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NMU 248 – Boswellia Supplement Shown to Improve Knee Arthritis

Nutrition/Natural Medicine Update No 248 (June 29, 2022)

with Dr. James Meschino

Topic: Boswellia Supplement Shown to Improve Knee Arthritis

Source: Phytotherapy Research (March 2019)


I don’t have to tell you that osteoarthritis (OA) is a disabling degenerative joint disorder that involves chronic inflammation, joint pain, and decreased mobility, which often has a negative impact on a person’s quality of life. OA of the knee is the most common form of arthritis and has a high prevalence rate compared with other types of OA. The use of non-steroidal anti-inflammatory drugs (NSAIDs) and/or acetaminophen are often prescribed to reduce inflammation and pain, but many people don’t respond well to these medications. As well, NSAIDs are known to cause intestinal tract erosion, ulceration, and intestinal bleeding, and can produce a decline in kidney function and increase cardiovascular disease risk (high blood pressure, congestive heart failure). Acetaminophen is the leading cause of drug-induced liver failure. So, the published study in the journal Phytotherapy Research in March 2019 should be of great interest to people with osteoarthritic problems, especially those with knee OA. These researchers used the extract of the Boswellia serrata plant to treat 24 patients with mild to moderate knee OA for a period of 120 days (four months) while the 24 members in the placebo group were given a placebo pill for the same period of time. This was a double-blind, placebo-controlled clinical trial, meaning that neither the patient nor the doctor knew which patients were taking the Boswellia supplement and which patients were taking the placebo pill. This was also the longest study to date (120 days) where researchers tested a Boswellia supplement to treat knee arthritis.

The results showed that Boswellia supplementation significantly improved the physical function of the patients by reducing pain and stiffness compared with placebo. X-ray studies also showed improved knee joint gap space and reduced osteophytes (spur), confirming the efficacy of Boswellia supplement treatment. Boswellia supplementation also significantly reduced blood levels of an important inflammatory marker known as (hs-CRP) high-sensitive C-reactive protein. And no serious adverse events or side effects were reported with Boswellia supplementation. Previous studies have shown that Boswellia supplementation can be helpful in knee OA, but this was a larger study and had a longer duration and the research methodology was superior to most previous studies.

How Does Boswellia Help?

Experimental studies show that certain constituents in Boswellia (Boswellic acids) produce anti-inflammatory effects via several important mechanisms – similar to the effects of some anti-inflammatory drugs, but without causing adverse side effects like intestinal tract irritation, bleeding, or decline in kidney function or raising blood pressure or triggering congestive heart failure. But if you choose to use Boswellia to treat an arthritic problem it is important to use a product that contains a standardized grade of Boswellic acids (70% Boswellic Acids) to ensure it will provide the desired effect. For patients with osteoarthritis, I personally like the combination of Turmeric (Curcumin), with Boswellia, White Willow Extract, and Ginger, combined in a single capsule. These four natural anti-inflammatory agents work synergistically to help reduce inflammation and pain in various arthritic conditions and do not produce the side effects associated with NSAIDs and acetaminophen. So, the 2019 study in Phytotherapy Research has strengthened our appreciation for the degree to which Boswellia supplementation can be helpful in treating knee osteoarthritis, which is an important consideration for many adults who suffer from this problem.

I have included the reference for this research paper in the text below.

Majeed M et al. A pilot, randomized, double-blind, placebo-controlled trial to assess the safety and efficacy of a novel Boswellia serrata extract in the management of osteoarthritis of the knee. Phytother Res. 2019; 33 (5): 1457-1468.

Eat Smart, Live Well, Look Great,

Dr. Meschino

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