Royal Jelly

IMPORTANCE: Currently, many postmenopausal women experience symptoms related to the cessation of hormone production, and hormone therapy is the most commonly used treatment to alleviate these symptoms. However, it is contraindicated in several situations, which highlights the importance of alternative therapies such as royal jelly (RJ), particularly given the limited number of studies demonstrating its effectiveness. OBJECTIVE: To evaluate the effects of RJ supplementation on postmenopausal symptoms in women. EVIDENCE REVIEW: We developed a search strategy using "royal jelly" and "menopause" with their synonyms. Terms were combined using Boolean operators (OR for synonyms, AND between concepts). We searched MEDLINE (PubMed), LILACS (BVS), Embase (Elsevier), and Cochrane Library through May 2025. Studies were included if they evaluated interventions for postmenopausal symptoms, with outcomes including genitourinary symptoms and quality of life measures. FINDINGS: A total of 281 studies were identified; 262 were excluded. Of the remaining 19, 14 were selected for full-text reading, and 6 studies involving 471 postmenopausal women were included in the final analysis. The studies were published between 2011 and 2021. RJ supplementation significantly improved postmenopausal symptoms compared with placebo (standardized mean difference=0.73; 95% confidence interval=0.50-0.96; P <0.00001; I2 =0%, two studies, 312 participants, moderate-quality evidence). CONCLUSIONS AND RELEVANCE: RJ supplementation may offer a promising nonhormone option for managing menopausal symptoms and supporting bone and genitourinary health, especially for women who cannot or prefer not to use hormone therapy.

BACKGROUND: Royal jelly (RJ) may contribute to glycemic control and liver function through various mechanisms. The present study aimed to quantify the effect of RJ supplementation on these outcomes. METHODS: A literature search of Web of Science, Scopus, and PubMed/Medline, was conducted for RCTs investigating the efficacy of RJ on plasma liver enzymes and glycemic indices. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated for net changes using a random-effects model. RESULTS: Ten RCTs were selected for inclusion in this meta-analysis. Combined estimate of effect sizes for the impact of RJ on neither the plasma liver enzymes nor the glycemic indices were statistically significant. Subgroup analysis showed a significant reduction of serum FPG in trials with intervention duration ≥ 8 weeks (WMD: -4.28 mg/dl, 95% CI -7.41 to -1.14 mg/dl, p = 0.007), and those conducted in non-healthy populations (WMD: -4.28 mg/dl, 95% CI -7.41 to -1.14, p = 0.007). CONCLUSION: RJ does not significantly affect liver function and glycemic profile of adult population. In trials with longer intervention and those conducted in non-healthy populations a significant reduction of serum FBG was observed. This meta-analysis should be repeated in the future, with more primary articles included, in order to provide conclusive results.

Bee products including propolis, bee wax, pollen and royal jelly (RJ) have been used as medicine from ancient times. A vast number of in-vivo and in-vitro studies as well as clinical trials have been conducted to investigate potential health related properties of RJ. A growing number of clinical trials have been performed to assess effects of RJ ingestion on different metabolic markers including glycemia, with diverse results. In the current meataanalysis, we aimed to evaluate effects of RJ ingestion on glycemic markers compared with placebo and set directions for future research. Electronic databases including Scopus, Pubmed, Scholar, Cochrane, Proquest, SID and Magiran were searched and 5 eligible studies were included in the quantitative analysis. Review Manager Software was used for statistical analysis and random effects model was used for pooling data. A total of 205 participants for FPG and 130 participants for HbA1c were included. The overall analysis revealed that RJ consumption reduced FPG by 0.95 mg/dl (95% CI: -5.83 to 3.87; p = 0.69; I2 = 0%; Tau2 = 0.00) and HbA1c by 0.32 (95% CI: -0.87 to 0.23; p = 0.25; I2 = 69 %; Tau2 = 0.16) which were not statistically significant. Funnel plot demonstrated no publication bias. In conclusion, RJ supplementation did not beneficially affect markers of glycemia. However, due to methodology issues and potential confounders like diet as well as diverse populations, we recommend future studies well designed and well controlled for major confounders so we can update these data to more precise results and more accurate conclusion.

