Honey

• Background
• Related terms
• Evidence
• Dosing
• Safety
• Methodology
• Selected references

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Honey

Background

Honey is a sweet, viscid fluid produced by honeybees ( Apis melliflera ) from the nectar of flowers. It is generally recognized as safe (GRAS), but there have been numerous reports of certain types of honey produced from the nectar of flowering plants from the genus Rhododendron and others that have toxic effects in humans and in animals.

Honey is easily absorbed and utilized by the body. It contains about 70-80% sugar; the rest is water, minerals, and traces of protein, acids, and other substances. Honey has been used by ancient Egyptians, Assyrians, Chinese, Romans, and Greeks as a medicinal remedy for the management of wounds, skin ailments, and various gastrointestinal diseases.

Honey's therapeutic importance as a known antibacterial agent has been recognized since 1892. Modern research has been conducted on the role of honey in chronic wound management and other indications. However, high quality studies are lacking, and further research is warranted to establish the therapeutic effect of honey in any indication.

Related terms

Acacia honey, adular, älskling, amour, andromedotoxin-containing honey, Apis mellifera (honey bee), apitherapy product, azaleas honey, bee products, blackberry honey, blueberry honey, borage honey, buckwheat honey, chou, cielo, citrus sinensis osbeck, clarified honey, clover honey, coisa doce, deli bal, endulzar, falar docemente, feng mi, flavonoids, grayanotoxin honey, hachimitsu, honeydew, honig, honing, honingkleur, honung, iets beeldigs, jelly bush honey, kamahi honey, kanuka honey, lastig portret, lavender honey, lief doen, liefje (aanspreekvorm), ling honey, ljuvhet, mad honey, madu, Manuka honey, mel, mel depuratum, melliferous products, miel, miel blanc, miele, mi vida, moeilijk probleem, mooi praten, mountain laurel honey, namorado, nectar, Nigerian citrus honey, nodding thistle honey, orange blossom honey, pasture honey, purified honey, rata honey, raw honey, rewarewa honey, rhododendron honey, schatz, sm;ouml;ra, sourwood honey, strained honey, sunflower honey, tala smickrande, tansy ragwort honey, Tasmanian leatherwood honey, tawari honey, tesoro, toppensak, toxic honey, tupelo honey, tutan bal, versuikeren, vipers bugloss honey, vleien, wild thyme honey, zoet maken.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Grading rationale

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acidosis (excessive acidity), antacid, anti-aging, anti-inflammatory, antimicrobial, antimycotic (antifungal), antioxidant, antiparasitic, antitumor, asthma, atopic dermatitis, breast ulcers, cancer prevention, cataracts, conjunctivitis (pink eye), cough, dental caries, dental surgery adjunct, diarrhea, edema (swelling), expectorant, eye infections/inflammation, fever, Helicobacter pylori infection, hyperglycemia (high blood sugar), immunostimulant, infections, leprosy, oral rehydration, pain, postherpetic corneal opacities, skin care, skin disorders, pressure sores, psoriasis, respiratory infections, septicemia, tinea corporis, tinea cruris, tinea faciei.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (over 18 years old)

There is no proven safe or effective medicinal dose for honey in adults. Commercial preparations of honey are available, and honey is typically taken by mouth or applied on the skin. Doses for topical use are often unspecific, but 15-30 milliliters is a common dose for Fournier's gangrene, burns, radiation induced mucositis, skin ulcers and other wounds. Various types of honey and honey products have been studied, including honey from wildflowers, Camellia sinensis honey, Medihoney dressings, Manuka honey, and Honey-Soft (honey medicated dressing).

For dermatitis and dandruff, a diluted solution of honey and warm water containing 90% water has been rubbed gently into the scalp for 2-3 minutes and then left on scalp for three hours. For type 2 diabetes mellitus and hypertension (high blood pressure), honey solutions with 30-90 grams of natural unprocessed honey with 250 milliliters of water have been studied.

Children (under 18 years old)

There is no proven safe or effective dose for honey in children, and use is not recommended. However, for neonatal post-operative infected wounds, 5-10 milliliters of commercial, unprocessed, non-pasteurized and non-irradiated honey applied locally to the wound and covered with a sterile gauze dressing has been used. Dressings were changed twice daily. Do not use honey in infants under 12 months of age due to potential toxicity of contaminated honey.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

The components of honey responsible for allergic reactions, ranging from cough to anaphylaxis, are usually thought to be pollens, glandular secretions and bee body material. There is some disagreement with the idea that honey allergies are primarily caused by the pollen particles found in the honey. Patients with polyvalent pollen or food allergies such as an allergy to celery, as well as patients with other bee-related allergens, should avoid honey consumption.

