Royal Jelly

• How It Works

  Royal jelly may benefit those with high cholesterol, but it has not been shown to treat cancer in humans.

  Royal jelly is a viscous substance secreted by worker bees that makes up the essential food for queen bees and their larvae. It is consumed as a health food around the world. Royal jelly has been shown to lower blood pressure, lower cholesterol levels, and reduce inflammation in laboratory and animal studies. It has not been studied as a cancer treatment in humans. Royal jelly has weak estrogenic activity and should not be used by patients with hormone-sensitive cancer.

• Purported Uses
  • Menopausal symptoms
    In one uncontrolled prospective study, royal jelly improved symptoms in postmenopausal women.
  • Osteoporosis
    Royal jelly improved bone health in laboratory and animal studies.
  • Cholesterol management
    Some research evidence supports its use for high cholesterol levels.
  • Male infertility
    One study suggests its use for male infertility, but more large-scale clinical trials are needed to confirm this effect.
  • Diabetes
    A few studies suggest it may improve some type 2 diabetes markers in both men and women. Confirmatory studies are needed.
  • Mucositis
    In patients receiving radiotherapy and chemotherapy, royal jelly along with standard mouthwash therapy improved symptoms of oral mucositis and healing time. Confirmatory studies are needed.
• Do Not Take If
  • You have estrogen receptor-positive breast cancer: Royal jelly can stimulate growth of cancer cells.
  • You are taking blood thinners such as warfarin: Royal jelly can enhance its effects.
  • You are taking cholesterol-lowering medications: Theoretically, royal jelly may have additive effects.
• Side Effects
  • Anecdotal weight gain, facial rash and gastrointestinal discomfort.
  • Several cases of anaphylaxis, asthma, and hemorrhagic colitis have been reported with use of royal jelly.

  Oral high-dose royal jelly for 4 weeks adversely affected the reproductive system of pubescent male rats. The severity of these effects lessened after stopping royal jelly administration.

• Clinical Summary

  Royal jelly is a viscous substance secreted by worker bees and constitutes the essential food for queen bees and their larvae. It is consumed as a health food around the world. It demonstrated vasodilatory, hypotensive, antihypercholesterolemic, antitumor, anti-inflammatory, and estrogenic effects ^{(1) (3) (9)}, although its affinity for estrogen receptors is weaker compared with diethylstilbestrol ⁽³⁾. Animal studies indicate that oral administration of royal jelly may be effective against colitis ^(10) (22) and improve testosterone levels ⁽¹⁹⁾.

  Clinical studies have demonstrated that royal jelly lowered total serum lipid levels and total serum cholesterol in individuals with moderately elevated cholesterol levels ⁽⁵⁾, and improved erythropoiesis, glucose tolerance and mental health in healthy subjects ⁽²⁰⁾. Royal jelly also improved type 2 diabetes markers in both men and women ^(23) (24), but was not found to be effective in healing diabetic foot ulcers ⁽²⁵⁾.

  Mid-cycle pericoital intravaginal applications of a combination of Egyptian bee honey and royal jelly improved infertility due to idiopathic asthenozoospermia ⁽²⁾. Royal jelly also improved premenstrual ⁽²⁶⁾ and menopausal symptoms ⁽⁶⁾. In a combination supplement, it appeared to benefit patients with mild cognitive impairment ⁽²⁷⁾. In human glioblastoma multiforme cells, royal jelly increased the cytotoxic activity of temozolomide ⁽²⁸⁾. It also inhibited growth-promoting effects from the environmental estrogen bisphenol A (BPA) on human breast cancer MCF-7 cells in vitro, but did not have this inhibiting effect in the absence of BPA ⁽⁷⁾. However, royal jelly was also shown to stimulate MCF-7 cell proliferation which was reversed by tamoxifen ⁽³⁾. In patients receiving radiotherapy and chemotherapy, royal jelly along with standard mouthwash therapy improved symptoms of oral mucositis and healing time ⁽²⁹⁾. Another study with a very small sample size also suggests benefit with topical royal jelly in head and neck cancer patients ⁽³⁰⁾.

  Because royal jelly has estrogenic effects, women with estrogen receptor-positive breast cancer should avoid this product. Prostate cancer patients should also use caution as royal jelly increased testosterone levels in animal studies.

• Purported Uses
  • Menopausal symptoms
  • Osteoporosis
  • Cholesterol management
  • Male infertility
  • Diabetes
  • Mucositis
• Mechanism of Action

  Royal jelly stimulated the production of type 1 collagen and other bone formation activities through its action on osteoblasts ⁽⁴⁾. In animal models, anti-inflammatory effects with royal jelly were likely mediated by CD3-, CD5-, CD8- and CD45-positive T-cell immune responses ⁽²²⁾. Protective effects against taxol-induced testicular damage were attributed to improved antioxidant status and E2f1 transcription factor upregulation ⁽³¹⁾.

