains a balance of omega-3 and omega-6 fatty acids. Omega-3 fatty acids help reduce inflammation, and some omega-6 fatty acids tend to promote inflammation. The typical American diet tends to contain 14 - 25 times more omega-6 fatty acids than omega-3 fatty acids.

The Mediterranean diet, on the other hand, has a healthier balance between omega-3 and omega-6 fatty acids. Many studies have shown that people who follow this diet are less likely to develop heart disease. The Mediterranean diet does not include much meat (which is high in omega-6 fatty acids) and emphasizes foods rich in omega-3 fatty acids, including whole grains, fresh fruits and vegetables, fish, olive oil, garlic, as well as moderate wine consumption.

There are several different types of omega-6 fatty acids, and not all promote inflammation. Most omega-6 fatty acids in the diet come from vegetable oils as linoleic acid (LA). Be careful not to confuse this with alpha-linolenic acid (ALA), an omega-3 fatty acid. Linoleic acid is converted to gamma-linolenic acid (GLA) in the body. It is then further broken down to arachidonic acid (AA). GLA can be gotten from several plant-based oils including evening primrose oil (EPO), borage oil, and black currant seed oil.

Gamma-linolenic acid (GLA) may actually reduce inflammation. Much of the GLA taken as a supplement is converted to a substance called DGLA that fights inflammation. Having enough of certain nutrients in the body (including magnesium, zinc, and vitamins C, B3, and B6) helps promote the conversion of GLA to DGLA.

Uses:

Omega-6 fatty acids may be useful for the following health conditions:

Diabetic neuropathy

Some studies show that taking gamma linolenic acid (GLA) for 6 months or more may reduce symptoms of nerve pain in people with diabetic neuropathy. People who have good blood sugar control may find GLA more effective than those with poor blood sugar control.

Rheumatoid arthritis

Studies are mixed as to whether evening primrose oil helps reduce symptoms of rheumatoid arthritis. Some preliminary evidence suggests evening primrose oil may reduce pain, swelling, and morning stiffness; but other studies have found no effect. When using GLA for symptoms of arthritis, it may take 1 - 3 months for benefits to appear. It is unlikely that evening primrose oil would help stop progression of the disease, so joint damage would still occur.

Allergies

Omega-6 fatty acids from food or supplements, such as GLA from evening primrose oil or other sources, have a longstanding history of folk use for allergies. And women and children who are prone to allergies appear to have lower levels of GLA in breast milk and blood. However, there is no good scientific evidence that taking GLA helps reduce allergy symptoms. Well-conducted research studies are needed.

If you decide to try GLA for allergies, work with your health care provider to first determine if it is safe for you. Then follow your allergy symptoms closely for any signs of improvement or lack or improvement.

Attention deficit/hyperactivity disorder (ADHD)

Clinical studies suggest that children with ADHD have lower levels of EFAs, both omega-6s and omega-3s. EFAs are important to normal brain and behavioral function. Some studies seem to indicate that taking fish oil (containing omega-3 fatty acids) may help reduce ADHD symptoms, though the studies have not been well designed. Studies that used evening primrose oil have found it was no better than placebo at reducing symptoms.

Breast cancer

One study found that women with breast cancer who took GLA had a better response to tamoxifen (a drug used to treat estrogen-sensitive breast cancer) than those who took only tamoxifen.

Eczema

Evidence is mixed as to whether evening primrose oil can help reduce symptoms of eczema. Some early studies found benefit, but they were not well designed. Later studies that examined people who took evening primrose oil for 16 to 24 weeks found no improvement in symptoms. If you want to try evening primrose oil, talk to your health care provider about whether it is safe for you to try.

High blood pressure (Hypertension)

There is some preliminary evidence that GLA may help reduce high blood pressure, either alone or in combination with omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in fish oil. In one study, men with borderline high blood pressure who took 6g of blackcurrant oil had a reduction in diastolic blood pressure compared to those who took placebo.

Another study examined people with intermittent claudication, pain in the legs while walking that is caused by blockages in the blood vessels. Those who took GLA combined with EPA had a reduction in systolic blood pressure compared to those who took placebo.

More research is needed to see whether GLA is truly effective for hypertension.

Menopausal symptoms

Evening primrose oil has gained popularity as a way to treat hot flashes associated with menopause, but so far studies have not shown that it works. If you want to try evening primrose oil for hot flashes and night sweats, ask your health care provider whether it is safe and right for you.

Mastalgia

Some evidence suggests that evening primrose oil may reduce breast pain and tenderness in people with cyclic mastalgia. It may also help reduce symptoms to a lesser extent in people with non-cyclic mastalgia. However, it does not seem to be effective for severe breast pain.

Multiple Sclerosis

Evening primrose oil has been suggested as an additional treatment (in addition to standard therapy) for multiple sclerosis (MS) although there is no scientific evidence that it works. MS patients who want to add evening primrose oil to their treatment regimens should talk with a health care provider.

Osteoporosis

Some studies suggest that people who don’t get enough of some essential fatty acids (particularly EPA and GLA) are more likely to have bone loss than those with normal levels of these fatty acids. In a study of women over 65 with osteoporosis, those who took EPA and GLA supplements had less bone loss over 3 years than those who took placebo. Many of these women also experienced an increase in bone density.

