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Honeybee Products

Scientific Name(s): Apis mellifera L.
Common Name(s): Honig, Miel blanc, Bee pollen, Clarified honey, Honey, Honeybee pollen, Mel, Purified honey, Royal jelly, Strained honey

Clinical Overview


Honeybee products have been used topically and internally for hundreds of years worldwide as remedies for a variety of illnesses; however, clinical trials are lacking for most uses. Honey and royal jelly exhibit antibacterial properties, and there is some evidence that honey might have a role in wound healing. Discrepancies among studies evaluating honey for wounds may be due to variations in the source and preparation of the honey. Bee pollen is most often used for its nutritional properties, and although it is nutritionally rich, claims that it enhances every-day and athletic performance have not been reliably verified. Data supporting the use of honeybee products for other indications are not well substantiated.


Honey is a common food and there are no dose restrictions on its use. It has been ingested and used topically.

The ideal dose of bee pollen is unknown, with doses varying among products because tablets contain differing amounts. Manufacturers' recommendations on product labeling may provide more guidance.

Clinical trials are generally lacking to recommend dosage for royal jelly. Small clinical trials have used royal jelly 6 to 10 g/day for 14 to 28 days when evaluating the effect on hyperlipidemia. A randomized, controlled trial investigating use of royal jelly for oral mucositis in patients receiving chemotherapy and radiation used a dose of 1 g/day in addition to standard mouthwash therapy. A dose of 2,400 mg/day for 8 weeks showed promise for patients with symptoms of dry eye in a controlled trial.


Honey should be used with caution in infant formulations. Allergy to bee venom is considered a relative contraindication to royal jelly. Other contraindications have not been identified for honey, bee pollen, or royal jelly.


Clinical data regarding safety and efficacy of these products in pregnancy and lactation are lacking. Honey is generally recognized as safe (GRAS) during pregnancy and lactation when used as food.


None well documented for honey or bee pollen. Case reports of hematuria due to potentiation of warfarin have been documented with royal jelly.

Adverse Reactions

Allergic reactions may occur to pollen in honey when ingested. Attempts to hyposensitize patients by administering bee pollen may produce severe anaphylaxis and other acute or chronic responses. Although rare, bee pollen can cause serious, sometimes fatal, adverse reactions. Some case reports of acute hepatitis and photosensitivity following ingestion of bee pollen have been reported. In many allergic patients, skin tests are positive for royal jelly. Occupational allergic respiratory disease from the inhalation of powdered royal jelly has been reported in workers. Case reports exist of allergy, acute exacerbation of asthma, anaphylaxis, and death.


Contaminated honey containing botulism spores can poison infants. The American Academy of Pediatrics and the World Health Organization recommend that honey should not be given to an infant younger than 12 months due to the potential for botulism. Honey made from the nectar of poisonous plants can be poisonous. Information on the toxicology of bee pollen or royal jelly is lacking.


Honey is a bee-concentrated and processed product of nectar from the flowers of numerous plants. This sweet secretion is deposited in honeycombs by honeybees (A. mellifera L., Fam. Apidae), as well as a few other species of bee in the tropics, and primarily consists of sugars. Minor components include phenols, glucose oxidase and catalase, ascorbic acid, carotenoids, organic acids, amino acids, proteins, and alpha-tocopherol. Composition varies with the pollen source, climate, environmental conditions, and processing.1, 2

Bee pollen consists of plant pollens collected by worker bees combined with plant nectar and bee saliva, usually a mixture of pollen species from several different plants. The pollens are packed by the insects into small dust pellets that are then used as a food source for male drones.

Royal jelly is a milky-white secretion produced by the hypopharyngeal and mandibular glands of worker honeybees (A. mellifera L.). It is the principal food of the honeybee queen, inducing differentiated growth and development. Because of this specialized nutrition, queen bees differ from workers in several ways: they are approximately twice the size of worker bees; they lay approximately 2,000 eggs a day (female worker bees are infertile); and they live 5 to 8 years, approximately 40 times longer than worker bees.3


Honey as flavoring for medicinal preparations was first known historically as a sweetening agent and was once officially listed in the National Formulary. Its use dates to ancient times.4 Early cultures universally hailed honey for its sweetening and nutritional qualities, as well as for its topical healing properties for sores, wounds, and skin ulcers.4 Honey is used directly as a sweetener and is also fermented into the sweet-tasting beverages of mead, cyser, or metheglin.5

The use of bee pollen increased during the late 1970s following testimonials by athletes that supplementation increased stamina and improved athletic ability. Products containing bee pollen have become widely available in health food stores and drugstores, as well as online.

In many countries, royal jelly has been widely promoted as a commercially available medicine, health food, cosmetic emollient, moisturizer, and source of nourishment. It is used in traditional medicine for longevity in Europe and Asia. Royal jelly has been sold as a skin tonic and hair growth stimulant.1, 3, 6


Bees and other insects extract thin, aqueous fluid nectar from the nectaries of various flowers. Some types of honey can be poisonous if the nectar is obtained from poisonous plants (eg, mountain laurel, jimson weed, azalea, rhododendron).7 When taken in by the bee, the nectar is modified by enzymes from glands in the head and thorax, forming levulose, dextrose, and sucrose. Honey is a thick, syrup-like liquid ranging in color from light yellow to golden brown. It is translucent when fresh, but darkens to opacity when old and can become granular through the crystallization of dextrose. Generally, honey has a characteristic odor and a sweet, faintly acrid taste. Honey is naturally mildly acidic. While honey varies in composition, its principle constituents are a mixture of dextrose and levulose in almost equal amounts ranging from 65% to 80% of one or the other. Sucrose ranges from 0.5% to 8%; dextrin from 1% to 10%.2 There have been numerous reports on an antimicrobial honey distillate fraction and related antifungal compounds.8, 9, 10, 11 The active antimicrobial principles have not been fully identified.

Bee pollen is a nutritional source for drone bees. It is a highly concentrated food source rich in vitamins, minerals, trace elements, enzymes, and amino acids. It contains approximately 30% protein, 55% carbohydrate, 1% to 2% fat, and 3% minerals and trace vitamins.12 Vitamin C concentrations of 3.6% to 5.9% have also been found in some samples.13 Bee pollen preparations often contain mixtures of pollens from diverse types of plants that vary with geographic origin.

Royal jelly is composed of a complex mixture of water (50%), proteins (approximately 15%), sugars, lipids, vitamins, pheromones, amino acids, and minerals.1, 14, 15 In addition, fatty acids (including hydroxydecanoic acids) and sterols (including sitosterol, desmosterol, and methylenecholesterol), tryptophan, organic acid glycosides and monoglycosides, glycopeptides, N-glycans, adenosine monophosphate N-oxide, apisimin, and a variety of major royal jelly proteins (MRJP) (including MRJP 1 to 9) have been identified.16, 17, 18, 19, 20, 21, 22, 23

Uses and Pharmacology

While more information is available on honey and bee pollen products, recent clinical trials evaluating these products are lacking, and suggested pharmacologic effects are largely based on in vitro and animal model experiments.


Compared to standard postsurgical therapy alone (antibiotic plus acetaminophen), adjunctive use of 5 mL of oral honey for 10 days significantly decreased average time of pain relief (7.65 vs 5.53 days, respectively, P < 0.001) as well as average acetaminophen use (17.53 vs 12.1 times, respectively, P < 0.001) in 80 Iranian children who underwent tonsillectomy.148 A systematic review and meta-analysis of 8 randomized controlled trials that evaluated the use of honey after tonsillectomy reported significant improvements overall in postoperative pain during the first 7 days postop with the use of honey compared to controls (P=0.05 to P<0.0001). However, after subgroup analyses by intervention and blind studies, significant pain reduction was seen only with honey plus antibiotics and not honey alone, and for only 1 day postop (day 2). Similarly, the number of analgesics used were statistically significantly lower with honey plus antibiotics for 2 postop days (days 1 and 3) with a mean difference of −1.39 and −1.03, respectively (P=0.0001 to P=0.005). Doses were highly variable across the studies and the quality of studies was rated as poor.154


Bee pollen administered to rats was also found to possibly have antiaging effects.118

Antibacterial activity

Apidaecins and abaecin, potent antibacterial peptides, have been isolated and characterized in the honeybee (A. mellifera L.) itself,24, 25 and a potent antibacterial protein named royalisin has been found in the royal jelly of the honeybee.26 The antibacterial activity in diluted honey with the right pH (range, 3.2 to 5) is attributed to hydrogen peroxide (H2O2), an enzymatic byproduct of the formation of gluconic acid from glucose. However, most of the hydrogen peroxide–related antibacterial activities of honey are lost after heating or prolonged exposure to sunlight.27, 28 A second mechanism, nonperoxide antimicrobial activity, is independent of light, heat, and storage time, but dependent on the flower source of the nectar. As a result, not all honey possesses this activity. Other characteristics that may contribute to honey's antibacterial activity are the presence of lysozymes and honey's low pH and high osmolarity.1 Honeydew honey from the conifer forests of the mountainous regions of central Europe and honey from manuka (Leptospermum scoparium) in New Zealand have particularly high antibacterial activity.29

