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Oskaar
12-05-2007, 01:16 AM
Saving lives! LOL

http://www.medpagetoday.com/PrimaryCare/PreventiveCare/tb/7560

Cheers,

Oskaar

liff
12-05-2007, 08:41 AM
Retail pharmacist in my part time job here (nuclear pharmacist full-time). Three big points to look out for in this study.

1) The honey board or something like that paid for this study. That makes everything questionable. Just like the tobacco company paying for a study that shows smoking does not cause cancer. Does not mean the study is wrong, invalid, or biased; it just means the person paying for the study should not have any interest in the study.

2) Remember how the FDA just pulled cough and cold medicine for children under 6? The reason was that the medicines are not effective in children that young, and they are somewhat dangerous (all medicine is). That means 2 placebos were tested against honey.

3) Remember point number 1? Now re-read point number 2 and think about the timing of the release of the honey study.

There are too many things that just strike me as 'funny' about this study and the timing. Clearly I am paranoid, but that does not explain everything.

That said, it makes sense to me that pure honey would relieve short term cough symptoms, I just could not recommend this to parents based on this study alone.

My 2 cents in the quarter conversation....

Liff

Scadsobees
12-05-2007, 09:47 AM
Hey, why not? My kids like honey better than cough syrup, and I'd guess that honey is better for them and honey is cheaper...and if cough syrup doesn't work, then that sets the bar pretty low.

They did, however, leave out the secret ingredient....whiskey!!! honey whiskey and lemon juice, mix and warm. Of course you spend so much time gasping from the fumes that you forget all about your cough... :drunken_smilie:

Rick

ehanuise
12-05-2007, 11:13 AM
:icon_study: keep in mind that honey should not be fed to newborns and toddlers. There is a documented risk of Clostridium Botulinum, which is present but dormant in 10% of honey. Toddlers and babies under 1 year cannot effectively prcess/digest/fight this and have a risk of being infected.

http://en.wikipedia.org/wiki/Honey

Most microorganisms do not grow in honey because of its low water activity of 0.6[3]. However, it is important to note that honey frequently contains dormant endospores of the bacteria Clostridium botulinum, which can be dangerous to infants as the endospores can transform into toxin-producing bacteria in the infant's immature intestinal tract, leading to illness and even death[4] (See "Precautions" below).

...

Precautions

Due to the natural presence of botulinum endospores in honey, children under one year of age should not be given honey. The more developed digestive systems of older children and adults generally destroy the spores. Infants, however, can contract botulism from honey.[36]

wayneb
12-05-2007, 12:11 PM
Hey, why not? My kids like honey better than cough syrup, and I'd guess that honey is better for them and honey is cheaper...and if cough syrup doesn't work, then that sets the bar pretty low.

They did, however, leave out the secret ingredient....whiskey!!! honey whiskey and lemon juice, mix and warm. Of course you spend so much time gasping from the fumes that you forget all about your cough... :drunken_smilie:

Rick


ABSOLUTELY, the H-W-L remedy was a staple at our house when I was growing up. Much cheaper than the commercial cough remedies, and much more effective. I'd have done the same for my kids, but my wife (the RN) warned me about the latent botulism threat, so we didn't. Now that the kids are well beyond the age when the infection could be a problem, they don't get coughs! Go figure... :P

David Baldwin
12-05-2007, 07:28 PM
My personal favorite variation on this theme is Honey, Lemon, and Spiced Rum.

We've had good success with it for our son who has asthma. It works well, and doesn't give him the jitters like the albuterol does.

Medsen Fey
12-05-2007, 08:19 PM
I made a batch of "Rocket Fuel" that tasted just like Mom's H-W-L, I wonder if it will work for cough. :sad4:

wayneb
12-06-2007, 12:53 AM
Give it a try and let us know! :laughing7:

Or, you could always throw in a handful of medicinal herbs, and make a true elixir out of it! Good fer what ails ye! ;D

BeeFolks
12-10-2007, 09:20 PM
liff - get a copy of the study. It is published in the Archives of Pedatric Adolescent Medicine. You can get a copy of it from your local university.

