15 Second Summary
While it may seem a natural and safe alternative, there is limited quality research on the effectiveness of apitherapy treatments, and there is the potential for associated adverse events. The scientific community is divided on the effectiveness of apitherapy, and although there is enthusiasm surrounding its potential medicinal uses, until there is more scientific evidence suggesting that apitherapy does more good than harm, I would avoid this alternative therapy.
What Is Apitherapy?
I must say, when I started doing some research on apitherapy I was intrigued, or should I say ‘a little stung’ by the hype surrounding this form of alternative medicine.
For thousands of years, humans have been fascinated with bees and have used bee products to treat a range of ailments. Apitherapy refers to a group of alternative therapies that use products from honeybees (e.g. honey, pollen, royal jelly, and bee venom) for medicinal purposes. The term Apitherapy comes from the Latin word “Apis”, which means “bee”.
An initial google search of apitherapy took me straight to the American Apitherapy Society (AAS) (http://www.apitherapy.org/about-apitherapy/what-is-apitherapy/), which provides a good introduction to apitherapy. The AAS is a well-established organization with a journal that is published four times a year (since 2004), but the articles are only available to members, and it is important to keep in mind, it is not a peer reviewed scientific journal.
As I explored the AAS’s website, I was drawn to (and a little concerned by) the “Conditions Treated” tab which claims that apitherapy can be used to treat a multitude of health conditions. Those listed include:
- Immune system dysfunction or problems (Multiple Sclerosis, Rheumatoid arthritis, Hay fever)
- Neurologic problems (Lou Gehrig’s Disease, Shingles, Scar pain)
- Musculoskeletal problems (Arthritis, Gout, Tendonitis, bursitis, Spinal pain
- Infectious problems (Bacterial, viral, and fungal illnesses
- Traumas (Wounds, acute and chronic
- Burns (Sprains, Fractures)
- Tumors (Benign or Malignant cancers
It is important to note that the site had a disclaimer at the top of the page clearly stating that: “This list does not imply that these conditions are cured. Further, this list does not address the totality of conditions that Apitherapy addresses.”
Certainly this is a long list of health conditions that they are suggesting can be treated and improved by bee products – but with no citations listed to support these claims. Maybe all the information related to these claims is in the journal articles which are only available to members?
A search of Pubmed for components of apitherapy, such as “bee venom”, “honey”, and “Royal Jelly,” produced a wealth of published literature investigating the efficacy and safety of these treatments.
Bee Venom Therapy (BVT) yielded the most literature and therefore this article will focus on BVT and its health claims.
What Is Bee Venom Therapy (BVT)?
Bee venom therapy (BVT) involves the application of bee venom into the skin by administration of live bee stings or injections with a needle, including acupuncture into acupoints.
It is believed that bee venom exhibits analgesic, anti-inflammatory, anti-arthritic, and anti-cancer effects through multiple mechanisms. Although BVT has been used in alternative medicine for a long time, there is limited evidence of its effectiveness.
However, based on the more recent literature there is certainly an interest in BVT among the scientific community.
Before You Read Further: A Note On Publication Bias
A number of the published studies I review below contain positive findings regarding Bee Venom Therapy. But this is far from a reason to consider it a safe, effective alternative therapy.
Due to our fascination with ‘new’ and ‘alternative’ treatments in modern medicine, it would be difficult to publish a manuscript in a scientific journal that yields null findings (e.g. bee venom has no effect).
Whereas, if the results suggest that an ‘alternative’ therapy such as BVT does improve particular illnesses then it will generate some interest, generate attention for the journal and hence it is more likely to be published. This phenomenon is referred to as publication bias.
Lastly, it is also interesting to note that the majority of published studies are from Asian countries where apitherapy has been part of the culture for thousands of years.
There is very little literature (published studies) on this topic from Western countries, highlighting the fact that apitherapy is not well accepted in modern medicine, as with many alternative therapies.
Does Bee Venom Therapy Help With Pain?
Because of its potential anti-inflammatory properties, BVT has been administered as an analgesic (a pain reliever) and a handful of studies have investigated the effectiveness of BVT on reducing pain.
A meta-analysis of data from 11 randomized clinical trials assessing the effectiveness of BVT on musculoskeletal pain reported that bee venom acupuncture was associated with reduced pain compared to control treatments in 10 trials.
Adverse events were reported in four of the trials with itching and skin hypersensitivity being the most common. The authors concluded that there was suggestive evidence for the effectiveness of bee venom acupuncture in treating musculoskeletal pain (Lee 2008).
A similar meta-analysis analyzed data from four randomized clinical trials assessing the effectiveness of BVT in relieving shoulder pain after stroke. The four studies were selected from 138 potential studies and all four trials reported favourable effects of BVT on shoulder pain after stroke. The authors concluded that further studies are needed to confirm the role of BVT in alleviating post-stroke shoulder pain (Lim 2015).
One smaller study and one case report also showed a positive effect of Bee Venom on pain associated with Tennis Elbow, and delayed onset muscle soreness (after a workout) but their samples were very small (both 20 subjects) small and they can't be said to represent credible evidence for BVT's benefits.
Does Bee Venom Therapy Help With Arthritis?
Back in 2005 there was a review article published on the effectiveness of bee venom acupuncture (BVA) in the treatment of arthritis.
Two randomized controlled trials and three uncontrolled clinical trials showed that BVA was effective in the treatment of arthritis. The authors concluded that it is highly likely that the effectiveness of BVA for arthritis is a promising area of future research.
However, they further conclude that there is currently limited evidence demonstrating the efficacy of BVA in arthritis.
