Royal jelly is perhaps more than any other dietary supplement one of controversy. With a brief history of use and scant biochemical studies it appears to be an unlikely contender in the supplement scene. Yet, its popularity remains high and anecdotal reports of energy enhancement abound. However, recently, a novel mechanism of liver support has emerged that supports at least some of its traditional uses. In this article I will outline some of this emerging research on this supplement based on recent product development work I conducted for a specialized bee product company.

Traditional Use
Apitherapy is becoming increasingly popular in China and there are more and more institutes that use bee products in their pharmaceutical regimen (such as Xi'an of Shanxi, Lianyungang of Zhenjiang and Nanjing of Jiangsu). Arthritis is treated by bee stings, which have also been used recently for muscular dystrophy in the US. Other bee products used for medicine include honey, propolis, and royal jelly and is very popular among "intellectuals" (professors, researchers, etc). Royal Jelly was highly valued by Chinese monarchs as a way to increase longevity and sexual power. Royal jelly has been used in Traditional Chinese Medicine for 70-80 years. It is used for conditions such as rheumatoid arthritis, hypertension, diabetes, chronic hepatitis, duodenal ulcer, menstrual problems, uterine bleeding and infertility, fatigue, weakness, poor nutrition, leucopenia, and cancer therapy support. Shen Nong's Herbal Classic (100-200 BC) explains that bee products "treat evil influence, supplement the insufficiency in the five visceras, help qi and mend the heart."

They also relieve pain and detoxify, "get rid of a hundred diseases," can be "mixed with hundreds of medicines," and "strengthen the will and tighten the body, make people young and prolong life." The herbal compendium Materia Medica by Li Shishen written during the Ming Dynasty states that bee products "are sweet and mild, so that they can detoxify; soft so that they can soften and moisten; slow for taking it easy." As a result they are considered good for "relieving heart pain, stomach pain, sore muscles, and ulcers" and "can bring peace to the heart and can add harmony to hundreds of medicines."

In the Materia Medica royal jelly is considered a tonic for yin deficiency (and general deficiencies) like ginseng, fo-ti, dang qui, astragalus, common jujube and lycium fruit. Royal jelly is combined with these and other herbs. In Traditional Chinese Medicine energy or Qi is thought to flow from or be regulated by the liver, which is significant biologically given the recent research on royal jelly's regenerative effects on the liver described below. Case studies from Japan document its traditional and popular use and effectiveness for fatigue (Inoue 1986). Japanese office workers consume royal jelly in genki drinks, which are energizing tonics. In addition, royal jelly has been used in Eastern European countries as an adaptogen (broadly defined as an agent that increases strength, endurance and resistance to stress). (Wagner et al. 1984)

Other Insect Medicines
Other insects and insect products are widely used in traditional medicine. In Chinese medicine there were 21 insects used in medicine according to the Shennong Pharmacopoeia (100-200AD) which has since been enlarged to include 73 insects in Compendium Materia Media published in 1578. Chinese galls (Wubeizi) are used for sores and are produced by an aphid on Chinese sumac (Chou Io, 1990). One of the most pricey insect medicines is Dong Chong Tsia Tsiao (winter caterpillar summer grass) which is a caterpillar fungus that consists of larvae of Hepialus armoricanus infected with a entomopathogenic fungus Cordyceps sinensis that costs $700 a kilo in China wholesale! (Steinkraus and Whitefield, 1994). These are now being artificially cultivated.

Legend has it that this fungus has effects like ginseng and also restores impotence, shortness of breath, lung dysfunction and pain. The egg cases of praying mantis and blister beetles as well as cicada exuvia (molts) from trees (which cure scrofula and ulcers) are hot commodities as well. Silkworm frass treats diarrhea and cockroaches stop bleeding and heal bone fractures and swelling. One village of extremely long lived people who live beyond age 90 like to fry copious amounts of ants which they credit to their longevity. The main herbal medicine for hepatitis B (Mayi Yigan Ning) contains ants and works in 60% of cases which is twice as effective as interferon. You can also find many wines and tonics made with ants.

Origin and Production
Royal jelly is a white substance secreted by the pharyngeal glands of worker honeybees (family Apidae) for the queen bee who survives upon it her whole life. The queen's life-span is many times as long as worker bees, up to several years, and she develops to twice the size of worker bees and drones. In contrast, worker bees and drones do not consume royal jelly and live much shorter lives. Worker and queen are genetically identical which suggests the difference in their lifespan and other developmental factors is completely dietary and owed to the royal jelly.

