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In the Gospel story of the birth of Jesus, three wise men from the East appear bearing gifts, including gold, frankincense, and myrrh. Frankincense, which is also known by its modern botanical name Boswellia seratta, was important in Ayurvedic medicine 2, 000 years ago, even as it is today.
Boswellia serrata, also known as frankincense, is a moderate to large branching tree that grows in arid regions of northern Africa, the Middle East, and India. Strips of bark are peeled away to expose a resin that is allowed to dry before it is collected for making herbal medicines. There are minor differences between Boswellia serrata and the Boswellia sacra species associated with the Jesus story, the Boswellia papyrifera found in Ethiopia and at one time used as alternative source of papyrus, and the Boswellia frereana sold to pilgrims in Mecca, but all are sources of boswellic acids for healing.
Boswellia benefitted Ayurvedic medicine, and later Unani medicine (Indian and Pakistani herbal medicine encouraged by Muslim rulers), as an antiseptic for treating wounds, millenniums before antibiotics were available. It was used to stop oozing from rashes and as a cough medicine. It was also used to soothe aching joints.
There have been about 30 laboratory and clinical studies of frankincense in relation to health conditions. The most important action of the resin is fighting inflammation, especially inflammation activated by the complement system.
A "complement" completes the activity of white blood cells. It stimulates macrophages (the white blood cells with a name that literally means "big eaters") to surround and consume whole microorganisms. It acts as a signal that attracts macrophages to the site of an infection to destroy microbes and that also attracts neutrophils to the site of an injury or infection to dissolve affected tissues.
Complement can alter the structure of viruses, make white blood cells clump around the site of an infection, or break down the cell walls of bacteria.
Usually the complement system is a good thing. In rheumatoid arthritis, however, the complement system runs amok, destroying health tissue in the lining of joints as well even in the absence of infection. Stopping the action complement stops tissue destruction.
Frankincense also contains chemicals that deactivate human leukocyte elastase, the enzyme that causes mucus to "slime" over mucous membranes in the throat and lungs. In treating upper respiratory conditions, this gives the natural processes of expectoration a chance to get rid of accumulated mucus and phlegm. Boswellia serrata side effects have never been reported, so this herb is an ideal adjunct to or even replacement for many conventional medications.
The action of chemicals in frankincense that stop the action of complement relieve pain and swelling in arthritic joints about as effectively as aspirin, Tylenol, Advil, and ibuprofen. Most people who take Boswellia preparations for joint pain continue to take other pain relievers. They just don't take as much. The big advantage of boswellin (the primary pain relief chemical in frankincense) over the standard pain relievers is that the other pain relievers destroy joint tissue at the same time they relieve pain.
Non-steroidal anti-inflammatory drugs (NSAIDs) interfere with a joint's ability to make glycosaminoglycans. These are the protein fibers the joints make from chondroitin and glucosamine. If you take a large amount of aspirin, Tylenol, and similar pain relievers, you will get pain relief as long as you are taking the drug, but your underlying joint problem will just get worse and worse.
Boswellin won't break down joint tissue. It won't cause stomach upset. In fact, it may heal stomach upset caused by prolonged use of other pain relievers. Combined with curcumin, zinc, and/or ashwagandha, boswellin usually offers far better relief than standard pain relievers taken alone. You will also experience less pain and more flexibility if you take the herbal preparation by itself, without any other pain relief products.
An optimal daily dose of boswellic acids is 250 mg a day. You may experience some relief if you take just 100 mg a day, but a clinical trial in India found that 250 mg a day works better than the lower dose. (On the other hand, there is no reason to take more than 250 mg a day.)
It takes about a week to start feeling results, and in the meantime, there is no reason not to continue taking your other pain relief medications. You will probably need them less and less as time goes on. Clinical studies have not found any side effects or drug interactions related to this herb.
Ayurvedic and Unani herbal medicine used frankincense in formulas to treat asthma that could be described as "phlegmy." It's not an ingredient that lowers an asthmatic's susceptibility to drafts, changes in temperature, cigarette smoke, or other fumes. It's more of an ingredient that helps asthmatics expectorate phlegm to clear out air passages, at least in traditional herbal medicine.
There is also a group of people who have asthma that the science predicts boswellin would help. These are the asthmatics who like potato chips, cheeseburgers, hot dogs, nachos, and similar foods. At least in laboratory studies, boswellin modulates the chemical reactions that produce the inflammatory chemicals 5-hydroxyeicosatetraenoic acid and leukotriene B4.
These hormone-like substances cause airway constriction. The body makes more of them when people eat diets that are high in the kinds of fat found in these common North American fast foods. At least in theory, boswellin should help reduce the effects of a junk food diet on asthma.
The scientific "proof" that boswellin helps people with asthma is, I have to admit, pretty thin. There was a study published in 1998 that compared 40 asthmatics taking 300 mg of boswellin three times a day for six weeks with 40 asthmatics taking a placebo.
Actually, both groups had people who got better (whether they were taking an herb or nothing at all) and both groups had people who had no response (which is what you would expect with the placebo). But about 70% of asthmatics who took boswellin for six weeks experienced symptom relief. That's not a magic bullet, but actually this response is about what is expected of many medications-without steroid side effects.
