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Boswellia (Boswellia serrata)

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Also listed as: Adam's needle
Related terms
Background
Evidencetable
Tradition
Dosing
Safety
Interactions
Attribution
Bibliography

Related Terms
  • 2-O-acetyl-11-keto-beta-boswellic acid, 3-O-acetyl-11-keto-beta-boswellic acid (AKBA), 3-acetyl-alpha-boswellic acid, 3-acetyl-beta-boswellic acid, 3-alpha-acetoxy-tirucallic acid, 3-beta-acetoxy-tirucallic acid, 3-oxo-tirucallic acid, 5-Loxin®, 11-keto-beta-boswellic acid, acetyl-11-keto-beta-boswellic acid (AKBA), Aflapin®, African elemi (Boswellia frereana), Afrikanischer Weihrauch (German), Afrikanischer Weihrauch-Baum (German), Afrikanischer Weihrauchbaum (German), albero dell'incenso (Italian), alpha-boswellic acid, Arabian incense (Bakhour), árbol del incienso (Spanish), arbre à encens (French), arbre à encens d'Afrique (French), arbre à encens de l'Inde (French), bakhor (Arabic), beta-boswellic acid, Bible frankincense, Bible incense (Boswellia carterii), birdwood, bosvelliia kartera (Russian), bosvelliia mil'chataia (Russian), Boswellia carterii, Boswellia dalziellii, Boswellia frereana, Boswellia ovalifoliolata, Boswellia papyrifera, Boswellia sacra, Boswellia serrata, Boswellia serrata gum resins, Boswellia serrata non-volatile oil, Boswellia serrate resin extract, boswellic acids, boswellic acid acetate, boswellie (French), BSB108, Burseraceae (family), carterii, dhup, diterpenes, elephant-tree, fan hun shu (Chinese), frankincense, Frankincense der Weihrauch (German), furankinsensu (Japanese), gajabhakshya (Sanskrit), guggals, H15®, incensole acetate, Indiai tömjénfa (Hungarian), Indian frankincense, Indian olibanum tree, indish incense, Indischer Weihrauch (German), kundur luban (Hindi), magher (Arabic), Mexican bursera, mirafur (Somali), mogar (Arabic), monoterpenes, moxor (Somalia), mughur (Arabic), nopane, ogaden etan (Amharic), oleogum resins, oleo-resin, olibán (Spanish), olibano (Italian), olibanum, pentacyclic triterpenic acids, pentacyclic triterpenoid, røgelsestræ (Danish), rökelseträd (Swedish), ru xiang (Chinese), ru xiang shu (Chinese), saagjas viirukipuu (Estonian), sacra, salai (Hindi), salai gugaal (Hindi), salai guggal (Hindi), salai guggulu (Sanskrit), sallai guggul (Hindi), Sallaki®, sanlaki (Thai), S-compound®, sesquiterpenes, shallaki (Sanskrit), Sudanese frankincense, triterpenoids, ubani (Swahili), Weihrauchbaum (German), Weihrauchpflanze (German), wierookboom (Dutch), wierookboom soort (Dutch), yagar (Somalia), ye ru xiang shu (Chinese), yigaar (Somalia).
  • Combination product examples: Articulin-F® (Withania somnifera [ashwagandha], Boswellia serrata, Curcuma longa [turmeric], zinc complex); RA-1 (Withania somnifera [ashwagandha], Boswellia serrata, Zingiber officinale [ginger], Curcuma longa [turmeric]), BHUx (Termenalia arjuna, Strychnox nux vomica, Boswellia serrata, Commiphora mukul, and Semecarpus anacardium), RA-1® (an herbal mixture of Boswellia serrata, Withania somnifera [ashwagandha], Zingiber officinale [ginger], and Curcuma longa [turmeric]).

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.

Evidence Table

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. GRADE *


Boswellia has been found to have anti-inflammatory effects. It has been used to treat osteoarthritis and is supported by strong evidence.

A


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


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


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


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


Boswellia may help reduce headache intensity and frequency in people who have chronic cluster headaches. However, more research is needed in this area.

C


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


Research suggests that Proxelan®, which contains boswellia, may improve chronic prostate inflammation. More research is needed on the effects of boswellia alone.

C


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


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 for this use (it may not work)
F: Strong scientific evidence against this use (it likley does not work)


Tradition / Theory

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

  • 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 (WokvelTM) 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.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid if allergic or sensitive to boswellia, its parts, or members of the family Burseraceae.

