Boswellia
Specifically for Multiple Sclerosis
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Why it works for Multiple Sclerosis:
Leukotriene pathway / 5-lipoxygenase (5-LOX) inhibition. The main boswellic acid, AKBA, is an allosteric inhibitor of 5-LOX, a key enzyme in leukotriene synthesis. 5-LOX and its products are present and upregulated in MS lesions and in EAE (the MS animal model), making this a biologically plausible target. RCSB PDB
Potential immunomodulation / lipid mediators. In RRMS patients treated with a standardized frankincense extract (SFE), exploratory metabololipidomic work linked shifts in lipid mediators to MRI/immunologic changes during the trial. Nature
How to use for Multiple Sclerosis:
RRMS disease-activity study (SABA trial; standardized frankincense extract “Boswelan/SFE”).
- Design: phase IIa, open-label, baseline-to-treatment. Dosing: individualized dose-finding to the highest well-tolerated dose (details in the protocol; not a one-size dose). Duration: 8 months (with extension). Use of a standardized extract is key. JNNP
Cognition trials (adjunctive symptom target):
- B. serrata RCT: 450 mg twice daily of standardized extract for MS patients with subjective cognitive complaints. ScienceDirect
- B. papyrifera RCT: improvement mainly in visuospatial memory (dosing per paper; used standardized resin preparation). Europe PMC
If you and your neurologist decide to try it as an adjunct:
- Prefer a standardized extract that declares boswellic acid content (AKBA % varies widely between products). Quality-assured brands (e.g., USP/NSF/third-party tested) are advisable because composition drives pharmacology. (General background on standardized AKBA extracts.) pharmadvances.com
- Start low, monitor for GI effects, headaches, allergic symptoms, or bruising/bleeding, and check liver enzymes if you have liver risk factors or symptoms (see warnings). Pairing with your usual DMT should be co-managed by your MS team; don’t self-stop DMTs.
Scientific Evidence for Multiple Sclerosis:
Disease activity (MRI lesions; RRMS):
- SABA phase IIa (open-label) – Journal of Neurology, Neurosurgery & Psychiatry (2018): Oral standardized frankincense extract over 8 months reduced the number and volume of contrast-enhancing MRI lesions vs. baseline; safety was acceptable. Because this was not randomized or blinded, it’s a signal-generating study, not proof of efficacy. Trial registration NCT01450124. JNNP
Cognition (symptom domain):
- RCT – B. serrata (double-blind, placebo-controlled): 450 mg twice daily improved selected cognitive test scores in MS patients with subjective cognitive complaints (details in paper). ScienceDirect
- RCT – B. papyrifera (randomized clinical trial): improved visuospatial memory; limited effects on other domains. Europe PMC
Mechanistic/biomarker extensions from SABA:
- Lipid mediator profiling during SFE therapy linked shifts in immunoregulatory lipid mediators with MRI/immunologic measures (exploratory). Nature
Context / broader evidence base:
- Systematic reviews of frankincense in other conditions show anti-inflammatory signals (e.g., osteoarthritis) but underscore heterogeneity and the need for higher-quality trials; nothing establishes Boswellia as a disease-modifying therapy for MS. BMJ
Specific Warnings for Multiple Sclerosis:
Not a substitute for MS DMTs. Major guidelines (AAN; reaffirmed 2024) discuss FDA-approved DMTs; Boswellia doesn’t appear as a disease-modifying option. Do not replace your DMT with Boswellia. American Academy of Neurology
Bleeding risk / antiplatelet effects. Boswellia may inhibit platelet aggregation; caution with anticoagulants/antiplatelets (warfarin, DOACs, aspirin, clopidogrel) and with NSAIDs due to additive bleeding risk. Evidence includes in-vitro data and expert safety summaries; clinical significance is uncertain—so monitor and consult. The ASCO Post
Immune effects / autoimmune disease caution. Some references caution Boswellia could modulate immune activity; discuss with your neurologist, especially if your regimen includes immunosuppressants. WebMD
Pregnancy & breastfeeding. Safety in therapeutic doses is insufficiently established; avoid unless your clinician agrees. WebMD
Liver considerations. Data are mixed; hepatotoxicity is rare and evidence often confounded by multi-ingredient products, but prudence suggests avoiding use with active liver disease and checking enzymes if symptoms arise. pharmadvances.com
Allergy. Possible hypersensitivity to tree resins; discontinue if rash, wheeze, or swelling occur. (General safety overviews.) NCCIH
Product variability. AKBA % differs widely; some extracts minimize pro-inflammatory β-boswellic acid and enrich AKBA—another reason to use reputable, standardized products and keep your care team informed. pharmadvances.com
General Information (All Ailments)
What It Is
Boswellia, also known as Indian frankincense, is a resin extracted from the bark of trees in the Boswellia genus — particularly Boswellia serrata. The resin has been used for centuries in traditional Ayurvedic and Chinese medicine to treat various inflammatory conditions.
The active compounds in Boswellia are boswellic acids, including acetyl-11-keto-β-boswellic acid (AKBA), which is believed to be primarily responsible for its therapeutic effects.
Boswellia is commonly available in:
- Resin form (for burning or topical use)
- Capsules or tablets (standardized extracts)
- Creams and ointments (for joint pain)
- Essential oils (for aromatherapy or topical applications)
How It Works
Boswellia works mainly by modulating the body’s inflammatory response through several biochemical pathways:
- Inhibition of 5-Lipoxygenase (5-LOX):
- Boswellic acids block the enzyme 5-LOX, which is involved in the production of leukotrienes — inflammatory molecules that play a role in asthma, arthritis, and inflammatory bowel diseases.
