Royal Jelly

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Royal Jelly

For Patients & Caregivers

How It Works

Evidence on royal jelly in humans is limited, with no clear evidence of benefit on markers of diabetes or risk factors for heart disease.

Royal jelly is a viscous substance secreted by worker bees that makes up the essential food for queen bees and their larvae. It is consumed as a health food around the world. Laboratory and animal studies suggest royal jelly may reduce blood pressure, cholesterol levels, and inflammation. However, studies in humans are quite limited and do not provide adequate evidence of benefit.

Because laboratory studies identified some estrogenic activity with royal jelly, it should not be used by patients with hormone-sensitive cancer.

Purported Uses
  • Cholesterol management
    Some research suggests benefit, but evidence is very limited. 
  • Diabetes
    A few small studies suggest it may improve some markers of type 2 diabetes, but a meta-analysis determined it does not improve glucose levels, and quality of evidence has been cited as low.
  • Menopausal symptoms
    In a small uncontrolled prospective study, royal jelly improved symptoms in postmenopausal women.
  • Mucositis
    In patients receiving radiotherapy and chemotherapy, royal jelly along with standard mouthwash therapy improved symptoms of oral mouth sores and healing time. Confirmatory studies are needed.
Do Not Take If
  • You have estrogen receptor-positive breast cancer: Laboratory studies showed that royal jelly can stimulate growth of cancer cells.
  • You are taking blood thinners such as warfarin: A case report suggests that royal jelly can enhance its effects and possibly increase bleeding.
Side Effects
  • Anecdotal weight gain, facial rash and gastrointestinal discomfort.
  • Several cases of allergic reaction, asthma, and bloody diarrhea.
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For Healthcare Professionals

Clinical Summary

Royal jelly is a viscous substance secreted by worker bees and constitutes the essential food for queen bees and their larvae. It is consumed as a health food around the world. In laboratory studies, it demonstrated vasodilatory, hypotensive, antihypercholesterolemic, anti-inflammatory, and estrogenic effects (1) (3) (9), although its affinity for estrogen receptors is weaker compared with diethylstilbestrol (3). Royal jelly appeared to increase cytotoxic activity of temozolomide (28), but has also shown both inhibitory (7) and proliferative (3) effects. Animal studies suggest royal jelly may be effective against colitis (10) (22) and improve testosterone levels (19).

Evidence on royal jelly in humans is limited. Small clinical studies suggest that it may lower total serum lipid and cholesterol levels in those with moderately elevated levels (5), and improve erythropoiesis and glucose tolerance in healthy subjects (20). Other small studies suggest that royal jelly may improve type 2 diabetes (23) (24) or cardiometabolic markers (33), but a meta-analysis determined that supplementation does not improve glucose levels (34), and quality of evidence has been cited as low (35).

A combination supplement that contained royal jelly appeared to benefit patients with mild cognitive impairment (27). Other studies suggest that royal jelly supplementation may improve premenstrual (26) and menopausal symptoms (6).

Only a few studies have been conducted in cancer patients. Royal jelly swished, then swallowed, along with standard mouthwash therapy improved symptoms of oral mucositis and healing time in patients receiving radiotherapy and chemotherapy (29). Another small study suggests benefit with topical royal jelly ointment in head and neck cancer patients (30).

Because royal jelly has estrogenic effects (3), women with estrogen receptor-positive breast cancer should avoid this product. Prostate cancer patients should also use caution as royal jelly increased testosterone levels in animal studies (19).

Purported Uses
  • High cholesterol 
  • Diabetes
  • Menopause
  • Mucositis
Mechanism of Action

In animal models, anti-inflammatory effects with royal jelly were likely mediated by CD3-, CD5-, CD8- and CD45-positive T-cell immune responses (22). Protective effects against taxol-induced testicular damage were attributed to improved antioxidant status and E2f1 transcription factor upregulation (31).

Various mechanisms for cholesterol-lowering effects have been posited (5). Royal jelly may decrease reabsorption of cholesterol in the GI tract and increase its excretion in the bile due to the presence of phytosterols, mainly B-sitosterol. Another explanation offered is that royal jelly suppresses hepatic cholesterol synthesis (8).

Effects against oxidative stress are attributed to antioxidant peptides (24). Improved glucose tolerance and erythropoiesis occur from accelerated conversion of DHEA-S to testosterone via activation of 3β-HSD2 and/or 17β-HSD3 (32). In type 2 diabetic women, royal jelly supplementation reduced hemoglobin A1c and fasting blood glucose levels, increased insulin concentrations, and decreased oxidative stress via improvement of malondialdehyde levels, erythrocyte superoxide dismutase, and glutathione peroxidase activities (23).

Compounds identified in royal jelly exhibit weak estrogenic activity, but also inhibit binding of estradiol to estrogen receptor beta (4).

Contraindications
  • Women with estrogen-receptor positive breast cancer should avoid products containing royal jelly as they may stimulate the cancer (3).
Adverse Reactions
  • Anecdotal weight gain, facial rash, and gastrointestinal discomfort (6).
  • Several cases of anaphylaxis (11) (12) (13), asthma (14) (15) (16), and hemorrhagic colitis (17).
Herb-Drug Interactions
  • Warfarin: In a case report of elevated INR and subsequent bleeding, royal jelly was the only identified source of warfarin’s enhanced effects (18).
  • Temozolomide: Laboratory studies suggest royal jelly may increase the cytotoxic effect of temozolomide (28). Clinical relevance has yet to be determined.
Herb Lab Interactions
  • Royal jelly lowered both total and LDL cholesterol levels in humans (5).
  • Royal jelly increased prothrombin time and fibrinolytic activity in rats (8).
Dosage (OneMSK Only)
References
  1. Suzuki KM, Isohama Y, Maruyama H, et al. Estrogenic activities of Fatty acids and a sterol isolated from royal jelly. Evid Based Complement Alternat Med. Sep 2008;5(3):295-302.