BACKGROUND: No clinical trials have reported on the wrinkle-improving effects of cosmetics which activate stem cells in vitro. AIMS: To evaluate the anti-wrinkle effects of protease-treated royal jelly (pRJ)-containing cream application to the skin. MATERIALS & METHODS: Seventy healthy Japanese women concerned about skin aging were treated with pRJ-containing cream or placebo for 12 weeks using the split-face method in a placebo-controlled, double-blind, parallel-group study. RESULTS: The pRJ-containing cream group showed an improvement in the maximum depth and average depth of the biggest wrinkle in the crow's feet wrinkle, along with increased water content of the stratum corneum and dermal thickness, compared to the placebo group. Significant decreases in the relative amount of bacterial microbiome of the cheeks were observed only in the pRJ-containing cream group. In the ex vivo study, expression of COL17A1, epidermal stem cell function marker, was significantly up-regulated with the use of the pRJ-containing cream compared with the placebo cream. CONCLUSION: This is the first study to demonstrate the wrinkle-improving effects of pRJ. Our results suggest that pRJ not only controls stratum corneum water content, dermal thickness, and bacterial microbiome, but also affects stem cell competition and mesenchymal stem cell activation. pRJ can reduce or eliminate certain skin concerns of women by improving age-related wrinkles. © 2025 The Author(s). Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.

BACKGROUND: Reducing cardiovascular risk markers is an essential target in chronic kidney disease (CKD). Thus, this study aimed to evaluate the effect of royal jelly plus green propolis supplementation on cardiovascular disease (CVD) risk factors in patients with CKD undergoing hemodialysis (HD). METHODS: This randomized, double-blind, placebo-controlled trial involved HD patients allocated to receive either royal jelly plus green propolis EPP-AF® (100 mg RJ + 500 mg GP) or placebo capsules daily for 2 months. Before and after the intervention period, the biochemical parameters, inflammatory cytokines, and uremic toxins were measured. RESULTS: A total of 38 HD patients completed the 2-month supplementation study, with 19 patients in each group. After 2 months, the treated group showed a significant reduction in plasma levels of IL-6 (0.78 to 0.63 pg/mL, p = 0.008) and total cholesterol (138.60 to 111.85 mg/dL, p = 0.03), whereas no changes were observed in the placebo group. Uremic toxins did not change after intervention. CONCLUSION: Apitherapy with RJ + GP EPP-AF® extract significantly reduced plasma IL-6 and total cholesterol in HD patients. This supplementation shows promise as a non-pharmacological strategy to reduce cardiovascular risk markers in this population.

BACKGROUND: The study investigates the effects of royal jelly (RJ) on patients with relapsing-remitting multiple sclerosis (RRMS), focusing on its potential to reduce oxidative stress, improve antioxidant levels, and enhance quality of life. METHODS: A total of 61 RRMS patients were randomly assigned to either a RJ group or a placebo group, receiving a daily dose of 500 mg for 45 days. Key outcomes measured included expanded disability status scale (EDSS) scores, levels of malondialdehyde (MDA), and activities of antioxidants such as catalase (CAT) and superoxide dismutase (SOD), along with assessments of fatigue and quality of life. RESULTS: Results indicated that the RJ group experienced a significant reduction in EDSS scores (P < 0.001) and MDA levels (P < 0.0001). The activity of SOD and CAT after consumption of RJ had increased significantly (P < 0.0001, P < 0.001), respectively. Additionally, improvements were noted in some parameters of fatigue and quality of life measures. CONCLUSION: The findings suggest that RJ may help decrease oxidative stress and improve motor function and anti-oxidant capacity in MS patients, potentially slowing disease progression. TRIAL REGISTRATION: This study was registered on the Iranian Registry of Clinical Trials (Registration No. IRCT20220116053732N1) on 2022.05.08. © 2025. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

