Boswellia
Boswellia (frankincense) extracts are studied for joint and inflammatory outcomes. Results depend on extract standardization.
Overview
What is boswellia?
Boswellia serrata is an anti-inflammatory herbal remedy that may improve joint pain and other symptoms of osteoarthritis.
It inhibits an enzyme known as 5-lipoxygenase (5-LO or 5-LOX) which may contribute to joint pain.
In manufacturer-funded studies, boswellia has been shown to improve knee function and pain after 5–7 days.
However, recent research from non-manufacturer funded studies suggests that other boswellic acids found in non-standardised formulations may be responsible for most therapeutic effects.
Dosage
A typical dose of boswellia is around 100 to 600 mg per day.
Boswellia should be taken with a fat-containing meal.
Most studies use dosages between 100 to 300 mg per day.
Effect graph
Effect heatmap
SupplementDEX Database
14 conditions for , and rated at least stars. All purchase bands. No minimum star filter.
Database Snapshot
Most boswellia research is concentrated in a handful of conditions.
- Osteoarthritis accounts for 17 of 36 studies (47%).
- Delayed onset muscle soreness accounts for 3 of 36 studies (8%).
- Diabetes accounts for 2 of 36 studies (6%).
- Sparse coverage remains for Diabetes, Irritable bowel syndrome (IBS), Traumatic brain injury (TBI).
Dietary Sources
Dietary sources
Boswellia resin is typically consumed through supplements rather than as a regular dietary ingredient.
Safety
Boswellia is likely safe and generally well tolerated at recommended dosages.
Studies have used boswellia at dosages of up to 1 g per day for 6 months without major adverse side effects. In studies, boswellia is well tolerated at dosages of around 300 to 1000 mg per day.
Rare side effects include headache, diarrhea or nausea at higher doses.
The effects of boswellia in pregnant or lactating women are not well understood. Usage should be avoided. The effects of boswellia in children are not well understood. Usage should be avoided.
Market Safety Report: Poor overall. Prefer lab-tested supplements where available. A study of six US products representing 78% of units sold and 11 European products representing 30% of units sold found that only 5 out of 17 products disclosed all relevant information and 41% did not comply with label regulations. Boswellia serrata products have been found to contain other species including Boswellia sacra.
Frequently Asked Questions
Takeaway
Boswellia is a herbal extract that can help to reduce joint pain. Combining boswellia with a fat-containing meal appears to increase its effects. Whilst standard boswellic acids are possibly more beneficial, most brands use a specific form of boswellic acid known as AKBA which inhibits the 5-LOX enzyme. New research suggests that the AKBA form of boswellia is less effective than non-standardised forms containing higher concentrations of other boswellic acids.
References
Sources36 references
SupplementDEX uses only high-quality sources to determine supplement effectiveness.
SupplementDEX Database · Osteoarthritis
17 references1.SupplementDEX Database: Osteoarthritis — Efficacy of Extracts of Oleogum Resin of Boswellia in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis2024
A meta-analysis of 13 knee osteoarthritis trials found high heterogeneity overall, but subgroup analysis showed Boswellia oleogum resin extracts significantly lowered WOMAC scores versus placebo.
2.SupplementDEX Database: Osteoarthritis — Efficacy evaluation of standardized Boswellia serrata extract (AflapinⓇ) in osteoarthritis: A systematic review and sub-group meta-analysis study2024
A meta-analysis of 9 osteoarthritis RCTs (712 participants) found Boswellia serrata supplementation significantly reduced pain VAS; standardized Aflapin® extract showed larger reductions in VAS, LFI, and WOMAC subscores than other Boswellia extracts.
