MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Bee venom acupuncture is a form of acupuncture in which bee venom is applied to the tips of acupuncture needles, stingers are extracted from bees, or bees are held with an instrument exposing the stinger, and applied to acupoints on the skin.

Bee venom consisting of multiple anti-inflammatory compounds such as melittin, adolapin, apamin. Other substances such as phospholipase A2 can be anti-inflammatory in low concentrations and pro-inflammatory in others. However, bee venom also contains proinflammatory substances, melittin, mast cell degranulation peptide 401, and histamine.

Bee venom acupuncture has been used to treat a number of conditions such as lumbar disc disease, osteoarthritis of the knee, rheumatoid arthritis, adhesive capsulitis, lateral epicondylitis, peripheral neuropathies, stroke and Parkinson’s Disease. The quality of these studies tends to be so poor that any verdict on the effectiveness of bee venom acupuncture would be premature.

A new clinical trial of bee-venom acupuncture for rheumatoid arthritis (RA) might change this situation. A total of 120 cases of RA patients were randomized into bee-sting acupuncture group (treatment) and western medicine group (control). The patients of the control group were treated by oral administration of Methotrexate (10 mg, once a week) and Celecoxlb (0.2 g, once a day). Those of the treatment group received 5 to 15 bee stings of Ashi-points or acupoints according to different conditions and corporeity, and with the bee-sting retained for about 5 min every time, once every other day. The treatment lasted for 8 weeks. The therapeutic effect was assessed by examining:

  • symptoms and signs of the affected joints as morning stiffness duration,
  • swollen/tender joint counts (indexes),
  • handgrip strength,
  • 15 m-walking time,
  • visual analogue scale (VAS),
  • Disease Activity Score including a 28-joint count (DAS 28),
  • rheumatoid factor (RF),
  • erythrocyte sedimentation rate (ESR),
  • C-reactive protein (CRP),
  • anti-cyclic citrullinated peptide antibody (ACCPA).

For assessing the safety of bee-venom acupuncture, the patients’ responses of fever, enlargement of lymph nodes, regional red and swollen, itching, blood and urine tests for routine were examined.

Findings of DAS 28 responses displayed that of the two 60 cases in the control and bee-venom acupuncture groups, 15 and 18 experienced marked improvement, 33 and 32 were effective, 12 and 10 ineffective, with the effective rates being 80% and 83. 33%, respectively. No significant difference was found between the two groups in the effective rate (P>0.05). After the treatment, both groups have witnessed a marked decrease in the levels of morning stiffness duration, arthralgia index, swollen joint count index, joint tenderness index, 15 m walking time, VAS, RF, ESR, CRP and ACCPA, and an obvious increase of handgrip strength relevant to their own levels of pre-treatment in each group (P<0.05). There were no significant differences between the two groups in the abovementioned indexes (P>0.05). The routine blood test, routine urine test, routine stool test, electrocardiogram result, the function of liver and kidney and other security index were within the normal range, without any significant adverse effects found after bee-stinging treatment.

The authors (from the Department of Acupuncture and Moxibustion, Bao’an Hospital of Traditional Chinese Medicine, Shenzhen, China) concluded that bee-venom acupuncture therapy for RA patients is safe and effective, worthy of popularization and application in clinical practice.

Where to start? There is so much – perhaps I just comment on the conclusion:

  • Safety cannot be assessed on the basis of such a small sample. Bee venom can cause anaphylaxis, and several deaths have been reported in patients who successfully received the therapy prior to the adverse event. Because there is no adverse-effect monitoring system, the incidence of adverse events is unknown. Stating that it is safe, is therefore a big mistake.
  • The trial was a non-superiority study. As such, it needs a much larger sample to be able to make claims about effectiveness.
  • From the above two points, it follows that popularization and application in clinical practice would be a stupid exercise.

So, what is left over from this seemingly rigorous RCT?

NOTHING!

(except perhaps a re-affirmation of my often-voiced fear that we must take TCM-studies from China with more than just one pinch of salt)

5 Responses to Bee venom acupuncture? No thanks!

  • A friend of mine suffers quite badly from arthritis. I think I will suggest that he take up bee keeping. The odd sting may help his arthritis and, in any case, I should get some honey.

  • I am not advocating the use of bee venom, but for the record I should point out that there are concerns with COX-2 inhibitors such as celecoxib that long-term use is associated with an increased risk of myocardial infarction, as well as most of the other risks associated with non-steroidal anti-inflammatory drugs (NSAIDs) including congestive cardiac failure and kidney damage; the main advantage of celecoxib is that it has a lower risk of gastrointestinal side-effects than other anti-inflammatories.

    Methotrexate, on the other hand, is a drug that needs to be used with particular care. Oncologists use quite high single doses, but rheumatologists tend to give low doses weekly, which results in a different toxicity profile (mainly liver fibrosis and bone marrow suppression).

    The point I am making here is that the treatment in the control arm is associated with a significant risk of serious toxicxity (though of course that risk is well-documented and quantified), as indeed are other treatments for rheumatoid disease such as gold, corticosteroids immunosuppressants etc.

    While most of the assessments mentioned would be sensitive to the placebo effect, the haematological and serological tests probably wouldn’t be, and if there really was an improvement comparable to that found with conventional treatment, then this is worth investigating further (this is not the same as adopting it as a treatment). RA is an unpleasant, progressive disease, and we don’t have and really good treatments for it.

    Having said that, it seems to me that, while it makes some sense to investigate been venom, and to try to establish what, if any, are the active components, combining it with acupuncture seems a daft approach. There are also, as you point out, the known issues with Chinese medical research publication.

    • I really appreciated your comment Dr Julian Money-Kyrle, on this very interesting subject. I am very familiar with bee venom therapy (though I did not know that Chinese medicine used it as well) as I took it for the first stage of my RA. I was treated by a wacky Anthroposophical rheumatologist in Germany. Unfortunately it was unsuccessful and I think even placebo effects have proven useless for my condition. I also did all the research on corticosteroids, NSAIDs and Methotrexate and opted out of them too. After 7 years I have a completely damaged knee and elbow and might even need surgery sometime soon. Now I don’t know whether or not I should have went on low dosage of Methotrexate and risk the side effects or just go a long and accept surgery and what ever else later down the track. Is my quality of life better without the drugs? This is not an easy question since I don’t like alternative medicine and mainstream medicine saved my life when I was an asthmatic kid.

  • News story from March 2018

    A woman has died after undergoing bee-sting therapy, a form of treatment backed by Gwyneth Paltrow.
    The 55-year-old Spanish woman had been having live bee acupuncture for two years when she developed a severe reaction.

    She died weeks later of multiple organ failure.

    Researchers who studied the case say live bee acupuncture therapy is “unsafe and unadvisable”.

    https://www.bbc.com/news/health-43513817

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

If you want to be able to edit your comment for five minutes after you first submit it, you will need to tick the box: “Save my name, email, and website in this browser for the next time I comment.”
Recent Comments

Note that comments can be edited for up to five minutes after they are first submitted but you must tick the box: “Save my name, email, and website in this browser for the next time I comment.”


Click here for a comprehensive list of recent comments.

Categories