With six out of seven double-blind studies reporting benefit, boswellia seems to be worth trying for osteoarthritis, asthma, colitis, and Crohn's disease.  It has very few side-effects and is inexpensive.  For boswellia extract 375 mg. three times a day, the cost is $11 per month buying it on www.iHerb.com in June, 2004, although shipping costs are added to this price. 

The Boswellia serrata tree is commonly found in India. Its gum resin, known in Indian Ayurvedic medicine as Salai guggal, contains boswellic acids, which reportedly have been shown to inhibit leukotriene biosynthesis.  This gives it anti-inflammatory, anti-arthritic and analgesic activity.  

I would recommend all arthritis sufferers to take glucosamine with chondroitin, since each of these has been shown to be able to halt joint deterioration.  If that is not enough, boswellia could be taken as a second medication while continuring the glucosamine and chondroitin.  Asthma sufferers may take the boswellia on top of their usual medications, but should not decrease their usual medications unless clear improvement has occurred.  The same goes for colitis and Crohn's disease.  I wonder if boswellia might help some irritable bowel syndrome patients.

I haven't started using boswellia yet, having just discovered the research.  However, I have ordered a supply and hope to cautiously try it out with several patients.

Boswellia Some Help for Osteoarthritis: In a 30-patient DB PC crossover study of osteoarthritis of the knee, boswellia was given for eight weeks. Osteoarthritis is a common, chronic, progressive, skeletal, degenerative disorder, which commonly affects the knee joint. All patients reported decrease in knee pain, increased knee flexion, swelling, and increased walking distance on boswellia. Radiologically there was no change. There were only minor GI side-effects. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Indira Gandhi Medical College. Phytomedicine. 2003 Jan;10(1):3-7

Boswellia No Help for Rheumatoid Arthritis: In a 37-patient DB PC study using 9 tablets of active drug (3600 mg) or placebo daily, there was no subjective, clinical or laboratory parameter showing a significant benefit. Is H15 (resin extract of Boswellia serrata, "incense") a useful supplement to established drug therapy of chronic polyarthritis? Results of a double-blind pilot study. Sander O, Herborn G, Rau R. Evangelisches Fachkrankenhaus Ratingen. Z Rheumatol. 1998 Feb;57(1):11-6

Boswellia-Curcumin-Zinc-Withania Concoction Helped Osteoarthritis: In a one-month 42-patient DB PC cross-over study with a 15-day washout between crossover, clinical efficacy was evaluated every fortnight on the basis of severity of pain, morning stiffness, Ritchie articular index, joint score, disability score and grip strength. Treatment with the herbomineral formulation produced a significant drop in severity of pain (P less than 0.001) and disability score (P less than 0.05). Radiological assessment, however, did not show any significant changes. Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study. Kulkarni RR, Patki PS, et al. University of Poona. J Ethnopharmacol. 1991 May-Jun;33(1-2):91-5

Boswellia Helped Asthma: In a DB PC 80-patient 6-week trial of 300 mg three times a day for long-standing asthma, 70% of patients had decreases in dyspnea, rhonchi, number of attacks, increase in FEV subset1, FVC and PEFR as well as decrease in eosinophilic count and ESR. Only 27% of patients in the control group showed improvement. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Gupta I, Gupta V, et al. Universitat Tubingen, Eur J Med Res. 1998 Nov 17;3(11):511-4

Boswellia Helped Chronic Colitis: In a 6-week DB study, 20 patients were given a preparation of the gum resin of Boswellia serrata (300 mg 3 times a day) and 10 patients were given sulfasalazine (1 gm 3 times a day). 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 hemoglobin, serum iron, calcium, phosphorus, proteins, total leukocytes and eosinophils. In the control group 6 out of 10 patients showed similar results. 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. Boswellia has minimal side effects. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Gupta I, Parihar A, et al. Medical College Jammu, India. Planta Med. 2001 Jul;67(5):391-5

Boswellia Helped Ulcerative Colitis as Well as Sulfasalazine: Boswellic acids are specific, nonredox and noncompetitive inhibitors of 5-lipoxygenase, the key enzyme of leukotriene biosynthesis. In patients suffering from ulcerative colitis grade II and III the effect of Boswellia serrata gum resin preparation (350 mg thrice daily for 6 weeks) on stool properties, histolopathology and scan microscopy of rectal biopsies, blood parameters including Hb, serum iron, calcium, phosphorus, proteins, total leukocytes and eosinophils was studied. Patients receiving sulfasalazine (1 g thrice daily) served as controls. Of boswellia patients, 82% went into remission vs. sulfasalazine 75%. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Gupta I, Parihar A, et al. Jammu, India. Eur J Med Res. 1997 Jan;2(1):37-43.

Boswellia a Little Better than Mesalazine for Crohn's: In a DB PC 102-patient study, the Crohn Disease Activity Index (CDAI) was reduced by 90 after a boswellia preparation vs. by 53 with mesalazine. The difference was not statistically significant. Therapy of active Crohn disease with Boswellia serrata extract H 15. Gerhardt H, Seifert F, et al. Universitat Heidelberg. Z Gastroenterol. 2001 Jan;39(1):11-7.

Thomas E. Radecki, M.D., J.D.

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