Boswellia: Health Benefits, Dosage, Side Effects, and Warnings (2019)
While Boswellia extract is a relatively new item in the West, it is a familiar herbal remedy for those in the east. What is Boswellia? What are the benefits of taking a Boswellia complex? What are the side effects of Boswellia? How can you take it? What are some of the forms and mixtures Boswellia extract is found in? And who shouldn’t take Boswellia? We’ll answer these questions and more about Boswellia.
What Is Boswellia?
Boswellia or Boswellia Serrata is also known as Indian frankincense, salai guggul, Loban, kundur, sallaki, and Indian olibanum. Boswellia plants are found across India, Arabia, and Africa. Boswellia sacra or B. sacra is the Boswellia species native to Yemen. There are two dozen other species in the Boswellia family, as well. In this article, we’ll focus on Boswellia serrata.
Boswellia is an herbal remedy used for gastrointestinal and musculoskeletal problems. It has been prescribed in Indian medicine for everything from inflammatory bowel disease to arthritis. Boswellia “guggul” can refer to the resin extract from Boswellia plants and a mix of Boswellia and Commiphora plants. However, guggul can refer to other herbal remedies, as well.
In order to make Boswellia extract, the trunk of these trees is tapped. The resin is harvested, purified and then used in everything from religious ceremonies to herbal remedies. You’ve probably heard of it as just frankincense. Note that Boswellia is in no way related to myrrh except that they’re both often offered as part of religious rituals.
The resin of various Boswellia trees may be consumed as a pill, burned and inhaled, drunk as a tea and ingested in other forms. The main active ingredient in these herbal remedies is known as the Boswellic acids.
Summary: Boswellia is a generic term for a number of species; Boswellia serrata is the main one used in Chinese, Middle Eastern and Indian traditional medicine.
The Health Benefits of Boswellia
Boswellia sacra extract suppresses aggressive breast cancer tumors, at least in the lab.  One study found that it killed pancreatic cancer cells in cultures, too, a particularly valuable feature given that pancreatic cancer is typically found after it has spread.  In theory, this along with the known anti-oxidant power of Boswellia would be a reason to take it regularly. However, these anti-cancer effects haven’t yet been demonstrated in humans.
Historical use of Boswellia extract that we can all appreciate is its anti-microbial and anti-bacterial properties, fighting infection. The ability of these plants to fight protozoan infections was demonstrated in a 2011 study. A 2018 scientific study found that it works on several fronts to fight multiple chronic diseases. Another study found that Boswellia could be used to fight the herpes simplex virus or HSV.  That research was building on the historical use of Boswellia for treating various skin ailments. That study suggested that Boswellia was indeed a viable way to treat herpes skin infections.
Because guggul is an FXR antagonist, it is regularly to lower cholesterol. It prevents bile acid-induced metaplasia in the intestines. On top of that, it seems to stimulate the thyroid and protect the heart.
Boswellia essential oils have been used for thousands of years in aromatherapy. This is in part because of the anti-inflammatory and antibiotic effects associated with frankincense in all forms. Acetyl-11-keto-β-boswellic acid or AKBA is probably the most potent anti-inflammatory compound in Boswellia.  In various models, it has been seen to reduce ulcerative colitis. ABKA has been linked to a reduction in oxidative stress, inflammation, and immune dysregulation.  Boswellia has been shown to interfere in the formation of leukotrienes, molecules that cause inflammation for conditions such as asthma. These same molecules are what drive rheumatoid arthritis. Depending on the study you read, patients reported pain levels fell anywhere from 33% to 66%. An investigation as far back as 1998 found that Boswellia can reduce both asthma symptoms and indicators.  We don’t have hard data on whether or not it is equally beneficial for those with respiratory allergies.
Burning frankincense and inhaling the fumes have been used to create a more significant sense of wellbeing and altered consciousness for ages. The psychoactive effects of Boswellia were proven in a 2010 study.  While we cannot say definitively that Boswellia is a good, generic pain reliever, its use is associated with improved pain tolerance and a higher overall pain threshold.  And it achieves this without cardiovascular and gastrointestinal effects. For example, NSAIDs reduce pain and inflammation but are linked to higher blood pressure, kidney impairment, heart failure, and gastrointestinal bleeding. Unlike NSAID drugs, Boswellia does not reduce fever.
There are ongoing clinical trials to test its effectiveness in treating nodulocystic acne, psoriasis, gingivitis, eczema, and breast fibroadenoma.  A 2001 study suggests that Boswellia extract may treat Crohn’s disease.  On the flipside, a study in “Inflammatory Bowel Disease” found no significant difference in relapse time, duration of remission or severity of symptoms for those with Crohn’s disease. Boswellia may be able to treat ulcerative colitis, as well. Animal studies show that it can reduce colitis inflammation. However, research regarding humans is ongoing.
A 2018 meta-data analysis of several dozen studies found that Boswellia formulations were more effective than placebos improving mobility and range of motion in those with arthritis. At the same time, there was no difference between Boswellia extract and placebos in safety outcomes. In essence, Boswellia provided partial relief from various forms of arthritis but with far fewer adverse side effects than conventional arthritis drugs.  A different 2003 study published in Phytomedicine found that those who consumed it had a higher degree of knee flexion and could walk further. Boswellia extract manufacturers found that increasing the dosage increases physical ability and reduces the level of enzymes in the body that degrade cartilage over time.
