Medicine: Boswellia

There are many plants in history that have been revered for their medicinal value, others whose renown has been due to their religious or spiritual value. Boswellia serrata is one of the rare plants that “lives” in both of these worlds.

Boswellia, also known as Frankincense, is a large shrub that particularly likes the hot, dry climates of the Near Eastern lands. It is primarily associated with ancient Persia, in the place we now call Iran, but it grows in many other places in the world. Boswellia’s religious significance is best represented by its use as one of the gifts of the Magi to the Christ child. It is also the incense used in the Roman Catholic Mass and other religious events as a way to call people to worship, to focus their attention on the spiritual matters at hand. Its primary medical use has been as a medicine to “warm the joints”, to relieve stiffness, and to, in general, reduce inflammation. Our question is, what do these phenomena have in common, how do they interrelate?

In Anthroposophical literature, the “Christ event” was associated with the birth of the ego in the world of humans. In more general terms, I would interpret this time as a turning point, maybe represented by that event, when humans became able to be more self-conscious than they had previously. People began to identify less with a tribe or group and more as individuals standing apart from others. The history of the past two thousand years reflects this individuation as the theme of humanity as we struggle to know ourselves and define ourselves more and more as individuals, apart even from our immediate families. In other words, unlike in former times, we no longer have to have the same profession or even speak the same language as our tribe or even our families. As those who have read The Fourfold Path to Healing know, this ego is the seat of our warmth body, the element in us that regulates and guards or protects our ability to generate warmth.

In medicine, the warmth body is considered the captain of the ship in the sense that an inflammation without a fever (hence the increased involvement of the warmth body) can easily become the setting for the inflammation becoming the type of chronic condition that is at the root of so many of our chronic ailments. Asthma is a chronic inflammation in the lungs, colitis in the intestines, eczema of the skin, etc. Even coronary artery disease is now considered to arise from chronic inflammation in the coronary arteries. In all these cases, increasing the warmth principle will help guide the inflammation to its conclusion, much as the fever guides the inflammation to its ultimate healing. For all these conditions, Boswellia as a medicine has been shown in the medical literature to provide relief. In essence, Boswellia guides us in this process of individuation, or self-awareness, that is so intimately wrapped up with the task of humanity in our current age. It does this by increasing our warmth, exactly that part of us that makes us human. It warms our hearts (the organ of the warmth body), increases our circulation, and works towards bringing to a healthy conclusion the unresolved aspects (i.e. inflammations) in our lives.

Because I use boswellia in my practice, I share with you below several research papers and studies on this therapeutic treatment.

I have included below a selection of papers, studies and trials that have been conducted using boswellia. Click on the link at Abstract to read the full abstract at the National Center for Biotechnology Information’s National Library of Medicine website,

Please note that this is for informational and educational purposes only and is not intended to replace consultation with a doctor.

Selected Papers Abstracts link to NCBI’s National Library of Medicine PubMed site

Human genome screen to identify the genetic basis of the anti-inflammatory effects of Boswellia in microvascular endothelial cells.

Roy S, Khanna S, Shah H, Rink C, Phillips C, Preuss H, Subbaraju GV, Trimurtulu G, Krishnaraju AV, Bagchi M, Bagchi D, Sen CK.
Laboratory of Molecular Medicine, Department of Surgery, The Ohio State University Medical Center, Columbus, Ohio 43210, USA.

DNA Cell Biol. 2005 Apr;24(4):244-55.
Inflammatory disorders represent a substantial health problem. Medicinal plants belonging to the Burseraceae family, including Boswellia, are especially known for their anti-inflammatory properties. Realtime PCR studies showed that while TNF alpha potently induced VCAM-1 gene expression, BE completely prevented it. This result confirmed our microarray findings and built a compelling case for the anti-inflammatory property of BE. In an in vivo model of carrageenan-induced rat paw inflammation, we observed a significant antiinflammatory property of BE consistent with our in vitro findings. These findings warrant further research aimed at identifying the signaling mechanisms by which BE exerts its anti-inflammatory effects.

PMID: 15812241

Effects of Boswellia serrata in mouse models of chemically induced colitis.

Kiela PR, Midura AJ, Kuscuoglu N, Jolad SD, Solyom AM, Besselsen DG, Timmermann BN, Ghishan FK.

Dept. of Pediatrics, Children’s Research Center, Univ. of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA. Am J Physiol Gastrointest Liver Physiol. 2005 Apr;288(4):G798-808. Epub 2004 Nov 11.

The goal of this study was to evaluate the effectiveness of boswellia extracts in controlled settings of dextran sulfate- or trinitrobenzene sulfonic acid-induced colitis in mice.

PMID: 15539433

Boswellic acid acetate induces apoptosis through caspase-mediated pathways in myeloid leukemia cells.

Xia L, Chen D, Han R, Fang Q, Waxman S, Jing Y. Division of Hematology/Oncology, Department of Medicine, Box 1178, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029-6547.

Mol Cancer Ther. 2005 Mar;4(3):381-8.

