Boswellia: benefits, dosage, contraindications
Other name(s)
Olibanum, frankincense tree
Scientific name(s)
Boswellia serrata, Boswellia carteri, Boswellia sacra, Boswellia papyrifera
Family or group:
Plants
Active ingredients:
Boswellic acid
Beta-boswellic acid
Frankincense acetate
3-O-acetyl-11-keto-β-boswellic acid
Indications
Scoring methodology
EFSA approval.
Osteoarthritis ✪✪✪✪✪
A meta-analysis of small randomized controlled trials conducted in patients with knee osteoarthritis shows that taking Boswellia extract (B. serrata) at 100 to 250 mg per day for 1 to 3 months moderately reduces pain and improves function compared with placebo. The included studies tested a specific Boswellia serrata extract (5-Loxin), as well as a specific Boswellia serrata gum-resin extract (known as Aflapin). More recent data on the use of a Boswellia gum-resin extract (Aflapin) at 100 mg per day for 30 days are consistent with the results of this meta-analysis. Other studies have tested synergistic combinations; examples include Boswellia 100 mg with ashwagandha 450 mg, turmeric 50 mg and zinc 50 mg (Articulin-F) three times daily for 3 months, or 1 g of Boswellia serrata extract, 100 mg of curcumin, 1 g of Harpagophytum tubers, and 330 mg of ginger rhizome per day for 36 weeks
Posologie
Oral: resin
250 mg
3 months
essential oil, standardized extract
Synergies
Double-blind trial of solid lipid Boswellia serrata particles (SLBSP) vs. standardized Boswellia serrata gum extract (BSE) for osteoarthritis of knee
Boswellic Acids and Their Role in Chronic Inflammatory Diseases
Boswellia–Curcumin Preparation for Treating Knee Osteoarthritis: A Clinical Evaluation
Prospective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis
A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee
Efficacy and Tolerability of Boswellia Serrata Extract in Treatment of Osteoarthritis of Knee--A Randomized Double Blind Placebo Controlled Trial
Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis
Efficacy and Safety of Aflapin®, a Novel Boswellia Serrata Extract, in the Treatment of Osteoarthritis of the Knee: A Short-Term 30-Day Randomized, Double-Blind, Placebo-Controlled Clinical Study
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
Arthritis ✪✪✪✪✪
Boswellia is frequently used in Ayurvedic medicine to treat inflammatory disorders, such as arthritis. For inflammatory conditions, 300-400 mg of a standardized extract (containing 60% boswellic acids) three times a day is recommended.
Posologie
Oral: resin
900 - 1200 mg
essential oil, standardized extract
Boswellic Acids and Their Role in Chronic Inflammatory Diseases
Boswellia–Curcumin Preparation for Treating Knee Osteoarthritis: A Clinical Evaluation
A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee
Efficacy and Tolerability of Boswellia Serrata Extract in Treatment of Osteoarthritis of Knee--A Randomized Double Blind Placebo Controlled Trial
Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis
A commercialized dietary supplement alleviates joint pain in community-dwelling adults: a double-blind, placebo-controlled community trial
Ulcerative colitis ✪✪✪✪✪
An animal study was conducted in rats to determine the efficacy of Boswellia extract and one of its components, acetyl-11-keto-β-boswellic acid (AKBA), on leukocyte–endothelial interactions in inflammatory bowel disease. Ulcerative colitis was induced in rats by subcutaneous injection of indomethacin. The animals then received either Boswellia, or AKBA at two different doses (low or high), or a placebo. It was observed that Boswellia extract, and both doses of AKBA, reduced leukocyte rolling (by up to 90%) and leukocyte adhesion (by up to 98%), attenuated tissue lesion scores, and substantially reduced macroscopic and microscopic inflammation of the intestinal mucosa. According to another study, leukotrienes may play a role in the inflammatory process of ulcerative colitis. A Boswellia extract (350 mg three times a day) was compared with sulfasalazine (1 g three times a day) in patients with ulcerative colitis. Patients taking the Boswellia extract showed greater improvement than those on sulfasalazine. Indeed, 82% of patients treated with the Boswellia extract entered remission, compared with 75% of those on sulfasalazine. A follow-up study of patients with chronic colitis taking Boswellia serrata gum resin (900 mg per day in three divided doses for six weeks) or sulfasalazine (3 g per day in three divided doses for six weeks) showed similar improvements. Furthermore, 14 of the 20 patients (70%) treated with Boswellia serrata gum resin entered remission compared with 4 of 10 patients (40%) treated with sulfasalazine.