Boswellia Serrata has been used to treat diabetic patients in Iran for years.  Clinical research over the past few years have shown that it does improve glucose levels and blood lipids in Type II diabetic patients in addition to doing so in mice. That is consistent with its traditional use of the oleo-gum as an anti-diabetic.
Iran also has a track record of treating the gradual decline in memory in the aging with Boswellia serrata along with Melisa officinalis.  A 2018 randomized study found that it improved the user’s memory on all accounts. They remembered more of what they heard. They were more likely to remember what they saw. Their short-term memory increased overall. And their working memory was enhanced. This study was a double-blind, placebo-controlled clinical trial. However, further research is needed to verify these results before we’ll suggest that patients take Boswellia along with other supplements to improve their memory.
Boswellia has been studied in its effectiveness of treating heavy menstrual bleeding. The duration of the heavy bleeding was decreased by those who took Boswellia or Indian frankincense along with ginger. They also reported a higher, overall quality of life. In this case, further study was recommended before the researchers were willing to approve the herbal remedy combination as a treatment for menorrhagia. This is in line with the use of Boswellia in treating menstrual cramps.
Summary: Recent scientific studies have validated many traditional uses of Boswellia whether treating arthritis, diabetes, dementia or pain.
The general recommended dosage is 300 to 500 milligrams taken two to three times a day. If you’re taking it for arthritis, it would be 300 mg three times a day. If you have digestive tract problems that interfere with its absorption such as IBS, then the dosage would be 400-500 mg three times a day. The three times a day regimen is recommended for chronic conditions because the critical enzyme in Boswellia serrata lasts in the blood for about six hours. 
While Boswellia has long been burned to create inhaled fumes, especially to alter one’s mood, we cannot recommend that method if you suffer from respiratory problems. Taking Boswellia extract in pill form would be a better choice if you have asthma or another respiratory disorder. A 2015 study done in Europe suggested that Boswellia could reduce the need for inhalation treatment for those with mild to severe asthma.
We need to note that the effectiveness of Boswellia products - regardless of form - are based on their concentration of Boswellic acids like AKBA. If you’re taking a 300 to 400-milligram dose several times a day, make sure it contains at least 50% Boswellic acids. Standardized extracts should include at least 37.5% Boswellic acids. These are sometimes listed as “Boswellin” on the ingredients list. Do your research, since the quality and purity of Boswellia supplements are quite variable; some Boswellia products contain only a few or even none of the Boswellic acids.
In theory, Boswellia is so safe it could be given to children. In these cases, give children half of the adult dosage.
Boswellia extract is often sold in supplements that include curcumin (turmeric) or other herbs. Check the ingredients list to see what all is involved, and avoid supplements that include curcumin if you cannot safely use that herbal remedy. Curcumin can irritate your stomach in and of itself, and that effect may be amplified if you’re taking it with Boswellia. Conversely, you may be able to take it safely with ginger as long as that doesn’t irritate your digestive tract.
Summary: Boswellia can be taken in many forms; the right method of consumption depends on the condition you’re treating.
Boswellia Side Effects
One common side effect is a rash if it is applied to the skin. If taken orally, it can cause diarrhea, acid reflux, bloating and nausea. One tactic for reducing these side effects is to take a lower dose and take another dose each day. If you continue to see these Boswellia side effects, stop taking it.
The pain-relieving and anti-inflammatory benefits of Boswellia extract may interact with non-steroidal anti-inflammatory drugs like aspirin and ibuprofen. Consult with a doctor before you try to take Boswellia and NSAIDs at the same time; this will give you a chance to learn what side effects to look out for that would tell you to stop taking one or the other.
Summary: Digestive irritation and acid reflux are known as Boswellia side effects. If this is already a problem for you, you shouldn’t take herbal remedies that contain Boswellia.
Boswellia doesn’t come with a laundry list of warnings regarding drugs it can interact with. It doesn’t cause severe interactions with any known prescription drugs. Do talk to your doctor before you take Boswellia while taking any anti-inflammatory drugs.
Boswellia can cause allergic reactions. If you’ve suffered stomach pain or severe digestive upset from taking it, consider applying it to your skin before you take another dose of Boswellia extract. If that triggers a rash, stop taking Boswellia complex.
Because Boswellia can cause acid reflux, heartburn, and nausea, people with gastritis or gastroesophageal reflux disease may not be able to take Boswellia. If you already have nausea for any other reason, skip the Boswellia dose for today.
There is no significant research on the safety of Boswellia when taken while pregnant. There is tentative evidence it can increase menstrual flows or trigger a miscarriage. Therefore, pregnant women should not take Boswellia. There have been several reports of people taking blood thinners having dangerously elevated INR levels when taking Boswellia; consult with your doctor before you take Boswellia if you are taking blood-thinning medications, anti-platelet drugs or have a medical condition that affects blood clotting. Stop taking Boswellia two weeks before any scheduled surgery to be safe.
Summary: Do not take Boswellia if pregnant or may be allergic to it. If you are taking blood thinners or have issues with blood clotting, consult with a doctor.
Boswellia extract is one of the critical ingredients of Asian medicine, and scientific research is repeatedly validating what Eastern medical practitioners have known for millennia. Whether you want to reduce arthritis pain and inflammation, improve your body’s resistance to disease, enhance cardiovascular health or lift your mood, Boswellia extract in one form or another is something you should consider trying.
 pain tolerance
 diabetes and lipids
 pancreatic cancer
 Crohn’s disease
 asthma study
 memory study in Iran