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Boswellia Serrata, New Uses for an Old Plant

Article at-a-glance:

  • Boswellia serrata possesses supports healthy inflammatory activity, with six potent acids that significantly inhibit pro-inflammatory compounds in the body.
  • The most potent of these acids is thought to be acetyl-11-keto-β-boswellic acid (AKBA)
  • Clinical trials show Boswellia promotes joint health, healthy joint mobility, and joint comfort in people with knee osteoarthritis
  • Boswellia also may also help other inflammatory conditions, such as asthma and colitis
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Boswellia serrata is an ancient and treasured herb prized in Ayurvedic medicine and used in oil form in sacred ceremonies in Persia, Babylon, Rome, and Greece.[1] In fact, the medicinal power of the Boswellia tree’s dried gum resin, known as “Guggul”, was described as far back as 1700 BC in a sacred Sanskrit text, Sushrut Samhita.[2] It was such an important plant that it was one of the gifts brought to Jesus when he was born. As told in Matthew 2:1-12, an infant Jesus was visited by three Magi bearing gifts of gold, frankincense (Boswellia serrata), and myrrh.

Today the plant is revered for its powerful and broad-spectrum and ability to breakdown inflammatory molecules. Boswellic acids—the biologically active molecules in Boswellia—have been shown in numerous studies to significantly inhibit compounds in the body that increase inflammation.[3],[4],[5] There are six boswellic acids, but it is thought that acetyl-11-keto-β-boswellic acid (AKBA) is the most potent one, able to significantly inhibit an enzyme that increases inflammation, called 5-lipoxygenase.[6],[7]

The plant also counters inflammation by helping regulate many other pro-inflammatory molecules in the body, such as prostaglandins, interleukins, tumor necrosis factor (TNF), and nuclear factor- κB (NF-κB).[8] They also directly counter highly inflammatory molecules called lipopolysaccharides, also known as endotoxins, which are created by gram-negative bacteria.[9] These bacteria can create dangerous infections, including pneumonia, peritonitis (inflammation of the lining of the abdominal cavity), urinary tract infections (UTI), blood infections, meningitis, and wound and surgical site infections.

This powerful quenching of inflammation is good news since chronic inflammation contributes to so many health conditions. These include asthma, chronic colitis, and ulcerative colitis, Crohn’s disease, rheumatoid arthritis, osteoarthritis, ulcers, eczema, atherosclerosis, diabetes, and more.[10]

Arthritis: Where Boswellia Shines

Both osteoarthritis and rheumatoid arthritis are painful, chronic conditions. Around 27 million Americans suffer from osteoarthritis, and the risk of developing the condition increases with age.[11] By 2040, according to the CDC, 78 million Americans are projected to have doctor-diagnosed arthritis.[12]

Osteoarthritis is marked by the irreversible destruction of articular cartilage, which is a highly specialized connective tissue in the joints, meant to provide a smooth and lubricated surface. The condition leads to bone erosion, triggered by pro-inflammatory molecules, pain, swelling, and decreased mobility. Collagen is degraded as well.

Rheumatoid arthritis is a chronic progressive autoimmune disease, and though medications effectively treat symptoms, they have many side effects. Like with osteoarthritis, the destruction of joints in rheumatoid arthritis also involves chronic inflammation.

Boswellia has been shown to reduce inflammation and protect joints. In animal studies of arthritis, numerous inflammatory mediators were reduced and bone structure improved.[13] Human studies confirm these results. In a randomized, double-blind, placebo-controlled clinical trial of 75 volunteers with osteoarthritis, a Boswellia extract standardized to 30% AKBA, led to improved pain and physical functioning. The participants took 100 mg or 250 mg of Boswellia extract daily for three months. Both doses of Boswellia extract led to clinically significant improvements in pain and physical function.[14]

Not only has Boswellia been shown to improve the symptoms of osteoarthritis, but it also has beneficial effects on joint anatomy. Bone spurs (also called osteophytes) are hard bumps of extra bone that form on the ends of bones. When they grow into joints they can create pain. Boswellia’s effectiveness was demonstrated in a double-blind, placebo-controlled study of 48 patients with knee osteoarthritis. For four months, participants were given either Boswellia or a placebo, and x-rays showed an improved knee joint gap and reduced spurs.[15]

Boswellia is rapidly acting. Indeed, a double-blind, randomized, placebo-controlled study found that Boswellia reduced pain and increased functionality within a week.[16] Finally, a review of seven different studies involving 545 individuals found that Boswellia relieved pain and stiffness, and was a safe and helpful option.[17]

Asthma: Breathe Easy with Boswellia

Asthma is a chronic inflammatory disease of the respiratory tract, and over 25 million Americans suffer from it–including 7.7 percent of adults and 8.4 percent of children.[18] Symptoms include wheezing, breathlessness, and chest tightness.

