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The gummy resin of the boswellia tree has a long history of use in Indian herbal medicine as a treatment for arthritis, bursitis, respiratory diseases, and diarrhea.
Growing evidence suggests that boswellia has anti-inflammatory effects.5-8 On this basis, the herb has been tried for a number of conditions in which inflammation is involved, including painful conditions such as bursitis, osteoarthritis, rheumatoid arthritis, and tendonitis. For the same reason, it has also been tried for asthma and inflammatory bowel disease ( ulcerative colitis or Crohn’s Disease). In addition, boswellia has shown promise for the relatively rare disease of the colon in which inflammation plays a role: collagenous colitis.14
Furthermore, extracts of boswellia have been studied as an aid to standard care for malignant glioma (a type of incurable brain tumor).9-11 Use of boswellia appears to decrease symptoms, probably by decreasing inflammation in the brain (as well as through other mechanisms). However, this has not been proven, and individuals with cancer should not use boswellia (or any other herb or supplement) except on physician’s advice.
According to a review of unpublished studies, preliminary double-blind trials have found boswellia effective in relieving the symptoms of rheumatoid arthritis.2 Two placebo-controlled studies, involving a total of 81 people with rheumatoid arthritis, reportedly found significant reductions in swelling and pain over the course of 3 months. In addition, a comparative study of 60 people over 6 months found that boswellia extract produced symptomatic benefits comparable to oral gold therapy. However, this review was rather sketchy on details.
A more recent double-blind, placebo-controlled study that enrolled 78 people with rheumatoid arthritis found no benefit.3 However, about half of the patients dropped out, which seriously diminishes the significance of the results.
A 6-week, double-blind, placebo-controlled study of 80 people with relatively mild asthma found that treatment with boswellia at a dose of 300 mg 3 times daily reduced the frequency of asthma attacks and improved objective measurements of breathing capacity.4
In a double-blind study of 30 people with osteoarthritis of the knee, researchers compared boswellia against placebo.13 Participants received either boswellia or placebo for 8 weeks and were then switched over to the opposite treatment for an additional 8 weeks. The results showed significantly greater improvement in knee pain, knee mobility, and walking distance with boswellia compared to placebo.
The therapeutic effects of boswellia were evaluated in a review of 4 randomized trials. It was associated with significant pain reduction and improved physical function in people with osteoarthritis.15
An 8-week, double-blind, placebo-controlled trial of 102 people with Crohn’s disease compared a standardized boswellia extract against the drug mesalazine.12 Participants taking boswellia fared at least as well as those taking mesalazine, according to a standard score of Crohn’s disease severity. A small, poorly designed trial found some indications that boswellia might also offer benefit in ulcerative colitis.4
A typical dose of boswellia is 300 to 400 mg 3 times a day of an extract standardized to contain 37.5% boswellic acids. Some studies have used dosages as high as 1,200 mg 3 times daily.
In clinical trials of pharmaceutical grade standardized boswellia extract, no serious side effects have been reported. Crude herb preparations, however, may not be as safe as the specially manufactured extract. Safety in young children, pregnant or nursing women, or individuals with severe liver or kidney disease has not been established.
1. Gupta I, Parihar A, Malhotra P, et al. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res. 1997;2:37-43.
2. Etzel R. Special extract of Boswellia serrata (H 15) in the treatment of rheumatoid arthritis. Phytomedicine. 1996;3:91-94.
3. Sander O, Herborn G, Rau R. Is H15 (resin extract of Boswellia serrata, "incense") a useful supplement to established drug therapy of chronic polyarthritis? Results of a double-blind pilot study [in German, English abstract]. Z Rheumatol. 1998;57:11-16.
4. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res. 1998;3:511-514.
5. Safayhi H, Sailer ER, Ammon HPT. 5-lipoxygenase inhibition by acetyl-11-keto-beta-boswellic acid (AKBA) by a novel mechanism. Phytomedicine. 1996;3:71-72.
6. Singh GB, Atal CK. Pharmacology of an extract of salai guggal ex-Boswellia serrata, a new non-steroidal anti-inflammatory agent. Agents Actions. 1986;18:407-412.
7. Wildfeuer A, Neu IS, Safayhi H, et al. Effects of boswellic acids extracted from a herbal medicine on the biosynthesis of leukotrienes and the course of experimental autoimmune encephalomyelitis. Arzneimittelforschung. 1998;48:668-674.
8. Safayhi H, Boden SE, Schweizer S, et al. Concentration-dependent potentiating and inhibitory effects of Boswellia extracts on 5-lipoxygenase product formation in stimulated PMNL. Planta Med. 2000;66:110-113.
9. Janssen G, Bode U, Breu H, et al. Boswellic acids in the palliative therapy of children with progressive or relapsed brain tumors. Klin Padiatr. 2000;212:189-195.
10. Winking M, Sarikaya S, Rahmanian A, et al. Boswellic acids inhibit glioma growth: a new treatment option? J Neurooncol. 2000;46:97-103.
11. Glaser T, Winter S, Groscurth P, et al. Boswellic acids and malignant glioma: induction of apoptosis but no modulation of drug sensitivity. Br J Cancer. 1999;80:756-765.
12. Gerhardt H, Seifert F, Buvari P, Vogelsang H, et al. Therapy of active Crohn disease with Boswellia serrata extract H 15. Z Gastroenterol. 2001;39:11-17.
13. Kimmatkar N, Thawani V, Hingorani L, et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee—a randomized double blind, placebo controlled trial. Phytomedicine. 2003;10:3-7.
14. Madisch A, Miehlke S, Eichele O, et al. Boswellia serrata extract for the treatment of collagenous colitis. A double-blind, randomized, placebo-controlled, multicenter trial. Int J Colorectal Dis. 2007 Sep 2. [Epub ahead of print]
15. Cameron M, Chrubasik S. Oral herbal therapies for treating osteoporosis. Cochrane Database Syst. Rev. 2014;5:CD002947
Last reviewed December 2015 by EBSCO CAM Review Board Last Updated: 12/15/2015