The Health Benefits of Boswellia

Can this Herb Ease Inflammation and Pain?

By Cathy Wong Medically reviewed by Richard N. Fogoros, MD Updated on July 17, 2019

Boswellia is an extract sourced from the gum resin produced by the Boswellia serrata, a
branching tree native to Africa and Arabia. Also known as "Indian frankincense" or "olibanum,"
boswellia is commonly used in ayurveda.

Boswellia is rich in boswellic acids, substances that may have anti-inflammatory effects.

Health Benefits
Boswellia serrata and other species of boswellia are used in essential oils or burned as
incense. The oil is also used in food, cosmetics, soaps, and beverages.

In herbal medicine, boswellia is sometimes taken by mouth or applied to the skin to manage the
following conditions:

Asthma

Collagenous arthritis
Crohn's disease
 Menstrual cramps

Osteoarthritis
Rheumatoid arthritis
Ulcerative colitis

Some studies suggest that boswellia may have some anti-inflammatory and anti-tumor effects,
but large-scale, industry-independent clinical trials are needed.

Here's a look at several findings from the available research:

Osteoarthritis Pain
For a report published in the Cochrane Database of Systematic Reviews in 2014, researchers
analyzed previously published trials testing the effects of herbal supplements for osteoarthritis.
Their analysis of studies involving boswellia found evidence that it reduced pain (as measured
by a pain scale) and improved physical function compared to a placebo.

Asthma
A small 2015 study published in the European Review for Medical and Pharmacological
Sciences, Boswellia may help reduce the need for inhalation therapy in people with persistent
asthma. Participants in the study (who had mild-to-severe persistent asthma) received either
inhalation therapy with an oral boswellia supplement or inhalation therapy alone.

After four weeks of treatment, those who took the Boswellia supplement in addition to the
inhalation therapy had a decrease in the number of inhalations needed compared to those who
had inhalation therapy alone.

Crohn’s Disease
A study published in Inflammatory Bowel Diseases found that a boswellia extract may not help
people with Crohn’s disease who are in remission. After 12 months of treatment with a boswellia
extract, there was no significant difference in relapse time, the severity of symptoms, or
maintenance of remission.
Inflammatory Bowel Disease
In a 2007 study involving 31 people with collagenous colitis (a type of inflammatory bowel
disease that causes chronic diarrhea), researchers found that taking a boswellia extract three
times daily for six weeks was not more effective than a placebo when comparing clinical
remission, lab testing, or quality of life.

Possible Side Effects

Boswellia is likely safe when taken by mouth for up to six months. Boswellia is possibly safe
when applied to the skin for up to five weeks. Follow your health provider's instructions.

Boswellia has been known to cause nausea, diarrhea, bloating, acid reflux, heartburn, and
allergic reactions. It may stimulate blood flow in the uterus. Pregnant and nursing women
shouldn't take boswellia.

Boswellia may interact with medications, such as non-steroidal anti-inflammatory (NSAID) drugs
like ibuprofen and drugs that are substrates of P-Glycoprotein (P-Gp), so be sure to consult your
healthcare provider before using it. If you have gastritis or gastroesophageal reflux disease
(GERD), you may not be able to take boswellia.

Two case reports describe dangerously elevated INR (a test used to measure blood clotting) in
people who were taking warfarin (Coumadin), a type of drug often referred to as a "blood
thinner". Boswellia was considered the probable cause in both cases.
If you're taking any type of blood thinner or have a condition that affects blood clotting, be sure
to consult your doctor before taking boswellia. It shouldn't be taken within two weeks of
scheduled surgery.

Dosage and Preparation

There is no recommended dose of boswellia. Various doses have been used in research when
investigating different health benefits of boswellia.

For example, for studies investigating osteoarthritis, 100-1000 mg of boswellia extracts or 300-
600 mg of boswellia extract in combination with other herbs has been used daily. And for
ulcerative colitis a treatment of 350 mg three times daily for six weeks has been used.

A cream containing 2 percent boswellia was used in a study investigating the herb's effect on
skin during radiation treatment. The cream was applied twice daily during radiation therapy.

What to Look For

Available in many health food stores, boswellia is sold in supplement form and in formulas
containing curcumin (turmeric) and other herbs.

The quality and purity of boswellia supplements is an issue. Due to the fact that dietary
supplements are largely unregulated, the content of some products may differ from what is
specified on the product label.

For example, boswellia products have been found not to contain any of the six boswellic acids
(considered to be the active ingredients), suggesting the use of a different species instead of
boswellia serrata.

Although some natural approaches may help to reduce inflammation, it's important to not delay
treatment or stop taking your prescribed treatment, as certain conditions can have longer-term
health effects if they aren't treated properly.

