Propolis for Upper Respiratory Tract Infections
Propolis for Upper Respiratory Tract Infections
Could bees provide a solution to a prevalent and costly problem?
When patients with an upper respiratory tract infection used a propolis spray, packed with antimicrobial and immune-enhancing properties, their symptoms disappeared 2 days earlier than in the placebo group.
This article is part of our May 2021 special issue. Download the full issue here.
Reference
Esposito C, Garzarella EU, Bocchino B, et al. A standardized polyphenol mixture extracted from poplar-type propolis for remission of symptoms of uncomplicated upper respiratory tract infection (URTI): a monocentric, randomized, double-blind, placebo-controlled clinical trial. Phytomedicine. 2021;(80):153368.
Study Objective
To evaluate the effects of a standardized oral spray of poplar-type propolis extract (M.E.D. Propolis) on the symptoms of mild upper respiratory tract infections (URTIs)
Design
A monocentric, placebo-controlled, double-blind clinical trial performed in an outpatient setting
Participants
This study involved 122 subjects (58 in the propolis group and 64 in the placebo group). The age range was from 18 to 77 years; 54 subjects were male, and 68 were female. All subjects had signs and/or symptoms of a URTI. Subjects were examined by a physician and were eligible for inclusion in the study if they suffered from 1 or more of the following common URTI symptoms: sore throat, muffled dysphonia, and swelling and redness of the throat that began on the same day as the baseline visit (t=0).
Intervention
The subjects were randomly assigned to receive either a propolis oral spray or a placebo spray from t1 to t3 (5 days). Dose was 2 to 4 sprays 3 times daily. Researchers evaluated each participant at 4 time points: baseline=t0, after 3 days=t1, after 5 days=t2, and at 15 days=t3.
The propolis spray was standardized to contain 15 mg/mL of polyphenols. The spray had a reproducible composition of the 6 major flavonoids found in this type of propolis (ie, galangin, chrysin, pinocembrin, apigenin, pinobanksin, quercetin). Each participant used 2 to 4 sprays 3 times daily for 5 days. The placebo spray had an identical appearance and flavor to the propolis spray.
Study Parameters Assessed
Apart from the primary outcome measure, the researchers evaluated the persistence of positive bacterial throat cultures at t3. They performed throat swabs on all subjects at t0 and then again at t2 and t3 on those subjects who had an initially positive throat culture. At t0, 8 people in the treatment group and 7 people in the placebo group were positive for a bacterial URTI. At t3, none of the subjects in either the treatment or placebo group were found to have a positive bacterial throat culture.
Primary Outcome Measures
The primary outcome measure was the resolution of URTI symptoms. Researchers assessed these symptoms at baseline (t0), 3 days (t1), after 5 days (t2), and at the final timepoint (t3) of the study, 15 days.
At t1, 17% of the participants in the treatment group still had 1 symptom of an URTI. In contrast, about 72% of people in the placebo group still displayed 1 symptom (RR: 2.93, CI: 1.95–4.42).
The results of a univariate analysis showed that only treatment with oral propolis spray was related to the disappearance of symptoms (resolution of all symptoms in the treatment group vs the placebo group: X2=35.57, df=1, P<0.001; resolution from sore throat in the propolis vs placebo group: X2=28.38, df=1, P<0.001; resolution of muffled dysphonia in the propolis vs placebo group: X2=4.38, df=1, P=0.036; and resolution of swelling and redness of the throat in the propolis vs placebo group: X2=16.85, df=1, P<0.001).
Clinicians using natural medicine should not be shy to incorporate propolis into treatment plans for many types of infections.
All logistic models of the data were also significant, showing that the propolis spray was the only variable that correlated with the resolution of all symptoms and single symptoms (all symptoms: X2=46.51, df=7, P<0.001; sore throat: X2=34.21, df=6, P<0.001; swelling and redness of the throat: X2=23.19, df=6, P<0.001; muffled dysphonia: X2=7.87, df=3, P=0.048).
There was no relationship noted between the resolution of symptoms after 3 days and the type of infection (bacterial or viral) or the age or gender of the subjects.
Key Findings
The disappearance of all URTI symptoms occurred 2 days earlier in the propolis group vs the placebo group. Symptoms were gone within 5 days in the placebo group and within 3 days for the treatment group. This finding held true for both viral and bacterial URTIs. Since there were so few bacterial URTIs noted in this study, the authors were not able to make any conclusions related to the effects of propolis on antibiotic-resistant bacteria.
