Boswellia serrata

Tier 2 — promising · Joint pain · OA

One of the best-supported natural options for joint pain relief. A 2025 network meta-analysis ranked Boswellia first among 7 supplements tested for knee osteoarthritis pain. It works by blocking 5-LOX — an inflammation enzyme — rather than the COX pathway that NSAIDs target, so it has a different and complementary mechanism. NCCIH considers it well-tolerated. Take with a fat-containing meal.

Dose: 300–500 mg extract (≥65% boswellic acids, ≥30% AKBA) 2–3× daily with a fat-containing meal