Honey is an important foodstuff to introduce into the human diet, due to the presence of numerous substances that can help maintain good health. Few people know, however, that it can be used, in the form of medical honey, as an effective medicinal product for the treatment of certain diseases.
This article outlines the requirements for the use of medical honey and the main diseases and pathological conditions it can counteract.
Medical honey in historical and traditional medicine
Medical honey (or medical-grade honey, MGH) is a medicinal product that can work on various pathological conditions, enhance the body’s functions or counteract wounds or other skin conditions such as burns, surgical wounds or ulcers. Traditional Chinese medicine (TCM) presents a wide use of medical honey, recognised as part of the principle of medicine and food homology, suggesting that many substances can be used both as food and medicine, providing nutritional value and therapeutic benefits. The main uses include treating coughs, gastrointestinal problems and improving body resistance. (1)
One of the most recognised applications of honey in traditional Chinese medicine is its role in hydration in conditions caused by an imbalance of fluids in the body, or for dry coughs due to its ‘lubricating’ action on the lungs. Another role is attributed to the treatment of constipation or for applications on external injuries. Finally, it is used as a vehicle for the administration of herbal preparations and to encourage the intake of bitter herbs due to its physical viscosity and high sweetness for sensory acceptability.
The use of honey as a therapeutic agent has been documented historically in many civilisations around the world, apart from China. Just think of ancient Egypt, where honey was regarded as a sacred substance called ‘nectar of the gods’ and used to heal wounds due to its antimicrobial properties. In India, Ayurveda recognises honey as Yogavahi, a carrier that increases the bioavailability and efficiency of plants similar to TCM, for uses such as digestive and skin disorders, or respiratory infections. Similar uses were also present in Greek and Roman medicine, with Hippocrates as the main promoter.
Requirements for the production of MGH
Sterility is the main requirement that should be provided for medical honey, due to the possible presence of Clostridium botulinum spores from wounds, paying attention to the differences that may occur between different batches. Furthermore, biological activity must be carefully evaluated on the basis of the botanical origin of the honey and its constituents, especially the minor ones (e.g. vitamins, minerals, polyphenols) capable of exerting medical action, in order to identify the right product to use for the treatment of the pathology of interest.
It is inadvisable to use honeys coming directly from beekeepers or purchased from supermarkets, as there is a lack of sufficient quality control, which, while it may be sufficient for a food use, may not be sufficient for a medical use. The reasons may be related to possible residues of pesticides or contaminants in the product, or the use of heat treatment or filtration that may compromise the characteristics of the MGH and make it unsuitable for such use.
The approval of honey requires the selection of a careful raw material, possibly organic, free of contaminants and residues or other contaminants (e.g. antibiotics) to be verified analytically, along with quality requirements (3). Sterilisation generally requires gamma (γ) ray treatment to eliminate viruses, spores and viable forms of microorganisms. To be suitable for clinical use, an MGH must be sterile and bioactive.
Effects of MGH on disease treatment
The documented effects of MGH on human health are many and varied, and have been addressed by several scientific literature reviews in order to verify the different properties and potential uses from a medicinal point of view. The main health effects found, in addition to those already seen in historical and traditional medicine, are: (4)(5)
- Antioxidant: honey plays a significant role in disease management by inhibiting pro-antioxidant/oxidative agents and enhancing antioxidant enzyme activities;
- Anti-inflammatory and wound-healing: honey shows anti-inflammatory and wound-healing properties through modulation of cytokines and pro-inflammatory enzymes;
- Anti-cancer: honey and its constituents play an effective role in cancer management through modulation of cell signalling pathways. They are also involved in the action of tumour suppressor genes, the inhibition of tumour metastasis-related angiogenesis and the induction of apoptosis (programmed cell death) in cancer cells;
- Antibacterial, antifungal and antiviral: honey is able to contain cell proliferation of bacteria, yeasts and fungi, and viral replication. These effects are related to the types of honey and the resistance capacity of microorganisms and viruses.
