An integrative exploration of borage’s traditional uses, phytochemistry, and clinical applications in supporting self-compassion, stress resilience, and emotional regulation in naturopathic practice.
Dr. Katelyn Mudry, ND, MSc
Introduction
Over the past year, self-love has become one of the most important mental health factors I discuss in my clinic. In the literature, the term Self-Compassion, strongly developed by Kristin Neff, has emerged as a critical component of mental, emotional, and physical well-being.1 A growing body of research shows higher levels of self-compassion being associated with improved mood regulation, decreased psychological distress, and greater resilience across the lifespan.2,3 In clinical contexts, self-love and self-compassion offer patients a framework through which they can reinterpret stressors, challenge internalized shame, and reconnect with their own humanity. Kristin Neff’s seminal model of self-compassion—comprised of self-kindness, common humanity, and mindfulness—remains one of the most widely discussed validated frameworks for assessing and cultivating internal emotional support.1 Clinically I use both terms, self love and self compassion, as self love is more colloquially recognized. Sonja Renee Taylor’s work, ‘The Body is Not an Apology – The Power of Radical Self Love,’ is one I reference frequently in clinic as well.4
Within this therapeutic paradigm, Borage (Borago officinalis) is one of my go-to herbs and one deserving of a revival. Traditionally known as the “herb of courage,” borage has been used for centuries to restore bravery, uplift the spirit, and fortify the heart.5 Inspired to use this easily grown herb through finding it in many UK herbal books, it has become a permanent fixture in my garden and clinic. In naturopathic practice, borage offers a bridge between physiological support for the nervous system and the emotional reclamation necessary for genuine self-love.
The Importance of Self-Love and Expression in Mental Health
Self-love and emotional expression contribute substantially to mental health by supporting emotional processing, resilience, and the capacity to tolerate distress. Research demonstrates that higher levels of self-compassion correlate with decreased anxiety, depression, shame, and emotional burden, while increasing positive affect, well-being, and adaptive coping.6,7 Low levels of self love include increased cortisol, stress reactivity, and impaired emotional regulation.8 Interestingly empathy is associated with increases in pain signaling and distress (activity in the anterior insula and anterior midcingulate cortex, and other parts of the insular cortex) vs. compassion-activating places of reward, affiliation and love in the brain (the insula, ventral striatum and medial orbitofrontal cortex).9,10
Patients with low self-compassion frequently exhibit heightened sympathetic activation, internalized criticism, isolation, and overall worse health outcomes in chronic disease including multiple sclerosis and breast cancer.2,3,11,12 These patterns create a clinical need for interventions that have a deep focus then our standard low mood or depression work and conversations.
Shame and isolation—core features of low self-love—are highly detrimental to psychological health. Shame is associated with global self-devaluation, avoidance, anger, and increased cortisol.13,14 As noted in the clinical literature, shame thrives in secrecy, silence, and judgment, limiting emotional expression and constricting the patient’s sense of self. Helping patients develop emotional language, identify internal narratives, and safely express their needs is therefore essential in reducing shame and fostering self-compassion.15
In discussing the barriers and people have to feeling, expressing and honoring the importance of self love I often turn to ‘The Body is Not an Apology’ by Sonja Renee Taylor. Her book is about RADICAL self love. Why Radical? Radical means the root, going to the extremes, getting to the origin of the issue, something existing inherently in a person, and making drastic social and political reforms.4 She discusses many of the social/economical/political structures that impact self love. She defines self love as “deeper and wider and more expansive than anything we would call self-confidence or self-esteem. It is juicer than self acceptance. Including the word ‘radical’ offers us a self love that is at the root of our relationship with who we are.”4
When I ask people in clinic what they want to feel from their treatment plan most often they respond “FREE”. Borage, with its longstanding association with courage, helps people choose love, emotional freedom, and self compassion in world that can often be lacking in those. In his quote “The privilege of a lifetime is to become who you truly are”, Carl Jung seems to agree.
