Bee venom can be delivered into the human body in the following ways:
- sting of a bee;
- medical syringe – a dose of processed bee venom delivered as intradermal or subcutaneous injection;
- rubbing into the skin ointments containing bee venom;
- inhalation of a solution containing bee venom;
- sublingual tablets for delivering bee venom through the oral mucosa;
- injection of bee venom through the skin using electricity and ultrasound;
Each of these methods has its own indications for use, its own advantages and disadvantages. All of them, except for ointment application, should be used only as directed and under the supervision of a physician. In case of ointment application, the patient is obliged to familiarize himself with the instructions for use and strictly follow the recommendations.
Bee Sting Therapy
Among all the methods of delivering bee venom into the human body, it is the oldest and most reliable, giving the most pronounced clinical effect method. Bee venom in the native form is injected by the bee directly through the skin; in this case all components of the bee venom participate in the creation of a biological effect. However, the use of bee stinging has several disadvantages:
- patient’s fear of stinging;
- pain, redness and swelling in the location of a sting;
- difficulty of estimating the dose of delivered bee venom;
- the possibility of severe allergic complications;
- difficulties of obtaining bee venom, especially during winter season.
Difficulty of estimating the dosage of injected bee venom is the main disadvantage of bee sting method. The amount of delivered bee venom depends on a number of reasons. A very young bee has too little venom and for that reason only mature bees should be considered for a treatment; During the summer time, only those bees which are at least 18 days old should be taken for a bee venom collection, which means that only the bees flying out of hive to collect nectar must be used for a bee venom collection. In the autumn and winter all bees are suitable for that procedure. The fact that in winter the production of bee venom is reduced should be taken into account, and the number of bees used per treatment session should be increased.
It was empirically established that during the sting the bee injects 0.2-0.3 mg of bee venom, and if the venom of the mature bee has not been consumed before, then the amount of injected bee venom might reach 0.8 mg. If the bee used its sting in the fight against other insects and animals, then it ejects significantly less venom because after 18 days of bee life venom gland degrades and venom reservoir is not refilled.
The amount of bee venom entering the human body also depends on how long after treatment the sting will stay in the human body (sting exposure). The longer the sting remains in the skin, the more bee venom will be injected. In addition, the dose of bee venom entering the human body depends on the patient’s skin condition, the location of the sting, the depth of sting penetration. Thickened, puffy skin and atrophic skin with a poor developed capillary network delimits the penetration and spread of bee venom.
It is important to pick and handle a bee gently; coarsely grabbed bee can extract some of the bee venom before stinging and the patient will receive less bee venom.
Bee venom injected into the patient’s body by stinging contains all components. Some of components have ability to cause severe side effects leading to anaphylactic shock. In order to avoid such complications, it is necessary to conduct a careful selection of patients, taking into account indications and contraindications to bee venom treatment.
General Principles of Bee Sting Therapy
Bee sting therapy can be done by a physician with sufficient general clinical training, who is familiar with apitherapy, and has a deep knowledge in providing emergency care to patients with shock and allergic reactions. Bee sting therapy is used as:
- honey – 1 table spoon 2 times a day 30 minutes before meals;
- pollen – 1 teaspoon 2 times daily before meals;
- royal jelly mixed with honey (1:100) – half a teaspoon twice a day, to keep under the tongue until completely dissolved;
Bee sting therapy should always be carried out following a scheme defined by a physician in accordance with patient’s gender, age, particular physical and psycho-emotional state, the nature and state of the disease, the effectiveness of previous treatment. In the course of treatment, this scheme can be adjusted according to patient’s response to the treatment.
The treatment scheme prescribes:
- the number of bee stings for each session;
- number of sessions;
- frequency of sessions (daily, every other day, 2 times a week, once a week);
- the approximate number of bee stings in the course of treatment;
- the total duration of treatment (the number of courses);
- where to place a sting (for every session);
- the exposure (duration) of the sting in the patient’s skin (for every session);
If after the first course of treatment there is no positive dynamics in patient’s clinic, then the further use of bee sting therapy is inappropriate. But the physician should not rush to evaluate the results of bee sting treatment because the evidence of the effect may appear only in a few weeks, or even months after the end of treatment. The therapeutic effect of bee stinging develops gradually, slowly, but at the same time it is retained for a longer time.