Almost 10 years later (2014) the same author published a review of randomized clinical trials investigating the use of BVA for therapy of rheumatoid arthritis. The review first identified 304 potential studies, but only one study met the strict inclusion criteria. Therefore the authors concluded that there was still insufficient evidence to suggest that BVA is an effective therapy for rheumatoid arthritis (Lee et al. 2014).
Can Bee Venom Therapy Help In Treating Cancer?
There have been quite a few in vivo/vitro and animal studies suggesting that bee venom has anti-cancer properties through mechanisms such as induction of apoptosis, necrosis, proliferation, cytotoxicity, and growth inhibition of different types of cancer cells (Oršoli 2012).
These effects are largely due to an antimicrobial peptide called melittin, which makes up about 50-70% of bee venom. It is said that melittin can induce cycle arrest, growth inhibition, and apoptosis in various tumour cells (Oršoli 2012).
If you are wanting to read more on the potential anti-cancer properties of bee venom, then I highly recommend you read the article titled “Bee venom in cancer therapy” by Oršoli (2012).
In the meantime, as much as it is easy to get excited about BVT having potential cancer curing properties, it is still very early days and despite the handful of animal studies showing positive effects, no human studies have investigated the effectiveness on BVT curing cancer.
Think about it, if you were diagnosed with cancer and were asked to participate in a blinded (e.g. you may receive the treatment of interest, or you may receive the placebo – but you will never know!) randomized clinical trial wanting to see if bee venom will cure cancer, would you? Most people wouldn’t risk it. Hence, it is very difficult to conduct human studies assessing the effectiveness of BVT as a treatment for cancer.
Will Bee Venom Therapy Treat Sexual Dysfunction?
Bee venom has also been reported to help sexual dysfunction. This claim was based on a single case-report of a 51 year old male who had undergone surgery on his lower back due to a herniated disc.
During admission he asked the physician if his sexual dysfunction be treated with alternative therapies. He was then given treatments using pharmacopuncture of sweet bee venom and his sexual dysfunction had improved according to the International Index for Erectile Dysfunction (Lee et al. 2014).
Does Bee Venom Help With Psoriasis?
Psoriasis is an inflammatory skin disease marked by red, itchy, scaly patches, of which can be very painful.
An Egyptian study randomized 50 people who had recalcitrant localized plaque psoriasis into a BVT (named the “Apitherapy” group in the study) treatment group (n=25) and placebo group (n=25).
Both treatments were injected into skin lesions at weekly intervals for a maximum of 12 treatments. There was significant improvement in the BVT group and the authors concluded that Apitherapy is an effective and safe treatment for recalcitrant localized plaque psoriasis, when other topical or physical therapies have failed (Eltaher et al. 2014).
Will Bee Venom Help Your Facial Wrinkles?
Facial wrinkles? Where will these health claims stop?
In a South Korean study twenty-two generally healthy women aged between 30 and 49 years were selected from volunteers. Applied bee venom serum on their face for 12 weeks. Dermatological tests for wrinkles were performed at 4-week intervals. A dermatologist’s visual assessment, photographs, and image analysis were used to evaluate changes in skin wrinkles. Compared to the control group, bee venom serum was associated with a decrease in total wrinkle area, total wrinkle count, and average wrinkle depth (Han et al. 2015).
Be Warned: The Risks Associated with Bee Venom Therapy
BVT comes with risks! As we all know, some people have an allergic reaction when stung by bees and although the apitoxin is diluted when administering BVT, there is potential for adverse reactions – we could however say the same about many medications!
A recent meta-analysis of the risks associated with BVT looked at data in 145 studies, including 20 RCTs and randomized crossover studies, 79 audits and cohort studies, 33 single-case studies, and 13 case series. Results showed that BVT was strongly associated with adverse events such as systemic reactions and local reactions, some of which are serious (Park et al. 2015).
A recent case-report highlighted the dangers of BVT. A 68-year-old woman was admitted to the emergency room with progressive symmetrical muscle weakness and tingling sensation in both legs for three days. The physicians found out that two weeks prior to the emergency room admission the patient started BVT for pain in her knees and lower back. Ten days after she received the first BVT the patient began to experience weakness and difficulty walking, which then developed into progressive quadriplegia. The electrophysiological findings were consistent with Guillain-Barré syndrome (Lee et al. 2015).
In another case-report, a 31-year-old woman developed a case of serum sickness after receiving bee venom injection therapy. The woman had been experiencing lower back pain for 5 months and decided to be treated with bee venom injection therapy. After multiple treatments for 4 months the pain improved without any side effects (Seo & Lee 2015). However, back pain had recurred and the patient received another injection of bee venom. Four days after re-treatment, reddish skin lesions and swelling developed on the patient’s legs and then spread to the trunk (Fig. 1), with pain in the knees and ankles as well as abdominal discomfort.
Conclusion: Don’t get stung by the hype
After reading the literature it is easy to conclude that the scientific community has not come to a general consensus on the effectiveness of BVT for many of the its health claims.
If anything, there is lack of scientific evidence supporting the health claims of Bee Venom Therapy (and apitherapy for that matter).
An excellent overview/review article about Bee Venom Therapy (titled “The nociceptive and anti-nociceptive effects of bee venom injection and therapy: A double-edged sword” by Chen and Lariviere (2010) summed it up best:
“Overall, the experiential evidence for the effectiveness of bee venom injections to relieve chronic ongoing pain in people is tentative at best. The evidence from studies of animal models is somewhat more consistent and robust, but often lacks critical controls that bias the results towards interpretation and conclusion that bee venom injection has only beneficial effects.”
“In patients, the degree of effectiveness still requires further study with larger scale, better designed trials. Nonetheless, the practice of BVT for pain relief continues despite inherent risks of the procedure.”
Finally, given our current knowledge, be aware that the potential risks associated with Apitherapy outweigh the potential benefits.