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Boswellia (Frankincense)

Most recognized for its traditional use and studied potential in supporting joint health and immune response.

Evidence · Grade D
Meta-analysis availableSystematic review availableHuman trial evidenceTraditional useInteraction riskNeeds more research

Resin extract of Boswellia serrata with strong evidence for osteoarthritis, inflammatory bowel disease, and emerging anti-tumor research.

Boswellia, also known as frankincense, is a resin extract derived from the Boswellia serrata tree, native to India and parts of Africa. It has a long history of use in traditional medicine, particularly Ayurvedic medicine, for managing inflammatory conditions. Today, it is commonly consumed as an oral supplement, often in capsule or tablet form, to support joint health and overall well-being. Its primary active compounds are boswellic acids.

Quick answer

What it is: Boswellia, also known as frankincense, is a resin extract derived from the Boswellia serrata tree, native to India and parts of Africa.

May support:Lupus (SLE), Joint Pain, Chronic Back Pain, Carpal Tunnel Syndrome, Osteoarthritis, Crohn's Disease, Plantar Fasciitis, Psoriasis, Psoriatic Arthritis, Tendinitis, Herniated Disc, Multiple Sclerosis, Asthma, Rheumatoid Arthritis, Sciatica, Ulcerative Colitis, Inflammatory Bowel Disease, Ankylosing Spondylitis, Cancer (Adjunctive Support)

Evidence:Evidence · Grade D

Evidence Summary

Evidence · Grade D

Current evidence primarily includes a mix of preclinical studies, small human clinical trials, and some meta-analyses synthesizing these trials, often focusing on inflammation-related conditions. The 'D' grade reflects early-stage research that suggests potential benefits, but lacks definitive, high-quality human data to strongly support widespread use or specific health claims.

Last reviewed · Jun 2026

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Why It Works

Boswellia appears to exert its effects primarily by modulating inflammatory pathways. Its active compounds, boswellic acids, may help to reduce the production of certain pro-inflammatory molecules in the body.

How it works in more detail

The primary active constituents, boswellic acids, are thought to inhibit the enzyme 5-lipoxygenase (5-LOX), thereby reducing the synthesis of leukotrienes, which are potent mediators of inflammation. One specific boswellic acid, acetyl-11-keto-β-boswellic acid (AKBA), is considered particularly active in this regard. Preclinical studies also suggest AKBA exhibits pro-apoptotic activity in certain cancer cell lines, such as glioma and colorectal cancer, although these are cell culture findings and require further investigation in living systems.

How to use

Always consult a qualified clinician.

Editorial guidance

Suggested dosage
300–500 mg/day standardized boswellic acids, with food.
Research dosage range
300–400 mg 2-3 times/day of an extract standardized to 60–65% boswellic acids, or 100 mg 3 times/day of an extract standardized to 30% AKBA.
Typical onset
Some individuals may report acute effects, but consistent use over several weeks to months is often suggested to observe more pronounced and sustained benefits, particularly for chronic conditions.
Typical forms
capsule, tablet, extract, resin, topical cream
Quality markers
Look for products standardized to contain a specific percentage of total boswellic acids, often 60% to 85%, and sometimes specifying AKBA content (e.g., 30% AKBA). Third-party testing for purity and potency helps ensure product quality and absence of contaminants. The country of origin, such as India for Boswellia serrata, can also be a consideration.
Medication interactions
  • Anticoagulants (blood thinners)
  • Antiplatelet drugs
  • NSAIDs (non-steroidal anti-inflammatory drugs)
  • Immunosuppressants
Avoid if
  • Pregnant (due to insufficient safety data)
  • Breastfeeding (due to insufficient safety data)
  • Known allergy to Boswellia or frankincense

Community tips

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Suggested dosage

300–500 mg/day standardized boswellic acids, with food.

General guidance — discuss specifics with a clinician.

Active medicinal compounds

Boswellic acids (AKBA, KBA), terpenes.

Traditional use

Ayurvedic and ancient Egyptian use for arthritis, respiratory issues, and ritual.

Safety

Safety warnings

Generally well tolerated; can cause GI upset, heartburn, or rash.

Avoid if

  • Pregnant (due to insufficient safety data)
  • Breastfeeding (due to insufficient safety data)
  • Known allergy to Boswellia or frankincense

Medication interactions

  • Anticoagulants (blood thinners)
  • Antiplatelet drugs
  • NSAIDs (non-steroidal anti-inflammatory drugs)
  • Immunosuppressants

Reported side effects

  • Mild gastrointestinal upset
  • Nausea
  • Diarrhea
  • Heartburn

General guidance — discuss specifics with a clinician.

Evidence ecosystem

Scientific literature, clinical guidance, government sources, ongoing research, traditional use, and lived experience — grouped by source type and quality.

Overall grade (D)

Current evidence primarily includes a mix of preclinical studies, small human clinical trials, and some meta-analyses synthesizing these trials, often focusing on inflammation-related conditions. The 'D' grade reflects early-stage research that suggests potential benefits, but lacks definitive, high-quality human data to strongly support widespread use or specific health claims.