The protein royalisin found in royal jelly has potent in vitro antibacterial activity against gram-positive bacteria, but is inactive against gram-negative bacteria. Hydroxydecanoic acid has in vitro bacteriostatic activity against Streptococcus aureus and Escherichia coli, which may modestly enhance host defenses in honeybees. Additive or synergistic effects have been demonstrated in vitro with starch and honey.30, 31, 32

Animal data

Manuka honey has a high level of activity against a variety of bacteria including S. aureus, Staphylococcus epidermidis, Streptococcus pyogenes, and Enterobacteriaceae.33, 34, 35, 36 Active manuka honey and its Australian equivalent are the only commercially available types of honey that are tested for antibacterial activity. Manuka honey contains an additional antibacterial component found only in honey produced from Leptospermum plants known as the "unique manuka factor."37

Clinical data

Manuka honey is a safe alternative topical antibiotic when compared with povidone iodine for the prophylaxis of dialysis catheter–related sepsis.38 However, 2 g of medical-grade honey from The Netherlands had no effect on reducing colonization of skin at central venous catheter sites in intensive care unit patients when used in combination with standard site dressing of 0.5% chlorhexidine in 70% alcohol.142 Honey has also been used for treating Helicobacter pylori, the gastric ulcer causative agent.39, 40, 41

Antioxidant activity

The growing interest in the antioxidant properties of foods is based on an attempt to protect cells against the damage caused by oxygen. The production of free radicals, which leads to oxidative stress, plays a part in many diseases, including cardiovascular disease, cancer, and diabetes. Oxidation in foods also leads to undesirable effects, such as reduced shelf life and unpleasant odors and flavors. Honeybee products such as honey and royal jelly have a naturally high antioxidant potential.1

Animal and in vitro data

Antioxidant activity has been demonstrated with royal jelly using different in vitro and plant models,42, 43, 44, 45 while protection against oxidative stress–induced injury has been demonstrated in animal experiments.43, 46, 47, 48 Using royal jelly, lipid peroxidation was inhibited in vitro and in experiments in rats.49

Bee pollen may possess antioxidant effects50 possibly attributed to polyphenolic substances, such as quercetin, caffeic acid, pinocembrin, and galangin, among others. One study found that bee pollen and propolis extracts inhibited respiratory burst, a transient increase in oxygen consumption following the production of reactive oxygen species within cancer cell lines, an effect attributed to the antioxidant potential.51 Another study found that bee pollen modulated antioxidant enzymes in the livers, brains, and lysates of erythrocytes in mice, and also decreased hepatic lipid peroxidation.52

Antitumor activity

Animal and in vitro data

Honey has demonstrated moderate antitumor and pronounced antimetastatic effects in rat and mouse tumors.53 A study showed that application of commercial honey to surgical wounds in mice impeded subsequent tumor implantation.54 Royal jelly exhibited antitumor activity in experimental mouse leukemias55; antiangiogenesis activity has been demonstrated in vitro.18 In human cervical/uterine carcinoma cells, some royal jelly fractions actively inhibited tumor growth.20 One study found that royal jelly inhibited the growth-promoting effect of bisphenol on breast cancer MCF-7 cell lines, although another study showed that royal jelly enhanced MCF-7 proliferation.23, 56


A number of related activities and unique medical applications include the successful use of honey in treating senile cataracts113 and postherpetic opacities of the cornea.114


Based on data in a few randomized, controlled trials, honey may offer benefits over placebo, no treatment, salbutamol, and diphenhydramine for symptomatic relief of acute cough in children, and may have similar effecacy as dextromethorphan.116, 140, 155 Results from a randomized, controlled trial (N = 300) indicated a significant benefit in total symptom scores for nocturnal acute cough in children 1 to 5 years of age who took 10 g of honey (eucalyptus, citrus, or labetiae) as a single dose or diluted in a noncaffeinated drink 30 minutes before bed compared with placebo (silan date extract).138

Dry eye syndrome

The safety and efficacy of royal jelly oral supplementation used for signs and symptoms of dry eye was investigated in a double-blind, randomized, placebo-controlled study (n=43) and followed with a mouse model to explore underlying mechanisms of action. Japanese adults complaining of mild or moderate dry eye symptoms were administered placebo or 2,400 mg/day of enzyme-treated royal jelly tablets (800 mg 3 times daily after meals) for 8 weeks; the tablets were standardized to a minimum of 3.5% (E)-10-hydroxy-2-decenoic acid and 0.6% 10-hydroxy-decanoic acid. At 8 weeks, only tear volume was significantly improved with administration of oral royal jelly compared to both baseline and placebo, and only for patients with an initial Schirmer score of 10 or less (P=0.0005 each). Tear film break-up time was significantly improved with royal jelly compared to baseline and placebo at 4 weeks (P=0.0271) but not at 8 weeks. No adverse events were observed. The mechanism appears to involve restoration of the lacrimal gland function by royal jelly.152

Estrogenic activity

Animal and in vitro data

Effects on estrogen receptors are weak compared with the effects of diethylstilbestrol and phytoestrogens; however, stimulation of messenger ribonucleic acid (mRNA) expression in estrogen-responsive genes and enhanced MCF-7 cell proliferation, which could be blocked by tamoxifen, has been demonstrated in vitro.23, 57 Animal experiments in rats and ewes have also been conducted. Mild hypertrophy of the uterine luminal epithelium was achieved in rats supplemented with royal jelly,23 while effects in ewes were varied. The effect of royal jelly supplementation on the onset of estrus has shown mixed results in ewes, with 1 trial showing no effect, while another exhibiting a shorter time to estrus compared with control and no difference compared with gonadotropin.58, 59, 60 In both experiments, positive effects on pregnancy and lambing rates were demonstrated.

Clinical data

A number of studies evaluated royal jelly for the relief of menopausal symptoms in the 1970s. However, recent clinical trials are lacking.


Animal data

Following GI enzymatic hydrolysis, peptides derived from royal jelly demonstrated angiotensin 1–converting enzyme inhibitory activity in the spontaneously hypertensive rat. Other studies suggest that trans-2-octenoic acid and hydroxydecanoic acid may account for the antihypertensive activity, but different fractions exert lesser or greater effects on duration of action. Royal jelly was also associated with protective action and therapeutic activity in adrenaline-induced arrhythmia; however, no effect on heart rate has been observed.61, 62, 63, 64

Immunoregulatory activity

Animal and in vitro data

Various in vitro experiments examined the actions of royal jelly and its constituents on the immune system.14, 65, 66, 67, 68, 69 Animal experiments demonstrated immunoregulatory activities, with the administration of royal jelly at 500 to 1,500 mg/kg/day, increasing survival in tumor-bearing mice and demonstrating positive effects on bone marrow stem cells and tumor-induced splenic hematopoiesis.70 Additionally, autoimmunity was inhibited in systemic lupus erythematous–prone mice, with a delay in disease progression, decreased proteinuria, and increased survival.71 Increased healing rates were observed in guinea pig tympanic membrane perforation.72

In an in vitro study using lymphocytes from healthy volunteers and patients with Graves disease, royal jelly caused lymphocytes to proliferate and certain cytokines to be secreted, suggesting a potential immunomodulatory role in the management of the disease.73

Insulin-like activity

Animal and in vitro data

In rats and in vitro experiments, insulin-like activity has been shown with royal jelly, and components may be structurally and functionally related to insulin. In an insulin-resistance model in rats, royal jelly reduced plasma insulin and triglycerides without affecting plasma glucose levels.20, 64

Lipid profile

Clinical data

Small clinical trials have demonstrated mixed effects on lipid profile in humans receiving royal jelly. Royal jelly administered at 10 g/day for 14 days increased serum high-density lipid (HDL) levels in elderly participants, while a trend toward improved low-density lipid (LDL) levels was seen with no effect on serum triglycerides.74 In another trial, 6 g/day for 4 weeks resulted in decreased serum total cholesterol and LDL, but had no effect on HDL or triglycerides.75

