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JOURNAL OF MEDICINAL FOOD

Volume 6, Number 2, 2003


Mary Ann Liebert, Inc.

Short Communication
Effects of Daily Consumption of Honey Solution on
Hematological Indices and Blood Levels of Minerals and
Enzymes in Normal Individuals
NOORI S. AL-WAILI, M.D., Ph.D.

ABSTRACT
Seven men and three women (mean age, 31.2 years; range, 2045 years) received a strictly controlled regular diet during a 2-week control period, followed by the regular diet supplemented
with daily consumption of 1.2 g/kg body weight honey dissolved in 250 ml of water during
a 2-week test period. At the end of each period, overnight fasting blood samples were withdrawn for assays of blood glucose, blood minerals, vitamin C, b-carotene, uric acid, glutathione reductase, immunoglobulin E, hemoglobin, blood indices and cells, serum ferritin,
serum iron, and iron-binding capacity. Results showed that honey increased antioxidant
agents. It increased blood vitamin C concentration by 47%, b-carotene by 3%, uric acid by
12%, and glutathione reductase by 7%. Honey increased serum iron by 20% and decreased
plasma ferritin by 11%. It increased the percentage of monocytes by 50%, and increased lymphocyte and eosinophil percentages slightly. Honey reduced serum immunoglobulin E by
34% and increased serum copper by 33%. It decreased aspartate transaminase by 22% and alanine transaminase by 18%. Honey markedly reduced lactic acid dehydrogenase by 41%, decreased creatinine kinase by 33%, and reduced fasting blood sugar by 5%. It caused slight elevations in blood zinc and magnesium, hemoglobin, and packed cell volume. It may be
concluded that honey increased antioxidant agents, serum iron and blood indices, and trace
elements and decreased immunoglobulin E, liver and muscle enzymes, and fasting blood
sugar in healthy subjects.
SHORT COMMUNICATION

oldest known medicines. It was valued highly in the Middle


East. Honey was mentioned in the Holy Quran
1400 years ago. The use of honey as medicine
eventually came to exist only in folk medicine
but now has been reborn into modern medicine.
ONEY IS ONE OF THE

Honey has been used for the treatment of respiratory diseases, urinary diseases, gastrointestinal diseases, skin ulcers, wounds, eczema,
psoriasis, and dandruff.13 It has been reported
that honey has an inhibitory effect against aerobic and anaerobic bacteria, yeast, fungi, and
viruses.49 We found that honey could enhance
antibody production against thymus-dependent and thymus-independent antigens.10

Dubai Specialized Medical Center and Medical Research Laboratories, Islamic Establishment for Education, Dubai,
United Arab Emirates.

135

136

Topical honey application caused faster


eradication of bacterial infections, reduced antibiotic use and hospital stay, accelerated
wound healing, and resulted in minimal scar
formation.11 In addition, we used honey to treat
seborrheic dermatitis and dandruff.8 For
chronic diseases of skin such as eczema, psoriasis, urticaria, and pityriasis rosa, we used a
mixture of honey, olive oil, and beeswax. The
honey mixture accelerated healing of skin lesions and caused all signs and symptoms to
subside.2 The mechanism of action of honey is
not definitely known, although acidity, osmolality, and hydrogen peroxide production have
been proposed as important factors.12
In addition to antimicrobial activities, honey
has other important therapeutic and biological
effects. It was found to stimulate insulin secretion and decrease blood glucose levels.13,14
Honey improved lipid profile, lowered normal
and elevated C-reactive protein, and deceased
triglycerides in patients with hypertriglyceremia.15 In animal experimentation, absolute
feeding with honey for 2 weeks caused marked
elevation in serum iron and hemoglobin that
was associated with a reduction in white blood
cells.16 Recently, we found that honey increased nitric oxide in saliva taken from normal individuals.17 In addition, various honeys
contained different amounts of nitric oxide
metabolites, and intravenous honey increased
urinary nitrite excretion in the animals.18 There
have been no previous reports regarding the effects of honey on hematological indices, blood
trace elements, and enzymes in humans. Therefore, it was decided to study the effects of oral
honey solution on these parameters in normal
individuals.
The study included seven men and three
women (mean age, 31.2 years; range, 2045
years). The criteria for inclusion were as follows: normal healthy volunteer, no signs or
symptoms of any diseases. The subjects participated in a 4-week trial to study the effects of
honey on hematological and biochemical tests.
The volunteers were our medical staff, including doctors, nurses, and laboratory technicians.
They gave their written consent to participate
in the study after being informed of the purpose and steps of the trial. The subjects received
a strictly controlled regular diet during first 2