Practice Implications
Propolis has always interested me, and it has defied my attempts to categorize it. Is it an herbal medicine? Well, not exactly. It is certainly a “natural medicine.” Propolis is a very complex mixture consisting of polyphenols, wax, resins, pollen, essential oils, minerals, vitamins, and other components. It is created when bees collect plant exudates and mix them with their saliva.1 The bees use propolis to seal their hives, and it has an antimicrobial effect on the hive. The composition of propolis varies based on the type of bees, the time of the year, the plants the bees visit, and other variables.2
Dietrich Klinghardt, MD, recommends the incorporation of Brazilian green propolis into treatment plans for those with Lyme disease accompanied by bartonellosis. Bartonella is a gram-negative, intraerythrocytic bacteria that can be transmitted to humans by ticks and other vectors.3 In my experience, concomitant bartonellosis can make Lyme disease more complex to treat. People with chronic tick-borne diseases need treatment options, and it is nice to know that propolis can be on the menu.
The bad thing about propolis, for the pharmaceutically minded, is that it is such a complex and variable mixture, making the “active compounds” difficult to identify. The good thing about propolis, for those who study and respect natural medicine, is that it is such a complex and variable mixture, with assumed synergies in medicinal compounds. A 2019 review by Przybylek and Karpinski notes that “this diversity of chemical composition gives propolis an additional advantage as an antibacterial agent. The combination of many active ingredients and their presence in various proportions prevents bacterial resistance from occurring.”4 Because of the concerning rise in nosocomial infections from antibiotic-resistant bacteria (especially of the gram-negative variety), there has been a recent focus on the development of “antibiotic hybrids.” These new drugs combine various classes of antibiotics in an attempt to overcome bacterial resistance.5 Perhaps the many constituents in propolis make it the ultimate “antibiotic hybrid?”
Clinicians using natural medicine should not be shy to incorporate propolis into treatment plans for many types of infections. As with many natural medications, propolis has nutrients that can enhance immunity and anti-inflammatory compounds to help deal with the inflammatory nature of infections.6 It has the multifaceted ability to be directly antimicrobial, nourishing, and immune-enhancing all at the same time.7 This is a high bar that would be quite hard for a synthetic drug to reach.
As I continue to review studies on botanical/natural medicine, it appears less common to see a well-designed study on these topics conducted in the United States. This study is no exception. The current study was a collaboration between scientists in Italy and China. There are myriad variables that figure into the equation of the US medical system. One thing is certain though: We spend more on healthcare and have poorer outcomes than other developed nations.8 I can’t help but wonder how much it would benefit us if even a minute fraction of the money that we invest in pharmaceutical research were funneled into investigating natural medications and there were a serious attempt to integrate them into our primary healthcare system. This seems especially true in the age of growing microbial resistance to conventional antibiotics.
I remember being impressed while on a trip to Japan that prescription “Kampo” herbal formulas were readily available at pharmacies. Every pharmacist whom we dropped in on was familiar with Kampo herbal formulas and had a handy Kampo reference book to help them describe to us the composition and effects of these common prescriptions. In Japan, 90% of physicians prescribe Kampo herbal formulas, and the national insurance plan covers them.9
URTIs are the most common reason that people visit doctors worldwide. They result in a cost of $22 billion dollars and cause more than 20 million missed school/work days annually.10 Imagine the suffering that could be averted, and the money that could be saved, by incorporating propolis into the average primary-care URTI visit. This could help patients avoid more complicated URTIs and lessen the need for prescriptions such as steroids and codeine, which have significant side effects. Patients may also be better nourished to ward off the next immunologic assault.
Bee Culture
by Stephanie Bruneau
What is propolis?
Most beekeepers are all too familiar with the sticky, resinous ‘bee glue,’ propolis, lining the inside of every honeybee hive. You can scrape and scrape all you want – the bees will just replace it! Every tiny gap or drafty crack in the hive will be sealed with propolis, which also coats the hive entrance, walls, and even the honeycomb. But in addition to making hive inspections stickier, propolis serves several crucial functions in the honeybee hive, and has been been recognized as valuable by humans throughout the ages.
At once providing structural support and sterilizing action, propolis has been called both ‘bee glue’ and ‘bee penicillin.’ It is strongly anti-bacterial, inhibiting the growth of any bacteria, fungus, or other unwanted microbe that might thrive in the warm and humid hive environment. In fact, the word ‘propolis’ is derived from the Greek ‘pro’ (in front of, at the entrance to) and polis (community or city), meaning ‘before the city’ or ‘in defense of the city’ (ie, the hive). Bees also use propolis to contain potential pathogens brought in by mice and other hive intruders. These intruders will be killed by the bees, and their carcasses mummified in propolis to prevent their decay from degrading the hive environment.