Background and Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a clinical pathological syndrome characterized by steatosis and fat accumulation in liver parenchymal cells in patients without a history of excessive alcohol drinking. Currently, there is no definitive treatment for MASLD, and its prevalence increases with age and obesity, and after menopause. Among the ways to treat it, we can mention regular sports exercises and the use of natural supplements. Therefore, the aim of this research is to investigate and compare the effects of aerobic-resistance training with royal jelly supplementation on changes in paraoxonase 1, oxidized LDL, liver function, and lipid profile in postmenopausal women with Dysfunction-Associated Steatotic Liver Disease. Materials and Methods: This semi-experimental study involved 23 women with Dysfunction-Associated Steatotic Liver Disease with an average weight (71.34 ± 11.63 kg), age (48.54 ± 3.88 years), and body mass index (27.63 ± 4.20 kg/m2). They were randomly divided into two groups: exercise + supplement (n = 12) and exercise + placebo (n = 11). Both groups performed eight-station resistance exercises (8-12 repetitions in 2-4 sets) for 8 weeks, with three sessions per week (for 35-40 min, from 10-15 RPE), and then, for 10-15 min of active rest, they performed aerobic exercises with an intensity of 40-85% of the target heart rate, in two-minute intervals with 45 s of active rest. Royal jelly supplement (500 mg on training days, before each training session) was consumed. Blood sampling was done before and 48 h after the last training session. Statistical analysis was performed using a variance test with repeated measures (two groups × two stages of pre-test-post-test) in SPSS software (Version 26) with a significance level of p < 0.05. Results: The results of the statistical analysis show that the effects of eight weeks of exercise + supplement and exercise + placebo on PON1, oxLDL, lipid profiles (HDL, LDL, TC, and TG), and liver enzymes (ALT, AST) in women with non-alcoholic fatty liver showed a significant difference (p < 0.05). The results show a significant increase in PON1 (p = 0.008) and

Corticosteroids improve the complications of Covid-19 but may cause some side effects such as hyperglycemia. Royal jelly is one of the bee products that exert anti-inflammatory, insulin-like, and hypoglycemic activities. The present study was conducted to investigate the effect of royal jelly capsules on blood sugar and the clinical course of Covid-19 in the patients receiving corticosteroid therapy. In this clinical trial, 72 Covid-19 patients with positive reverse transcription polymerase chain reaction (RT-PCR) test and pulmonary involvement hospitalized in Shahrekord Hajar Hospital were enrolled and randomized into two groups: treatment (receiving corticosteroids and Royal Jelly 1000 mg capsules daily for 7 days) and placebo (given corticosteroids and placebo). Laboratory tests, blood sugar, and clinical courses were determined and compared. Data was analyzed using SPSS version 16. On day 7 after the onset of the intervention, the dosage and frequency of insulin, FBS level, and required corticosteroid showed a decrease in both groups but the inter-group difference was not significant (P > .05). As well, the Spo2 level indicated a non-significant increase and hospital stay length indicated a non-significant decrease in the intervention group (P > .05). Among the symptoms, only headache, cough, and dyspnea indicated an improvement in the intervention group (P < .05). Overall, the results indicated the short-term consumption of royal jelly could not significantly improve blood sugar and the clinical course of Covid-19; however, it could significantly improve headache, cough, and dyspnea in the patients.

BACKGROUND: Excessive production of free radicals caused by many types of exercise results in oxidative stress, which leads to muscle damage, fatigue, and impaired performance. Supplementation with royal jelly (RJ) or coenzyme Q10 (CoQ10) has been shown to attenuate exercise-induced oxidant stress in damaged muscle and improve various aspects of exercise performance in many but not all studies. Nevertheless, the effects of treatments based on RJ plus CoQ10 supplementation, which may be potentially beneficial for reducing oxidative stress and enhancing athletic performance, remain unexplored. This study aimed to examine whether oral RJ and CoQ10 co-supplementation could improve high-intensity interval exercise (HIIE) performance in swimmers, inhibiting exercise-induced oxidative stress and muscle damage. METHODS: Twenty high-level swimmers were randomly allocated to receive either 400 mg of RJ and 60 mg of CoQ10 (RJQ) or matching placebo (PLA) once daily for 10 days. Exercise performance was evaluated at baseline, and then reassessed at day 10 of intervention, using a HIIE protocol. Diene conjugates (DC), Schiff bases (SB), and creatine kinase (CK) were also measured in blood plasma and saliva before and immediately after HIIE in both groups. RESULTS: HIIE performance expressed as number of points according to a single assessment system developed and approved by the International Swimming Federation (FINA points) significantly improved in RJQ group (p = 0.013) compared to PLA group. Exercise-induced increase in DC, SB, and CK levels in plasma and saliva significantly diminished only in RJQ group (p < 0.05). Regression analysis showed that oral RJQ administration for 10 days was significantly associated with reductions in HIIE-induced increases in plasmatic and salivary DC, SB, and CK levels compared to PLA. Principal component analysis revealed that swimmers treated with RJQ are grouped by both plasmatic and salivary principal components (PC) into a separate cluster compared to PLA. Strong negative correlation between the number of FINA points and plasmatic and salivary PC1 values was observed in both intervention groups. CONCLUSION: The improvements in swimmers'

