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Boswellia: Proven To Help Arthritis Pain and Inflammation


General Features
Boswellia is a moderate to large branching tree found in India, whose trunk yields a
gummy oleoresin when tapped. A purified extract of this resin is used in modern herbal
preparations as an effective anti-inflammatory agent in the management of injuries,
arthritis, inflammatory bowel diseases, and certain respiratory illnesses.1,6,7

Principle Active Constituents
Pentacyclic triterpenes – The terpenoid portion gives rise to the boswellic acids that have
been shown to be the active constituents.1

Clinical Application and Mechanism of Action
a. Arthritis – Boswellic acids inhibit the synthesis of pro-inflammatory mediators such as leukotrienes,
by inhibiting the 5-lipoxygenase enzyme.2 Unlike non-steroidal anti-inflammatory drugs,
long-term use of Boswellia does not lead to irritation or ulceration of the stomach.3
Boswellia extract has been shown to reduce inflammation and provide significant
symptom relief in patients with rheumatoid arthritis and osteoarthritis, in several human
b. Ulcerative Colitis – Boswellia extract has been shown to be useful in the treatment of ulcerative colitis in
controlled, double blind studies. In one trial, Boswellia produced a similar benefit as the
drug sulfalazine (1gm, tid), which is used to treat ulcerative colits.4 Other studies
demonstrate its ability to reduce signs and symptoms of Crohn’s disease and chronic
colitis.8,9 In one study Boswellia supplementation performed equally as well as did the
drug mesalazine in Crohns disease patients, and some researchers indicate that given the
benefit to risk evaluation of sulfalazine and mesalazine compared to Boswellia, that
Boswellia appears to be as effective and safer than these drugs for some patients with
inflammatory bowel diseases.4,6,7,8,9
c. Chronic Respiratory Illnesses – Some investigators suggest that Boswellia may be of benefit in the management of
asthma, emphysema and/or chronic bronchitis. In a double-blind, placebo-controlled
study, forty patients with bronchial asthma (18-75 years of age) were treated with
Boswellia extract (300 mg, three time per day) for six consecutive weeks. 70% showed
improvement of the disease as evidenced by disappearance of physical symptoms and
signs of dyspnea (shortness of breath), rhonchi, number of attacks, decreased eosinophil
and ESR blood count, and improved lung capacity and performance test results. In the
placebo group 27% of patients showed overall improvement by comparison. It has been
proposed that the ability of boswellic acids to improve certain chronic respiratory
illnesses results from their biological action involving the inhibition of leukotriene
formation in white blood cells (via inhibition of 5-lipoxygenase enzyme that converts
arachidonic acid to inflammatory leukotienes, e.g. LTB4). 10,11

Dosage and Standardized Grade
1. Arthritis and Joint Inflammatory Conditions – 150 mg, (standardized to 37.5 – 75%
boswellic acids), three times per day – as a single agent for the treatment of rheumatoid
and osteoarthritis, as well as other joint inflammatory states.3,7
2. Inflammatory Bowel Diseases – 150 mg, (standardized to 37.5 – 75% boswellic acids),
three times per day.4,6,7,8,9
3. Chronic Respiratory Illnesses – 300 mg, three times per day of Boswellia extract,
standardized to 37.5 – 75% boswellic acids.11

Adverse Side Effects, Toxicity and Contraindications
Boswellia has been shown to be very safe at recommended doses.3,4,5,6,7,8,9,11 Rare side
effects include diarrhea, skin rash and nausea.6

Drug Interactions
There are no well-known drug interactions reported to date in regards to the use of

Pregnancy and Lactation
During pregnancy and lactation, the only supplements that are considered safe include standard prenatal vitamin and mineral
supplements. All other supplements or dose alterations may pose a threat to the developing fetus and there is generally
insufficient evidence at this time to determine an absolute level of safety for most dietary supplements other than a prenatal
supplement. Any supplementation practices beyond a prenatal supplement should involve the cooperation of the attending
physician (e.g., magnesium and the treatment of preeclampsia.)
References: Pregnancy and Lactation
1. Encyclopedia of Nutritional Supplements. Murray M. Prima Publishing 1998.
2. Reavley NM. The New Encyclopedia of Vitamins, Minerals, Supplements, and Herbs. Evans and Company Inc. 1998.
3. The Healing Power of Herbs (2nd edition). Murray M. Prima Publishing 1995.
4. Boon H and Smith M. Health Care Professional Training Program in Complementary Medicine. Institute of Applied Complementary Medicine Inc. 1997.



1. Safayhi H, Sailer ER, Amnon HPT. 5-lipoxygenase inhibition by acetyl-11-keto-b-boswellic acid.
Phytomed 1996;3:71-2.
2. Safayhi H, Mack T, Saieraj J, Boswellic acids: novel, specific, nonredox inhibitors of 5-
lipoxygenase. J Pharmacol Exp Ther 1992;261:1143-6.
3. Etzel R. Special extract of Boswellia serrata (H15) in the treatment of rheumatoid arthritis. Phytomed
4. Gupta I, Parihar A, Malhotra P, Effects of Boswellia serrata gum resin in patients with ulcerative
colitis. Eur J Med Res 1997;2:37-43.
5. Singh GB, Atal CK. Pharmacology of an extract of salai guggal ex-Boswellia serrata, a new non-steroidal
anti-inflammatory agent. Agents Actions 1986;18: 407-12.
6. Healthnotes Online, Healthnotes Inc., 1999.
7. Dietary Supplement Information Boswellia
8. Gerhadt H, Seifert F, Buvari P, Vogelsang H, et al. Therapy of active Crohn disease with Boswellia
serrata H 15. Gastroenterol. 2001; 39 (1): 11-7
9. Gupta I, Parihar A, Malhotra P, et al. Effects of gum resin of Boswellia serrata in patients with chronic
colitis. Planta Med. 2001; 67
10. Safayhi H, et al. Inhibition by boswellic acids of human leukocyte elastase. J Pharmacol. Exp ther. 1997;
281 (1): 460-63

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