Using Frankincense (Boswellia) Properly: Quality, Boswellic Acid Content, Dosage and Limits
Not all frankincense is the same. Incense resin, food supplements and study extracts are worlds apart, in their boswellic acid content as much as in their dosage. I will show you how to read a label, which amounts were used in studies, what the legal situation is in Germany and where the limits lie.
The package says frankincense. But the capsule can contain many things, from a carefully tested extract to resin with almost no boswellic acids. The decisive question is rarely whether frankincense can do anything. It is: which frankincense, how much of it and for whom.
Maybe you have taken frankincense before and did not notice anything. Or you have only just heard about it and want to get it right from the start. Both are good reasons to take a closer look.
Behind this question is a need I understand well. You want to do something for yourself without wasting money and hope on a label.
I have described where boswellic acids may intervene in inflammatory metabolism and what studies show for joints and the gut in Frankincense for joints and gut. Here, it is about the question that comes first: What is in your product, and what do the numbers on the package mean?
I look at this through several lenses: lab analyses of commercial products, studies on absorption in the body, clinical data, the legal situation in Germany and KPNI. KPNI stands for clinical psychoneuroimmunology, the interplay of nerves, the immune system, hormones and metabolism.
What you will find here
- Incense resin or supplement: why species and purpose matter
- What percentages and AKBA on the package mean
- Why many commercial products do not deliver what the label says
- The AKBA pitfall: more on the label does not mean more in the blood
- Which daily amounts were used in studies
- Why frankincense belongs with a meal and what lecithin or micelles change
- Food supplement, pharmacy, medicine: the legal gray area in Germany
- Side effects, interactions, liver values and pregnancy
Incense resin or supplement: Is all frankincense the same?
Maybe you can smell it right away. Candlelight, cold air, a hint of resin. For many people, frankincense is a feeling first and an active substance only second.
Short answer: No. Frankincense is a collective name for the resins of various Boswellia species, and their composition differs by species and even by growing location. Most clinical studies used extracts from Boswellia serrata, Indian frankincense. Incense resin is meant for burning, not for swallowing.
Frankincense is dried resin sap. When the bark of a Boswellia tree is injured, a milky sap emerges and hardens into grains in the air. Indian frankincense comes from Boswellia serrata. Many incense resins come from other species, such as Boswellia sacra, which grows on the Arabian Peninsula and in the Horn of Africa.
Think of apples. A Boskoop and a Granny Smith are both apples, and yet they differ in acidity and sweetness. Variety and location shape what is inside. It is the same with frankincense, except that you cannot taste the difference.
In 2016, a team led by Mannino in Turin compared the resins of Boswellia sacra and Boswellia serrata in the journal Molecules, using precise mass spectrometry.
Relative to resin weight, Boswellia sacra contained 29 percent boswellic acids, Boswellia serrata 16 percent. For AKBA, the gap was even larger, around 7 versus 0.7 percent. The researchers considered claims of 70 percent boswellic acids or 30 percent AKBA in natural resins unrealistic or the result of incorrect measurement.
What this means for you: the species determines what is inside. And of all things, the frankincense used in most studies is naturally rather low in AKBA.
Mannino G, Occhipinti A, Maffei ME. Molecules. 2016;21(10):1329. DOI: 10.3390/molecules21101329In 2019, a group led by Schmiech in Ulm analyzed 41 resin samples from various Boswellia species, also in Molecules. The composition of the triterpenic acids could be assigned to specific species and even to specific growing locations. In the authors' view, uncertainties in botanical identification make it harder to develop medicines from frankincense.
Boswellia serrata
Indian frankincense. Most clinical studies and reviews refer to it. The European Pharmacopoeia has a monograph for its resin with KBA and AKBA as quality markers.
Boswellia sacra
Frankincense from the Arabian Peninsula and the Horn of Africa, also called Boswellia carterii. In one analysis, it contained more boswellic acids and considerably more AKBA, but the clinical evidence on taking it is a different story.
Incense resin in stores
Sold as incense, not as food. Neither intended nor labeled for consumption. The composition of frankincense resins varies by species and growing location.
And the smoke?
Burning incense is a ritual thousands of years old. There may even be a hint of biology behind the idea that the scent can be calming. In 2008, a team led by Moussaieff in Jerusalem showed that incensole acetate, a component of the resin, activated the heat sensor TRPV3 in the brains of mice. In a behavioral test, the animals showed less anxiety. This has not been studied in humans, and a mouse in the lab is not a person in a church pew.
But smoke also has another side. Burning produces fine particulate matter and combustion products, no matter how good it smells.
A team led by Friborg followed 61,320 people of Chinese descent in Singapore, aged between 45 and 74 at the start, and recorded their use of incense at home.
Long-term incense burning was associated with a 1.8-fold higher risk of squamous cell carcinomas of the respiratory tract. For lung cancer overall, there was no association.
This referred to incense used in everyday Asian life, not specifically Boswellia resin, and an observational study shows an association, not proof. What this means for you: smoke is still smoke, even when it smells good.
Friborg JT, Yuan JM, Wang R, et al. Cancer. 2008;113(7):1676-1684. DOI: 10.1002/cncr.23788If you want to take frankincense internally, the choice therefore starts with the species: Boswellia serrata, the gum resin, an extract with a documented composition. Incense resin stays in the incense burner. And if you like burning incense, air the room well afterwards.
Genuine is not the same as suitable. An incense resin can be real frankincense and still be the wrong product for your stomach.
So the question is not only: Is this frankincense? But: Which one, for what, and who has checked what is in it?
And now you know why the scent in the church and the capsule from the pharmacy tell two different stories.
