I’ve been hearing people ask about using honey for spring allergies (which just started to kick in for me this week), so I thought I’d do a bit of evidence-based digging for you, and here’s what I found. The answer, unfortunately for some, is no, there is no strong evidence that taking honey helps decrease allergies. Or to say it more bluntly: there is good evidence that taking honey does nothing to help spring allergies. One article from the always-excellent New York Times health section talks about a well designed 2002 study which specifically looked at this issue. Here’s their synopsis:

In the study, published in the Annals of Allergy, Asthma and Immunology in 2002, the scientists followed dozens of allergy sufferers through the springtime allergy season. The subjects were randomly split into three groups. One consumed a tablespoonful daily of locally collected, unpasteurized and unfiltered honey; another ate commercial honey; and a third was given a corn syrup placebo with synthetic honey flavoring.

After tracking the subjects’ symptoms for months, the scientists found that neither of the honey groups saw improvements over the placebo group.

Dr. Stanley Fineman, president-elect of the American College of Allergy, Asthma and Immunology, said he has seen a growing number of patients ask about local honey. “Seasonal allergies are usually triggered by windborne pollens, not by pollens spread by insects,” he said. So it’s unlikely that honey “collected from plants that do not cause allergy symptoms would provide any therapeutic benefit.”

And as usual, the outstanding Natural Medicines Database has a free article discussing all natural therapies for allergic rhinitis (“hayfever”). They don’t even mention honey; their very handy color graph at the bottom of their article lists no natural products as proven to be in the top category of “likely safe and likely effective”; the best evidence is for 3 products that are “possibly safe and possibly effective”. These include butterbur; thymus extract and tinospora cordifolia. I’ve never used these but the evidence for butterbur was promising:

Several clinical trials have evaluated butterbur for allergic rhinitis. Most studies have used a specific extract called ZE 339 (Tesalin, Zeller AG), which is not available in North America. Taking one tablet of this extract 3-4 times daily seems to significantly decrease mediators of nasal inflammation and symptoms of allergic rhinitis.7595,10336,10337,14414 Some evidence also suggests that this extract might be comparable to cetirizine (Zyrtec) 10 mg/day or fexofenadine (Allegra) 180 mg/day for reducing symptoms.7595,14414

If patients want to try butterbur, advise them to look for products that are standardized to contain at least of 7.5 mg petasin and isopetasin. This is similar to the product that has been studied.

Butterbur naturally contains unsaturated pyrrolizidine alkaloids (UPAs), which are hepatotoxic, carcinogenic, mutagenic, renal toxic, and can cause veno-occlusive disease. Tell patients to only used butterbur products that specifically indicate that they are “UPA-free.”

A brand name similar to the one that has been studied and that is labeled UPA-free is Petadolex.

Practice Pearl: Butterbur might not be appropriate for people who are allergic to ragweed.

Don’t Forget The Basics

My favorite non-Rx treatment is always salt water nasal rinsing, which can work wonders. But my first choice for medicines remains the over-the-counter antihistamines, sometimes with the decongestant pseudoephedrine to dry the nose and sinuses. You can read my previous posts and see my slide show on allergy problems here.

What about my readers: which natural or Rx medicines do you use for hayfever?