Boswellia benefits and side effects

Boswellia is an herbal extract taken from the Boswellia serrata tree that is used to help treat osteoarthritis, joint pain, bursitis and tendonitis.

It’s found in many joint supplements.

Also known as Indian frankincense, it is traditionally used in Indian Ayurvedic medicine and may also be helpful in treating ulcerative colitis, abdominal pain, rheumatoid arthritis and asthma (1, 2, 3).

Benefits

Gum resin extracts from the bark of the boswellia tree contain biologically active acids that have strong anti-inflammatory and pain-relieving properties (4) and have been used in the treatment of various types of chronic inflammatory diseases.

The resin contains monoterpenes, diterpenes, triterpenes, tetracyclic triterpenic acids and four major pentacyclic triterpenic acids. These acids have been shown in studies to prevent the formation of inflammatory-causing enzymes (5) and molecules known as leukotrienes (6).

Boswellia may significantly improve symptoms of osteoarthritis. Osteoarthritis (OA) is a common degenerative joint disease in which the cushioning cartilage between the bone joints gradually wears away, leading to pain, swelling and difficulty moving the joint (7).

Several clinical trials conducted in the past decade have repeatedly shown the efficacy of boswellia serrata extract in reducing pain and improving joint function and movement (8). In one randomized double-blind, placebo-controlled study involving 30 patients with OA of the knee, 15 were given specially manufactured boswellia extract and 15 received a placebo. At the end of the study, all of the patients who received the extract drug treatment reported a decrease in knee joint pain, improved knee flexion, increased walking distance and a decrease in the frequency of swelling of the knee (9).

In another study, Aflapin, a synergistic composition derived from boswellia serrata gum resin, was given to OA patients. Significant improvements in both pain and functional ability were reported as early as seven days (10) in those who took a daily dose of 100 mg.

Treatment of OA with boswellic acid comes in topical cream and pill form. A study performed to assess the effectiveness of the oral or topical administration showed that cartilage loss was significantly reduced in mice whether they were treated with oral or topical boswellic acid. Inflammation and the formation of osteophytes, or painful, tender bone spurs, were also reduced (11).

Results are mixed on the effectiveness of boswellia for the treatment of rheumatoid arthritis. According to Penn State Hershey, some studies have found that it relieved pain and swelling, while several others have found it to be no more efficacious than a placebo (12). More research is needed to form a more accurate conclusion.

Boswellia may alleviate symptoms of bronchial asthma. In a double-blind, placebo-controlled study, 40 patients who were suffering from bronchial asthma were treated with 300 mg of gum resin three times a day for six weeks. At the end of the study, 70 percent of patients showed a marked improvement and even disappearance of symptoms such as dyspnea (difficulty breathing), rhonchi (rattling lung sounds) and a decrease in the number of reported asthma attacks (13).

Boswellia serrata extract controls symptoms of mild irritable bowel syndrome. Irritable bowel syndrome is a chronic gastrointestinal disorder that causes cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. Seventy-one patients were given Casperome supplementation (made from boswellia serrata extract) and were evaluated for four weeks. Researchers found that many of the symptoms, namely abdominal pain and altered bowel movements, improved during the observational period. In addition, patients reported lower incidences of side effects, mainly stypsis (14).

Boswellia serrata gum resin shows positive effects on those with ulcerative colitis, a chronic inflammatory disease of the colon. Patients suffering from moderate to severe ulcerative colitis were given a 350 mg gum resin preparation three times a day for six weeks. At the end of the study, all parameters tested improved, including stool properties, blood results and histolopathology. In conclusion, researchers found that 82 percent of treated patients went into remission (15).

Early studies in animals show the ability of boswellia acids to help inhibit cancer growth. While more in-depth studies are needed, preliminary studies in lab animals show that boswellia compounds may slow down the replication of cancer cells and cause cell death of some types of cancer cells (16). Researchers from Memorial Sloan Kettering Cancer Center stress that its anticancer effects have not yet been shown in humans (17).

Boswellia has a similar effect on inflammation as anti-inflammatory drugs (NSAIDs). Unlike the long-term use of NSAIDS, however, boswellia does not appear to cause stomach irritation or ulcerations. (18).

Side Effects

Boswellia is generally safe when used as directed and under the care of a physician.

Side effects may include stomach pain, nausea and diarrhea (19).

Boswellia may cause a skin allergy. When applied topically for the treatment of OA, boswellia serrata extract may cause allergic contact dermatitis in the area in which it was applied.

Boswellia may increase the risk of bleeding in those who are taking anticoagulant and/or anti-platelet medications (21). Medications to look out for include aspirin, clopidogrel (Plavix) or warfarin (Coumadin).

It may also affect how drugs that are substrates of P-Glycoprotein (P-gp) are absorbed or metabolized (22).

Not enough is known about the safety of using boswellia during pregnancy or breastfeeding. Safety in use by children and those with severe liver or kidney disease also has not yet been studied (20).

As with any other medication or herb, it is important to speak to your doctor about the safety of boswellia use.

Recommended dosage

The dosage depends on the condition being treated along with several factors such as the patient’s overall health and medical conditions. General recommendations are as follows (23):

Osteoarthritis: 333 mg of Boswellia extract taken orally three times daily

Ulcerative colitis: 350 mg gum resin preparation taken orally three times a day.

Bronchial asthma: 300 mg taken orally three times a day.

Inflammatory bowel disease: typically 300-500 mg taken orally two to three times daily, but sometimes higher doses are recommended.

Recap

Gum resin extracts from the bark of the boswellia tree contain biologically active acids that have shown to have strong anti-inflammatory and pain-relieving properties.

Available in topical and pill form, boswellia has shown promise in treating osteoarthritis, bronchial asthma, irritable bowel syndrome, ulcerative colitis and other types of chronic inflammatory disease. More studies and trials are needed to better evaluate its efficacy, safety and long-term effects on rheumatoid arthritis and cancer in humans.

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