30. Wise Men, Indeed -- The Medicinal Benefits of Frankincense

"And going into the house, they saw the child with Mary, and they fell down and worshipped him. Then, opening their treasures, they offered him gifts of gold, frankincense and myrrh." (Mathew 2:11)

As it gets closer to Christmas, I feel like now is a great time to started dumping my research of natural medicine on you all, lol. I've been into it on-and-off over the years, but this year I've really dived deep into it and have started building up my knowledge base. I believe we're at a point where awareness of corruption and propaganda in the healthcare industry is at an all time high, and people are turning back to traditional medicine and "the old ways". People are tired of paying out the nose for insurance, only to have to wait forever for an appointment, only to have to take tons of different tests, only to never find out what's actually wrong with them. Then they're given 3 different synthetic drugs that don't address the root cause, and then later given more drugs to treat the side effects of those drugs. Oh, and that'll be a $50 copay, please!

So, I'm going to start periodically posting about natural/herbal remedies for common ailments, and (of course) the science to back them up. My research is ongoing, so I'll likely add to these type of posts in the future as I learn more. And why not start with frankincense? Very christmas-y, and Biblical, if you're into that.

***THIS IS NOT MEDICAL ADVICE. I AM NOT A MEDICAL PROFESSIONAL. ALWAYS CONSULT YOUR DOCTOR BEFORE TAKING ANYTHING ESPECIALLY IF YOU'RE PREGNANT OR BREASTFEEDING.***

Ahem. Frankincense has been used for centuries in traditional medicine, for everything from pain and inflammation, to GI issues, to oral health and infections. It has also been used for beauty purposes because of its benefits for the skin, and queens such as Esther and Cleopatra used it with oils in beauty rituals. It was also used as incense. It has been used and traded as one of the most valuable materials since the beginning of written history, worth its weight in gold.

More recently, frankincense has been studied for its effects on cancer, microbial infection, and chronic pain and inflammation. The compounds in frankincense gum extracts and resins -- namely boswellic acid and triterpenes -- were studied due to their efficacy in treating rheumatoid arthritis and chronic pain, without side effects and toxicity.

Frankincense comes from Boswellia trees, found throughout the Middle East and parts of Asia and Africa. There are a few different types depending on the region/variety of tree -- the most popular varieties are Boswellia sacra (grown in the Arabian Peninsula), Boswellia carteri (Somalia), and Boswellia serrata (India and China). Frankincense is a hardened resin that can be lit as incense, or ground into a powder to be infused into oils or alcohol extracts.

Frankincense essential oil is a bit different, as it's extracted not from the resin but from different parts of the plant such as roots, seeds, leaves, and flowers. Essential oils are extracted via steam distillation, which means that for skincare purposes, they are not as effective. The main skincare component, boswellic acid, is not water-soluble and therefore cannot be extracted into essential oil. However, the essential oil is just fine for other purposes.

DIGESTIVE PROBLEMS:

B. serrata has been used in Indian traditional medicine to treat arthritis, asthma, ulcers, and skin diseases. It was also used for various GI issues such as diarrhea, gas/bloating, intestinal blockage, and vomiting. 

One study had patients with chronic colitis take 900 mg of B. serrata daily for 6 weeks. Out of the 20 patients treated, 18 showed improvement in one or more parameters including stool properties, pathology, hemoglobin, calcium, phosphorus, proteins and total leukocytes. The control group was given sulfasalazine instead, and out of the 10 patients treated, only 6 showed similar improvements. 

One study observed mice who were given frankincense orally for a 14-day period, to determine its effects on the gut microbiome and blood metabolites. In male mice, the compound AKBA significantly decreased gut bacterial richness, but had no effect on females. The bacterium Akkermansia muciniphila, associated with weight loss and anti-inflammation, was significantly increased in both males and females. Bifidobacterium was also found to be increased in females.

As such, frankincense may be beneficial in improving gut bacteria and digestion in females, and may help reduce overgrowth of gut bacteria in males.

(2022, https://pmc.ncbi.nlm.nih.gov/articles/PMC8877038/)

RESPIRATORY:

In a study in patients with bronchitis, and 70% of the patients treated (900 mg daily) showed improvements. The control group (placebo) only showed 27% improvements in symptoms. 

