Boswellia Serrata supplement herbal extract benefit for arthritis, dosage, side effects by Ray Sahelian, M.D. use as an anti-inflammatory herbal product, combination and complex with other herbs and natural substances

Boswellia is an Ayurvedic plant that contains anti-inflammatory triterpenoids called boswellic acids. Boswellic acid and its derivatives have anti-carcinogenic, anti-tumor, and blood lipid lowering activities. Dried extracts of the resin of the boswellia serrata tree have been used since antiquity in India to treat inflammatory conditions.

Mechanism of action
Boswellia reduces inflammation. It inhibits proinflammatory 5-lipoxygenase chemicals and blocks leukotriene synthesis. By doing so, it may be helpful in medical conditions involved in inflammation.

Nature's Way buy Boswellia Extract , 65% Boswellic Acids

Boswellia Extract is standardized to 65% boswellic acids, with the researched clinical dose used to support joint health and mobility and is concentrated from the specially processed resins and gums of the tree by the same name. The benefits of this herb are due to the presence of four triterpene acids, especially beta boswellic acid.

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Supplement Facts:
Boswellia serratta dried extract 307 mg   
    Yielding 65% extract, yielding: 200 mg Boswellic Acids

Supplement Facts:
Glucosamine sulfate, Chondroitin sulfate, MSM, CMO complex, Boswellia serrata extract, Curcumin, Cat's claw extract, Devil's claw extract, and Sea Cucumber.

 

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Potential benefits and medical uses

Asthma and breathing problems
In a double-blind, placebo-controlled trial, the use of 300 mg of boswellia serrata 3 times daily led to improvement in signs and symptoms of asthma, including a reduction in asthma attacks.

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.
Known in Indian Ayurvedic system of medicine as Salai guggal, contains boswellic acids, which have been shown to inhibit leukotriene biosynthesis. In a double-blind, placebo-controlled study forty patients with bronchial asthma were treated with a preparation of boswellia gum resin of 300 mg thrice daily for a period of 6 weeks. 70% of patients showed improvement of disease as evident by disappearance of physical symptoms and signs such as dyspnoea, rhonchi, number of attacks, increase in FEV subset1, FVC as well as decrease in eosinophilic count and ESR. In the control group only 27% showed improvement.

Cancer
Cytostatic and apoptosis-inducing activity of boswellic acids toward malignant cell lines in vitro.
Anticancer Res. 2002.
Boswellic acids from frankincense were indentified as the active compounds which inhibit leukotriene biosynthesis, 5-lipoxygenase and exert antiproliferative activity toward a variety of malignant cells. Because of the relevance for the clinical application, we tested the ethanolic extract of Boswellia serrata gum resin containing a defined amount of boswellic acids for its cytotoxic, cytostatic and apoptotic activity on five leukemia and two brain tumor cell lines. The extract induced dose-dependent antiproliferative effects on all human malignant cells tested.

Colitis, chronic
Effects of gum resin of Boswellia serrata in patients with chronic colitis.
Planta Med. 2001.
Patients studied here suffered from chronic colitis characterized by vague lower abdominal pain, bleeding per rectum with diarrhoea and palpable tender descending and sigmoid colon. The inflammatory process in colitis is associated with increased formation of leukotrienes causing chemotaxis, chemokinesis, synthesis of superoxide radicals and release of lysosomal enzymes by phagocytes. The key enzyme for leukotriene biosynthesis is 5-lipoxygenase. Boswellic acids were found to be non-redox, non-competitive specific inhibitors of the enzyme 5-lipoxygenase. We studied the gum resin of Boswellia serrata for the treatment of this disease. Thirty patients, 17 males and 13 females in the age range of 18 to 48 years with chronic colitis were included in this study. Twenty patients were given a preparation of the gum resin of Boswellia serrata (900 mg daily divided in three doses for 6 weeks) and ten patients were given sulfasalazine (3 gm daily divided in three doses for 6 weeks) and served as controls. Out of 20 patients treated with Boswellia gum resin 18 patients showed an improvement in one or more of the parameters: including stool properties, histopathology as well as scanning electron microscopy, besides haemoglobin, serum iron, calcium, phosphorus, proteins, total leukocytes and eosinophils. In the control group 6 out of 10 patients showed similar results with the same parameters. Out of 20 patients treated with Boswellia gum resin 14 went into remission while in case of sulfasalazine remission rate was 4 out of 10.

