May 10, 2016
Manuka honey is often referred to as an alternative medicine, however, with a growing body of scientific research into its therapeutic benefits, combined with a serious need to find a way to combat antibiotic resistant bacterial strains, manuka honey is now coming into the spotlight with legitimate medical uses.
The healing benefits of honey have been known for thousands of years. Dioscorides, the great Greek physician and pharmacist is attributed to saying, honey is good for sunburn and spots on the face and for all rotten and hollow ulcers. Honey heals inflammation of the throat and tonsils, and cures coughs. As it turns out, Dioscorides was on to something way back in c 60 AD!
Dioscorides wasn’t the only one, Hippocrates prescribed honey to be taken daily for health. Aristotle advised using honey as a salve for wounds and sore eyes. The wise Solomon praises the virtues of honey in the old-testament. The Romans used honey to cure pneumonia, pleurisy and snake bites. The Mayans used honey for treatment of cataracts. The healing properties of honey are mentioned in the Koran and it has been used in traditional Chinese Medicine for over 2000 years. We were still using honey in the trenches in World War 1 but the therapeutic benefits of honey got pushed aside with the advent and wide spread use of man-made antibiotics in the 1960s.
Antibiotics revolutionized medicine in the 20th century, and have together with vaccination led to the near eradication of diseases such as tuberculosis in the developed world. However, the effectiveness of man-made antibiotics and easy access has led to an overuse and now there is a serious and increasing problem of bacteria almost inevitably developing resistance to antibiotics where they are extensively used. This is such a big problem that the World Health Organization has classified antimicrobial resistance as a “serious threat [that] is no longer a prediction for the future, it is happening right now in every region of the world and has the potential to affect anyone, of any age, in any country.” (1)
The good news is manuka honey is emerging as a possible solution.
Attempts to generate honey-resistant strains of bacteria in the laboratory have failed and
the low chance of bacteria developing a resistance to honey
makes the use of manuka honey an attractive alternative for control of infection. (2)
When antibiotics are used to treat infections the usual practice is to first identify the species of the bacteria and to test its sensitivity to antibiotics. This is done to select an antibiotic for treatment, ensuring that the antibiotic used is effective for that strain of bacteria. This is not necessary when honey is used. The very broad spectrum of antimicrobial activity of honey and the absence of strains of bacteria with resistance to it means that it is almost certain to be effective if a honey with an appropriate standardised level of antibacterial potency is used. (3)
Honey works differently from antibiotics, which attack the bacteria's cell wall or inhibit intracellular metabolic pathways. Honey is hygroscopic, meaning it draws moisture out of the environment which dehydrates bacteria. Its sugar content is also high enough to hinder the growth of microbes and the pH level of honey being low (3.4 – 5.5) make a hostile environment for bacteria. It has also been recently discovered that in the process of the bees breaking down the glucose of the nectar the bees’ stomach enzymes produce hydrogen peroxide which also provides an antibacterial quality to the honey. The hydrogen peroxide levels of different honeys can vary widely, from almost untraceable to very high.
Manuka honey comes from honey made by bees that have feasted on manuka bush nectar. Professor Peter Molan of Waikato University, New Zealand, was the first to report the unusual activity of manuka honey and began testing its action against a wide range of different bacterial species in the mid 1980s. Whilst it was clear manuka honey contained special antibacterial qualities, for a long time it was a mystery as to why. It has been quite recently that scientists have attributed manuka honey’s special antibacterial component to methyl gloxal (MGO). MGO results from the presence of dihydroxyacetone (DHA), a naturally occurring phytochemical found in the nectar of flowers of the Leptospermum species (the manuka family) native to New Zealand and Australia. (4)
A recent review of the scientific literature on the therapeutic uses of manuka honey found that in
97 research articles, 61 different strains of bacteria were tested.
To date manuka honey can effectively inhibit all problematic bacterial pathogens tested. (5)
No longer is manuka honey an ‘alternative’ treatment. As well as clinical trials, the anti-inflammatory action of manuka honey has been extensively observed in animals. Animals are incapable of having attitudes that influence their healing process, such as believing a natural product is more effective or being influenced by a blog about manuka honey and healing. Thus, the positive results in animal trails can’t possibly be because of a placebo effect.
