Boswellia is an herbal extract made from the gum resin or bark of Boswellia serrata, also called Indian frankincense. Human studies most often examine oral extracts for knee osteoarthritis; results suggest possible improvements in joint symptoms, but the studies vary and higher-quality research is still needed. The National Center for Complementary and Integrative Health (NCCIH) says there is not enough high-quality evidence to determine whether boswellia is useful for any health condition.
Quick facts about boswellia studies
| Question | What human research covers |
|---|---|
| Forms studied | Oral boswellia extracts; topical frankincense has also been studied. |
| Amounts used | NCCIH reports oral Boswellia serrata extract use up to 1,000 mg daily for as long as 6 months, and 2,400 mg for up to 1 month. |
| Typical study length | At least 4 weeks in the 2020 osteoarthritis meta-analysis; one knee osteoarthritis trial lasted 120 days. |
| Main studied uses | Knee osteoarthritis, asthma symptoms, topical use for joint conditions, and brain swelling in a small study of people receiving radiation for brain tumors. |
| What “systematic review” means | A study that gathers and evaluates results from several earlier studies. See ingredient evidence vs marketing claims for how to weigh that kind of claim. |
What do human studies show?
Knee osteoarthritis
This is the best-studied use. A 2026 systematic review and network meta-analysis included 20 randomized controlled trials with 1,633 people with knee osteoarthritis. Modified boswellia formulations improved WOMAC pain, stiffness, and physical-function scores compared with other intervention groups. WOMAC is a questionnaire that measures pain, stiffness, and daily function.
The overall picture is not completely settled. A 2024 systematic review and meta-analysis included 13 studies, with 850 participants contributing WOMAC data and 1,185 contributing pain-scale data. Its main pooled analysis did not find a significant difference between boswellia and control groups because the studies differed greatly; a subgroup analysis against placebo did find lower WOMAC scores with boswellia extracts.
An earlier 2020 systematic review and meta-analysis combined seven trials involving 545 people and reported lower pain and stiffness scores and better function with boswellia or its extract than with control treatment. These reviews point in a favorable direction for knee symptoms, but they do not make every boswellia form or label interchangeable.
One small randomized, double-blind, placebo-controlled trial followed 48 people with knee osteoarthritis for 120 days. The 2019 trial reported better pain, stiffness, and physical-function results in the extract group than in the placebo group, with no serious adverse events reported. A 48-person trial is useful but too small to answer every safety or effectiveness question on its own.
Asthma symptoms
Several small studies suggest oral boswellia may reduce asthma symptoms, but NCCIH’s boswellia overview says rigorous evidence is not sufficient to determine whether it is useful for asthma. If you use asthma medicine, NCCIH says to talk with your health care provider before adding a dietary supplement and not to substitute another approach for prescribed asthma care.
Brain swelling during radiation for brain tumors
NCCIH describes a small study in people with malignant glioma, an aggressive brain tumor, in which oral boswellia may have reduced cerebral edema, meaning swelling in the brain, but not the tumor. That finding concerns a specific clinical setting and does not show that boswellia treats a brain tumor.
Topical frankincense for joints
Frankincense is resin from the bark of Boswellia serrata or other Boswellia species. NCCIH says topical boswellia has been studied for osteoarthritis, rheumatoid arthritis, and other conditions, but there is not enough evidence to show it is an effective treatment.
What doses did researchers use?
Researchers used different extracts, which matters because an extract’s amount alone does not tell you its composition. NCCIH reports that clinical trials have used Boswellia serrata extract at up to 1,000 mg daily for up to 6 months and 2,400 mg for up to 1 month. The 2020 osteoarthritis meta-analysis concluded that study duration should be at least 4 weeks; the 2019 knee trial ran for 120 days.
Those are study details, not a personal dose recommendation. For another example of why a milligram number needs context about the ingredient form and study outcome, see turmeric and curcumin benefits evidence.
Safety, side effects, and medicine interactions
NCCIH says boswellia is likely safe when taken by mouth at the studied amounts above. It also says frankincense may be safe for topical use or aromatherapy. The same page advises anyone taking medicine to speak with a health care provider before using an herbal product because herbs and medicines can interact in harmful ways.
There is no liver or kidney safety conclusion in the human-study summaries here. The available trial lengths and sizes are also not designed to settle every question about daily use over years. Boswellia should not replace a prescribed medicine, and you should not start, stop, or change a medicine without guidance from the clinician managing it.
Who should talk to a clinician first?
- People who take any medicine, because herb-and-medicine interactions can be harmful.
- People using medicine for asthma; NCCIH specifically advises discussing a supplement before adding it to an asthma plan.
- People who are pregnant or breastfeeding. NCCIH says food amounts are likely safe, but little is known about oral medicinal amounts or frankincense use during pregnancy or breastfeeding.
- People diagnosed with cancer. NCCIH says complementary approaches may interfere with conventional cancer care or carry other risks.
What is still unknown?
The key uncertainty is whether boswellia is useful for any particular health condition. NCCIH characterizes most studies as small and low quality. The osteoarthritis reviews also conflict: some pooled results favor boswellia, while the 2024 review’s main analysis was not statistically significant because the studies were highly different from one another.
It is also unclear whether combining boswellia with curcumin improves outcomes. The 2026 network meta-analysis said possible benefits of combined curcumin-and-boswellia preparations need further investigation. Boswellia has not been shown to prevent or treat COVID-19, according to NCCIH.
How should you read a boswellia label?
- Find the form. Look for whether the label identifies an oral extract, resin, or a topical or aromatherapy product. Human osteoarthritis studies discussed here concern oral extracts.
- Check the amount per serving.
- Watch for proprietary blends. A blend may list a total amount for several ingredients without saying how much boswellia is in one serving. That makes a study-to-label comparison harder.
- Separate ingredient research from product claims. Dietary supplements are not approved by the FDA before sale; NCCIH explains that manufacturers and distributors are responsible for evaluating safety and labeling before marketing.
Before you order: Ask the seller which boswellia form is used, how much is in one serving, whether the amount is disclosed outside any proprietary blend, and whether the product fits with your current medicines.
By ClinicalStudyConnect.com Research Desk