28.1 The Mind Is a Powerful Thing

The physician should have some out-of-the box knowledge regardless of his/her opinion on alternative remedies. The goal of every physician is to help patients. To provide the best care, a physician should try to balance the knowledge acquired through study, the experience gained through clinical practice, and the evidence that has been evaluated in the literature to make the best possible treatment recommendations. There are still quite a few areas of clinical practice where physicians recommend or prescribe things that are off-label or don’t have a lot of thorough evidence behind them. There is also the desire among some patients to avoid pharmaceuticals, to try alternative remedies, or to use “natural” therapies. On one hand, this is very frustrating for a physician, especially when there are treatments to offer backed up by thorough medical evidence; on the other hand, the physician sometimes prescribe off-label treatments they “know” work, but don’t have solid proof supporting them.

The author struggles to keep this equilibrium in mind when approaching the patient who is resistant to using traditional therapy. However, being familiar with them can help discuss them with patients and gain their trust. If patients trust the physician, they may listen and the practitioner may have a shot at helping them, rather than letting them walk out of the door thinking they have visited just another “drug pusher.”

28.2 Honey/Local Honey/Raw Honey

Honey is the most attractive of all the alternative remedies, not just because it is heard the most, but because of its potential similarity to sublingual allergy treatments. The thought is that locally produced pollens are incorporated into honey and by consuming it regularly an oral tolerance to these allergens develops. However, the types of pollen that tend to cause allergic immunoglobulin E (IgE) sensitization tend to be airborne (anemophilous). The type of pollen collected by insects is entomophilous (insect-borne) pollen which is sticky, heavy, and not thought to cause IgE-mediated respiratory disease.

Honey has been shown to have some antibacterial, wound healing, and general anti-inflammatory effects. The evidence regarding the use of honey to treat allergic rhinitis is equivocal, demonstrating no clear benefit in humans. Reportedly, honey must be consumed daily at high doses to demonstrate health benefits. For European bee honey, the dose should be around 7 teaspoons (50 gm) to 11.5 teaspoons (80 gm).

28.3 Risks/Side Effects

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  Honey is generally considered safe.

  
  
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  Be cautious in diabetics/prediabetics due to increases in blood sugar.

  
  
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  Do not give to children under the age of 1 year because of risks of infantile botulism.

  
  
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  Mad Honey disease is a risk to humans and animals when consuming unprocessed honey from small batches due to grayanotoxins produced by rhododendrons, azaleas, and some other flowers. Symptoms of Mad Honey disease include dizziness, excessive sweating, nausea, vomiting, hypotension, palpitations, seizures, and rarely death.