Boswellia (Boswellia serrata)

Background

Boswellia has been used in Africa and India for many years. Frankincense also comes from a boswellia species. Boswellia has been used for well-being, skin disorders, infections, wound healing, joint problems, menstrual disorders, and bruises. Boswellia has been used to tone the skin and smooth wrinkles.
Today, boswellia is widely available and is often used to treat inflammation. Research has focused on its possible benefit for conditions such as arthritis, inflammatory bowel diseases, and asthma. Boswellia may also have anti-cancer effects.
There is strong evidence to support the use of boswellia for osteoarthritis. There is good evidence to support its use for asthma and swelling in people who have brain tumors. However, evidence is lacking for other uses.
Side effects involving the stomach have been reported with boswellia use.

Scientific Evidence

Uses	Grade*
Osteoarthritis Boswellia has been found to have anti-inflammatory effects. It has been used to treat osteoarthritis and is supported by strong evidence.	A
Asthma Boswellia has been studied as a therapy for chronic asthma. Studies suggest that it may improve breathing and reduce wheezing. Although promising, more research is needed to determine the long-term safety and effectiveness of boswellia. Avoid using boswellia for asthma attacks.	B
Brain tumors Boswellia has been used as a cancer treatment. Many studies suggest that it may have anti-cancer benefits and may reduce swelling in the brain. More high-quality research is needed before further conclusions can be made.	B
Blood circulation Treatments containing boswellia has been taken by mouth and applied to the skin. These have been found to improve blood circulation, reduce pain, and decrease swelling. More research is needed to determine the effects of boswellia alone.	C
Crohn's disease Studies have shown that boswellia may have anti-inflammatory benefits. Boswellia has been suggested as a treatment for Crohn's disease. Although some positive effects have been shown, more research is needed before firm conclusions can be made.	C
Headaches Boswellia may help reduce headache intensity and frequency in people who have chronic cluster headaches. However, more research is needed in this area.	C
Intestinal inflammation Studies have shown that boswellia may have anti-inflammatory benefits. Boswellia has been suggested as a treatment for inflammation of the intestine. There have been positive effects on symptoms of inflammatory bowel disease. However, results are mixed, and more evidence is needed in support of boswellia for this use.	C
Prostate inflammation Research suggests that Proxelan^®, which contains boswellia, may improve chronic prostate inflammation. More research is needed on the effects of boswellia alone.	C
Rheumatoid arthritis Studies have shown that boswellia may have anti-inflammatory benefits. Boswellia has been suggested as a treatment for rheumatoid arthritis. One review reports that the boswellia extract H15^® lacks effect on acute pain, but may relieve swelling and stiffness. Combination products containing boswellia (RA-1^® and Articulin-F^®) have also been studied for rheumatoid arthritis. More evidence is needed to support the use of boswellia for this condition.	C
Skin aging Early study suggests that a cream containing boswellia may help reduce skin aging. More high-quality research is needed in this area.	C

*Key to grades:

A: Strong scientific evidence for this use;

B: Good scientific evidence for this use;

C: Unclear scientific evidence for this use;

D: Fair scientific evidence against this use (it may not work);

F: Strong scientific evidence against this use (it likely does not work).

Tradition

Acne, amenorrhea (lack of menstrual period), antibacterial, antifungal, anti-inflammatory, antioxidant, astringent, belching, bladder inflammation, blood purification, boils, breast cysts, bruises, bursitis (soft tissue inflammation), cancer, cervical spondylosis (abnormal wear on neck bones and cartilage), chronic obstructive pulmonary disease (COPD), clogged arteries, digestive, expectorant (loosens mucus), gas, heart disease, hepatitis C, high cholesterol, immune function, improved mental clarity, improving urine flow, infections, indigestion, insect repellant, kidney inflammation, liver damage, multiple sclerosis (MS), pain, parasites, sedative, sexually transmitted diseases, tendonitis, varicose veins, well-being, wound healing.