The bees make propolis from tree resins that they collect from leaf buds and tree sap. Worker bees collect the resins and carry them back to the hive on their legs in their pollen baskets. Perhaps because the resin is so sticky, the worker bees cannot unload it themselves (unlike pollen), rather, they have to have another bee unload their bounty for them. The bees mix the collected resins with wax, honey, and enzymes from their stomachs to turn it into the amazing and ever-useful substance that we know as propolis. The end composition is ~50% resins, 30% waxes, 10% essential oils, 5% pollen and 5% plant debris, although each hive’s propolis is a bit different, based on the variety of unique resins collected from a given hive’s local trees.
How is propolis harvested by the beekeeper?
To harvest propolis, the beekeeper places a flexible plastic screen with cracks on top of the frames in the hive, underneath the hive cover. The fastidious bees will quickly work to seal all of the cracks with propolis. This plastic screen can be easily removed by the beekeeper and placed temporarily in the refrigerator or freezer – the propolis, which is soft and sticky in the warm hive, will quickly become brittle in the cold. Flexing the screen easily cracks the brittle resin off of the screen where it can be collected.
How has propolis been used by people – past and present?
Propolis has been used for health and healing since ancient times – at least since the time of Aristotle (384 – 322 BC), who is actually said to have coined the word ‘propolis’ himself! Taking advantage of its antiseptic qualities, Ancient Egyptians used propolis to embalm cadavers. In ancient Greece, Aristotle (384 – 322 BC), the physician Pedanius Dioscorides (40 – 90 AD) and Galen (129 – 217 AD) prominent Greek physician).
In ancient Rome, the naturalist and author Pliny the Elder (23 – 79 AD) used propolis extensively. In his famous Natural History, he wrote that “propolis is produced from the sweet gum of the vine or the poplar, and is of a denser consistency, the juices of flowers being added to it. Still, however, it cannot be properly termed wax, but rather the foundation of the honey-combs; by means of it all inlets are stopped up, which might, otherwise, serve for the admission of cold or other injurious influences.”(1) Pliny also wrote that propolis “has the property of extracting stings and all foreign bodies from the flesh, dispersing tumours, ripening indurations, allaying pains of the sinews, and cicatrizing ulcers of the most obstinate nature.”(2)
The ancient Jews also considered ‘tzori’ (the Hebrew word for propolis) to be medicine, and tzori is mentioned throughout the Old Testament.(3)
In more recent times there has been a significant amount of research on the biological activity of propolis, and many of the healing properties that so many civilizations have touted in propolis throughout the ages have been confirmed by modern day science. Research has demonstrated its anti-bacterial, anti-fungal, anti-viral, and anti-inflammatory properties, its ability to protect the liver, to increase the body’s natural resistance to viruses and infections, to heal problems of the mouth and gums, and to treat peptic ulcers (among other attributes). At least 180 different compounds have been identified so far.
Today, propolis is used as a popular remedy. Current sales of propolis in the United States are estimated at 40,000 lb/yr. Because of its long and varied list of touted benefits, the range of uses is long and varied in home remedies and body care products. It is available in capsules, as an extract in alcohol or glycerin, as a mouthwash, and can be found in many creams and cosmetics.
Recipes!
You can make your own products from raw propolis very easily! You can collect propolis using a propolis trap as described above, or you can scrape small amounts from the edges and sides of your hive components.
Raw propolis can be easily infused into a topical cream or oil, a liquid (propolis extract), and can be purchased at your local natural foods store in capsule form as well. Together these products are an amazing defense system at your service, with an ability to assist your body with healing and germ fighting.
Propolis Infused Oil
Of all methods of infusion, research indicates that an oil extract of propolis may have the strongest anti-microbial effect. Applied topically, propolis oil is soothing and healing on cuts and abrasions. Propolis infused oil can be used as an ingredient in lotions or salves, and can work wonders on areas of skin irritation or severe dryness such as psoriasis or eczema.
Materials
~10 grams propolis scrapings (about 1 TBS)
7 oz olive oil (other oils can be used, such as apricot kernal oil, sweet almond oil, etc.)
