A bowl of boswellia resin, also known as frankincense, Boswellia fights pain, boswellia with turmeric, therapeutic frankincense

People with arthritis are caught between a rock and a hard place. If they find a medication that alleviates pain, they may discover that it has unacceptable side effects. Popular NSAIDs like ibuprofen and naproxen, for example, raise blood pressure and increase the risk of cardiovascular complications. They also irritate the digestive tract and can cause ulcers. No wonder people can get excited when they learn that boswellia fights pain!

Boswellia Effects and Side Effects:

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 boswellia fights pain better than any other remedy for me. Is there a way I could continue to take it without feeling sick?

The Straight and Skinny on Boswellia:

A. The Indian herb Boswellia has anti-inflammatory activity but can cause heartburn for some. This may account for your throat irritation. You probably won’t be able to take it without suffering, though the esomeprazole (Nexium) should have helped a bit in counteracting the discomfort.

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. Ayurvedic medical practitioners have used various parts of the boswellia plant 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.

A small Italian study found that boswellia extract (FlexiQule) was effective in reducing pain, stiffness and improving walking distance without pain (Minerva Gastroenterologica e Diatelogica, online, Oct 22, 2015).

Combinations Containing Boswellia:

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.”

Another study of 54 people with osteoarthritis had no comparative arm, so cannot be considered scientifically strong. The investigators found, however, that a combination (Movardol) of ginger, Boswellia serrata and n-acetylglucosamine improved function and pain-free walking distance (Bolognesi et al, European Review of Medical and Pharmacological Sciences, Dec. 2016). As in other studies, they reported that these herbs are safe and that the subjects had no major complaints.

Boswellia Side Effects:

As you discovered, however, boswellia may trigger 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.

Alternatives to Fight Pain:

Since you cannot tolerate boswellia, even though it was so helpful against arthritis symptoms, we would like to suggest our book, The People’s Pharmacy Quick & Handy Home Remedies. In addition to boswellia, we discuss how people use bee stings to soothe painful joints. Cayenne, Certo and grape juice, cherries and turmeric all have anti-inflammatory benefits. Vitamin D, fish oil, gin-soaked raisins, pineapple juice, honey and vinegar or soap (yes, soap!) are other alternatives that can fight pain and probably won’t cause you heartburn.

If you prefer an online resource, consider our Guide to Alternatives for Arthritis. It devotes more than 50 pages to the pros and cons of various treatments for joint pain.

Revised 6/22/2017

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  1. Young K

    I read articles and comments. Where can I purchase this Boswellia?
    I really want to buy for my wife who has serious symptom her knee.
    Please advise.

  2. Kim
    Los Angeles, CA

    I have been taking Boswellia for several months, and it has taken my very bad arthritis pain away. I also add a little Turmeric. But the Boswellia on its own is great. I have had zero side effects, and I take other supplements for other conditions. However, I do not take any prescription medications and refuse to do so. That stuff will kill you eventually with all the long-term side effects and damage they do to your body. I have used natural medicine for the last 30 years. I have had far more success with natural medicine, and zero success with prescription drugs.

    • Birgit

      Where do you purchase your boswellia from? I was hoping for a natural product. Thank you.

  3. William F. W

    My osteoarthritis has kicked up a notch, so I went online to see just how much more I could take of my antiinflammatories: boswellia, turmeric etc. I found very little information on maximum doses. Maybe the max doses on the labels take into consideration the side effects, and minimizing them. But I almost never get any side effects from anything, and surely the label has a sort of safety factor built in, so I think I could take more than the label recommends – but I don’t want to do anything stupid. I did order your book. What to do?

  4. John

    Stomach and throat irritation can be abated with a couple of ways. We use the essential oil rather than raw frankincense or caps (We are always suspect of “standardized” powders and the “fillers” most add). Make sure it is certified for internal use. I put two drops under my tongue and let it absorb before I eat/drink anything.

    My Wife prefers it in tea in which she has added a bit of coconut oil to trap the oil and hasn’t noticed any gastric problems. We started with 1 drop morning and evening and now use 2 drops morning and evening.

    Zongle Therapeutics is an excellent economical brand available on Amazon. It is USDA Certified Organic and Certified pure therapeutic grade essential oil safe for ingestion. We really need to be careful of where we obtain oils on the internet. To many cheats and contaminants out there.

  5. Doreen
    Palm Beach Gardens

    How common is bezoar when taking Boswellia? I have celiac and now concerned. Does taking bromilain with Boswellia help with inflammation. I want to get off NSAIDs.

    • Terry Graedon

      With just one case in the medical literature, we doubt it is common at all. But we don’t know how the celiac disease may have contributed to this woman’s problem or to your own risk.

      • Robert

        One case in the literature justifies an article of warning?

    • Carla

      Great info, thanks!

  6. Elma
    Oakland, CA

    I started taking a Truejoint FLX for my knee.. After taking it for about a week, I started noticing I had no sense of taste. Would boswellia, which has 100mg in it, have anything to do with that?

  7. Malcolm

    Curcumin. I am 71 and have been taking Glucosamine & Chondroitin for almost 20 years to good effect and have had to increase the dosage from time to time to where I was taking 3 grams a day. I started putting 95% curcumin on my food – about half to 3/4 tsp a day and within a week noticed that the peripheral pains and stiffnesses were abating. After a couple of months I reduced the G&C and again a month later. I am back to 1 gram and feel fine. When I started on the G&C i was walking with a cane and riding the carts at the grocery store. I stride now and only occasionally feel a twinge in a toe or my hand.

    • Robert

      Where does one purchase 95% curcumin?

      • John

        Amazon is a good source, read reviews for each offering.

  8. Linda G
    W. Montana

    I have recently started using grape juice with pectin for my arthritis pain, assuming that pectin is an acceptable substitute for Certo (mainly I did this because the powdered pectin is easier to use than the liquid Certo). Whatever, the pectin seems to work for me.

  9. Van

    I have been using boswellia now for some time as a replacement for the NSAIDs that I used to take every day. If there is a problem with tolerating it, I would suggest trying Bromelain. When I was researching trying to find a natural replacement for the NSAIDs these two both showed evidence of good anti-inflammatory effects.

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