Neurological activity

Animal data

Traditional use of royal jelly in preventing aging has led to experiments regarding neuronal activities. Stimulation of production of glial cell line–derived neurotrophic factor has been demonstrated in the adult mouse brain, with a prediction of a neuroprotective role for royal jelly.76 In addition, 10-hydroxy-trans-2-decanoic acid increased the generation of neurons from neural stem (progenitor) cells in vitro,77 while adenosine monophosphate stimulated neuronal differentiation of pheochromocytoma PC12 cells.78 Activity on the pituitary gland in middle-aged rats has also been demonstrated,79 and orally administered royal jelly increased granule cell content in the hippocampus, with an observed improvement in induced cognitive impairment in mice.77

Oral mucositis

An assessment of interventions for preventing oral mucositis for patients receiving cancer treatment reported some weak statistical evidence of the benefits for honey used to either prevent or reduce the severity of mucositis compared with either a placebo or no treatment.115 Additionally, in a randomized controlled trial (N = 103), the mean time to resolution of oral mucositis (grade 1 to 3) was significantly reduced in patients undergoing radio- and chemotherapy who rinsed orally with royal jelly 1 g/day in addition to standard mouthwash therapy of benzydamine hydrochloride and nystatin rinses.141 However, subgroup analysis of 9 randomized clinical trials published up through June 2014 evaluating the effects of honey on oral mucositis in patients with head and neck cancer undergoing radio- or chemoradiotherapy found no significant effect in patients receiving chemotherapy. In contrast, significant improvements (lower incidence of moderate to severe mucositis, later onset time, lower 3-week mean grade) was seen in the honey groups compared to placebo or no treatment, with greater effects in patients undergoing radiotherapy alone compared with chemoradiotherapy.145


In tissue culture models and ovariectomized rats, a positive effect on osteoporosis was demonstrated with royal jelly. Increased calcium content and recovered bone mass were suggested as results of enhanced intestinal calcium absorption, rather than antagonism of the parathyroid hormone.117

Performance enhancement

Articles in the popular press have suggested that athletes could enhance performance by ingesting bee pollen; however, 1 investigation found no beneficial effect.80

Animal data

In a pilot study, 10 Arabian horses were randomized to receive either Dynamic Trio, a product containing 55% bee pollen or placebo consisting of 50% red wheat bran, 25% evaporated cane juice crystal sugar, 17% baking flour, and 8% powdered apple peels for 42 days. At baseline, the horses performed a standard exercise test. During the study, they continued to participate in horsemanship classes and were ridden throughout the week. Additionally, the horses performed the standard exercise test twice weekly, with a gradual increase in exercise intensity. At the end of this study, there were no treatment differences for V150 and V200, values of projected velocities at heart rates of 150 and 200 beats per minute, respectively. No changes were noted in heart rate, or in lactate, hematocrit, or hemoglobin levels. Horses receiving bee pollen tended to digest more neutral detergent fiber and acid detergent fiber. Additionally, they had less phosphorus excretion and tended to retain nitrogen. Thus, the product containing bee pollen may only have been beneficial in the performance of horses by stimulating food intake and nutrient retention.81

Clinical data

A 2-year, double-blind study found bee pollen "absolutely not a significant aid in the metabolism, workout training, or performance" of athletes.82 The results of another study conducted in track athletes suggested that runners who took bee pollen recovered faster after exercise, therefore being of value in relieving common tiredness and lack of energy. Critics of this study found the test group to be small, the blinding inadequate, and the conclusions premature.83 Another 6-week study in 20 competitive swimmers found no differences in strength and endurance tests between those treated with bee pollen and those treated with placebo (cod liver oil). However, it was noted in a post hoc analysis that swimmers treated with bee pollen missed fewer days (4 days) of training due to upper respiratory tract infections compared with those treated with placebo (27 days).84

Premenstrual syndrome and menopausal symptoms

Animal data

In a study of mice, Melbrosia, a product containing pollen, perga-pollen (bee bread), and royal jelly, was given in doses of 6, 60, and 600 mg/kg orally for 3 days to groups of 10 immature rats. Melbrosia was administered subcutaneously in the same doses to groups of 12 ovariectomized rats for 3 days. Estrogenic effects were not evident with Melbrosia therapy.85

Clinical data

In a randomized, double-blind, placebo-controlled, crossover study, the effect of Femal (an herbal remedy containing pollen extract 36 mg, combined pollen and pistil extract 120 mg, and royal jelly 6 mg) on premenstrual syndrome (PMS) was assessed in 32 women with regular menstrual cycles. Each participant received Femal or placebo for 2 consecutive menstrual cycles, followed by the alternate treatment for 2 more consecutive cycles. Three women dropped out of the study, and 29 participants were included in the analysis. Overall symptoms such as irritability and dysphoria were improved, and 6 of 9 symptom scores were reduced by 27% to 57%. Evidence also suggested a slow onset of action (no effect was noted between Femal and placebo after the first cycle of treatment), and protracted effect, considering that the placebo group first experienced a reduction in symptoms. Except for sleep quality, there were no differences in symptoms in participants receiving Femal before placebo. Weight gain was reduced by 50% in participants treated with Femal compared with placebo. Although the results suggest that Femal may be beneficial in improving PMS symptoms, they should be interpreted cautiously because there was no washout period, which raises doubt that the authors found a carry-over effect, and a preliminary phase designed to eliminate placebo responders was not conducted.86

Melbrosia is used in Europe and contains the active ingredients phytosterols, phytoestrogens, amino acids, oligopeptides, and enzymes.87 The effects of Melbrosia on ameliorating climacteric symptoms were clinically assessed. Two groups of women were followed; 32 served as a control group and 34 received Melbrosia. Patients receiving therapy experienced a reduction in the Kupperman menopausal index. Specifically, Melbrosia was most effective on nervousness, anxiety, irritability, headache, and hot flashes. No changes were noted in gonadotropin, estradiol, or lipid values. Thus, products containing bee pollen may serve as potential treatment options for patients suffering from climacteric symptoms associated with menopause.88 Similarly, another randomized, placebo-controlled study in women with severe menopausal symptoms found that the use of Melbrosia resulted in improvements in headache, urinary incontinence, vaginal dryness, and decreasing vitality. However, no changes in biochemical parameters were noted.89

In an open, multicenter, uncontrolled, prospective observation study, the effects of Melbrosia on menopausal symptoms and cardiovascular risk markers were assessed. Fifty-five postmenopausal women with climacteric complaints received 2 capsules of Melbrosia once daily for the first 2 weeks, followed by 1 capsule daily for the remaining 10 weeks. Twenty-seven of the 55 patients underwent laboratory assessment of cardiovascular risk markers, including cholesterol and C-reactive protein (CRP) levels. A significant reduction in the standardized Kupperman score (P < 0.001) and other symptom measuring tools (ie, Zerssen symptoms list and Zung depression score) were noted with treatment. Improvements were also demonstrated in problem-solving (P = 0.0015) but not in self-esteem or self-assessment. Additionally, patients experienced worsening irritability with Melbrosia therapy (P < 0.001). Total cholesterol (P = 0.03), LDL (P = 0.0053), and HDL (P = 0.018) improved with Melbrosia. However, triglyceride levels increased significantly (P = 0.0088). CRP levels did not significantly differ with Melbrosia therapy (P = 0.37). Thus, products containing bee pollen may not only improve menopausal symptoms, but also may improve cholesterol parameters.87

Prostate conditions

Cernilton, an extract of bee pollen, has been used in prostate conditions for its presumed anti-inflammatory and antiandrogenic effects.90 A single dose of Cernilton contains 60 mg of cernitin T60 (a water soluble pollen extract fraction) and 3 mg of cernitin GBX (an acetone-soluble pollen extract fraction). Cernilton has antiandrogenic effects via relaxation of urethral smooth muscle tone and increases in bladder muscle contraction and/or acts on alpha-adrenergic receptors and relaxes internal and external sphincter muscles.91

Clinical data

There is some evidence involving the use of bee pollen for the management of prostatitis and benign prostatic hyperplasia (BPH). Studies using Cernilton have shown modest improvement in urological symptoms, but have been limited by their short duration, small number of participants, and questionable standardization of preparations.91, 92, 93, 94, 95

Two placebo-controlled trials and 2 comparative trials enrolling 444 participants receiving treatment for 12 to 24 weeks were included in a systematic review published in 2000. The weighted mean relative risk (RR) of self-improvement for those receiving Cernilton versus placebo was 2.4 (range, 1.21 to 4.75) versus 1.42 (range, 1.21 to 4.75) with Tadenan (an extract from the African plum plant). Nocturia was reduced with Cernilton therapy compared with placebo, with an RR of 2.05 (range, 1.41 to 3). When compared with Paraprost (a mixture of amino acids), the weighted mean difference for nocturia was −0.4 times per evening (range, −0.73 to 0.07). Cernilton did not improve urinary flow rates, residual volume, or prostate size when compared with placebo or active comparators. The only reported adverse effect with Cernilton was nausea.91