1. Patients were recruited between 9/2005 and 3/2006 upon presentation at a single university affiliated pediatric clinic for an acute care visit. Patients were aged 2-18 years. They exluded several subjects, such as if they were exhibiting asthma-like symptoms, had a history of asthma, were on medications that interfered with the metabolism of dextromethorphan (DM), if they had taken DM the night before, etc. (translation - they had to meet strict standards to even be in the study, and most of the patients that were initially considered were not accepted for one reason or another). 105 patients completed the study.

2. The DM was prepared in house, 17mg/5mL prepared using DM hydrobromide powder (100% pure USP grade), artificial honey flavoring, coloring, stevia liquid extract, methocel, and simple syrup. The study specifically states that the DM was prepared to look and taste as close as possible to Buckwheat Honey.

3. The study was double-blind (translation - the syringes with the DM/honey were coded such that neither the administrators nor the participants knew what they were receiving).

4. The article states: This work was supported by an unrestricted research grant from the National Honey Board, an industry-funded agency of the USDA.

5. This research group performed an earlier study that proved that DM was ineffective as a cough medication. I do not believe that study was financed by the honey board....

BeeFolks
12-10-2007, 09:22 PM
ehanuise - Do you have a citation for that 10% figure? I have never seen a study that tested more than one jar of honey for botulism, but I would love to see it if you know of one.

liff
12-11-2007, 09:07 AM
Hi BeeFolks,

Sometimes I come across as arugementative. Please don't take anything I type that way.

[Edit]Basically I want to do two things, 1) disagree and 2) not offend.



liff - get a copy of the study. It is published in the Archives of Pedatric Adolescent Medicine. You can get a copy of it from your local university.

I have a copy, and this is a bad study, and that is the whole problem.



1. Patients were recruited between 9/2005 and 3/2006 upon presentation at a single university affiliated pediatric clinic for an acute care visit. Patients were aged 2-18 years. They exluded several subjects, such as if they were exhibiting asthma-like symptoms, had a history of asthma, were on medications that interfered with the metabolism of dextromethorphan (DM), if they had taken DM the night before, etc. (translation - they had to meet strict standards to even be in the study, and most of the patients that were initially considered were not accepted for one reason or another). 105 patients completed the study.

The problem is that the patients were aged between 2 and 18. Children do not have adult organs/organ systems, which is one of the reasons for the lack of efficacy of the OTC cough and cold medicines. 2 to 18 is such a huge tremendous gap that this one point makes this study damned near worthless. Something that I know is hard to internet search for is, Why do you think the children with asthma were excluded? I'll tell you with reference if you can't find it.

105 patients completed the study? Thats it? Well, that one point makes this study .... 105 people is not enough to complete a real medical study. In 'landmark' studies there is a minimum of 6000 people, 3000 in each group. 105 is nothing.



2. The DM was prepared in house, 17mg/5mL prepared using DM hydrobromide powder (100% pure USP grade), artificial honey flavoring, coloring, stevia liquid extract, methocel, and simple syrup. The study specifically states that the DM was prepared to look and taste as close as possible to Buckwheat Honey.


The DM was prepared in house!?!?!?! What?!?! Well, that one point makes this study .... This is just wrong. They should have purchased this from an outside source to show that there was no hint of an allegation of tampering with the competing therapies. For me, this is one point (of many) that really, truely hurt the credibility of this study.



3. The study was double-blind (translation - the syringes with the DM/honey were coded such that neither the administrators nor the participants knew what they were receiving).


Actually, the study was double blind, placebo controlled. It would have been nice for a crossover, double blind, placebo controlled, but this is what we got. Thanks for the translation, very nice. :icon_thumleft:



4. The article states: This work was supported by an unrestricted research grant from the National Honey Board, an industry-funded agency of the USDA.

That is always a bad thing. The tobacco thing again.


Anyways, please remember in the first post I wrote,



There are too many things that just strike me as 'funny' about this study and the timing. Clearly I am paranoid, but that does not explain everything.

That said, it makes sense to me that pure honey would relieve short term cough symptoms, I just could not recommend this to parents based on this study alone.

My 2 cents in the quarter conversation....

Liff

"That said, it makes sense to me that pure honey would relieve short term cough symptoms, I just could not recommend this to parents based on this study alone." I stand by that statement.