What do AKBA and the percentages on the package mean?
You turn the jar around. It says 65 percent boswellic acids, or 30 percent AKBA. That sounds precise, almost like a lab report. But percent of what, and measured how?
Short answer: Frankincense resin contains six typical boswellic acids, including KBA and AKBA. The European Pharmacopoeia uses KBA and AKBA as quality markers for Indian frankincense. A large total figure on the package says little as long as it remains unclear which acids are meant and how they were measured. In lab analyses, a large share of commercial products did not match their own label claims.
The six most important boswellic acids have unwieldy names. Remember two of them: KBA, 11-keto-beta-boswellic acid, and AKBA, its acetylated sister. Both were long considered the main players in the lab. That is why the European Pharmacopoeia uses them as markers for the quality of Indian frankincense resin, as a 2011 review describes.
A marker is like a fingerprint. It tells you whether you are holding the right thing. It does not tell you how much of it reaches your body. More on that in a moment.
In 2016, a team led by Meins from the Central Laboratory of German Pharmacists examined 17 top-selling frankincense products from Europe and the USA, published in Planta Medica.
Only five stated the species, plant part and boswellic acid content in full, and ten gave no content at all. In total, 41 percent did not match their label claims. One product from Italy contained none of the six typical boswellic acids, and a US product contained only traces. Two products did not disclose that their extract had been technically enriched to up to 66 percent AKBA.
What this means for you: the label is a claim, not a lab report. To be fair: the team also included employees of an extract manufacturer.
Meins J, Artaria C, Riva A, et al. Planta Med. 2016;82(6):573-579. DOI: 10.1055/s-0042-103497For the product with only traces, the researchers suspected that no frankincense had been used at all, or Boswellia frereana instead of Boswellia serrata. In another product, the ratio of the acids was a better match for Boswellia sacra or Boswellia carterii. So not all frankincense is the same, even when it is genuine.
In 2024, a group led by Püski at the University of Szeged tested 14 commercial frankincense extracts used in food supplements, published in the Journal of Dietary Supplements.
Only two met the specifications for KBA and AKBA. The total boswellic acid content was correct according to classic titration, but ten extracts contained 6 to 11 percent citric acid, which does not belong there. The researchers suspect an undeclared addition so that the titration yields the promised value.
What this means for you: a number can be formally correct and still mislead.
Püski P, Körmöczi T, Berkecz R, et al. J Diet Suppl. 2024;21(4):462-477. DOI: 10.1080/19390211.2023.2299886Imagine you want to know how many apples are in a crate, and you only weigh the crate. Anyone who adds a few stones makes the crate heavier, but not richer in apples. A titration that measures acids as a whole works in a similar way.
In 2021, a team led by Zwerger in Innsbruck examined further commercial products. The acid they found most of was beta-boswellic acid, but in amounts between 0.9 and 16.9 percent. That is a difference of almost twentyfold, in products that are all called frankincense. Germany's consumer advice center, the Verbraucherzentrale, also reports products advertised with 80 percent boswellic acids, of which tests often detected 35 percent at most, sometimes none at all.
How to read a frankincense label
Species
Boswellia serrata is the species used in most clinical studies. If the species is missing, there is no basis for any comparison.
Plant part
This should be the gum resin. In the market analysis, three of 17 products did not name the resin as the part used.
Extract type
Native extract or technically enriched with AKBA? Both exist, and studies with one cannot be transferred to the other.
Individual acids
KBA and AKBA content in percent, even better all six boswellic acids. A single total figure reveals little.
Measurement method
HPLC or mass spectrometry distinguish the individual acids. Titration alone measures acids as a whole and can be fooled.
Documentation
A certificate of analysis for the batch that also covers heavy metals and residues. Ask for it, reputable suppliers should be able to provide one.
The more fully a label answers these six points, the better you can compare a product with a study. If more than one point is missing, ask.
The biggest number on the package is not the most important information. A label stating 80 percent without a measurement method can reveal less than one stating 2 percent AKBA, measured by HPLC.
You recognize precision by its details, not by its size.
And now you know why a plain package sometimes deserves more trust than a loud one.
More AKBA, more effect? The bioavailability pitfall
It sounds logical. If AKBA is the star, you simply take the product with the most AKBA. This is exactly where a pitfall lies that hardly anyone has on their radar while shopping.
Short answer: Not necessarily. After swallowing, AKBA reaches the blood only in very small amounts, far below the concentrations that were active in the lab. Beta-boswellic acid reaches levels around a hundred times higher. AKBA is a quality marker, not a promise of effect.
In 2011, Abdel-Tawab, Werz and Schubert-Zsilavecz evaluated lab, animal, pharmacokinetic and clinical data on Boswellia serrata in Clinical Pharmacokinetics.
The plasma levels of AKBA and KBA were far below the concentrations that were active in the test tube, and AKBA was poorly absorbed in permeability studies. In human whole blood, boswellic acids did not inhibit the formation of leukotrienes. Beta-boswellic acid, by contrast, reached levels around a hundred times higher and, in the lab, inhibits two other building blocks of inflammation.
What this means for you: the star of the label may play only a supporting role in the blood.
Abdel-Tawab M, Werz O, Schubert-Zsilavecz M. Clin Pharmacokinet. 2011;50(6):349-369. DOI: 10.2165/11586800-000000000-00000In 2009, a group led by Krüger from the Central Laboratory of German Pharmacists tested this in a model made of human intestinal cells. AKBA passed through the cell layer only poorly, KBA moderately, and a large part remained stuck in the cells.