Posologie
By mouth: resin
900 - 1050 mg
6 - weeks
hydroalcoholic extract, standardized extract, dry extract
Effects of Boswellia Serrata Gum Resin in Patients With Ulcerative Colitis
Effects of Gum Resin of Boswellia Serrata in Patients With Chronic Colitis
Managing ulcerative colitis in remission phase: usefulness of Casperome®, an innovative lecithin-based delivery system of Boswellia serrata extract
Acetyl-11-keto-beta-boswellic Acid, a Constituent of a Herbal Medicine From Boswellia Serrata Resin, Attenuates Experimental Ileitis
Skin healing ✪✪✪✪✪
Clinical research shows that the topical application of a cream containing a 2% Boswellia extract twice a day for about 5 weeks during radiotherapy reduces erythema. In dermatology, frankincense essential oil is healing, firming, and is recommended to treat scars, stretch marks or wrinkles.
Posologie
Topical: resin
essential oil
Effects of topical boswellic acid on photo and age-damaged skin: clinical, biophysical, and echographic evaluations in a double-blind, randomized, split-face study
Clinical evaluation of safety and efficacy of Boswellia-based cream for prevention of adjuvant radiotherapy skin damage in mammary carcinoma: a randomized placebo controlled trial
Neurodegenerative diseases ✪✪✪✪✪
The neuroprotective potential of Boswellia resin against age-related morphological changes and concurrent cognitive deficits could make it a therapeutic agent in neurodegenerative diseases. The neuroprotective effects of Boswellia are likely related to its anti-inflammatory, anti-apoptotic, and antioxidant activities. Several clinical trials including patients with brain tumors, traumatic brain injuries such as diffuse axonal injury, multiple sclerosis (MS), or healthy elderly subjects, have highlighted the role of extracts from several Boswellia species in attenuating cerebral edema and disruption of the blood-brain barrier, reducing neurological deficits, and improving cognitive outcomes. In a randomized, parallel, double-blind, placebo-controlled clinical trial, administration of Boswellia (B. serrata) and lemon balm extracts (290 mg and 27 mg, for one month) improved memory in 70 older adults. Overall, this evidence provides preliminary support for the efficacy of the Boswellia genus (B. serrata and B. papyrifera) in cognitive improvement.
Posologie
Oral administration: resin
250 - 4200 mg
hydroalcoholic extract, standardized extract, dry extract
Synergies
Boswellic Acids and Their Role in Chronic Inflammatory Diseases
The effect of tablet containing Boswellia serrata and Melisa officinalis extract on older adults' memory: A randomized controlled trial
Genus Boswellia as a new candidate for neurodegenerative disorders
Effect of Boswellia papyrifera on cognitive impairment in multiple sclerosis
The effect of Boswellia Serrata on neurorecovery following diffuse axonal injury
Crohn's disease ✪✪✪✪✪
The chemical mediators of inflammation were studied in a clinical trial comparing a Boswellia serrata extract to mesalazine in the treatment of acute Crohn's disease. The study population included 44 patients treated with Boswellia extract and 39 patients treated with mesalazine. Between the start and the end of treatment, the Crohn's disease activity index decreased significantly with both Boswellia extract and mesalazine. Although the difference between the two treatments was not statistically significant, the Boswellia extract proved to be as effective as the anti-inflammatory drug (mesalazine).
Posologie
Oral: resin
1200 - 3600 mg
8 days
hydro-alcoholic extract, standardized extract, dry extract
Asthma ✪✪✪✪✪
In a 1998 study on the effects of Boswellia on bronchial asthma, 40 patients took 300 mg of a Boswellia preparation three times a day for six weeks, while 40 other patients took a placebo. 70% of patients taking Boswellia showed a significant improvement in their symptoms and in objective measures of pulmonary and immune function; whereas only 27% of patients taking a placebo had an improvement in their symptoms. Boswellia is frequently used in Ayurvedic medicine to treat inflammatory disorders, such as asthma. Boswellic acid, the main constituent of Boswellia, inhibits the synthesis of 5-lipoxygenase and leukotrienes, substances that cause narrowing of the airways, which helps improve breathing. For inflammatory or asthmatic conditions, 300–400 mg of a standardized extract (containing 60% boswellic acids) three times a day is suggested.