OBJECTIVES: To evaluate the moisturizing function and other effects of royal jelly extract on the skin. The effects of applying an essence containing royal jelly extract on the skin of healthy Japanese males and females were examined. METHODS: Thirty-five healthy Japanese men and women who were aware of their skin dryness applied an essence containing royal jelly extract or placebo for 4 weeks using the split-face method in a placebo-controlled, double-blind, parallel comparative study. The stratum corneum water content, transepidermal water evaporation, pigmentation, pores, and redness were evaluated. RESULTS: The stratum corneum water content significantly increased by the application of essence containing royal jelly extract to the cheeks for 4 weeks compared with placebo. CONCLUSION: The application of an essence containing royal jelly extract significantly improved the moisture content of the stratum corneum of the cheeks, confirming the improvement in the moisturizing function of the royal jelly extract. Furthermore, no adverse events were observed at the application site during the application period, and the test products and royal jelly extract contained in the test product were considered highly safe. © 2022 Wiley Periodicals LLC.

AIMS: Royal jelly, a creamy substance secreted by honeybees, has been reported to have beneficial effects against dyslipidemia and metabolic syndrome. However, the effects of royal jelly on atherogenesis remain unknown. Hence, we prospectively evaluated whether royal jelly augments vascular endothelial function, which can reflect early atherogenesis, in healthy volunteers. METHODS: This was a single-center, double-blind, 1:1 randomized placebo-controlled study conducted from October 2018 to December 2019. A total of 100 healthy volunteers were randomly assigned to receive either royal jelly 690 mg or placebo daily for 4 weeks. The primary endpoint was augmentation in vascular endothelial function as assessed using the change in the reactive hyperemia peripheral arterial tonometry index (RH-PAT) index, and the secondary endpoints were the changes in liver function and lipid profiles between baseline and 4 weeks after enrollment. RESULTS: The mean age of the participants was 35.0±9.3 years in the placebo group and 36.1±9.1 years in the royal jelly groups; 45% and 50% of the placebo and the royal jelly groups, respectively, were male. The percentage relative change in the RH-PAT index was significantly higher in the royal jelly group than in the placebo group (21.4%±53.1% vs. 0.05%±40.9%, P=0.037). The percentage relative changes in alanine aminotransferase and γ-glutamyl transpeptidase were significantly lower in the royal jelly group than in the placebo group (alanine aminotransferase: -6.06%±22.2% vs. 11.6%±46.5%, P=0.02; γ-glutamyl transpeptidase: -3.45%±17.8% vs. 4.62%±19.4%, P=0.045). Lipid profiles were not significantly different between the two groups. CONCLUSIONS: Royal jelly might have antiatherogenic property by improving vascular endothelial function. It also augmented liver functions in healthy volunteers.

Exposure to heavy metals and unbalanced diets poses significant global health concerns. This study investigated the neurotoxic effect of chronic lead acetate and high-fat diet (Pb/HFD) co-exposure in rats and the neuroprotective potential of 10-hydroxydecanoic acid (HDA) and zinc oxide nanoparticles (ZnO-NPs). Rats were allocated into naive, HDA, ZnO-NPs, MIX (HDA/ZnO-NPs), Pb/HFD, Pb/HFD + HDA, Pb/HFD + ZnO-NPs, and Pb/HFD + MIX, with 10 rats per group. For 12 weeks, rats received a daily oral dose of PbAc (30 mg/kg) alongside a 40% fat HFD. Following this induction period, groups continued the Pb/HFD exposure for an additional 4 weeks while also receiving a daily dose of either HDA (5 mg/kg), ZnO-NPs (5 mg/kg), or a combination of both. Spatial learning and memory, brain lead content, and key markers of oxidative stress, neuroinflammation, amyloidogenesis, and apoptosis were evaluated. Pb/HFD co-exposure significantly increased brain lead levels, leading to cognitive impairment as evidenced by the Morris water maze test. This was attributed to a rise in oxidative stress, inflammatory responses, and amyloidogenesis, alongside a reduction in antioxidant markers and a proliferation of glial cells. In contrast, HDA effectively mitigated both the cognitive deficits and the underlying neuroinflammation and oxidative stress. Conversely, ZnO-NPs alone were linked to detrimental cognitive effects, primarily through oxidative stress and neuroinflammation. Our findings support a neuroprotective role for HDA and highlight the need for caution regarding ZnO-NPs monotherapy. Critically, the combination of HDA and ZnO-NPs exhibited a synergistic neuroprotective effect, offering a promising and enhanced therapeutic strategy against environmental and dietary neurotoxic stressors. © 2025. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Alzheimer's disease (AD), the most common form of neurodegenerative dementia among the older population, is associated with acute or chronic inflammation. As a nonsteroidal anti-inflammatory drug, aspirin has recently been widely studied in the prevention and treatment of neurodegenerative diseases. However, there is a controversy about the efficacy as well as the adverse effects of aspirin. 10-Hydroxydecanoic acid (10-HDAA) is a characteristic fatty acid found in the honey bee product royal jelly. In this study, we found that 10-HDAA attenuated the activation of the NF-κB pathway, then targeted Ptgs-1/2, the well-known target of aspirin. Hence, combined therapy of 10-HDAA and aspirin was conducted. In vitro assays suggested that this combinatory group alleviated LPS-induced inflammation in BV-2 cells, as assessed by the downregulation of nitric oxide, COX-2, and IL-6 compared to 10-HDAA or aspirin treatment alone. In vivo assays showed that the combined treatment synergistically inhibited the overactivation of glial cells and decreased the levels of pro-inflammatory mediators. Moreover, 10-HDAA alleviated the adverse effects of aspirin on gastrointestinal injuries and microbiota dysbiosis. The Morris water maze test indicated that neither 10-HDAA nor aspirin effectively improved LPS-induced memory dysfunction, but the combined therapy showed synergistic effects. Altogether, our findings support 10-HDAA and aspirin combinatory therapy as the basis for future therapeutics for AD and other neuroinflammation-related diseases with minimal adverse effects.

