Interactions on record — worth a quick check against your medications. Based on 2 of 6 ingredients. Check your meds →
Dietary supplement

The Total EFA Ingredients & Drug Interactions

by Health From The Sun

Liquid Category: Botanical With Nutrients
Most serious interaction: Moderate
The interaction bottom line Most serious interaction: Moderate

The Total EFA is a dietary supplement by Health From The Sun with 6 active ingredients. Its ingredients are commonly taken for eczema and dry skin, rheumatoid arthritis, inflammation.Based on those ingredients, 312 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are organic Borage seed oil, Oleic Acid. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

HelloPharmacist Scorecard of The Total EFA by Health From The Sun

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 6 of its 6 active ingredients.
  • “Organic Evening Primrose Seed Oil” is listed as a grouped ingredient — the label gives one combined amount (580 mg) without saying how much of each component you get.

The Total EFA contains 6 active ingredients — all essential fatty acids and oils. You're getting gamma-linolenic acid, linoleic acid, oleic acid, and alpha-linolenic acid alongside organic flaxseed oil and organic borage seed oil.

These are the omega fatty acids your body needs but can't make on its own; they support heart, brain, and skin health. The product also contains an antioxidant blend as an inactive ingredient to keep the oils from spoiling.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: nutritional support for heart brain and whole body health.
  • We looked for evidence on: Cardiovascular disease (CVD), Coronary heart disease (CHD), Hypercholesterolemia, Hypertension, Rheumatoid arthritis (RA), Atopic dermatitis (eczema) — and 4 related terms.
  • The strongest evidence on file: Oleic Acid is rated "Possibly Effective" for Coronary heart disease (CHD) (Natural Medicines).
  • Also on file: Oleic Acid is rated "Possibly Effective" for Hypercholesterolemia.
  • Also on file: Borage is rated "Possibly Ineffective" for Atopic dermatitis (eczema).

Oleic acid is possibly effective for high cholesterol and coronary heart disease, based on the data we hold. Borage seed oil shows insufficient evidence for ADHD and acute respiratory distress syndrome, and it's rated possibly ineffective for atopic dermatitis (eczema).

The evidence isn't established for the other active ingredients in our data.

The evidence, ingredient by ingredient Borage Oleic Acid

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 1 of the 2 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 2 of 2.
  • General safety write-ups exist for 2 of 2.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Oleic acid from foods is generally recognized as safe, but concentrated supplement doses haven't been well studied during pregnancy or breastfeeding. Borage seed oil is generally well tolerated when taken by mouth — the most common side effects are belching, bloating, diarrhea, and soft stools.

However, borage plant parts (leaf, flower, and seed itself) can contain liver-toxic compounds called pyrrolizidine alkaloids. This product specifies borage seed oil, which contains little to none of these toxins, but the safety data advises against borage during pregnancy because of the theoretical risk.

We don't hold pregnancy or breastfeeding safety data for the other ingredients.

Side effects, ingredient by ingredient Borage Oleic Acid

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 2 of the 2 matched ingredients can interact with medications — Borage, Oleic Acid.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; diabetes medications.
  • For scale: 313 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check before you start if you take antidiabetes drugs (blood sugar medication), anticoagulants or antiplatelets (blood thinners or aspirin), phenothiazines (antipsychotic medications), or CYP3A4 inducers — all carry documented interactions with ingredients in this product. No interactions are documented for the other ingredients we could check.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product is a source of essential fatty acids and may be helpful if you're interested in heart and cholesterol support. If you take diabetes medication, blood thinners, antipsychotics, or any CYP3A4-inducing drugs, check your specific medications with the tool on this page before starting.

Talk to your pharmacist if you're pregnant, breastfeeding, or have liver concerns.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 2 of 6 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Jun 25, 2014.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about The Total EFA, straight from the product label.

Brand Health From The Sun
Barcode (UPC) 010043050955
Net contents 8 fl. Oz.; 236 mL
Market status On market
Date entered into DSLD Jun 25, 2014
DSLD ID 34312
Product type Botanical With Nutrients
Supplement form Liquid
Dietary claims / uses All Other
Intended target group(s) Vegetarian, Adult (18 - 50 Years), Organic
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for The Total EFA by Health From The Sun, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
1 tsp
Maximum serving Sizes:
1 tsp
Servings per container
15
UPC/BARCODE
010043050955
IngredientAmount% DV
Calories130 {Calories}--
Calories from Fat120 {Calories}--
Total Fat14 Gram(s)22%
Saturated Fat1.5 Gram(s)8%
Gamma-Linolenic Acid290 mg--
Linoleic Acid2300 mg--
Oleic Acid1700 mg--
Alpha-Linolenic Acid5800 mg--
Organic Flaxseed Oil and Particulate12.2 Gram(s)--
organic Borage seed oil1400 mg--
Organic Evening Primrose Seed Oil580 mg--

Other ingredients: Antioxidant Blend

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Seals/Symbols

USDA ORGANIC

CERTIFIED ORGANIC

General Statements

OMEGA 3-6-9

Together, these potent plant oils supply an optimal fatty acid profile, intended to provide nutritional support for heat, brain and whole body health in just one tablespoon per serving.