Chronic pruritic cheilitis (dry, itchy lips), occupational asthma, urticaria on the hands, chronic bronchitis, bronchial asthma, angioedema (swelling under the skin) with dysphagia (difficulty swallowing), dysponia (abnormal voice), and dyspnea (difficulty breathing) have all been reported.

Side Effects and Warnings

In general, honey is well tolerated in the recommended does and for daily consumption. Honey has generally recognized as safe (GRAS) status in the United States. However, there are reported cases of honey intoxication documented in the literature as an adverse effect of consuming toxic honey also known as 'mad honey,' which is produced from the nectar of certain flowering plants such as those of the genus Rhododendron . The symptoms of honey intoxication vary from case to case and may include weakness, sweating, hypotension (low blood pressure), bradycardia (lowered heart rate), Wolff-Parkinson-White syndrome, gastritis (inflammation of stomach), peptic ulcer, nausea, vomiting, faintness, leukocytosis (abnormally high white blood cell count), mild paralysis, dizziness, vertigo, blurred vision, convulsions and respiratory rate depression. Avoid the use of honey that is produced from the nectar of flowering plants of the genus Rhododendron.

There is a concern with some third world countries that the topical use of honey on deep leprotic (of leprosy) ulcers may increase the risk of maggot infestation in the wound by houseflies and bluebottle flies. Topically, honey may cause excessive dryness of wounds, which may delay healing. Applying saline packs as needed may treat this.

Honey contains fructose in excess of glucose, which may lead to incomplete fructose absorption associated with abdominal symptoms and/or diarrhea.

Many cases of infant botulism (bacterial illness) caused by consumption of honey containing Clostridium botulinum spore have been reported. Clostridium botulinum spores can proliferate in the intestines of infants and cause botulism poisoning. However, this potential risk does not pertain to older children or adults. Do not use honey in infants under 12 months of age. Another concern is that due to its acidity, the practice of keeping honey in the mouth for a prolonged period may erode dental enamel.

Pregnancy & Breastfeeding

There are some concerns regarding the use of honey in pregnant and breastfeeding women. Potentially harmful contaminants such as C. botulinum and grayanotoxins can be found in some types of honey and may be harmful to pregnant or breastfeeding woman and to the growing fetus.

Methodology

This patient information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Monograph methodology

Selected references

1. Abenavoli FM, Corelli R. Honey therapy. Ann.Plast.Surg. 2004;52(6):627.
2. Al Waili NS. Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions. Med.Sci.Monit. 2004;10(8):MT94-MT98.
3. Bose B. Honey or sugar in treatment of infected wounds? Lancet 4-24-1982;1(8278):963.
4. Hou YC, Ching H, Chao PD, et al. Effects of glucose, fructose and 5-hydroxymethyl-2-furaldehyde on the presystemic metabolism and absorption of glycyrrhizin in rabbits. J.Pharm.Pharmacol. 2005;57(2):247-251.
5. Kaufmann A, Kaenzig A. Contamination of honey by the herbicide asulam and its antibacterial active metabolite sulfanilamide. Food Addit.Contam 2004;21(6):564-571.
6. Keast-Butler J. Honey for necrotic malignant breast ulcers. Lancet 10-11-1980;2(8198):809.
7. Molan PC, Betts JA. Clinical usage of honey as a wound dressing: an update. J.Wound.Care 2004;13(9):353-356.
8. Postmes T, van den Bogaard AE, Hazen M. Honey for wounds, ulcers, and skin graft preservation. Lancet 3-20-1993;341(8847):756-757.
9. Schumacher HH. Use of medical honey in patients with chronic venous leg ulcers after split-skin grafting. J.Wound.Care 2004;13(10):451-452.
10. Staunton CJ, Halliday LC, Garcia KD. The use of honey as a topical dressing to treat a large, devitalized wound in a stumptail macaque (Macaca arctoides). Contemp.Top Lab Anim Sci. 2005;44(4):43-45.
11. Subrahmanyam M. A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. Burns 1998;24(2):157-161.
12. Subrahmanyam M. Early tangential excision and skin grafting of moderate burns is superior to honey dressing: a prospective randomised trial. Burns 1999;25(8):729-731.
13. Subrahmanyam M. Honey dressing versus boiled potato peel in the treatment of burns: a prospective randomized study. Burns 1996;22(6):491-493.
14. Subrahmanyam M. Honey impregnated gauze versus polyurethane film (OpSite) in the treatment of burns--a prospective randomised study. Br.J.Plast.Surg. 1993;46(4):322-323.
15. Subrahmanyam M. Storage of skin grafts in honey. Lancet 1-2-1993;341(8836):63-64.

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