I've sorted the findings into the top 7 scientifically proven therapeutic uses of manuka honey:
Burns, wounds and ulcers: One of the most extensively researched therapeutic benefits of Manuka honey is its use in wound care. Particularly for the treatment of chronic and infected wounds and for the treatment of burns. It is now accepted by many medical professionals that some highly antibacterial honeys, such as a high grade manuka honey, hastens healing and promotes healthier tissue regrowth. Manuka honey’s anti-inflammatory effects reduce swelling, scaring, pus and pain. The high sugar content of manuka honey has an osmotic effect, which draws water from bacteria cells and keeps the wound moist by mobilizing the fluid in the surrounding tissue. (6) Further research has shown Manuka to have increased healing and lower incidence of infection over the standard hydrogel therapy used for venous ulcers. (7)
MRSA other bacteria with multiple drug resistance: The main reason why medical professionals first try using honey on wounds seems to be because the wounds are failing to heal with best modern treatment. This is especially so in cases where the wounds are infected with antibiotic-resistant strains of bacteria such as MRSA which cannot be controlled by the usual treatments. Some scientists now suggest that regular topical use on cuts and infections (especially in the hospital and nursing home setting) may keep MRSA naturally at bay. For example, patients with kidney failure who have catheters for dialysis treatment have a risk of getting blood-stream infections from Staphylocci which grow on the catheters. The usual way of protecting patients from this risk is to apply the antibiotic mupirocin, but this long-term use of the antibiotic makes it likely that strains of bacteria resistant to mupirocin will develop. Honey has been found to be as effective as mupirocin in preventing blood-stream infections in these patients and removes the risk of developing antibiotic-resistant strains of bacteria. (8)
A case study: “Five years ago a 12-year old patient was submitted to our unit. Doctors at another hospital had removed an abdominal lymphoma, leaving an open drainage site on his abdomen. On admission, his wound was infected with methicillin-resistant Staphylococcus aureus (MRSA). In order to avoid nosocomial spread, the patient was immediately isolated, a difficult situation for the child to comprehend with significant additional costs from the perspective of the hospital. Although the patient was scheduled to receive chemotherapy, treatment could not commence until the infection cleared. The wound was treated with a local antiseptic (octenidin) for 12 days. Since no improvement occurred, we decided to use a leptospermum [manuka] honey, a type with excellent in vitro activity against MRSA. The wound was free of bacteria two days later, and the chemotherapy against the underlying illness could be started.” (9)
Another case study: “A teenager had extensive deep infected skin sores resulting from meningococcal septicaemia. These sores had a heavy growth of Pseudomonas, Staphylococcus aureus and Enterococcus. They had remained non-healing for 8 months despite a wide range of treatments with various antibiotics and modern wound dressing products being tried. The patient was in a high-dependency unit in the hospital and needed a general anaesthetic for dressing changes on the sores because they were so painful. The cost of hospitalisation and treatment was estimated to be GB£1 million. After reading a publication of a laboratory study showing that Pseudomonas was killed by manuka honey the hospital staff tried using manuka honey dressings on the wounds. Anaesthetic was no longer needed for dressing changes. Within a few days, signs of growth of new skin on the sores were seen and skin grafting became possible as the bacteria were cleared. The patient was able to go home after two weeks of commencing the treatment with honey. Complete healing was achieved within 10 weeks.” (10)
Gingivitis and tooth decay: Several studies from the School of Dentistry in Dunedin, New Zealand found that sucking on manuka honey significantly reduced plaque and bleeding sites. (11)
Post chemotherapy and radiation care: Many cancer patients suffer from mucositis, a side effect of chemotherapy that attacks the entire gastrointestinal tract leaving the patient prone to ulcerations and infections. In a healthy person wounds in the mouth heal quickly, but chemotherapy does not distinguish between healthy and malignant cells and attacks any rapidly reproducing cells, including the important and beneficial cells in the gastrointestinal tract. 20–40% of all cancer patients receiving intensive chemotherapy suffer from mucositis, the number climbs to 80% when chemotherapy and radiation are combined, and staggers even higher in patients receiving treatment for cancer in the head and neck area. Open sores in cancer patients suffering from mucositis leave them susceptible to infection. One study found that just over a teaspoon of manuka honey just before, just after and 6 hours post treatment gave a significant reduction in mucositis. (12)
Strep throat: There have been several studies in the last decade showing how Manuka honey stops the growth of strep bacteria, the bacteria that gives you a sore throat. (13)
Gastroenteritis (stomach flu): Diarrhea and vomiting isn’t really a ‘flu’ but can be caused by a bacterial infection. Salmonella and campylobacter bacteria are the most common bacterial causes of gastroenteritis in the U.S. and are usually spread by undercooked poultry, eggs, or poultry juices. Salmonella can also be spread through pet reptiles or live poultry. E. coli, whilst less common, is another bacteria that can cause gastroenteritis. (14)
Small intestine bacterial overgrown (SIBO), low stomach acid or acid reflux: A recent study found that bacteria found in all three of these conditions were susceptible to Manuka honey’s bactericidal effects. Taking Manuka honey is beneficial for reducing acid reflux and balancing your digestive system. (15)
There is more manuka honey research coming out every month, with small studies and a heap of anecdotal evidence for using manuka honey on eczema, acne, psoriasis, ring worm, sunburn and rashes, IBS / IBD, stomach ulcers, gastritis and bronchitis. Research is also being conducted in using honey in opthamology and the treatment of cancer so there are lots of exciting things happening in manuka honey research.
