Consider boswellia as a natural alternative to anti-inflammatory drugs like ibuprofen. It can be tried for long term inflammatory joint problems like osteo- and rheumatoid arthritis, especially when any pain is relieved by heat. There is a long tradition in India of combining boswellia with turmeric for this purpose.

There are both traditional reputations and modern research to consider using it in chronic lung problems, especially if there are asthmatic elements.

The ability of this plant when externally applied to exposed tissue to reduce inflammation and to aid granulation means that  it is useful for both pain and  inflammation for improved wound healing.

There is new and so far little explored potential of boswellia in managing inflammation in the gut. An affect in reducing disturbances of gut flora (the microbiome) is also possible.

Boswellia has the dual energetic reputation of being both heating and cooling. It heats by stimulating circulation and cools with its anti-inflammatory action.

Boswellia resin contains triterpene constituents collectively known as ‘boswellic acid’. This fraction has anti-inflammatory properties that is quite distinct from conventional non-steroidal anti-inflammatories (NSAIDs) like ibuprofen. NSAIDs reduce enzymes called cyclo-oxygenases (COXs) that produce prostaglandins. However they leave unchanged an enzyme called 5-lipoxygenase (5-LOX) that produces leukotrienes, which can damage the stomach wall (and induce asthma). Boswellic acid inhibits 5-LOX (not COX) and can therefore protect the gut wall from damage and also improve asthmatic like respiratory problems.

There is a persistent traditional reputation for boswellia affecting the brain and central nervous functions. It has had a long-term connection with the spiritual realm and religious ceremony. It is also used in psychiatric and mental conditions.

We now understand that unusually among anti-inflammatory remedies that some of its constituents can cross the ‘blood-brain barrier’ meaning it can access the brain. This puts boswellia into contention for a wide range of neurological and psychiatric conditions, depression, dementia, and even chronic fatigue, all linked by elements of ‘neuroinflammation’.

In traditional Indian medicine boswellia is used as a stimulant and expectorant (internal use) and an astringent and anti-inflammatory agent (topically).   It was used for pulmonary diseases, especially if chronic, rheumatic disorders, diarrhoea, dysentery, painful periods and liver disorders. It is also used for general weakness and to improve appetite.

The plants essential oils are said to support the spiritual body and work where we would now place the pituitary and hypothalamus gland.

Analgesics are medications that are applied internally or externally to reduce pain. Many of them work by depressing the functions of the central nervous system, Examples of effective analgesics include Jamaican Dogwood (Piscidia erythrina), Pasqueflower (Anenome pulsatilla), California Poppy (Eschscholzia californica), Corydalis (Corydalis yanghusuo) and Wild Lettuce (Lactuca virosa). Topically, Aconite (Aconitum napellus) and Cayenne (Capsicum minimum) are powerful anodynes.

Anti-inflammatory herbs reduce inflammation in the body. There are different systems in the body that anti-inflammatory plants target. For example for the gastrointestinal tract chamomile, fenugreek and meadowsweet are useful. For the musculoskeletal system rosehips, turmeric and celery seed are useful. For inflammation against immune mediated inflammation gotu kola (centella asiatica), rehmannia (rehmannia glutinosa) and feverfew (tanacetum parthenium) can be useful.

Antimicrobials are herbs that interfere with the proliferation and life-cycle of microbes; bacteria, fungi, and viruses. Examples include Thyme leaf (Thymus vulgaris), Echinacea (Echinacea species), Elderberry (Sambucus nigra).

Antirheumatic medicines prevent or relieve rheumatic symptoms such as joint pains, limited mobility and swelling. Plants that have this effect include celery seed (apium graveolens), black cohosh (cimicifuga racemose), nettle leaf (urtica dioca), devils claw (harpagophytum procumbens) and willow bark (salix alba).

Carminative herbs are high in essential oils and help ease digestion by relieving gas, spasms and cramps. Examples include Aniseed (Pimpinella anisum), Fennel seed (Foeniculum vulgare) and Peppermint leaf (Mentha piperita).

Expectorants are herbs that assist the body in expelling mucus from the upper respiratory tract. Examples include Licorice root (Glycyrrhiza glabra), Elecampane root (Inula helenium) and Thyme leaf (Thymus vulgaris).

