As long as there has been civilization, and some might even say even before it, humans utilized the panacea known as honey. Sweet, nutritive, and medicinal, this complex substance represents the pinnacle of symbiosis. From the plant’s propagation cycle to the bee’s livelihood, to medicine for animals and humans, honey connects the world. Moreover, it is one of the few common threads in virtually every early civilization. As far back as 8,000 years ago in Spain we have found paintings of warriors attempting to gather honey. In a post-Mesolithic rock painting in Rajat Prapat in Central India presents honey collection as well, and to this day honey is still used as a vital part of worship in many Indian temples. Meanwhile, the earliest known writing on honey came from the Egyptians in 5500 BCE, depicting keeping bees near temples to use honey for medicine, and to appease the gods. Suffice to say, the history of honey is as exciting and complex as the substance itself.
Meanwhile, in modern times, we see honey relegated to two primary uses: as a sweetener for foods and beverages, and for its use in respiratory conditions including its ability to manage the symptoms of coughs and sore throat. While honey has other recorded uses in the modern era, none other has been researched and assessed like its ability to impact cough. Honey enjoys being in the minority of natural products that have been evaluated through the Cochrane review system, and to have come out with favorable conclusions. In their review of the pediatric use of honey for acute cough, they found honey relieves cough symptoms to a greater extent than no treatment, diphenhydramine, and placebo. Additionally, the authors conclude that honey not only relieves cough symptoms, but also reduces cough duration better than placebo and salbutamol.
Primary research has also found that honey improves sleep quality, likely through its ability to exert an antitussive effect, though perhaps not exclusively so. In a study of 300 children, patients were given two days of no treatment followed by two days of treatment with a honey containing product composed of eucalyptus honey, citrus honey, mint-flower honey, or placebo. The days immediately following administration, sleep latency and sleep maintenance were observed and were found to be improved in the three honey groups. As an aside, the authors also noted parents who administered these medicines also enjoyed higher sleep maintenance.
With clinical trials supporting the use of honey for the management of cough, it begs the question as to how does it work? To begin to understand honey’s mechanism of action, one must first define what is honey from a biochemical standpoint. On its face, honey is a mixture of monosaccharides, disaccharides, and oligosaccharides, water, and “other molecules” which include amino acids, vitamins, enzymes, and minerals. When we fractionate the carbohydrates and water from rest of the honey, we find that about 2-5% of the honey contains the B vitamins riboflavin, niacin, folic acid, pantothenic acid, and vitamin B6. It also contains ascorbic acid (vitamin C), and the minerals calcium, iron, zinc, potassium, phosphorous, magnesium, selenium, chromium, and manganese. Additionally, the enzymes that have been isolated from honey include amylase, peroxide oxidase, catalase and acid phosphorylase.
One of the important subgroups found in honey is its antioxidant molecules which come in the form of ascorbic acid, manganese, chromium, and flavonoids. The flavonoids in honey are part of what gives honey its color. As a rule, the darker the honey, the higher the flavonoid concentrations. Flavonoids work by quenching free radicles present in cellular metabolic functions thus protecting the cells that utilize them as part of their antioxidant system. Cellular oxidative damage is of course higher at times of infection due to both the immune system and pathogen’s ability to create oxidative stress in an effort to harm the other. Antioxidants such as flavonoids work to dampen the severity of this battle which leads to disease as well as symptom improvement.
The other mechanism by which honey helps alleviate cough is through its phenolic acids, which are different from flavonoids structurally. These exert strong antibacterial and antiviral effects which help to support the immune system in its ability to clear infection. Manuka honey, which is derived from honey distilled by bees from the manuka bush, Leptospermum scoparium, is extremely high in phenolic acids compared to other honeys. This is why it is the preferred honey for topical use as an anti-infective agent. With all this chemistry taken into account, when you then consider that honey bees collect pollen from over 200 flowers, each with their own unique DNA and distill this into honey, it is no wonder these proto-alchemists are able to take the seed of life, and transform it into gold, with an abundance of properties and uses.
The above is not by any means an exhaustive list of the mechanisms and chemistry of honey; it is but a sampling of what we know of its potential for soothing coughs and sore throats. It gives us a beginning look into all that can be achieved with honey at the helm. Given what we know about various herbal medicines and their own unique effects on both disease and health, it is no wonder we find honey as an important anchor to so many potent herbal formulations. As honey has united man to honey-bee, to plant, so too does honey unite the flavors and functions of our herbal formulations. As the adage goes, a spoon full of sugar does indeed, make the medicine go down (and work better).
Piece Contributed by Brian Keenan, ND, LAc,