If you have an inflammatory condition, your symptoms may be keeping you from doing everyday
activities. You may be seeking ways to further manage your pain and find relief.

Although boswellia shows promise for certain conditions, further research is still needed from
large-scale clinical trials to confirm these effects. If you're still thinking of trying boswellia, speak
with your doctor first to see if it's appropriate (and safe) for you and whether it can become a
part of your treatment plan, possibly in combination with other herbs with anti-inflammatory
properties, like ginger and turmeric.

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts
within our articles. Read our editorial process to learn more about how we fact-check and keep our
content accurate, reliable, and trustworthy.

1. Cameron M, Chrubasik S. Oral herbal therapies for treating osteoarthritis. Cochrane Database of
Systematic Reviews 2014, Issue 5. Art. No.: CD002947. DOI: 10.1002/14651858.CD002947.pub2.

2. Ferrara T, De Vincentiis G, Di Pierro F. Functional study on Boswellia phytosome as complementary

intervention in asthmatic patients. Eur Rev Med Pharmacol Sci. 2015;19(19):3757–3762.

3. Holtmeier W, Zeuzem S, Preiss J, et al. Randomized, placebo-controlled, double-blind trial of

Boswellia serrata in maintaining remission of Crohn's disease: good safety profile but lack of
efficacy. Inflamm Bowel Dis. 2011;17(2):573–582. doi:10.1002/ibd.21345

4. Madisch A, Miehlke S, Eichele O, et al. Boswellia serrata extract for the treatment of collagenous
colitis. A double-blind, randomized, placebo-controlled, multicenter trial. Int J Colorectal Dis.
2007;22(12):1445–1451. doi:10.1007/s00384-007-0364-1

5. Ammon HP. Boswellic Acids and Their Role in Chronic Inflammatory Diseases. Adv Exp Med Biol.
2016;928:291–327. doi:10.1007/978-3-319-41334-1_13

6. Ahangarpour A, Heidari H, Fatemeh RA, et al. Effect of Boswellia serrata supplementation on blood
lipid, hepatic enzymes and fructosamine levels in type2 diabetic patients. J Diabetes Metab Disord.
2014;13(1):29. Published 2014 Feb 4. doi:10.1186/2251-6581-13-29

7. Roe AL, Wilcox R, Price JM, Li L, Dai H, Freeman K, Friley W, Herman A, Black CB, Brouwer KR,
and Jackson JP. An Evaluation of Potential Inhibition of CYP3A4/5 and CYP2C9 Enzymatic Acttivity
by Boswellia serrata Extract. Applied In Vitro Toxicology. 2019; 5(1) doi.org/10.1089/aivt.2018.0023

8. Memorial Sloan Kettering Cancer Center. Boswellia. mskcc.org April 15, 2019

9. Gupta I, Parihar A, Malhotra P, et al. Effects of Boswellia serrata gum resin in patients with ulcerative
colitis. Eur J Med Res. 1997;2(1):37–43.

10. Togni S, Maramaldi G, Bonetta A, Giacomelli L, Di pierro F. Clinical evaluation of safety and efficacy
of Boswellia-based cream for prevention of adjuvant radiotherapy skin damage in mammary
carcinoma: a randomized placebo controlled trial. Eur Rev Med Pharmacol Sci. 2015;19(8):1338-44.

11. Crawford C, Boyd C, Berry K, Deuster P; HERB Working Group. Dietary Ingredients Requiring
Further Research Before Evidence-Based Recommendations Can Be Made for Their Use as an
 Approach to Mitigating Pain. Pain Med. 2019;20(8):1619–1632. doi:10.1093/pm/pnz050

Additional Reading

Boswellia. Natural Medicines Database. Professional Monograph.

Boswellia. Memorial Sloan Kettering Cancer Center. About Herbs, Botanicals, and Other Products.

Cameron M, Chrubasik S. Oral herbal therapies for treating osteoarthritis. Cochrane Database Syst
Rev. 2014 May 22;(5):CD002947.

Ferrara T, De Vincentiis G, Di Pierro F. Functional study on Boswellia phytosome as complementary

intervention in asthmatic patients. Eur Rev Med Pharmacol Sci. 2015 Oct;19(19):3757-62.

Holtmeier W Zeuzem S, Preiss J,et al. Randomized, placebo-controlled, double-blind trial of

Boswellia serrata in maintaining remission of Crohn's disease: good safety profile but lack of efficacy.
Inflamm Bowel Dis. 2011 Feb;17(2):573-82.

Madisch A, Miehlke S, Eichele O, et al. Boswellia serrata extract for the treatment of collagenous
colitis. A double-blind, randomized, placebo-controlled, multicenter trial. Int J Colorectal Dis. 2007
Dec;22(12):1445-51.