Q. I take a number of medications for arthritis. I have had a hip replacement and a shoulder replacement and I am fighting to keep my left knee. I take Nexium and Celebrex plus other meds.
A few months ago I read an article about boswellia and decided to give it a try. I can’t tell you how wonderful this was. I had no pain!
Then I started to have a bad throat irritation. I went to the ENT, who told me that I was OK, to try a gastro. My gastro did an endoscopy, and couldn’t find a thing (except for an irritated throat), but diagnosed me with gastritis and told me to take an antacid as well as the Nexium.
I started to play with my meds, eliminating one at a time to check for side effects. Boswellia was the culprit, much to my dismay. I have been without the boswellia for about 10 days. My throat discomfort has almost gone, but the joint pain is back. I have tried gin-soaked raisins, pineapple, and vinegar, but nothing works as well as boswellia for me. Is there a way I could continue to take it without feeling sick?
A. The Indian herb Boswellia has anti-inflammatory activity but can cause heartburn for some. This may account for your throat irritation. It’s probably no longer an option for you, though the Nexium (esomeprazole) should have helped a bit in counteracting the discomfort.
The Straight and Skinny on Boswellia
If you have ever read the Bible, you know a bit more about boswellia than you think. The resin from this plant is frankincense. It was considered so valuable it was part of the gifts of the Magi (the “three wise men”), which also included myrrh and gold.
The boswellia that you will find in health food stores is known as Indian frankincense or Boswellia serrata. In Ayurvedic medicine various parts of the boswellia plant have been used to treat a variety of conditions including asthma, dysentery, osteoarthritis, ulcers and skin problems.
Boswellia for arthritis:
The independent and highly regarded Cochrane Database of Systematic Reviews analyzed the data on boswellia for osteoarthritis. Here is the bottom line:
“Five studies of three different extracts from Boswellia serrata were included. High-quality evidence from two studies (85 participants) indicated that 90 days treatment with 100 mg of enriched Boswellia serrata extract improved symptoms compared to placebo…The studies reported no serious adverse events.”
A review of the data from numerous clinical trials in the journal BMJ (online, Dec. 17, 2008) also concluded:
“Collectively, these data seem to indicate that B serrata extracts are effective in treating a range of conditions caused or maintained by inflammatory processes.”
When this overview was published, however, the authors concluded that more research was necessary before assuming that boswellia would be clinically effective.
More recently a small Italian study found that boswellia extract (FlexiCule) was effective in reducing pain, stiffness and improving walking distance without pain (Minerva Gastroenterologica e Diatelogica, online, Oct 22, 2015).
A formulation that combined curcumin (the active ingredient in turmeric) and boswellia [CB] was compared to the nonsteroidal anti-inflammatory drug (NSAID) celecoxib (Celebrex). In this small study published in Molecular Medicine Reports (Nov., 2013) the authors concluded:
“The treatment was well tolerated and did not produce any adverse effect in patients, as judged by the vital signs, hemogram, liver and renal function tests. The CB [curcumin-boswellia] formulation at 500 mg administered twice a day, was more successful than administering celecoxib 100 mg twice a day for symptom scoring and clinical examination. The formulation was found to be safe and no dose-related toxicity was found.”
Boswellia Side Effects:
As you discovered, boswellia is not devoid of side effects. This compound may cause reflux and symptoms of heartburn. Some people lose their appetite as a result. There is one case in the medical literature of a woman who ended up with a bezoar in her stomach. This is like a hair ball in a cat. Fiber and other material accumulate within the stomach or small intestine. She also had celiac disease, so it is hard to determine how likely this complication might be for those without celiac disease.
Boswellia should not be used during pregnancy. It may also interact with some prescription drugs.
Since you cannot tolerate boswellia, even though it was so helpful against arthritis symptoms, we would like to suggest our book, Best Choices From The People’s Pharmacy. In addition to boswellia we discuss the pain-relieving properties of vitamin D, green-lipped mussel extract, pomegranates, cherries and turmeric. All these have anti-inflammatory benefits. You will find a number of other non-drug ways to ease inflammation in this 524-page book.
Anyone who purchases a copy of Best Choices from The People’s Pharmacy will also receive one free tube of our People’s Pharmacy Natural Pomegranate Lip Care (a $3.49 value) while supplies last. If you click on that link you will see the reviews of this lip balm. You can also read more about Best Choices and see reader reviews here.