Boswellia: what the research shows for joints and how to buy
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- Boswellia serrata extract capsules. Best for: Adults with joint pain who want boswellia on its own. See options on Amazon
- Boswellia with standardized AKBA. Best for: Buyers comparing standardized boswellic acid content. See options on Amazon
- Boswellia and turmeric blend. Best for: People who want both herbs in one capsule. See options on Amazon
What boswellia is
Boswellia serrata is a tree found in India, the Middle East and North Africa. Memorial Sloan Kettering Cancer Center (MSK) explains that the gummy resin collected by peeling away the bark is known as frankincense or olibanum, and that it is used widely in Ayurveda for arthritis, ulcerative colitis, coughs, sores, wound healing and asthma.
The main active compounds are boswellic acids, which block an inflammation enzyme called 5-lipoxygenase. MSK notes two named boswellic acids, KBA and AKBA, which are often listed on supplement labels.
What the research shows
| Review | What it found |
|---|---|
| 2020 meta-analysis, 7 trials, 545 people with osteoarthritis | May relieve pain; treat at least 4 weeks |
| 2024 meta-analysis, 13 knee osteoarthritis studies | Better than placebo in subgroup analysis; no clear overall effect; better trials needed |
| MSK summary of other uses | Promising small studies; larger trials needed |
Osteoarthritis. A 2020 meta-analysis in BMC Complementary Medicine and Therapies pooled 7 randomized trials with 545 patients and found boswellia and its extracts may relieve pain, with an average drop of about 8 points on a visual pain scale. The authors suggested treatment of at least 4 weeks.
A 2024 meta-analysis in Phytotherapy Research looked at 13 studies of knee osteoarthritis. Because the studies differed widely, the overall comparison was not significant, but a subgroup analysis against placebo showed lower WOMAC scores, a common measure of knee pain, stiffness and function. The authors said higher quality studies are needed.
Why people look at it. The 2024 review notes knee osteoarthritis ranks as the 11th highest contributor to global disability, and more than 40% of patients use complementary approaches such as plant extracts. The authors suggested boswellia could interest people who have side effects from NSAID pain relievers, but that needs confirmation in better trials.
Other uses. MSK lists small studies suggesting benefit for tendon pain, low back pain, asthma, ulcerative colitis and mild IBS, while evidence was unclear or negative for collagenous colitis and showed no benefit for keeping Crohn's disease in remission. MSK also reports that supplements containing boswellia were comparable to acetaminophen for musculoskeletal pain in one study and reduced joint pain caused by aromatase inhibitor breast cancer drugs in another.
Safety and interactions
- Generally well tolerated. MSK says boswellia is generally well tolerated.
- Blood thinners. Boswellia extracts can reduce platelet clumping and may raise bleeding risk with warfarin or other anticoagulant and antiplatelet drugs. Talk to your doctor first.
- Other medicines. Lab studies show boswellic acids affect drug transport proteins, though the real-world effect is unknown.
- Stomach upset. NOW Foods notes its boswellia product may cause minor, short-lived digestive discomfort.
- Large amounts. MSK describes a 17-year-old with celiac disease who developed a stomach blockage after excessive frankincense intake, which required surgery.
- Skin allergy. Allergic skin reactions have been reported, mainly with boswellia oil and creams.
- Pregnancy and nursing. NOW Foods advises consulting a physician.
Reading a boswellia label
- Plant and part. Look for Boswellia serrata gum resin extract.
- Standardization. Labels list boswellic acids, organic acids or AKBA as a percentage. Compare products using the same measure.
- Check for blends. Many boswellia products also contain turmeric. NOW Foods' Boswellia Extract, for example, gives 500 mg of boswellia extract per 2 capsules plus turmeric extract and turmeric powder.
- Directions. NOW Foods directs 1 to 2 capsules 1 to 3 times daily, preferably with food.
- Joint formulas. Some combine boswellia with glucosamine, chondroitin or MSM. Each ingredient adds its own cautions; see our turmeric guide for that ingredient.
Give it time, and keep your doctor in the loop
The 2020 meta-analysis suggested at least 4 weeks of treatment, so judge results over weeks rather than days. Joint pain with swelling, warmth, redness, fever, or pain after an injury needs a medical check. If you take pain relievers, blood thinners or other medicines, ask your doctor or pharmacist before adding boswellia.
What to look for when you buy
Boswellia serrata extract capsules
Best for: Adults with joint pain who want boswellia on its own
Single-ingredient extracts let you see how you respond to boswellia without other herbs.
Watch out: Ask your doctor first if you take blood thinners. Give it at least 4 weeks.
See options on AmazonBoswellia with standardized AKBA
Best for: Buyers comparing standardized boswellic acid content
AKBA is one of the boswellic acids MSK names, so a stated percentage tells you how the extract was standardized.
Watch out: A higher percentage has not been shown to work better. Follow the label.
See options on AmazonBoswellia and turmeric blend
Best for: People who want both herbs in one capsule
NOW Foods combines 500 mg of boswellia extract with turmeric extract and powder per 2 capsules, taken with food.
Watch out: Turmeric adds its own cautions, including with blood thinners. May cause mild stomach upset.
See options on AmazonQuestions people ask
- What is boswellia good for?
- It is used mainly for osteoarthritis pain, where meta-analyses suggest a modest benefit, though study quality varies.
- How long does boswellia take to work?
- A 2020 meta-analysis suggested treatment for at least 4 weeks.
- Is boswellia the same as frankincense?
- Yes. The resin of Boswellia serrata is known as frankincense or olibanum.
- Can I take boswellia with blood thinners?
- Only with your doctor's okay. Boswellia may raise bleeding risk with anticoagulant or antiplatelet drugs.
- What is AKBA?
- AKBA is one of the boswellic acids in boswellia resin, often used to standardize extracts.
Sources
- Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis (pmc.ncbi.nlm.nih.gov), BMC Complementary Medicine and Therapies (PMC7368679)
- Efficacy of Extracts of Oleogum Resin of Boswellia in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis (pmc.ncbi.nlm.nih.gov), Phytotherapy Research (PMC11634824)
- Boswellia: About Herbs (mskcc.org), Memorial Sloan Kettering Cancer Center
- Boswellia Extract Veg Capsules (www.nowfoods.com/products/supplements/boswellia-extract-250-mg-veg-capsules), NOW Foods