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Boswellia

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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)

Note: You are viewing ailment-specific information above. This section shows the general remedy information for all conditions.

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:

  1. Inhibition of 5-Lipoxygenase (5-LOX):
  2. 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.
  3. Reduction of Pro-inflammatory Cytokines:
  4. It helps reduce levels of inflammatory mediators like tumor necrosis factor-alpha (TNF-α) and interleukins (IL-1β, IL-6).
  5. Prevention of Cartilage Breakdown:
  6. Boswellia may help protect joint cartilage by inhibiting enzymes (such as MMPs) that degrade connective tissue, making it useful for osteoarthritis.
  7. Antioxidant and Immunomodulatory Effects:
  8. 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.

Crohn's Disease 0% effective
Arthritis 0% effective
Back Pain 0% effective
Asthma 0% effective
Diverticulitis 0% effective
Sciatica 0% effective
14
Conditions
0
Total Votes
68
Studies
0%
Avg. Effectiveness

Detailed Information by Condition

Crohn's Disease

0% effective

Boswellia's therapeutic potential in Crohn’s disease is primarily attributed to its active compounds, particularly boswellic acids, which are believed...

0 votes Updated 2 months ago 0 studies cited

Arthritis

0% effective

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...

0 votes Updated 2 months ago 6 studies cited

Back Pain

0% effective

Boswellia’s main actives (boswellic acids—especially AKBA) inhibit 5-lipoxygenase (5-LOX) and reduce leukotriene production, key mediators of inflamma...

0 votes Updated 2 months ago 5 studies cited

Asthma

0% effective

Targets leukotrienes (inflammation pathway central to asthma). A key boswellia constituent—AKBA (3-acetyl-11-keto-β-boswellic acid)—directly inhibits...

0 votes Updated 1 month ago 4 studies cited

Diverticulitis

0% effective

Anti-inflammatory mechanism: The most active Boswellia constituents (boswellic acids — especially 3-O-acetyl-11-keto-β-boswellic acid, AKBA) inhibit 5...

0 votes Updated 2 months ago 6 studies cited

Sciatica

0% effective

Sciatica pain is most often driven by inflammation around a compressed or irritated lumbar nerve root. Boswellia’s major acids—especially AKBA (acetyl...

0 votes Updated 2 months ago 5 studies cited

Psoriasis

0% effective

Lowers leukotrienes (5-LOX inhibition): Boswellic acids—especially AKBA—directly inhibit 5-lipoxygenase, reducing leukotriene-driven inflammation impl...

0 votes Updated 1 month ago 5 studies cited

Anti-inflammatory pathways: Boswellic acids—especially AKBA (3-O-acetyl-11-keto-β-boswellic acid)—inhibit 5-lipoxygenase (5-LOX), lowering leukotriene...

0 votes Updated 1 month ago 4 studies cited

Tendonitis

0% effective

Boswellia has plausible anti-inflammatory mechanisms and decent human data for joint pain (especially osteoarthritis). Direct, high-quality trials for...

0 votes Updated 2 months ago 7 studies cited

Anti-inflammatory mechanism: Boswellic acids—especially AKBA (acetyl-11-keto-β-boswellic acid)—are direct, non-redox inhibitors of 5-lipoxygenase (5-L...

0 votes Updated 2 months ago 2 studies cited

Leukotriene pathway / 5-lipoxygenase (5-LOX) inhibition. The main boswellic acid, AKBA, is an allosteric inhibitor of 5-LOX, a key enzyme in leukotrie...

0 votes Updated 1 month ago 5 studies cited

It targets the leukotriene pathway (5-LOX). The most active boswellic acid (AKBA) directly inhibits 5-lipoxygenase, lowering leukotrienes that drive i...

0 votes Updated 2 months ago 7 studies cited

Leukotriene pathway inhibition (5-LOX): AKBA (3-acetyl-11-keto-β-boswellic acid), a key boswellic acid, directly inhibits 5-lipoxygenase, lowering pro...

0 votes Updated 1 month ago 6 studies cited

Pleurisy

0% effective

Boswellia (Indian frankincense, Boswellia serrata) has well-documented anti-inflammatory actions (notably via boswellic acids such as AKBA inhibiting...

0 votes Updated 2 months ago 6 studies cited

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