3.SupplementDEX Database: Osteoarthritis — A standardized Boswellia serrata extract shows improvements in knee osteoarthritis within five days — a double-blind, randomized, three-arm, parallel-group, multi-center, placebo-controlled trial2024
A manufacturer-funded study including 98 newly diagnosed osteoarthritis patients found that boswellia serrata supplementation (300 mg/day or 600 mg/day) led to improvements in pain from 5 days after starting supplementation. After 90 days, pain scores were reduced by 45.3% in the 300 mg/day group and by 61.9% in the 600 mg/day group (Visual Analog Scale). Distance walked in 6 minutes improved by 21.2% (300 mg/day) and 21.9% (600 mg/day) after 90 days. After 90 days, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score improved by 70.2% (300 mg/day) and 73.9% (600 mg/day). WOMAC stiffness improved by by 65.6% (300 mg/day) and 68.9% (600 mg/day). WOMAC function improved by 68.8% (300 mg/day) and 74.2% (600 mg/day). WOMAC total score (Pain, Stiffness & Function) improved by 68.5% (300 mg/day) and 73.6% (600 mg/day). Levels of TNF-alpha, hs-CRP and IL-6 were reduced in the boswellia serrata group compared to placebo. This manufacturer-funded study included study authors employed by Sami-Sabinsa Group Limited.
4.SupplementDEX Database: Osteoarthritis — Efficacy and Safety of Aflapin®, a Novel Boswellia Serrata Extract, in the Treatment of Osteoarthritis of the Knee: A Short-Term 30-Day Randomized, Double-Blind, Placebo-Controlled Clinical Study2023
In 67 adults with knee osteoarthritis, Aflapin® 100 mg/day for 30 days improved VAS, LFI, and WOMAC pain, stiffness, and function scores by 40–66% versus baseline, with benefits seen by day 5.
5.SupplementDEX Database: Osteoarthritis — Efficacy and safety of a supplement combination on hand pain among people with symptomatic hand osteoarthritis: an internet-based, randomised clinical trial (the RADIANT study)2021
In 106 adults with symptomatic hand osteoarthritis over 12 weeks, a supplement combining Boswellia, pine bark, MSM, and curcumin did not reduce hand pain VAS more than placebo (between-group difference 5.34; 95% CI −2.39 to 13.07).
6.SupplementDEX Database: Osteoarthritis — Prospective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis2021
In 107 adults with symptomatic mild knee osteoarthritis followed ~36 weeks, adding Tregocel® (curcumin, Boswellia, harpagophytum, celery, ginger) to standard care increased 6-minute walk distance by 26 m, improved WOMAC scores, and cut regular OA medication use from 99% to 55%.
7.SupplementDEX Database: Osteoarthritis — Double-blind trial of solid lipid Boswellia serrata particles (SLBSP) vs. standardized Boswellia serrata gum extract (BSE) for osteoarthritis of knee2020
In knee osteoarthritis treated 2 months, solid lipid Boswellia serrata particles (SLBSP) and standard BSE both improved WOMAC and VAS scores similarly, but SLBSP markedly reduced rescue analgesic use and lowered pro-inflammatory cytokines versus rising levels on BSE.
8.SupplementDEX Database: Osteoarthritis — A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee2019
In 48 patients with knee osteoarthritis treated 120 days, Boswellin® Boswellia serrata extract significantly reduced pain and stiffness versus placebo, improved radiographic joint gap, and lowered high-sensitivity C-reactive protein without serious adverse events.
9.SupplementDEX Database: Osteoarthritis — Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: Randomized trial2016
In 120 patients with knee arthritis treated 60 days, MSM plus boswellic acids (5 g + 7.2 mg/day) and glucosamine sulfate (1500 mg/day) each improved VAS pain and Lequesne Index scores, with a trend favoring the MSM/BA group at 6 months.
10.SupplementDEX Database: Osteoarthritis — Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial2013
In 440 patients with symptomatic knee osteoarthritis over 24 weeks, Ayurvedic formulations containing Boswellia serrata were equivalent to glucosamine sulfate and celecoxib for reducing pain and improving knee function.
