Honey has been used as medicine for centuries – does it really work?

I am a honey fanatic. On sourdough bread with lots of butter, in smoothies or Asian stir fries, I can’t get enough. I justify my habit based on some vague recollection of hearing that it has some health benefits, but am I kidding myself?

Honey is often thought of as a healthier alternative to refined white sugar because it is less processed and doesn’t cause the same blood sugar spikes. It’s plant nectar, thickened by bees, and mostly comprises the simple sugars glucose and fructose, along with traces of lesser-known sugars like trehalose, kojibiose, nigerose, melibiose, gentiobiose and palatinose. But whether it’s “healthier” than other sugars depends on where the bees sourced their nectar.

One measure we can use to compare sugars and honey is the glycaemic index (GI), which gauges how quickly a food increases blood sugar. For refined white sugar, the GI is around 65, while honeys clock in all over the GI range. Honey made from the nectar of the Middle Eastern Sidr tree, for example, has a GI of just 32, but honey made from Greek thyme has a GI up at 85. (If you’re curious about your favourite variety, you can look up the GI values of different honeys on the University of Sydney’s enormous GI database.)

One reason for this variation is the different ratios of glucose and fructose. Glucose quickly raises blood sugar, whereas fructose does not, so this ratio affects GI. Refined sugar has a less variable GI because it always contains equal parts glucose and fructose that are packaged together as sucrose.

Another reason some honeys have low GI values is because they contain other components like phenolic acids and flavonoids that slow down the absorption of glucose in the gut. These components also have antioxidant properties, which are thought to make them mildly protective against cancer, heart disease and other conditions related to oxidative stress. However, you’re probably better off getting these antioxidants from fruits and vegetables, since those foods contain higher amounts while also being lower in sugar and calories.

Raw honey, the type you usually find at local markets, is considered healthier than mass-produced brands because it retains more phenolic acids and flavonoids. This is honey taken straight from the hive and simply strained into jars. Unlike raw milk, raw honey is considered pretty safe. The main risk is contamination with Clostridium botulinum bacteria, which produce botulinum toxin – a neurotoxin that paralyses muscles, which is why it is used in Botox treatments. The toxin is particularly dangerous for infants under the age of 1, which is why parents are advised not to give them honey (probably good to avoid Botox at that age as well).

Mass-produced honeys are pasteurised to kill microbes, which makes them safer and extends their shelf lives, but also destroys some beneficial antioxidants. Some commercial honey products have also been found to be adulterated with cheap sugar syrups. Others that advertise themselves as natural aphrodisiacs have even been found to contain tadalafil, the active ingredient in the erectile dysfunction drug Cialis.

A simple way to gauge the content of valuable phenolic acids and flavonoids in your honey is by its colour, with darker honeys generally containing higher amounts. I buy a beautiful deep brown raw honey from a home beekeeper who lives a few blocks away, and find it far tastier than supermarket honey, perhaps because it contains more of these flavoursome components. His bees make the honey from local Eucalyptus trees, which hopefully means it has a relatively low GI, based on testing of other Eucalyptus honeys.

I’ve heard that consuming local honey can be good for hay fever, but unfortunately this isn’t true. The thinking behind this myth is that honey contains traces of pollens that bees pick up from local plants, which might train the immune system to tolerate these pollens better. However, hay fever is caused by pollen from trees that aren’t visited by bees. These trees spread their pollen via the wind rather than by hitching on bees, which is how it ends up in your nose.

On the other hand, there is evidence that honey can slightly alleviate sore throats and coughs caused by viral or bacterial infections, perhaps owing to its comforting texture and natural antimicrobial properties. A review of all previous studies concluded that honey was better than nothing for reducing cough symptoms in children and about as effective as over-the-counter cough medicines. This will be obvious to anyone who has brewed up a lemon and ginger tea with a large spoonful of honey when feeling poorly.

Honey can also be beneficial in wound care. The most common type used in wound ointments and dressings is medical-grade manuka honey, which is approved in the UK, the US and Australia. This honey is made by bees in Australia and New Zealand from the nectar of manuka tea trees and is sterilised by gamma radiation to remove any harmful microorganisms. It contains high levels of an antimicrobial compound called methylglyoxal, which helps to prevent or treat wound infections.

Whatever you do, don’t eat honey made from the nectar of rhododendrons, particularly species native to Nepal and Turkey. This honey causes “mad honey disease”, characterised by confusion, drunken-like behaviour, dizziness and vomiting. It has even been used as a bioweapon. In 65 BC, for example, Mithridates VI Eupator, ruler of the kingdom of Pontus in Northern Anatolia, strategically left out honeycombs of mad honey to tempt enemy Roman troops, then slaughtered them as they lay around dazed and confused.

I think I’ll stick to my local stuff, which may not do anything for my hay fever, but at least won’t send me mad. I’m disappointed to learn that honey probably isn’t that much better for my health than straight sugar, but it does bring me great joy, and what’s sweeter than that.