AL-WAILI

weeks (control period). This regular diet was


supplemented with daily consumption of 1.2
g/kg body weight of honey dissolved in 250 ml
of water during the next 2 weeks (test period).
The subjects were instructed not to take any
medications or natural supplements during the
period of study.
Natural unprocessed honey, dark yellow in
color and of multifloral origin, was used for experimentation. Honey was collected from
Lootah Farm, Al-Theed City, United Arab Emirates. Biochemical tests showed that honey
composition included fructose, 38 g%; glucose,
30 g%; acidity, 13%; moisture, 20%; vitamin C,
2.3 mg%; copper, 0.098 mg%; zinc, 0.6 mg%; vitamin E, 0.74 mg%; vitamin A, 0.49 mg%; selenium, 0.44 mg%; chromium, 0.007 mg%; iron,
0.2 mg%; cobalt, 0.016 mg%; calcium, 17 mg%;
and glutathione reductase, 0.52 mg%.
At the end of each period, after overnight
fasting, blood samples were withdrawn at 8:00
AM from the participants to assay blood glucose, blood minerals, vitamin C, b-carotene,
uric acid, glutathione reductase, immunoglobulin E, hematological indices and cells, serum
ferritin, serum iron, and iron-binding capacity.
The tests were performed by routine methods.
All of the values were expressed as the
mean 6 SD. Students t test was used for statistical analyses; a probability value of P , .05
was considered significant.
Table 1 demonstrates changes in the blood
hematological indices, blood minerals and enzymes, and antioxidant agents obtained after
use of honey. The results showed that 2 weeks
of honey consumption increased the concentrations of antioxidants in the blood. It increased the blood vitamin C concentration by
47%, b-carotene by 3%, uric acid by 12%, and
glutathione reductase by 7%. Honey increased
serum iron by 20% and slightly increased the
hemoglobin, red blood cell count, and packed
cell volume. Ferritin level was reduced by 11%.
A 50% increase in monocytes was obtained, associated with slight elevations in the percentages of lymphocytes and eosinophils. Serum
immunoglobulin E was reduced by 34% after
use of honey. A 33% increase in the serum copper level was obtained, with slight elevation in
magnesium and zinc blood levels. Liver enzymes were decreased after use of honey; the

137

EFFECTS OF HONEY ON BLOOD LABORATORY VALUES


TABLE 1.

BLOOD INDICES , MINERALS ,

Blood variables
Zinc (mg/dl)
Copper (mg/dl)
Calcium (mg/dl)
Phosphorus (mg/dl)
Magnesium (mg/dl)
Creatinine kinase
AST (IU/L)
ALT (IU/L)
Alkaline phosphatase (IU/L)
Lactic acid dehydrogenase
(IU/L)
Amylase (U/L)
Vitamin C (mg/dl)
B-Carotene (mg/dl)
Ferritin (ng/ml)
Iron (mg/dl)
Iron binding capacity (mg/dl)
Red blood cells (million/ml)
Packed cell volume (%)
White blood cell (k/ml)
Neutrophils (%)
Lymphocytes (%)
Eosinophils (%)
Monocytes (%)
Hemoglobin (g/dl)
Immunoglobulin E (IU/L)
Platelet count (k/ml)
Uric acid (mg/dl)
Fasting blood sugar (mg/dl)
Glutathione reductase (mg/dl)

AND

ENZYMES

AT

Control period
(regular diet)

END

OF

CONTROL

AND

TEST PERIODS (MEAN 6 SD)

Test period (regular


diet with honey)