Imagine AKBA as a key that fits the lock perfectly in the lab. In the body, it first has to get through the intestinal wall. Many keys get stuck there before they even see the door.
The simplest lever: your plate
Boswellic acids are fat-loving molecules. In 2004, a group led by Sterk in Ulm gave healthy men 786 milligrams of a dry frankincense extract, once on an empty stomach and once with a high-fat meal. With the meal, the blood levels of several boswellic acids rose several times over. Two acids were measurable only after eating.
This is the only lever in this article that costs nothing. If you swallow a product on an empty stomach, you may be wasting a large part of it.
Lecithin and micelles: more in the blood, more benefit?
Manufacturers try to improve absorption technically. In 2016, a group led by Riva compared an extract with its lecithin formulation in 12 healthy people, using two capsules of 250 milligrams each. Except for KBA, the boswellic acids from the lecithin form were absorbed faster and to a greater extent. The team included employees of an extract manufacturer.
In 2024, a group led by Schmiech in Ulm gave 20 healthy people a single dose of 800 milligrams of a native and of a micellar frankincense product, published in Phytomedicine.
With the micellar form, the bioavailability of the boswellic acids rose 17 to 43 times, most strongly for AKBA. In the subsequent lab test with blood samples, both products dampened the release of inflammatory messengers, but the micellar form did not do so more strongly than the native one.
What this means for you: a higher blood level is a prerequisite, not a result. Which form offers the most in everyday life remains open.
Schmiech M, Abdel-Kahaar E, Ulrich J, et al. Phytomedicine. 2024;132:155863. DOI: 10.1016/j.phymed.2024.155863Four lenses on one capsule
KPNI looks through four windows at the same time. With frankincense, each one has something to contribute to the question of quality.
Metabolism
Boswellic acids are fat-loving, and with a high-fat meal, their blood levels rose several times over. In intestinal cells, AKBA barely got through. And transporters in the liver and gut, which also move medications, responded to KBA and AKBA in the lab.
Immune system
What mainly reaches the blood is beta-boswellic acid. In the lab, it inhibits microsomal prostaglandin E synthase-1 and the enzyme cathepsin G, two building blocks of inflammation. Which acid plays the biggest part in the body remains open.
Nervous system
The scent is more than atmosphere. Incensole acetate from the resin activated the heat sensor TRPV3 in the brains of mice and reduced anxiety behavior. This has not been shown for humans or for capsules.
Hormonal system
Cortisol is the body's own inflammation damper, and dexamethasone is a strong synthetic relative. In a study on cerebral edema, the dexamethasone dose did not differ between the frankincense and placebo groups. So frankincense is not established as a substitute for cortisone.
AKBA is a quality marker, not a promise of effect. A high AKBA value shows you that someone has measured.
Whether enough of it reaches the blood, and whether that does anything for your symptoms, it does not answer.
And now you know why chasing the highest AKBA number can lead you astray.
What frankincense dosage was used in studies?
How much should I take? Almost every search for frankincense starts with this question. My answer sounds unsatisfying at first: there is no uniform dose.
Short answer: In studies, daily amounts ranged from 100 milligrams of an AKBA-enriched extract to 4,200 milligrams of another frankincense product. Because the extracts are so different, the numbers cannot be compared. According to a Cochrane review, an optimal daily dose has not been established. All of the following figures are study doses, not a recommendation.
The reason is simple. Almost every study used a different extract. Milligrams without information on the extract are like a price without a currency: the number is there, but you do not know what it is worth.
The following overview shows which daily amounts were used in selected studies. It is meant to put things in context, not to be copied.
| Research question | Product in the study | Daily amount | Duration | Result |
|---|---|---|---|---|
| Knee osteoarthritis | Extract enriched to 30 percent AKBA | 100 or 250 mg | 90 days | Pain and function better than with placebo, manufacturer study with 75 people |
| Knee osteoarthritis, Cochrane analysis | Enriched extract | 100 mg | 90 days | Pain on average 17 of 100 points lower than with placebo, high-quality evidence from two studies |
| Knee osteoarthritis, Cochrane analysis | Non-enriched extract | 999 mg | Single small study | Indications of benefit, low-quality evidence |
| Crohn's disease, maintaining remission | Extract, 400 mg capsules | 2,400 mg | 52 weeks planned, stopped early | No difference from placebo, well tolerated |
| Cerebral edema during radiotherapy | Boswellia serrata product | 4,200 mg | During radiotherapy | Edema reduced by more than three quarters in 60 versus 26 percent of participants, pilot study with 44 people |
| Absorption into the blood | Dry extract | 786 mg once | Single dose | Several times higher blood levels with a high-fat meal than on an empty stomach |
At 4,200 milligrams, the highest amount is 42 times the lowest of 100 milligrams. Yet both figures can make sense for their respective extract. That is exactly what makes frankincense so hard to compare.
The osteoarthritis study with the enriched extract comes from a manufacturer's research center. In 2008, the group led by Sengupta reported in Arthritis Research and Therapy on 75 people who received 100 or 250 milligrams for 90 days. With both amounts, pain and mobility improved compared with placebo, with 250 milligrams in some cases after just seven days.
In 2014, Cameron and Chrubasik analyzed 49 randomized trials on medicinal plants for osteoarthritis for the Cochrane Collaboration, including five studies with three different extracts from Boswellia serrata.
In two studies with 85 people, 100 milligrams of an enriched extract over 90 days reduced pain by an average of 17 of 100 points compared with placebo, and the evidence was rated as high. For 999 milligrams of a non-enriched extract and 250 milligrams of an enriched one, there was only low-quality evidence. According to the authors, the optimal daily dose needs further study.