11.SupplementDEX Database: Osteoarthritis — Clinical evaluation of a formulation containing Curcuma longa and Boswellia serrata extracts in the management of knee osteoarthritis2013
In 28 osteoarthritis patients, a Curcuma longa plus Boswellia serrata formulation (500 mg twice daily) outperformed celecoxib 100 mg twice daily on symptom scores and clinical examination, with no dose-related toxicity.
12.SupplementDEX Database: Osteoarthritis — A double blind, randomized, placebo controlled clinical study evaluates the early efficacy of aflapin in subjects with osteoarthritis of knee2011
A 30-day manufacturer-funded study including 59 patients with mild to moderate osteroarthritis found that 100 mg/day boswellia (Aflapin) led to significant reductions (P < 0.001) in pain (-49.1%, VAS), function (-34.4%, LFI), WOMAC pain (-49.5%), WOMAC stiffness (-48.4%) and WOMAC function scores (-45.2%) compared to placebo. Boswellia supplementation to significant reductions in pain (-14.8%, VAS) and improved function (+16.3%, Lequesne’s Functional Index) as early as 5 days after beginning supplementation. This study was funded by the Laila Group of Industries, India.
13.SupplementDEX Database: Osteoarthritis — Clinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis)2011
A non-placebo-controlled study of 49 patients (aged 40 to 70 yrs) with mild osteoarthritis found boswellia supplementation (6 g/day in 3 divided doses after meals) or boswellia supplementation + local topical application of boswellia ointment led to significant improvements in overall joint mobility, joint pain, joint stiffness and joint swelling. The addition of topical boswellia to oral supplementation did not confer a greater benefit for complete remission or marked improvement of overall symptoms compared to oral supplementation alone.
14.SupplementDEX Database: Osteoarthritis — Comparative efficacy and tolerability of 5-Loxin and Aflapin Against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study2010
A 90-day manufacturer-funded study including 57 patients with mild to moderate osteroarthritis found that whilst both 100 mg/day 5-Loxin and 100 mg/day Aflapin led to significant improvements in joint function and pain, aflapin exhibited better therapeutic efficiency. Aflapin worked faster than 5-Loxin to reduce knee pain, with benefits as early as 7 days after initiating treatment. Both formulations had similar safety profiles. This study was funded by the Laila Group of Industries, India.
15.SupplementDEX Database: Osteoarthritis — A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee2008
In 70 knee osteoarthritis patients over 90 days, 5-Loxin (100 or 250 mg/day) significantly improved pain and physical function versus placebo; the 250 mg dose improved scores by day 7 and reduced synovial fluid MMP-3.
16.SupplementDEX Database: Osteoarthritis — Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee – a randomized double blind placebo controlled trial2003
An 8-wk crossover study (8-week treatment + 8 week placebo) including 30 knee osteoarthritis patients (mean age 59.03 yrs) found that boswellia supplementation (1000 mg/day for 8 weeks) led to clinically and statistically significant reductions in pain severity, swelling and loss of function (all P < 0.001).
17.SupplementDEX Database: Osteoarthritis — Treatment of osteoarthritis with a herbomineral formulation: a double-blind, placebo-controlled, cross-over study1991
In 42 osteoarthritis patients, herbomineral Articulin-F containing ashwagandha reduced pain and disability versus placebo over a crossover trial, without radiographic change.
SupplementDEX Database · Alzheimer's disease
1 reference18.SupplementDEX Database: Alzheimer's disease — Boswellic Acids Improve Clinical Cognitive Scores and Reduce Systemic Inflammation in Patients with Mild to Moderate Alzheimer's Disease2023
In 85 patients with mild-to-moderate Alzheimer's disease, boswellic acids (K-Vie™) for 6 months improved MMSE by 3.1 points and CDR-SOB by 1.6 points versus placebo, with reduced IL-6 and TNF-α.
SupplementDEX Database · Asthma
1 reference19.SupplementDEX Database: Asthma — Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study1998
In 40 patients with bronchial asthma, Boswellia serrata gum resin 300 mg three times daily for 6 weeks improved symptoms and lung function in 70% versus 27% on placebo.