Filter by source type

Meta-Analyses(1)

Pooled analyses across multiple human trials.

Very High Quality
  • Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis.

    Liu X, Machado GC, Eyles JP, Ravi V, Hunter DJ · British journal of sports medicine · 2018

    To investigate the efficacy and safety of dietary supplements for patients with osteoarthritis. An intervention systematic review with random effects meta-analysis and meta-regression. MEDLINE, EMBASE, Cochrane Register of Controlled Trials, Allied and Complementary Medicine and Cumulative Index to Nursing and Allied Health Literature were searched from inception to April 2017. Randomised controlled trials comparing oral supplements with placebo for hand, hip or knee osteoarthritis. Of 20 supplements investigated in 69 eligible studies, 7 (collagen hydrolysate, passion fruit peel extract, Curcuma longa extract, Boswellia serrata extract, curcumin, pycnogenol and L-carnitine) demonstrated large (effect size >0.80) and clinically important effects for pain reduction at short term. Another six (undenatured type II collagen, avocado soybean unsaponifiables, methylsulfonylmethane, diacerein, glucosamine and chondroitin) revealed statistically significant improvements on pain, but wer

    Meta-AnalysisPubMedVery High Quality

Systematic Reviews(1)

Structured reviews of the full body of evidence (incl. Cochrane).

Very High Quality
  • Frankincense: systematic review.

    Ernst E · BMJ (Clinical research ed.) · 2008

    To assess evidence from randomised clinical trials about the effectiveness of extracts of Boswellia serrata (frankincense). Systematic review. Electronic searches on Medline, Embase, Cinahl, Amed, and Cochrane Library. Hand searches of conference proceedings, bibliographies, and departmental files. All randomised clinical trials of B serrata extract as a treatment for any human medical condition were included and studies of B serrata preparations combined with other ingredients were excluded. Titles and abstracts of all retrieved articles were read and hard copies of all relevant articles were obtained. Selection of studies, data extraction and validation were done by the author. The Jadad score was used to evaluate the methodological quality of all included trials. Of 47 potentially relevant studies, seven met all inclusion criteria (five placebo controlled, two with active controls). The included trials related to asthma, rheumatoid arthritis, Crohn's disease, osteoarthritis, and

    Systematic ReviewPubMedVery High Quality

Randomized Human Trials(1)

Controlled human studies with random assignment.

High Quality
  • A Standardized Boswellia serrata Extract Improves Knee Joint Function and Cartilage Morphology in Human Volunteers with Mild to Moderate Osteoarthritis in a Randomized Placebo-Controlled Study.

    Kumar B, Ghaytidak AB, Pandey AK, Somepalli RR, Sarda P, Raychaudhuri SP · Journal of the American Nutrition Association · 2025

    Boswellia serrata Roxb. ex Colebr. (Family: Burseraceae; Genus: Boswellia) gum resin (Salai guggul) has profound therapeutic value in Ayurvedic and Unani medicines in alleviating several chronic inflammatory illnesses, including arthritis, asthma, skin and blood diseases, fever, etc. SN13108F (Aflapin®) is a proprietary, standardized Boswellia serrata gum resin extract. This 180-day randomized, placebo-controlled clinical study aimed to evaluate cartilage morphology using magnetic resonance imaging (MRI), pain and joint function and long-term safety in the SN13108F-supplemented volunteers with knee osteoarthritis (KOA). Eighty adult male and female subjects with the Kellgren-Lawrence grade II - III KOA were supplemented with SN13108F (100 mg/day) or a matched placebo for 180 consecutive days. SN13108F reduced (p < 0.001; vs. baseline and placebo) Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale, Lequesne's Functional I

    Randomized TrialPubMedHigh Quality

Observational Studies(4)

Cohort, case-control, and cross-sectional human studies.

Moderate Quality
  • Aromatherapy and Essential Oils: Holistic Strategies in Complementary and Alternative Medicine for Integral Wellbeing.

    Caballero-Gallardo K, Quintero-Rincón P, Olivero-Verbel J · Plants (Basel, Switzerland) · 2025

    Complementary and alternative medicine (CAM) encompasses a variety of ancient therapies with origins in cultures such as those of China, Egypt, Greece, Iran, India, and Rome. The National Institutes of Health (NIH) classifies these integrative therapies into five categories: (1) mind-body therapies, (2) biological practices, (3) manipulative and body practices, (4) energy medicine, and (5) whole medical systems, including traditional Chinese medicine and Ayurvedic medicine. This review explores the role of biological practices utilizing aromatic plants, particularly through inhalation aromatherapy and massage with essential oils, as effective complementary strategies within health systems. The review compiles information on the most commonly used plants and essential oils for holistic health maintenance from a complementary and alternative perspective. Given their accessibility and relative safety compared to conventional treatments, these therapies have gained popularity worldwide. Fu

    Observational StudyPubMedLow Quality
  • Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis.