What this means for you: the most robust data apply to a specific extract type, not to frankincense in general.
Cameron M, Chrubasik S. Cochrane Database Syst Rev. 2014;(5):CD002947. DOI: 10.1002/14651858.CD002947.pub2A group led by Dalmonte in Bologna shows how much the differences between products blur the overall assessment. In 2024, it pooled thirteen studies on knee osteoarthritis. Across all studies, the meta-analysis found no significant effect because of the large differences. Only in subgroups compared with placebo did an advantage appear.
In 2025, a network meta-analysis led by Zhang compared seven supplements for knee osteoarthritis across 39 studies. Boswellia had the highest probability of performing best for pain and stiffness. Nevertheless, the authors call for larger studies with more standardized dosages and formulations.
And the duration? In 2020, a meta-analysis led by Yu derived a duration of use of at least four weeks from seven studies. Based on these data, judging any sooner would be premature.
I think it makes sense to measure a product against a study extract: the same extract type, comparable content, a similar daily amount. Without this information, there is no basis for any question about dosage.
Any use also needs a time frame and medical supervision. If nothing happens, increasing the dose on your own is the wrong reflex.
The question is not: How many milligrams? It is: How much of what, taken how and for what?
And now you know why two products with the same milligram figure can be two entirely different things.
Is frankincense a medicine or a food supplement? The situation in Germany
In German drugstores, frankincense sits on the shelf next to magnesium and vitamin D. That feels tested, almost official. Is it?
Short answer: According to Germany's consumer advice center, the Verbraucherzentrale (as of March 2026), frankincense is not approved as a medicine in Germany, apart from homeopathic preparations. It is mainly sold as a food supplement. In Germany, food supplements count as food, are notified to a federal authority instead of being approved, and need no proof of efficacy.
Under German law, food supplements are food. Anyone who wants to sell one in Germany notifies the Federal Office of Consumer Protection and Food Safety no later than the first sale and submits a sample of the label. This is set out in Section 5 of the German Food Supplements Regulation, the Nahrungsergänzungsmittelverordnung. It does not provide for an approval.
It is like registering with an authority, not being checked by that authority. According to the Verbraucherzentrale, food supplements do not need proof of efficacy.
How frankincense got caught between two categories
Orphan status in the EU
The European Commission granted an extract from the resin of Boswellia serrata, applied for by a German company, the status of a medicine for rare diseases, for swelling in the brain around tumors. In 2006, the status was removed at the applicant's request. The European Medicines Agency emphasizes: such a status is not a marketing authorization.
Sales ban in Saarland
The authorities in the German state of Saarland banned the sale of Weihrauch H 15 tablets as a food supplement and classified them as a medicine requiring authorization. Each tablet contained 400 milligrams of Indian frankincense extract, and one tablet daily was recommended. In Austria, the same product was sold as a food.
European Court of Justice
Following a referral from Germany's Federal Administrative Court, the European Court of Justice clarified: a product is not a medicine simply because its substance is physiologically active at a certain dose. What matters is whether, under normal use and at its dosage, it can influence bodily functions.
Frankincense capsules from the pharmacy
A German pharmacy made frankincense extract capsules itself, as part of its normal operations and in limited quantities. Following a ruling by the European Court of Justice, Germany's Federal Court of Justice decided that such capsules do not need a marketing authorization. The case had been brought by the supplier of a frankincense food supplement called H 15.
Where things stand in Germany today
According to the Verbraucherzentrale, frankincense is not approved as a medicine in Germany, apart from homeopathic preparations, and is mostly available as a food supplement. According to this guidance, results from studies with special extracts cannot simply be transferred to products sold over the counter.
So in Germany, the same resin can be a food on the drugstore shelf and, at the pharmacy, a medicine made in-house without a marketing authorization. For a rare disease, one extract was even once on its way to becoming a medicine in its own right. The legal status describes the route of review, not the efficacy.
What else capsules can contain
Quality does not only mean: enough of the right thing. It also means: nothing of the wrong thing. The citric acid from the Hungarian analysis was one example. Heavy metals are another.
In 2005, a team led by Saper in Boston bought randomly selected Ayurvedic products online and reported on the analysis of 193 products in JAMA in 2008.
Of these, 20.7 percent contained detectable lead, mercury or arsenic, with products from the USA affected about as often as those from India. All contaminated products exceeded at least one limit for daily intake, and 75 percent of them advertised good manufacturing practice.
This concerned Ayurvedic remedies in general, not frankincense specifically. What this means for you: with herbal products from unclear sources, the question about heavy metal testing belongs on your list.
Saper RB, Phillips RS, Sehgal A, et al. JAMA. 2008;300(8):915-923. DOI: 10.1001/jama.300.8.915With food supplements, part of the checking therefore falls to you. Ask for the certificate of analysis for the batch. If tested quality matters to you, ask at the pharmacy whether the resin was tested according to the European Pharmacopoeia monograph.
A status is not a seal of quality. A food supplement is not automatically bad, and a pharmacy product is not automatically effective.
Above all, both routes tell you who checked what beforehand and who did not.
And now you know why the shelf next to the magnesium tells you nothing about the capsule yet.
Where are the limits? Side effects, interactions, liver and pregnancy
Plant-based, so harmless? You may know this thought. It is understandable, and it falls short.
Short answer: In studies, frankincense extract was mostly well tolerated, and mild gastrointestinal complaints were the most common. Lab experiments show, however, that frankincense extracts can influence enzymes and transporters that many medications depend on. Robust safety data are lacking for pregnancy, breastfeeding and children. No liver signal has been described so far, but liver values were rarely measured systematically.