Claudin-2 is highly expressed in human lung adenocarcinoma cells and involved in the promotion of proliferation. Here, we searched for a compound, which can decrease claudin-2 expression using lung adenocarcinoma A549 cells. In the screening using compounds included in royal jelly and propolis, the protein level of claudin-2 was dose-dependently decreased by caffeic acid phenethyl ester (CAPE), whereas the mRNA level and promoter activity were only decreased by 50 μM CAPE. These results suggest that CAPE down-regulates claudin-2 expression mediated by two different mechanisms. CAPE (50 μM) decreased the level of p-NF-κB, whereas it increased that of IκB. The CAPE-induced decrease in promoter activity of claudin-2 was blocked by the mutation in an NF-κB-binding site. The inhibition of NF-κB may be involved in the decrease in mRNA level of claudin-2. The CAPE (10 μM)-induced decrease in claudin-2 expression was inhibited by chloroquine, a lysosomal inhibitor. CAPE increased the expression and activity of protein phosphatase (PP) 1 and 2A. The CAPE-induced decrease in claudin-2 expression was blocked by cantharidin, a potent PPs inhibitor. The cell proliferation was suppressed by CAPE, which was partially rescued by ectopic expression of claudin-2. In addition, the toxicity and accumulation of doxorubicin in 3D spheroid cells were enhanced by CAPE, which was inhibited by ectopic expression of claudin-2. Taken together, CAPE down-regulates claudin-2 expression at the transcriptional and post-translational levels, and enhances sensitivity of cells to doxorubicin in 3D culture conditions. CAPE may be a useful adjunctive compound in the treatment of lung adenocarcinoma.

OBJECTIVES: To evaluate the synergistic action of starch on the antibacterial activity of royal jelly (RJ), a comparative method of adding RJ with and without starch to culture media was used. METHODS: Strains of Staphylococcus aureus and Escherichia coli have been used to determine the minimum inhibitory concentration (MIC) of a variety of freshly reaped RJ. In a second step, lower concentrations of RJ than the MIC were incubated with a set of concentrations of starch and then were added to media to determine the minimum synergistic inhibitory concentration. RESULTS: The MIC of RJ without starch was 1.7% (vol/vol) and 2% (vol/vol) against S. aureus and E. coli, respectively. When starch was incubated with RJ and then added to media, a significant MIC drop has been noticed against both strains. This MIC drop was 61% and 30% against S. aureus and E. coli, respectively. CONCLUSIONS: The effectiveness of RJ against bacteria has been extensively reviewed, but this bee product remains unaffordable in most countries. Our findings suggest that combined mixture of RJ and starch could be used to treat infections that are resistant to conventional drugs, at a lower cost.

