Expert Answer: Boswellia - A Potential Herbal Remedy

Question: My doctor suggested Gliacin/Boswellia as natural alternative to prevent migraine. Is there any data available on this?

A number of herbal remedies have been reported to help relieve migraine and other headaches. The best known are two common plants, feverfew and butterbur. Both of these herbs have the best scientific evidence for their efficacy (I participated in testing butterbur). While feverfew is safe to consume in any form (tea, raw leaves, extracts, etc.), butterbur has toxic ingredients which can cause liver problems, fetal malformations, and cancer. Highly purified forms of butterbur appear to be safe, but countries like the UK and Germany ban sales of all butterbur products.

Boswellia (Indian frankincense) is another common plant which is safe to consume in any form and which may help relieve headaches. There have been no rigorous trials of Boswellia conducted to date, but two anecdotal reports suggest that it may be worth a try for cluster and indomethacin-responsive headaches. The latter include chronic paroxysmal hemicranias, hemicranias continua, primary stabbing, and some cases of exercise-induced headaches.

An Austrian neurologist, Dr. Christian Lampl and his colleagues reported on four patients with chronic cluster headaches whose headaches improved after taking Boswellia extract. The dose of Boswellia was 350 to 700 mg three times a day. All four patients failed at least three preventive medications for cluster headaches, such as verapamil (Calan), topiramate (Topamax), and lithium. Dr. Eric Eross, a headache specialist from Arizona, reported that gliacin, a Boswellia extract relieved indomethacin-responsive headaches in 21 of 27 patients. Indomethacin is a very strong non-steroidal anti-inflammatory medication, but it also tends to have strong gastro-intestinal side effects. This makes Boswellia much preferred since it does not cause serious side effects, although it is important to know that any herbal product can cause an allergic reaction. Another caveat with all herbal products is that herbal products are poorly regulated and you may not always be getting Boswellia or not getting the amount that is stated on the label. The way to avoid this problem is to stick to major brands, that is products made by large well-known companies. I usually recommend Boswellia made by Nature’s Way.

We do not know how Boswellia works, but it has been known for many years to have anti-inflammatory properties and it has been widely used for joint pains, asthma, and other problems. Because of similarities between migraines and cluster headaches, I’ve given Boswellia to my patients with migraine headaches and several had a significant improvement. One patient had complete relief, while prescription drugs were ineffective. I also had a woman tell me that her headaches did not improve, but her joint pains were much relieved.

In conclusion, because of its safety and some anecdotal experience Boswellia should be added to the potential herbal products to try for a variety of headache types despite the lack of strong scientific evidence.

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