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Complementary & Alternative Medicine
Index of Herbal Medicines, Supplements and Therapies
The decision to use products containing or claiming to contain boswellia should be carefully considered.
Boswellia (Boswellia serrata)
Be aware that the U.S. Food and Drug Administration does not strictly regulate herbs and dietary supplements. There is no guarantee of strength, purity or safety of products containing or claiming to contain boswellia. Decisions to use herbs or supplements should be carefully considered. Individuals using prescription drugs should discuss taking herbs or supplements with their pharmacist or health care provider before starting.
Scientists have studied boswellia for the following health problems:
Boswellia may reduce the number of asthma attacks. It is not clear what dose is safe or effective or how boswellia may interact with other asthma treatments. Asthma attacks can be serious, and because there are other well-studied therapies for asthma, the choice of therapy should be discussed with a health care provider.
Boswellia has been used as a cancer treatment but there are not enough human data to support this use over standard therapies. Cancer should be treated by a medical oncologist.
Animal studies of boswellia show that it possesses anti-inflammatory properties. As a result, some studies suggest that boswellia may provide benefits for treating osteoarthritis and rheumatoid arthritis. A recent clinical trial suggests positive effects of Boswellia serrata extract in knee osteoarthritis. The product was well tolerated, except for minor gastrointestinal side effects. Overall, studies in humans have been small, with flaws in their designs, and results of different studies have disagreed with each other. Therefore, it is unclear whether there is any benefit from boswellia for these conditions.
Inflammatory bowel diseases
Because there is a scientific basis for boswellia possessing anti-inflammatory properties, this herb has been proposed as a possible therapy for Crohn's disease and ulcerative colitis. However, there is only limited research in humans using boswellia specifically to treat inflammatory bowel diseases. These studies have been small, with flaws in their designs. Therefore, it is unclear whether there is any benefit from boswellia in these diseases.
Boswellia has been suggested for many other uses, based on tradition or on scientific theories. However, these uses have not been thoroughly studied in humans, and there is limited scientific evidence about safety or effectiveness. Some of these suggested uses are for conditions that are potentially very serious and even life-threatening. You should consult a health care provider before taking boswellia for any unproven use.
Chronic obstructive pulmonary disease
Lack of menstrual period
Peptic ulcer disease
Sexually transmitted diseases
Skin ulcers or sores
Toxin-induced liver damage
Upper respiratory infections
Allergic contact dermatitis has been associated with the use of a naturopathic cream containing Boswellia serrata extract. Avoid in individuals with a known allergy to boswellia, its constituents, or members in the Burseraveae family.
Boswellia has been well tolerated in most studies. Some people may experience stomach discomfort, including nausea, acid reflux (heartburn), a feeling of fullness, stomach pain or diarrhea. Irritation of the skin has been reported from a multiherb product containing boswellia.
Pregnancy And Breast-Feeding
Boswellia cannot be recommended during pregnancy or breast-feeding because of the risk of birth defects or spontaneous abortion.
Interactions with drugs, supplements and other herbs have not been thoroughly studied. The interactions listed below have been reported in scientific publications. If you are taking prescription drugs, speak with your health care provider or pharmacist before using herbs or dietary supplements.
Interactions With Drugs
Laboratory and animal studies suggest that boswellia may increase the effects or toxicity of some drugs. Examples include some drugs used to treat asthma, such as montelukast (Singulair), some anticancer drugs, cholesterol-lowering drugs and some antifungal drugs. However, these interactions have not been studied in humans. In theory, boswellia could reduce the effectiveness of some anti-inflammatory pain relievers, such as aspirin, ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve, Anaprox). Boswellia may interact with immunomodulators, drugs broken down by the liver, antibiotics, fat soluble drugs and sedatives.
Interactions With Herbs And Dietary Supplements
Boswellia may act additively with supplements used to treat joint diseases, such as glucosamine or chondroitin; supplements that may have anticancer properties, such as mistletoe (Viscum album
); antifungal agents, such as tea tree oil (Melaleuca alternifolia
); and cholesterol-lowering supplements, such as garlic
) or red yeast. Beneficial effects and possibly side effects may be increased if boswellia is used with supplements that possess similar properties. As a result, dosages of other agents may need to be reduced.
Meals that are high in fat seem to increase the concentration of boswellia in the body. Boswellia may interact with immunomodulators, herbs and supplements broken down by the liver, antibiotics, fat-soluble drugs, chondroitin, glycosaminoglycans (GAGS) and sedatives.
The doses listed below are based on scientific research, publications or traditional use. Because most herbs and supplements have not been thoroughly studied or monitored, safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients even within the same brand. Combination products often contain small amounts of each ingredient and may not be effective. Appropriate dosing should be discussed with a health care provider before starting therapy; always read the recommendations on a product's label. The dosing for unproven uses should be approached cautiously, because scientific information is limited in these areas.