This product is shelf stable until opened.

WHOLE BODY NUTRITIONAL SUPPORT

Keep your licensed health care practitioner informed when using this product.

Rigorously quality tested to guarantee purity, potency and truth-in-labeling.

Product of Canada

FDA Statement of Identity

DIETARY SUPPLEMENT

Formulation

ORGANIC

VEGETARIAN

Certified Organic by Pro-Cert

Formula

FLAX~BORAGE~EVENING PRIMROSE

The Total EFA(TM) is of certified organic flax, borage and evening primrose oils.

with Flax Lignans

OMEGA-3 5,800 MG GLA 290 MG

Brand IP Statement(s)

The superior flavor and freshness of the Total EFA(TM) is preserved with a special antioxidant blend and nitrogen-flushed, induction-sealed bottle. Enjoy The Total EFA(TM) by the spoonful or add to smoothies, dips or dressings for easy omega nutrition

Discussion: The Total EFA(TM) 100% vegetarian liquid is a comprehensive, purity plant-based omega-3-6-9 nutritional supplement, fortified with lignan-rich flax particulate.

(C)2011

Precautions

WARNING: Do not use if safety seal is broken or missing.

Keep out of reach of children.

Suggested/Recommended/Usage/Directions

Directions: Use only as directed. Take one tablespoon daily with a meal or as directed by your health care practitioner. Shake well before each use.

Storage

Refrigerate after opening.

General

5031956 1011

See for yourself

The Total EFA by Health From The Sun label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

What’s inside

The Ingredients in The Total EFA by Health From The Sun

These are the 6 active ingredients this product is made of. Select any to open its full monograph.

Serving size1 tsp Dosage formLiquid Servings per container15 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Organic Flaxseed Oil and Particulate

12.2 Gram(s) per serving

Organic Borage seed oil

Interacts with
226 drugs
1400 mg per serving

Borage is a Mediterranean herb whose seed oil is rich in gamma-linolenic acid (GLA), an omega-6 fatty acid studied mostly for skin conditions and arth...

Organic Borage seed oil monograph & interactions

Organic Evening Primrose Seed Oil

580 mg per serving
  • › Gamma-Linolenic Acid
  • › Linoleic Acid
  • Oleic Acid
  • › Alpha-Linolenic Acid

Other (inactive) ingredients: Antioxidant Blend. These complete the product’s ingredient list but are not active constituents.

Interaction report

The Total EFA by Health From The Sun Drug Interactions

Want to check YOUR meds against The Total EFA?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

Go to the checker
312Drugs
312 Moderate

Ingredients driving the most interactions

Each ingredient & the kinds of drugs it affects

For each ingredient in The Total EFA with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

organic Borage seed oil3 drug types · 226 drugs

Anticoagulant/Antiplatelet Drugs

Theoretically, borage seed oil may increase the risk of bleeding if used with anticoagulant or antiplatelet drugs.
In healthy individuals, borage seed oil supplementation does not seem to affect platelet aggregation. However, gamma-linolenic acid, a constituent of borage seed oil, seems to decrease platelet aggregation by 45% and increase the risk of bleeding by 40% in animal and clinical research.

Likelihood Possible Evidence B
Cytochrome P450 3A4 (Cyp3A4) Inducers

Theoretically, taking borage with drugs that induce CYP3A4 might increase levels of pyrrolizidine alkaloid (PA) toxic metabolites.
Although borage seed oil contains little to no PAs, some borage plant parts, such as the leaf, flower, and seed, can contain hepatotoxic PAs. Hepatotoxic PAs are substrates of CYP3A4, which converts these chemicals into toxic metabolites. Tell patients to avoid borage preparations that are not certified and labeled as hepatotoxic PA-free.

