Dr Clare Materia Medica

Boswellia

Also known as: Indian Frankincense, Indian Olibanum, Ru Xiang, Salai Guggul.

Scientific name: Boswellia serrata. 

Botanical Family: Burseraceae.

Part used: The medicinal part of Indian frankincense plant is the gum resin. The gum resin is obtained by pulling away the bark of the Indian frankincense tree. 

Traditional use.

Indian frankincense is used for osteoarthritis, rheumatoid arthritis, rheumatism, bursitis, and tendonitis. Other uses include ulcerative colitis, abdominal pain, asthma, allergic rhinitis, sore throat, painful menstruation, acne, and cancer. It is also used as a stimulant, respiratory antiseptic, diuretic, and for stimulating menstrual flow.

Safety.

 There are no safety concerns when used orally and appropriately. Indian frankincense has been safely used in several clinical trials lasting up to ninety days. ^{(1,2, 3, 4, 5, 6, 7, 8, 9, 10)}

Pregnancy: Safe when used orally in amounts commonly found in foods.⁽¹¹⁾ For medicinal use consult an Herbal Medicine Physician.

Breastfeeding: Safe when used orally in amounts commonly found in foods.⁽¹¹⁾ For medicinal use consult an Herbal Medicine Physician.

Constituents

Boswellic acids (triterpenoids)

Essential oils including cymene and thujone

Scientific evidence.

Osteoarthritis. Some clinical research shows that taking specific Indian frankincense extracts can reduce symptoms of osteoarthritis. In two clinical trials, using a specific Indian frankincense extract (5-Loxin) 100 mg daily or 250 mg daily significantly improved pain and functionality scores in patients with osteoarthritis after 90 days of treatment. Pain scores were reduced by about 32% to 65%. Patients began to have significant improvement within 7 days of treatment. The extract used in this study was standardized and enriched to contain 30% of the boswellic acid AKBA. ^(8,9)

One clinical trial evaluated another specific Indian frankincense extract (Aflapin) 100 mg daily. This extract significantly improved pain and functionality scores in patients with osteoarthritis after 90 days of treatment. Pain scores were reduced by about 47%. Patients began to have significant improvement within 7 days of treatment. The extract used in this study was standardized and enriched to contain 20% of the boswellic acid AKBA. ⁽⁹⁾

In a preliminary crossover trial, taking a different Indian frankincense extract, 333mg daily also significantly reduced symptoms of osteoarthritis, such as knee pain and swelling. ⁽³⁾

Ulcerative colitis. Two clinical trials show that taking Indian frankincense can improve some symptoms of ulcerative colitis and some pathological measures. In one study, taking whole plant Indian frankincense resin 350 mg three times daily significantly improved symptoms and disease markers in patients with ulcerative colitis. In this study, about 82% of patients taking Indian frankincense went into remission compared to 75% taking the commonly prescribed drug sulfasalazine.⁽²⁾ In another preliminary clinical study, taking whole plant Indian frankincense resin 300 mg three times for 6 weeks improved symptoms and some measures of disease pathology in about 90% of patients. In this study 70% of patients taking Indian frankincense went into remission compared to 40% taking sulfasalazine 3 grams daily. ⁽⁷⁾

Asthma. There is some preliminary evidence that taking Indian frankincense extract orally might help asthma. It may improve forced expiratory volume, reduce the number of asthma attacks, and decrease clinical signs of asthma. ⁽¹⁾ 

Crohn's disease. There is preliminary evidence that taking Indian frankincense extract orally might reduce some symptoms of Crohn’s disease. One clinical study found that it worked as well as mesalamine (Asacol, Pentasa) for Crohn's disease;⁽⁶⁾ however, other clinical research shows that taking Indian frankincense 800 mg orally three times a day did not increase rates of remissions and quality of life any more than placebo in patients with Crohn's disease. ⁽¹²⁾

Rheumatoid arthritis. There is conflicting research about the usefulness of Indian frankincense extract taken orally for rheumatoid arthritis. ^(4,5) 

Mechanism of action.

The principle constituents of Indian frankincense are boswellic acid and alpha- and beta-boswellic acid, which are thought to have anti-inflammatory properties. ^(13,14) The boswellic acid (AKBA) constituent appears to be the most potent anti-inflammatory constituent. ⁽¹⁴⁾

The gum resin also contains up to 16% essential oils including alpha-thujene and p-cymene. ⁽¹⁵⁾

In preliminary research, some Indian frankincense extracts show anti-inflammatory, analgesic, and anti-arthritis effects; however, not all Indian frankincense-containing products seem to have these effects. ⁽³⁾

Boswellic acids, especially AKBA, inhibit 5-LOX enzymes and reduce leukotriene synthesis and inhibit leukocyte elastase, which are the likely mechanisms for its anti-inflammatory properties. Boswellic acids may also have a disease modifying effect by decreasing  the breakdown of glycosaminoglycan and thus reducing cartilage damage. Indian frankincense may also inhibit mediators of autoimmune disorders. It seems to reduce production of antibodies and cell-mediated immunity. ^(3,7,16,17)

Indian frankincense may be useful in treating cancer. Preliminary research suggests that boswellic acids have an anti-proliferative effect and an effect of increasing the rate of cell death (apoptosis) in cancer cells. ⁽¹⁶⁾

Preliminary research suggests that boswellic acids stabilize mast cells, this suggests usefulness for asthma and other allergic conditions.⁽¹⁸⁾ Other preliminary research suggests that boswellic acids might help prevent organ rejection and ischemia/reperfusion injury.⁽¹⁹⁾

Indian frankincense has an elimination half-life of 6 hours from the blood stream.⁽²⁰⁾

Adverse reactions.

Indian frankincense is well-tolerated. Side effects reported in clinical trials did not occur more commonly than placebo. ⁽⁸⁾ Some reported side effects include diarrhea, nausea, abdominal pain, and heartburn. ^{(3,7,8 ,9 ,10)} No serious adverse events have been documented.⁽¹⁰⁾ 

Interactions with herbs and supplements.

None known.

Interactions with drugs.

None known.

Interactions with foods.

None known.

Interactions with lab tests.

None known.

Interactions with diseases or conditions.

None known.

Dosage.

For osteoarthritis, a specific Indian frankincense extract (5-Loxin) 100 mg daily or 250 mg daily has been used.⁽⁸⁾ Indian frankincense extract 333 mg three times daily has been used. ⁽³⁾

For rheumatoid arthritis, Indian frankincense extract 3,600 mg daily has been used. ⁽⁴⁾

For Crohn's disease, 800 mg three times daily has been used. ⁽²¹⁾

For ulcerative colitis, a gum resin preparation of 300-350 mg three times daily has been used. ^(2,7)

For asthma, 300 mg three times daily has been used. ⁽¹⁾