Bee sting therapy
Bee Venom Therapy Update
Posted by Steven Novella on June 20, 2012 (10 Comments)
I wrote previously about bee venom therapy (BVT), also called apitherapy or bee sting therapy, as an emerging “alternative” therapy. Both use and research into BVT continue, providing an excellent example of the many things that are wrong with the CAM movement.
A recent Reuters article on the topic is also an excellent example of the frequent complete failure of the mainstream media in dealing with such topics. The articles discusses a Filipino bee keeper who decided to practice medicine based upon his personal anecdotal experience. Joel Magsaysay suffered a stroke and right-sided weakness. He attributes his recovery from the stroke partly to bee stings.
He admits he is not a physician and has no medical or scientific background. He has concluded that BVT works based upon anecdote along. He seems to be unaware of the unreliability of individual anecdotes in stroke recovery. Most patients will improve following a stroke. There are also two kinds of recovery, including neurological recovery from brain plasticity.
But there is also functional recovery separate from repairing some of the brain damage itself. After being hospitalized with a stroke and then having a prolonged recovery, there is likely going to be a degree of debility from the loss of normal activity. Depression is also common following a stroke. Patients deciding they are going to do something to improve their function, no matter they decide to do, is likely going to be accompanied by greater physical activity and perhaps elevated mood. Stroke researchers are careful to control for this so-called “cheerleader effect” (a type of placebo effect) when trying to determine if a specific intervention is having a physiological effect.
Magsaysay, in other words, has no idea what the effect of bee stings was on his recovery. He likely would have recovered to the same degree without the stings. But now he feels qualified to treat a range of conditions with his bees. The Reuters report, for example, shows him treating a woman with an enlarged thyroid. She was hopeful that it would help because “people are saying it helps” and because it’s “natural.”
Bee venom is an interesting compound because it is a mixture of powerful chemicals. Venoms as a category are usually highly biological active – they evolved to be highly active, either inducing pain, paralysis, or death. So it is no surprise that they are a resource of potentially powerful drugs. The question, of course, is if they can be exploited for therapeutic effect. The best way to approach this is to isolate and purify specific components of a venom and then go through the normal process of drug testing to find a safe and effective therapeutic dose for a specific indication. This has not happened, but there is some interesting basic science and animal research being done.
Ultimately, whether purified, diluted, or simply given as bee stings, we need rigorous clinical trials to assess ultimate safety and efficacy. My previous article focused mainly on BVT for multiple sclerosis. In the last four years there has been no new published research on this question – it seems to be a dead end. BVT is not effective for
There are no published clinical studies of BVT and stroke recovery (however I did find a case report of a stroke following bee stings). There is also no legitimate scientific reason to suspect that BVT would be effective in stroke recover. Magsaysay gives his own explanation for how he thinks it works. His description is pure pseudoscience, just made up science-sounding nonsense. He claims that the pain induced by BVT causes neurons to synapse and reconnect to the brain. This does not even make basic anatomical sense. The problem with stroke is not with the peripheral nerves connecting to the brain, but to neurons in the brain itself that have been damaged.
The area of BVT research that seems the most promising is with neuropathic pain. Bee venom induces pain and inflammation acutely. A number of studies show that it also decreases markers of pain and inflammation following the exposure. This can simply be the effect of compensatory mechanisms kicking in. We see this as a general phenomenon – after any stimulus that causes pain and inflammation the body mobilizes mechanisms to counteract the pain and inflammation and reestablish the normal baseline. This effect is also temporary. Perhaps, however, the duration of the decrease in pain and inflammation is longer than that induced acutely by the sting.
This is still a matter of investigation, and it is not clear if any useful therapy will emerge from this. There are some interesting animal studies working with injecting diluted bee venom into a rat model of neuropathic pain. This is a long way from a specific clinical application, however.
After years of research there is still no proven application for bee venom therapy. The most encouraging preliminary data is with pain, and I would not be surprised if a component of bee venom is isolated that is useful for neuropathic (nerve induced) or nociceptive (tissue) pain. There is still a focus on rheumatoid arthritis, because of the alleged anti-inflammatory effects of BVT, but the data so far may just be reflecting the pain effects of BVT.
There are no neurological uses of BVT that are backed by any reasonable evidence. At this point I think we can say that it is not effective for multiple sclerosis. For other neurological conditions there is no clinical data, only the most preliminary basic science (looking at specific biochemical effects of bee venom).
While it is still unclear if any legitimate treatment will emerge from the study of bee venom, it is a mixture of powerfully biological active chemicals and is a potentially fruitful target of research. This does not justify, however, the exploitation of bee venom by the CAM community, who are making claims that go beyond the basic science evidence and are not supported by clinical evidence.
In fact we can see, side by side, the legitimate scientific approach to bee venom and the CAM approach. The scientific approach is reductionist, methodical, and rigorous and actually has the potential to develop something useful. The CAM approach is to make appeals to nature and antiquity, to make nonsensical hand-waving pseudoscientific justifications, to call it “therapy” before any proven therapeutic effect, and to use it carelessly for a wide range of different conditions.