Likelihood Possible Evidence D
Phenothiazines

Theoretically, taking borage sed oil with phenothiazines might increase the risk of seizures.
Borage seed oil contains gamma-linolenic acid (GLA). There is concern that taking supplements containing GLA might cause seizures, or lower the seizure threshold, when taken with phenothiazines. This is based on limited data from two reports published in the 1980s. In one report, three patients with schizophrenia who had received phenothiazines developed EEG changes suggestive of temporal lobe epilepsy after starting treatment with evening primrose, another source of GLA. However, none experienced an actual seizure. In the other report, two patients with schizophrenia who were stabilized on phenothiazines developed seizures when evening primrose 4 grams daily was added. One of these patients had a prior history of seizures. It is unclear whether evening primrose had any additive epileptogenic effects with the phenothiazines, but there is no evidence that taking GLA-containing supplements alone can cause seizures.

Likelihood Possible Evidence D

Oleic Acid1 drug type · 86 drugs

Antidiabetes Drugs

Theoretically, oleic acid might increase the effects of antidiabetes drugs. Preliminary clinical research in patients with type 2 diabetes taking oral hypoglycemic drugs shows that eating a diet rich in oleic acid from olive oil decreases fasting blood glucose levels when compared to eating a diet rich in linoleic acid from sunflower oil. It is unknown if taking oleic acid supplements would have this effect or if this change is clinically significant. Until more is known, use caution. Dose adjustment may be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.

Likelihood Possible Evidence B
The maker

Brand information

Manufacturer and brand details for The Total EFA, from the product label.

Health From The Sun

See all Health From The Sun products
Name
Nutraceutical Corp.
Web Address
www.nutraceutical.com
Pharmacist Counseling Corner

The Total EFA by Health From The Sun: Common Questions

Does The Total EFA by Health From The Sun interact with any medications?
Yes. Based on its ingredients, The Total EFA has a known interaction with 312 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
The Total EFA contains 6 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm pregnant or breastfeeding?
Borage seed oil should be avoided during pregnancy because of possible liver-toxic compounds and a theoretical risk to the uterus. For the other ingredients in this product, we don't hold enough safety data to say either way — talk with your doctor or pharmacist for personalized advice.
Will this help my cholesterol or heart health?
The oleic acid in this product is possibly effective for high cholesterol and coronary heart disease based on the data we have. The evidence for the other ingredients isn't established in our records.
What are the most common side effects?
Borage seed oil may cause belching, bloating, diarrhea, and soft stools. The other ingredients in this product don't have documented adverse effects in our data.
Why is this called 'essential' fatty acids?
Essential fatty acids are ones your body needs but can't make itself — you have to get them from food or supplements. This product gives you several of them in concentrated form.
Is this product safe if I have liver problems?
Borage contains compounds that can be toxic to the liver, though borage seed oil (what's in this product) contains little to none of them. If you have liver disease or concerns, check with your pharmacist or doctor before starting.
Should I take this on an empty stomach?
The facts we hold for this product don't include guidance on timing or food. Ask your pharmacist for advice on how to take it best.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Not sure if The Total EFA is safe with your meds?

Our pharmacists answer your medication & supplement questions — free.

