What is it?

Indian frankincense is an Ayurvedic remedy that can be purchased over the counter in capsule form. It can prevent the production of inflammatory substances in the joints. Current evidence, based on four RCTs, suggests that it might have some beneficial effects in treating participants with osteoarthritis of the knee which might last for a period of time after treatment is stopped.

  • Family: Ayurvedic medicine of the Burseraveae family
  • Scientific name: Boswellia serrate
  • Other names: Resin, olibanum, salai guggal, 11-keto ß-boswellic acid, acetyl-11-keto ß-boswellic acid (AKBA), African elemi, Arabian incense (Bakhour), Boswellia serrata gum resins, boswellic acids, boswellic, Sallaki®, S-compound®, 5-LOXIN®

Ayurvedic medicine is a Hindu system of alternative treatment which originated in India. Indian frankincense is a plant extract used as an Ayurvedic remedy to treat a number of diseases. You can buy it from high-street shops.

How does it work?

Indian frankincense prevents the production of hormone-like substances in your body that act as triggers for joint inflammation.

Is it safe?

Indian Frankincense is safe to use in a daily dose of 1 g (used in RCTs in participants with osteoarthritis). Dosage hasn’t been well studied, but high doses can have serious side-effects on the liver. Interactions with other medications haven’t been well studied.

Indian frankincense trials for osteoarthritis

Trial 1

In the first trial, 30 participants with osteoarthritis were randomly given either 333 mg Indian frankincense capsules three times a day or placebo tablets for eight weeks.

  • The Indian frankincense group had moderate improvement in pain, knee flexion and walking distance compared to the placebo group.
  • The compound was well tolerated by participants, with only minor stomach upsets reported.

Trial 2

The potential beneficial effects of 333 g Indian frankincense were compared with valdecoxib (a non-steroidal anti-inflammatory drug) in treating osteoarthritis of the knee in 66 people over six months.

  • Participants in both groups showed considerable improvement in pain, stiffness and ability to perform physical activity during the trial, but this happened more slowly in participants who were given Indian frankincense.
  • One month after treatment had finished, those in the Indian frankincense group experienced a significant improvement in symptoms compared to participants who received valdecoxib, which might indicate that this compound has a relatively long-lasting effect.
  • Only minor gastrointestinal side-effects were reported by participants in both treatment groups.

Trial 3

The effectiveness and safety of 5-LOXIN®, a drug made of Indian frankincense extract enriched with an anti-inflammatory acid called AKBA, was evaluated. The 75 participants were randomly given one of the following once a day for three months:

  • 100 mg of 5-LOXIN®
  • 250 mg of 5-LOXIN®
  • placebo tablets.

Results showed the following:

  • Compared to the placebo group, participants who were on either dose of 5-LOXIN® had a significantly greater improvement in pain and physical function. Those on 250 mg had the quickest improvement (as early as seven days after the start of treatment).
  • The level of an inflammatory and cartilage-destroying chemical in the knee fluid was significantly reduced in participants taking 5-LOXIN®.
  • Only minor side-effects (gastrointestinal problems and mild fever) were reported by participants across all treatment groups.

Trial 4

In this trial, 60 people with knee osteoarthritis were given one of the following twice a day for three months:

  • 50 mg 5-LOXIN® tablet
  • 50 mg Aflapin® tablet (made of Boswellia serrata extract enriched with at least 20% AKBA)
  • 50 mg Boswellia serrata non-volatile oil tablet
  • a placebo.

The trial found the following:

  • All groups reported improvements in pain, function and stiffness.
  • Those who received 5-LOXIN ® reported a greater improvement in pain and stiffness than the placebo group; meanwhile those who received Aflapin® reported greater improvements in pain, stiffness and function in comparison with the placebo group.
  • Those who received 5-LOXIN ® or Aflapin® reported improvements in pain and physical ability as early as seven days after beginning the treatment and continued to improve throughout the study.