Safety of use beyond six months has not been studied. Oral doses of 200 to 400 milligrams may be standardized to contain 37.5% boswellic acids per dose. However, gum resins typically contain 30% boswellic acids, ethanol extracts often contain 43% boswellic acids and some sources may contain up to 65% boswellic acids.
Adults (Aged 18 Or Older)
Tablets/capsules: A dose of 300 to 400 milligrams three times per day by mouth has been used.
Tablets/capsules: A dose of 200 to 400 milligrams three times per day by mouth has been used.
There is a lack of high-quality trials that have investigated boswellia for use in brain tumors.
Tablets/capsules: A dose of 350 to 400 milligrams three times per day by mouth has been used.
Tablets/capsules: A dose of 1,200 milligrams three times daily by mouth for up to eight weeks has been used.
Children (Younger Than 18)
There are not enough scientific data to recommend boswellia for use in children, and this herb is not recommended because of potential side effects.
Boswellia has been suggested as a treatment for many conditions. There is some research to support the use of boswellia as a treatment for asthma, although it is not clear what dose is safe and effective. There is not enough scientific evidence to support the use of boswellia for any other medical condition. Boswellia may cause stomach discomfort. It should be avoided in pregnant or breast-feeding women and in children. Safety of use beyond six months has not been well studied. Consult your health care provider immediately if you have any side effects.
The information in this monograph was prepared by the professional staff at Natural Standard, based on thorough systematic review of scientific evidence. The material was reviewed by the Faculty of the Harvard Medical School with final editing approved by Natural Standard.
- Natural Standard: An organization that produces scientifically based reviews of complementary and alternative medicine (CAM) topics
- National Center for Complementary and Alternative Medicine (NCCAM): A division of the U.S. Department of Health & Human Services dedicated to research
Selected Scientific Studies: Boswellia
Natural Standard has reviewed all of the currently available medical literature to prepare the professional monograph from which this version was created.
Some of the more recent studies are listed below:
- Ammon HP. Boswellic acids (components of frankincense) as the active principle in treatment of chronic inflammatory diseases [article in German]. Wien Med Wochenschr 2002;152(15-16):373-378.
- Basch E, Boon H, Davies-Heerema T, et al. Boswellia: an evidence-based systematic review by the Natural Standard Research Collaboration. J Herb Pharmacother 2004;4(3):63-83.
- Chande N, McDonald JW, MacDonald JK. Interventions for treating collagenous colitis.Cochrane Database Syst Rev. 2006 Oct 18;(4):CD003575.
- Gerhardt H, Seifert F, Buvari P, et al. [Therapy of active Crohn disease with Boswellia serrata extract H 15.] Z Gastroenterol 2001;Jan, 39(1):11-17. In German.
- Gupta I, Parihar A, Malhotra P, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med 2001;67(5):391-395.
- Hostanska K, Daum G, Saller R. Cytostatic and apoptosis-inducing activity of boswellic acids toward malignant cell lines in vitro. Anticancer Res 2002;Sep-Oct, 22(5):2853-2862.
- Jaber R. Respiratory and allergic diseases: from upper respiratory tract infections to asthma. Prim Care 2002;Jun, 29(2):231-261.
- 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;Jan, 10(1):3-7.
- Liu JJ, Nilsson A, Oredsson S, et al. Boswellic acids trigger apoptosis via a pathway dependent on caspase-8 activation but independent on Fas/Fas ligand interaction in colon cancer HT-29 cells. Carcinogenesis 2002;Dec, 23(12):2087-2093.
- Natural Standard Research Collaboration, Chief Editors: Ulbricht C, Basch E, Natural Standard Herb and Supplement Reference - Evidence-Based Clinical Reviews, USA: Elsevier/Mosby, 2005.
- Park YS, Lee JH, Harwalkar JA, et al. Acetyl-11-keto-beta-boswellic acid (AKBA) is cytotoxic for meningioma cells and inhibits phosphorylation of the extracellular-signal regulated kinase 1and 2. Adv Exp Med Biol 2002;507:387-393.
- Reichling J, Schmokel H, Fitzi J, et al. Dietary support with boswellia resin in canine inflammatory joint and spinal disease. Schweiz Arch Tierheilkd 2004;Feb, 146(2):71-79.
- Tripathi YB, Reddy MM, Pandey RS, et al. Anti-inflammatory properties of BHUx, a polyherbal formulation to prevent atherosclerosis. Inflammopharmacology 2004;12(2):131-152.
Last updated September 04, 2008
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