Just because I am a doctor does not mean I’m immune to anecdotal pressures. A friend told me she hasn’t been sick since she started taking a spoonful of Manuka honey daily. I decided to try it and– guess what? I have not been sick since I started taking it, despite my husband and all three of my kids having multiple colds these past few months.
So is it the Manuka honey or did I just get lucky these past six months? I reviewed the science and was surprised to find limited human studies on Manuka.
But First, What is Manuka Honey?
Honey has long been known for its antimicrobial and anti-inflammatory properties. King Tut was found with honey thousands of years old, naturally preserved. Found only in New Zealand and Australia, Manuka, a single-flower honey, is believed to have additional properties due to the methylglyoxal (MGO), a compound found in other honeys but uniquely potent in Manuka. Manuka honeys are priced based on their MGO concentration, ranging roughly from 50+ to 1450+, or their Unique Manuka Factor (UMF) grade, which incorporates MGO potency along with other chemical markers of purity and freshness. UMF grades commonly range from 5+ to 28+, with higher UMF corresponding to higher MGO. It is not uncommon for an 8 oz jar to cost $50.
Proponents of Manuka claim several benefits, including immune and gut support. I found some intriguing in vitro (think petri dish) studies but not too much in the way of human data. Here is what I found:
Honey and Wound Care
This is where the science on Manuka best holds up. Medical-grade honey, including Manuka, has been used in burns and wound care and can reduce dressing-change frequency and pain, which matters because dressing changes of burns and wounds are quite uncomfortable. Manuka’s anti-inflammatory and antimicrobial properties may be helping here, and animal and human data suggest modulation of inflammatory cytokines and activity against antibiotic-resistant bacteria.
Manuka Honey and Antimicrobial Properties
This is what I was excited about. Is eating Manuka yummy and helping me fight infections? While I did not come across any robust studies on humans showing fewer common infections from ingesting Manuka, there are fascinating in vitro data demonstrating activity against multi-drug resistant bacteria and recalcitrant culprits like C. difficile. Similarly, Manuka can inhibit a range of bacteria and some viruses in vitro, though these effects are not always strictly tied to the UMF or MGO rating, making me wonder about the value of very high scores.
Gut Health and GERD
There was one small, human study showing no difference in gut bacteria composition in participants before and after daily consumption of Manuka. The study concluded it was safe to eat UMF 20+ Manuka daily, but the authors did not find a significant difference in the gut bacteria they measured. Now, it is possible that prebiotics in Manuka honey, or the non-digestable sugars in any honey, affect the microbiome; however, this was not measured in the study.
However, there was one interesting pilot study demonstrating improved gastroesophageal reflux (GERD) symptoms and histopathology (what the tissue looked like under the microscope) in adults taking Manuka honey for four weeks compared with placebo.
In Summary, When it Comes to Human Studies and the Benefits of Manuka:
- Topically, Manuka honey is helpful in wound healing, likely because of its antimicrobial and anti-inflammatory properties. However, Manuka honey is not the only honey used in wound healing.
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- One pilot study on GERD seems promising, but it is a small study warranting further investigation.
- Sadly, I did not find any studies on humans showing improved immunity, fewer viral infections, change in gut bacteria, or other measured health benefits from consuming Manuka.
So Will I Continue to Eat Manuka?
Since my personal immune streak this cold and flu season is exceeding expectations, I will continue to use a half teaspoon of Manuka to sweeten my coffee. Even if placebo (and not the honey) is making my immune system stronger, it may be fueled by the act of ingesting Manuka.
I am hopeful more human studies on Manuka will emerge. Please send me any you come across.
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References:
Nolan, Victoria C et al. “Clinical Significance of Manuka and Medical-Grade Honey for Antibiotic-Resistant Infections: A Systematic Review.” Antibiotics (Basel, Switzerland) vol. 9,11 766. 31 Oct. 2020, doi:10.3390/antibiotics9110766
Grabek-Lejko, Dorota et al. “The comparison of the antioxidant, antibacterial and antiviral potential of Polish fir honeydew and Manuka honeys.” Scientific reports vol. 14,1 31170. 28 Dec. 2024, doi:10.1038/s41598-024-82429-0
Cooper, R A et al. “Absence of bacterial resistance to medical-grade manuka honey.” European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology vol. 29,10 (2010): 1237-41. doi:10.1007/s10096-010-0992-1
Hammond, Eric N, and Eric S Donkor. “Antibacterial effect of Manuka honey on Clostridium difficile.” BMC research notes vol. 6 188. 7 May. 2013, doi:10.1186/1756-0500-6-188
Wallace, Alison et al. “Demonstrating the safety of manuka honey UMF 20+in a human clinical trial with healthy individuals.” The British journal of nutrition vol. 103,7 (2010): 1023-8. doi:10.1017/S0007114509992777
Schell, Kathleen R et al. “The Potential of Honey as a Prebiotic Food to Re-engineer the Gut Microbiome Toward a Healthy State.” Frontiers in nutrition vol. 9 957932. 28 Jul. 2022, doi:10.3389/fnut.2022.957932
Gośliński, Michał et al. “Application of Manuka honey in treatment patients with GERD.” Food science & nutrition vol. 12,1 172-179. 12 Oct. 2023, doi:10.1002/fsn3.3748
