Boswellia or Indian frankincense, is an ayurvedic herb that is derived from the resin of the plant Boswellia serrata. It is used traditionally to treat arthritis, ulcerative colitis, coughs, sores, snakebite, and asthma. Its major component is boswellic acid (1), which was shown in animal studies to be a potent 5-lipoxygenase inhibitor with anti-inflammatory and antiarthritic effects (1) (2) (3). Boswellic acid seems to have fewer adverse effects than steroids and non-steroidal anti-inflammatory drugs. However, its long-term effects on humans are unknown. Although similar in many functions, boswellia should not be confused with guggul or myrrh.
Boswellic acid, the major constituent of boswellia, is thought to contribute to most of the herb's pharmacological activities. In vitro studies and animal models show that boswellic acid inhibits 5-lipoxygenase selectively (1) (3) and has anti-inflammatory (4) and antiarthritic effects (2). Boswellia has also been shown to reduce chemically-induced edema and inflammation in rodents.
A randomized double blind placebo controlled crossover study was conducted to assess the efficacy, safety and tolerability of Boswellia serrata Extract (BSE) in 30 patients of osteoarthritis of knee, 15 each receiving active drug or placebo for eight weeks. After the first intervention, washout was given and then the groups were crossed over to receive the opposite intervention for eight weeks. All patients receiving drug treatment reported decrease in knee pain, increased knee flexion and increased walking distance. The frequency of swelling in the knee joint was decreased. Radiologically there was no change. The observed differences between drug treated and placebo being statistically significant, are clinically relevant. BSE was well tolerated by the subjects except for minor gastrointestinal ADRs. BSE is recommended in the patients of osteoarthritis of the knee with possible therapeutic use in other arthritis (5).
A typical dose of boswellia is 300 to 400 mg 3 times a day of an extract standardized to contain 37.5% boswellic acids. Some studies have used dosages as high as 1,200 mg 3 times daily.
- Dahmen U, Gu YL, Dirsch O, et al. Boswellic acid, a potent antiinflammatory drug, inhibits rejection to the same extent as high dose steroids. Transplant Proc. Feb-Mar 2001;33(1-2):539-541.
- Safayhi H, Boden SE, Schweizer S, et al. Concentration-dependent potentiating and inhibitory effects of Boswellia extracts on 5-lipoxygenase product formation in stimulated PMNL. Planta Med. Mar 2000;66(2):110-113.
- Safayhi H, Mack T, Sabieraj J, et al. Boswellic acids: novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther. Jun 1992;261(3):1143-1146.
- Madisch A, Miehlke S, Eichele O, et al. Boswellia serrata extract for the treatment of collagenous colitis. A double-blind, randomized, placebo-controlled, multicenter trial. Int J Colorectal Dis. Dec 2007;22(12):1445-1451.
- Kimmatkar N, Thawani V, Hingorani L, et al. 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.