Premenstrual syndrome (PMS)

Although most studies have found no effect, some women report relief of PMS symptoms when using GLA. The symptoms that seem to be helped the most are breast tenderness and feelings of depression as well as irritability and swelling and bloating from fluid retention.

Dietary Sources:

For general health, there should be a balance between omega-6 and omega-3 fatty acids. The ratio should be in the range of 2:1 - 4:1, omega-6 to omega-3. The average diet provides plenty of omega-6 fatty acids, so supplements are usually not necessary. People with specific conditions such as eczema or psoriasis, arthritis, diabetes, or breast tenderness (mastalgia) may want to ask their health care providers about taking omega-6 supplements.

Available Forms:

Omega-6 fatty acids are available in supplemental oils that contain linoleic acid (LA) and gamma linolenic acid (GLA), such as evening primrose (Oenothera biennis) and black currant (Ribes nigrum) oils. Spirulina (often called blue-green algae) also contains GLA.

How to Take It:

For general health, there should be a balance between omega-6 and omega-3 fatty acids. The ratio should be in the range of 2:1 - 4:1, omega-6 to omega-3. The average diet provides sufficient omega-6 fatty acids, so supplementation is usually not necessary unless treating for a specific condition such as eczema or psoriasis, arthritis, diabetes, or breast tenderness (mastalgia).

Pediatric

For nursing infants: There are enough essential fatty acids in breast milk if the mother is eating a healthy diet.

For eczema in children 2 - 18 years of age: Evening primrose oil, 3 grams daily, divided into several smaller doses throughout the day. It is reported that the maximum dose should not be greater than 0.5 gram per kilogram of body weight daily. Do not give supplements to a child without first talking to your doctor.

Adult

• For eczema or atopic dermatitis: Evening primrose oil, 4,000 - 8,000 mg daily, or gamma-linolenic acid (GLA), 2,800 mg daily, both divided into several smaller doses throughout the day.
• For rheumatoid arthritis: Evening primrose oil, 3,000 mg daily, or GLA, 1,400 mg daily, both divided into several smaller doses throughout the day.
• For diabetes: GLA, 480 mg daily, divided into several smaller doses throughout the day.
• For breast tenderness (mastalgia) or PMS: Evening primrose oil, 3,000 - 4,000 mg daily, divided into several smaller doses throughout the day.

Precautions:

Because of the potential for side effects and interactions with medications, dietary supplements should be taken only under the supervision of a knowledgeable health care provider.

Do not take omega-6 if you have a seizure disorder because there have been reports of these supplements causing seizures. Several reports describe seizures in people taking evening primrose oil. Some of these seizures developed in people with a previous seizure disorder, or in people taking evening primrose oil in combination with anesthetics. People who plan to undergo surgery requiring anesthesia should stop taking evening primrose oil 2 weeks ahead of time.

Borage seed oil, and possibly other sources of gamma-linolenic acid (GLA), should not be taken during pregnancy because they may harm the fetus and induce early labor.

Avoid doses of GLA greater than 3,000 mg per day. At that level, an increase in inflammation may occur.

Side effects of evening primrose oil can include occasional headache, abdominal pain, nausea, and loose stools. In animal studies, GLA is reported to decrease blood pressure. Early results in human studies do not show consistent changes in blood pressure.

Laboratory studies suggest that omega-6 fatty acids, such as the fat found in corn oil, promote the growth of prostate tumor cells. Until more research is done, health care professionals recommend not taking omega-6 fatty acids, including GLA, if you are at risk of or have prostate cancer.

Possible Interactions:

If you are currently being treated with any of the following medications, you should not use omega-6 supplements without first talking to your health care provider.

Blood thinning medications -- People taking blood thinning medications, including warfarin (Coumadin) or clopidogrel (Plavix) should not take omega-6 fatty acid supplements without consulting a health care provider. Omega-6 and omega-3 fatty acids may increase the risk of bleeding.

Ceftazidime -- Gamma linolenic acid (GLA) may increase the effectiveness of ceftazidime. Ceftazidinme, an antibiotic, is used against a variety of bacterial infections.

Chemotherapy for cancer -- GLA may increase the effects of anti-cancer treatments, such as doxorubicin, cisplatin, carboplatin, idarubicin, mitoxantrone, tamoxifen, vincristine, and vinblastine.

Cyclosporine -- Cyclosporine is a medication used to suppress the immune system after organ transplant. Taking omega-6 fatty acids with cyclosporine may increase the immunosuppressive effects of this medication. It may also protect against kidney damage (a potential side effect from this medication).

Phenothiazines -- People taking a class of medications called phenothiazines to treat schizophrenia should not take evening primrose oil. Evening primrose oil may interact with these medications and increase the risk of seizures. The same may be true for other omega-6 supplements. These medications include:

• Chlorpromazine (Thorazine)
• Fluphenazine (Stelazine)
• Perphenazine (Trilafon)
• Promethazine (Compazine)
• Thioridazine (Mellaril)

Alternative Names:

Evening primrose oil; EPO; Linoleic acid; LA