Scientific Names: Boswellia serrata
Other Common Names: Boswellin, Indian frankincense, Indian olibanum
Overall Safety: 😊
Therapeutic Efficacy and Considerations:
Osteoarthritis: 😊 Preparations of the gum resin of Boswellia serrata have been used in Ayurvedic medicinal therapies for centuries in the treatment of inflammatory diseases. One high quality clinical trial examined effects in knee osteoarthritis; results were highly significant reductions in pain and swelling, increased flexion, and walking a stair-climbing capacity. Although evidence is limited, considering the favorable safety profile, Boswellia can be cautiously recommended as an option for use in osteoarthritis. Dose: not well-determined; 300-350 mg extract TID with meals.
Ulcerative Colitis: 😊 Two small controlled, but non-randomized, trials comparing Boswellia to sulfasalazine have noted similar results in symptom and histological improvements. In one study, the remission rate in the Boswellia group was almost double the sulfasalazine group (75% versus 40%). An additional trial, published in German, compared Boswellia to mesalamine in Chron’s disease with similar efficacy noted. Although evidence is not definitive, considering the favorable safety profile, Boswellia can be cautiously recommended as an option for use in patients with ulcerative colitis. Until more is known about the extent of efficacy and the optimum dosage, limiting use to those patients who cannot tolerate or refuse standard treatments is advisable. Dose: 300 mg extract TID with meals.
Asthma: 😐 One controlled trial has examined Boswellia's efficacy against placebo for the prevention of acute asthma attacks. The Boswellia group experienced fewer attacks and greater improvements in lung spirometry parameters. Evidence can be considered promising but very preliminary; Boswellia cannot be generally recommended for this indication. More research is warranted, especially to determine usefulness in conjunction with other therapies. Asthma can be a life-threatening condition; patients desiring to try Boswellia should be strongly counseled to not stop conventional pharmaceutical treatment. Dose: 300 mg extract TID with meals.
Chemistry/Pharmacology:
The primary active components of the gum resin of the Boswellia serrata tree are the boswellic acids. Absorption of these acids is increased by the presence of bile acids. Boswellic acids have anti-inflammatory effects and reduce leukotrienes via direct, non-competitive inhibition of 5-lipoxygenase. The gum resin has been shown to reduce WBC count in the synovial fluid of inflamed joints. Boswellia seems to be non-toxic; the LD50 in rats is more than 2 grams per kilogram of body weight. A recent animal study noted that Boswellia inhibits intestinal motility; this may explain some benefit for inflammatory bowel disease.
Drug Interactions:
Theoretically, use with leukotriene inhibitors could produce additive effects and increase the risk of adverse events. Boswellia seems to inhibit P-glycoprotein in vitro; if this occurs in vivo, the potential for drug interactions exists, although none have been reported to date.
Contraindications/Precautions:
Contraindicated in pregnancy or lactation due to lack of information on effects.
Adverse Effects:
Generally, very well tolerated. Heartburn, anorexia, nausea, and diarrhea have been reported in trials.