Acute respiratory distress syndrome (ARDS) in severe cases is the main cause of death associated with COVID-19. It is an uncontrolled systemic inflammatory response caused by the release of large amounts of pro-inflammatory cytokines and chemokines. This cytokine storm triggers a violent attack by the immune system on the body, causing ARDS and multiple organ failure. A 2021 review highlighted frankincense's use in treating inflammatory lung conditions, proposing that it could be used to reduce that deadly systemic inflammation -- "It is reported that traditional Chinese medicine has been used in the control of infectious disease and many patients with SARS-CoV infection have benefited from these herbal treatments (Yang et al. 2020; Luo et al. 2020)."

"This review aims to highlight currently published research that has shown evidence, based on the activity of B. serrata against pulmonary lesions, oxidative stress, inflammation, immune disturbance, viruses, and secondary microbial infection, for the potential therapeutic effects of boswellic acids (BA) and B. serrata extract against COVID-19 and the conditions associated with it. We propose that B. serrata extract in small to moderate dose (100–200 mg/day) can be used in early stages in mild to moderate symptoms of COVID-19 to enhance the adaptive immune response. However a large dose of B. serrata extract or boswellic acid can be used to suppress the uncontrolled activation of the innate immune response that leads to cytokine storm."

(2021, https://pmc.ncbi.nlm.nih.gov/articles/PMC8256410/)

ANTI-CARCINOGENIC:

Boswellic acid (BA) is one of the most extensively studied naturally occurring anti-cancer agents, due to its anti-carcinogenic, anti-tumor, and anti-hyperlipidemic activities. An in vitro study using five isolated terpenoids from B. carterii showed that 3 different compounds exhibited moderate cytotoxic effects against human cancer cell lines. They were compared against cisplastin, a chemotherapy drug used to treat several types of tumors. While the cisplastin was more effective against the cancer cell lines, the frankincense compounds still showed promising results and may work synergistically with cisplastin and other chemotherapies (more study is needed).

It is known that 11-keto-β-boswellic acid (KBA), and 3-O-acetyl-11-keto-β-boswellic acid (AKBA) are mainly responsible for anti-tumor activity of Boswellia as they are highly competent in altering the inflammatory NF-κB and Akt pathway. NF-κB and Akt are involved in the cancer progression, as well as in the induction of chemo and radio resistance in cancer cells.

ANTIMICROBIAL:

In general, the natural compounds of plants are considered better alternatives to synthetic antimicrobial and antioxidant agents. The effects can of course vary depending on the amount of compounds present in the plant or extract.

Studies were conducted on the effects of B sacra resin, leaf extract, and essential oil on the growth and aflatoxin production by Aspergillus flavus and Aspergillus parasiticus. They concluded that the resin and essential oil, but not the leaf extract, of B. sacra could be used as safe preservatives to increase the shelf life of food and feed products.

Fungal and bacterial biofilms were found to be susceptible to B. papyrifera and B. rivae essential oils. These biofilms often form on the surfaces of implanted medical devices, and are especially problematic because they're resistant to conventional antibiotics and antifungal agents. They are a major cause of device-related infections and are difficult to treat. B. papyrifera and B. rivae essential oils showed substantial activity against biofilms formed by both S. epidermidis and S. aureus. The essential oil of B. papyrifera also demonstrated noticeable antimicrobial effects on S. epidermidis biofilms. Similarly, B. rivae essential oil was effective against preformed C. albicans biofilms. The essential oils especially inhibited germ tube formation and thus hyphal formation. The hyphal formation is vital for the virulence, biofilm formation, and structural integrity of C. albicans. A large part of the inhibitory activity of B. rivae oil was shown to be due to the presence of limonene (28%).

DENTAL / ORAL HEALTH:

Periodontitis is one of the major oral diseases that affect more than half the population. It is linked to certain bacterial species, and plaque and biofilm formation, resulting in inflammation. Current treatments are still unable to fully remove biofilms. 

