Apitherapy involves the therapeutic use of honeybee products, including bee pollen, honey, propolis, royal jelly, beeswax, and venom, to treat a variety of ailments. The most well-known and well-practiced facet of apitherapy is Bee Venom Therapy (BVT), which involves the medicinal use of bee stings. The venom is thought to reduce inflammation and boost the body's immune system. When most people refer to apitherapy, they are referring to BVT.
The medicinal use of bees goes back to ancient times. Chinese texts dating back 2,000 years mention it, and Hippocrates wrote about it. The Egyptians were said to treat diseases with an ointment made from bees, and Greek physician and writer Galen (129–c. 199), wrote about bee treatments. In 1888, Phillip Terc, an Austrian physician, published a paper on one of the first clinical studies involving bee stings titled Report About a Peculiar Connection Between the Beestings and Rheumatism. Thereafter, its use expanded throughout Europe and the United States. It spread as a type of folk remedy popularized by anecdotal accounts, but as the twenty-first century approached, the medical community began investigating the therapy, studying its use on a pharmacological level. Though clinical studies had begun by 2000, most people using the therapy were either doing it themselves or with the help of lay practitioners. Physicians were beginning to use the therapy but mostly with an injectable form of the venom.
The American Apitherapy Society says it has anecdotal evidence showing bee venom is effective in the treatment of:
- immune system problems, such as arthritis and multiple sclerosis (MS)
- cardiovascular disease, such as hypertension, arrhythmias, atherosclerosis, and varicose veins
- endocrine disorders, such as premenstrual syndrome, menstrual cramps, irregular periods, and decreased blood glucose levels
- infections, like herpes simplex 1 and 2, warts, mastitis, and laryngitis
- psychological disturbances, such as depression or mood swings
- rheumatologic disturbances, such as rheumatoid arthritis, osteoarthritis, juvenile rheumatoid arthritis, bursitis, and "tennis elbow"
- skin conditions, such as eczema, psoriasis, corns, warts, and topical ulcers
Apitherapy is thought of as a last-resort treatment but may be beneficial to those who cannot be helped by traditional therapies and medicines. MS patients have reported increased stability, along with less fatigue and muscle spasm, after trying the therapy. Patients with rheumatoid arthritis and osteoarthritis have said pain and swelling have decreased following the stings. It has also been said to shrink the size of rheumatoid nodules. For those who have not achieved relief with other treatments, apitherapy may help.
Honey bee venom contains more than 40 active substances, many of which have physiological effects. The most abundant compound is an anti-inflammatory agent called melittin. This substance causes the body to produce cortisol, which is an agent of the body's own healing process. As an anti-inflammatory, melittin is 100 times more potent than hydrocortisol. It is noted in Paul L. Cerrato's RN article that experiments have shown that melittin can slow the body's inflammatory response. That is why the venom may be helpful in treating inflammatory conditions such as rheumatoid arthritis.
Other compounds that may have pharmacological effects include apamin, which works to enhance nerve transmission; adolapin, which is an anti-inflammatory and an analgesic; and other neurotransmitters like norepinephrine and dopamine and seratonin, which figure in depression.
The most prevalent use of BVT is for immune system and inflammatory disorders. One of the most promising uses may be relieving the symptoms of treatment-resistant MS. More than 1,300 people with MS have sent testimonials to the American Apitherapy Society in support of the treatment saying the therapy helped relieve fatigue and muscle spasm, as well as to restore stability.
Most people receiving the therapy do it themselves or with the help of a lay practitioner. The cost of learning the therapy and the cost for the bees is generally not covered by insurance. The therapy may be covered, however, if prescribed and administered by a physician who uses an injectable form.
To receive treatment, a bee is taken from a jar or hive with a pair of tweezers and held on the body part to be stung. The stinger should be left in for 10 to 15 minutes. The number of stings delivered in a session and the frequency of the sessions varies, depending on the patient's tolerance and the nature of the problem. To treat tendonitis, a patient might need only two to five therapy sessions involving only two to three stings per session. Treating a more chronic problem like arthritis can take several stings per session two to three times per week for up to three months. Treating MS is a prolonged effort. Those who have used it say the therapy must happen two to three times per week for six months in order to start working.
