Key Constituents

Boswellic acids (pentacyclic triterpenes, especially KBA and AKBA)^[12]

The principal anti-inflammatory compounds; AKBA inhibits 5-lipoxygenase. Absorption improves when taken with a high-fat meal.

Boswellic acidsTerpenes / terpenoids

Other triterpenes and essential oil of the resin^[12]

Additional constituents of the oleo-gum-resin.

Essential (volatile) oilTerpenes / terpenoids

Pharmacological Actions

Analgesic (pain relief)^{[2, 3, 9, 10, 13]}

Analgesic (pain relief)

Anti-inflammatory^{[1, 2, 3, 4, 5, 6, 8, 9, 10, 11, 12]}

Anti-inflammatory (inhibits 5-lipoxygenase / leukotriene synthesis and NF-kB signalling); Reduces inflammatory markers (e.g. hs-CRP) and, in one RCT, improved knee joint-space and reduced osteophytes on radiograph

Traditional & Indicated Uses

Arthritis / joint pain^{[2, 12, 13, 14]}Strong · 9/10

Osteoarthritis: reduces joint pain and stiffness and improves function (over at least 4 weeks); Supports inflammatory arthritis including rheumatoid arthritis

more plants for arthritis / joint pain →detailed sources →

Asthma^[12]Traditional · 2/10

Supportive in bronchial asthma

more plants for asthma →detailed sources →

Back pain^[13]Good · 7/10

inferred from analgesic action

more plants for back pain →detailed sources →

Headache^[13]Good · 7/10

inferred from analgesic action

more plants for headache →detailed sources →

Inflammatory bowel disease (IBD)^[12]Traditional · 2/10

Supportive in inflammatory bowel disease (ulcerative colitis, Crohn's disease)

more plants for inflammatory bowel disease (ibd) →detailed sources →

Inflammation (general)^{[2, 12]}Moderate · 5/10

inferred from anti-inflammatory action

more plants for inflammation (general) →detailed sources →

Pain (general)^{[2, 13, 14]}Strong · 9/10

Analgesic (pain relief); Osteoarthritis: reduces joint pain and stiffness and improves function (over at least 4 weeks)

more plants for pain (general) →detailed sources →

Skin irritation^{[2, 12]}Moderate · 5/10

inferred from anti-inflammatory action

more plants for skin irritation →detailed sources →

Safety, Cautions & Contraindications

Safety note^{[12, 13]}Info

Generally well tolerated; the most commonly reported side effects are mild gastrointestinal symptoms, and allergic reactions are rare.

Safety note^[12]Caution

Boswellic acids can affect drug-metabolising enzymes, so caution is advised when taking other medicines; safety in pregnancy and breastfeeding is not established, so avoid medicinal doses.