Posologie
Oral: resin
900 - 1200 mg
6 weeks
Essential oil, hydroalcoholic extract, standardized extract, dry extract
Irritable bowel syndrome ✪✪✪✪✪
Preliminary clinical research conducted on patients with mild irritable bowel syndrome (IBS) shows that taking a lecithin-based boswellia extract at 250 mg per day for 6 months reduces abdominal pain, cramps, and gas compared with standard treatment. Patients receiving the boswellia extract required fewer rescue medications and had a 46% lower risk of needing additional medical care, including hospitalization.nnIt should be noted that in a shorter 4-week trial, although IBS symptoms improved compared with baseline, there were no significant differences between the boswellia extract and standard treatment options.nn
Posologie
Oral: resin
250 mg
6 months
Casperome®
Synergies
Oral administration of a lecithin-based delivery form of boswellic acids (Casperome®) for the prevention of symptoms of irritable bowel syndrome: a randomized clinical study
Supplementation with a lecithin-based delivery form of Boswellia serrata extract (Casperome®) controls symptoms of mild irritable bowel syndrome
Wrinkles ✪✪✪✪✪
In preliminary clinical trials, the application of a 0.5% boswellia cream to the face significantly reduced fine lines, tactile roughness, and photoaging scores in women.nnIn dermatology, frankincense essential oil has wound-healing and firming properties and is recommended to help combat wrinkles.nn
Posologie
Topical: resin
essential oil
Effects of topical boswellic acid on photo and age-damaged skin: clinical, biophysical, and echographic evaluations in a double-blind, randomized, split-face study
Clinical evaluation of safety and efficacy of a Boswellia-based cream for prevention of adjuvant radiotherapy skin damage in breast carcinoma: a randomized, placebo-controlled trial
Emotional balance ✪✪✪✪✪
Major studies by Moussaieff et al. revealed that frankincense and its acetate are inhibitors of nuclear factor-κB, which suggests their contribution to the overall anti-inflammatory activity known for frankincense. It is noteworthy that incensole acetate showed strong neuroprotective activity following brain trauma in mice. The antidepressant and anxiolytic effects of incensole acetate have been demonstrated in mice. Incensole and its acetate have shown the traditional effects of frankincense: exceptional anti-inflammatory and antidepressant activity. Furthermore, naturally derived incensole and incensole acetate are lipophilic in nature, which is a limiting factor in terms of bioavailability. Boswellia papyrifera and Boswellia elongata are the two main sources of incensole and its acetate. The methanol extract of Boswellia papyrifera contains the largest amounts of incensole (18.4%), followed by an n-hexane fraction (13.5%) and an ethyl acetate fraction (3.6%). It should be noted that only trace amounts were detected in fractions of Boswellia sacra (B. carteri) and Boswellia serrata.
Posologie
By inhalation: resin
essential oil
Incensole Acetate: A Novel Neuroprotective Agent Isolated from Boswellia Carterii
Evaluating the efficacy of a mixture of Boswellia carterii, Zingiber officinale, and Achillea millefolium on the severity of symptoms, anxiety, and depression in patients with irritable bowel syndrome
Distribution of the anti-inflammatory and antidepressant compounds incensole and incensole acetate in the genus Boswellia
Properties
Anti-inflammatory
Preliminary research has shown that certain Boswellia extracts have anti-inflammatory, analgesic, and anti-arthritic effects. Boswellic acids inhibit 5-lipoxygenase (the enzyme involved in the production of certain chemicals in the body called leukotrienes, which play a role in inflammatory processes), reduce leukotriene synthesis, and inhibit leukocyte elastase (an enzyme produced by certain white blood cells that can damage tissues during inflammatory responses), which are the likely mechanisms underlying their anti-inflammatory and analgesic properties. Boswellic acids may also decrease the degradation of glycosaminoglycans (called GAGs; these are essential components of cartilage that help maintain its elasticity and shock-absorbing capacity) and cartilage damage. Boswellic acids can reduce the levels of other enzymes involved in conditions such as arthritis, including glutamic-pyruvic transaminase, glycohydrolase, and beta-glucuronidase. Other preliminary research also suggests that boswellic acids stabilize mast cells, which suggests their usefulness for asthma.
Usages associés
Analgesic
Administration of a non-phenolic fraction of crude Boswellia produced analgesia in 60% of rats treated with a dose of 60.0 mg/kg. The degree of analgesia was comparable to a dose of 3-4.5 mg/kg of morphine. A dose of 150.0 mg/kg also produced a 70% reduction in spontaneous motor activity that lasted 2 hours.