  Various mechanisms for cholesterol-lowering effects have been posited ⁽⁵⁾. Royal jelly may decrease reabsorption of cholesterol in the GI tract and increase its excretion in the bile due to the presence of phytosterols, mainly B-sitosterol. Another explanation offered is that royal jelly suppresses hepatic cholesterol synthesis ⁽⁸⁾.

  Effects against oxidative stress are attributed to antioxidant peptides ⁽²⁴⁾. Improved glucose tolerance and erythropoiesis occur from accelerated conversion of DHEA-S to testosterone via activation of 3β-HSD2 and/or 17β-HSD3 ⁽³²⁾. In type 2 diabetic women, royal jelly supplementation reduced hemoglobin A1c and fasting blood glucose levels, increased insulin concentrations, and decreased oxidative stress via improvement of malondialdehyde levels, erythrocyte superoxide dismutase, and glutathione peroxidase activities ⁽²³⁾.

  Compounds identified in royal jelly exhibit weak estrogenic activity, but also inhibit binding of estradiol to estrogen receptor beta ⁽⁴⁾.

• Contraindications

  Women with estrogen-receptor positive breast cancer should avoid products containing royal jelly as they may stimulate the cancer.

• Adverse Reactions
  • Anecdotal weight gain, facial rash and gastrointestinal discomfort ⁽⁶⁾.
  • Several cases of anaphylaxis ^{(11) (12) (13)}, asthma ^{(14) (15) (16)}, and hemorrhagic colitis ⁽¹⁷⁾ have been reported.

  Oral high-dose royal jelly for 4 weeks adversely affected the reproductive system of pubescent male rats. These effects decreased with cessation of administration ⁽²¹⁾.

• Herb-Drug Interactions
  • Warfarin: Royal jelly can enhance its effects ⁽¹⁸⁾.
  • Cholesterol-lowering medications: Theoretically, royal jelly may have additive effects ⁽⁵⁾.
  • Temozolomide: Royal jelly may increase the cytotoxic effect of temozolomide ⁽²⁸⁾.
• Herb Lab Interactions
  • Royal jelly lowered both the total and LDL cholesterol levels in humans ⁽⁵⁾.
  • Royal jelly increased prothrombin time and fibrinolytic activity in rats ⁽⁸⁾.
• References

  1. Suzuki KM, Isohama Y, Maruyama H, et al. Estrogenic activities of Fatty acids and a sterol isolated from royal jelly. Evid Based Complement Alternat Med. Sep 2008;5(3):295-302.

  2. Abdelhafiz AT, Muhamad JA. Midcycle pericoital intravaginal bee honey and royal jelly for male factor infertility. Int J Gynaecol Obstet. May 2008;101(2):146-149

  3. Mishima S, Suzuki KM, Isohama Y, et al.Royal jelly has estrogenic effects in vitro and in vivo. J Ethnopharmacol. Oct 3 2005;101(1-3):215-220.

  4. Miyata T. Pharmacological basis of traditional medicines and health supplements as curatives. J Pharmacol Sci. Feb 2007;103(2):127-131.

  5. Guo H, Saiga A, Sato M, et al. Royal jelly supplementation improves lipoprotein metabolism in humans. J Nutr Sci Vitaminol (Tokyo). Aug 2007;53(4):345-348.

  6. Georgiev DB, Metka M, Huber JC, Goudev AR, Manassiev N. Effects of an herbal medication containing bee products on menopausal symptoms and cardiovascular risk markers: results of a pilot open-uncontrolled trial. MedGenMed. 2004;6(4):46.

  7. Nakaya M, Onda H, Sasaki K, Yukiyoshi A, Tachibana H, Yamada K. Effect of royal jelly on bisphenol A-induced proliferation of human breast cancer cells. Biosci Biotechnol Biochem. Jan 2007;71(1):253-255.

  8. Vittek J. Effect of royal jelly on serum lipids in experimental animals and humans with atherosclerosis. Experientia. Sep 29 1995;51(9-10):927-935.

  9. Moutsatsou P, Papoutsi Z, Kassi E, et al. Fatty acids derived from royal jelly are modulators of estrogen receptor functions. PLoS One. 2010 Dec 22;5(12):e15594.

  10. Karaca T, Bayiroglu F, Yoruk M, et al. Effect of royal jelly on experimental colitis Induced by acetic acid and alteration of mast cell distribution in the colon of rats. Eur J Histochem. 2010 Oct 21;54(4):e35.