The number of bees used for one session is determined by gender, age of the patient, nature of the pathology, patient tolerance of procedures, dynamics of symptoms during the treatment process. The physician should never strive to use the maximum number of bees per procedure and the entire course of treatment. It has long been known that small doses of bee venom have a good therapeutic effect, and the probability of occurrence of complications is minimal. In some diseases, especially with poor tolerance of procedures, the number of bees per session and for the entire course of treatment should be reduced. This question is decided only by a physician. It should, however, be noted that in certain diseases (bronchial asthma), a rapid decrease in the number of bee stings can promote an allergic reaction. It is known that in winter the amount of venom in a bee decreases, therefore, the physician can carefully increase the number of bees by 30% or even 80% compared with the summer dose.
Exposure – the duration of time bee sting stays in the patient’s skin. The dose of bee venom injected into the human body directly depends on exposure. When choosing the exposure, it is important to look at the results of two biological tests. When deciding on the length of the exposure, the physician takes into account many factors, including sex, age of the patient, the nature of his/her illness, tolerance to the bee venom and the dynamics of the pathological process.
The choice of the location of the sting is a very important stage in the defining the scheme of the treatment. In the distant past, beekeepers, and then physicians, focused mainly on the localization of pain and the pronounced signs of the disease – bees were seated at these places. In the middle of the last century, apitherapists positioned bees in accordance with Zakharyin-Geda zones. In the following decades, in accordance with the ideas of Eastern medicine, the choice of the location was based on biologically active points corresponding to meridians passing through the area of pathological process.
Apireflexotherapy is more effective than conventional bee stinging, especially in the treatment of angina pectoris, endarteritis, hypertension, diseases of the peripheral nervous system, pathology of the joints, thyroid gland.
Currently, apitherapists also use for treatment skin projections of the nerve branches, projections of large nerve trunks and large vessels of the extremities. In case of spine diseases, stings are made along the spine in the places of the projection of the nerve roots to the right and left of spine (1.5 and 3 tsun from the mid line). Treatment of wounds and ulcers is carried out by stinging around the circumference of the pathological center at a distance of 4-5 cm from the edge of the wound, as well as along the sensory nerve of the area. In case of hypertension, bees are placed on the lateral surfaces of the limbs, on the lower back, and behind the auricles. Diseases of the thyroid gland are treated with stings directly above the thyroid gland to the left and right and in the lumbar region. For eye diseases, the areas of the temples are places for stinging.
The choice of acupuncture points for stinging is a difficult and very important task and the success of the treatment depends on it. If the apitherapist has decided to use for treatment biologically active points, then he/she should adhere to the existing rules of reflexology and be familiar with principals of acupuncture (for e.g. in acute pain syndromes follow the “bottom-top” rule).
In conclusion, it is necessary to emphasize, that the choice of the treatment scheme for bee sting therapy, while strictly individual, is a creative and dynamic process. A template in treatment, an incorrectly defined scheme, and a delayed adjustment during the cause of treatment may not provide the desired result, and sometimes even harm the patient. This often happens after beekeepers, having read popular literature, begin practicing the bee sting therapy.
Selection of Patients for Bee Sting Therapy
Selection of patients is carried out individually and in accordance with existing indications and contraindications for sting therapy. At the first visit, the physician should familiarize himself with the patient’s medical condition:
- study patient’s medical history;
- learn the specific complaints and the history of the disease being treated;
- find out about treatment methods used in the past, their effectiveness, whether bee sting therapy was used in the past, its effectiveness, whether there were any complications in the treatment process;
- conduct in-depth objective study of the patient with the assessment of the current state of all organs and systems;
- conduct a series of laboratory and instrumental tests: complete blood count, urine test, biochemical test, including the study of blood sugar, indicators of the activity of the inflammatory process, the state of the blood coagulation system;
- perform ECG , X-ray examinations of the lungs and diseased joints;
- study history of allergy, reaction to bee stings in the past. If the reaction to the sting was pronounced, then such patients are contraindicated for bee sting treatment.
