Health Care Professional Information

Common Name

Bee propolis, propolis resin, propolis wax, bee glue, bee putty

Clinical Summary

Propolis is a resinous mixture of pollen and beewax collected by honeybees from the buds and exudates of certain trees and plants (1). It has been used in folk medicine and in food and beverages to improve health and to prevent disease. Propolis is thought to have antibacterial, antiviral, anti-inflammatory, antioxidant, immunostimulatory, antiproliferative, cardioprotective, and radioprotective properties (2) (3).
Clinical data show propolis to be an effective adjuvant treatment for asthma (4) and for the treatment of plane and common warts, possibly due to its immunomodulating and antiviral properties (5). A propolis/zinc suspension reduced the number of acute otitis media infections in children (6).
An in vitro study found propolis to have greater cytotoxic activity against human lung adenocarcinoma (A549) and human fibrosarcoma (HT-1080) cells compared to 5-fluorouracil (7). However, the anticancer effects of propolis have not been confirmed in humans.

Bee pollen, a constituent of propolis, is a mixture of plant pollens, nectar, and bee saliva that bees form into granules to store as food (8). It is claimed as a “cure all” by some and is touted for its antiaging and stamina increasing properties, antioxidant effects, and for chronic prostatitis, among other conditions. Aside from its nutritional value, clinical data show that bee pollen has limited benefits in improving athletic performance (9) (10).

The use of propolis and bee pollen is relatively benign. However, hypersensitivity reactions to each of these supplements have been reported. Patients who are allergic to bee venom (i.e., bee stings), honey, ragweed, or chrysanthemum should not take these products. A case study reported that bee pollen may elevate the international normalized ratio (INR) above the therapeutic range in patients taking warfarin (8).

Purported Uses
  • Cancer
  • Diabetes
  • Heart Disease
  • Infections
  • Inflammation
Constituents

The composition of propolis varies according to hive, region, season, and vegetation. The biological activity of propolis depends on the presence of more than 300 compounds, particularly flavonoids, phenolics, and esters (2).

Mechanism of Action

Many constituents of propolis have antitumor effects, including caffeic acid phenyl ester, quercetin, luteolin, galangin, and artepillin C (2). One of the flavonoids extracted from propolis showed a more potent cytotoxic activity against human lung adenocarcinoma (A549) and human fibrosarcoma (HT-1080) cells than did the anticancer drug 5-fluoruracil (7). Propolis was also found to inhibit proliferation and induce apoptosis in human leukemia (HL-60) cells through activation of caspase-3 via the mitochondrial pathway (2). Pretreatment of rats with orally-administered propolis extract also reduced the oxidative damage to heart mitochondria caused by an acute intraperitoneal dose of doxorubicin (3). Propolis demonstrated immunomodulatory effects in mice through increasing the expression of toll-like receptors and the production of the cytokines, IL-1beta and IL-6 (12).

Contraindications

Patients allergic to bee stings (bee venom), intolerance to honey, or allergic to ragweed/chrysanthemums should avoid products containing bee pollen, such as propolis (8).

Adverse Reactions

Reported: Hypersensitivity reaction causing pruritus, headache, swelling, sneezing, anaphylaxis, hypereosinophilia, and eosinophilic gastroenteritis consisting of nausea, abdominal pain, and diarrhea (13).
Acute hepatitis has been reported in two patients taking bee pollen (6).
Case Report: A 32-year-old woman suffered phototoxic reaction (itching, rash) after taking a dietary supplement containing ginseng, goldenseal and bee pollen (14).

Herb-Drug Interactions
  • Warfarin: A published case report described a probable interaction between warfarin and honeybee pollen, which caused an increase in the international normalized ratio (INR) (8).
Herb Lab Interactions

The bee pollen in propolis contains flavonoids that are known to inhibit cytochrome P450 (CYP) isoenzyme 2C9 in vitro. Because this isoenzyme is responsible for much of the hepatic metabolism of warfarin, its inhibition may elevate the International Normalized Ratio (INR) (8).

Literature Summary and Critique

Marchisio P, Esposito S, Bianchini S, et al. Effectiveness of a propolis and zinc solution in preventing acute otitis media in children with a history of recurrent acute otitis media. Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):567-75.
This randomized, single-blinded, prospective study enrolled 122 children (aged 1-5 years) with a history of recurrent acute otitis media (AOM). Respiratory-related morbidity and AOM were assessed at baseline and every 4 weeks. Environmental risk factors (smoke, pacifier use, full-time day care attendance) were eliminated for both the treatment and placebo groups. During the 3 month treatment period, AOM was diagnosed in 50.8% (n=31) of the patients receiving the propolis/zinc suspension (n=61), and 70.5% (n=43) of the children in the control group (n=61;p=0.04). The mean number of AOM episodes per child/per month was 0.23 + 0.26 for the propolis/zinc treatment group and 0.34 + 0.29 for the control group (p=0.03). No effect on any other types of respiratory infections was detected. Investigators concluded that the propolis/zinc suspension safely and significantly reduced the risk of new AOM episodes in children with a history of recurrent AOM.