References

REF-1809, REF-0573, REF-1810, REF-1811, REF-1812, REF-1813, REF-1814, REF-1815, REF-1816, REF-1817, REF-1818

References & Sources

Siddiqui, M.Z (2011) 'Boswellia serrata, a potential antiinflammatory agent: an overview', Indian Journal of Pharmaceutical Sciences, 73(3), pp. 255-261. doi:10.4103/0250-474X.93507 Meta-analysis / review
https://doi.org/10.4103/0250-474X.93507
Majeed, M., Majeed, S., Narayanan, N.K. and Nagabhushanam, K (2019) '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', Phytotherapy Research, 33(5), pp. 1457--1468. doi:10.1002/ptr.6338 Randomized trial
https://doi.org/10.1002/ptr.6338
Karlapudi, V., Sunkara, K.B., Konda, P.R., Sarma, K.V. and Rokkam, M.P (2022) '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', Journal of the American Nutrition Association, 42(2), pp. 159-168. doi:10.1080/07315724.2021.2014370 Randomized trial
https://doi.org/10.1080/07315724.2021.2014370
Kirste, S., Treier, M., Wehrle, S.J., Becker, G., Abdel-Tawab, M., Gerbeth, K., Hug, M.J., Lubrich, B., Grosu, A.L. and Momm, F (2011) 'Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors: a prospective, randomized, placebo-controlled, double-blind pilot trial', Cancer, 117(16), pp. 3788-3795. doi:10.1002/cncr.25945 Randomized trial
https://doi.org/10.1002/cncr.25945
Abdel-Tawab, M., Werz, O. and Schubert-Zsilavecz, M (2011) 'Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data', Clinical Pharmacokinetics, 50(6), pp. 349-369. doi:10.2165/11586800-000000000-00000 Meta-analysis / review
https://doi.org/10.2165/11586800-000000000-00000
Gomaa, A.A., Mohamed, H.S., Abd-Ellatief, R.B. and Gomaa, M.A (2021) 'Boswellic acids/Boswellia serrata extract as a potential COVID-19 therapeutic agent in the elderly', Inflammopharmacology, 29(4), pp. 1033-1048. doi:10.1007/s10787-021-00841-8 Meta-analysis / review
https://doi.org/10.1007/s10787-021-00841-8
Khan, M.A., Ali, R., Parveen, R., Najmi, A.K. and Ahmad, S (2016) 'Pharmacological evidences for cytotoxic and antitumor properties of Boswellic acids from Boswellia serrata', Journal of Ethnopharmacology, 191, pp. 315-323. doi:10.1016/j.jep.2016.06.053 Meta-analysis / review
https://doi.org/10.1016/j.jep.2016.06.053
Ammon, H.P.T (2010) 'Modulation of the immune system by Boswellia serrata extracts and boswellic acids', Phytomedicine, 17(11), pp. 862-867. doi:10.1016/j.phymed.2010.03.003 Meta-analysis / review
https://doi.org/10.1016/j.phymed.2010.03.003
Alluri, V.K., Kundimi, S., Sengupta, K., Golakoti, T. and Kilari, E.K (2020) 'An Anti-Inflammatory Composition of Boswellia serrata Resin Extracts Alleviates Pain and Protects Cartilage in Monoiodoacetate-Induced Osteoarthritis in Rats', Evidence-Based Complementary and Alternative Medicine, 2020, pp. 7381625. doi:10.1155/2020/7381625 Preclinical
https://doi.org/10.1155/2020/7381625
Henrotin, Y., Dierckxsens, Y., Delisse, G., Maes, N. and Albert, A (2022) 'Curcuma and Boswellia serrata extract combination for hand osteoarthritis: an open-label pre-post trial', Pharmaceutical Biology, 60(1), pp. 2295-2299. doi:10.1080/13880209.2022.2147550 Clinical study
https://doi.org/10.1080/13880209.2022.2147550
Cherepanova, M.O. and Subotyalov, M.A (2023) 'Component Composition and Biological Activity of Oleo-Gum Resin from Boswellia serrata (Burseraceae)', Doklady Biological Sciences, 512(1), pp. 336-342. doi:10.1134/S0012496623700643 Meta-analysis / review
https://doi.org/10.1134/S0012496623700643
Ammon, H.P.T (2016) 'Boswellic Acids and Their Role in Chronic Inflammatory Diseases', Advances in Experimental Medicine and Biology. doi:10.1007/978-3-319-41334-1_13 Preclinical
https://doi.org/10.1007/978-3-319-41334-1_13
Yu, G., Xiang, W., Zhang, T., Zeng, L., Yang, K. and Li, J (2020) 'Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis', BMC Complementary Medicine and Therapies. doi:10.1186/s12906-020-02985-6 Meta-analysis / review
https://doi.org/10.1186/s12906-020-02985-6
Liu, X., Machado, G.C., Eyles, J.P., Ravi, V. and Hunter, D.J (2018) 'Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis', British Journal of Sports Medicine, 52(3), pp. 167--175. doi:10.1136/bjsports-2016-097333 Meta-analysis / review
https://doi.org/10.1136/bjsports-2016-097333

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