What the studies show about tolerability
In 2008, a systematic review by Ernst in the BMJ evaluated seven randomized trials on extracts from Boswellia serrata, in asthma, rheumatoid arthritis, Crohn's disease, osteoarthritis and collagenous colitis. No serious safety problems were found. The author called the efficacy data encouraging but not compelling.
The Cochrane review also reports no serious side effects. Whether mild ones occur more often remained unclear because of inconsistent reporting. In the cerebral edema study with 4,200 milligrams per day, six people reported mild gastrointestinal complaints, and there were no serious side effects in either group. The Verbraucherzentrale lists nausea, heartburn and allergic reactions and points out that little is known about long-term effects.
Interactions: what the lab shows
In 2006, Frank and Unger from Würzburg tested extracts from four frankincense species on human enzymes that break down many drugs, published in the Journal of Chromatography A.
All four extracts inhibited the most important cytochrome P450 enzymes to a similar degree, including CYP3A4, CYP2C9 and CYP2D6. The boswellic acids themselves were not the main reason for the inhibition.
What this means for you: in the lab, frankincense can slow down exactly the enzymes many medications depend on. Whether this plays a role in the body is open, but it cannot be ruled out.
Frank A, Unger M. J Chromatogr A. 2006;1112(1-2):255-262. DOI: 10.1016/j.chroma.2005.11.116In 2006, a group led by Weber in Frankfurt showed in Planta Medica that a frankincense extract and the keto-boswellic acids slowed down the pump P-glycoprotein in cell experiments. This pump moves many medications out of cells. Because of the low blood levels, the authors considered this of little relevance for the brain, but they could not rule out interactions in the gut.
The group led by Krüger also found that, in the lab, KBA and AKBA influenced the transporters OATP1B3 and MRP2, which move other drugs through the liver and gut. The group considers relevant interactions with certain medications possible. The Verbraucherzentrale advises against using frankincense products together with anticoagulants such as warfarin.
Liver values
As of 2020, the US database LiverTox of the National Institutes of Health records neither increases in liver values during use nor cases of clinically apparent liver injury for extracts from Boswellia serrata. However, it points out that only a few studies have specifically measured liver values at all. In the osteoarthritis study with the enriched extract, the safety values in blood and urine remained almost unchanged compared with placebo.
When it comes to the liver, product quality therefore matters too. A properly tested product is something different from a capsule of unknown origin. If you have your liver values checked anyway, mention the product.
Pregnancy, breastfeeding and children
In my research, I did not come across any studies that specifically examined pregnant or breastfeeding women. According to the Verbraucherzentrale, frankincense products are not suitable for children. In these phases of life, restraint is therefore the usual approach, and any product should be discussed with a doctor beforehand.
Not a substitute for treatment
In 2011, a group led by Holtmeier tested in 22 German centers whether a frankincense extract could maintain remission in Crohn's disease. With the extract, 59.9 percent remained in remission, with placebo 55.3 percent, a difference without statistical significance. The study was stopped early. And in the cerebral edema study led by Kirste, both groups needed similar amounts of dexamethasone. Frankincense can be a complement. It is not established as a substitute for ongoing treatment.
- you take anticoagulants such as warfarin or phenprocoumon, or medications that keep platelets from clumping,
- you take medications with a narrow therapeutic range, such as immunosuppressants, certain antiepileptic drugs or cancer medications,
- you are pregnant, breastfeeding or want to treat a child,
- you have liver disease or abnormal liver values,
- surgery is planned,
- you are being treated for a chronic inflammatory bowel or joint disease.
Never reduce or stop an ongoing treatment on your own because you are starting frankincense.
Well tolerated means: in these studies, with these extracts, over this period. It does not yet say anything about your medications, your liver or your phase of life.
And now you know why a plant belongs on your medication list.
What can you do now in practice?
You do not need your own lab to make a good decision. You need the right questions, and you are allowed to ask them.
This is not about resin. It is about making decisions about your body with a clear view instead of believing a label. That is a quiet but real form of freedom.
Three levers for your next decision
- Read the label like a lab report. Species, plant part, extract type, content of individual boswellic acids, measurement method and batch. If more than one of these is missing, ask or leave the product on the shelf.
- Think in extracts, not in milligrams. Compare a product with the extract used in a study, not with a number from a forum. Take it with a meal that contains fat, and give any use a clear time frame with medical supervision.
- Do the safety check before the first capsule. Medication list, pregnancy and breastfeeding, liver, planned surgery. Whatever applies to you should be discussed beforehand.
- Swallow incense resin because it is real frankincense.
- Increase the dose on your own because nothing happens after a few days.
- Stop an ongoing treatment because a herbal product feels good.
What is established and what remains open
Well established
- Commercial products differ greatly, and in analyses many did not match their label claims.
- With a high-fat meal, blood levels of boswellic acids rose several times over.
- In two studies, an enriched extract at 100 milligrams per day reduced osteoarthritis pain more than placebo.
Open or shown only in the lab
- Which boswellic acid contributes most to an effect in the body.
- Whether higher blood levels from lecithin or micelles also bring more benefit.
- How relevant the interactions shown in the lab are in humans.
- How safe frankincense is during pregnancy, breastfeeding and long-term use.
For me, frankincense is one of the more fascinating plant substances. That is exactly why it deserves more than a pretty label and a big number.
And now you know why the best frankincense dosage starts with a question, not with a number.
Frequently asked questions about frankincense, quality and dosage
How much frankincense was taken in studies?
