The herbal supplement boswellia is claimed by its proponents to treat, well, just about everything—from arthritis, Parkinson’s disease, and irritable bowel syndrome to cancer, heart disease, and infections. Can it really do all (or any) of that? Here’s what we know about it, based on limited available research.
Also known as Indian frankincense, boswellia is extracted from the bark of the Boswellia serrata tree, which is native to India, Northern Africa, and the Middle East. The resin of this tree (shown in the photo above) has been used in traditional Indian medicine (Ayurveda) for millennia to treat a variety of conditions, from asthma to arthritis.
The active compounds in boswellia are known as boswellic acids. Some test-tube and animal studies have shown them to have anti-inflammatory, analgesic (pain-relieving), and anti-cancer properties, as well as to help inhibit the autoimmune process and help prevent cartilage loss.
But published studies of boswellia in humans are relatively few, and all have been small. The most promising evidence is for pain and osteoarthritis. In a 2019 pilot study in Phytotherapy Research that included 48 people with knee osteoarthritis, for example, those taking a boswellia supplement for four months had greater reductions in pain and stiffness and could walk farther than those in a placebo group. Plus they had X-ray evidence of improvements in the knee joint (the placebo group had no evidence of joint improvement and in fact showed evidence of worsening arthritis).
Blood tests also showed a greater reduction in C-reactive protein (a marker of inflammation) in the supplement group than in the placebo group. However, the study was funded by the company that made the supplement.
Two earlier clinical trials, from 2008 and 2011, similarly found that boswellia extracts improved pain and function in people with knee osteoarthritis over one and three months, but those studies, too, were funded by the manufacturers.
The Natural Medicines database, which evaluates research on herbal and other alternative therapies, rates boswellia as “possibly effective” for osteoarthritis, ulcerative colitis, and (in topical form) skin rash due to radiation therapy. It says there is insufficient evidence to rate boswellia for its many other purported uses. The Arthritis Foundation includes boswellia among the herbs it recommends for people who have osteoarthritis or rheumatoid arthritis.
Studies of boswellia in humans have raised no serious safety concerns, but long-term safety data are lacking since the studies have been short-term and haven’t involved many people. Allergic skin reactions are possible from topical boswellia products, and excessive oral doses may cause gastrointestinal upset.
Bottom line: Given the lack of independent research—along with the fact that, as with all dietary supplements, you often can’t be sure of the purity or potency of what’s in the bottle—we don’t recommend taking boswellia. If you do want to try it, talk with your doctor first, especially if you take medication. Boswellia may interact with a number of drugs, including the anti-clotting drug warfarin (Coumadin and generic versions) and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin, and generics).
This article first appeared in the UC Berkeley Wellness Letter.