Whilst there are no known adverse effects of manuka honey all medical treatment should be under the supervision of your primary health care professional. The very complex and rather unpredictable nature of honey is challenging for scientists and medical practitioners alike. Since honey is a natural product spores can occasionally be found in honey. Medical grade brands often gamma irradiate as a safety measure to inactivate such spores. In saying that, not a single case has been reported in the literature of C botulinum wound infection being related to the use of non-irradiated honey.
A more real issue that you are likely to encounter is the variation of authenticity and potency of manuka honey. Read here about how to know if it's authentic and certified manuka honey. Once you have found an authentic brand the potency must also be considered. The above studies used at least UMF 10+, UMF 15+ or even UMF18+ and UMF20+ are considered the level required to reap therapeutic benefits. I recommend buying certified and highly potent manuka honey from here.
Adams C. J, Manley-Harris M, & Molan P. C. (2009). The origin of methylglyoxal in New Zealand manuka (Leptospermum scoparium) honey. Carbohydrate Research, 344, 1050-1053. doi: 10.1016/j.carres.2009.03.020
Biswal B.M, Zakaria A, & Ahmad N.M. (2003). Topical application of honey in the management of radiation mucositis: a preliminary study. Support Care Cancer, 11, 242-248.
Blair S, Cokcetin N, Harry E, & Carter D. (2009). The unusual antibacterial activity of medical-gradeLeptospermum honey: antibacterial spectrum, resistance and transcriptome analysis. European Journal of Clinical Microbiol Infectious Diseases 28, 1199-1208. doi: 10.1007/s10096-009-0763-z
Carter D.A, Blair S.E, Cokcetin N.N, Bouzo D, Brooks P, Schothauer R, & Harry E.J. (2016). Therapeutic Manuka Honey: No Longer So Alternative. Front Microbial, 7, 569. doi: 10.3389/fmicb.2016.00569
Dunford C, Cooper R, & Molan P.C. (2000). Using honey as a dressing for infected skin lesions. Nursing Times, 96(14), 7-9.
English H, Pack A, & Molan P. (2004). The effects of manuka honey on plaque and gingivitis: a pilot study. Journal of the International Academy of Periodontology, 6, 63-67.
Fischer, C. (2013). Trust and communication in European agri-food chains. Supply Chain Management, 18(2), 208-218. doi: http://dx.doi.org/10.1108/13598541311318836
Gethin G, & Cowman S. (2009). Manuka honey vs hydrogel – a prospective, open label, multicentre, randomised controlled trial to compare desloughing efficacy and healing outcomes in venous ulcers. Journal of Clinical Nursing, 18(3), 466. doi: 10.1111/j.1365-2702.2008.02558.x.
Hammond, E. N., & Donkor, E. S. (2013). Antibacterial effect of Manuka honey on Clostridium difficile. BMC Research Notes, 6(1), 1-5. doi: 10.1186/1756-0500-6-188
Lin S.M, Molan P.C, & Cursons R.T. (2011). The controlled in vitro susceptibility of gastrointestinal pathogens to the antibacterial effect of manuka honey. European journal of clinical microbiology & infectious diseases, 30(4), 569-574.
Lin S.M, Molan P.C, & R.T, C. (2010). The post-antibiotic effect of manuka honey on gastrointestinal pathogens. International Journal of Antimicrobial Agents., 36(5), 467-468. doi: 10.1016/j.ijantimicag.2010.06.046
Maddocks S.E, Lopez M.S, Rowlands R.S, & Cooper R.A. (2012). Manuka honey inhibits the development of Streptococcus pyogenes biofilms and causes reduced expression of two fibronectin binding proteins. Microbiology, 158, 781-790. doi: 10.1099/mic.0.053959-0
Molan P.C. (2002). Re-introducing honey in the management of wounds and ulcers – theory and practice. Ostomy Wound Management., 48(11), 28-40.
The World Heatlh Organization. (2014). WHO's first global report on antibiotic resistance reveals serious, worldwide threat to public health. Press release 30 April 2014.
Wilkinson J.M, & Cavanagh M.A. (2005). Antibacterial activity of 13 honeys against Escherichia coli and Pseudomonas aeruginosa. Journal of Medical Food, 8(1), 100-103. doi: 10.1089/jmf.2005.8.100.
Disclaimer: The content of this blog post is for general information purposes only and does not constitute, nor does it intend to constitute medical diagnosis or treatment or other professional advice. You should seek prompt medical care for any health issues and consult your doctor before using alternative medicine or making a change to your regime.
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