Frankincense Effective on Osteoarthritis Pain

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Frankincense comes from the resin found in the tree Boswellia.
Frankincense comes from the resin found in the tree Boswellia.

Yes, the holidays are past and the topic of frankincense will probably not be on most of our minds for another year. However, with the increasing popularity of essential oils, frankincense is now the topic of intense research. Many of those raised with Christian traditions grew up hearing the story of the three Magi and their gifts of gold, frankincense, and myrrh. Although gold may be familiar to most, the value of frankincense (and myrrh) is not well-known. Promising studies indicate that frankincense may be useful in fighting the rapid growth of cancer cells and many other immune and inflammatory conditions. 

Background

Frankincense comes from the resin found in the tree Boswellia.1 While there are 4 main types of Boswellia, the more common species from which most commercial resin is harvested is Boswellia serrata. Frankincense is a term derived from the French language meaning ‘high-quality incense.' These trees grow in the harsh terrains of the Middle East, North Africa, and Somalia, and they have been documented in folk literature and as valued trading goods for more than 5000 years.2 The prized resin is harvested by slashing the bark of the tree and allowing the resin to ‘weep' and gradually harden. The oils are distilled from these nuggets. 

Science 

One of the more exciting potential uses of frankincense is in the treatment of cancer. Early studies indicate that the mechanism of action may be two-pronged. Frankincense exerts an anti-inflammatory effect that is not cell-specific, so any localized tumor swelling and irritation is reduced. Frankincense also interferes specifically with the development of the cancer cell at several points in the cell cycle, ultimately both reducing the growth of new cells and enhancing cell death of malignant cells. 

One laboratory trial examined the effect of frankincense oil on a line of cultured human bladder cancer cells.3 These cell cultures were divided into a control group that was maintained to simply continue its current growth pattern and the other group was sub-divided into several sets that were subjected to increasing dilutions of frankincense oil. The experimental groups were monitored for increase in cell number and attachment to the tissue medium over time and compared with the control group. Cells exposed to frankincense oil showed dramatic decreases in cell number as well as detachment, or ‘shrinking' from the tissue culture. Further analysis indicated that cell death and inhibition of new cell growth was due to stimulation of factors inducing cell death.3 

In another study, researchers recruited 44 patients who were receiving radiation therapy for brain tumors.4 The primary endpoint of the study was to monitor the effect of oral frankincense on cerebral edema, a problematic effect of this type of therapy. Results of the trial showed that 60% of patients receiving frankincense had a decrease from baseline in brain tissue swelling in a range of no edema at all to <25%. Patients in the study who received the extract were also found to have a superior response to the radiotherapy compared with control patients. 

In a study using cultured human breast cancer cells to evaluate cell death and cell cycle progression in cells treated with frankincense oil, outcomes achieved were nearly identical to the bladder cancer study, giving further evidence of frankincense oil's ability to selectively target cancer cells.5

These actions closely interact with the immunomodulatory and inflammatory activities of the body. In a study of 75 patients with diagnosed osteoarthritis, participants were randomly assigned to receive daily doses of 100 mg or 250 mg of a standardized Boswellia serrata extract or placebo.6,7 Patients were assessed at baseline and 90 days using validated scales for pain and physical function. Both active treatment groups showed significant improvement in these outcomes. 

Safety, interactions, side effects

Any initial use of a frankincense product should be approached with caution until individual tolerance is determined. For oils, a simple small ‘patch' test on the inner arm is a good test for allergic response.8 The use of any frankincense product is not recommended for children, pregnant women, or nursing mothers.

Potential drug interactions have been reported when using frankincense in conjunction with a selective serotonin reuptake inhibitor. People interested in daily frankincense use should consult with their healthcare provider.

How supplied, dose, cost 

Frankincense may be purchased in a variety of forms. Most products are either oral or topical. Essential oil of frankincense can be costly, as much as $50 or more per 0.5 ounces. Oral capsules of the resin are less expensive due to the lower concentration of the essential oil. 

Frankincense essential oil is typically applied directly to the skin up to 4 times daily. Oral frankincense capsule doses can range from 900 mg to as high as 3 gm daily. 

Summary

Frankincense is one of a multitude of rediscovered botanical products that is now being studied for its potential use in treating a variety of diseases and conditions. Since there is not yet a large body of evidence-based literature for this product, recommendation for use should be carefully evaluated for both safety and efficacy. 

 

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References

  1. Dharmananda S. Myrrh and frankincense. Institute for Traditional Medicine website. http://www.itmonline.org/arts/myrrh.htm. Published May 2003. Accessed February 15, 2017.
  2. Ammon HP. Bowellic acids in chronic inflammatory diseases. Planta Med. 2006;72:1100-1116.
  3. Frank MB, Yang Q, Osban J, et al. Frankincense oil derived from Boswellia carteri induces tumor cell-specific cytotoxicity. BMC Complement Altern Med. 2009; 9:6.
  4. Kirste S, Treier M, Wehrle SJ, et al. Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors. Cancer. 2011;117:3788-3795.
  5. Suhail MM, Wu W, Cao A, et al. Boswellia sacra essential oil induces tumor-cell-specific apoptosis and suppresses tumor aggressiveness in cultured human breast cancer cells. BMC Complement Altern Med. 2011;11:129.
  6. Sengupta K, Alluri KV, Satish AR, et al. A double-blind, randomized, placebo-controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the knee. Arthritis Res Ther. 2008;10:R85.
  7. Khajuria A, Gupta A, Suden P, et al. Immunomodulatory activity of biopolymeric fraction BOS 2000 from Boswellia serrata. Phytother Res. 2008;22:340-348.
  8. Burfield T. Safety of essential oils. International Journal of Aromatherapy. 2000;10:16-29. 
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