How we rate
“Strong” = several concordant meta-analyses or systematic reviews. “Moderate” = one synthesis, or several controlled trials. “Limited” = early trials only. The rating is about the quality of the studies, not about how useful the supplement is.
Boswellia
The resin of an Indian tree (Boswellia serrata): in knee osteoarthritis, slightly less pain and stiffness in small, low-quality trials; a few isolated results on the intestine and asthma, nothing on blood glucose.
Benefits
- Relieves osteoarthritis: in a meta-analysis of 7 trials (545 patients), 8.3 points less pain on the visual scale, and an improvement in knee stiffness and function
- Acts quickly on the knee: in two trials, pain decreased from the 5th day; at 90 days, the pain score dropped by 45% at 150 mg and by 62% at 300 mg twice a day (105 patients)
- With curcumin: in 201 osteoarthritic patients, the curcumin + boswellic acid mixture reduced joint pain and improved physical tests compared to placebo, better than curcumin alone
- Collagenous colitis: 63.6% remission in 6 weeks versus 26.7% under placebo (31 patients), a difference that is no longer significant when counting all randomized patients
- Asthma: 70% of patients improved in 6 weeks (300 mg three times a day) versus 27% under placebo (80 patients)
- Cerebral edema after radiotherapy: reduced by more than 75% in 60% of patients on boswellia (4,200 mg per day) compared to 26% on placebo (44 patients)
Precautions
Side effects: mostly digestive and minor in the trials; the 2008 review reports no serious safety issues across 7 trials, a year of intake was well tolerated in Crohn's disease, and in multiple sclerosis the reported effects are mostly digestive and minor infections. No study in this sheet covers pregnancy or interactions with medications. Limitations: the trials are small (most under 100 participants) and of overall low quality according to the 2018 meta-analysis; the 2008 review judges the evidence "encouraging but not convincing"; in the 2003 knee trial, the X-ray did not change; in colitis, the control group took sulfasalazine, without placebo; in diabetics, the trial showing lower cholesterol had no placebo, and the placebo-controlled one found nothing on blood glucose or blood fats.
Recommended dosage
100 to 600 mg of standardized extract per day in osteoarthritis; 900 to 1,200 mg of resin in three doses in trials on the intestine and asthma
How to take it
- For whom: the trials involve sick people (knee osteoarthritis, inflammatory bowel diseases, asthma); only two were conducted in healthy individuals, one on experimentally induced pain, the other on persistent knee discomfort.
- Knee osteoarthritis: 100 mg of an AKBA-rich extract for 30 days, or 150 to 300 mg twice daily for 90 days; the meta-analysis recommends at least 4 weeks of treatment.
- Onset of action: in two trials on the knee, pain began to decrease from the 5th day.
- Form: recent trials use extracts standardized to 20 or 30% AKBA (one of the boswellic acids), older ones use gum resin; no study in this sheet compares the two.
- Intestine: 350 to 400 mg of resin or extract three times daily for 6 weeks in colitis; a form combined with lecithin, one tablet daily for 6 months, in mild irritable bowel syndrome.
- With curcumin: a capsule of 350 mg of curcuminoids and 150 mg of boswellic acid three times daily, for 12 weeks.
- What does not work: maintaining remission in Crohn's disease (59.9% versus 55.3% under placebo over one year) and blood glucose in diabetics (500 mg per day for 8 weeks, no better than placebo).
Did you know?
In two trials on knee osteoarthritis, pain began to decrease from the fifth day of intake, whereas the meta-analysis on the subject advises counting at least four weeks of treatment.
What the studies say
This meta-analysis examined seven randomized controlled trials involving 545 patients suffering from osteoarthritis. The results indicate that Boswellia and its extract could relieve pain and stiffness, and improve joint function in these patients. The study suggests that Boswellia could be an effective and safe treatment option, with a recommended duration of at least 4 weeks.
Yu G, Xiang W, Zhang T, Zeng L, Yang K, Li J. — BMC complementary medicine and therapies (2020) — View the source study
Pairs well with
For information only: not a substitute for medical advice. Dietary supplements are not a replacement for a varied, balanced diet. Learn more