GOLD, FRANKINCENSE and myrrh. Three treasures worthy of a new-born King.
Frankincense is an aromatic resin obtained from trees belonging to the genus Boswellia. These trees grow in India, northern Africa and the Middle East. A slit is made in the bark of the trees, out of which the gummy resin exudes. This is allowed to harden or can be extracted to yield a purified resin.
Frankincense has a long history of use as incense in religious ceremonies, in perfume production and medicinally. Four different Boswellia species can be used to make frankincense, and each comes in various grades. The frankincense brought to the stable in Bethlehem was probably made from Boswellia sacra and is no longer used medicinally.
However, frankincense made from Boswellia serrata continues to generate interest as a herbal remedy. It is also called “Indian frankincense” because of its long history of use in Ayurveda, the traditional medicine of India. The most common recommendations for its use are as a treatment for various inflammatory illnesses, in particular osteoarthritis and rheumatoid arthritis.
Detailed analysis of the contents of Indian frankincense reveals that it contains several compounds called boswellic acids. In laboratory tests these have been shown to have anti-inflammatory effects. Studies in mice and rats have produced results that confirm these activities.
A small number of randomised controlled trials have been published in which Indian frankincense was tested for various anti-inflammatory diseases. The results were inconsistent and are limited because only one study has been published for most of the diseases, like asthma, Crohn’s disease or colitis. The results generally favoured frankincense, but were not of the highest quality because they included small numbers of participants and had other methodological problems.
The only condition for which more than one controlled trial has been published is osteoarthritis of the knee. Three studies have been published in this area, but the largest one had only 75 participants. Two of the studies found frankincense to be more effective than placebo in reducing arthritic pain and improving physical functioning.
In the third study, frankincense relieved pain from knee osteoarthritis as effectively as the prescription drug, valdecoxib. This was one of the pharmaceutical “COX-2 inhibitors” withdrawn from the market in 2005 due to an increased risk of heart attacks and strokes. Overall, these three studies support the continued development and testing of Indian frankincense.
In controlled studies, serious adverse effects have not been reported. Interactions with other drugs have not been reported either. However, heartburn, nausea and diarrhoea have occurred in some people taking frankincense.
A wide variety of frankincense products are available, including combination products containing several different herbs. The quality and effectiveness of most of these have not been tested. In some of the animal studies, some extracts were found to be active and others inactive.
A wide range of doses has been used, ranging from 300mg to 1200mg three times daily. Given the current lack of data, the optimal dose of frankincense is not known.
The birth of Jesus was marked by the expensive gift of frankincense. Today, frankincense is being promoted as a valuable gift to those suffering from osteoarthritis and other inflammatory diseases. For now, the early evidence suggests that frankincense may be effective for people with osteoarthritis.
However, the product requires more development to ensure its quality is standardised and more research to determine whether of not it is effective and, if so, what dose is best and safe.
Dónal O’Mathúna has a PhD in pharmacy, researching herbal remedies, and an MA in bioethics, and is a senior lecturer in the School of Nursing, Dublin City University. He is author of Alternative Medicine: The Christian Handbook, Updated and Expanded Edition, Zondervan, 2007
