Boswellia resin or frankincense is an age old natural remedy and a tool for spiritual ceremonies. Folks have used it to relieve pain and inflammation, heal the joints, improve blood flow, and more. Modern research supports many of its traditional uses and reveals other potentials. Read on to learn the benefits, dosage, and side effects of Boswellia.
What is Boswellia?
Boswellia resins, also known as frankincense/olibanum, are obtained from Boswellia trees. Incisions are made in the trunks of the trees to produce exuded gum, which appears as milk-like resin and hardens into orange-brown gum resin [1, 2].
There are many Boswellia species and varieties, including Boswellia sacra from Oman and Yemen, Boswellia carteri from East Africa and China, Boswellia frereana from Somalia and Boswellia serrata from India.
Today the most traded frankincense is produced in Oman, Yemen, and Somalia. Boswellia resins have been considered throughout the ages to have a wealth of healing properties [3].
Snapshot
Proponents:
- Great anti-inflammatory
- Protects the gut and skin
- Improves joint function
- May support cognition and mental health
- May help with diabetes
Skeptics:
- May cause nausea and heartburn
- Has poor absorption
- Most benefits lack solid clinical evidence
Traditional Uses
Since ancient times, frankincense has been used in Africa, China, India, and the Middle East for the prevention and treatment of various illnesses, especially chronic inflammatory diseases [3].
Resins from this herb have been traditionally used to treat rheumatoid arthritis and other inflammatory diseases such as Crohn’s disease [1].
Boswellia serrata is one of the most valued ancient herbs in Ayurveda. In the Indian system of medicine, it has been used as an anti-inflammatory, anti-arthritic, and analgesic agent [4].
In Traditional Chinese Medicine, frankincense of B. carterii is commonly used as a remedy for improving blood circulation and relieving pain [3].
Modern medicine and pharmacology support some of the Boswellia’s anti-arthritic, anti-inflammatory, heart-friendly, pain-relieving and liver-protecting properties [4].
Main Components
The four major boswellic acids found in frankincense are responsible for the inhibition of pro-inflammatory enzymes [3]:
- β-boswellic acid (BA)
- acetyl-β-boswellic acid (ABA)
- 11-keto-β-boswellic acid (KBA)
- 3-O-acetyl-11-keto-β-boswellic acid (AKBA)
KBA is the most potent anti-inflammatory component of the resin and selectively blocks leukotriene biosynthesis by inhibiting 5-lipoxygenase activity [2].
AKBA has shown the potential against a large number of inflammatory diseases such as arthritis, bronchial asthma, chronic colitis, ulcerative colitis (UC), Crohn’s disease (CD), and cancer [3].
Besides boswellic acids, additional triterpene acids (i.e., tircuallic, lupeolic, and roburic acids) isolated from frankincense have the anti-inflammatory potential [5].
Health Benefits of Boswellia
Possibly Effective:
1) Osteoarthritis
In two clinical trials of 135 osteoarthritis patients, a specific boswellia extract, 5-Loxin (100 mg or 250 mg daily for 3 months) significantly improved joint pain and functionality. Patients began to experience significant improvement after 7 days of treatment with a higher dose [6, 7].
Different types of Boswellia extract were able to reduce pain and improve knee function in three studies of 145 osteoarthritis patients [8, 9, 10]
Boswellic acids reduced swelling and showed anti-arthritic activity in studies on rats and mice with joint disorders [4].
2) Ulcerative Colitis
Wound-healing, anti-ulcer, and anti-diarrhea properties of Boswellia have been cherished in traditional medicine for ages [11, 12].
Boswellia serrata oleo-gum extract (BSE), has antioxidant activity and protects the intestinal epithelial barrier from inflammatory damage [13].
It was effective in the treatment of 30 patients with chronic colitis with minimal side effects [14].
In another trial, gum resin of B. serrata (350 mg, 3 times daily for 6 weeks) improved ulcerative colitis in patients with 80-82% remission [15].
In studies on rats, it showed anti-inflammatory and antioxidant effects, inhibiting inflammation in acute colitis and preventing diarrhea [16, 17, 18].
One study showed no superiority of Boswellia versus placebo in patients with Crohn’s disease, another form of IBD [19].
3) Skin Protection
A cream containing Boswellic acids on facial skin led to significant improvements in photoaging, tactile roughness, and fine lines; increased elasticity; and decreased sebum production in 15 women [20].
