Boswellia, also known as Indian frankincense, is an herbal extract from the Boswellia serrata tree. It may help reduce inflammation and benefit people with certain health conditions.

Resin made from boswellia extract has been used for centuries in Asian and African folk medicine. It’s believed to treat chronic inflammatory illnesses as well as a number of other health conditions. Boswellia is available as a resin, pill, or cream.

Studies show that boswellia may reduce inflammation and may be useful in treating the following conditions:

Because boswellia is an effective anti-inflammatory, it can be an effective painkiller and may prevent the loss of cartilage. Some studies have found that it may even be useful in treating certain cancers, such as leukemia and breast cancer.

Boswellia may interact with and decrease the effects of anti-inflammatory medications. Talk to your doctor before using boswellia products, especially if you’re taking other medications to treat inflammation.

Some research shows that boswellic acid can prevent the formation of leukotrienes in the body. Leukotrienes are molecules that have been identified as a cause of inflammation. They may trigger asthma symptoms.

Four acids in boswellia resin contribute to the herb’s anti-inflammatory properties. These acids inhibit 5-lipoxygenase (5-LO), an enzyme that produces leukotriene. Acetyl-11-keto-β-boswellic acid (AKBA) is thought to be the most powerful of the four boswellic acids. However, other research suggests other boswellic acids are responsible for the herb’s anti-inflammatory properties.

Boswellia products are generally rated on their concentration of boswellic acids.

Many studies of boswellia’s effect on OA have found that it’s effective in treating OA pain and inflammation.

One 2003 study published in the journalPhytomedicine found that all 30 people with OA knee pain who received boswellia reported a decrease in knee pain. They also reported an increase in knee flexion and how far they could walk.

Newer studies support the continued use of boswellia for OA.

Another study, funded by a boswellia production company, found that increasing the dosage of enriched boswellia extract led to an increase in physical ability. OA knee pain decreased after 90 days with the boswellia product, compared to a lesser dosage and placebo. It also helped reduce the levels of a cartilage-degrading enzyme.

Studies on the usefulness of boswellia in RA treatment have shown mixed results. An older study published in the Journal of Rheumatology found that boswellia helps to reduce RA joint swelling. Some research suggests that boswellia may interfere with the autoimmune process, which would make it an effective therapy for RA. Further research supports the effective anti-inflammatory and immune-balancing properties.

Due to the herb’s anti-inflammatory properties, boswellia may be effective in treating inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis (UC).

A 2001 study compared H15, a special boswellia extract, to the anti-inflammatory prescription drug mesalamine (Apriso, Asacol HD). It showed that the boswellia extract may be effective in treating Crohn’s disease.

Several studies found the herb could be effective in treating UC as well. We’re just beginning to understand how the anti-inflammatory and immune-balancing effects of boswellia can improve the health of an inflamed bowel.

Boswellia can play a role in reducing leukotrienes, which causes bronchial muscles to contract. A 1998 study of the herb’s effect on bronchial asthma found that people who took boswellia experienced decreased asthma symptoms and indicators. This shows the herb could play an important role in treating bronchial asthma. Research continues and has shown the positive immune-balancing properties of boswellia can help the overreaction to environmental allergens that happens in asthma.

Boswellic acids act in a number of ways that may inhibit cancer growth. Boswellic acids have been shown to prevent certain enzymes from negatively affecting DNA.

Studies have also found that boswellia may fight advanced breast cancer cells, and it may limit the spread of malignant leukemia and brain tumor cells. Another study showed boswellic acids to be effective in suppressing the invasion of pancreatic cancer cells. Studies continue and the anti-cancer activity of boswellia is becoming better understood.

Boswellia products can differ greatly. Follow the manufacturer’s instructions, and remember to speak to your doctor before using any herbal therapy.

General dosing guidelines suggest taking 300–500 milligrams (mg) by mouth two to three times a day. The dosage may need to be higher for IBD.

The Arthritis Foundation suggests 300–400 mg three times per day of a product that contains 60 percent boswellic acids.

Boswellia may stimulate blood flow in the uterus and pelvis. It can accelerate menstrual flow and may induce miscarriage in pregnant women.

Other possible side effects of boswellia include:

Boswellia extract may also interact with medications, including ibuprofen, aspirin, and other non-steroidal anti-inflammatory drugs (NSAIDs).