Side Effects and Warnings

  • Boswellia is likely safe when taken by mouth in amounts normally found in foods.
  • Boswellia is possibly safe when taken by mouth in otherwise healthy people for asthma, brain tumors, intestinal inflammation, Crohn's disease, osteoarthritis, or rheumatoid arthritis. Boswellia is possibly safe in commonly studied doses, including: doses up to 1,000 milligrams boswellic acids, up to 126 milligrams per kilogram of H15® daily for nine months, up to 4,200 milligrams daily until the end of radiotherapy treatment, or up to 2,400 milligrams daily for 12 months. Boswellia is possibly safe when applied to the skin for up to 30 days as a cream containing 0.5 percent boswellic acids.
  • Boswellia may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.
  • Use cautiously in children and in breastfeeding women, due to a lack of safety information.
  • Use cautiously in people who have liver damage or dysfunction, or those taking agents that may harm the liver. High doses of boswellia may cause liver damage or dysfunction.
  • Boswellia may interfere with the way the body processes certain drugs, herbs, or supplements using the liver's "cytochrome P450" enzyme system.
  • Use cautiously in people who have autoimmune diseases or those taking agents that affect the immune system. Boswellic acids may affect the immune system.
  • Use cautiously in people who have skin disorders. Boswellia may cause allergic skin reaction (inflammation and itching).
  • Use cautiously in people who have stomach disorders. Boswellia may cause acid reflux, anorexia, changes in acid levels, constipation, diarrhea, a feeling of fullness, mass of foreign material trapped in the stomach (bezoar), nausea, stomach cramps, stomach pain, and upset stomach.
  • Use cautiously in people who have nervous system disorders. Boswellia may cause dizziness and headache. Use caution if driving or operating heavy machinery.
  • Use cautiously when inhaled in the form of incense. Boswellia may cause harmful changes in lung tissue when inhaled.
  • Avoid using in pregnant women. Boswellia may cause abortion.
  • Avoid if allergic or sensitive to boswellia, its parts, or members of the family Burseraceae.
  • Boswellia may also cause fatigue, fever, infection, swelling (ankles or legs), and weakness.

Pregnancy and Breastfeeding

  • There is a lack of scientific evidence on the use of boswellia during pregnancy or breastfeeding.
  • Use cautiously in breastfeeding women, due to a lack of safety information.
  • Avoid using in pregnant women. Boswellia may cause abortion.

Interactions

Interactions with Drugs

  • Boswellia may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.
  • Boswellia may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.
  • Boswellia may increase the amount of sedation or drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.
  • Boswellia may also interact with agents that affect the immune system, agents that harm the liver, agents that treat arthritis, agents that treat asthma, agents that treat lung disorders, agents that treat swelling, antibiotics, anticancer agents, antifungal agents, anti-inflammatory agents, cholesterol-lowering agents, leukotriene receptor antagonists, lung agents, nervous system agents, pain relievers, sedatives, skin agents, stomach agents, and tumor necrosis factor inhibitors.

Interactions with Herbs and Dietary Supplements

  • Boswellia may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.
  • Boswellia may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
  • Boswellia may increase the amount of drowsiness or sedation caused by some herbs or supplements.
  • Boswellia may also interact with antibacterials, anticancer herbs and supplements, antifungal herbs and supplements, anti-inflammatory herbs and supplements, cholesterol-lowering herbs and supplements, chondroitin sulfate, glucosamine, herbs and supplements that affect the immune system, herbs and supplements that harm the liver, herbs and supplements that treat arthritis, herbs and supplements that treat asthma, herbs and supplements that treat lung disorders, herbs and supplements that treat nervous system disorders, herbs and supplements that treat skin disorders, herbs and supplements that treat stomach disorders, herbs and supplements that treat swelling, and pain relievers.

Attribution
  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. Abdel-Tawab M, Werz O, and Schubert-Zsilavecz M. Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data. Clin Pharmacokinet. 2011;50(6):349-369.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. Ke F, Yadav PK, and Ju LZ. Herbal medicine in the treatment of ulcerative colitis. Saudi.J Gastroenterol 2012;18(1):3-10.
  9. 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.
  10. 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.
  11. Posadzki P, Watson LK, and Ernst E. Adverse effects of herbal medicines: an overview of systematic reviews. Clin Med 2013;13(1):7-12.
  12. 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.
  13. 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.
  14. 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.
  15. 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.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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