Good Night Honey

Honey is that rare thing on our shelves that's a food first and a remedy second, so these are the questions our naturopaths ask when you're choosing a jar.

A good fit if

• You want something for a night-time cough in a child over one
• You'd rather use a food than a medicated syrup
• You're comparing Manuka, Jarrah or Leatherwood and want to know what makes them different
• You'll use it now and then rather than every day

Check with us first if

• You're managing diabetes or watching your blood sugar, because honey is still sugar.
• The cough has lasted more than a couple of weeks, or it comes with a fever.
• You're buying for a child under two, where any cough use needs medical advice first.
• You've had an allergic reaction to bee products, pollen or propolis before.
• You want to use honey on a wound rather than for a cough.

• Plain or blended table honey. Best known for: Cough and sore throat, and everyday eating. Absorption: Polyphenol and enzyme levels vary with the flowers it came from, and are not declared. Typical use: The simplest way to get the coating effect that helps a cough.
• Raw honey. Best known for: Keeping the pollen and enzymes that heating removes. Absorption: We could not verify a legal Australian definition of "raw", so the label is the producer's word. Typical use: It crystallises faster. That is a matter of preference rather than a proven difference.
• Manuka honey. Best known for: Measured non-peroxide activity, graded by MGO or UMF. Absorption: Its methylglyoxal does not fade the way hydrogen peroxide activity does. Typical use: When you want a number on the jar that you can compare.
• Jarrah and Marri honey (WA). Best known for: Peroxide-active honeys sold with a TA (total activity) number. Absorption: Works through hydrogen peroxide, the opposite way to Manuka. Typical use: An Australian alternative to Manuka.
• Medical-grade wound honey. Best known for: Sterile, standardised gels and dressings. Absorption: Regulated as a medical device, not as a food or listed medicine. Typical use: A clinical product. Item 2575 only allows honey in medicines taken by mouth.

Reference values. There's no Nutrient Reference Value for honey, because it's a food rather than a nutrient. In your diet it counts as added sugar.

Typical supplemental range. Most cough trials used a single dose in the evening. The Cochrane review in children pooled studies that gave honey once at night, and one Italian study used 10 ml of wildflower honey in 90 ml of milk on three evenings in a row.

Upper level. There isn't one. The limit that matters is sugar rather than toxicity, and one trial found 10 g a day had an unwanted effect on systolic blood pressure in people with existing metabolic concerns.

Worth knowing. The trials used single evening doses for a cough, not a daily routine. What you need depends on your age, diet and health, so talk to one of our naturopaths.

Food first, where the diet allows it.

• Honey itself: honey is the food; it's mostly fructose and glucose

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• Babies under 12 months. Australian labels must carry the warning (BABY2) "Not suitable for infants under the age of twelve months", because of the risk of infant botulism.
• Children under 2. Every allowed cough and upper respiratory infection (URTI) claim requires medical advice before use at this age.
• You have diabetes or metabolic concerns. Honey is sugar, and 10 g/day had a negative effect on systolic blood pressure in one trial.
• You are allergic to bee products, pollen or propolis. Pollen (item 3972) must carry a warning about severe allergic reactions.
• Children in general. Stomach and bowel side effects were more common on honey than placebo (RR 1.91, moderate certainty).
• Using honey on wounds. Listed medicines may only contain honey to be taken by mouth. Wound-care honeys are regulated as medical devices.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before you start.