    Zhang Y, Gui Y, Adams R, Farragher J, Itsiopoulos C, Bow K · Nutrients · 2025 · n=4599

    Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that can greatly affect quality of life in middle-aged and elderly individuals. Nutritional supplements are increasingly used for KOA due to their low risk, but direct comparative evidence on their efficacy and safety remains scarce. This study aimed to systematically compare the effectiveness and safety of seven common nutritional supplements for KOA. Methods: A systematic review and network meta-analysis were conducted following PRISMA guidelines. Embase, PubMed, and the Cochrane Library were searched through December 2024 for randomized controlled trials (RCTs) evaluating use of eggshell membrane, vitamin D, Boswellia, curcumin, ginger, krill oil, or collagen, versus placebo, in adults with KOA. Primary outcomes included changes in scores for WOMAC pain, stiffness and function, and pain visual analog scale (VAS). Adverse events were also assessed. Bayesian network meta-analyses estimated ranking probabil

    Observational StudyPubMedLow Quality
  • A Supplement with Ribes Nigrum, Boswellia Serrata, Bromelain and Vitamin D to Stop Local Inflammation in Chronic Sinusitis: A Case-Control Study.

    De Luca P, D'Ascanio L, Cingolani C, Latini G, Grigaliute E, Di Mauro P · Journal of clinical medicine · 2023 · n=60

    Although chronic sinusitis widely affects the adult population, the treatments currently used did not always satisfactorily solve the symptoms. Traditional therapy with steroids and antibiotics presents risks and benefits and the new drugs, i.e., monoclonal antibody, are valid solutions despite being quite expensive. Natural molecules could be a valid treatment that combines good efficacy and low price. We conducted a case -control study to evaluate the benefit of an oral supplement with Ribes nigrum, Boswellia serrata, Bromelain and Vitamin D on chronic sinusitis symptoms. 60 patients were randomly assigned to one of the three groups: control using nasal steroids only, treatment 1 using nasal steroid and 1 dose of the oral supplement for 30 days and treatment 2 in which patients used nasal steroid and two oral supplement doses daily for 15 days. Conditions of the nasal mucosa and a blood sample (WBC, IgE and CRP) were analyzed at T0, T1 (15 days after treatment) and T2 (30 days after

    Observational StudyPubMedModerate Quality

Government Health Sources(1)

Public-health agencies: NCCIH, NIH, CDC, NHS.

High Quality
  • NHS website

    NHS

    The NHS website provides information on various health conditions and treatments, often including advice on complementary and alternative medicines, which might include information relevant to boswellia.

    Government SourceNHSHigh Quality

Clinical Trial Registries(2)

Registered ongoing or completed trials (ClinicalTrials.gov).

Moderate Quality
  • Positive Outcomes of the Supplementation With Lecithin-based Delivery Form of Curcuma Longa and of Boswellia Serrata in IBS Subjects With Small Bowel Dysbiosis

    n=64 · NCT06407609 · COMPLETED · COMPLETED

    Small bowel dysbiosis (SBD), is a frequent finding in subjects with irritable bowel syndrome (IBS). The formula-tion in sunflower lecithin (Phytosome) of Curcuma longa and Boswellia serrata demonstrated beneficial effects on intestinal microbiota. The aim of this study was to evaluate the effect of a lecithin-based delivery formulation of Curcuma longa and of Boswellia serrata extracts (CUBO), on SBD in IBS subjects.

    Clinical TrialClinicalTrials.govModerate Quality
  • Positive Effect of Lecithin-based Delivery Form of Curcuma and Boswellia Extracts on Post-acute COVID-19 Irritable Bowel Syndrome. Two Cohorts of an Open-label Study.

    n=44 · NCT06423586 · COMPLETED · COMPLETED

    This open-label study investigates the effects of lecithin-based formulations of Curcuma longa (Meriva™) and Boswellia serrata (Casperome™) extracts on post-acute COVID-19 irritable bowel syndrome (PCIBS) and irritable bowel syndrome (IBS) without prior COVID-19 infection. A total of 44 participants, 16 with PCIBS and 28 controls with IBS, were supplemented for 30 days. Outcomes measured included abdominal bloating, abdominal pain, enteral dysbiosis, and global assessment of efficacy. The study found significant reductions in bloating and pain in both groups, with a notable decrease in dysbiosis only in the IBS group. This suggests potential benefits of the supplementation in managing gastrointestinal symptoms associated with PCIBS and IBS.

    Clinical TrialClinicalTrials.govModerate Quality

Limitations: Existing human trials are often limited by small sample sizes, short study durations, heterogeneity in study designs and preparations used, and potential for publication bias. More large-scale, well-controlled clinical trials are needed to confirm initial findings and establish optimal dosages and long-term safety.

This page is educational. Statements use phrases like "may support" and "has been studied for"because no remedy here is approved to cure, treat, or reverse any condition. Discussion happens on the ailment pages — community statistics here are derived from those reports. Always consult a qualified clinician.

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