  2. Abdelhafiz AT, Muhamad JA. Midcycle pericoital intravaginal bee honey and royal jelly for male factor infertility. Int J Gynaecol Obstet. May 2008;101(2):146-149

  3. Mishima S, Suzuki KM, Isohama Y, et al.Royal jelly has estrogenic effects in vitro and in vivo. J Ethnopharmacol. Oct 3 2005;101(1-3):215-220.

  4. Guo H, Saiga A, Sato M, et al. Royal jelly supplementation improves lipoprotein metabolism in humans. J Nutr Sci Vitaminol (Tokyo). Aug 2007;53(4):345-348.

  5. Nakaya M, Onda H, Sasaki K, Yukiyoshi A, Tachibana H, Yamada K. Effect of royal jelly on bisphenol A-induced proliferation of human breast cancer cells. Biosci Biotechnol Biochem. Jan 2007;71(1):253-255.

  6. Moutsatsou P, Papoutsi Z, Kassi E, et al. Fatty acids derived from royal jelly are modulators of estrogen receptor functions. PLoS One. 2010 Dec 22;5(12):e15594.

  7. Takahama H, Shimazu T. Food-induced anaphylaxis caused by ingestion of royal jelly. J Dermatol. 2006 Jun;33(6):424-6.

  8. Testi S, Cecchi L, Severino M, et al. Severe anaphylaxis to royal jelly attributed to cefonicid. J Investig Allergol Clin Immunol. 2007;17(4):281.

  9. Katayama M, Aoki M, Kawana S. Case of anaphylaxis caused by ingestion of royal jelly. J Dermatol. 2008 Apr;35(4):222-4.

  10. Harwood M, Harding S, Beasley R, Frankish PD. Asthma following royal jelly. N Z Med J. 1996 Aug 23;109(1028):325.

  11. Bullock RJ, Rohan A, Straatmans JA. Fatal royal jelly-induced asthma. Med J Aust. 1994 Jan 3;160(1):44.

  12. Thien FC, Leung R, Plomley R, Weiner J, Czarny D. Royal jelly-induced asthma. Med J Aust. 1993 Nov 1;159(9):639.

  13. Yonei Y, Shibagaki K, Tsukada N, et al. Case report: haemorrhagic colitis associated with royal jelly intake. J Gastroenterol Hepatol. 1997 Jul;12(7):495-9.

  14. Lee NJ, Fermo JD. Warfarin and royal jelly interaction. Pharmacotherapy. 2006 Apr;26(4):583-6.

  15. Elnagar SA. Royal jelly counteracts bucks’ “summer infertility”. Anim Reprod Sci. 2010 Aug;121(1-2):174-80.

  16. Morita H, Ikeda T, Kajita K, et al. Effect of royal jelly ingestion for six months on healthy volunteers. Nutr J. 2012 Sep 21;11:77.

  17. Yang A, Zhou M, Zhang L, et al. Influence of royal jelly on the reproductive function of puberty male rats. Food Chem Toxicol. 2012 Jun;50(6):1834-40.

  18. Karaca T, Uz YH, Demirtas S, et al. Protective effect of royal jelly in 2,4,6 trinitrobenzene sulfonic acid-induced colitis in rats. Iran J Basic Med Sci. Apr 2015;18(4):370-379.

  19. Shidfar F, Jazayeri S, Mousavi SN, et al. Does Supplementation with Royal Jelly Improve Oxidative Stress and Insulin Resistance in Type 2 Diabetic Patients? Iran J Public Health. Jun 2015;44(6):797-803.

  20. Borawska MH, Markiewicz-Zukowska R, Naliwajko SK, et al. The interaction of bee products with temozolomide in human diffuse astrocytoma, glioblastoma multiforme and astroglia cell lines. Nutr Cancer. 2014;66(7):1247-1256.

  21. Erdem O, Gungormus Z. The effect of royal jelly on oral mucositis in patients undergoing radiotherapy and chemotherapy. Holist Nurs Pract. Jul-Aug 2014;28(4):242-246.

  22. Delkhoshe-Kasmaie F, Malekinejad H, Khoramjouy M, et al. Royal jelly protects from taxol-induced testicular damages via improvement of antioxidant status and up-regulation of E2f1. Syst Biol Reprod Med. Apr 2014;60(2):80-88.

  23. Morita H, Ikeda T, Kajita K, et al. Effect of royal jelly ingestion for six months on healthy volunteers. Nutr J. 2012;11:77.

  24. Mahboobi S, Jafarnejad S, Eftekhari MH. Royal jelly does not improve markers of glycemia: A systematic review and meta-analysis of Randomized Clinical Trials. Complement Ther Med. Jun 2019;44:235-241.

  25. Omer K, Gelkopf MJ, Newton G. Effectiveness of royal jelly supplementation in glycemic regulation: A systematic review. World J Diabetes. Feb 15 2019;10(2):96-113.

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