Different doses of Cernilton for the prevention of BPH progression were assessed in a comparative study. Men with BPH (N = 240) received Cernilton 375 or 750 mg twice daily for 4 years. Patients receiving the higher dose of Cernilton experienced a greater improvement in the international prostate symptom score (IPSS), prostate volume, postvoid residual urine, and maximal flow rate (Qmax) assessments compared with those receiving the lower dose (P < 0.0001). Additionally, patients receiving the higher dose of Cernilton experienced improvements in IPSS and Qmax after 3 and 6 months of therapy, compared with 6 and 9 months in those receiving the lower dose.96

The efficacy of Cernilton N for the treatment of chronic prostatitis syndrome was assessed in 90 patients. The supplement was administered as 1 tablet 3 times daily for a 6-month period. The participants were divided into 2 groups: those with complicating factors (n = 18), such as urethral strictures, prostatic calculi, and bladder neck sclerosis; and those without complicating factors (n = 72). Seventy-eight percent of patients without complicating factors experienced a favorable response with Cernilton N therapy. Thirty-six percent were cured of their symptoms, and 42% improved in measures such as flow rate, leukocyturia in postprostate massage urine, and complement C3/coeruloplasmin in ejaculate fluid. Only 1 patient with complicating factors demonstrated a response. Thus, consideration for complicating factors may be an important determinant for successful treatment.97

One study evaluating the effects of the chloroform extract of bee pollen from Brassica campestris, a plant used as an herbal cancer chemopreventative in China, found that the steroid-containing extract could induce cytotoxicity in prostate cancer PC-3 (human) cells via apoptosis.98 Additional studies of bee pollen in the treatment of prostate cancer are needed.

Respiratory infections

Other potential uses of bee pollen include combating the effects of aging, treating respiratory infections and endocrine disorders, and relief of enteritis, colitis, and constipation. A double-blind, randomized, controlled trial conducted in 64 Iranian adults 18 to 65 years of age who had failed standard medical treatment for chronic rhinosinusitis found significantly improved endoscopic scores post-endoscopic surgery in the group treated with thyme honey nasal spray (35% w/v honey, 200 microg/mL thymol) compared to placebo. However, no significant differences were seen in sinonasal outcome test, endoscopy, or computerized tomography scan scores between the groups.146


A placebo-controlled randomized trial investigated the efficacy of topical 90% medical-grade kanuka honey (with 10% glycerine) applied twice daily for 8 weeks as a treatment for rosacea in 138 adult New Zealanders. Participants were predominantly between the ages of 50 and 70 years of age with a mean duration of rosacea of 15 years. The proportion of participants who experienced a clinically significant improvement was significantly higher in the treatment group (34.3%) compared to placebo (17.4%) (P = 0.02). Additionally, the proportion of patients who demonstrated full resolution of rosacea was 13.2% versus 2.9% in the honey versus placebo groups, respectively (P = 0.031). Both the investigator-rated and participant-rated severity scores were also significantly improved at weeks 2 and 8 in the treatment group compared to placebo.119

Wound healing

Wound healing activity, particularly anti-ulcerous properties, of honeybee products is attributed primarily to the presence of phenolic compounds.1

Clinical data

A review of literature through March 2001 found numerous articles verifying the use of honey in wound healing. A representative sample includes articles on honey for wounds, ulcers, and skin graft preservation99; an analysis of 40 cases in which honey was used on wounds and showed a positive (88% healing) effect100; honey and its healing properties for leg ulcers101; the successful use of honey for superficial wounds and ulcers102; honey as a wound-healing agent with antibacterial activity103; the use of honey in wound management104 and treating burns105, 106, 107; and usefulness of honey in managing abdominal wound disruption in 15 patients after cesarean delivery.108 The Scottish Intercollegiate Guidelines (SIGN, 2010) for the management of chronic venous leg ulcers state that honey dressings are not recommended in the routine treatment of patients with venous leg ulcers; no recommendation can be made for manuka honey as a debridement agent.109 A Cochrane systematic review of evidence-based decisions for local and systemic wound care found strong evidence for the use of honey and included venous ulcers, acute wounds, pressure ulcers, diabetic ulcers, and arterial ulcers.110 However, a Cochrane review of treatments for venous leg ulcers alone found that honey-based preparations offered no benefit in time to healing or complete healing when compared with usual care.111 An updated Cochrane review evaluated clinical data in 26 trials (N = 3,011) on the use of honey as a topical treatment for acute and chronic wounds. High-quality evidence favored improved healing with honey for partial thickness burns compared to conventional dressings in addition to a reduced overall risk of adverse events relative to treatment with silver sulfadiazine. Low-quality data supported improved healing of burns as well as mixed population acute and chronic wounds with honey compared to silver sulfadiazine. Other favorable outcomes were seen for Fournier’s gangrene with honey versus Eusol soaks, improved pressure ulcers with honey versus saline soaks, and healing of infected postoperative wounds with honey versus antiseptic washes; fewer adverse events were also seen with honey when used for postoperative wound infection. Beyond these, results were unclear due to poor quality of the evidence.144 It was also reported that while honey may be superior to some conventional dressing materials, the reproducibility of results is uneven.112 Other data support reduced healing time, but not healing rate, of lower leg ulcers in patients with type 2 diabetes.139 Whereas a small double-blind, randomized, controlled trial (N = 25) in patients with type 2 diabetes found no significant difference in healing parameters with application of 5% topical royal jelly over 12 weeks.147 A larger randomized controlled trial (unblended) conducted in 348 patients with Wagner’s grade 1 or 2 foot ulcers reported significantly improved wound healing and healing time honey-impregnated dressings compared to saline dressings. Only beri honey (Ziziphus jujuba) samples that provided at least an 18 mm zone of inhibition at 50% w/v against Staphylococcus aureus in agar diffusion test were used for the study. Maximum follow up was 120 days. Significantly more wounds healed with honey-impregnated dressings than saline dressings (75.97% vs 57.39%, respectively, P=0.001). Additionally, the number of wounds that were incompletely healed were significantly lower with honey (17.87%) compared to saline (31.36%; P=0.001). Mean wound healing time was also significantly shorter with honey than saline (18 vs 29 days, P<0.001).150


Honey is a common food and there are no dose restrictions on its use. It has been ingested and used topically, sometimes on surgical dressings.120

The ideal dose of bee pollen is unknown, with doses varying among products because tablets contain differing amounts. Manufacturers' recommendations on product labeling may provide more guidance.

Clinical trials are generally lacking to recommend dosage for royal jelly. Small clinical trials have used 6 to 10 g/day for 14 to 28 days when evaluating the effect on hyperlipidemia.74, 75 A randomized, controlled trial investigating use of royal jelly for oral mucositis in patients receiving chemotherapy and radiation used a dose of 1 g/day in addition to standard mouthwash therapy.98 Whereas 2,400 mg/day (800 mg 3 times daily with meals) was used safely for 8 weeks in a double-blind, randomized, placebo-controlled trial with some benefit in improving tear volume in patients with dry eye.152

Pregnancy / Lactation

Honey is GRAS when used as food. Safety and efficacy for dosages above those in foods is unproven.

Pregnant Sprague-Dawley rats fed bee pollen had fetuses with higher birth weights and decreased death rates, suggesting that bee pollen may be an effective prenatal nutrient.121 Human data regarding safety and efficacy of bee pollen in pregnancy and lactation are lacking.

Information regarding safety and efficacy of royal jelly in pregnancy and lactation is lacking. Estrogenic effects of royal jelly and its constituents have been demonstrated in animals.23, 57, 58, 59, 60, 117


No interactions have been well-documented for honey.

Warfarin: Bee pollen may enhance the anticoagulant effect of warfarin. Monitor therapy.156, 157, 158

Case reports of hematuria due to potentiation of warfarin have been documented with royal jelly.122 Based on a few animal experiments, potentiation of insulin activity may exist.20, 64

Other interaction data

Some studies have reported insignificant pharmacokinetic drug interactions with natural products. Limited information as well as potentially high interpatient variability in clinical response warrants cautious interpretation and/or application of these data in practice.

Nigerian honey consumption resulted in a dose-related variable, but had a statistically nonsignificant effect on quinine metabolism to 3-hydroxquinine in a 3-phase randomized crossover trial in 10 healthy volunteers. Young adult Nigerians 20 to 28 years of age consumed 10 or 20 mL of honey twice daily for 1 week prior to administration of quinine; the quinine metabolic ratio increased by 24.4% after the 10 mL phase and decreased 23.9% after the 20 mL phase (P = 0.15).143

Adverse Reactions


Pollen in honey may cause allergic reactions.