Four varieties of honey and one variety of freshly reaped royal jelly (RJ) were used to evaluate their additive action against Staphylococcus aureus (ATCC 29523). In a first step honey and RJ were used separately to determine their minimum inhibitory concentration (MIC) against the tested strain. In a second step, lower concentrations of honey than the MIC were added to lower concentrations of RJ than the MIC and then incorporated into media to determine the minimum additive inhibitory concentration. When tested separately, the MIC of the four varieties of honey ranged between 20% and 21% (vol/vol), and that of RJ was 2% (vol/vol). When used jointly, all honey varieties had a more than 50% decrease in MIC with 1% (vol/vol) RJ. A strong linear correlation was noted between the MIC decrease of all varieties of honey and RJ.

An 87-year-old African-American man came to the internal medicine clinic for a routine anticoagulation management visit. He had no complaints. His medical history was significant for stage IV-A follicular non-Hodgkin's lymphoma, atrial fibrillation, and hypertension. His long-term drug therapy consisted of warfarin, felodopine, lisinopril-hydrochlorothiazide, controlled-release diltiazem, potassium chloride, and oxycodone. He reported adherence with his prescribed drugs and denied taking any over-the-counter or herbal products. Overall, the patient's drug therapy had been consistent during the preceding 3 months, no significant changes had occurred in his clinical status, and no significant changes had been noted in his diet; his international normalized ratio (INR) had ranged from 1.9-2.4 (therapeutic range 2-3). He denied tobacco use, alcohol consumption, and recent travel. Four weeks later, the patient came to the emergency department with hematuria. He denied dysuria, taking more than the prescribed amount of warfarin, any changes in his diet, taking any over-the-counter or herbal products, and any other bleeding. On admission to the hospital, his INR was 6.88, which increased to 7.29 during his hospital stay. On further investigation, the patient admitted that he had started taking an herbal supplement, royal jelly, 1 week earlier. When asked specifically about the ingredients in the supplement, he stated that royal jelly was the only component. Relative to the patient's denial of any other changes in his condition or drug regimen, the most probable explanation for his elevated INR and subsequent bleeding is a possible interaction between royal jelly and warfarin. To our knowledge, no case reports concerning royal jelly and warfarin taken concomitantly have been reported. Clinicians should be proactive and repeatedly provide education regarding the potential dangers of dietary supplements taken with conventional drugs.

Since 1991, the Medical Toxicology Unit (MTU) at Guys' Hospital, London, has been assessing the toxicological problems associated with the use of traditional and herbal remedies and dietary supplements. This assessment was carried out by evaluating reports to the National Poisons Information Service (London) [NPIS(L)] which provides emergency information to medical professionals. Relevant telephone enquiries to NPIS(L) were identified. Further case details were obtained by follow-up questionnaire, clinical consultation, toxicological analysis of samples from patients and/or products and botanical identification of plant material. Of 1297 symptomatic enquiries evaluated there was a possible/confirmed association in 785 cases. Case series have been identified which substantiate previous reports, including liver problems following the use of Chinese herbal medicine for skin disorders, allergic reactions to royal jelly and propolis and heavy metal poisoning caused by remedies from the Indian subcontinent. Although the overall risk to public health appears to be low, certain groups of traditional remedies have been associated with a number of potentially serious adverse effects. Considering the extent of use of herbal remedies and food supplements a comprehensive surveillance system for monitoring the adverse health effects of these products is essential. Surveillance of a large population is needed for the complex task of identifying the uncommon and unpredictable adverse effects which are potentially serious. In the UK, the Medicines Control Agency responded to the MTU report by recognising the need for vigilance and by incorporating adverse reactions reporting on unlicensed herbal remedies into their drug reaction monitoring function. As a further step to safeguard the patients/consumers an effective single regulatory system is required which would ensure the safety and quality of all herbal remedies and food supplements available in the UK.

88. Folia Med (Plovdiv). 1966;8(2):77-82. [The relation of functional synergism and antagonism between royal jelly and various drugs]. [Article in Russian] Peĭchev P.