Patients who were stung in the past by a bee or wasp without any significant reaction still have to undergo biological tests before deciding to use bee sting therapy. When collecting allergic history, it is necessary to clarify the patient’s tolerance to other beekeeping products – honey, propolis, bee bread, royal jelly, pharmacological preparations containing bee products, as well as food products, cosmetic creams containing honey, propolis and royal jelly. In case of allergic reaction to other bee products, the decision to proceed with bee sting therapy should be based on the results of biological tests. An allergic history should also include information on the patient’s tolerance of medicines, vaccinations, tolerance to such foods as citrus fruits, strawberries, raspberries, eggs, milk, and cheese as well as the patient’s reaction to house dust, pollen allergens, home and field flowers, pets chemicals used in the household. In the presence of an allergy to the above listed factors, bee sting therapy is allowed after a biological test.
Patients with gallstone and urolithiasis, in the acute phase of rheumatism and rheumatoid, traumatic arthritis should be taken for bee sting therapy with a certain caution. The treatment may aggravate the disease.
Techniques of Bee Sting Therapy
It is most important to remember that the capture (handling) of the bee should not be traumatic (for the wing, for the leg, for the head). This is very annoying for the bee and causes panic among the surrounding bees.
The time the sting resides in the patient’s skin is regulated by the physician. It takes about 20-30 minutes to empty the bee venom bag. The pain, burning, redness and swelling in the next few minutes are a normal reaction to a sting.
The place of sting application should be washed with soap without any flavoring agents. If before the session the skin of a certain area appears to be contaminated, then it should be washed only with warm water and soap. Rubbing skin with alcohol is not recommended. After the treatment session, the patient should lie on the couch or sit in a chair for 20-30 minutes. The spot in the place of a sting can be smeared with Boric Vaseline or other neutral ointment, but it is better to give it the opportunity to simply dry out.
Before placing the bee, the doctor or nurse should feel the painful area, determine the area of greatest pain, massage it (harmonizing massage), and then apply the sting. Repeating sting in this place is recommended only in 2-4 days, provided there is no edema, redness and severe pain. Often this becomes possible only in 4-5 days.
Recommendations to a Patient Undergoing Bee Sting Therapy
The success of treatment, the prevention of possible adverse reactions and complications will largely depend on the strict following by the patient of all medical recommendations and some rules:
- before every treatment procedure, take a warm shower (no fragrant soap, lotions, perfumes, creams, ointments);
- during the entire course of treatment, do not overwork physically and psycho-emotionally, strictly observe the regime of rest and sleep;
- in nutrition, limit the consumption of carbohydrates, salt, meat products, spices; food should be dairy-vegetable, with a sufficient number of berries, fruits, vegetables;
- during the course of treatment, eat daily 50-100 g of honey, in 3 doses, 30 minutes before meals, preferably with apple juice or rose hip broth;
- immediately inform the doctor and nurse if you feel unwell after treatment procedure;
- after each treatment procedure, rest for 30-60 minutes, and go home only if you feel well;
- start a treatment procedure no earlier than 30 minutes after eating;
- procedure is not carried out if you are fasting, immediately after eating, after a sleepless night, after prolonged physical exertion;
- in the course of treatment after the fifth session and after the last one, take a blood and urine test;
- during the entire course of treatment with bee venom strictly avoid alcohol consumption, because alcohol destroys apitoxin and treatment will be ineffective;
- due to the risk of increased bleeding the treatment is not conducted during critical days of menstruation;
Apitherapist is obliged to teach the patient how to self-monitor their health and how to provide emergency care before first aid. With a significant deterioration of health (severe weakness, dizziness, extensive skin rash, difficulty breathing, swelling of the oral mucosa, larynx), the patient should go to bed and immediately call an ambulance and inform the ambulance doctor about the bee venom treatment.
Pharmaceutical Preparations Containing Bee Venom
There are several save (for bees) methods to collect and preserve bee venom. We might describe them in the future if the interest to learn more about collecting bee venom will be expressed by our audience.
Pharmaceutical manufacturing is using dried bee venom. It is processed using a special technology, and the most aggressive components that cause adverse reactions (allergy, intoxication) are removed from it. As a result, the majority of patients tolerate such bee venom much better than unprocessed bee venom. However, for individual patients, the likelihood of intolerance still exists. Therefore, when using preparations containing bee venom, it is necessary to observe the same precautions as for bee sting therapy:
- careful collection of allergological anamnesis from patients;
- carrying out a biological tests;
- close observation of the patient during the treatment process;
Other serious advantages of pharmacological drugs in comparison with bee sting is their exact dosage and that the patient does not have to fear the presence of bees.