P Value

96.7
85.4
10
3.9
2.02
55.3
17.8
27.1
125
169.7

6
6
6
6
6
6
6
6
6
6

12.1
13.3
0.244
0.8
0.244
27.3
6.73
17
49.13
37

98.4
113.4
9.7
3.48
2.12
37
13.9
22.9
119.7
100

6
6
6
6
6
6
6
6
6
6

13.2
28.7
0.24
0.27
0.215
27
8.27
19.48
41.3
50.14

0.7685
0.006
0.0065
0.1343
0.1066
0.02
0.0046
0.1223
0.8308
0.0005

40
0.821
44.2
81.96
80.63
290
4.975
43.2
7.17
58
35.63
3
2
13.03
128.5
217.7
4.525
100
48.1

6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6

14.42
0.496
6.64
22.77
8.1
27.7
0.654
3.03
1.263
7.665
8.417
1.871
1.225
0.62
122
52
0.972
6.46
4.01

40.2
1.209
45.38
72.63
95.88
285.8
5.022
44
7.133
57.3
36
3.77
3
13.13
85
219.5
5.063
95.8
51.4

6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6

18.3
0.769
15.47
28.41
13.08
16.16
0.79
6.48
1.01
5.244
4.598
0.66
1.732
1.06
90.78
42.7
1.13
6.25
3.43

0.9661
0.1558
0.837
0.1561
0.0187
0.5964
0.8261
0.7312
0.8403
0.7762
0.8452
0.1739
0.2462
0.6671
0.0453
0.9201
0.322
0.0725
0.0109

level of glutamic oxaloacetic transaminase


(now aspartate aminotransferase [AST]) was
decreased by 22%, and glutamate pyruvate
transaminase (now alanine aminotransferase
[ALT]) by 18%. Marked reduction (41%) was
obtained in the serum concentration of lactic
acid dehydrogenase. Fasting blood sugar was
reduced by 5%.
The results of this pilot study showed that
honey can affect the levels of many blood elements in normal subjects. Greater effect might
be obtained using honey for longer periods (.2
weeks). Honey increased the levels of antioxidants in the blood, as well as those of some
other important nutrient elements. This effect
might be attributed to the composition of
honey, which contains many nutrient elements
and antioxidants. Honey decreased fasting
blood glucose levels. This is a result of the ability of honey to stimulate insulin production
and secretion from the panaceas, which we
demonstrated in an earlier observation. 13,14

Honey increased the serum iron concentration, possibly as a result of its iron content.
However, honey might increase iron absorption and iron utilization too. This could explain
the elevation in red blood cells and in hemoglobin content after 2 weeks, although the elevation obtained was slight. Moreover, it has
been demonstrated that prostaglandins reduce
serum iron, and oral honey inhibits prostaglandin synthesis.1921 Hence, inhibition of
prostaglandin may be a means for the elevation of serum iron obtained after honey consumption.
Honey reduced serum ferritin despite the elevation of serum iron. Therefore, honey probably increased the availability of iron to be used
for red blood cell production. Ferritin is an
iron-storing protein that is made in the liver,
spleen, and bone marrow; in tumor cells; and
at sites of inflammation. Cancer, liver diseases,
and blood transfusion increase the ferritin
level. Ferritin was found to be deleterious to