Cardiovascular diseases and diabetes are associated with significant mortality, morbidity, and economic burden, highlighting the need for alternative preventive strategies. Honey bee products, including honey, royal jelly, and propolis, are considered potential interventions for managing cardiometabolic risk factors. This umbrella review aimed to compare the effectiveness of these products in cardiometabolic health. PubMed, Scopus, and Web of Science databases were systematically searched from inception through 21ST October 2024 to identify eligible meta-analyses and primary randomized controlled trials (RCTs). Random-effect pairwise analysis combined trial findings, while dose-response and influence analyses assessed result robustness. Evidence quality and certainty were evaluated using AMSTAR-II, ROB, GRADE, and ICEMAN criteria. Analysis of 69 RCTs with 3544 participants revealed that 10 g of honey daily may lower Hemoglobin A1C but adversely affect systolic blood pressure, Aspartate transferase, triglycerides, fasting blood glucose, and high-sensitive C-reactive protein. Royal jelly improved blood pressure, lipid profiles, glycemic indices, and total antioxidant capacity. Propolis demonstrated reductions in anthropometric measures and improvements in lipid profile, glycemic control, liver enzymes, and inflammation and oxidative stress markers. While long-term or high-dose honey consumption in individuals with health concerns warrants caution, RJ and propolis demonstrated dose-dependent benefits for cardiometabolic health with proper certainty. Future research should focus on population-specific characteristics and optimized dosages. © 2025. The Author(s).

The increasing use of bee products in the food, cosmetic, and pharmaceutical industries has intensified interest in their therapeutic properties. However, the safety of these natural compounds warrants careful consideration, particularly within the context of pharmacovigilance. This study aimed to conduct an integrative review of the scientific literature and official pharmacovigilance databases (Notivisa, EudraVigilance, FDA/MedWatch, TGA, among others) to identify adverse effects and toxicological risks associated with the use of honey, apitoxin (bee venom), propolis, royal jelly, bee pollen, and beeswax. The findings indicated that although widely used, these products are not free from risk. Reported cases included infant botulism and grayanotoxin poisoning linked to honey; anaphylaxis and fatalities following therapeutic use of bee venom; contact dermatitis and systemic reactions induced by propolis; severe asthma attacks after royal jelly consumption; adulteration of pollen-based supplements with illicit pharmacological substances; and allergic reactions to beeswax in cosmetic products. Allergic responses were the most prevalent type of adverse event, particularly among atopic individuals. These findings highlight the need for appropriate labeling, post-marketing surveillance, and educational campaigns to ensure the safe use of these products. It is concluded that despite their recognized benefits, apitherapeutic products must be used with caution, and the strengthening of pharmacovigilance systems is essential to safeguard public health. © 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

BACKGROUND: Breast cancer is the most common cancer in women which can be cured in most individuals with early-stage non-metastatic disease. Imbalance in estrogen signaling pathways and propagating levels of estrogens has important roles in breast cancer development. Targeting the estrogen receptor signaling pathway is linked to breast cancer treatment. Royal jelly is one of the bee products containing 10-hydroxy-2-decenoic acid, a structure similar to mammalian estrogen, allowing it to attach to estrogen receptors. It is considered as a general tonic and immunomodulator which may be helpful in reducing the side effects of cancer treatments. Currently, there are controversial data regarding the pros and cons of royal jelly in cancer. Here we provide an overview of the effects of royal jelly on sex hormones and its possible role in breast cancer. METHODS: Electronic databases including PubMed, Scopus, and Web of Science were searched with the search terms royal jelly, cancer, and sexual hormones. All preclinical and clinical studies regarding the hormonal effects of royal jelly were included. RESULTS: According to the collected preclinical data, consumption of royal jelly at daily doses below 200 mg/kg can be useful to decrease the risk of breast cancer since it reduces the serum level of estrogen; whereas increases progesterone, which subsequently decreases the expression of ERs on the ER-positive cells. CONCLUSION: Future clinical studies are essential to confirm the safe dose of royal jelly as an adjuvant therapy in breast cancer. © 2024. The Author(s), under exclusive licence to Tehran University of Medical Sciences.

Bee products, including honey, have been utilized since ancient times for nutritional and therapeutic purposes. Recently, other bee products such as bee pollen, royal jelly, and propolis have caught a lot of attention. Being high in antioxidants and bioactive compounds, these products have established their applications in the pharmaceutical field as supplementary or alternative medicines. This review focuses on their use against polycystic ovarian syndrome (PCOS)-related infertility. A systematic search of electronic databases including PubMed, Web of Science ScienceDirect, and Google Scholar was conducted from their inceptions up to November 2022. Studies with a small sample size, studies with inconclusive data, and pre-prints have been excluded. A narrative synthesis was performed during draft preparation after the authors independently performed a literature search. A total of 47 studies were finalized for the review. It can be observed that in vivo data on the use of bee products in treating PCOS mostly deals with their use in synergism with the PCOS medicines to enhance their effect and/or curb their side effects; however, clinical trials for the same are limited. With the amount of data being limited, it is difficult to map out the mechanism by which these products act in managing PCOS inside the human body. The review gives detailed insights into the reversal and restorative properties of bee products against the aberrations in reproductive health caused by PCOS.