Bee Pollen

There have been numerous case reports of adverse reactions related to allergic reactions after ingestion of bee pollen by sensitive individuals. Single doses of bee pollen as low 5 mL have precipitated acute allergic reactions, including anaphylaxis.12, 123, 124, 125 The development of hypereosinophilia and neurologic and GI symptoms were reported in a woman who ingested bee pollen for more than 3 weeks.126 Allergic symptoms resolved upon discontinuation. The reactivity of bee pollen was assessed in 145 atopic patients and 57 healthy volunteers. All patients received skin-prick testing with 6 standard aeroallergens (olive, grasses mix, Parietaria, mugwort, Dermatophagoides pteronyssinus, and Dermatophagoides farinae) and homemade bee pollen extracts. There was a strong correlation between cutaneous reactions to bee pollen extracts and olive, grasses mix, and mugwort. Additionally, strong cutaneous reactions to bee pollen were observed in atopic patients compared with healthy volunteers.127

Two case reports of acute hepatitis following bee pollen ingestion have been reported. In 1 report, a 33-year-old woman had been taking 2 tablespoons of pure bee pollen daily for several months and subsequently developed sharp midepigastric and right upper quadrant pain. Liver function tests (LFT) were elevated. Although she was taking several other medications, only the bee pollen was discontinued. Within 6 weeks, a complete resolution with normalization of laboratory values occurred. In the second report, a 69-year-old man was taking 14 tablets daily of a mixed herbal product containing bee pollen. He developed worsening pruritus and nausea, followed by anorexia, weight loss, and jaundice, as well as elevated LFT. His only other medication was metoprolol tartrate. Within 8 weeks of discontinuation of only the herbal product, his symptoms dissipated and LFTs normalized.128

Royal Jelly

Although skin tests were positive for royal jelly in many allergy patients, some have been able to consume honey with no problems. Allergy, acute exacerbation of asthma, anaphylaxis, and death have been reported. Some occupational allergic respiratory cases have been reported in workers handling powdered royal jelly.122, 129, 130, 131, 132, 133, 153


Generally, honey is considered safe as a sweet food product, gargle, cough-soothing agent, and a topical product for minor sores and wounds. However, medical reports indicate that honey can be harmful when fed to infants because some batches contain spores of Clostridium botulinum, which can multiply in the intestines and result in botulism poisoning.134, 135, 136 The American Academy of Pediatrics and the World Health Organization recommend that honey should not be given to an infant younger than 12 months due to the potential for botulism. Research regarding toxicity with the use of bee pollen and royal jelly is lacking. A case report described mucosal hemorrhage, edema, and inflammation attributed to royal jelly consumption. A drug-induced lymphocyte stimulation test for royal jelly was positive.137

Honey made from the nectar of poisonous plants can be poisonous. This is most commonly seen in Turkey, with honeys produced from the genus Rhododendron in the Eastern Black Sea region; 15 to 20 cases per year of "mad honey" intoxication are reported that result from consumption of honey containing grayanotoxin that blocks sodium channels and most often leads to bradycardia, hypotension, nausea, vomiting, syncope, and possibly also mild hypothermia.149 Three cases of honey poisoning, including 1 fatality, were reported in Southwest China from consumption of honey contaminated with pollen from Tripterygium wilfordii Hook F. The patients, who were young males otherwise previously healthy, presented with frequent vomiting, acute renal failure, and toxic myocarditis.151