A clinical trial at the University of Heidelberg in Germany compared treatment of Crohn's disease with either boswellin from frankincense or the prescription drug mesalazine. (This is the drug marketed as Canasa, Rowasa, Pentasa, Asacol, Lialda, Apriso in the US and Canada, Asacol, Ipocal, Pentasa, Salofalk, Mezavant XL in the UK, Australia, and New Zealand, Mesacol in India, and Salofalk in Latin America.) Both treatments worked equally well for relieving Crohn's symptoms, although boswellin did not cause as many side effects, such as the diarrhea, nausea, abdominal cramping, and flatulence often caused by the drug.
Would I personally use boswellin to treat Crohn's disease, ulcerative colitis or some other inflammatory bowel disease?
Yes, but I would buy some other supplements to add to my routine.
First, I'd take a good probiotic. Frequent bouts of diarrhea, loss of appetite, and side effects of medication interfere with the absorption of nutrients from food. People with IBD are especially prone to developing deficiencies of vitamins A, B12, C, D, E, and K, folic acid, calcium, copper, magnesium, and selenium. A daily multivitamin tablet with minerals is always indicated. People who have surgery for Crohn's disease are especially likely to develop vitamin D deficiency and there is general agreement, even in mainstream medicine, that taking up to 1,000 IU of vitamin D a certainly can't hurt.
I'd also take a good probiotic supplement. At least one clinical study has found that probiotic Lactobacillus acidophilus and Bifidobacterium greatly reduce the risk of recurrence of “pouchitis,” an inflammatory condition that commonly occurs after surgery for IBD. Scientists at the University of Bologna in Italy reported that 3 out of 20 patients given probiotics suffered relapses of pouchitis over a 9-month period, whereas all 20 patients given a placebo suffered flare-ups of the condition.6 The are no contraindications for the probiotics in IBD.
Fish oil is also a good idea. Fish oil is widely recommended for treatment of IBD, and the clinical data indicate it at least prolongs remission, although it does not prevent relapses of the disease. If fishy-smelling burps are a problem, make sure you have a brand delivers at least 400 mg of fatty acids in a single capsule. This way there is simply no room for the byproducts that cause digestive upset in some brands. If you are a vegetarian or a vegan, then use microalgae or flaxseed oil. I'd take either five 1,000 mg capsules of fish oil or microalgae a day, or ten 1,000 mg capsules of flaxseed oil.
Then there's a need for vitamin E and Vitamin K. If you have inflammatory bowel disease, you probably can't get enough of these vitamins from food. Deficiencies of vitamin E and vitamin K tend to occur at the same time, and at any given time about a third of people with IBD are deficient in these two vitamins.
Vitamin K is especially likely to be depleted during treatment with antibiotics. The doses needed to prevent deficiency are so small that they are highly unlikely to interfere with any prescription drugs. Zinc supplements are frequently recommended in IBS, but zinc levels are actually above normal when the disease is active, and very few IBS sufferers are deficient in zinc.
Herbs also can help. Demulcent herbs, such as slippery elm, relieve inflammation by coating the lining of the colon and rectum. Taken as a warm tea, they do not interfere with any medications. Robert's Formula is a combination of baptisia (wild indigo), Echinacea angustifolia, geranium, cabbage powder, marshmallow root, goldenseal, and slippery elm. Available from naturopathic physicians and compounding pharmacists, Robert's Formula is both demulcent and anti-inflammatory.
And diet? Some physicians recommend medium-chain triglycerides (MCTs) as a nutritional supplement for IBD patients. MCTs are easily absorbed through the intestine and readily converted to energy, but very little MCT is stored as fat. Milk fat is a natural source of MCTs, as is butter. If you are a vegan or a vegetarian, then you might choose virgin coconut oil.
That's a whole lot more than just boswellin, but it's what you actually need. I have no doubt that if the only supplement someone took for inflammatory bowel disease were boswellin, it would probably do a lot of good, but bowel diseases benefit from broader nutritional support.
Generally, I would only recommend boswellin or boswellic acids from frankincense for asthma, arthritis, and inflammatory bowel disease. There is enough scientific evidence and I've interacted with enough users to have confidence that the product works for those three conditions. There are a few more conditions, however, for which I think this herb won't interfere with treatment and is worth a try.
Psoriasis. Some research coming from China has found that, in animals, boswellic acids slow the production of a compound called NF-kappa B. This puts the breaks on the autoimmune process that causes extremely fast growth of skin in psoriasis. When the skin does not grow as quickly, there is less flaking, reddening, itching, and irritation. For this application, a salve containing frankincense will get better results than a boswellic acid supplement you take by mouth, although either probably will make a difference.
Cancer. Although I often write about natural products in the treatment of cancer, there is always a little fear in my heart-because I don't want anyone seeing just part of what I have to say about any product. Although boswellic acids and frankincense extracts are being used in laboratory experiments to stop the growth of several different cancer cell lines, there just is not enough evidence to recommend frankincense or boswellic acids as any kind of treatment for cancer-even as one supportive treatment among many others.
I hear from people who have cancers and researchers nearly every day, however, and if there are updates, I will share them. In the meantime, please feel free to post comments and questions on the Comments Page.
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