- Reduction of Pro-inflammatory Cytokines:
- It helps reduce levels of inflammatory mediators like tumor necrosis factor-alpha (TNF-α) and interleukins (IL-1β, IL-6).
- Prevention of Cartilage Breakdown:
- Boswellia may help protect joint cartilage by inhibiting enzymes (such as MMPs) that degrade connective tissue, making it useful for osteoarthritis.
- Antioxidant and Immunomodulatory Effects:
- Boswellia also exerts antioxidant actions that help reduce oxidative stress and may improve overall immune function.
Why It’s Important
Boswellia has attracted modern scientific interest because it provides natural anti-inflammatory effects comparable to some nonsteroidal anti-inflammatory drugs (NSAIDs), but with fewer gastrointestinal side effects.
Key potential benefits include:
- Joint Health: May improve flexibility and reduce pain and swelling in osteoarthritis and rheumatoid arthritis.
- Respiratory Support: Helps manage asthma and bronchial inflammation.
- Digestive Health: May reduce symptoms of inflammatory bowel diseases (Crohn’s disease, ulcerative colitis).
- Brain and Cognitive Function: Early research suggests potential neuroprotective effects, possibly beneficial in neuroinflammatory conditions.
- Overall Well-being: Because chronic inflammation is linked to many diseases, Boswellia’s modulation of inflammatory pathways supports systemic health.
Considerations
While Boswellia is generally well tolerated, there are important factors to consider:
1. Safety and Side Effects
- Common side effects are mild and may include nausea, diarrhea, acid reflux, or skin rashes.
- Rarely, allergic reactions may occur.
- Long-term high-dose use has not been extensively studied.
2. Interactions
- May interact with anti-inflammatory or anticoagulant medications (e.g., NSAIDs, warfarin).
- Should be used cautiously with other herbs or supplements affecting inflammation or the immune system.
3. Dosage and Standardization
- Typical doses of Boswellia serrata extract range from 300–500 mg, taken 2–3 times daily, standardized to contain 30–65% boswellic acids.
- Consistency in formulation is crucial, as potency can vary widely among products.
4. Pregnancy and Medical Conditions
- Not enough research exists to confirm safety during pregnancy or breastfeeding.
- People with gastrointestinal conditions or taking medications should consult a healthcare professional before use.
5. Quality and Purity
- Look for standardized extracts (e.g., 65% boswellic acids or specific AKBA content).
- Choose products tested for contaminants (heavy metals, adulteration).
Helps with these conditions
Boswellia is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.
Detailed Information by Condition
Crohn's Disease
Boswellia's therapeutic potential in Crohn’s disease is primarily attributed to its active compounds, particularly boswellic acids, which are believed...
Arthritis
The active molecules in Boswellia (boswellic acids — especially 3-O-acetyl-11-keto-β-boswellic acid, AKA AKBA) inhibit 5-lipoxygenase (5-LOX), an enzy...
Back Pain
Boswellia’s main actives (boswellic acids—especially AKBA) inhibit 5-lipoxygenase (5-LOX) and reduce leukotriene production, key mediators of inflamma...
Asthma
Targets leukotrienes (inflammation pathway central to asthma). A key boswellia constituent—AKBA (3-acetyl-11-keto-β-boswellic acid)—directly inhibits...
Diverticulitis
Anti-inflammatory mechanism: The most active Boswellia constituents (boswellic acids — especially 3-O-acetyl-11-keto-β-boswellic acid, AKBA) inhibit 5...
Sciatica
Sciatica pain is most often driven by inflammation around a compressed or irritated lumbar nerve root. Boswellia’s major acids—especially AKBA (acetyl...
Psoriasis
Lowers leukotrienes (5-LOX inhibition): Boswellic acids—especially AKBA—directly inhibit 5-lipoxygenase, reducing leukotriene-driven inflammation impl...
Rheumatoid Arthritis
Anti-inflammatory pathways: Boswellic acids—especially AKBA (3-O-acetyl-11-keto-β-boswellic acid)—inhibit 5-lipoxygenase (5-LOX), lowering leukotriene...
Tendonitis
Boswellia has plausible anti-inflammatory mechanisms and decent human data for joint pain (especially osteoarthritis). Direct, high-quality trials for...
Carpal Tunnel Syndrome
Anti-inflammatory mechanism: Boswellic acids—especially AKBA (acetyl-11-keto-β-boswellic acid)—are direct, non-redox inhibitors of 5-lipoxygenase (5-L...
Multiple Sclerosis
Leukotriene pathway / 5-lipoxygenase (5-LOX) inhibition. The main boswellic acid, AKBA, is an allosteric inhibitor of 5-LOX, a key enzyme in leukotrie...
Temporomandibular Joint Disorder
It targets the leukotriene pathway (5-LOX). The most active boswellic acid (AKBA) directly inhibits 5-lipoxygenase, lowering leukotrienes that drive i...
Rheumatoid Osteoarthritis
Leukotriene pathway inhibition (5-LOX): AKBA (3-acetyl-11-keto-β-boswellic acid), a key boswellic acid, directly inhibits 5-lipoxygenase, lowering pro...
Pleurisy
Boswellia (Indian frankincense, Boswellia serrata) has well-documented anti-inflammatory actions (notably via boswellic acids such as AKBA inhibiting...
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Helps With These Conditions
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