1. Viuda-Martos M, Ruiz-Navajas Y, Fernández-López J, Pérez-Alvarez JA. Functional properties of honey, propolis, and royal jelly. J Food Sci. 2008 Nov;73(9):R117-124.19021816
2. Osol A, Pratt R. The Dispensatory of the United States of America. New Drug Developments Vol 2. Philadelphia: Lippincott; 1960.
3. Tyler VE. The New Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 2nd ed. Philadelphia, PA: G.F. Stickley Co; 1987.
4. Carper J. The Food Pharmacy. New York: Bantam Books; 1988.
5. Klein R. The Green World: An Introduction to Plants and People. 2nd ed. New York: Harper & Row; 1987.
6. Inoue S, Koya-Miyata S, Ushio S, Iwaki K, Ikeda M, Kurimoto M. Royal jelly prolongs the life span of C3H/HeJ mice: correlation with reduced DNA damage. Exp Gerontol. 2003;38(9):965-969.12954483
7. Honey poisoning. BMJ. 1999;319(7222):1419A.10574866
8. Obaseiki-Ebor E, Afonya TC. In vitro evaluation of the anticandidiasis activity of honey distillate (HY-1) compared with that of some antimycotic agents. J Pharm Pharmacol. 1984;36(4):283-284.6144786
9. Radwan SS, El-Essawy AA, Sarhan MM. Experimental evidence for the occurrence in honey of specific substances active against microorganisms. Zentralbl Mikrobiol. 1984;139(4):249-255.6475343
10. Elbagoury EF, Rasmy S. Antibacterial action of natural honey on anaerobic bacteroides. Egyp Dent J. 1993;39(1):381-386.7905406
11. Efem SE, Udoh KT, Iwara CI. The antimicrobial spectrum of honey and its clinical significance. Infection. 1992;20(4):227-229.1521889
12. Mirkin G. Can bee pollen benefit health? JAMA. 1989;262(13):1854.
13. Tyler VE. The Honest Herbal: A Sensible Guide to the Use of Herbs and Related Remedies. 3rd ed. New York, NY: Pharmaceutical Products Press; 1992.
14. Kimura Y, Ushijima T, Maeda M, et al. Tumor antigen occurs in N-glycan of royal jelly glycoproteins: honeybee cells synthesize T-antigen unit in N-glycan moiety. Biosci Biotechnol Biochem. 2006;70(10):2583-2587.17031027
15. Schönleben S, Sickmann A, Mueller MJ, Reinders J. Proteome analysis of Apis mellifera royal jelly. Anal Bioanal Chem. 2007;389(4):1087-1093.17673985
16. Schmitzová J, Klaudiny J, Albert S, et al. A family of major royal jelly proteins of the honeybee Apis mellifera L. Cell Mol Life Sci. 1998;54(9):1020-1030.9791542
17. Bíliková K, Hanes J, Nordhoff E, Saenger W, Klaudiny J, Simúth J. Apisimin, a new serine-valine-rich peptide from honeybee (Apis mellifera L.) royal jelly: purification and molecular characterization. FEBS Lett. 2002;528(1-3):125-129.12297291
18. Izuta H, Chikaraishi Y, Shimazawa M, Mishimas, Hara H. 10-Hydroxy-2-decenoic acid, a major fatty acid from royal jelly, inhibits VEGF-induced angiogenesis in human umbilical vein endothelial cells. Evid Based Complement Alternat Med. 2009;6(4):489-494.18955252
19. Zhang JZ, Xue XF, Zhou JH, et al. Determination of tryptophan in bee pollen and royal jelly by high-performance liquid chromatography with fluorescence detection. Biomed Chromatogr. 2009;23(9):994-998.19399758
20. Salazar-Olivo LA, Paz-González V. Screening of biological activities present in honeybee (Apis mellifera) royal jelly. Toxicol In Vitro. 2005;19(5):645-651.15893447
21. Hattori N, Nomoto H, Mishima S, et al. Identification of AMP N1-oxide in royal jelly as a component neurotrophic toward cultured rat pheochromocytoma PC12 cells. Biosci Biotechnol Biochem. 2006;70(4):897-906.16636457
22. Kodai T, Umebayashi K, Nakatani T, Ishiyama K, Noda N. Compositions of royal jelly II. Organic acid glycosides and sterols of the royal jelly of honeybees (Apis mellifera). Chem Pharm Bull (Tokyo). 2007;55(10):1528-1531.17917301
23. Suzuki KM, Isohama Y, Maruyama H, et al. Estrogenic activities of fatty acids and a sterol isolated from royal jelly. Evid Based Complement Alternat Med. 2008;5(3):295-302.18830443
24. Casteels P, Ampe C, Jacobs F, Vaeck M, Tempst P. Apidaecins: antibacterial peptides from honeybees. EMBO J. 1989;8(8):2387-2391.2676519
25. Casteels P, Ampe C, Riviere L, et al. Isolation and characterization of abaecin, a major antibacterial response peptide in the honeybee (Apis mellifera). Eur J Biochem. 1990;187(2):381386.2298215
26. Fugiwara S, Imai J, Fujiwara M, et al. A potent antibacterial protein in royal jelly. Purification and determination of the primary structure of royalisin. J Biol Chem. 1990;265(19):11333-11337.2358464
27. Krell R. The physiological effects of honey. In: Value-added Products from Beekeeping. Rome Food and Agriculture Organization of the United Nations;1996:Chap 2.
28. Waikato Honey Research Unit. Honey as an antimicrobial agent. Honey Research Unit-University of Waikato (Auckland, NZ).
29. Mandal MD, Mandal S. Honey: its medicinal property and antibacterial activity. Asian Pac J Trop Biomed. 2011;1(2):154-160.23569748
30. Supabphol R. Antibacterial activity of royal jelly royalisin: potent antibacterial protein from royal jelly. Warasan Phesatchasat. 1995;22:33-38.
31. Boukraâ L, Meslem A, Benhanifia M, Hammoudi SM. Synergistic effect of starch and royal jelly against Staphylococcus aureus and Escherichia coli. J Altern Complement Med. 2009;15(7):755-757.19534615
32. Boukraâ L, Niar A, Benbarek H, Benhanifia M. Additive action of royal jelly and honey against Staphylococcus aureus. J Med Food. 2008;11(1):190-192.18361756
33. Quadri K, et al. Manuka honey for central vein catheter exit site care. Semin Dial. 1999;12(5):397-398.
34. Waikato Honey Research Unit. Activity of honey against wound-infecting bacteria (including "superbugs"). Honey Research Unit-University of Waikato (Auckland, NZ).
35. Allen KL, et al. The potential for using honey to treat wounds infected with MRSA and VRE. First World Wound Healing Congress,10-13Sep00, Melbourne, Australia.
36. Cooper R, Molan PC, Harding KG. Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds. J R Soc Med. 1999;92(6):283-285.10472280
37. Waikato Honey Research Unit. What's special about active manuka honey? Honey Research Unit-University of Waikato (Auckland, NZ).
38. Quadri K, et al. A prospective randomized controlled trial of topical honey versus povidone iodine in the prevention of hemodialysis catheter related sepsis. J Am Soc Nephrol. 1998;9:180A-181A.
39. al Somal N, Coley KE, Molan PC, Hancock BM. Susceptibility of Helicobacter pylori to the antibacterial activity of manuka honey. J R Soc Med. 1994;87(1):9-12.8308841
40. Ali A, Chowdhury MN, al Hymayyd MS. Inhibitory effect of natural honey on Helicobacter pylori. Trop Gastroenterol. 1991;12(3):139-143.1841451
41. Osato MS, Reddy SG, Graham DY. Osmotic effect of honey on growth and viability of Helicobacter pylori. Dig Dis Sci. 1999;44(3):462-464.10080135
42. Jamnik P, Goranovic D, Raspor P. Antioxidative action of royal jelly in the yeast cell. Exp Gerontol. 2007;42(7):594-600.17383134
43. El-Nekeety AA, El-Kholy W, Abbas NF, Ebaid A, Amra HA, Abdel-Wahhab MA. Efficacy of royal jelly against the oxidative stress of fumonisin in rats. Toxicon. 2007;50(2):256-269.17490698
44. Nagai T, Inoue R, Suzuki N, Nagashima T. Antioxidant properties of enzymatic hydrolysates from royal jelly. J Med Food. 2006;9(3):363-367.17004899
45. Liu JR, Yang YC, Shi LS, Peng CC. Antioxidant properties of royal jelly associated with larval age and time of harvest. J Agric Food Chem. 2008;56(23):11447-11452.19007163
46. Silici S, Ekmekcioglu O, Eraslan G, Demirtas A. Antioxidative effect of royal jelly in cisplatin-induced testes damage. Urology. 2009;74(3):545-551.19616287
47. Kanbur M, Eraslan G, Silici S, Karabacak M. Effects of sodium fluoride exposure on some biochemical parameters in mice: evaluation of the ameliorative effect of royal jelly applications on these parameters. Food Chem Toxicol. 2009;47(6):1184-1189.19425189
48. Kanbur M, Eraslan G, Beyaz L, et al. The effects of royal jelly on liver damage induced by paracetamol in mice. Exp Toxicol Pathol. 2009;61(2):123-132.18693095
49. Guo H, Ekusa A, Iwai K, Yonekura M, Takahata Y, Morimatsu F. Royal jelly peptides inhibit lipid peroxidation in vitro and in vivo. J Nutr Sci Vitaminol (Tokyo). 2008;54(3):191-195.18635904
50. Nakajima Y, Tsuruma K, Shimazawa M, Mishima S, Hara H. Comparison of bee products based on assays of antioxidant capacities. BMC Complement Altern Med. 2009;9:4.19243635
51. Aliyazicioglu Y, Deger O, Ovali E, et al. Effects of Turkish pollen and propolis extracts on respiratory burst for K-562 cell lines. Int Immunopharmacol. 2005;5(11):1652-1657.16039555
52. Sarić A, Balog T, Sobocanec S, et al. Antioxidant effects of flavonoid from Croatian Cystus incanus L. rich bee pollen. Food Chem Toxicol. 2009;47(3):547-554.19124059
53. Gribel' NV, Pashinkiĭ VG. The antitumor properties of honey [in Russian]. Vopr Onkol. 1990;36(6):704-709.2378090
54. Hamzaoglu J, Saribeyoglu K, Durak H, et al. Protective covering of surgical wounds with honey impedes tumor implantation. Arch Surg. 2000;135(12):1414-1417.11115344