Method
Mix the propolis and oil together in the top of a double boiler. Use a thermometer to monitor the temperature and heat the oil to no higher than 122°F (as higher temperatures may destroy some of the beneficial qualities contained in the propolis). Stir and heat for at least 30 minutes, and up to four hours. The propolis will not all dissolve.
Strain this mixture through cheesecloth or a paper coffee filter. If you use cheesecloth, you may have to filter the oil twice. The propolis that remains in the filter can be used again to make more oil – refrigerate or freeze it for another time. Store your finished oil in a sealed jar in a dark place.
Keep in an amber dropper bottle, and store in your medicine or kitchen cabinet.
Propolis Tincture
Mix two parts propolis by weight to nine parts of clear grain alcohol, by weight (we use 75 proof or higher vodka, or Everclear) (Do not use ethanol alcohol – it is poisonous!).
Mix together in a lidded container, such as a canning jar. Shake. Store in a dark place. Shake two to three times a day for one to two weeks. Strain through a cheesecloth or paper coffee filter, and store in a dark place or in a dark jar. You can collect and store the propolis left in in the filter, as it may be reused for another tincture or oil (store in the fridge or freezer).
Keep in an amber dropper bottle, and store in your medicine or kitchen cabinet.
Herbal Mouthwash
Use this as a rinse after brushing at night, and keep the dentist away!
3/4 cup water
1/4 cup vodka
2 dropperfuls calendula tincture
2 dropperfuls echinacea root tincture
1 dropperful myrrh tincture
2 dropperfuls propolis tincture
1 drop peppermint or spearmint essential oil (I actually like it better without this! But others who are used to a minty flavor enjoy this optional addition).
(Note that the essential oils and calendula, echinacea and myrrh tinctures can be found in a natural food store.)
Honey Propolis Throat Spray
Spray in the back of the mouth anytime sore throat hits! This powerful spray can be great to prevent bacterial throat infections such as strep throat.
– Mix three TBS of propolis tincture (see recipe above) with two TBS of raw local honey and one TBS of warm water in a spray bottle. The propolis tincture can be combined with other herbal tinctures as well for their immediate relief and longer-lasting benefits in the face of illness; our favorites are echinacea, marshmallow, ginger and/or elderberry tinctures, all of which can be found in a natural food store.
Stephanie Bruneau is beekeeper, mom, herbalist and artist. She runs The Benevolent Bee selling honey, candles and beeswax-based body care products. She is a co-founder and of the Boston Area Beekeepers Association.1. Bostock J, Riley HT, editors. Pliny the Elder, the Natural History, Book XI. The Various Kinds of Insects. London, UK: Taylor and Francis; 1855.
2. Bostock J, Riley HT, editors. Pliny the Elder, the Natural History, Book XXII. The Properties of Plants and Fruits. London, UK: Taylor and Francis; 1855.
3. The Bible. Jeremiah 8, verse 22, Jeremiah 46, verse 11, Jeremiah 51, verse 8.
Bee Products for Better Health, C. Leigh Broadhurst, PhD, 2013
Grange, J. M., and R. W. Davey. “Antibacterial properties of propolis (bee glue).” Journal of the Royal Society of Medicine 83.3 (1990): 159-160.
Castaldo, Stefano, and Francesco Capasso. “Propolis, an old remedy used in modern medicine.” Fitoterapia 73 (2002): S1-S6.
Ghisalberti EL (1979). Propolis: A review. Bee World, 60, 59-84.
Burdock, G. A. “Review of the biological properties and toxicity of bee propolis (propolis).” Food and Chemical toxicology 36.4 (1998): 347-363.
Kuropatnicki AK, Szliszka E, Krol W. Historical Aspects of Propolis Research in Modern Times. Evidence-based Complementary and Alternative Medicine : eCAM. 2013;2013:964149. doi:10.1155/2013/964149
Havenhand, Gloria. Honey Nature’s Golden Healer. Firefly Books, 2011.
The Bible
Bostock J, Riley HT, editors. Pliny the Elder, the Natural History, Book XI. The Various Kinds of Insects. London, UK: Taylor and Francis; 1855.
Bostock J, Riley HT, editors. Pliny the Elder, the Natural History, Book XXII. The Properties of Plants and Fruits. London, UK: Taylor and Francis; 1855.
Propolis: Benefits, Side Effects, Dosage, and Interactions
Propolis is a resinous substance that bees produce from materials collect from tree buds. Rich in flavonoids, a class of antioxidants, propolis has a long history of use as a natural treatment for a host of health problems.
