·      Raw honey straight from the hive (filtered or unfiltered forms)

·      Regular honey pasteurized, with added sugars

·      Pure honey pasteurized, no added sugar/ingredients

·      Manuka honey from the manuka bush

·      Forest honey (bees feed on tree honeydew instead of flower nectar)

·      Acacia honey (bees feed on flowers of black locust tree)

·      Organic honey (raw or regular)

·      Medical grade honey (topical therapeutic)

Raw honey contains water, bee pollen (26 amino acids), bee propolis (resin, oil and wax, pollen, amino acids, minerals, sugars, vitamin B, vitamin C and vitamin E, aromatic compounds), antioxidants (flavonoids), enzymes (diastase, invertase, glucose oxidase), minerals (calcium, copper, iron, magnesium, manganese, phosphorus, potassium zinc), and vitamins (pantothenic acid, niacin, riboflavin).

Raw honey may contain a few more antioxidants and enzymes than pasteurized honey. Pasteurization is necessary to kill any yeast, but may reduce raw honey’s antibacterial action, wound healing benefits, antioxidant value, and anti-inflammatory effects. Don’t microwave raw honey or put it directly in boiling water to dissolve crystals that form over time as this may destroy some of its nutrient value. Organic honey is available as raw or regular, as some manufacturers pasteurize their organic honey.

Honey is a carbohydrate that contains 30% glucose and 40% fructose, both of which when broken down by the body may cause spikes in our blood sugar levels. Pure honey has a glycemic index of 58. The type of flowers that bees pollinate to make the honey determine its taste, color, antioxidant and vitamin content. One tablespoonful honey contains 64 calories.

Honey may be a good natural alternative for treating upper respiratory tract infections (Abuelgasim.  BMJ Evidence-Based Medicine August 18, 2020). In this review of 14 studies mostly in children and a few adults with URIs, authors concluded raw honey used to coat the throat was superior to usual care (e.g., dextromethorphan) for improving cough severity, cough frequency, or both.

Honey has a low pH level (acidic) that may kill harmful bacteria in wounds.  As seen in vitro studies, topical therapeutic (medical grade) honey may inhibit bacterial growth due to its high sugar content, acid pH, hydrogen peroxide production within the wound to aid in debridement, and moisture.  Subrahmanyam described a prospective randomized clinical and histological study of burn wound healing in two groups of 25 patients assigned to either topical therapeutic honey or topical silver sulfadiazine.  In the honey treated group, 84% of patients demonstrated epithelialization by day seven, and all of them demonstrated satisfactory wound healing by day twenty one. In the silver sulfadiazine treated group, epithelialization was present by day seven for 72% of patients and by day 21 for 84% of patients.  Regarding histological evidence of wound healing, 80% of patients treated with honey showed wound improvement by day seven compared to 52% of silver sulfadiazine treated patients by day seven. These outcomes continued to improve for both groups up to 21 days of treatment.

Medical grade honey should only be applied with the advice and consent of a physician.  Bacterial susceptibility varies based on length of topical exposure to therapeutic honey.  It is prudent to closely monitor the use of therapeutic honey in patients with all wounds, especially diabetic ulcers due to risk of infection.  Before therapeutic honey is used on an open wound, the wound should be swabbed for bacteria culture and sensitivity to honey determined before treatment if necessary. 

Not all food grade honey is sterile, and Clostridium botulinum can survive in honey, thereby causing a risk of wound botulism when applied to the wound.  Food-grade honey should not be used for wound healing.  Clinicians should consult the honey manufacturer to find out more about the product before applying honey to an open wound.

Using/taking honey by any route of administration is contraindicated in individuals allergic to honey or pollens contained therein, and in children less than one year of age (Abell. Honey for upper respiratory tract infections. Pharmacy Today November 2020). Individuals with diabetes mellitus should monitor oral honey consumption and its effect on their blood sugar levels.

Honey is one alternative to table sugar or agave for sweetening effects, nutritional value, and potential medicinal use. Please consult with your physician for an accurate diagnosis and direction on how best to use honey for any medicinal purposes.

References

Lusby PE. Honey: a potent agent for wound healing? J WOCN 2002;29:295-300.

Subrahmanyam M. A prospective randomized clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. Urns 1998;24:157-161.

Cooper R, Wigley P, Burton NF. Susceptibility of multi-resistant strains of Burkholderia cepacia to honey. Lett Appl Microbiol 2000;31:20-24.

Olaitan PB. Honey: a reservoir for microorganisms and an inhibitory agent for microbes. African Health Sci 2007;7:159-165.

Boukraa L. Honey use in burn management: potentials and limitations. Forsch Komplementmed 2010;17:74-80.