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Does bee venom therapy work? Stings cause pain, itching, or even death in some people, so how might potential benefits outweigh the risks?

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[♪ INTRO].

Everyone knows that bee stings don’t feel the best. And for the 1-7% of us with allergies to insect venom, they can be deadly.

But a growing number of people are choosing to inject themselves with the toxic stuff, or even receive intentional stings, in the hopes of finding relief from conditions like arthritis and chronic pain. It’s incredibly controversial, and risky, but clinical studies have found some evidence backing bee venom therapy: the medical use of bee venom. And further research into why it seems to help could lead to breakthroughs for diseases we don’t currently have good ways to treat.

The medicinal use of bees, or apitherapy, has been around for ages. The Greek physician Hippocrates was doling out stings as treatment as far back as 460 BCE. Then again, he also thought that if a woman didn’t have sex with a man or give birth for a while, her uterus would start wandering around her body and cause a bunch of health problems.

So that’s not saying much. Today, apitherapy is mostly popular among people who believe in alternative medicine. But it’s also started to get some attention from evidence-based medicine, because clinical research has backed some therapeutic claims.

Venom is typically collected from bees and then delivered through acupuncture. Small amounts of a diluted toxin mixture, equivalent to one thousandth of a sting or less, are pricked right into the skin with each needle. But some opt for a more natural route.

Yes, that means live bees delivering real stings. Either way, the venom usually comes from honey bees, and it contains dozens of potent compounds, though a small protein called melittin is the most abundant. Combined with the rest of the chemical cocktail, it produces the burning pain and itching associated with stings as well as the hot, red lump that continues to throb for hours.

So it might seem weird to think that the venom from a sting, which we typically associate with pain and swelling, might reduce things like pain and swelling. But that’s exactly what researchers have found. Bee venom seems to be most effective for inflammatory diseases: conditions where excess inflammation is a major part of the problem.

Inflammation is one of the body’s immune responses. It’s what causes infections or injuries to become red, warm, and puffy. But when there’s too much, or it occurs in response to the wrong things, you can end up with chronic problems.

And weirdly enough, studies have shown that both whole bee venom and melittin alone can reduce inflammation from other sources. Melittin, for example, directly binds with key molecules that activate pro-inflammatory genes, blocking them from binding to DNA. And in some studies, this seems to translate to results in humans.

A handful of papers have shown that bee venom therapy can help with the painful, swollen joints that characterize arthritis, for example. A randomized controlled trial in Korea in 2003 found that the 37 patients who received bee venom acupuncture had less stiffness and pain in the affected joints than the 32 controls that received saline instead. That lines up with what studies in animal models of the condition have found.

A few studies have also found that bee venom therapy reduced chronic pain, which is often due to inflammation. Not in the short term, because a sting is still, well, stingy. But in a study of 54 patients with chronic lower back pain published in 2017, those treated with bee venom acupuncture reported more improvement than those who received saline, similar results to a 2006 trial of 30 patients with shoulder pain.

Some research has found that bee venom might even help treat neurodegenerative diseases like Parkinson’s, where inflammation in the brain harms and eventually kills neurons. But a clinical trial of 73 patients published in early 2018 found that the symptoms of those receiving bee venom acupuncture had improved: they had a better walking gait, postural stability, and quality of life over those who received saline instead. It could be that the venom actually protected their neurons by reducing the dangerous inflammation, something seen in animal models of the disease.

But while all these examples are promising, many doctors aren’t ready to embrace bee stings just yet. Because the results of individual small trials aren’t enough to say if a treatment works. You have to look at the research as a whole.

Review papers published in 2008 and 2014 analyzed the results of previous studies on bee venom therapy for pain and arthritis, respectively. And both concluded that when you look at all the studies on this, there’s not enough evidence to say if venom is effective because the trials to date were too small or had other flaws. Plus, attempts to use venom for other conditions have not had such great results.

For example, a 2005 trial in 26 patients with multiple sclerosis, a disease where chronic inflammation slowly causes nerve damage, found that bee venom did nothing for the patients that received it. And while the evidence in support of bee venom therapy remains somewhat shaky, its dangers are well established. There are dozens of side effects that come along with injecting people with an insect venom, ranging from, oh I don’t know, pain, and itching, to deadly allergic reactions.

In a 2015 review and meta-analysis of dozens of studies, researchers found that bee venom therapy substantially increased the risk of a bad reaction to treatment, which ranged from itching to death. In fact, of the 397 patients that received bee venom across 20 clinical trials, 148 of them had adverse reactions. And these were patients who had initially tested negative for venom allergies.

So, even if bee venom therapy does work, the benefits might not outweigh the risks. To make it a useful treatment, researchers would need to figure out how to harness the therapeutic potential of venom while reducing those risks. Part of the problem is that most studies use whole bee venom and all of its allergy-inducing components when it’s likely only some or even one compound is needed for the desired effect.

In the meantime, the results of a few small studies probably aren’t enough to justify jabbing venom-spiked needles into your body. Thanks for watching this episode of SciShow! And if you want to learn more about insect venom, you might like our episode on 8 of the most painful stinging insects. [♪ OUTRO].