That depended heavily on the extract. In knee osteoarthritis, for example, 100 or 250 milligrams per day of an extract enriched to 30 percent AKBA were studied over 90 days. In a study on maintaining remission in Crohn's disease, it was 2,400 milligrams of a different extract, and in a pilot study on cerebral edema during radiotherapy, 4,200 milligrams per day. These are study doses, not a recommendation, and a Cochrane review considers the optimal daily dose unclear. Which amount might be right for you is a question for a conversation with your doctor.
Why are milligram figures for frankincense so hard to compare?
Because frankincense products are made in very different ways. A native extract, an extract technically enriched with AKBA and ground resin can contain very different amounts of boswellic acids at the same milligram figure. In commercial products, the share of beta-boswellic acid alone varied between 0.9 and 16.9 percent. That is why Germany's consumer advice center, the Verbraucherzentrale, does not consider statements such as 400 mg frankincense extract helpful for comparing products. It is more informative to know which individual boswellic acids a product contains and in what amounts.
Is more AKBA in a product automatically better?
No, not automatically. AKBA is an important quality marker, but after swallowing, it reaches the blood only in very small amounts. One review describes plasma levels far below the concentrations that were active in the lab, while beta-boswellic acid reaches levels around a hundred times higher. In one analysis, natural resin from Boswellia serrata contained only about 0.7 percent AKBA, and very high values come from technically enriched extracts. What matters more is whether a product corresponds to an extract type that has been tested in studies.
What does the statement 65 percent boswellic acids mean?
Often it is a total value from a titration. This method measures acids as a whole and does not distinguish between individual boswellic acids. In a Hungarian analysis of 14 commercial extracts, the titration value was correct, but 10 extracts contained 6 to 11 percent citric acid, which does not belong in frankincense resin. Only two extracts met the specifications for KBA and AKBA. Statements on individual boswellic acids, measured with HPLC, for example, are more informative.
How do I recognize a good frankincense product?
By the details, not by big numbers. The label should state the species Boswellia serrata, the plant part gum resin and the extract type, plus the content of individual boswellic acids, at least KBA and AKBA, and ideally the measurement method. Ask for a certificate of analysis for the batch that also covers heavy metals and residues. In an analysis of 17 top-selling products, only five stated species, plant part and content in full. A plain, complete label deserves more trust than a loud one.
Can I take frankincense sold as incense?
I advise against it. Incense resin is sold for burning and is neither intended nor labeled for consumption. It may come from different Boswellia species than the study extracts, and the composition of frankincense resins varies by species and growing location. Moderation also makes sense when burning it: in a large cohort from Singapore, long-term incense burning was associated with a higher risk of certain tumors of the respiratory tract. If you like burning incense, air the room well afterwards.
Is Indian frankincense better than frankincense from Arabia or Africa?
Not better across the board, but better studied. The clinical reviews refer mainly to extracts from Boswellia serrata, and the European Pharmacopoeia has a monograph for Indian frankincense with KBA and AKBA as quality markers. In one analysis, resin from Boswellia sacra even contained more AKBA. For one product with only traces of boswellic acids, researchers suspected that no frankincense at all had been used, or Boswellia frereana instead of Boswellia serrata. What matters, therefore, is the documented composition, not the origin alone.
Is frankincense approved as a medicine in Germany?
According to Germany's consumer advice center, the Verbraucherzentrale (as of March 2026), it is not, apart from homeopathic preparations. In Germany, frankincense is mainly available as a food supplement, meaning a food that is notified to the Federal Office of Consumer Protection and Food Safety but not approved. In addition, German pharmacies may make frankincense capsules themselves in limited quantities, as the Federal Court of Justice confirmed in 2017. None of these products has therefore gone through an officially reviewed proof of efficacy of the kind required for a marketing authorization as a medicine. That does not mean they are ineffective, but it does mean that nobody checked this in advance.
What was the story behind H15?
H15 was the name of a frankincense product from India that kept authorities and courts busy. According to a 2009 judgment of the European Court of Justice, each tablet contained 400 milligrams of Indian frankincense extract, the product was sold as a food in Austria, and one tablet daily was recommended. In 2002, the German state of Saarland banned its sale as a food supplement and classified it as a medicine requiring authorization. The Court clarified that classification depends on whether a product can influence bodily functions under normal use. The case shows how much the legal status depends on dose and presentation.
Do I need to take frankincense with food?
The data suggest so. In a crossover study from Ulm, blood levels of several boswellic acids rose several times over with a high-fat meal compared with taking them on an empty stomach. Two boswellic acids were detectable only when the capsules were taken with food. Boswellic acids are fat-loving molecules and are poorly absorbed in the gut without fat. Taken on an empty stomach, even a good product may deliver little.
Do frankincense products with lecithin or micelles offer more?
They can bring more boswellic acids into the blood, but whether more benefit follows is open. In 12 healthy people, most boswellic acids from a lecithin formulation were absorbed faster and to a greater extent, and a manufacturer was involved in this study. A micellar form increased bioavailability 17 to 43 times in 20 people. In the lab test with blood samples, however, it did not dampen inflammatory messengers more strongly than the native extract. What this means for symptoms cannot be read from such short-term studies.
What side effects can frankincense have?
In studies, frankincense extract was mostly well tolerated, and mild gastrointestinal complaints were the most common. A systematic review in the BMJ found no serious safety problems in seven randomized trials, and the Cochrane review reports no serious side effects. Germany's consumer advice center, the Verbraucherzentrale, lists nausea, heartburn and allergic reactions and points out that little is known about long-term effects. In its assessment, frankincense products are not suitable for children. Good tolerability in studies applies to the extracts and time periods tested there.
Does frankincense interact with medications?