Dosage (Inside MSKCC Only)
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References
  1. Ohta T, Kunimasa K, Kobayashi T, et al. Propolis suppresses tumor angiogenesis by inducing apoptosis in tube-forming cells. Biosci Biotechnol Biochem. 1998;72(9);2436-2440.
  2. Eom HS, Lee EJ, Yoon BS, et al. Propolis inhibits the proliferation of human leukaemia HL-60 cells by inducing apoptosis through the mitochondrial pathway.Nat Prod Res. 2010 Mar;24(4):375- 86.
  3. Alyane M, Kebsa LB, Boussenane HN, et al. Cardioprotective effects and mechanism of action of polyphenols extracted from propolis against doxorubicin toxicity. Pak J Pharm Sci. 2008 Jul;21(3):201-9. PMID: 18614413
  4. Khayyal MT, el-Ghazaly MA, el-Khatib AS, et al. A clinical pharmacological study of the potential beneficial effects of a propolis food product as an adjuvant in asthmatic patients. Fundam Clin Pharmacol. 2003 Feb;17(1):93-102. PMID: 12588635
  5. Zedan H, Hofny ER, Ismail SA. Propolis as an alternative treatment for cutaneous warts. Int J Dermatol. 2009 Nov;48(11):1246-9.
  6. Marchisio P, Esposito S, Bianchini S, et al. Effectiveness of a propolis and zinc solution in preventing acute otitis media in children with a history of recurrent acute otitis media.Int J Immunopathol Pharmacol. 2010 Apr-Jun;23(2):567-75.
  7. Li F, Awale S, Tezuka Y, Kadota S. Cytotoxicity of constituents from Mexican propolis against a panel of six different cancer cell lines. Nat Prod Commun. 2010 Oct;5(10):1601-6.
  8. Hurren KM, Lewis CL. Probable interaction between warfarin and bee pollen. Am J Health Syst Pharm. 2010 Dec 1;67(23):2034-7.
  9. Maughan RJ, Evans SP. Effects of pollen extract upon adolescent swimmers. Br J Sports Med. 1982 Sep;16(3):142-5.
  10. Steben RE, Boudreaux P. The effects of pollen and protein extracts on selected blood factors and performance of athletes. J Sports Med Phys Fitness. 1978;18:221-6.
  11. Mirkin G. Can bee pollen benefit health? JAMA 1989;262:1854.
  12. Orsatti CL, Missima F, Pagliarone AC, et al. Propolis immunomodulatory action in vivo on Toll-like receptors 2 and 4 expression and on pro-inflammatory cytokines production in mice. Phytother Res. 2010 Aug;24(8):1141-6.
  13. DerMarderosian A, editor. The Review of Natural Products. St. Louis: Facts and Comparisons; 1999.
  14. Palanisamy A, Haller C, Olson KR. Photosensitivity reaction in a woman using an herbal supplement containing ginseng, goldenseal, and bee pollen. J Toxicol Clin Toxicol. 2003;41(6):865-7.

Consumer Information

How It Works

Bottom Line: A few studies have investigated the efficacy of propolis in treating various conditions. However, further study is needed to determine whether propolis is an effective treatment for any of these conditions.

Propolis is a mixture of pollen, beewax, and resin that is collected by honeybees from the buds and sap of certain trees and plants. It has been used in folk medicine and in food and drinks to improve health and prevent disease. Propolis is thought to be effective against cancer, diabetes, heart disease, infections, and inflammation.

Bee pollen, found in propolis, is a mixture of plant pollens, nectar, and bee saliva that bees form into granules to store as food. It is claimed as a “cure all” by some and is thought to have antiaging and stamina increasing properties, as well as antioxidant effects. Bee pollen has been used to treat chronic inflammation of the prostate, as well as other conditions. However, aside from its nutritional value, clinical data show that the benefits of bee pollen are limited.

Allergic reactions to propolis and bee pollen have been reported. Therefore, patients who are allergic to bee venom (i.e., bee stings), honey, ragweed, or chrysanthemum should not take either of these supplements. Bee pollen may increase the side effect of warfarin, a blood thinning drug.

Purported Uses
  • Cancer
    Laboratory studies show that propolis has anticancer properties. Human data are lacking.
  • Diabetes
    There is no scientific evidence to support this use.
  • Heart Disease
    This claim is not backed by clinical data.
  • Infections
    A few studies show that propolis can be effective in treating ear infections.
  • Inflammation
    Laboratory studies show that propolis has immunomodulatory effects. Human studies are needed.
Do Not Take If
  • You are taking warfarin (propolis can increase the time required for blood coagulation).
Side Effects

Reported: Hypersensitivity reaction causing itching, headache, swelling, sneezing, allergic shock, elevated white blood cell levels, and inflammation of the stomach and intestines (causing nausea, abdominal pain, and diarrhea).
Case Report: A 32-year-old woman experienced a toxic reaction to sunlight (itching, rash) after taking a dietary supplement containing ginseng, goldenseal and bee pollen.

Special Point

Propolis is not a recommended treatment for ear infections. If an ear infection is suspected, a physician should be immediately consulted for advice regarding an appropriate treatment.

E-mail your questions and comments to aboutherbs@mskcc.org.