SupplementDEX Database · Crohn's disease
1 reference20.SupplementDEX Database: Crohn's disease — Randomized, placebo-controlled, double-blind trial of Boswellia serrata in maintaining remission of Crohn's disease: good safety profile but lack of efficacy2011
In 66 Crohn's disease patients in remission, Boswelan extract 2400 mg/day for 52 weeks did not outperform placebo for maintaining remission (59.9% vs 55.3%; P=0.85), though tolerability was good.
SupplementDEX Database · Diabetes
2 references21.SupplementDEX Database: Diabetes — Effect of boswellia (Boswellia serrata L.) supplementation on glycemic markers and lipid profile in type 2 diabetic patients: a systematic review and meta-analysis2024
A 2024 meta-analysis of 5 RCTs (287 type 2 diabetes patients) found boswellia significantly lowered HbA1c, total cholesterol, triglycerides, and LDL versus placebo; fasting glucose reduction was not significant.
22.SupplementDEX Database: Diabetes — Effectiveness and Safety of Ayurvedic Medicines in Type 2 Diabetes Mellitus Management: A Systematic Review and Meta-Analysis2022
A systematic review of 199 Ayurvedic medicine RCTs (21,191 participants) found Boswellia serrata reduced HbA1c by 0.5% (95% CI −0.7 to −0.4) compared with control in type 2 diabetes.
23.SupplementDEX Database: Delayed onset muscle soreness — Modulation of Affective and Sensory Qualities of Acute Nociceptive Pain by Curcuma longa and Boswellia serrata Extract Formulation: A Randomized, Double-Blind, Placebo-Controlled Design in Subjects With Exercise-Induced Acute Musculoskeletal Pain2025
In 232 healthy adults with exercise-induced musculoskeletal pain, 1000 mg/day turmeric–Boswellia extract for 6 hours significantly reduced McGill pain scores for both sensory and affective pain versus placebo.
24.SupplementDEX Database: Delayed onset muscle soreness — Ten days of supplementation with a standardized Boswellia serrata extract attenuates soreness and accelerates recovery after repeated bouts of downhill running in recreationally active men2025
In 50 recreationally active men (mean age 28), 60 mg/day standardized Boswellia serrata extract for 10 days around downhill running reduced muscle soreness VAS by 8.0 mm versus placebo on day 10 (p=0.006).
25.SupplementDEX Database: Delayed onset muscle soreness — Fast pain relief in exercise-induced acute musculoskeletal pain by turmeric-boswellia formulation: A randomized placebo-controlled double-blinded multicentre study2022
In 232 adults with moderate-to-severe exercise-induced musculoskeletal pain, a single 1000 mg turmeric–boswellia dose produced meaningful pain relief within ~3 hours, with 97.85% cumulative responder improvement versus 2.46% on placebo.
SupplementDEX Database · Diarrhea
1 reference26.SupplementDEX Database: Diarrhea — Positive Effects of a Lecithin-Based Delivery Form of Boswellia serrata Extract in Acute Diarrhea of Adult Subjects2022
In 49 adults with acute diarrhea, 250 mg/day lecithin-based Boswellia serrata extract (CASP) for 5 days shortened time to recovery (3.08 vs 4.44 days; p<0.0001) and reduced stool frequency, abdominal pain, and nausea.
27.SupplementDEX Database: Irritable bowel syndrome (IBS) — Oral administration of a lecithin-based delivery form of boswellic acids (Casperome®) for the prevention of symptoms of irritable bowel syndrome: a randomized clinical study2019
In 69 otherwise healthy adults with mild IBS followed 6 months, daily Casperome® boswellic acid tablets reduced IBS symptoms and rescue medication use versus standard symptomatic drug management.