That is possible, but little has been shown in humans. In the lab, extracts from four frankincense species inhibited the most important enzymes that break down many medications, including CYP3A4, CYP2C9 and CYP2D6. Further lab studies show effects on transporters such as P-glycoprotein, OATP1B3 and MRP2. Germany's consumer advice center, the Verbraucherzentrale, advises against using frankincense together with anticoagulants such as warfarin. If you take medication regularly, discuss frankincense with a doctor or pharmacist beforehand.
Can frankincense strain the liver?
No clear liver signal has been described so far. As of 2020, the LiverTox database of the US National Institutes of Health records neither increases in liver values during use nor cases of clinically apparent liver injury for Boswellia serrata extracts. However, liver values were rarely measured systematically in studies. Product quality also plays a role: in Ayurvedic products bought online, researchers found lead, mercury or arsenic in about one fifth. If you have liver disease or abnormal liver values, discuss any product with your doctor.
Can I take frankincense during pregnancy and breastfeeding?
Robust safety data for this are lacking. In my research, I did not come across any studies that specifically examined pregnant or breastfeeding women. On top of that come possible interactions and variable product quality. That is why restraint is the usual approach during pregnancy and breastfeeding. If you are pregnant, breastfeeding or planning a pregnancy, talk to your gynecologist before taking any frankincense product.
Where else this topic plays a role
The question of species, form and absorption does not only arise with frankincense. These articles approach it from other directions.
Frankincense: Quality and Dosage
Label, study doses, legal status, limits
this articleFrankincense for joints and gut
The leukotriene pathway and the evidence
Curcumin and bioavailability
Why the form matters with turmeric too
Cinnamon: Ceylon or cassia
Another example where the species matters
Turmeric for osteoarthritis
What studies show on joint pain
Exercise for osteoarthritis
Movement as a building block in knee osteoarthritis
Scientific sources and documents
All studies were checked via PubMed for existence, authorship, journal, year and abstract content, and the DOI links were checked to confirm that they resolve. Legal information comes from official and court documents and from the Verbraucherzentrale, Germany's consumer advice center. The study type is given in square brackets so you can judge the robustness of the evidence yourself.
- Mannino G, Occhipinti A, Maffei ME. Quantitative Determination of 3-O-Acetyl-11-Keto-βBoswellic Acid (AKBA) and Other Boswellic Acids in Boswellia sacra Flueck (syn. B. carteri Birdw) and Boswellia serrata Roxb. Molecules. 2016;21(10):1329. DOI: 10.3390/molecules21101329 [In vitro, resin analysis]
- Schmiech M, Lang SJ, Werner K, Rashan LJ, Syrovets T, Simmet T. Comparative Analysis of Pentacyclic Triterpenic Acid Compositions in Oleogum Resins of Different Boswellia Species and Their In Vitro Cytotoxicity against Treatment-Resistant Human Breast Cancer Cells. Molecules. 2019;24(11):2153. DOI: 10.3390/molecules24112153 [In vitro, analysis of 41 resin samples]
- Moussaieff A, Rimmerman N, Bregman T, et al. Incensole acetate, an incense component, elicits psychoactivity by activating TRPV3 channels in the brain. FASEB J. 2008;22(8):3024-3034. DOI: 10.1096/fj.07-101865 [In vivo, mouse]
- Friborg JT, Yuan JM, Wang R, Koh WP, Lee HP, Yu MC. Incense use and respiratory tract carcinomas: a prospective cohort study. Cancer. 2008;113(7):1676-1684. DOI: 10.1002/cncr.23788 [Cohort, prospective, n=61,320]
- Abdel-Tawab M, Werz O, Schubert-Zsilavecz M. Boswellia serrata: an overall assessment of in vitro, preclinical, pharmacokinetic and clinical data. Clin Pharmacokinet. 2011;50(6):349-369. DOI: 10.2165/11586800-000000000-00000 [Review, pharmacokinetics and mechanisms]
- Meins J, Artaria C, Riva A, Morazzoni P, Schubert-Zsilavecz M, Abdel-Tawab M. Survey on the Quality of the Top-Selling European and American Botanical Dietary Supplements Containing Boswellic Acids. Planta Med. 2016;82(6):573-579. DOI: 10.1055/s-0042-103497 [Real-world, market analysis, 17 products]
- Püski P, Körmöczi T, Berkecz R, Barta A, Bajtel Á, Kiss T. Rapid Detection of Adulteration in Boswellia Extracts with Citric Acid by UPLC-HRMS and 1H NMR. J Diet Suppl. 2024;21(4):462-477. DOI: 10.1080/19390211.2023.2299886 [Real-world, product analysis, 14 commercial extracts]
- Zwerger M, Ganzera M. Analysis of boswellic acids in dietary supplements containing Indian frankincense (Boswellia serrata) by Supercritical Fluid Chromatography. J Pharm Biomed Anal. 2021;201:114106. DOI: 10.1016/j.jpba.2021.114106 [Real-world, product analysis]
- Verbraucherzentrale. Mit Weihrauch wieder gehen können? As of 18 March 2026. verbraucherzentrale.de [Consumer information, in German]
- Krüger P, Kanzer J, Hummel J, Fricker G, Schubert-Zsilavecz M, Abdel-Tawab M. Permeation of Boswellia extract in the Caco-2 model and possible interactions of its constituents KBA and AKBA with OATP1B3 and MRP2. Eur J Pharm Sci. 2009;36(2-3):275-284. DOI: 10.1016/j.ejps.2008.10.005 [In vitro, Caco-2 cell model and transporters]