Research shows propolis has many healing properties, including antimicrobial, anti-fungal, anti-viral, anti-inflammatory, and anti-tumor qualities.
Found in small quantities in honey, propolis is widely available in supplement form. Propolis is also used as an ingredient in certain medicinal products applied directly to the skin, such as ointments and creams. In addition, propolis is sometimes found in nasal sprays and throat sprays, as well as in mouthwash and toothpaste.
Propolis is touted as a natural treatment for the following health problems and conditions:
acne
bacterial infections
burns
canker sores
colds
cold sores
diabetes
giardiasis
herpes
inflammation
influenza
peptic ulcer disease
In addition, propolis is said to stimulate the immune system and prevent tooth decay.
Health Benefits
Although few clinical trials have tested the health effects of propolis, there's some evidence that propolis may offer certain benefits. Here's a look at several key findings from the available studies:
Cold Sore Treatment
Preliminary research suggests that topically applying propolis may help heal cold sores. In a study published in Phytotherapy Research in 2010, for example, scientists found that extracts of propolis possess virus-fighting effects that may help knock out against herpes simplex virus type 1, the virus that causes cold sores.
Genital Herpes Treatment
Applying a propolis-based ointment may help treat sores related to genital herpes, according to a study published in Phytomedicine. For the 10-day study, 90 men and women with genital herpes used an ointment containing flavonoids sourced from propolis, an ointment containing acyclovir (a drug used to reduce pain and speed healing of herpes-related sores), or a placebo ointment.
By the study's end, 24 out of the 30 participants in the propolis group had healed (compared to 14 out of 30 in the acyclovir group and 12 out of 30 in the placebo group). Given this finding, the study's authors concluded that an ointment containing flavonoids sourced from propolis may be more effective than both acyclovir and placebo ointments in healing sores related to genital herpes.
Burn Treatment
Propolis may promote the healing of minor burns, according to a study from the Journal of Alternative and Complementary Medicine. For the study, researchers compared the effects of a propolis-based skin cream with those of silver sulfadiazine, a drug commonly used in the treatment of second- and third-degree burns, in patients with second-degree burns.
Study results showed that propolis and silver sulfadiazine were similarly effective in the treatment of burns. What's more, propolis appeared to offer greater anti-inflammatory benefits than silver sulfadiazine did.
Gastrointestinal Disorders
Research suggests propolis can help treat gastrointestinal disorders, including ulcerative colitis, gastrointestinal cancers, and ulcers. Components in propolis, including caffeic acid phenethyl ester (CAPE), artepillin C, kaempferol, and galangin, have been shown to effectively eliminate pathogens, including H. pylori. The research, however, is limited to animal studies and cell cultures.
Cavity Control
Propolis may help fight cavities, a study from Biological & Pharmaceutical Bulletin shows. In laboratory research, scientists found that compounds found in propolis helped inhibit the growth of Streptococcus mutans, an oral bacteria known to contribute to the development of cavities.
The study suggests that propolis may also help stop Streptococcus mutans from sticking to the teeth.
Diabetes Management
Findings from animal-based research indicate that propolis may aid in the treatment of diabetes. In a 2005 study published in Pharmacological Research, for example, tests on diabetic rats revealed that treatment with propolis helped lower blood sugar levels and reduce cholesterol. These results have not be replicated in human studies, however.
Possible Side Effects
Do not use propolis if you have asthma or are allergic to bee by-products (including honey), conifers, poplars, Peru balsam, and salicylates. Propolis may slow blood clotting and increase the risk of bleeding in people with bleeding disorders or during surgery.
Verywell / Anastasia Tretiak
Dosage and Preparations
Propolis is available in many forms, including tablets, capsules, powder, extract, and lozenge. When used topically, it's found in ointments, creams, lotions, and other personal-care products.
There is no recommended daily allowance of propolis and there is not enough human studies to determine how much propolis should be taken to support health conditions.
What to Look For
When selecting a brand of supplements, look for products that have been certified by Consumer Labs, The U.S. Pharmacopeial Convention, or NSF International.
Other Questions
Is propolis the same as beeswax?
Bees make propolis from beeswax, saliva, and plant materials gathered. In the hive, propolis is used as a glue to close up small gaps, while beeswax is used to fill larger holes. While propolis is made from beeswax, they are not the same.
Is propolis found in honey?
A small amount of propolis may be found in certain kinds of honey. Since heat can destroy the healing qualities of propolis, stick to raw honey which is unfiltered and unpasteurized.
