Boswellia Serrata

What is Boswellia?

Boswellia serrata, also called Indian frankincense, is a tree native to India. Its gum resin has been used for centuries in Ayurvedic medicine. The resin contains boswellic acids, including one called AKBA (3-acetyl-11-keto-beta-boswellic acid), which researchers have studied for effects on inflammatory pathways.

What the research says

Boswellia has some of the more consistent evidence among herbal ingredients for osteoarthritis, though the effects are modest. A 2014 Cochrane review of oral herbal therapies found high-quality evidence from two studies (85 participants) that 100 mg a day of an AKBA-enriched Boswellia serrata extract for 90 days reduced pain by an average of 17 points on a 100-point scale and improved function compared with placebo (Cochrane). NCCIH summarizes the evidence as showing slight improvements that some patients might not consider meaningful (NCCIH).

A 2020 meta-analysis of seven trials (545 patients) reported improvements in pain, stiffness and function with Boswellia or its extracts (BMC Complement Med Ther). A 2024 meta-analysis of 13 studies did not find a significant overall effect because the studies varied so much, although subgroup analysis favored Boswellia over placebo (Phytother Res). Extracts differ widely in their boswellic acid profile, which makes it hard to compare products.

An older systematic review of Boswellia serrata trials across several conditions, including osteoarthritis, rheumatoid arthritis, asthma and inflammatory bowel conditions, called the evidence encouraging but not compelling and noted no serious safety issues (BMJ, 2008). Most osteoarthritis trials have been short, lasting one to three months, and many were small or sponsored by extract makers. No good evidence shows that Boswellia slows cartilage loss or changes the course of osteoarthritis. In a broad 2018 review of supplements for osteoarthritis, Boswellia extract was among those with large short-term effects on pain, but the quality of evidence was very low and no supplement showed clinically important long-term benefits (Br J Sports Med).

How it’s used in supplements

Boswellia is sold as a standalone extract and in joint formulas, usually at 100 to 500 mg a day of a standardized extract. Look for the standardization on the label, such as total boswellic acids or AKBA percentage, since many studies used branded, AKBA-enriched extracts.

Side effects in trials have generally been mild and include stomach upset, nausea, diarrhea and heartburn. Little is known about long-term safety, and NCCIH notes that safety information on most herbal products for osteoarthritis is limited. Because Boswellia may affect inflammatory and possibly platelet pathways, people taking blood thinners or anti-inflammatory drugs should check with a doctor first. Avoid it during pregnancy and breastfeeding unless advised by a doctor.