- Sterk V, Büchele B, Simmet T. Effect of food intake on the bioavailability of boswellic acids from a herbal preparation in healthy volunteers. Planta Med. 2004;70(12):1155-1160. DOI: 10.1055/s-2004-835844 [RCT, crossover, healthy men]
- Riva A, Morazzoni P, Artaria C, et al. A single-dose, randomized, cross-over, two-way, open-label study for comparing the absorption of boswellic acids and its lecithin formulation. Phytomedicine. 2016;23(12):1375-1382. DOI: 10.1016/j.phymed.2016.07.009 [RCT, crossover, n=12, with manufacturer involvement]
- Schmiech M, Abdel-Kahaar E, Ulrich J, Pfeiffer M, Duweb A, Zolk O, Syrovets T, Simmet T. Single-dose comparative pharmacokinetic/pharmacodynamic study of a micellar formulation versus a native Boswellia serrata dry extract in healthy volunteers. Phytomedicine. 2024;132:155863. DOI: 10.1016/j.phymed.2024.155863 [Clinical study, crossover, n=20, with ex vivo lab test]
- Kirste S, Treier M, Wehrle SJ, et al. Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors: a prospective, randomized, placebo-controlled, double-blind pilot trial. Cancer. 2011;117(16):3788-3795. DOI: 10.1002/cncr.25945 [RCT, pilot study, n=44]
- 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(4):R85. DOI: 10.1186/ar2461 [RCT, n=75, manufacturer study]
- Cameron M, Chrubasik S. Oral herbal therapies for treating osteoarthritis. Cochrane Database Syst Rev. 2014;(5):CD002947. DOI: 10.1002/14651858.CD002947.pub2 [Systematic review and meta-analysis, 49 RCTs]
- Holtmeier W, Zeuzem S, Preiss J, et al. Randomized, placebo-controlled, double-blind trial of Boswellia serrata in maintaining remission of Crohn's disease: good safety profile but lack of efficacy. Inflamm Bowel Dis. 2011;17(2):573-582. DOI: 10.1002/ibd.21345 [RCT, multicenter, n=82 randomized]
- Dalmonte T, Andreani G, Rudelli C, Isani G. Efficacy of Extracts of Oleogum Resin of Boswellia in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Phytother Res. 2024;38(12):5672-5689. DOI: 10.1002/ptr.8336 [Meta-analysis, 13 studies]
- Zhang Y, Gui Y, Adams R, et al. Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis. Nutrients. 2025;17(15):2547. DOI: 10.3390/nu17152547 [Meta-analysis, network, 39 RCTs]
- Yu G, Xiang W, Zhang T, Zeng L, Yang K, Li J. Effectiveness of Boswellia and Boswellia extract for osteoarthritis patients: a systematic review and meta-analysis. BMC Complement Med Ther. 2020;20(1):225. DOI: 10.1186/s12906-020-02985-6 [Meta-analysis, 7 RCTs, n=545]
- Verordnung über Nahrungsergänzungsmittel (NemV), § 5 Anzeige. gesetze-im-internet.de [Official document, German legal text on the notification of food supplements, in German]
- European Medicines Agency. EU/3/02/117: Orphan designation for Boswellia serrata (resin extract) for the treatment of peritumoral oedema derived from brain tumours. Granted on 21 October 2002, removed from the register at the sponsor's request in November 2006. ema.europa.eu [Official document]
- European Court of Justice. Judgment of 30 April 2009, Case C-27/08, BIOS Naturprodukte GmbH v Saarland (Weihrauch H 15 tablets). eur-lex.europa.eu [Court judgment, linked version in German]
- European Court of Justice. Judgment of 26 October 2016, Case C-276/15, Hecht-Pharma, ECLI:EU:C:2016:801; German Federal Court of Justice (Bundesgerichtshof). Judgment of 9 February 2017, I ZR 130/13 (frankincense extract capsules). eur-lex.europa.eu · BGH judgment (rewis.io) [Court judgments, linked versions in German]
- Saper RB, Phillips RS, Sehgal A, et al. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA. 2008;300(8):915-923. DOI: 10.1001/jama.300.8.915 [Real-world, product analysis, 193 products]
- Ernst E. Frankincense: systematic review. BMJ. 2008;337:a2813. DOI: 10.1136/bmj.a2813 [Systematic review, 7 RCTs]
- Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A. 2006;1112(1-2):255-262. DOI: 10.1016/j.chroma.2005.11.116 [In vitro, human CYP enzymes]
- Weber CC, Reising K, Müller WE, Schubert-Zsilavecz M, Abdel-Tawab M. Modulation of Pgp function by boswellic acids. Planta Med. 2006;72(6):507-513. DOI: 10.1055/s-2006-931536 [In vitro, cell models]
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Boswellia Serrata. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda. Last updated 4 November 2020. ncbi.nlm.nih.gov [Official document, database]
Transparency about the evidence. The statements on product quality are based on lab analyses of commercial products and resins. They show snapshots of specific products and cannot be applied to every single product. The data on absorption in the body come from small short-term studies in healthy people. The clinical studies are mostly small and short, and some were conducted or funded by manufacturers of the extracts tested. So far, interactions have mainly been shown in the lab, and their significance in humans is open. The legal information describes the situation in Germany as reflected in the documents cited. It may differ in other countries and does not replace legal advice.
Not a substitute for medical advice. This article is for information only and does not replace an individual medical examination, diagnosis or treatment. The amounts mentioned are study doses and not a dosage recommendation. If you take medication, are pregnant or breastfeeding, have liver disease, are planning surgery or are being treated for a chronic inflammatory condition, discuss frankincense products with a doctor beforehand. Never reduce or stop an existing treatment on your own.