The mechanism of the cytotoxic effect of boswellic acid acetate, a 1:1 mixture of alpha-boswellic acid acetate and beta-boswellic acid acetate, isolated from Boswellia carterri Birdw on myeloid leukemia cells was investigated in six human myeloid leukemia cell lines (NB4, SKNO-1, K562, U937, ML-1, and HL-60 cells). Data taken together suggest that boswellic acid acetate induces myeloid leukemia cell apoptosis through activation of caspase-8 by induced expression of DR4 and DR5.

PMID: 15767547

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.
MS Orthopedics, Indira Gandhi Medical College, Nagpur, India. Phytomedicine. 2003 Jan;10(1):3-7.

A randomized double blind placebo controlled crossover study was conducted to assess the efficacy, safety and tolerability of Boswellia serrata Extract (BSE) in 30 patients of osteoarthritis of knee, 15 each receiving active drug or placebo for eight weeks. BSE is recommended in the patients of osteoarthritis of the knee with possible therapeutic use in other arthritis.

Publication Types: Clinical Trial, Randomized Controlled Trial 

PMID: 12622457

Therapy of active Crohn disease with Boswellia serrata extract H 15 [Article in German]

Gerhardt H, Seifert F, Buvari P, Vogelsang H, Repges R.
Colitis-Crohn-Ambulanz, I. Medizinische Klinik, Klinikum Mannheim der Universitat Heidelberg. Z Gastroenterol. 2001 Jan;39(1):11-7.

The purpose of this clinical trial was to compare efficacy and safety of the Boswellia serrata extract H15 with mesalazine for the treatment of active Crohn’s disease. CONCLUSIONS: The study confirms that therapy with H15 is not inferior to mesalazine, which can be interpreted as evidence for the efficacy of H15 according to the state of art in the treatment of active Crohn’s disease with Boswellia serrata extract, since the efficacy of mesalazine for this indication has been approved by the health authorities. Considering both safety and efficacy of Boswellia serrata extract H15 it appears to be superior over mesalazine in terms of a benefit-risk-evaluation.

Publication Types: Clinical Trial, Randomized Controlled Trial 

PMID: 11215357

Effects of gum resin of Boswellia serrata in patients with chronic colitis.

Gupta I, Parihar A, Malhotra P, Gupta S, Ludtke R, Safayhi H, Ammon HP.
Department of Medicine, Medical College Jammu, J&K, India.

Planta Med. 2001 Jul;67(5):391-5.

Patients studied here suffered from chronic colitis characterized by vague lower abdominal pain, bleeding per rectum with diarrhoea and palpable tender descending and sigmoid colon. This study shows that a gum resin preparation from Boswellia serrata could be effective in the treatment of chronic colitis with minimal side effects.

Publication Types: Clinical Trial, Randomized Controlled Trial 

PMID: 11488449

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, Parihar A, Gupta S, Ludtke R, Safayhi H, Ammon HP.
Pharmakologie fur Naturwissenschaftler, Pharmazeutisches Institut der Universität Tubingen, Auf der Morgenstelle 8, D-72076 Tubingen, Germany. Eur J Med Res. 1998 Nov 17;3(11):511-4.

In a double-blind, placebo-controlled study forty patients, the data show a definite role of gum resin of Boswellia serrata in the treatment of bronchial asthma.

Publication Types: Clinical Trial, Randomized Controlled Trial 

PMID: 9810030

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 [Article in German]

Sander O, Herborn G, Rau R.
Rheumatologische Klinik, Evangelisches Fachkrankenhaus Ratingen. Z Rheumatol. 1998 Feb;57(1):11-6

BACKGROUND: Leukotrienes and prostaglandines are important mediators of inflammation. Resinous extracts of Boswellia serrata (H15, indish incense), known from traditional ayurvedic medicine, decrease leukotriene synthesis in vitro. Case reports suggest a clinical role for that drug. Controlled studies including a greater patient population are necessary to confirm or reject our results.

Publication Types: Clinical Trial , Controlled Clinical Trial, Multicenter Study, Randomized Controlled Trial 

PMID: 9566100

Effects of Boswellia serrata gum resin in patients with ulcerative colitis.

Gupta I, Parihar A, Malhotra P, Singh GB, Ludtke R, Safayhi H, Ammon HP.
Department of Medicine, Govt. Medical College, Jammu, J&K, India. Eur J Med Res. 1997 Jan;2(1):37-43.

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. All parameters tested improved after treatment with Boswellia serrata gum resin, the results being similar compared to controls: 82% out of treated patients went into remission; in case of sulfasalazine remission rate was 75%.

Publication Types: Clinical Trial, Controlled Clinical Trial 

PMID: 9049593

Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study.

Kulkarni RR, Patki PS, Jog VP, Gandage SG, Patwardhan B.
Bryamjee Jeejeebhoy Medical College, University of Poona, Pune, India. J Ethnopharmacol. 1991 May-Jun;33(1-2):91-5.

The clinical efficacy of a herbomineral formulation containing roots of Withania somnifera, the stem of Boswellia serrata, rhizomes of Curcuma longa and a zinc complex (Articulin-F), was evaluated in a randomized, double-blind, placebo controlled, cross-over study in patients with osteoarthritis.

PMID: 1943180