  11. Takahama H, Shimazu T. Food-induced anaphylaxis caused by ingestion of royal jelly. J Dermatol. 2006 Jun;33(6):424-6.

  12. Testi S, Cecchi L, Severino M, et al. Severe anaphylaxis to royal jelly attributed to cefonicid. J Investig Allergol Clin Immunol. 2007;17(4):281.

  13. Katayama M, Aoki M, Kawana S. Case of anaphylaxis caused by ingestion of royal jelly. J Dermatol. 2008 Apr;35(4):222-4.

  14. Harwood M, Harding S, Beasley R, Frankish PD. Asthma following royal jelly. N Z Med J. 1996 Aug 23;109(1028):325.

  15. Bullock RJ, Rohan A, Straatmans JA. Fatal royal jelly-induced asthma. Med J Aust. 1994 Jan 3;160(1):44.

  16. Thien FC, Leung R, Plomley R, Weiner J, Czarny D. Royal jelly-induced asthma. Med J Aust. 1993 Nov 1;159(9):639.

  17. Yonei Y, Shibagaki K, Tsukada N, et al. Case report: haemorrhagic colitis associated with royal jelly intake. J Gastroenterol Hepatol. 1997 Jul;12(7):495-9.

  18. Lee NJ, Fermo JD. Warfarin and royal jelly interaction. Pharmacotherapy. 2006 Apr;26(4):583-6.

  19. Elnagar SA. Royal jelly counteracts bucks’ “summer infertility”. Anim Reprod Sci. 2010 Aug;121(1-2):174-80.

  20. Morita H, Ikeda T, Kajita K, et al. Effect of royal jelly ingestion for six months on healthy volunteers. Nutr J. 2012 Sep 21;11:77.

  21. Yang A, Zhou M, Zhang L, et al. Influence of royal jelly on the reproductive function of puberty male rats. Food Chem Toxicol. 2012 Jun;50(6):1834-40.

  22. Karaca T, Uz YH, Demirtas S, et al. Protective effect of royal jelly in 2,4,6 trinitrobenzene sulfonic acid-induced colitis in rats. Iran J Basic Med Sci. Apr 2015;18(4):370-379.

  23. Pourmoradian S, Mahdavi R, Mobasseri M, et al. Effects of royal jelly supplementation on glycemic control and oxidative stress factors in type 2 diabetic female: a randomized clinical trial. Chin J Integr Med. May 2014;20(5):347-352.

  24. Shidfar F, Jazayeri S, Mousavi SN, et al. Does Supplementation with Royal Jelly Improve Oxidative Stress and Insulin Resistance in Type 2 Diabetic Patients? Iran J Public Health. Jun 2015;44(6):797-803.

  25. Siavash M, Shokri S, Haghighi S, et al. The efficacy of topical royal jelly on healing of diabetic foot ulcers: a double-blind placebo-controlled clinical trial. Int Wound J. Apr 2015;12(2):137-142.

  26. Taavoni S, Barkhordari F, Goushegir A, et al. Effect of Royal Jelly on premenstrual syndrome among Iranian medical sciences students: a randomized, triple-blind, placebo-controlled study. Complement Ther Med. Aug 2014;22(4):601-606.

  27. Yakoot M, Salem A, Helmy S. Effect of Memo(R), a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment. Clin Interv Aging. 2013;8:975-981.

  28. Borawska MH, Markiewicz-Zukowska R, Naliwajko SK, et al. The interaction of bee products with temozolomide in human diffuse astrocytoma, glioblastoma multiforme and astroglia cell lines. Nutr Cancer. 2014;66(7):1247-1256.

  29. Erdem O, Gungormus Z. The effect of royal jelly on oral mucositis in patients undergoing radiotherapy and chemotherapy. Holist Nurs Pract. Jul-Aug 2014;28(4):242-246.

  30. Yamauchi K, Kogashiwa Y, Moro Y, et al. The effect of topical application of royal jelly on chemoradiotherapy-induced mucositis in head and neck cancer: a preliminary study. Int J Otolaryngol. 2014;2014:974967.

  31. Delkhoshe-Kasmaie F, Malekinejad H, Khoramjouy M, et al. Royal jelly protects from taxol-induced testicular damages via improvement of antioxidant status and up-regulation of E2f1. Syst Biol Reprod Med. Apr 2014;60(2):80-88.

  32. Morita H, Ikeda T, Kajita K, et al. Effect of royal jelly ingestion for six months on healthy volunteers. Nutr J. 2012;11:77.