Biological tests with pharmacological preparations for intracutaneous and subcutaneous delivery are carried out according to the same principles as for bee sting therapy. Symptoms of intolerance to the bee venom drug, the doctor’s tactics in their assessment and the provision of emergency care to the patient are no different from what is observed and followed during bee sting therapy. Before applying ointment or cream containing bee venom, it is also necessary to test for tolerability. To do this, take size of a pea portion of the investigated drug, apply it to the skin of the forearm and gently rub in for 1-2 minutes.
The use of bee venom in the form of ointment, cream (rubbing into the skin) is available to any patient in any conditions and has a predominantly local effect. It causes local irritation due to stimulation of peripheral nerve endings, has a direct vasodilator effect, improving the supply of oxygen to tissues, accelerating the breakdown of metabolic products that cause pain. Bee venom activates metabolic processes in the tissues in the area of its application to the skin, increases the elasticity of the connective tissue, and reduces muscle tone. The maximum effect is achieved if ointment is rubbed into the locations of acupuncture and trigger points (the technique was developed in 1987 by E.A. Ludyansky).
Most often, ointments containing bee venom are used for arthralgia, myalgia, neuralgia, as well as for warming up muscles and improving peripheral circulation before sport competitions.
Contraindications to use of ointments and creams with bee venom:
- hypersensitivity to bee venom, salicylates and isothiocyanates;
- acute arthritis;
- during pregnancy and lactation;
- diseases of the kidneys, liver, pancreas, cachexia, diabetes, infections (tuberculosis, sepsis) and diseases of blood systems in the phase of decompensation;
- children demonstrating hypersensitivity to bee venom;
When using any ointment containing bee venom, in addition to local or general allergic manifestations, possible general signs of intolerance in the form of indisposition, headache, pain in the joints, drowsiness. For such patients further treatment with bee venom in any form is contraindicated. Application of ointment and cream with bee venom to damaged skin causes severe burning and pain. Avoid applications to the scalp and face.
Before rubbing the ointment into the skin in the zone of pain, it is necessary to wash it with warm water and soap and make a hot compress. This will improve the penetration of the poison through the skin.
For the purpose of treatment, the ointment is slowly but intensively rubbed with the index or middle finger in the skin. In case of severe pain syndrome, rubbing is performed for 10-15 seconds. If pain is not severe, rub it in for 2-4 minutes until the skin dries out under the finger. Usually, in 2-5 minutes after the procedure, appear localized redness and a sensation of heat. The treated place must be wrapped with wool to retain the heat. The ointment is applied 2-3 times a day or only for the night. The course of treatment is 7-10 days; you can repeat it in 1-2 months. In severe pathology, the intradermal injection of poison can be combined with rubbing in ointment.
Bee venom can be injected into human tissue through the skin using iontophoresis (electrophoresis) and phonophoresis (ultrasound). This way has advantages since the procedure is painless, all components of the poison arrive slowly, and up to 90% of patients have a positive effect. For iontophoresis, you can use dried natural bee venom obtained from bees. Pads under electrodes are moistened with a solution of natural bee venom. When using phonophoresis, bee venom is administered as follows. Apply ointment on skin. Sound impact is carried out by circular movements of the sensor. In such procedures participate 2 factors – ultrasound and bee venom
After iontophoresis or phonophoresis at the site of bee venom contact might occur swelling, redness, a local increase in temperature, soreness, and itches. All these signs usually disappear in 2-4 hours, but can last up to 2-3 days. With increased sensitivity to poison possible general reaction in the form of urticaria, generalized itching of the skin, irritation of the mucous membranes (tickling, sneezing, runny nose). In these cases, the duration of the procedure should be reduced and prescribed desensitization therapy (dimedrol, tavegil), and in case of pronounced symptoms, the treatment should be stopped.
Pills with bee venom for sublingual use were proposed by J. Broadman in (NY, 1962). Today it is a well-known fact that in the patient’s stomach the bee venom is rapidly destroyed. With sublingual intake, it is absorbed by the oral mucosa, producing a healing effect. Unfortunately, this fact is not mentioned in modern publications on the use of venom.