Boswellia is a moderate to large branching tree found in the dry hilly areas of India. When the tree trunk is tapped, a gummy oleoresin is exuded. A purified extract of this resin is used in modern herbal preparations.
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3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
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1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Osteoarthritis (Ashwagandha, Turmeric)
1,000 mg daily boswellia resin herbal extract or two capsules, three times per day of Aticulin-F (formula containing 100 mg boswellia, 450 mg ashwagandha, 50 mg turmeric, and 50 mg zinc)
A combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness in one study, without the stomach irritation that is a common side effect of NSAIDs.
Boswellia has anti-inflammatory properties that have been compared to those of the NSAIDs used by many for inflammatory conditions.1 Clinical trials have found that boswellia is more effective than a placebo for relieving pain and swelling and preventing loss of function in people with osteoarthritis.2 Boswellia has also been found to be as effective as the anti-inflammatory drug valdecoxib (Bextra). In addition, while the improvements occurred more slowly in the boswellia group than in the valdecoxib group, they persisted for a longer period of time after treatment was discontinued.3 One clinical trial found that a combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness associated with OA but did not improve joint health, according to X-rays of the affected joint.4 Unlike NSAIDs, long-term use of boswellia does not lead to irritation or ulceration of the stomach.
300 mg three times per day of a resin extract
In one trial, people with acute bronchial asthma who took powdered boswellia resin extract had significantly fewer asthma attacks and improved measurements of breathing capacity.
One double-blind trial has investigated the effects of the Ayurvedic herb boswellia in people with acute bronchial asthma.5 Participants took 300 mg of powdered boswellia resin extract or placebo three times daily for six weeks. By the end of the study, the number of asthma attacks was significantly lower in the group taking boswellia. Moreover, objective measurements of breathing capacity were also significantly improved by boswellia.
400 to 800 mg of gum resin extract three times daily
Boswellia, an herb used in Ayurvedic medicine to treat arthritis, has reduced rheumatoid arthritis symptoms in most reports.
Boswellia is an herb used in Ayurvedic medicine (the traditional medicine of India) to treat arthritis. Boswellia has reduced symptoms of RA in most reports.6 While some double-blind trials7 using boswellia have produced positive results, some equivocal results8 and negative findings have also been reported.9 In some trials where boswellia has appeared ineffective, though, patients have been allowed to continue use of nonsteroidal anti-inflammatory drugs (NSAIDs). Such use of NSAIDs can confound experimental results, because boswellia and NSAIDs work in a similar fashion to reduce inflammation. Some doctors suggest using 400–800 mg of gum resin extract in capsules or tablets three times per day.
Ginger is another Ayurvedic herb used to treat people with arthritis. A small number of case studies suggest that taking 6–50 grams of fresh or powdered ginger per day may reduce the symptoms of RA.10 A combination formula containing ginger, turmeric, boswellia, and ashwagandha has been shown in a double-blind trial to be slightly more effective than placebo for RA;11 the amounts of herbs used in this trial are not provided by the investigators.
550 mg of gum resin three times a day
Supplementing with boswelia may help reduce severity and encourage remission.
A small clinical study found that people with UC taking 550 mg of boswellia gum resin three times daily for six weeks had similar improvement in symptoms and the severity of their disease as people with UC taking the drug sulfasalazine.12 Overall, 82% of patients receiving boswellia, along with 75% of patients taking sulfasalazine, went into remission.
Refer to label instructions
Some doctors recommend using the anti-inflammatory herbs boswellia, turmeric, willow, and topical cayenne ointment for bursitis.
Refer to label instructions
In case reports, several patients with chronic cluster headaches showed improvement after supplementing with Boswellia serrata extract, though more research is needed to confirm these findings.
In case reports, four patients with chronic cluster headaches showed improvement after supplementing with Boswellia serrata extract.15 The amount used varied from 350 mg three times per day to 700 mg three times per day. Placebo-controlled trials are needed to confirm these reports.