I started another topic that lists some very good medical uses of honey, supported by some very good studies that didn't make the news. I believe that natural solutions are best and that all medicine is dangerous. Please remember that no where did I imply that the results of the study are wrong, only the study is wrong/flawed. I would love to see a study that was paid for by the right people and done in a more scientific manner.

I appriciate your thoughts on this topic and your points. Thank you very much. I don't get the chance to debate the value of drug studies as much as when I was in school. Hopefully I offended no one, if I did, I am sorry as it was not my intention.

Liff

liff
12-11-2007, 09:30 AM
Very quickly to the point, I could not find any good honey to botulism spore count study, however I did find studies which lend support to the 'about 10% or less or more' figure, depending on where you get your honey.

This article (http://www.hc-sc.gc.ca/iyh-vsv/diseases-maladies/botu_e.html) says less than 5%.

Infant Botulism (http://www.aafp.org/afp/20020401/1388.html) This article says up to 25%.

How Common Is Botulism in Honey?
California researchers have isolated botulism bacteria spores from about 10 percent of store-bought honey samples. (http://diseases.emedtv.com/infant-botulism/botulism-in-honey.html)

177 honey samples (http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&uid=9411489&cmd=showdetailview&indexed=google) and only 1.1% positive.

Microorganisms in honey (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T7K-3W2T595-1&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9b59fb10cc667cb788278a913d844d2c)

Most of the articles say something to the effect of the warmer the climate, the more Botulism spores there are. So any specific figure is wrong, except to the batches that were tested for that study, as this seems to vary widely.

I don't think anyone will question that the spores are in honey, just how many spores and how much honey is affected are the questions that I have no good answer to, and it looks like the answer is, "it depends on your source of honey".

Liff

ehanuise
12-11-2007, 10:35 AM
Indeed.
I did not keep the reference, I googled several websites before posting my reply, read that 10% figure one one of them, and then eventually only posted the wikipedia link, which seemed the most on-topic.
Sorry I can't provide the reference, if I ever find it back i'll make sure to do so;

this being said, YMMV, as you just replied.

wayneb
12-11-2007, 12:27 PM
liff,

It is a pleasure to read a properly critical review of the structure of this study! As you noted, the conditions of the study were not configured to allow any definitive conclusions to be drawn from it. However, also as you noted, that does not mean the conclusions were wrong -- merely that they cannot be defended by any data derived from this study, as its scope was too limited and the process was not sufficiently neutral-biased.

In fact the results of this small effort are intriguing enough to suggest that more research, with better parametric controls and undertaken with a larger population in each of the target age groups, should be done.

liff
12-11-2007, 06:31 PM
Wayne,

One of the problems I have is a distinct inability to write well. Your 2 paragraphs are a great summation of my thoughts. I have tried, but I continually fail to write that smoothly and concisely.

Thank you,

Liff

BeeFolks
06-23-2008, 01:16 AM
Hey, liff, if you are still reading this, sorry to take so long to respond. Been busy in my own way these last six months, but that is a story for another entire book!




Sometimes I come across as arugementative. Please don't take anything I type that way.

[Edit]Basically I want to do two things, 1) disagree and 2) not offend.

No problem. I play Devil's Advocate all the time. More fun that way. BTW - my background (prior to beekeeper) is as a biochemist for phase 2&3 pharmaceutical clinical trials for nearly two years, then 10 years as a drug analyst in the crime lab. Became tired of the government politics which included, among other things, negative reactions by management to my suggestions that we tighten up some of our testing procedures. So, I dropped out of lab life and decided to expand the beekeeping business. Besides which, this way I can better help my stroke-survivor husband with his recovery, and spend more time with our 2.5 year old daughter....



The problem is that the patients were aged between 2 and 18. Children do not have adult organs/organ systems, which is one of the reasons for the lack of efficacy of the OTC cough and cold medicines. 2 to 18 is such a huge tremendous gap that this one point makes this study damned near worthless. Something that I know is hard to internet search for is, Why do you think the children with asthma were excluded? I'll tell you with reference if you can't find it.

105 patients completed the study? Thats it? Well, that one point makes this study .... 105 people is not enough to complete a real medical study. In 'landmark' studies there is a minimum of 6000 people, 3000 in each group. 105 is nothing.