BACKGROUND: Apitherapy represents a certain form of complementary and alternative medicine that uses bee products in combination with other methods from this field. One of the basic concepts of this type of medicine is that all diseases can be treated using apitherapy. This study was performed to assess the recommendations from authors of books on apitherapy regarding the treatment of seasonal allergic rhinitis and compare them to findings from the scientific literature. METHODS: One hundred and twenty-nine books on apitherapy were analysed regarding recommendations for allergic seasonal rhinitis. Scientific evidence regarding the efficacy of using various bee products was searched via PubMed and JUSTfind. RESULTS: Only 38.8% of the apitherapy books mentioned seasonal allergic rhinitis. Among these books, we found 29 different recommendations in favour of bee products and one against the use of honey. The most reasonable recommendation according to clinical studies on the subject, namely the use of a mix of honey and pollen, was only found once (0.8%). CONCLUSIONS: The large discrepancies and number of different recommendations demonstrate that apitherapy is not a consistent type of medicine. The recommendations regarding seasonal allergic rhinitis in the vast majority of apitherapy books cannot be considered adequate when compared to the scientific findings.

INTRODUCTION: Erectile dysfunction supplements (ED-Ss) are featured on online marketplaces like Amazon.com, with dedicated pages and claims that they naturally treat ED. However, their efficacy and safety are largely unknown, limiting the ability to counsel patients regarding their use. AIM: To evaluate the highest rated and most frequently reviewed ED-Ss on Amazon.com to facilitate patient counseling regarding marketing myths, ingredient profiles, and evidence for product efficacy and safety. METHODS: The Amazon marketplace was queried using the key term "erectile dysfunction" with default search settings and ranking items based on relevance. The top 6 ED-S products identified on September 29, 2018, were reviewed based on price, ratings, reviews, manufacturer, and ingredients. Consumer reviews were categorized using subtopics within the International Index of Erectile Function (IIEF) questionnaire to better understand ED-S efficacy and then reanalyzed following filtration of untrustworthy comments using ReviewMeta.com, a proprietary Amazon review analysis software. OUTCOMES: Quantitative and qualitative evaluation of ED-S products sold on Amazon.com. RESULTS: The top 6 ED-Ss had an average of 2,121 ± 1,282 reviews and a mean rating of 3.92 ± 0.42 stars. A total of 21 ingredients were identified in these ED-Ss. Ginseng, horny goat weed, L-arginine, and tongkat ali were the most popular ingredients included in the analyzed products. Our literature review identified 413 studies involving the 21 identified ingredients, of which 59 (16%) involved human subjects. Among these 69 human studies, only 12 (17%) investigated supplement ingredients individually and reported improvement in ED. Analysis of top-ranked customer reviews from the first 2 pages of reviews for each supplement revealed differences in IIEF scores before and after ReviewMeta.com filtration. After filtration, we observed a 77% decrease in reviews reporting improved erection strength, an 83% decrease in reviews reporting improved ability to maintain erection, a 90% decrease in reviews reporting increased sexual satisfaction, an 88% decrease in reviews reporting increased enjoyment with intercourse, and

Diabetes mellitus is one of the most common endocrine disorders in the world. This systematic review was conducted with focus on the current knowledge on the effect of royal jelly on metabolic variables in diabetes mellitus. PubMed, Scopus, Embase, ProQuest and Google Scholar databases were searched from inception until June 2018. All clinical trials and animal studies that evaluated the effects of royal jelly on diabetes mellitus, and were published in English-language journals were eligible. Studies that provided insufficient outcomes were excluded. Out of 522 articles found in the search, only twelve articles were eligible for analysis. Seven studies showed a significant reduction in FBS, and one reported HbA1c decrease following royal jelly supplementation. Although royal jelly supplementation resulted in significant reductions in HOM A-I R in three studies, the findings on insulin levels were controversial. In addition, royal jelly substantially improved serum levels of triglycerides, cholesterol, HDL, LDL, VLDL and Apo-A1 in diabetes mellitus. In addition, royal jelly resulted in a decrease oxidative stress indicators and increase antioxidant enzymes levels. In conclusion, royal jelly could improve glycemic status, lipid profiles and oxidative stress in diabetes mellitus. However, exploring the underlying mechanisms warrants further studies.