In another study, a cream with 2% Boswellia extract (twice daily for 5 weeks) significantly reduced skin redness and irritation caused by radiotherapy. It decreased the need to use cortisone cream by 60%, compared to placebo [21].
In 59 patients with psoriasis, scales, or skin irritation, the same product soothed the skin and improved the symptoms in 50-70% of cases [22].
4) Breast Pain and Benign Breast Lumps
A combination of boswellic acid, betaine, and myoinositol relieved breast pain and reduced benign breast lumps (fibroadenoma) in a study of 76 women. This treatment also reduced breast tissue density by 60% [23].
In another trial of 64 younger women, the same combination reduced the volume of benign breast lumps by 18% on average (vs. 6% placebo) [24].
5) Brain Swelling
In a study of 44 patients with brain cancer, B. serrata (4200 mg/day) reduced radiotherapy-related swelling with a 60% success rate (vs. 26% placebo) [25].
Administering 3600 mg/day of Boswellia extract, 7 days prior to surgery, reduced the fluild around the tumor by 70% in 8/12 patients with malignant glioma (brain cancer). The signs of brain damage further decreased during the treatment [26].
In another trial, an ethanolic extract of the gum resin of B. serrata reduced brain swelling due to by 22-48%. However, crucial details such as sample size are not available [27].
The use of Boswellia for this indication is still experimental and requires strict medical supervision.
6) Asthma
Boswellia has traditionally been valued for its effect on the respiratory system and has been used in steam inhalations, baths, and massages to treat a cough, catarrh, bronchitis, and asthma [28].
Boswellic acids found in frankincense is responsible for the inhibition of leukotriene biosynthesis and, therefore, may reduce and prevent inflammation in many chronic condition like asthma [29].
Gum resin of B. serrata improved the symptoms of bronchial asthma—such as difficulty breathing, wheezing lung sound, and the number of attacks—in a study of 40 patients [29].
7) Gum Health
In a study of 75 girls, the extract and powder of frankincense prevented plaque-induced gingivitis (gum inflammation) [30].
Insufficient Evidence:
No valid clinical evidence supports the use of Boswellia for any of the conditions in this section. Below is a summary of up-to-date animal studies, cell-based research, or low-quality clinical trials which should spark further investigation. However, you shouldn’t interpret them as supportive of any health benefit.
8) Cognitive Function
Boswellia is traditionally used to improve learning and memory [3].
B. papyrifera showed significant improvement in visuospatial memory in 80 multiple sclerosis (MS) patients but had no effect on verbal memory and information processing speed [31].
B. serrata enhanced cognition in a study of 38 patients with nerve injury, but didn’t significantly improve overall outcome [32].
Young rats whose mothers were treated with this herb in pregnancy showed improved cognition and an increase in the volume of hippocampal neurons [33].
In a rat epilepsy model, Boswellia extract improved learning ability and eliminated the adverse effects of seizures on cognitive function [34].
In mouse models of brain injury, incensole acetate (IA) isolated from Boswellia resin inhibited brain degeneration and improved cognitive performance [35, 36].
Despite the promising preliminary results, more studies are needed to investigate the pro-cognitive effects of Boswellia.
9) Diabetes
B. serrata significantly increased blood HDL levels, remarkably decreased cholesterol, LDL, fructosamine (sugar), and liver enzymes after 6 weeks in a trial of 60 diabetic patients [37].
In diabetic rats, oral administration of Boswellia glabra and Boswellia serrata reduced blood glucose, cholesterol, triglyceride, and prevented complications in the kidneys and liver [38, 39, 40].
Boswellia extract prevented the increase of blood glucose levels, prevented pancreatic islet destruction and consequent hyperglycemia in an animal model of type 1 diabetes [40].
10) Pain Reduction
B. serrata significantly increased the pain threshold and pain tolerance in 12 healthy volunteers [41].
Boswellia sacra has shown painkiller properties different mouse models [42].
11) Headaches
Oral B. serrata reduced the intensity and frequency of headaches in four patients with CCH (chronic cluster headache) [43].
This study lacked a control group and had a tiny sample, so it doesn’t allow for conclusions.
Animal and Cellular Research (Lacking Evidence)
No clinical evidence supports the use of Boswellia for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based studies; they should guide further investigational efforts but should not be interpreted as supportive of any health benefit.