Ask a pharmacist

Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

The Total EFA label
Sources

Sources & How We Checked

The Total EFA's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 30 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Oleic Acid 19 references
  1. Madigan C, Ryan M, Owens D, et al. Dietary unsaturated fatty acids in type 2 diabetes: higher levels of postprandial lipoprotein on a linoleic acid-rich sunflower oil diet compared with an oleic acid-rich olive oil diet. Diabetes Care 2000;23:1472-7. PubMed
  2. Gillingham, L. G., Gustafson, J. A., Han, S. Y., Jassal, D. S., and Jones, P. J. High-oleic rapeseed (canola) and flaxseed oils modulate serum lipids and inflammatory biomarkers in hypercholesterolaemic subjects. Br J Nutr 2011;105(3):417-427. PubMed
  3. Jones PJ, Senanayake VK, Pu S, Jenkins DJ, Connelly PW, Lamarche B, Couture P, Charest A, Baril-Gravel L, West SG, Liu X, Fleming JA, McCrea CE, Kris-Etherton PM. DHA-enriched high-oleic acid canola oil improves lipid profile and lowers predicted cardiova
  4. Cater, N. B., Heller, H. J., and Denke, M. A. Comparison of the effects of medium-chain triacylglycerols, palm oil, and high oleic acid sunflower oil on plasma triacylglycerol fatty acids and lipid and lipoprotein concentrations in humans. Am.J Clin.Nutr PubMed
  5. Mozaffarian D, Clarke R. Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils. Eur J Clin Nutr. 2009;63(Suppl 2):S22-33. PubMed
  6. Cao Y, Hou L, Wang W. Dietary total fat and fatty acids intake, serum fatty acids and risk of breast cancer: A meta-analysis of prospective cohort studies. Int J Cancer. 2016;138(8):1894-904. doi: 10.1002/ijc.29938. PubMed
  7. FDA completes review of qualified health claim petition for oleic acid and the risk of coronary heart disease. November 2018. Available at: www.fda.gov/Food/NewsEvents/ConstituentUpdates/ucm624758.htm. Accessed January 25, 2019.
  8. Liu X, Kris-Etherton PM, West SG, et al. Effects of canola and high-oleic-acid canola oils on abdominal fat mass in individuals with central obesity. Obesity. 2016;24(11):2261-2268. PubMed
  9. Bowen KJ, Kris-Etherton PM, West SG, et al. Diets enriched with conventional or high-oleic acid canola oils lower atherogenic lipids and lipoproteins compared to a diet with a western fatty acid profile in adults with central adiposity. J Nutr. 2019;149(3 PubMed
  10. Steffen BT, Duprez D, Szklo M, Guan W, Tsai MY. Circulating oleic acid levels are related to greater risks of cardiovascular events and all-cause mortality: The Multi-Ethnic Study of Atherosclerosis. J Clin Lipidol. 2018;12(6):1404-1412. PubMed
  11. Banim PJ, Luben R, Khaw KT, Hart AR. Dietary oleic acid is inversely associated with pancreatic cancer - Data from food diaries in a cohort study. Pancreatology. 2018;18(6):655-660. PubMed
  12. Morin SJ, Gaziano JM, Djoussé L. Relation between plasma phospholipid oleic acid and risk of heart failure. Eur J Nutr. 2018;57(8):2937-2942. PubMed
  13. Samieri C, Féart C, Proust-Lima C, et al. Olive oil consumption, plasma oleic acid, and stroke incidence: the Three-City Study. Neurology. 2011;77(5):418-25. PubMed
  14. Compher CW, Kinosian BP, Rubesin SE, Ratcliffe SJ, Metz DC. Energy absorption is reduced with oleic acid supplements in human short bowel syndrome. JPEN J Parenter Enteral Nutr. 2009;33(1):102-8. PubMed
  15. Ben Fradj MK, Ouanes Y, Hadj-Taieb S, et al. Decreased oleic acid and marine n?-?3 polyunsaturated fatty acids in Tunisian patients with urothelial bladder cancer. Nutr Cancer. 2018;70(7):1043-1050.
  16. de Silva PS, Luben R, Shrestha SS, Khaw KT, Hart AR. Dietary arachidonic and oleic acid intake in ulcerative colitis etiology: a prospective cohort study using 7-day food diaries. Eur J Gastroenterol Hepatol. 2014;26(1):11-8. PubMed
  17. Higashi K, Shige H, Ito T, et al. Effect of a low-fat diet enriched with oleic acid on postprandial lipemia in patients with type 2 diabetes mellitus. Lipids. 2001;36(1):1-6. PubMed
  18. Lin HC, van Citters GW, Heimer F, Bonorris G. Slowing of gastrointestinal transit by oleic acid: a preliminary report of a novel, nutrient-based treatment in humans. Dig Dis Sci. 2001;46(2):223-9. PubMed
  19. Li D, Tong Y, Li Y. Associations between dietary oleic acid and linoleic acid and depressive symptoms in perimenopausal women: The Study of Women's Health Across the Nation. Nutrition. 2020 Mar;71:110602. PubMed

See these in context on the Oleic Acid monograph →

Borage 11 references
  1. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty A PubMed
  2. WHO working group. Pyrrolizidine alkaloids. Environmental Health Criteria, 80. WHO: Geneva, 1988.
  3. Fan YY, Chapkin RS. Importance of dietary gamma-linolenic acid in human health and nutrition. J Nutr 1998;128:1411-4.
  4. Takwale A, Tan E, Agarwal S, et al. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ 2003;327:1385. PubMed
  5. Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
  6. Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
  7. Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
  8. Holman CP and Bell AF. A trial of evening primrose oil in the treatment of chronic schizophrenia. J Orhtomolecular Psych 1983;12:302-304.
  9. Vaddadi KS. The use of gamma-linolenic acid and linoleic acid to differentiate between temporal lobe epilepsy and schizophrenia. Prostaglandins Med 1981;6(4):375-379. PubMed
  10. Bard, J. M., Luc, G., Jude, B., Bordet, J. C., Lacroix, B., Bonte, J. P., Parra, H. J., and Duriez, P. A therapeutic dosage (3 g/day) of borage oil supplementation has no effect on platelet aggregation in healthy volunteers. Fundam.Clin.Pharmacol. 1997;1
  11. Puri BK. The safety of evening primrose oil in epilepsy. Prostaglandins Leukotrienes Essential Fatty Acids 2007;77:101-3. PubMed

See these in context on the Borage monograph →

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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