Nervines are herbs that soothe the nervous system and have a calming effect on the emotions. Examples include Oatstraw flowering tops (Avena sativa), passionflower (Passiflora incarnata), Lavender (Lavandula officinalis), St. John’s Wort (Hypericum perforatum), Rosemary leaf (Rosmarinus officinalis), and Gotu Kola leaf (Centella asiatica).

A vasodilator is a substance that dilates or widens the blood vessels, for example olive leaves (olea europea).

Vulneraries are wound-healing herbs used internally and externally. Astringent herbs such as Witch Hazel (Hamamelis virginiana) and Shepherd’s Purse leaf (Capsella bursa-pastoris) directly stop bleeding and promote the formation of an eschar (scab). Mucilaginous herbs such as Plantain leaf (Plantago lanceolata) and Selfheal leaf (Prunella vulgaris)  soothe inflammation. Some vulneraries are used internally to speed tissue healing, including Marigold flower (Calendula officinalis), Plantain leaf (Plantago lanceolata), Selfheal leaf (Prunella vulgaris), and Marshmallow root (Althaea officinalis).

Inflammation: useful in inflammatory diseases, especially of the joints (osteo and rheumatoid arthritis), lungs (especially asthma), inflammatory bowel disease (eg Crohn’s and ulcerative colitis) and skin (eg psoriasis).

Gut health: boswellia can be considered in long-term inflammation gut disease, like Crohns and ulcerative colitis or any other persistent low gut problem with inflammatory or dysbiosis elements.

Pain: all types of pain, specifically arthritic or post trauma where there is inflammation and congestion. Energetically applied to cold and damp types of pain and swelling (ie. where the pain is relieved by heat).

Women’s health: a traditional remedy in the treatment of fibroids, cysts, painful periods with clots and pain caused by congestion the uterus.

Men’s health: a specific herb for impotence and sexual debility; it brings blood to the reproductive organs and therefore facilitates issues such as erectile dysfunction.

External uses: used to hasten the healing of wounds, broken bones and bruises, especially it there is local inflammation.

From laboratory studies it appears that boswellic acid inhibits the inflammatory enzyme 5-lipoxygenase (5-LOX) with little effect on cyclo-oxygenase (COX). COX enzymes produce inflammatory prostaglandins and are the main target of conventional non-steroidal anti-inflammatories (NSAIDs) like ibuprofen. 5- LOX generates leukotrienes. These are also potent inflammatory agents that particularly are involved in asthmatic problems, but perhaps even more significantly in damage to the gut wall. One reason conventional NSAIDS can damage the stomach is that they upset the COX/LOX balance and allow more leukotrienes to be produced (1). Boswellia’s mechanism of action is therefore quite distinct from NSAIDs and are not likely to have their complications.

Other immunological and anti-inflammatory mechanisms have been identified, including the inhibition of NFkappaB activation and consequent down regulation of proinflammatory cytokines TNF-alpha and decrease of IL-1, IL-2, IL-4, IL-6 and IFN-gamma (2). There is additional evidence pointing to an intriguing possible role on another anti-inflammatory marker, cathepsin G, this demonstrated against placebo ex vivo, that is in blood taken after oral consumption (3).

A double-blind trial on 48 patients with osteoarthritis of the knee with a boswellia extract or placebo for a period of 120 days, revealed that boswellia treatment significantly improved the physical function of the patients by reducing pain and stiffness compared with placebo. Radiographic assessments showed improved knee joint gap and reduced spurs. Boswellia also significantly reduced the serum levels of C-reactive protein, an inflammatory marker associated with osteoarthritis (4).

Inflammatory mediators are strongly associated with ischaemic stroke. Unlike NSAIDs, boswellic acids cross the blood-brain barrier and there is a case for appropriate modulation of inflammatory pathways in aiding stroke recovery. A double-blind placebo-controlled pilot trial randomized 80 ischaemic stroke patients within 72 hours of onset of neurological signs, for a month follow-up. Patients who were allocated to the boswellia group had a significant recovery in neurological function during the 1-month follow-up, compared with the placebo. The levels of plasma inflammatory markers were significantly decreased after 7 days of intervention in TNF-α, IL-1β, IL-6, IL-8, and PGE2 (5).

Patients irradiated for brain tumours often suffer from cerebral oedema and are usually treated with dexamethasone, which has various side effects. To investigate the activity of boswellia a prospective, randomized, placebo-controlled, double-blind, pilot trial was conducted. Forty-four patients with primary or secondary malignant cerebral tumours were randomly assigned to radiotherapy plus either boswellia 4200 mg/day or placebo. Compared with baseline and measured immediately after the end of radiotherapy and treatment, a reduction of cerebral oedema of >75% as measured by MRI was found in 60% of patients receiving boswellia and in 26% of patients receiving placebo (6).

