A bowl of boswellia resin, also known as frankincense

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.

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  1. Cathie
    Springfield, MO

    I have arthritis in most of my joints, am 70 years old. I’ve taken Relafen (Nabumatone) for many years. But, joints still ached. I added Boswellia and Curcumin in one tablet, plus bromelain to enhance the boswellia. My joints don’t ache as much, and I will up my dose of B and C. Instead of taking 300mg, I’ll use 600 mg. I have acid reflux, and use baking soda in water to calm it down.

  2. Heather

    I have started (for my rheumatoid) Boswellia 250 mgs day with Devils Claw 450mg with food morning. Bromelain 500mg before food. Boswellia can interfere with NSAIDS e.g. Ketaprofen so take in morning the latter in evening. Decided to start with less.

    Just started Nagestic osteo acute (curcumin) 12mg cumerone. This is new process.

    I was allergic to a brand of organic tumeric and was on 2,700mgs a day – too much for me broke out in hives rash sweat.

    Maybe your Boswellia could be mixed with oil and rubbed on joints instead ?

  3. Susan
    Fuquay Varina, NC

    I also read about Boswellia and ordered it online many months ago. I tried it as directed and after a few times the heartburn was horrible. At the time on was on a PPI. I managed to get off the PPI and just stick with zantac which helps. I decided to try Boswellia again because my osteoarthritis is horrible when the weather changes before it rains or when I sleep… Again, I could not get past a few days because of the heartburn! Too bad, because this is a good product if you can stand it!

  4. cpmt

    Careful with Turmeric and cinnamon. They are natural blood thinners and can cause other bad effects like increasing liver enzymes and other problems. Both should be taken with food containing some fat: oil, butter etc…

  5. Carolyn

    Several years ago I went on the Specific Carbohydrate Diet (SCD) for digestive problems. Not only did it cure them, it also brought complete relief from osteoarthritis pain in my hands. After a year I gradually returned to a more normal diet, which worked for 5 years before problems started to recur with both digestion and arthritis. So I am gearing up to do the diet again, which is a commitment. Gin soaked raisins did absolutely nothing (took them for 2 months) and after reading the above I won’t try boswellia. I avoid prescription drugs like the plague unless absolutely necessary.

  6. deena hammond
    United States

    I heard about boswelia through an Internet search. I started to take it for anti inflammatory. A few months later I had a persistent sore throat and then my eardrum ruptured. I went to ent and was diagnosed with gerd ..reflux. I’ve never had any symptoms and I know without a doubt it was from the boswelia. I threw it out, took omeprazole for 2 months and felt better but my throat has never been the same. Still have a feeling of something in my throat and my ear pain is still sporadically here.

    • em

      I started taking boswellia and berberine together about 3 weeks ago. I was tired of relying on naproxen and possible side effects from that. I lived with pain too, used ice, etc. My knees are arthritic, so walking and stairs are hard…or were.
      I started taking the B&B once per day with food. No problems. After the 3 weeks I read i can take 2 per day of each. Hmmm…. one each was helping, …so increase to 2 per day, always with food. VOILA! Now the knee pain has been gone for 2 days (this is all recent!). So I’ll continue this happily no apparent side effects and now that it’s cooling in FL, I can walk easier too. Each of my B&B are 500mg caps. I also have a gazebo and have started burning the Black Neglecto resin and enjoying that as it is a combo of boswellia and frankincense. Not sure if it has any affect BUT it has helped my seasonal asthma! Whatever helps…

  7. Doggerel
    PDX, OR

    There is Boswellia Phytosome on the market now. The absorption is supposed to be much better, so the dosage is lower. I took standardized herbal extract ( with fatty meal as recommended for intake) and it kicked up my GERD again. I was on Pepcid for years and used D-Limonene to wean off. Now I am trying the phytosome formulated boswellia in the AM and D-L before bed.

  8. Susan
    North Carolina

    I’ve been told to discontinue medications five days before hip replacement surgery. Is Boswellia considered a “medication”?