28.SupplementDEX Database: Irritable bowel syndrome (IBS) — Supplementation with a lecithin-based delivery form of Boswellia serrata extract (Casperome®) controls symptoms of mild irritable bowel syndrome2017
In 71 otherwise healthy adults with idiopathic IBS over 4 weeks, Casperome® supplementation improved abdominal pain, bowel habits, and meteorism comparably to antispasmodic drugs, with fewer side effects and less need for medical attention.
SupplementDEX Database · Knee pain
1 reference29.SupplementDEX Database: Knee pain — Efficacy of Boswellia serrata Extract and/or an Omega-3-Based Product for Improving Pain and Function in People Older Than 40 Years with Persistent Knee Pain: A Randomized Double-Blind Controlled Clinical Trial2023
In adults over 40 with persistent knee pain treated 8 weeks, omega-3 (AvailOm®) significantly reduced pain VAS versus placebo; combined Boswellia plus AvailOm® improved WOMAC quality-of-life scores most.
SupplementDEX Database · Menorrhagia
1 reference30.SupplementDEX Database: Menorrhagia — The effect of frankincense (Boswellia serrata, oleoresin) and ginger (Zingiber officinale, rhizoma) on heavy menstrual bleeding: A randomized, placebo-controlled, clinical trial2019
In 102 women with heavy menstrual bleeding, frankincense 300 mg or ginger 300 mg three times daily with ibuprofen for two cycles each shortened bleeding duration by ~1.8 days and improved quality-of-life scores versus placebo.
SupplementDEX Database · Microscopic colitis
1 reference31.SupplementDEX Database: Microscopic colitis — Boswellia serrata extract for the treatment of collagenous colitis: A double-blind, randomized, placebo-controlled, multicenter trial2007
In 26 patients with collagenous colitis, Boswellia serrata extract 400 mg three times daily for 6 weeks achieved clinical remission in 63.6% versus 26.7% on placebo (p=0.04), without histologic or quality-of-life differences.
SupplementDEX Database · Stroke
1 reference32.SupplementDEX Database: Stroke — Functional improvement and immune-inflammatory cytokines profile of ischaemic stroke patients after treatment with boswellic acids: a randomized, double-blind, placebo-controlled, pilot trial2019
In 80 ischemic stroke patients (NIHSS 4–20), boswellic acid supplementation for 1 month significantly improved NIHSS neurological scores and reduced plasma TNF-α, IL-1β, IL-6, IL-8, and PGE2 versus placebo.
33.SupplementDEX Database: Traumatic brain injury (TBI) — Boswellia serrata extract shows cognitive benefits in a double-blind, randomized, placebo-controlled pilot clinical trial in individuals who suffered traumatic brain injury2022
In 46 adults with traumatic brain injury 3 months to 3 years prior, K-Vie™ boswellic acids for 3 months significantly improved RAVLT, digit symbol, and trail-making cognitive test performance versus placebo.
34.SupplementDEX Database: Traumatic brain injury (TBI) — The effect of Boswellia serrata on neurorecovery following diffuse axonal injury2013
In 38 patients with diffuse axonal injury in a 12-week crossover study, Boswellia serrata showed no significant overall disability improvement, but cognitive self-care scores improved when patients were on Boswellia in one subgroup analysis.
SupplementDEX Database · Ulcerative colitis
2 references35.SupplementDEX Database: Ulcerative colitis — Managing ulcerative colitis in remission phase: usefulness of Casperome®, an innovative lecithin-based delivery system of Boswellia serrata extract2016
In 43 ulcerative colitis patients in remission over 4 weeks, daily Casperome® Boswellia serrata extract significantly improved pain, bleeding, bowel habits, anemia, and calprotectin versus no supplementation.
36.SupplementDEX Database: Ulcerative colitis — Effects of Boswellia serrata gum resin in patients with ulcerative colitis1997
In ulcerative colitis grade II–III treated 6 weeks, Boswellia serrata gum resin 350 mg three times daily achieved remission in 82% of patients versus 75% on sulfasalazine 1 g three times daily, with similar histologic improvement.