It is not unusual to see a study involving a hundred, or a few hundred, individuals. When you get down to funding, the amount of patients seen in a clinic, the timeframe involved, etc., it is not unusual at all. What typically happens is these smaller studies publish the results of their findings, other interested groups see if they can replicate (or disprove) the data, and maybe enough interest is generated to obtain funding for a landmark study. Shoot, I'm currently pregnant with triplets, and some of the "studies" I have been looking at regarding the complications I've been having revolve around *maybe* 30 patients per clinic over a decade, and oftentimes less. Are they the perfect study? Not even close. But, they are limited by funding, # of patients, etc.



The DM was prepared in house!?!?!?! What?!?! Well, that one point makes this study .... This is just wrong. They should have purchased this from an outside source to show that there was no hint of an allegation of tampering with the competing therapies. For me, this is one point (of many) that really, truely hurt the credibility of this study.

Of course the DM was prepared in house. They weren't synthesizing the DM, simply compounding it. Do you know any cough syrup that looks or tastes like Buckwheat Honey? There is no commercial source for something like that. If you don't want the patient to know they are taking DM or placebo, you would HAVE to make it inhouse. All you are looking at here is a concentration of DM/volume. I have been on the chemistry side of drug trials - any allegations would be quickly resolved by the notebook of the preparing chemists. If a study book was not kept - then I would be much more skeptical. But I'm not driven enough to call and ask for a copy of their raw notes. I'll wait for the next small clinic to produce a similar study.





4. The article states: This work was supported by an unrestricted research grant from the National Honey Board, an industry-funded agency of the USDA.

That is always a bad thing. The tobacco thing again.

I'm not sure I would compare honey to tobacco. First of all, if memory serves, the tobacco industry created their own labs. Second of all, in independent labs, they used their own statisticians to get the results they wanted. You know, nobody ever died of lung cancer, they died because their heart stopped. ;)

Well, let's go that route for a moment - ever look at the "gotmilk" campaign? Who do you think funds those studies? I think there is a conspiracy to get us to drink more milk than our bodies truly require. After all, when we were hunters/gatherers, do you think we paused to milk a yak? :laughing7:

But on a more serious note - even I would say that funding on this study may look hokey. But, funding has to come from somewhere, and it is only ethical to announce where the funding is coming from, especially in a situation like this. Besides which, Penn had already performed other, non-honey-related studies that suggested that DXM was no better than a placebo in kids. This is just another study in the same progression.



That said, it makes sense to me that pure honey would relieve short term cough symptoms, I just could not recommend this to parents based on this study alone.

I mostly agree with you there. I would not recommend honey to alleviate symptoms of, say, mild pneumonia, bronchitis, or asthma. (Not only is asthma a different triggering mechanism from a common cold, but DXM is known to produce allergic reactions in asthmatic patients - that is, it can trigger an asthma attack.) Still, I personally think the study was well-designed, within the scope for which it was intended.

The following statement is about another study, but makes what is probably the best point. I would infer that if DXM does limited good in kids, and if honey is more soothing to the throat, then why couldn't Buckwheat Honey be more effective than DXM?

Dr Harvey Marcovitch, a spokesman for the Royal College of Paediatrics and Child Health, said: "For children with their usual tickly coughs that they get all the time there really isn't much evidence that they (OTC DXM cough medicines) do any more good than any sort of warm drink." http://news.bbc.co.uk/1/hi/health/3869379.stm


With regards to the other topic on this thread - I would argue with the source of botulin in honey. I have read that the spores can come from several plant sources, including many raw vegetables and corn syrup. When an infant comes down with botulism, the leftover food is tested, and if the honey has been used as dip for veggies (which has been mentioned in some of the cases I have read about), then the source is tainted. Plus, considering how much of the honey on the supermarket comes from countries known for cutting their honey with corn syrup.... I have a strong belief that botulin isn't really brought in by bees from dusty fields like some studies suggest, but that it is coming from an outside source of contamination. But I have no proof of this. I *will* scour the articles you posted, though - they have references in them that I have not seen before. I'd love to see something on this topic that I think is a "good study" (or, at least addresses the variables I question!).

TheAlchemist
05-14-2011, 03:56 PM
Saving lives! LOL

http://www.medpagetoday.com/PrimaryCare/PreventiveCare/tb/7560

Cheers,

Oskaar

Or maybe a few sips of Buckwheat Pancakes...