Dosing

Adults (18 years and older)

In general, 200-400 milligrams of boswellia have been taken by mouth three times daily. Boswellia capsules (1,000-2,500 milligrams daily) are sold commercially.
To treat asthma, 300 milligrams of boswellia powdered gum resin capsules (S-compound^®) have been taken by mouth three times daily for six weeks. A dose of 400 milligrams of boswellia extract has been taken by mouth three times daily. Two boswellia capsules (500 milligrams of boswellic acid each) have been taken by mouth twice daily. One boswellia capsule (300 milligrams of boswellic acid) has been taken by mouth three times daily for 2-6 weeks.
To treat brain tumors, a maximum dose of 126 milligrams per kilogram of H15^® has been taken by mouth daily for an average of nine months. Four boswellia capsules have been taken by mouth three times daily for a total daily dose of 4,200 milligrams until the end of radiotherapy treatment.
To treat intestinal inflammation, 350-400 milligrams of boswellia extract has been taken by mouth three times daily for 6-8 weeks.
To treat Crohn's disease, 1,200 milligrams of standardized boswellia gum resin (H15^®) has been taken by mouth three times daily for up to eight weeks. Two boswellia capsules (400 milligrams of boswellia each) have been taken by mouth three times daily during or after a meal for 12 months.
To treat osteoarthritis, 333 milligrams of boswellia extract (Wokvel^TM) has been taken by mouth three times daily for eight weeks. A dose of 333 milligrams of boswellia has been taken by mouth three times daily for six months. Doses of 100-250 milligrams of boswellia extract (5-Loxin^®) have been taken by mouth daily for 90 days. A 50 milligram capsule of Aflapin^® has been taken by mouth twice daily for 30 days.
To treat rheumatoid arthritis, up to 3,600 milligrams of H15^® has been taken by mouth for 12 weeks.
To treat skin aging, a cream containing 0.5 percent boswellic acids has been applied to the skin once daily for 30 days.

Children (under 18 years old)

There is a lack of safety, effectiveness, and dosing information for boswellia in children. Boswellia should only be used with the guidance of a qualified healthcare professional.
To treat brain tumors, a maximum dose of 126 milligrams per kilogram of H15^® has been taken by mouth daily for nine months.

References

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Calzavara-Pinton P, Zane C, Facchinetti E, et al. Topical Boswellic acids for treatment of photoaged skin. Dermatol Ther 2010;23 Suppl 1:S28-S32. View Abstract
Clark CE, Arnold E, Lasserson TJ, et al. Herbal interventions for chronic asthma in adults and children: a systematic review and meta-analysis. Prim.Care Respir.J 2010;19(4):307-314. View Abstract
De Silva V, El-Metwally A, Ernst E, et al. Evidence for the efficacy of complementary and alternative medicines in the management of osteoarthritis: a systematic review. Rheumatology.(Oxford) 2011;50(5):911-920. View Abstract
Galeone G, Spadavecchia R, Balducci MT, et al. [The role of Proxelan in the treatment of chronic prostatitis. Results of a randomized trial]. Minerva Urol.Nefrol. 2012;64(2):135-141. View Abstract
Gerbeth K, Meins J, Kirste S, et al. Determination of major boswellic acids in plasma by high-pressure liquid chromatography/mass spectrometry. J Pharm.Biomed.Anal. 12-15-2011;56(5):998-1005. View Abstract
Holtmeier W, Zeuzem S, Preiss J, et al. Randomized, placebo-controlled, double-blind trial of Boswellia serrata in maintaining remission of Crohn's disease: good safety profile but lack of efficacy. Inflamm.Bowel.Dis 2011;17(2):573-582. View Abstract
Ke F, Yadav PK, and Ju LZ. Herbal medicine in the treatment of ulcerative colitis. Saudi.J Gastroenterol 2012;18(1):3-10. View Abstract
Kirste S, Treier M, Wehrle SJ, et al. Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors: a prospective, randomized, placebo-controlled, double-blind pilot trial. Cancer 8-15-2011;117(16):3788-3795. View Abstract
Lampl C, Haider B, and Schweiger C. Long-term efficacy of Boswellia serrata in four patients with chronic cluster headache. Cephalalgia 2012;32(9):719-722. View Abstract
Posadzki P, Watson LK, and Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med 2013;13(1):7-12. View Abstract
Rahimi R, Shams-Ardekani MR, and Abdollahi M. A review of the efficacy of traditional Iranian medicine for inflammatory bowel disease. World J Gastroenterol 9-28-2010;16(36):4504-4514. View Abstract
Sengupta K, Krishnaraju AV, Vishal AA, et al. Comparative efficacy and tolerability of 5-Loxin and AflapinAgainst osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 2010;7(6):366-377. View Abstract
Skarke C, Kuczka K, Tausch L, et al. Increased bioavailability of 11-keto-beta-boswellic acid following single oral dose frankincense extract administration after a standardized meal in healthy male volunteers: modeling and simulation considerations for evaluating drug exposures. J Clin Pharmacol 2012;52(10):1592-1600. View Abstract
Vishal AA, Mishra A, and Raychaudhuri SP. A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee. Int J Med Sci 2011;8(7):615-622. View Abstract