In the ancient Ayurvedic medical texts of India, the gummy exudate from boswellia is grouped with other gum resins and referred to collectively as guggals. Historically, the guggals were recommended by Ayurvedic physicians for a variety of conditions, including osteoarthritis, rheumatoid arthritis, diarrhea, dysentery, pulmonary disease, and ringworm.
The gum oleoresin consists of essential oils, gum, and terpenoids. The terpenoid portion contains the boswellic acids that have been shown to be the active constituents in boswellia.16 Today, extracts are typically standardized to contain 37.5–65% boswellic acids.
Studies have shown that boswellic acids have an anti-inflammatory action17—much like the conventional nonsteroidal anti-inflammatory drugs (NSAIDs) used for inflammatory conditions. Boswellia inhibits pro-inflammatory mediators in the body, such as leukotrienes.18 As opposed to NSAIDs, long-term use of boswellia does not appear to cause irritation or ulceration of the stomach. One small, controlled, double-blind trial has shown that boswellia extract may be helpful for ulcerative colitis.19
The standardized extract of the gum oleoresin of boswellia is recommended by many doctors. For rheumatoid arthritis or osteoarthritis, 150 mg of boswellic acids are taken three times per day.20 As an example, if an extract contains 37.5% boswellic acids, 400 mg of the extract would be taken three times daily. Treatment with boswellia generally lasts eight to twelve weeks. In the one clinical trial to date, people with ulcerative colitis used 550 mg of boswellia extract three times per day.
Boswellia is generally safe when used as directed. Rare side effects can include diarrhea, skin rash, and nausea. Any inflammatory joint condition should be closely monitored by a physician.
1. Safayhi H, Mack T, Saieraj J, et al. Boswellic acids: Novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther 1992;261:1143-6.
2. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. 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.
3. Sontakke S, Thawani V, Pimpalkhute S, et al. Open, randomized, controlled clinical trial of Boswellia serrata extract as compared to valdecoxib in osteoarthritis of knee. Indian J Pharmacol 2007;39:27-9.
4. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: A double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
5. 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;3:511-4.
6. Etzel R. Special extract of Boswellia serrata (H15) in the treatment of rheumatoid arthritis. Phytomed 1996;3:91-4.
7. Singh GB, Singh S, Bani S. New phytotherapeutic agent for the treatment of arthritis and allied disorders with novel mode of action. 4th International Congress on Phytotherapy, Munich, Germany, Sep 10-3, 1992.
8. Chopra A, Lavin P, Patwardhan B, Chitre D. Randomized double blind trial of an Ayurvedic plant derived formulation for treatment of rheumatoid arthritis. J Rheumatol 2000;27:1365-72.
9. 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. Z Rheumatol 1998 ;57:11-6 [in German].
10. Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypoth 1992;39:342-8.
11. Chopra A, Lavin P, Patwardhan B, Chitre D. Randomized double blind trial of an Ayurvedic plant derived formulation for treatment of rheumatoid arthritis. J Rheumatol 2000;27:1365-72.
12. 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.
13. Murray MT. The Healing Power of Herbs. Rocklin, CA: Prima Publishing, 1995.
14. Bradley PR, ed. British Herbal Compendium, Vol. 1. Bournemouth, Dorset, UK: British Herbal Medicine Association, 1992.
15. Lampl C, Haider B, Schweiger C. Long-term efficacy of Boswellia serrata in four patients with chronic cluster headache. Cephalalgia 2012;32:719–22.
16. Safayhi H, Sailer ER, Amnon HPT. 5-lipoxygenase inhibition by acetyl-11-keto-b-boswellic acid. Phytomed 1996;3:71-2.
17. Safayhi H, Mack T, Saieraj J, et al. Boswellic acids: Novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther 1992;261:1143-6.
18. Singh GB, Atal CK. Pharmacology of an extract of salai guggal ex-Boswellia serrata, a new non-steroidal anti-inflammatory agent. Agents Actions 1986;18:407-12.
19. 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.
20. Etzel R. Special extract of Boswellia serrata (H15) in the treatment of rheumatoid arthritis. Phytomed 1996;3:91-4.
Last Review: 07-22-2014
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