The medicinal ingredient must comply with the requirements outlined in the Natural health products ingredient database ( NHPID).

In these studies, along with the placebos, EPO and BO have the same, fairly common, mild, transient adverse effects, which are mainly gastrointestinal. Conventional medical treatments make life better for people; however, some people who do not see an adequate improvement in their eczema or fear side‐effects of conventional medical products, turn to complementary alternatives to conventional medical treatment. This review is of two such products:evening primrose oil (EPO) and borage oil (BO) taken orally (by mouth), which have been thought to have benefits for eczema. Lippert A, Renner B. Herb-Drug interaction in inflammatory diseases: Review of phytomedicine and herbal supplements. J Clin Med. 2022;11(6):1567. doi:10.3390/jcm11061567 Cancer is a leading cause of death worldwide, and pancreatic cancer is ranked as the 14th most common cancer and the 7th highest cause of cancer-related mortality. Pancreatic cancer, including pancreatic ductal adenocarcinoma (PDAC), is one of the most aggressive and malignant solid cancers, with a 5-year survival of approximately 5–9%. PDAC is an infiltrating neoplasm with glandular differentiation derived from the pancreatic ductal tree [ 11, 12]. It has demonstrated a family genetic predisposition, but precursor lesions within pancreatic tissue and somatic mutations of KRAS oncogene and CDKN2A, TP53 and SMAD4 suppressor genes are also implicated in PDAC pathogenesis [ 13, 14]. The main therapeutic approach for PDAC is surgical resection with adjuvant chemotherapy, but surgery is not always possible, especially in the case of metastases, and, moreover, PDAC response to chemotherapeutic drugs is very low. Given that PDAC is still considered an incurable cancer, new drugs and adjuvant supplementation are necessary to reduce mortality and improve therapeutic outcomes [ 4]. During the years since the protocol to this review was published, there have been changes in practice:For adult use only: Efamol advises optimising the body's natural store of these important nutrients by doubling the recommended intake for the first twelve weeks. Shake bottle before use Additional Information The trial report did not state the numbers randomised to each group (further information obtained from trial investigator) A total of 27 studies (1596 participants) met the inclusion criteria: 19 studies assessed evening primrose oil, and 8 studies assessed borage oil. For EPO, a meta‐analysis of results from 7 studies showed that EPO failed to significantly increase improvement in global eczema symptoms as reported by participants on a visual analogue scale of 0 to 100 (MD ‐2.22, 95% CI ‐10.48 to 6.04, 176 participants, 7 trials) and a visual analogue scale of 0 to 100 for medical doctors (MD ‐3.26, 95% CI ‐6.96 to 0.45, 289 participants, 8 trials) compared to the placebo group.

Total score (method: adding all 4 major parameter scores. The case was labelled as mild, moderate, or severe when the total score ranged from 1 to 4, 5 to 8, and 9 to 12, respectively) To examine the mechanism of EPO-induced cell death, we evaluated if EPO enhances ROS production. ROS are often associated with cell damage and, in cancer, induce cell death, given that cancer cells are more sensitive to oxidative stress [ 25, 26]. Our data showed that EPO induced ROS production in both cell lines. There has been one case report of lipoid pneumonia secondary to long‐term use of EPO in a person with gastroesophageal reflux disease (GERD) ( Rabahi 2010).Care should be taken when combining a range of products into a supplement programme to unsure that the upper safety limits of nutrients are not exceeded. Why does Efamol use DHA-rich oil rather than an EPA-rich fish oil for cognitive products? What’s the best balance of these Omega-3 fatty acids? For products providing vitamin E at doses lower than the minima specified in Table 2 of Appendix 1, vitamin E must be declared as a non-medicinal ingredient

Bamford 1985 also reported the overall severity of eczema as assessed by participants. However, they reported the results for all the participants irrespective of their treatment groups. Therefore, we could not calculate a treatment effect, and attempts to obtain the individual participant data were unsuccessful. The statistician of the study informed us that the original data had been destroyed. Although some results were presented in the form of some figures, it was not possible to accurately extract data from them since the figures were presented separately by age and dose and also because standard deviations of change were not graphed. Quote: "This was a single center, double‐blind, randomised, placebo‐controlled, crossover study of EPO versus safflower oil (SAFF, Placebo)"

Pure Evening Primrose Oil, capsule shell (bovine gelatin, humectant: glycerol, vitamin E (dl-alpha tocopheryl acetate). Recommended Intake The beneficial effect is obtained with a daily intake of 250mg of DHA. ‡The beneficial effect is obtained with a daily intake of 250mg of EPA and DHA.

DHA supports normal brain function and normal vision. The beneficial effect is obtained with a daily intake of 250mg of DHAAhmad Adni LL, Norhayati MN, Mohd Rosli RR, Muhammad J. A systematic review and meta-analysis of the efficacy of evening primrose oil for mastalgia treatment. Int J Environ Res Public Health. 2021;18(12):6295. doi:10.3390/ijerph18126295 Compliance to treatment: Although the protocol called for pill counting and cream weighing to determine use of treatments, the final report did not include any evaluation of these measures Thyme oil and vitamin E are included due to their antioxidant properties: these ingredients help protect the fatty acids in Efalex from damaging oxidation. Why you might supplement your diet with Omega-3 rich fish oil. Store in a cool, dry place away from direct sunlight and keep out of the sight and reach of young children. The results were evaluated 6 years after the completion of the study; other individuals evaluated the results. 1 child was included against protocol (age 12)