138

neutrophil phagocytosis and to lymphocyte


functions.22 Elevated ferritin in rheumatic diseases reflects disease activity.23 Increased ferritin may be a risk factor in primary hepatocellular carcinomas.24 The importance of
reduction of serum ferritin by honey needs further examination.
Honey reduced markedly the serum immunoglobulin E concentration in normal subjects. Immunoglobulin E is useful in serological
assays performed in the diagnosis of allergy.25
The ability to reduce serum immunoglobulin E
makes honey an excellent candidate for use in
testing protocols for allergic diseases. In addition, we have found that topical application of
honey reduces itching and inflammatory signs
and symptoms in urticaria, psoriasis, seborrheic
dermatitis, and fungal skin lesions.2,8,9 Monocytes and eosinophils are important leukocytes,
and both were increased by honey consumption. It is known that eosinophils are participants in allergic diseases. They work as antigenpresenting cells and can stimulate lymphocyte
activity.26,27
Honey accelerates wound healing, as measured by the thickness of granulation tissue, epithelization from the periphery of the wound,
and the size of the open wound.28 Honey accelerated wound healing and diminished scar
formation in infected surgical wounds.11 Vitamin C is important for synthesis of granulation
tissue and for wound healing.29,30 Honey contains vitamin C, and drinking honey for 2
weeks increased the serum vitamin C level.
This could explain the capability of honey to
accelerate wound healing when applied on infected wounds. The plasma ascorbic acid concentration is reduced in patients who are receiving antibiotics,31 so honey could be used as
a supplementary natural product when antibiotics are used. Vitamin C is an antioxidant
agent, and therefore use of honey may help
support the antioxidant profile of the human
body.
Uric acid is an endogenous antioxidant and
an inhibitor of peroxynitrite-related chemical
reactions.32 Patients with low serum uric acid,
such as those with multiple sclerosis,33 have
cells and tissues that are less protected against
oxidative agents. Patients consuming vegetables showed high concentrations of vitamin C

AL-WAILI

and uric acid, associated with less inflammatory changes in gastric mucosa.34 Honey increased the uric acid level, which was maintained within normal limits. Interestingly,
honey increased both vitamin C and uric acid,
an effect that would augment the antioxidant
capability of the body.
Copper is a trace mineral that the human
body needs for normal health and growth.
There is growing evidence concerning the roles
of copper and zinc in immunity.35 Copper deficiency leads to anemia, skeletal defects, degeneration of the nervous system, pronounced
cardiovascular lesions, elevated cholesterol,
impaired immunity, and defects in pigmentation of the hair. It also interacts with vitamin C
in the formation of collagen. Many enzymes,
including superoxide dismutase and catalase,
have been found to contain copper. Honey contains copper, and honey consumption markedly
increased subjects serum copper concentration. In addition, honey increased the serum
zinc level, although the increment was slight
after 2 weeks. Zinc protects against ultraviolet
radiation, enhances wound healing, decreases
risks of cancer and cardiovascular diseases, and
contributes to immune functions. It has an antioxidant role and is present in antioxidant enzymes such as superoxide dismutase.36 Pronounced and greater elevation in the serum
zinc concentration might be obtained with
longer consumption of honey.
Lactic acid dehydrogenase is an enzyme that
is found in many tissues and is used as an aid
in the diagnosis of liver diseases, heart attacks,
and anemia. It is elevated in muscle damage
and excessive destruction of cells. Creatine
kinase is an enzyme that catalyzes the phosphorylation of creatine to creatine phosphate.
It is present in skeletal muscles, cardiac muscles, brain, thyroid, lung, and intestine. AST is
found in the liver, muscles, and red blood cells.
It is increased in liver diseases, muscle damage,
and hemolysis. ALT is found in the liver and
is elevated in liver damage; it is involved in alanine metabolism. Concentrations of these enzymes and of alkaline phosphatase were
reduced by oral honey consumption. Marked
and significant reductions in serum levels of
lactic acid dehydrogenase, glutamic oxaloacetic
transaminase, and creatine kinase were ob-

EFFECTS OF HONEY ON BLOOD LABORATORY VALUES

tained. The clinical and pathological significance of these effects need further investigation.
From these results, it seems that honey could
increase the levels of essential elements and antioxidants in normal individuals. These findings may shed light on the mechanisms of action of honey in wound healing, immunity, and
health and could expand its use during pathological conditions.

12.
13.

14.

15.

16.

ACKNOWLEDGMENTS
The support of Haj Saeed Lootah, Chairman
of Islamic Establishment for Education and
Dubai College of Medicine, is greatly appreciated. Dr. Nader Boni, Dr. M. Akmal, and Miss
Faisa S. Al-Waili, Department of Medical Laboratories, Dubai Specialized Medical Center,
provided assistance.

17.
18.

19.

20.

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Address reprint requests to:


Noori S. Al-Waili
Professor and Director
Dubai Specialized Medical Center
Dubai, P. O. Box 19099
United Arab Emirates
E-mail: noori786@yahoo.com