On average, doctors who use the therapy delivered injections one to two times per week. The number of injections varied widely, from one to 30 per session, depending on the ailment being treated.
Physicians who use the therapy do not use live bees. Instead, they obtain venom in an injectable form and inject it under the skin.
Obviously, the more stings or injections to be administered, the more time the therapy is going to take per session.
Before the therapy is begun, a doctor will inject the patient with a weak form of the venom to test for allergic reaction. The doctor will have a syringe of epinephrine nearby in case a reaction does occur. If the patient is allergic to the venom, the therapy cannot be administered.
Lay practitioners and beekeepers who deliver live stings test patients with an initial sting to the knee or forearm and observe the patient to see if they are allergic. The test sting should only be administered if the practitioner has a bee-sting kit containing epinephrine nearby. If a person is allergic, a reaction will generally occur in 15 to 20 minutes. Up to 2% of the population may be allergic to insect venom.
Ice may be used to numb the area where the stings will occur. It can also be used afterward to soothe the pain.
Pain, itching, and swelling are common at the injection or sting site. Patients should also be cautioned that severe anaphylactic allergic reactions can lead to respiratory problems, cardiac collapse, and death. Some may develop nodular masses or ulcers at sting sites.
It seems, however, that major complications are rare. In September 1999, it was reported in Patient Care magazine that Christopher M. H. Kim, director of the Monmouth Pain Institute in Red Bank, New Jersey, says he has given more than 34,000 injections to 174 patients over the past 15 years and has yet to see any major complications. The venom Kim injects is equivalent to one to ten bee stings. The most common side effect reported by his patients is itching, reported by 80% of his patients after the first session. After 12 sessions, however, only 40% still experienced itching. Of his patients, 29.7% reported swelling; 6.4% reported headache; and 5.6% reported flushing.
Research & general acceptance
Due to a growing body of anecdotal evidence to support the use of BVT, formal clinical studies were launched as 2000 approached. The National Multiple Sclerosis Society has begun funding a study on apitherapy at Georgetown University Medical Center in Washington, D.C. The results were expected by the end of 2000.
While the study is ongoing, Joseph A. Bellanti, who is overseeing the study, has already changed his view of the therapy. "In the beginning I thought it was rather strange, but after some investigation, I saw that there are definite immunologic changes after bee venom therapy, and the use of venom began to seem less farfetched," he told Patient Care.
Over the years, researchers have experimented with the therapy on animals and have found that bee venom can keep arthritis at bay in rodents. A study was described in RN in which researchers induced a condition similar to rheumatoid arthritis in rats and found that daily injections of bee venom suppressed the disease.
Harvard Medical School professor John Mills, who works with arthritis patients, told Country Journal that he has seen patients achieve short-term relief through the sting therapy, though he does not condone its use. He believes the same response could be achieved through drug therapy without the allergic risk the venom poses to some.
While animal studies, preliminary results of clinical trials, and anecdotal evidence suggest BVT may have therapeutic effects, until clinical trials on humans are completed, there is no way to know if the treatment works. The placebo effect may also be responsible for some degree of benefit patients achieve.
Training & certification
Some physicians practice BVT, but the majority of those seeking treatment rely on lay practitioners, bee keepers, themselves, or a partner, who is taught to use the bees.
Those seeking treatment can contact the American Apitherapy Society to find a practitioner near them.
Cerrato, Paul L. "A Therapeutic Bee Sting?" RN 61, 8 (August 1998): 57-58.
D'Epiro, Nancy Walsh. "Bee Venom for Multiple Sclerosis." Patient Care 33, 14 (September 15, 1999): 27-31.
Granstrom, Chris. "Stinging Away the Pain." Country Journal 23, 5 (September/October 1996): 22-25.
Somerfield, Stanley D. "Bee Venom and Arthritis: Magic, Myth or Medicine?" New Zealand Medical Journal 99, 800 (April 1986): 281-283.
American Apitherapy Society. 5390 Grande Road. Hillsboro, OH 45133. (937) 364-1108. <http://www.apitherapy.org/aas>.
"Bee Venom Therapy." Spectrum Medical Arts. <http://www2.shore.net/-spectrum/apitherapy.html>