Usages associés
Immunomodulatory
Boswellia may inhibit mediators of autoimmune diseases. It appears to reduce antibody production and cell-mediated immunity. However, Boswellia oil and boswellic acids also have immune-stimulating effects, enhancing white blood cell activity in laboratory tests.
Usages associés
Anticancer
Boswellia may be useful in the treatment of cancer. Preliminary research suggests that boswellic acids, including 3-O-acetyl-11-keto-beta-boswellic acid (AKBA), have antiproliferative and pro-apoptotic effects on cancer cells. The anticancer effects of Boswellia have been demonstrated in some human studies (a trial with Boswellia serrata on cerebral edema in patients irradiated for brain tumors). Potential mechanisms may involve apoptosis and inhibition of invasion.
Neurological
Boswellic acids may also have interesting potential in the treatment of central nervous system disorders such as Parkinson's disease, Alzheimer's disease, and cognitive disorders. The effects of α-boswellic acids have been studied in primary human fetal astrocytes (cells that form the neuronal environment) under a stress paradigm as a likely model of Alzheimer's disease; the results showed that α-boswellic acids could be considered an effective remedy for preventing and reducing the progression of Alzheimer's disease in astrocytes. In a mouse neuroinflammatory model, AKBA (3-O-acetyl-11-keto-β-boswellic acid) demonstrated anti-apoptotic and anti-amyloidogenic effects via modulation of miRNA-155 (a microRNA involved in inflammation). Furthermore, boswellic acids showed a neuroprotective role in rat models of cognitive impairment.
Usages associés
Dermatologic effect
In human research, a cream containing boswellic acids may reduce the appearance of skin aging by decreasing sebum and skin laxity, and by increasing its thickness. The study suggests that Boswellia may induce remodeling of skin tissues, potentially through new deposition of collagen and elastic fibers while improving the quality of epidermal keratinization, thereby reducing the skin's tactile roughness.
Usages associés
Antidepressant
Incensole acetate, isolated from the resin of Boswellia, has been found to inhibit activation of nuclear factor-κB, a key transcription factor in the inflammatory response. Some studies suggest that it could serve as a novel neuroprotective agent thanks to this anti-inflammatory activity. Furthermore, the psychoactive properties of incensole acetate have been evaluated by activating TRPV3 channels in the brain. TRPV3 (transient receptor potential vanilloid) is an ion channel associated with heat perception in the skin. The role of TRPV3 channels is still unknown, but TRPV3 mRNA has also been found in neurons throughout the brain. Incensole acetate has been shown to be a potent TRPV3 agonist, which produces anxiolytic and antidepressant-like behavioral effects in mice.
Usages associés
Safe dosage
Adults 18 years and older: 300 mg - 1000 mg
The Boswellia extract at doses up to 1000 mg per day has been used safely in several clinical trials lasting up to 6 months.nnBoswellia extracts are generally standardized based on their boswellic acid content. Extracts are standardized to contain 10 to 30% AKBA (3-O-acetyl-11-keto-beta-boswellic acid) and up to 80% boswellic acid.nnTopically, 2% Boswellia cream has been used safely for 30 days.nn
Interactions
Médicaments
Immunosuppressant: low interaction
In vitro studies show that Boswellia has immunostimulatory properties.nnTheoretically, Boswellia could reduce the effectiveness of immunosuppressant medications. Immunosuppressant medications include azathioprine, basiliximab, daclizumab, muromonab-CD3, mycophenolate, tacrolimus, sirolimus, prednisone, and other corticosteroids.
Substrate of cytochrome P450 enzymes: weak interaction
In vitro, Boswellia inhibits cytochrome P450 1A2 (CYP1A2), cytochrome P450 2C19, cytochrome P450 2C9 (CYP2C9), cytochrome P450 2D6 (CYP2D6), and cytochrome P450 3A4 (CYP3A4).
Precautions
Autoimmune diseases: use with caution
Boswellia may have immunostimulant effects. Theoretically, Boswellia could exacerbate autoimmune diseases by stimulating immune activity.nn
Contraindications
Pregnancy: contraindicated
The essential oil is contraindicated in pregnant women.nnFor internal use, there is not enough reliable information available on the safety of using Boswellia in medicinal amounts.nn
Breastfeeding: contraindicated
The essential oil is contraindicated in breastfeeding women.nnFor internal use, there is not enough reliable information available on the safety of using Boswellia in medicinal amounts.nn
Children up to 7 years: contraindicated
Oral administration is not recommended in children under 7 years, to avoid any risk of seizure (high proportion of monoterpene hydrocarbons, some of which may lower the epileptogenic threshold).nn