A double-blind, placebo-controlled study on asthma followed 40 asthma sufferers who either took Boswellia three times a day or a placebo for 6 weeks. Seventy percent of those taking Boswellia improved, with less wheezing, fewer attacks, better breathing ability, and even lower levels of white blood cells associated with allergy.[19]

Colon Health

Boswellia has also been studied for chronic colitis, which is inflammation in the colon. Volunteers were given 900 milligrams of a Boswellia serrata extract (divided into 3 doses daily) for six weeks. Eighteen of the 20 volunteers taking Boswellia improved, and 14 experienced such dramatic improvement that they were considered in “remission.”[20] Other studies on inflammatory conditions such as Crohn’s disease have had equally promising results.[21]

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[1]Howes FN. Age-old resins of the Mediterranean region and their uses. Econ Bot. 1950;4:307–16. [Article]

[2]Kunnumakkara AB, Banik K, Bordoloi D et al. Googling the Guggul (Commiphora and Boswellia) for prevention of chronic diseases. Front Pharmacol. 2018 Aug 6;9:686 [Article]

[3]Verhoff M, Seitz S, Paul M et al. Tetra- and pentacyclic triterpene acids from the ancient anti-inflammatory remedy frankincense as inhibitors of microsomal prostaglandin E(2) synthase-1 J Nat Prod. 2014;77(6):1445–51. [Article]

[4]Ammon HP. Boswellic acids in chronic inflammatory diseases. Planta Med. 2006;72(12):1100-1116. [Article]

[5]Iram F, Khan SA, Husain A. Phytochemistry and potential therapeutic actions of Boswellic acids: A mini-review. Asian Pac. J. Trop. Biomed. 2017, 7, 513–523. [Article]

[6]Shah BA, Qazi GN, Taneja SC. Boswellic acids: a group of medicinally important compounds. Nat Product Rep, 26 (1) (2009), pp. 72-89 [Article]

[7]Siddiqui MZ. Boswellia serrata, a potential anti-inflammatory agent: an overview. Indian J Pharm Sci. 2011 May;73(3):255-61 [Article]

[8]Roy NK, Parama D, Banik K, et al. An Update on Pharmacological Potential of Boswellic Acids against Chronic Diseases. Int J Mol Sci. 2019;20(17):4101. August 2019 [Article]

[9]Henkel A, Kather N, Mönch B et al. Boswellic acids from frankincense inhibit lipopolysaccharide functionality through direct molecular interference. Biochem Pharmacol. 2012 Jan 1;83(1):115-2 [Article]

[10]Ammon HP. Boswellic Acids and Their Role in Chronic Inflammatory Diseases. Adv Exp Med Biol. 2016;928:291-327 [Article]

[11]Zelman D. The basics of osteoarthritis. Web MD. 2020 [Report]

[12]Arthritis Related Statistics. CDC July 2018 [Report]

[13]Umar S, Umark K, Sarwar AH et al. Boswellia serrata extract attenuates inflammatory mediators and oxidative stress in collagen induced arthritis. Phytomedicine. 2014;21(6):847–56 [Article]

[14]Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-LOXIN for treatment of osteoarthritis of the knee. Arthritis Res Ther. 2008;10(4):R85. [Article]

[15]Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res. 2019 May;33(5):1457-1468. [Article]

[16]Vishal, AA, Misrha A, Raychaudhuri SP.  A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee. Int. J. Med. Sci. 2011, 8, 615–622. [Article]

[17]Yu G, Xiang W, Zhang T et al. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complement Med Ther. 2020 Jul 17;20(1):225. [Article]

[18]Asthma and Allergy Foundation of America. Asthma Facts and Figures. June 2019. [Report]

[19]Gupta I, Gupta V, Pahihar A, Gupta S, et al. 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 Nov 17;3(11):511-4. [Article]

[20]Gupta I, Parihar A, Malhotra P. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med. 2001 Jul;67(5):391-5. [Article]

[21]Gerhardt H, Seifert F, Buvari P et al. Therapy of active Chrohn disease with Boswellia serrata extract H15. Z Gastroenterol 2001 Jan;39(1):11-7 [Article]

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