Written by Ellen McDonell, Gabriele Dennert and the CAM-Cancer Consortium.
Updated September 11, 2018

Boswellia spp

What is it?


Boswellia subspecies are trees (family: Burseraceae) found in India, Northern Africa and the Middle East 1. Frankincense is the hardened gum resin extruded from incisions in the trunk of several Boswellia species, including Boswellia carterii (African frankincense) and Boswellia serrata (Indian frankincense). The gummy oleo-resin is also known as olibanum (Boswellia carterii) and Salai Guggal (Boswellia serrata) 2.

Medicinal dry extracts from the gummy resin are traded under names such as "H15 Ayurmedica" or "Olibanum" and referred to as “Boswellia extracts” throughout this summary.


Boswellia resin is a mixture containing more than 200 different substances 3, for instance: resin, long-chain sugar compounds, essential oils, proteins, and inorganic compounds 4. Boswellic acids (BAs) have been identified as the putative active principle of the gum resin. BAs are pentacyclic triterpenes with different functional groups in position 3 and 11 of their carbon rings. The most important BAs are:

  • alpha-Boswellic acid
  • beta -Boswellic acid
  • Acetyl-beta-Boswellic acid
  • Acetyl-alpha-Boswellic acid
  • 11-Keto-beta-Boswellic acid (KBA)
  • Acetyl-11-beta-beta-Boswellic acid (AKBA).

Boswellia preparations vary naturally in terms of their content of the different BAs. Medicinal dry extracts are manufactured following standardised procedures to minimise sources of variation within the production process 1.

Application and dosage

Boswellia extracts are administered orally as capsules or tablets usually with a content around 400 mg of Boswellia extract. Providers recommend a daily dosage of 4 to 6 grams per day for adults in the treatment of perifocal brain oedema. Methods to enhance bioavailability have been developed such as lecithin formulations (50). Topically, creams containing 0.5%-2% Boswellic acids have been used (34-36). Essential oils of Boswellia (frankincense) are used as aromatherapy (37, 38).


Boswellia preparations have been used in Indian Ayurvedic medicine for the treatment of inflammatory diseases 4. It was also occasionally mentioned in European medical traditions from the Middle Ages to modern times 7. Current research is being conducted on the anti-inflammatory properties of Boswellia extracts and their use in chronic inflammatory diseases like Morbus Crohn or asthma bronchiale.

Claims of efficacy and alleged indications

Boswellia preparations have been used in Indian Ayurvedic medicine for the treatment of inflammatory diseases 4. It was also occasionally mentioned in European medical traditions from the Middle Ages to modern times 7. Current research is being conducted on the anti-inflammatory properties of Boswellia extracts and their use in chronic inflammatory diseases such as rheumatoid arthritis, Crohn’s disease, osteoarthritis, and asthma (48).

Mechanisms of action

Findings with healthy male volunteers indicated a possible initial fast gastric resorption, followed by intestinal resorption 5 depending on concomitant food intake 6. Gastrointestinal resorption of BAs was increased when taken with a high-fat meal. The concentration peak was seen after approximately 4.5 hours. Elimination half time was 6 hours in the mean and varied considerably with concomitant food intake. BAs were found to have a high volume of distribution.

A number of in-vitro molecular targets of boswellic acids have been described, such as 5-lipoxygenase (5-LO), leukocyte elastase 11, topoisomerase 1 and 2 (24), prostaglandin E2 (47), and NF-kappa B (48). The exact mechanisms remain unclear to date.

BAs selectively inhibit the key enzyme of leukotriene synthesis 5-LO 4 and reduce leukotriene biosynthesis in a concentration-dependent manner 10. Among the investigated BAs, AKBA showed the strongest inhibitory efficacy. When multicomponent extracts that contain several BAs (like all Boswellia gum resin extracts) were tested in in-vitro experiments, the composition and dose of the different Boswellic acids has been found to influence the observed effect. Inhibition of leukotriene synthesis could only be seen at higher concentrations; at lower concentrations an increased synthesis of leukotriens was observed.

Some BAs - especially AKBA (48) - have been found to reduce tumour cell proliferation and induce apoptosis in several in-vitro experiments with animal 12,13 and human malignant cell lines (15,27) including glioma (10, 40), melanoma12, leukemia14, multiple myeloma25, prostate26, breast and cervical41, and colon42, as well as in vivo animal studies (16, 43, 44). The underlying mechanism of BA-induced apoptosis and inhibition of cell proliferation are still being elucidated, but include interference with epigenetics in tumour cells 31, increase in caspase 3/7 mediated apoptosis (40, 45), increase in Bax/Bcl-2 ratio (42), modulation of Wnt/beta-catenin pathway and downregulation of NF-kappaB/COX-2 pathway (46), reduction in prostaglandin E2 and its downstream targets (47), and PARP cleavage (48) among others.

Prevalence of use

There is no data on the prevalence of use of Boswellia products in tumour or brain tumour patients.

Legal issues and providers

Boswellia products are traded as "dietary supplements". H 15 Ayurmedica is a registered Ayurvedic medication in India (Gufic, Mumbay, India). Its manufacturer also holds a partial license for Switzerland, but is not licensed within the EU. However, it can be imported to the EU for use in individual patients under specific circumstances and for use in clinical studies. Additionally, some companies sell Boswellia extracts as “dietary supplements” in the EU.

Cost(s) and expenditures

Costs for Boswellia extracts amount to between €40 to 60 per month (depending on the daily dose) when ordered via the internet (plus shipping).

Citation Ellen McDonell, Gabriele Dennert, CAM-Cancer Consortium. Boswellia spp [online document]. http://ws.cam-cancer.org/The-Summaries/Herbal-products/Boswellia-spp. September 11, 2018.


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