In a double-blind, randomized clinical trial, the effectiveness of current scaling and root planing methods were compared to the use of B. serrata extract or powder. B. serrata really checks all the boxes needed here; with the anti-inflammatory effects of BA and the antimicrobial properties of AKBA. The post-antibiotic effects of AKBA were determined to be greater than ciprofloxacin, and the authors concluded that B. serrata extract had results comparable or even superior to traditional scaling and root planing treatments. A hydro-alcoholic extract was shown to be most effective.

Furthermore, current periodontal treatments often utilize synthetic chemical agents such as chlorohexidine, which can cause toxicity to connective tissue, staining, dysgeusia, dry mouth and allergies. There were no observed side effects of B. serrata extract.

ANTI-INFLAMMATORY / PAIN:

The anti-inflammatory effects of boswellic acids have been well-established by studies in vitro, and preclinical and clinical trials. These properties are also due to the presence of pentacyclic triterpenic acids that inhibit pro-inflammatory processes.

Studies have shown anti-inflammatory potential to treat inflammatory bowel disease, rheumatoid arthritis, osteoarthritis, asthma, and brain edema associated with glioma.

SKINCARE:

Hydro-distilled frankincense oil and its solid lipid nanoparticles prohibited UVB-induced aging and wrinkle formation in rats via inhibiting ROS, MAPK (pERK, pJNK, and pp38) and PI3K/AKT signaling pathways as well as NF-κB, alongside upregulating TGF-β pathway.

OTHER:

Animal studies have shown that Boswellia is effective in reducing cholesterol levels in rats, as well as levels of liver enzymes SGPT and SGOT after 6 weeks of treatment. 

Other studies have shown that BA has strong anti-diabetic activity. Animals were treated with different concentrations (1, 2, and 10 mg per kg of body weight) for 21 days, and showed significant improvements in weight loss, water consumption, and blood glucose levels.

Frankincense essential oil was shown to dramatically lower the level of collagen III secreted by fibroblasts during the wound-repairing process. This would likely improve wound healing by reducing the chance of scar formation and wound persistence. Additionally, the robust anti-proliferative activity of FREO in skin cells could also contribute to better wound healing.

Frankincense works synergistically with myrrh, and they are often used together in natural medicine. Myrrh is another resin exuded from the bark of Commiphora myrrha trees (and other species of Commiphora). It exists mainly in tropical and subtropical areas such as the southern Arabian Peninsula, Somalia, and Ethiopia.

In traditional Chinese medicine, both frankincense and myrrh are used to treat blood stasis, inflammation, swelling, and pain. When combined, the two resins can produce complex physical and chemical changes that alter the concentration of compounds, and produce new compounds. The result is an amplification of the beneficial properties from each resin.

Gum resin of Boswellia is included in the list of substances Generally Recognized As Safe (GRAS), which allows its use as a food additive by the U.S. FDA. One could easily envision the incorporation of frankincense and some of its components such as BAs into mouthwashes and toothpaste, and into topical ointments for inflammatory disorders of the skin.

Sources:

(2022, https://pmc.ncbi.nlm.nih.gov/articles/PMC9268443/)

(2017, https://pmc.ncbi.nlm.nih.gov/articles/PMC5801908/)

(2019, https://pmc.ncbi.nlm.nih.gov/articles/PMC6749531/)

(2019, https://pmc.ncbi.nlm.nih.gov/articles/PMC6544398/)

(2023, https://pmc.ncbi.nlm.nih.gov/articles/PMC10735031/)

As with any medication, herb or supplement, ALWAYS check for interactions with anything else you're taking or any health conditions you might have.

As for me personally, I use frankincense in an essential oil blend for pain, and I just ordered some ground resin to infuse into oil for skincare. Here's the essential oil blend I use:

frankincense -- 22 drops

eucalyptus -- 22 drops

peppermint -- 22 drops

cinnamon leaf -- 22 drops

carrier oil -- 60 ml

This is a 5% dilution, which is quite strong. Don't use it on your face or intimate areas. If you have sensitive skin, you may want to try a lower dilution. There are plenty of charts you can look up for different ratios and percentages. The Tisserand Institute is a great resource for anything related to essential oils. I use this blend topically for pain anywhere I need it, most often on my knees, shoulders or back of my neck. I also use a drop on my temples for headaches, and it helps prevent them from getting worse.