Royal Jelly

Purported Benefits, Side Effects & More

Royal Jelly

Purported Benefits, Side Effects & More
Royal Jelly

Common Names

  • Bee Saliva
  • Bee Spit
  • Honey Bee Milk
  • Royal Bee Jelly

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.

What is it?

Evidence on royal jelly in humans is limited, with no clear benefit for conditions like diabetes or 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. Preclinical 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 lab studies identified some estrogenic activity with royal jelly, it should not be used by patients with hormone-sensitive cancers.

What are the potential uses and benefits?
  • 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 is generally low.
  • Menopausal symptoms

    Preliminary data suggest royal jelly may help improve some symptoms.
  • 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.
What are the side effects?
  • Anecdotal weight gain, face rash, gastrointestinal discomfort.

Case reports

  • Allergic reactions
  • Asthma
  • Bloody diarrhea
What else do I need to know?

Do Not Take if:

  • You are allergic to bee products: Several cases of allergic reactions have been reported. For this reason, propolis should also be avoided.
  • You have estrogen receptor-positive breast cancer: Lab studies identified some estrogenic activity with royal jelly.
  • You are taking blood thinners such as warfarin: A case report suggests royal jelly may enhance medication effects and possibly increase bleeding.

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. Preclinical studies suggest 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 it may be helpful for colitis (10) (22) or to improve testosterone levels (19).

Studies in humans are limited. Some suggest improved total serum lipid and cholesterol levels in those with moderately elevated levels (5), and improved erythropoiesis and glucose tolerance in healthy subjects (20). Other data suggest it 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 is generally 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 (6) symptoms. It may also help preserve bone mineral density in postmenopausal women (36).

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 and Benefits
  • 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).

Major royal jelly protein 3 was identified as the main allergen that can induce anaphylaxis and cross-reactivity with honeycomb (37).

  • Women with estrogen-receptor positive breast cancer should avoid products containing royal jelly as these may stimulate the cancer (3).
  • Patients allergic to bee products should avoid royal jelly (37). For this reason, propolis should also be avoided.
Adverse Reactions
  • Anecdotal weight gain, facial rash, and gastrointestinal discomfort (6)

Case reports

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: Lab 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)
  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. Miyata T. Pharmacological basis of traditional medicines and health supplements as curatives. J Pharmacol Sci. Feb 2007;103(2):127-131.
  5. 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.
  6. Georgiev DB, Metka M, Huber JC, Goudev AR, Manassiev N. Effects of an herbal medication containing bee products on menopausal symptoms and cardiovascular risk markers: results of a pilot open-uncontrolled trial. MedGenMed. 2004;6(4):46.
  7. 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.
  8. Vittek J. Effect of royal jelly on serum lipids in experimental animals and humans with atherosclerosis. Experientia. Sep 29 1995;51(9-10):927-935.
  9. 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.
  10. Karaca T, Bayiroglu F, Yoruk M, et al. Effect of royal jelly on experimental colitis Induced by acetic acid and alteration of mast cell distribution in the colon of rats. Eur J Histochem. 2010 Oct 21;54(4):e35.
  11. Takahama H, Shimazu T. Food-induced anaphylaxis caused by ingestion of royal jelly. J Dermatol. 2006 Jun;33(6):424-6.
  12. 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.
  13. Katayama M, Aoki M, Kawana S. Case of anaphylaxis caused by ingestion of royal jelly. J Dermatol. 2008 Apr;35(4):222-4.
  14. Harwood M, Harding S, Beasley R, Frankish PD. Asthma following royal jelly. N Z Med J. 1996 Aug 23;109(1028):325.
  15. Bullock RJ, Rohan A, Straatmans JA. Fatal royal jelly-induced asthma. Med J Aust. 1994 Jan 3;160(1):44.
  16. Thien FC, Leung R, Plomley R, Weiner J, Czarny D. Royal jelly-induced asthma. Med J Aust. 1993 Nov 1;159(9):639.
  17. 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.
  18. Lee NJ, Fermo JD. Warfarin and royal jelly interaction. Pharmacotherapy. 2006 Apr;26(4):583-6.
  19. Elnagar SA. Royal jelly counteracts bucks’ “summer infertility”. Anim Reprod Sci. 2010 Aug;121(1-2):174-80.
  20. 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.
  21. 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.
  22. 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.
  23. Pourmoradian S, Mahdavi R, Mobasseri M, et al. Effects of royal jelly supplementation on glycemic control and oxidative stress factors in type 2 diabetic female: a randomized clinical trial. Chin J Integr Med. May 2014;20(5):347-352.
  24. 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.
  25. Siavash M, Shokri S, Haghighi S, et al. The efficacy of topical royal jelly on healing of diabetic foot ulcers: a double-blind placebo-controlled clinical trial. Int Wound J. Apr 2015;12(2):137-142.
  26. Taavoni S, Barkhordari F, Goushegir A, et al. Effect of Royal Jelly on premenstrual syndrome among Iranian medical sciences students: a randomized, triple-blind, placebo-controlled study. Complement Ther Med. Aug 2014;22(4):601-606.
  27. Yakoot M, Salem A, Helmy S. Effect of Memo(R), a natural formula combination, on Mini-Mental State Examination scores in patients with mild cognitive impairment. Clin Interv Aging. 2013;8:975-981.
  28. 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.
  29. 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.
  30. Yamauchi K, Kogashiwa Y, Moro Y, et al. The effect of topical application of royal jelly on chemoradiotherapy-induced mucositis in head and neck cancer: a preliminary study. Int J Otolaryngol. 2014;2014:974967.
  31. 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.
  32. Morita H, Ikeda T, Kajita K, et al. Effect of royal jelly ingestion for six months on healthy volunteers. Nutr J. 2012;11:77.
  33. Khoshpey B, Djazayeri S, Amiri F, et al. Effect of Royal Jelly Intake on Serum Glucose, Apolipoprotein A-I (ApoA-I), Apolipoprotein B (ApoB) and ApoB/ApoA-I Ratios in Patients with Type 2 Diabetes: A Randomized, Double-Blind Clinical Trial Study. Can J Diabetes. Aug 2016;40(4):324-328.
  34. 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.
  35. 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.
  36. Matsushita H, Shimizu S, Morita N, et al. Effects of royal jelly on bone metabolism in postmenopausal women: a randomized, controlled study. Climacteric. Apr 2021;24(2):164-170.
  37. Li JD, Cui L, Xu YY, et al. A Case of Anaphylaxis Caused by Major Royal Jelly Protein 3 of Royal Jelly and Its Cross-Reactivity with Honeycomb. J Asthma Allergy. 2021;14:1555-1557.
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