Borage for Courage: Historical Use and Modern Application
Across Western herbal traditions, borage has been revered for its ability to “restore courage,” a theme reflected in the classical phrase Ego Borago gaudia semper ago – “I, Borage, always bring courage” – by Pliny the elder. Borage has adrenal supportive (supports adrenal cortex regeneration), anti-inflammatory, diuretic, and galactagogue properties.5 It is indicated for long lasting nervous system strain and feeling judged by others.16 Lucy Jones, author of ‘A Working Herbal Dispensary,’ has some of the most recent clinical comments on borage, using it in burnout and steroid withdrawal for its adrenal actions.5 It is heat clearing, supports the lungs and heart, promotes coolness.17 It can be used for palpitations and hyperthyroid symptoms similar to Lycopus.18
Energetically, borage is characterized as warming, expansive, uplifting, and stimulating, providing movement where there is contraction, depression and stagnation. These traits lend themselves to both somatic and emotional indications.
In Ayurvedic descriptions, borage “restores bliss and inner strength” and harmonizes the connection between heart and mind.19 Tibetan medicine describes borage as a rare warming bitter, supporting blood movement, kidney vitality, and emotional expansion.5
These energetic frameworks mirror the clinical themes of courage, internal warmth, and expressive movement.
Patients experiencing chronic emotional suppression, perfectionism, or long-term invalidation often develop patterns of hypothalamic/pituitary/adrenal axis dysfunction. These individuals may express palpitations, hyper vigilance, burnout, and difficulty asserting their needs. Borage’s role in helping patients shift out of sympathetic dominance allows them to focus on their inner feelings and needs and support the expression of them.
Safety Considerations
Borage is commonly known to contain some pyrrolizidine alkaloids (PAs) in it, similar to comfrey, which has likely decreased its usage in the modern day. PAs can be hepatotoxic in concentrated and chronic exposure, though the levels of alkaloids in Borage are quite low (0.01%). As PAs are most concentrated in the roots, usage of the leaves and flower of a plant can decrease levels.20 PAs are poorly water soluble, so aqueous preparations and lower-alcohol tinctures yield minimal extraction.20 All historical materia medicas for Borage list the leaves and flowers as the part to be used, and extractions in wine or water.21, 22,23 Certain materia medica give no contraindications or warnings and additionally list is as a galactagogue.17 Fresh-leaf and flower tinctures at ~50% alcohol reduce PA content.5
A 2020 systematic review identified no confirmed cases of borage-induced hepatotoxicity, with concerns largely attributed to mis-identification and inconsistent reporting.24 High-tannin herbs such as Camellia sinensis, Geranium, Hamamelis, Quercus, and Rosa can bind alkaloids and can be added to borage blends if concern is still present.20
Standard precautions apply, including avoiding use in pregnancy and lactation and limiting long-term high-dose intake. Clinically I will have people on a 50% flower and young leaf extract for 3-4 months as part of a tincture blend.
Dosing – Clinically I use borage in formula as a tincture. Formulas contain 5-8 herbs usually (20-10 mls per herb), equal parts unless noted as low dose (ld) which is 5 mls/100 mls. Most herbs are 1:4 extracts made in house.
Tincture blend dosing: 100ml (3.5 oz) dropper bottles (lasts 1 month)
Dosage: 2 dropperfuls 2x daily. Each dropperful being approx. 1.5 mls (0.05oz), and 2 dropperfuls being just over 1/2 teaspoon.
Timing: Morning and times when most needed such as mid afternoon for adrenal fatigue, before dinner for digestion, or before bed for sleep. I rarely see borage creating any sleep disturbances and can be dosed any time of day.
Case Studies
Case 1: “I’m Taking It Back!” — Courage and Reclaiming Self-Authority
A 51-year-old woman presented with hypertension, flushing, emotional reactivity, and longstanding patterns of minimizing her needs based on family-of-origin dynamics. She described feeling “caught between versions of myself,” unable to express her needs or release guilt around her life choices, especially related to childbearing and aging. Her nervous system showed chronic sympathetic activation and emotional contraction.
For the first two months, she was given a formula of motherwort, hawthorn, blue vervain, skullcap, rose, and linden. This blend produced mild softening and fewer spikes of frustration, but she continued to report feeling “small,” guilty, and unable to express anger or boundaries, noting that her heart felt “tight, hot, and frustrated.”