  9. liz48
    United States

    Does Bowellia interact with levothyroxine?

  10. Boo

    I just have question. Does Boswellia and Turmeric thin your blood?
    Thanks, Boo

    • Danny

      See a doctor and ask for Famotidine 20mg (for Gastric). I am taking Boswellia Ginger complex too and I goes with Famotidine and I am fine.

    • Jane

      Recommended website herbs2000 for information of effects of herbs and spices – like turmeric. Yes. Turmeric thins the blood. Please do not use herbs and spices without knowing, somewhat in depth, how they function. Even Slippery Elm, always stated to be “non-toxic,” can deplete important minerals. Use the drug-herb interaction checkers, for what good they are. I trust the University of Maryland Medical Center website for alternative, and all, medications. Don’t go for what’s popular and recently seen on tv.

  11. sheri
    Guerneville, Ca


    Try taking the Boswellia complex with fat from a turkey or swallowed with tablet folded into cold butter.

    Aloha for now

  12. KN

    put a boswellia capsule inside another empty capsule so it takes longer to dissolve through the gel and after it is past the stomach. You could find it still works but not at a price.

  13. NKB

    Can Boswellia cause high blood pressure? Does it have any affect at all on blood pressure?

  14. D M

    I’m a 65 year old male take blood pressure med hydrochlorothiazide 25 mg in morning and atenol 25mg at night. Also for cholesterol livalo 1mg twice a week and crestor 5mg once a week as it makes me ache, fenofibrate 160mg four times a week. I’ve been trying this rotation for about nine months will see dr. mid june. Now I have 5-LOXIN which is boswellia serrata and acetyl-11keto-beta boswellic acid (AKBA). Taking it thinking will help inflammations as my shoulder hands and elbow hurt as I feel a month ago.

  15. daud

    I just gets lots of frankinsense from oman, but you can get it anywhere and chew it all day, its cheap and effective.

  16. C K

    Get ginger capsules or DGL capsules, or even take one of each with your boswelia, as that will soothe your stomach, plus ginger is also a natural anti-inflammatory.

  17. sr

    I take 300 mg boswellia 3X/day with food for arthritis in my joints for more than a month now and having less upper gi track pain and heartburn. Joints seem to not lock up as much.

  18. SLG

    I take boswellia for knee pain. I recently tore my ACL (I had knee pain before this ACL-tearing accident, and was already taking the boswellia before the accident), and am scheduled for ACL reconstruction surgery in mid-December.
    The pre-surgery instructions say to stop taking anti-inflammatory products for 5 days prior to surgery. Does this apply to boswellia? If “yes”, then is 5 days enough time in advance of surgery to stop taking it? I have found that the pain-relieving effects of boswellia last for 2+ weeks after I stop taking it, so apparently it builds up in your system and lasts for a period of time. (Likewise, I find that it takes several weeks on boswellia before I feel the benefits, so for me, it’s slow to start working and slow to wear off.)
    I just want to make sure I’m not breaking any of the pre-surgery rules.

  19. EL

    I was diagnosed with RA a year ago. Have been trying everything natural including changing my eating habits (no gluten, no sugar, no diary, no grains and no yeast which has helped me lose weight and get rid of some of my GERD. The RA bloodwork still showed a lot of RA activity so my doc put me on Plaquenil, Sulfasalazine and Prednisone. I am working hard to get off all of these meds and one of my holistic docs introduced me to curcumin and boswellia.
    While on these for a number of months I have been able to wean down to 5 mg prednisone. So, BZYSZY, I used to have BAD allergies and GERD until I changed my diet and read about Apple Cider Vinegar WITH THE MOTHER LOAD! I did start taking Apple Cider Vinegar (@ 1 – 2 tblsp in a glass of water) each day. It really seems to help any of my GERD along with eating the right foods and not eating three hours before I go to bed.
    I do raise my head board of my bed up @ 6 inches which also helps my GERD. Maybe the Boswellia is contributing to your GERD but I have found a change in diet and physical habits (including exercise) and lots of prayer really changed my life! Good luck!

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