Crohn's disease
Therapy of active Crohn disease with Boswellia serrata extract H 15.
Z Gastroenterology. 2001.
The purpose of this clinical trial was to compare efficacy and safety of the Boswellia serrata extract H15 with mesalazine for the treatment of active Crohn's disease. The population included 44 patients treated with boswellia and 39 patients treated with mesalazine. The Crohn Disease Activity Index between the status of enrolment and end of therapy after treatment with boswellia was reduced by 90 and after therapy with mesalazine by 53 scores. Considering both safety and efficacy of boswellia serrata extract H15, it appears to be superior over mesalazine in terms of a benefit-risk-evaluation.

Diabetes, blood sugar
Is there anything definitive in the literature about the effects of boswellia on blood sugar? Is it safe for diabetics? I've read conflicting reports that it can raise blood sugar; or can lower it.
    I can only find one rodent study regarding the influence of boswellia in reducing blood sugar and this was boswellia glabra rather than serrata. What happens in rodents may not necessarily happen in humans since the dosages that are used per body weight can be quite different.

Hypoglycemic and other related effects of Boswellia glabra in alloxan-induced diabetic rats.
Indian J Physiol Pharmacol. 2007. Kavitha JV, Rosario JF, Chandran J, Anbu P, Bakkiyanathan. LN College of Pharmacy, Bhopal.
The hypoglycemic effect of the aqueous extract of the leaves and roots of Boswellia glabra was examined using alloxan-induced diabetic rats. A single oral administration of the leaf and root extract decreased the blood glucose level. The continued use of leaf and root extract for 28 days produced significant hypoglycemic effects; also there was a decrease in serum glucose, cholesterol, triglyceride, urea and creatinine levels and enzyme activities (alkaline phosphatase and glucose-6-phosphatase). The use of aqueous extract of Boswellia glabra increased the synthesis of secretory granules in the beta-cell.

Inflammatory bowel disease
In one study of 30 patients aged 18-48 with chronic colitis, 20 were given boswellia extract 300 mg 3 times a week for 6 weeks, and the other 10 were given sulfasalazine, 1 g three times a day. Of the 20 treated, 14 went into remission, as did 4 of the 10 treated with the drug.   Patients were studied at the Department of Medicine, Medical College Jammu, J&K, India suffered from chronic colitis characterized by vague lower abdominal pain, bleeding per rectum with diarrhea and palpable tender descending and sigmoid colon. The inflammatory process in colitis is associated with increased formation of leukotrienes causing chemotaxis, chemokinesis, synthesis of superoxide radicals and release of lysosomal enzymes by phagocytes. The key enzyme for leukotriene biosynthesis is 5-lipoxygenase. Boswellic acids were found to be inhibitors of the enzyme 5-lipoxygenase.

Leukemia research
Inhibitory activity of boswellic acids from Boswellia serrata against human leukemia HL-60 cells in culture.
Planta Med. 1998.
Four major triterpene acids including beta-boswellic acid inhibited the synthesis of DNA, RNA and protein in human leukemia HL-60 cells in a dose dependent manner.

Osteoarthritis
Boswellia serrata has been studied in combination with other herbs. An Ayurvedic herbal combination of ashwagandha, boswellia serrata , and curcumin was evaluated in a randomized, double-blind, placebo controlled, cross-over study in patients with osteoarthritis. Treatment with this formulation produced a significant drop in severity of pain.