Local effects in reducing inflammation has been supported in an uncontrolled clinical trial that showed boswellia can reduce the use of topical corticosteroids and is able to reduce skin rash and other superficial symptoms after radiation for breast cancer (7).

Indian frankincense can grow up to 15 metres and is a popular avenue tree in Indian cities.

Boswellia prefers hot and dry conditions, on the exposed slopes and ridges of rocky hills. Sometimes it is also found with other plants in open forests. It is native to central and certain peninsular of India, Northern Africa and Middle East.

In the IUCN Red list of Threatened Species Boswellia is classified as ‘near threatened’. Additionally, B. serrata is listed as Critically Endangered – Possibly Extinct (CEPE) on the National Red List of Sri Lanka.

Herbal Medicines are often extremely safe to take, however it is important to buy herbal medicines from a reputed supplier. Sometimes herbs bought from unreputable sources are contaminated, adulterated or substituted with incorrect plant matter.

Some important markers for quality to look for would be to look for certified organic labelling, ensuring that the correct scientific/botanical name is used and that suppliers can provide information about the source of ingredients used in the product.

A supplier should be able to tell you where the herbs have come from. There is more space for contamination and adulteration when the supply chain is unknown.

Boswellia requires hot and dry conditions and cannot withstand frost. Seeds and plants are rare and expensive to buy, even on the internet, but the plant grows well from cuttings. If one should be able to obtain a plant or cutting, the best chance will be to grow indoors.

• Obtain stem or root cuttings from an existing Boswellia plant. Observe for sprouts coming from roots at the base of the plant and carefully detach those roots from the plant, these are the samples that will grow most successfully. Otherwise, measure 6 to 8 inches from the tip of a healthy stem and make a diagonal cut for a stem cutting.
• Plant rooted cuttings at the same height as they were in the original pot into pots filled with pure pumice. Plant stem cuttings about one-third of their lengths into the soil. Press down firmly around the plant for extra support.
• Place the planted cuttings indoors in a warm area with filtered light. Water directly after planting. Keep the cuttings just moist enough so that they do not dry out.
• Move the boswellia cuttings to full sun when they start to grow on their own. They grow best in temperatures around 80 degrees. F. Boswellia is a slow grower, especially if it resides in cooler weather. If grown outdoors, the seedling can withstand temperatures down to 40 degrees.
• Water sparingly during the growing season, only enough to prevent the plant from drying out completely. Watering once a week will keep the plant healthy in most cases. Do not water during the dormant season in winter.
  

Joint protector tea

It’s almost an inevitable human condition that we will suffer from some sort of joint pain as we get older. All that wear-and-tear through our life can catch up with us but we have a herbal tea recipe that will help keep the red-hot inflammation of arthritis and gout at bay.

Ingredients:

• Turmeric root powder 3g
• Boswellia resin 2g
• Ginger root powder 2g
• Celery seed 2g
• Ashwagandha root 1g
• Licorice root 1g
• Meadowsweet leaf 1g
• Honey to taste

This will serve 2–3 cups of ache-free tea.

Method:

• Put all of the ingredients (except for the meadowsweet leaf and honey) in a saucepan with 600ml (21fl oz) cold filtered water. Cover with a lid and simmer for 15 minutes.
• Take off the heat and add the meadowsweet leaf.
• Leave to steep for 10 minutes, strain and add some honey to taste.

Recipe from Cleanse, Nurture, Restore by Sebastian Pole

1. Martel-Pelletier J, Lajeunesse D, Reboul P, et al (2003) Therapeutic role of dual inhibitors of 5-LOX and COX, selective and non-selective non-steroidal anti-inflammatory drugs. Annals of the Rheumatic Diseases 62: 501-509
2. Ammon HP. (2010) Modulation of the immune system by Boswellia serrata extracts and boswellic acids. Phytomedicine.17(11):862-867
3. Tausch L, Henkel A, Siemoneit U, et al. (2009) Identification of human cathepsin G as a functional target of boswellic acids from the anti-inflammatory remedy frankincense. J Immunol. 183(5): 3433-3442
4. Majeed M, Majeed S, Narayanan NK, Nagabhushanam K. (2019) A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia