Boswellia: Joint Pain, Anti-Inflammatory and Anti-Cancer Benefits

Bowellia is a resin from the Indian frankincense tree which appears to have quite amazing effects on pain and inflammation with some possible potential in cancer therapy. It has been studied for its effects on arthritis and joint pain in particular, and is becoming a popular addition to many joint pain relief supplements. Those with knee pain and back pain may receive the most benefit from this special herb as we will see in this research review! Yes, it may be considered a natural pain killer! It's anti-inflammatory properties don’t appear to be limited to just the joints, as it has shown benefit for a variety of inflammatory disorders.

We see it more and more being paired with turmeric in joint health supplements and it seems that many people are becoming aware of its benefits. It is actually classified as a phytopharmaceutical in Europe because of its usefulness for treating cerebral edema associated with cancer radiotherapy. Certain extracts of boswellia are patented like 5-loxin and aflapin.

What is remarkable is the preliminary evidence for cancer therapy where boswellia appears to be pretty potent at inhibiting cancer cell growth. Also, while the smell of frankincense, especially in combination with myrrh, is enjoyable...burping that smell from taking boswellia caps is weird!

We need to state that the particular genus/species we’re referring to is boswellia serrata. Other forms of boswellia or frankincense do not have the same amounts of the active compounds. The resin is also commonly burned or the essential oil used in aromatherapy and has been used for thousands of years, most notably in Ayurvedic and Traditional Chinese Medicine for both consumption and aroma, but many people also know of frankincense from biblical references to the incense.

In Ayurveda, it is known as Salai guggal and was frequently used for inflammatory conditions. Other historical uses point to it being used as a tranquilizer or anti-anxiety when combined with wine, but there is really no evidence that it works like that (probably mostly the alcohol having those effects).

However, much more research is pointing towards boswellia having some quite potent anti-cancer effects and some practitioners are recommending it for cancer therapy based on this info because of its safety profile. So how does the evidence match up to the claims?

Reducing joint pain

Multiple studies using the patented extracts 5-loxin and aflapin have found a significant reduction in joint pain in those with osteoarthritis when compared to placebo. Low doses (100mg) don’t appear to be very effective in improving overall function despite a slight reduction in pain. This means that while people generally experienced a reduction in pain, their mobility did not significantly increase. However, higher doses (250mg) are more effective and also tend to work quickly - within 1 week of beginning supplementation. These participants experienced pain relief and improvement in mobility and functionality from arthritis.

How would you go about getting something similar to those patented extracts? They are standardized from 20-30% boswellic acids with an emphasis on AKBA (3-O-acetyl-11-keto-beta boswellic acid). Another study found that a basic extract (non-standardized) required 2 grams 3 times per day to be effective, but the study was also not placebo controlled and not blinded, meaning that the results may be skewed by the placebo effect.

Anti-inflammatory Benefits

Boswellic acids work on the 5-LOX (lipoxygenase) enzyme which uses arachidonic acid in order to create pro-inflammatory cytokines. It works differently than other anti-inflammatories which tend to work on the COX enzymes, thus making boswellia a good combination with herbs which do work on the COX enzymes like turmeric and white willow. This is one of the reasons why these combinations are becoming more popular in joint health supplements. It also targets TNF-alpha and NF-kB (nuclear factor kappa light chain enhancer of B cells), two other pro-inflammatory compounds.

One human study noted that adults with collagenous colitis experienced higher remission rates with 1200mg of boswellia per day. This is in accordance with traditional use for inflammatory bowel conditions. However, another study found a lack of efficacy for prolonging remission of Crohn’s disease despite many patients having improvement in symptoms. The problem here is that Crohn’s disease can be highly dependent on the content of the diet, where offending foods may need to be removed before remission is achieved. It just goes to show that you cannot out-supplement a bad diet!

There are other anti-inflammatory benefits to boswellia as well. 300mg of boswellia resin extract helped to reduce inflammation in the lungs in those with acute asthma. This shows that the anti-inflammatory benefits appear to be systemic in nature, and not confined to certain areas of the body. However, we would like to see more research investigating its use in various other inflammatory disorders.

Brain supportive effects

Boswelia appears to have acetylcholinesterase inhibiting properties, meaning that it may have the potential to increase acetylcholine in the brain much like some other herbs like huperzia serrata. This gives it implications in being explored for things like Alzheimer’s disease (since acetylcholinesterase inhibitors are one of the primary treatments). However, this research is yet to be done.

Compared to nicotine as a control, rodent studies have found that spatial memory in a forced swim test was increased (nicotine acts similarly by mimicking acetylcholine). This may mean that boswellia can have memory supporting benefits as well, but it has not yet been researched as a nootropic compound.

Due to the reduction in overall inflammation and the fact that boswelia can cross the blood-brain barrier, there may be implications for disease states associated with higher brain inflammation. It is actually used as a European pharmaceutical agent for helping to reduce cerebral edema caused by radiation (for patients with brain tumors).

Some preliminary rodent studies suggest that there may be anti-depressive and anti-anxiety effects of boswellia, but these remain unexplored in humans. Considering that one of the traditional uses of boswellia is to help ease stress and anxiety, this makes sense. There are also anecdotal reports of boswellia resin being burned in order to reduce anxiety.

Cancer therapy

AKBA (the primary active compound in boswellia) has the potential to inhibit enzymes of cancer metabolism as well as inhibiting angiogenesis (the formation of new blood vessels, which is particularly of interest to “starving” cancer cells). Some cancer drugs actually work by helping to inhibit angiogenesis, and complimentary therapies to traditional cancer therapies also work in a similar manner.

It appears to reduce tumor and polyp size of multiple varieties of cancer in rodents including:

Brain - induces apoptosis of cancer cell lines, inhibits glioma growth

Colon - reduces polyp size, induces apoptosis

Prostate - inhibits growth of cells, suppresses enzymes of cancer growth, reduces weight of prostate tumors

Cervical - induces apoptosis of tumor cells

Leukemia - enhance the action of chemotherapy drugs

Breast - Induces apoptosis and reduce cancer aggressiveness

It also shows promise in inhibiting the growth of various other cancer cell types in vitro, but many of these remain unexplored in clinical trials on actual humans. A few case studies exist where cancer patients have noted reductions or abolition of tumors from boswellia supplementation, but unfortunately this is not enough evidence to make any inferences right now. It is always possible for cancer to remiss spontaneously, and this cannot be ruled out. However, cancer is also a very complex disease and certain compounds will not always have the intended effects, even chemotherapy.

What to look for in your supplement

AKBA is the extract that you want to look for in particular for the highest efficacy. Otherwise, you should aim for at least a 20-30% boswellic acids standardized extract, otherwise the doses required are going to be several grams per day.

Contrary to what we’ve heard some natural practitioners recommend, it’s probably not a good idea to drink frankincense essential oil. Be mindful of the extraction processes as well considering that some lower quality resins may be extracted using solvents.

Some Other Interesting Effects

AKBA actually rivals triclosan in terms of bacterial inhibition, especially in the mouth (I can’t imagine that a gum or mouthwash with the oil would taste good). This would be a great alternative considering that triclosan acts as an estrogen mimetic and may lead to hormonal abnormalities.

One study demonstrated that asthmatic patients tended to benefit from boswellia supplementation and saw a reduction in symptoms, likely due to the anti-inflammatory effects.

Safety and Toxicity Concerns

Side effects of boswellia include:

Gross frankincense flavored burps

May cause constipation or a feeling of fullness in some people related to how it reduces motility and spasms of the colon

Toxicity

No apparent toxicity noted in either humans or animals and seems to be very safe

Other implications

They need to really push through for more trials on cancer therapy because the preliminary evidence so far is pretty remarkable, especially for a compound that is essentially non-toxic.

Experiences and anecdotes

It is combined with turmeric and other ingredients usually in joint health formulas so many anecdotes aren’t with boswellia on its own even though it appears to work well by itself. There are some anecdotes of people using it for personal cancer therapy too, but obviously these should be taken with a grain of salt due to the lack of human evidence in controlled trials. In a formula with turmeric, black pepper, and collagen, I’ve seen some pretty great improvements in my joints with a highly significant reduction in pain and inflammation in my hips from running.

We suggest that you give this one a try, especially if you are someone suffering from arthritis, particularly knee pain or back pain. The anti-inflammatory benefits of boswellia are great as well and may be applicable to the entire body.

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Until next time, always remember that H = Health!