You say on your web page "Osteoarthritis -- boswellia serrata has been studied in combination with other herbs. An Ayurvedic herbal combination of ashwagandha, boswellia serrata, and curcumin was evaluated in a randomized, double-blind, placebo controlled, cross-over study in patients with osteoarthritis. Treatment with this formulation produced a significant drop in severity of pain." Do you have a reference for the study? I looked on Pubmed and found a study that has these herbs plus ginger, or these three herbs plus zinc. But not just these three herbs. If you could provide a reference so I can track down this study I would really appreciate it.
   Here is the boswellia osteoarthritis study.

Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee -- a randomized double blind placebo controlled trial.
Phytomedicine. 2003.
Osteoarthritis is a common, chronic, progressive, skeletal, degenerative disorder, which commonly affects the knee joint. Boswellia serrata tree is commonly found in India. The therapeutic value of its gum has been known. It possesses good anti-inflammatory, anti-arthritic and analgesic activity. A randomized double blind placebo controlled crossover study was conducted to assess the efficacy, safety and tolerability of Boswellia serrata extract 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 the herb 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.

Dietary support with Boswellia resin in canine inflammatory joint and spinal disease.
Schweiz Arch Tierheilkd. 2004.
An open multi-centre veterinary clinical trial, comparing conditions before and after treatment with a herbal dietary supplement consisting of a natural resin extract of Boswellia serrata, was conducted by 10 practicing veterinarians in Switzerland. This traditional plant-based supplement is known for its anti-rheumatic and anti-inflammatory properties. 29 dogs with manifestations of chronic joint and spinal disease were enrolled. Osteoarthritis and degenerative conditions were confirmed radiologically in 25 of 29 cases. The Boswellia resin extract (BSB108, product of Bogar AG) was administered with the regular food at a dose of 400 mg/10 kg body weight once daily for 6 weeks. Already after 6 weeks of treatment a statistically significant reduction of severity and resolution of typical clinical signs in individual animals, such as intermittent lameness, local pain and stiff gait, were reported.

I am currently taking prednisone for arthritis symptoms (10 mg tab 1x daily). Would it be advisable to take boswellia supplement before I finish taking the prednisone. How effective is boswellia for joint problems? I have arthritis symptoms and lupus symptoms.
    Research with boswellia supplements as a treatment for osteoarthritis is not extensive but early results show some benefit. As to taking a pill with prednisone or after, that is a decision you and your doctor would need to make.

Dosage
No guidelines have been established as to the ideal dosage of boswellia serrata. One option is to take boswellia 300 to 500 mg 2 or 3 times a day of an extract standardized to contain 30 to 40% boswellic acids. The full effect may take several weeks.

Allergy
Allergic contact dermatitis from Boswellia serrata extract in a naturopathic cream.
Contact Dermatitis. 2004. Department of Dermatology, Hospital de Cruces, Bilbao, Spain.

Safety, long term use, side effects, risk
I have read that boswellis supplement should be taken for no more than 8-12 weeks. Do you agree? I've started taking it recently for tendonitis at my bottom left knee. It helps reduce inflammation from IBS and upper respiratory problems I encounter.
   We have not come across long term human trials to know its long term safety and how often breaks are needed. Plus, each person has a different medical condition, and the length of use could depend on the dosage used, and how potent a boswellia extract is being taken, and also what other medicines or herbs are being used at the same time.

Use by dogs and animals, cats, horses
I was wondering if you have heard of dogs being given boswellia and Metacam. I give her Metacam in the evenings, and I was wondering if the herb could be given in the morning, as an adjunct for arthritis. Any anectodal information would be helpful and appreciated.
    I am not familiar with treating dogs with medicines or herbs, but we have had some owners say that their dog's arthritis seemed to improve with Joint Power Rx, although we don't have first had knowledge of this. Joint Power Rx has boswellia extract.

Interactions with medications
What data is there regarding reaction(s) between Boswellia pills and Atacand (for HBP), Zetia, Wellbutrin, Celexa and Tylenol?
    Boswellia pills have not been studied in relation to these drugs, so little is known about interactions.