This was the indication for Borage! The revised formula included borage along with motherwort, hawthorn, blue vervain, linden, and a slightly reduced amount of rose. Within four to six weeks of adding borage, she began speaking more assertively during appointments, reported less guilt, and described “a lift” in her chest where she previously felt collapse. Her flushing diminished when linked to emotional overwhelm, and she expressed a newfound sense of internal support.
By month four, she stated, “I’m taking it back,” referring to reclaiming authority and boundaries in her family and work life. Anger became easier to express without shame, and her experience of menopause shifted from fearing decline to stepping into a new, empowered stage. Sympathetic spikes decreased, blood pressure stabilized, and she no longer felt “heat trapped in the chest.”
Around months five to six, borage was gradually reduced and removed when she reported feeling grounded and confident without needing its stimulating, uplifting qualities. She expressed a desire for deeper cooling and consolidation as hot flashes increased during a stressful period, and the formula shifted back toward motherwort, linden, hawthorn, and rose. A great side note of this case was while she came in with clear hypertension, over the months her blood pressure decreased significantly and is now normotensive, with no medications or high dose naturopathic interventions needed.
Case 2: “Feel Safer With Myself” — From Self-Criticism to Self-Compassion
A 48-year-old woman sought care for migraines and weight loss. She struggled to identify or express emotions, often feeling she needed to “collapse or disappear” in conflict. Her history and presentation reflected chronic sympathetic overactivation, upper-body tension, shallow breathing, and emotional suppression. In our first appointment we discussed perfectionism and suppressed anger.
Her initial formula during the first month included skullcap, blue vervain, rose, motherwort, and linden. This blend reduced migraines slightly and softened irritability, but she continued to avoid emotional expression and described feeling “afraid of being seen.” We also talked about profound shame with her weight and how it started from parents making negatives comments when she was young about her body size.
At the one-month mark, borage was added at 15–20% of the formula to support emotional safety, courage, and heart-mind connection. The revised mix combined borage with rose, skullcap, blue vervain, linden, and a reduced proportion of motherwort. Within three to four weeks of adding borage, she stated, “I feel safer with myself,” and began identifying emotions more clearly.
She was able to sit with difficult feelings without shutting down and spontaneously began journaling—an important therapeutic milestone. Over the next two to three months, migraine frequency decreased further, correlating with reduced emotional bracing. She cried for the first time in years “without feeling ashamed,” experienced less perfectionistic collapse, and began voicing her needs more consistently. Somatically, shoulder and jaw tension decreased, sleep improved, and chest tightness during conflict lessened.
Around months four to five, borage was tapered when she began demonstrating more emotional independence and internal safety, no longer needing the uplifting and courage-promoting qualities. She shifted from needing activation to desiring gentleness and protection. The formula transitioned toward rose, linden, skullcap, and motherwort to support continued heart softening and nervous system balance.
Conclusion
Borage offers a unique combination of physiological and emotional actions that make it an exceptional botanical ally in clinical work centered on self-love, self-compassion, and emotional expression. Its traditional identity as a herb of courage aligns with modern psychological understandings of shame, emotional regulation, and the components of self-compassion and self love.
By warming the system, stimulating circulation, and supporting adrenal and emotional resilience, borage helps patients transition from contraction to expansion, from fear to expression, and from internalized shame to grounded self-kindness. I see no clinical safety issue regarding pyrrolizidine alkaloids through proper plant usage and preparation at this time. Borage can be used effectively and meaningfully in naturopathic care for patients to support the courage to their true self and increase capacity for self-love.
Dr. Katelyn Mudry, ND, MSc is a licensed naturopathic doctor based in Kimberley, British Columbia, with advanced training in integrative medicine from the National University of Natural Medicine. She brings a holistic approach to patient care that bridges physical, emotional, and nervous system health—supporting individuals through complex presentations including digestion, hormonal imbalance, pain, chronic stress, and emotional healing. Dr. Mudry’s practice emphasizes root-cause investigation, science-informed natural therapeutics, and compassionate partnership, guiding patients toward long-term resilience and alignment. She is also actively engaged in evidence-informed practice and interdisciplinary collaboration to optimize outcomes across the lifespan
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