12) Anxiety and Depression
Incensole acetate (IA), a Boswellia resin constituent, causes anxiolytic and antidepressive effects in studies on mice [44, 45].
13) Liver Protection
Scientists observed the potential of B. serrata extract to prevent liver injury in one animal study [46].
Non-alcoholic fatty liver disease (NAFLD) rats treated with boswellic acids showed improved insulin sensitivity and liver function [47].
In chronic hepatitis-associated fibrosis in mice, the combined oral administration of Boswellia and Salvia extracts improved the course of the disease [48].
Parasite Schistosoma eggs induce liver inflammation, but Boswellia extract significantly reduced these changes in a study on mice [49].
14) Anticancer Effects
The findings discussed below stem from animal and cell-based studies only. They should guide further investigation but shouldn’t be interpreted as supportive of the anticancer effects until more research is done. Boswellia supplements aren’t approved for cancer prevention or treatment
In multiple studied on mice, Boswellia serrata and Boswellic acid inhibited the growth and measthases of [50, 51, 52, 53, 54]:
- Colorectal cancer
- Stomach cancer
- Breast cancer
Boswellia and its components were able to kill different types of cancer cells in test tubes, but this doesn’t imply the same anticancer effects in living organisms [55, 56, 3, 57, 58, 59, 60].
More research is needed before making any conclusions about the potential anticancer effects of Boswellia.
15) Heart Health
Boswellia carteri exhibited mild cardioprotective effect and antioxidant activity in animals with a heart attack [61].
Boswellia showed blood thinning activity in two studies on rats [62, 63].
In another rat study, β-boswellic acid (BA) prevented blood clotting and protected blood vessels from injury [64].
16) Microbial Infections
Boswellia carterii and Boswellia dalziellii showed antimicrobial activity against various microorganisms such as fungi, gram-positive and gram-negative bacterial strains in test tubes [11, 65].
Viruses
Boswellia serrata gum resin showed antiviral activity against the mosquito-transmitted chikungunya virus (CHIKV) and vesicular stomatitis virus in the laboratory [66].
Bacteria
Boswellic acid (AKBA) prevents as well as reduces the biofilm generation by Staphylococcus aureus and Staphylococcus epidermidis [67].
AKBA exhibited an inhibitory effect on various oral cavity pathogens tested [68].
Protozoans
Diterpenes of this herb were found active against sleeping sickness inducing Trypanosoma brucei and malaria-inducing Plasmodium falciparum [69].
Fungi
Boswellia species (B. carteri and B. papyrifera) combat fungi and B. rivaehas showed the best activity against Candida albicans [70].
Boswellia Side Effects
This list does not cover all possible side effects. Contact your doctor or pharmacist if you notice any other side effects. In the US, you may report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada, you may report side effects to Health Canada at 1-866-234-2345.
Boswellia (frankincense) has not shown any major side effects and is considered safe. Possible side effects are mild and include [15, 3]:
- Nausea
- Abdominal pain
- Heartburn
- Itching
Boswellia resin has remarkably low toxicity. It’s included in the list of safe substances and its use is permitted by the US Food and Drug Administration (USFDA) as a food additive [R, R].
It’s even safe during pregnancy and lactation in the amounts found in food, but the safety of therapeutic doses (from supplements) hasn’t been evaluated. Speak with your doctor before supplementing.
A repeated dose oral (90 days) toxicity study of Boswellia serrata was carried out in rats, and Boswellia was relatively safe up to the dose of 500 – 1,000 mg/kg. No adverse impact on health was observed [71, 72].
In a routine toxicity study, Boswellia resin and AKBA showed moderate to low toxicity on the skin [73].
Boswellia Dosage
The below doses may not apply to you personally. If your doctor suggests using Boswellia, work with them to find the optimal dosage according to your health condition and other factors.
Boswellia (frankincense) is generally taken as a capsule, tablet or its bark decoction orally [4].
The suggested dosage for inflammatory or asthmatic conditions is 300-400 mg of the standardized extract (containing 60% boswellic acids) three times daily [3].
How to Take It
Several studies note that Boswellia has very poor bioavailability and absorption [74, 75, 66].
According to some research, plasma levels of boswellic acids become detectable only when administered with a high-fat meal [76].