55. Townsend GF, Morgan JF, Hazlett B. Activity of 10-hydroxydecenoic acid from royal jelly against experimental leukaemia and ascitic tumours. Nature. 1959;183(4670):1270-1271.13657083
56. Nakaya M, Onda H, Sasaki K, Yukiyoshi A, Tachibana H, Yamada K. Effect of royal jelly on bisphenol A-induced proliferation of human breast cancer cells. Biosci Biotechnol Biochem. 2007;71(1):253-255.17213647
57. Mishima S, Suzuki KM, Isohama Y, et al. Royal jelly has estrogenic effects in vitro and in vivo. J Ethnopharmacol. 2005;101(1-3):215-220.15946813
58. Kridli RT, Al-Khetib SS. Reproductive responses in ewes treated with eCG or increasing doses of royal jelly. Anim Reprod Sci. 2006;92(1-2):75-85.16023311
59. Husein MQ, Haddad SG. A new approach to enhance reproductive performance in sheep using royal jelly in comparison with equine chorionic gonadotropin. Anim Reprod Sci. 2006;93(1-2):24-33.16055281
60. Kridli RT, Husein MQ, Humphrey WD. Effect of royal jelly and GnRH on the estrus synchronization and pregnancy rate in ewes using intravaginal sponges. Small Rumin Res. 2003;49(1):25-30.
61. Matsui T, Yukiyoshi A, Doi S, Sugimoto H, Yamada H, Matsumoto K. Gastrointestinal enzyme production of bioactive peptides from royal jelly protein and their antihypertensive ability in SHR. J Nutr Biochem. 2002;13(2):80-86.11834223
62. Librowski T, Czarnecki R. Comparative analysis of Apistmul Crataegi Forte and royal jelly in the experimental heart action disturbance. Herba Pol. 2000;46(3):145-150.
63. Takaki-Doi S, Hashimoto K, Yamamura M, Kamei C. Antihypertensive activities of royal jelly protein hydrolysate and its fractions in spontaneously hypertensive rats. Acta Med Okayama. 2009;63(1):57-64.19247423
64. Zamami Y, Takatori S, Goda M, et al. Royal jelly ameliorates insulin resistance in fructose-drinking rats. Biol Pharm Bull. 2008;31(11):2103-2107.18981581
65. Okamoto I, Taniguchi Y, Kunikata T, et al. Major royal jelly protein 3 modulates immune responses in vitro and in vivo. Life Sci. 2003;73(16):2029-2045.12899927
66. Taniguchi Y, Kohno K, Inoue S, et al. Oral administration of royal jelly inhibits the development of atopic dermatitis-like skin lesions in NC/Nga mice. Int Immunopharmacol. 2003;3(9):1313-1324.12890429
67. Oka H, Emori Y, Kobayashi N, Hayashi Y, Nomoto K. Suppression of allergic reactions by royal jelly in association with the restoration of macrophage function and the improvement of Th1/Th2 cell responses. Int Immunopharmacol. 2001;1(3):521-532.11367535
68. Vucevic D, Melliou E, Vasilijic S, et al. Fatty acids isolated from royal jelly modulate dendritic cell-mediated immune response in vitro. Int Immunopharmacol. 2007;7(9):1211-1220.17630200
69. Gasic S, Vucevic D, Vasilijic S, Antunovic M, Chinou I, Colic M. Evaluation of the immunomodulatory activities of royal jelly components in vitro. Immunopharmacol Immunotoxicol. 2007;29(3-4):521-536.18075862
70. Bincoletto C, Eberlin S, Figueiredo CA, Luengo MB, Queiroz ML. Effects produced by royal jelly on haematopoiesis: relation with host resistance against Ehrlich ascites tumour challenge. Int Immunopharmacol. 2005;5(4):679-688.15710337
71. Mannoor MK, Shimabukuro I, Tsukamotoa M, Watanabe H, Yamaguchi K, Sato Y. Honeybee royal jelly inhibits autoimmunity in SLE-prone NZB x NZW F1 mice. Lupus. 2009;18(1):44-52.19074168
72. Calli C, Tugyan K, Oncel S, et al. Effectiveness of royal jelly on tympanic membrane perforations: an experimental study. J Otolaryngol Head Neck Surg. 2008;37(2):179-184.19128609
73. Erem C, Deger O, Ovali E, Barlak Y. The effects of royal jelly on autoimmunity in Graves' disease. Endocrine. 2006;30(2):175-183.17322576
74. Münstedt K, Henschel M, Hauenschild A, von Georgi R. Royal jelly increases high density lipoprotein levels but in older patients only. J Altern Complement Med. 2009;15(4):329-330.19388854
75. Guo H, Saiga A, Sato M, et al. Royal jelly supplementation improves lipoprotein metabolism in humans. J Nutr Sci Vitaminol (Tokyo). 2007;53(4):345-348.17934240
76. Hashimoto M, Kanda M, Ikeno K, et al. Oral administration of royal jelly facilitates mRNA expression of glial cell line-derived neurotrophic factor and neurofilament H in the hippocampus of the adult mouse brain. Biosci Biotechnol Biochem. 2005;69(4):800-805.15849420
77. Hattori N, Ohta S, Sakamoto T, Mishima S, Furukawa S. Royal jelly facilitates restoration of the cognitive ability in trimethyltin-intoxicated mice [published online ahead of print October 25, 2010]. Evid Based Complement Alternat Med.19376837
78. Hattori N, Nomoto H, Fukumitsu H, Mishima S, Furukawa S. Royal jelly and its unique fatty acid, 10-hydroxy-trans-2-decenoic acid, promote neurogenesis by neural stem/progenitor cells in vitro. Biomed Res. 2007;28(5):261-266.18000339
79. Narita Y, Ohta S, Suzuki KM, Nemoto T, Abe K, Mishima S. Effects of long-term administration of royal jelly on pituitary weight and gene expression in middle-aged female rats. Biosci Biotechnol Biochem. 2009;73(2):431-433.19202272
80. Steben RE, Boudreaux P. The effects of pollen and protein extracts on selected blood factors and performance of athletes. J Sports Med Phys Fitness. 1978;18(3):221-226.732296
81. Turner KK, Nielsen BD, O'Connor CI, Burton JL. Bee pollen product supplementation to horses in training seems to improve feed intake: A pilot study. J Anim Physiol Anim Nutr (Berl). 2006;90(9-10):414-420.16958799
82. Montgomery PL. Bee pollen: wonder drug or humbug? New York Times. February 6, 1977;5:1,7.
83. Blustein P. Pollinated presidents aside, experts doubt value of bee pick-me-up. Wall Street Journal. February 12, 1981.
84. Maughan RJ, Evans SP. Effects of pollen extract upon adolescent swimmers. Br J Sports Med. 1982;16(3):142-145.7139223
85. Einer-Jensen N, Zhao J, Andersen KP, Kristoffersen K. Cimicifuga and Melbrosia lack oestrogenic effects in mice and rats. Maturitas. 1996;25(2):149-153.8905606
86. Winther K, Hedman C. Assessment of the effects of the herbal remedy Femal on the symptoms of premenstrual syndrome: a randomized, double-blind, placebo-controlled study. Curr Ther Res Clin Exp. 2002;63(5):344-353.8905606
87. Georgiev DB, Metka M, Huber JC, Goudev AR, Manassiev N. Effects of an herbal medication containing bee products on menopausal symptoms and cardiovascular risk markers: results of a pilot open-uncontrolled trial. MedGenMed. 2004;6(4):46.15775873
88. Kolarov G, Nalbanski B, Kamenov Z, et al. Possibilities for an individualized approach to the treatment of climacteric symptoms with phytoestrogens [in Bulgarian]. Akush Ginekol (Sofiia). 2001;40(4):18-21.11803864
89. Szanto E, Gruber D, Sator M, Knogler W, Huber JC. Placebo-controlled study of Melbrosia in treatment of climacteric symptoms [in German]. Wien Med Wochenschr. 1994:144(7):130-133.8073778
90. Dhar NB, Shoskes DA. New therapies in chronic prostatitis. Curr Urol Rep. 2007;8(4):313-318.18519016
91. MacDonald R, Ishani A, Rutks I, Wilt TJ. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. BJU Int. 2000;85(7):836-841.10792162
92. Shoskes DA. Phytotherapy in chronic prostatitis. Urology. 2002;60 (suppl 6):35-37.12521591
93. Shoskes DA, Manickam K. Herbal and complementary medicine in chronic prostatitis. World J Urol. 2003;21(2):109-113.12720037
94. Wilt T, MacDonald R, Ishani A, Rutks I, Stark G. Cernilton for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2000;(2):CD001042.10796739
95. Elist J. Effects of pollen extract preparation Prostat/ Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized, double-blind, placebo-controlled study. Urology. 2006;67(1):60-63.16413333
96. Xu J, Qian WQ, Song JD. A comparative study on different doses of Cernilton for preventing the clinical progression of benign prostatic hyperplasia [in Chinese]. Zhonghua Nan Ke Xue. 2008;14(6):533-537.18649754
97. Rugendorff EW, Weidner W, Ebeling L, Buck AC. Results of treatment with pollen extract (Cernilton N) in chronic prostatitis and prostatodynia. Br J Urol. 1993;71(4):433-438.8499988
98. Wu YD, Lou YJ. A steroid fraction of chloroform extract from bee pollen of Brassica campestris induces apoptosis in human prostate cancer PC-3 cells. Phytother Res. 2007;21(11):1087-1091.17639562
99. Postmes T, van den Bogaard AE, Hazen M. Honey for wounds, ulcers, and skin graft preservation. Lancet. 1993;341(8847):756-757.8095651
100. Ndayisaba G, Bazira L, Habonimana E, Muteganya D. Clinical and bacteriological outcome of wounds treated with honey. An analysis of a series of 40 cases [in French]. Rev Chir Orthop. 1993;79(2):111-113.8121994
101. Bourne IH. Honey and healing of leg ulcers. J R Soc Med. 1991;84(11):693-694.1744891
102. Greenwood D. Honey for superficial wounds and ulcers. Lancet. 1993;341(8837):90.8093411
103. Kolmos HJ. Honey: A potential wound-healing agent with antibacterial activity [in Danish]. Ugeskr Laeger. 1993;155(42):3397-3398.8259634