- Immunomodulatory effect: the use of honey can considerably increase the production of interleukins and improve the killing of macrophages;
- Hepatoprotective, cardioprotective and neuroprotective activity: honey can reduce the effects of hepatic steatosis and improve the state of anxiety in people, as well as improve neural functions related to movement and degenerative diseases (e.g. Alzheimer’s). Honey can help reduce the size of heart attacks and the incidence of ventricular tachycardia, and lower reversible ventricular fibrillation.
Other effects, among many others, include protective action on the teeth, eyes, kidneys, stomach, skin and reproductive system. Protective effects against X-radiation and the contribution to maintaining an efficient respiratory system as well as reducing hypertension have also been observed. MGH consumption has also been associated with a reduction in obesity-related parameters, including a lower propensity to gain body weight, and type 2 diabetes.
Regulatory aspects
MGH is, by its nature, considered a medicinal product and not a food. Therefore, it does not have to comply with the food quality requirements of Codex Alimentarius standard CXS 12-1981, except for the use of the name ‘honey’.
In the EU, compliance must be provided with the Medicinal Products Directive 2001/83/EC and the Medical Diagnostic Devices (including in vitro) Reg. (EU) 2017/795 and Reg. (EU) 2017/796, and as honey is a product of animal origin, it is important to ensure compliance with the Animal By-products (ABPs) regulation provided for in Reg. (EC) No 1069/2009, which stipulates the conditions for use at the end of the manufacturing chain and use in the manufacture of medicinal products and in medical diagnostic devices of all kinds.
Compliance with Directive 2001/110/EC (Honey Directive) is not strictly required as for Codex, but the effects are considered equivalent. Other values of conformity that lead to a higher quality characteristic is the one related to Reg. (EU) 2018/848 on organic farming, whose logo may, however, only be shown on the labelling if authorised by the competent authority and is proven to have a beneficial effect on the therapeutic characteristics of a medicinal product, within the meaning of Directive 2001/83/EC. (6)
Provisional conclusions
Honey is not only an important foodstuff, but it is also capable of performing high-level medical functions to ensure optimum health and treat various diseases that would normally require the use of products obtained from synthetic chemistry. In this case, however, it presents itself as a natural alternative against various adverse conditions.
The quality of honey, especially in terms of sterility, is crucial to obtain a medical-grade honey that is able to exert its intended effects and avoid adverse and dangerous health effects (e.g. botulism). The selection of suppliers and the control of the production process are two aspects to which meticulous attention must be paid.
The MGH is a major opportunity for the honey sector. Although it is legally considered a medicine, the way it is taken can be considered equivalent to that of a foodstuff (with the exception of skin applications). Moreover, the synergy with other substances determines the possibility of devising different formulations to be used for this purpose.
Dario Dongo and Andrea Adelmo Della Penna
Notes
(1) Sharaf El-Din M.G. et al. (2025) Health benefits of honey: A critical review on the homology of medicine and food in traditional and modern contexts. Journal of Traditional Chinese Medical Sciences 12(2):147-164, https://doi.org/10.1016/j.jtcms.2025.03.015
(2) Peters L.J.F. et al. (2025) Medical-grade honey: its definition and refined standards. Journal of Wound Care 34(6):412-423, https://doi.org/10.12968/jowc.2024.0206
(3) Compliance with the quality requirements of Directive 2001/110/EC (Honey Directive) is a good starting point.
(4) Husain Rahmani A. & Yousif Babiker A. (2025) Review on role of honey in disease prevention and treatment through modulation of biological activities. Open Life Sci. 20(1):20251069, https://doi.org/10.1515/biol-2025-1069
(5) Seraik S. & Singh Thakur M. (2025) Natural Honey as a Potent Therapeutic Agent: A Review. Journal of Scientific Research and Reports 31(5):676-691, https://doi.org/10.9734/jsrr/2025/v31i53064
(6) See para. 57 of the judgment in Case C-618/23 of the Court of Justice of the European Union (CJEU).