104. Dunford C, Cooper R, Molan P, White R. The use of honey in wound management. Nurs Stand. 2000;15(11):63-68.11971572
105. Subrahmanyam M. Honey-impregnated gauze versus amniotic membrane in the treatment of burns. Burns. 1994;20(4):331-333.7945822
106. 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):322-223.8330089
107. Subrahmanyam M. Topical application of honey in treatment of burns. Br J Surg. 1991;78(4):497-498.2032114
108. Phuapradit W, Saropala N. Topical application of honey in treatment of abdominal wound disruption. Aust N Z J Obstet Gynecol. 1992;32(4):381-384.1290445
109. Scottish Intercollegiate Guidelines Network (SIGN). Management of chronic venous leg ulcers. A national clinical guideline. Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network (SIGN); 2010.
110. Brölmann FE, Ubbink DT, Nelson EA, Munte K, van der Horst CM, Vermeulen H. Evidence-based decisions for local and systemic wound care. Br J Surg. 2012;99(9):1172-1183.22777856
111. O'Meara S, Al-Kurdi D, Ologun Y, Ovington LG, Martyn-St James M, Richardson R. Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev. 2014;1:CD003557.24408354
112. Jull AB, Walker N, Deshpande S. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2013;2:CD005083.23450557
113. Golychev VN. Use of honey in conservative treatment of senile cataracts [in Russian]. Vestn Oftalmol. 1990;106(6):59-62.2075663
114. Mozherenkov VP. Honey treatment of postherpetic opacities of the cornea [in Russian]. Oftalmol Zh. 1984;(3):188.6483344
115. Worthington HV, Clarkson JE, Bryan G, et al. Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev. 2011;13;(4):CD000978.21491378
116. Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE. Honey for acute cough in children. Cochrane Database Syst Rev. 2012;3:CD007094.22419319
117. Hidaka S, Okamoto Y, Uchiyama S, et al. Royal jelly prevents osteoporosis in rats: beneficial effects in ovariectomy model and in bone tissue culture model. Evid Based Complement Alternat Med. 2006;3(3):339-348.16951718
118. Liu X, Li L. Morphological observation of effect of bee pollen on intracellular lipofuscin in NIH mice [in Chinese]. Zhongguo Zhong Yao Za Zhi. 1990;15(9):561-563, 578.2092719
119. Braithwaite I, Hunt A, Riley J, et al. Randomised controlled trial of topical kanuka honey for the treatment of rosacea. BMJ Open. 2015;5:e007651.26109117
120. Ahmed AK, Hoekstra MJ, Hage JJ, Karim RB. Honey-medicated dressing: transformation of an ancient remedy into modern therapy. Ann Plast Surg. 2003;50(2):143-148.12567050
121. Xie Y, Wan B, Li W. Effect of bee pollen on maternal nutrition and fetal growth [in Chinese]. Hua Xi Yi Ke Da Xue Xue Bao. 1994;25(4):434-437.7744390
122. Lee NJ, Fermo JD. Warfarin and royal jelly interaction. Pharmacotherapy. 2006;26(4):583-586.16553520
123. Cohen SH, Yunginger JW, Rosenberg N, Fink JN. Acute allergic reaction after composite pollen ingestion. J Allergy Clin Immunol. 1979;64(4):270-274.479479
124. Geyman JP. Anaphylactic reaction after ingestion of bee pollen. J Am Board Fam Pract. 1994;7(3):250-252.8059632
125. Greenberger PA, Flais MJ. Bee pollen-induced anaphylactic reaction in an unknowingly sensitized subject. Ann Allergy Asthma Immunol. 2001;86(2):239-242.11258697
126. Lin FL, Vaughan TR, Vandewalker ML, Weber RW. Hypereosinophilia, neurologic, and gastrointestinal symptoms after bee-pollen ingestion. J Allergy Clin Immunol. 1989;83(4):793-796.2708739
127. Pitsios C, Chliva C, Mikos N, Kompoti E, Nowak-Wegryzn A, Kontou-Fili K. Bee pollen sensitivity in airborne pollen allergic individuals. Ann Allergy Asthma Immunol. 2006;97(5):703-706.17165283
128. Shad JA, Chinn CG, Brann OS. Acute hepatitis after ingestion of herbs. South Med J. 1999;92(11):1095-1097.10586838
129. Rosmilah M, Shahnaz M, Patel G, et al. Characterization of major allergens of royal jelly Apis mellifera. Trop Biomed. 2008;25(3):243-251.19287364
130. Testi S, Cecchi L, Severino M, et al. Severe anaphylaxis to royal jelly attributed to cefonicid. J Investig Allergol Clin Immunol. 2007;17(4):281.17694707
131. Katayama M, Aoki M, Kawana S. Case of anaphylaxis caused by ingestion of royal jelly. J Dermatol. 2008;35(4):222-224.18419679
132. Leung R, Ho A, Chan J, Choy D, Lai CK. Royal jelly consumption and hypersensitivity in the community. Clin Exp Allergy. 1997;27(3):333-336.9088660
133. Peacock S, Murray V, Turton C. Respiratory distress and royal jelly. BMJ. 1995;311(7018):1472.8520337
134. A case of infant botulism. Commun Dis Rep CDR Wkly. 1994;4(12):53.7514930
135. Fenicia L, Ferrini AM, Aureli P, Pocecco M. A case of infant botulism associated with honey feeding in Italy. Eur J Epidemiol. 1993;9(6):671-673.8150073
136. Berkow R. The Merck Manual. 15th ed. Rahway, NJ; Merck Co; 1987.
137. Yonei Y, Shibagaki K, Tsukada N, et al. Case report: haemorrhagic colitis associated with royal jelly intake. J Gastroenterol Hepatol. 1997;12(7):495-499.9257239
138. Smith SM, Schroeder K, Fahey T. Over-the-counter (OTC) medications for acute cough in children and adults in community settings. Cochrane Database Syst Rev. 2014, Issue 11. Art. No.:CD001831.25420096
139. Kamaratos AV, Tzirogiannis KN, Iraklianou SA, Panoutsopoulos GI, Kanellos IE, Melidonis AI. Manuka honey-impregnated dressings in the treatment of neuropathic diabetic foot ulcers. Int Wound J. 2014;11(3):259-263.22985336
140. Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE. Honey for acute cough in children. Cochrane Database Syst Rev. 2014;12:CD007094.25536086
141. Erdem O, Gungormus Z. The effect of Royal jelly on oral mucositis in patients undergoing radiotherapy and chemotherapy. Holist Nurs Pract. 2014;28(4):242-246.24919094
142. Kwakman PH, Muller MC, Binnekade JM, et al. Medical-grade honey does not reduce skin colonization at central venous catheter-insertion sites of critically ill patients: a randomized controlled trial. Crit Care. 2012;16(5):R214.23111148
143. Igbinoba SI, Akanmu MA, Onyeji CO, et al. Influence of a Nigerian honey on CYP3A4 biotransformation of quinine in healthy volunteers [published online ahead of print July 14, 2015]. J Clin Pharm Ther.2617777810.1111/jcpt.12303
144. Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2015;3:CD005083.25742878
145. Cho HK, Jeong YM, Lee YJ, Hwang SH. Effects of honey on oral mucositis in patients with head and neck cancer: a meta-analysis. Laryngoscope. 2015;125(9):2085-2092.25778825
146. Hashemian F, Baghbanian N, Majd Z, Rouini MR, Jahanshahi J, Hashemian F. The effect of thyme honey nasal spray on chronic rhinosinusitis: a double-blind randomized controlled clinical trial. Eur Arch Otorhinolaryngol. 2015;272(6):1429-1435.25106547
147. Siavash M, Shokri S, Haghighi S, Shahtalebi MA, Farajzadehgan Z. The efficacy of topical royal jelly on healing of diabetic foot ulcers: a double-blind placebo-controlled clinical trial. Int Wound J. 2015;12(2):137-142.23566071
148. Mohebbi S, Nia FH, Kelantari F, Nejad SE, Hamedi Y, Abd R. Efficacy of honey in reduction of post tonsillectomy pain, randomized clinical trial. Int J Pediatr Otorhinolaryngol. 2014;78(1):1886-1889.25193590
149. Aygun A, Vuran HS, Aksut N, Karaca Y, Gunduz A, Turedi S. Mad honey poisoning-related hypothermia: a case series. J Emerg Med. 2016;50(1):51-54.26437804
150. Imran M, Hussain MB, Baig M. A randomized, controlled clinical trial of honey-impregnated dressing for treating diabetic foot ulcer. J Coll Physicians Surg Pak. 2015;25(10):721-725.26454386
151. Zhang Q, Chen X, Chen S, Liu Z, Wan R, Li J. Fatal honey poisoning caused by Tripterygium wilfordii Hook F in Southwest China: a case series. Wilderness Environ Med. 2016;27(2):271-273.27132027
152. Inoue S, Kawashima M, Hisamura R, et al. Clinical evaluation of a royal jelly supplementation for the restoration of dry eye: a prospective randomized double blind placebo controlled study and an experimental mouse model. PLoS ONE. 2017;12(1):e0169069.28060936
153. Torrijos EG, Diaz YM, Segade JM, et al. Occupational allergic respiratory disease due to royal jelly. Ann Allergy Asthma Immunol. 2016;117:102-103.27236220
154. Lai A, Chohan K, Chohan A, Chakravarti A. Role of honey after tonsillectomy: a systematic review and meta-analysis of randomised controlled trials. Clin Otolaryngol. 2017;42(3):651-660.27863042
155. Oduwole O, Udoh EE, Oyo-Ita A, Meremikwu MM, Honey for acute cough in children. Cochrane Database Syst Rev. 2014;4:CD007094.29633783
156. Hurren KM, Lewis CL. Probable interaction between warfarin and bee pollen. Am J Health Syst Pharm. 2010;67(23):2034-2037.21098375
157. Manach C, Williamson G, Morand C, Scalbert A, Remesy C. Bioavailability and bioefficacy of polyphenols in humans. I. Review of 97 bioavailability studies. Am J Clin Nutr. 2005;81(1 suppl):230S-242S.15640486
158. Si D, Wang Y, Zhou Y, et al. Mechanism of CYP2C9 inhibition by flavones and flavonols. Drug Metab Dispos. 2009;27:629-63419074529


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