Depending on environmental factors such as season, geography and climate, the composition of royal jelly can vary somewhat but usually consists of roughly 15% protein, 15% sugars, 6% fats, with the rest being water (60%) and some minerals, vitamins, and free amino acids. (FAQ data 1996) Fresh royal jelly (non-freeze dried) appears to be the most biologically active form (Salama 1977). One marker compound, 57 kDa protein, is especially sensitive to heat thus it is essential that royal jelly not be heated at any time in order to preserve its activity.

Laboratory/Clinical Evidence
One of the most important aspects of royal jelly's health benefits is its effects on the liver. Royal jelly appears to stimulate growth (Kato et al., 1988, Watanabe et al. 1998) particularly among liver cells (Kamakura et al. 2001). In particular a protein called 57 kDa appears to be responsible for this effect. Since the liver needs to regenerate constantly to replace cells that have been damaged by toxins, this helps to optimize liver function for detoxification and energy production, supporting traditional use in Traditional Chinese Medicine. It also seems to support glycogen restoration and decrease accumulation of waste products such as lactate and ammonia which cause fatigue (Kamakura et al. 2001). In addition it increases oxygen use and oxidative phosphorylation in the liver (Vittek 1995) as well as oxygen uptake in the brain (Uzbekova 1968). High 002 levels and low 02 levels cause weakness and fatigue (Vittek 1995). The queen uses more oxygen than worker bees which explains the need for this effect (Rembold 1965). Royal jelly appears to increase muscle power, vital capacity, respiratory function and energy levels (Bertuglia 1970). It improves appetite and strength and increases body weight in cases of malnutrition, underweight, depression, and anorexia (Fossati 1972). Some evidence documents feelings of mental wellbeing in older people who use royal jelly (Iannuzzi 1990).

Royal jelly works to increase feelings of wellbeing in patients with tuberculosis (Borgia 1984) and helps the cardiovascular system due to its vaso-dilative (Shinoda et al., 1978) and hypo-tensive effects (Townsend et al. 1961; Tamura et al., 1987). Royal jelly may also lower cholesterol and general blood lipids (Kaczor et al., 1962; Makarova, 1969; Vittek, 1995). Other research suggests it causes feelings of "eurphoria," wellbeing, increased strength and appetite in patients with heart conditions (Cho 1977). Due to all these effects it may help prevent atherosclerosis (Vittek 1995) The way royal jelly works to lower cholesterol is by binding with it in the GI tract due to the presence of phytosterols such as Bsisterol (Makarove 1969, Madar et al. 1965, Shinoda et al. 1978).

Royal jelly is also able to support optimal blood sugar levels by assisting in the oxidation of glucose in body fats for energy due to an insulin effect since insulin like peptides, are found in royal jelly (Kramer 1977, Kramer 1982). Furthermore, bee insulin is very similar to mammalian insulin (O'Connor 1985). High levels of magnesium in royal jelly may also reduce oxygen consumption and blood lactate (as shown in swimmers) and may also work to increase feelings of energy in patients with Chronic Fatigue Syndrome (Campbell et al. 1991).

Royal jelly contains a variety of B vitamins and one of them --pantothenic acid -- stimulates the adrenal glands and increases production of adrenal hormones. The pantothenic acid content (B5) of royal jelly is the highest of any known source (FAO data 1996). In humans, pantothenic acid is converted to coenzyme A which helps the body metabolize fats and carbohydrates. Again, we see convincing biochemical support of its use for energy in TCM. Royal jelly also contains testosterone which may help increase strength (Vittek et al. 1982).

Royal jelly works to prevent injury to tissues, control inflammation and reduce the bacterial load on the body -- all of which assist in maintaining energy. It works to decrease inflammation and increase wound healing (Fujii et al. 1990) due to the presence of an antibacterial peptide called royalisin (Fujiwara et al., 1990). It also prevents microbial growth due to the presence of a fatty acid called 10HDA (Blum 1959) and stimulates antibody production (Sver et al. 1987). By supporting proper immune function it prevents allergic reactions and histamine release (Oka et al. 2001) and increases levels of nitric oxide which reduces inflammation and improves cardiovascular function. Finally, its ability to inhibit capillary permeability explains its anti-inflammatory and tissue-healing ability (Fujii et al. 1990).

Conclusion
As can be seen from the above analysis, royal jelly is far from a "snake oil" supplement as many contend and contains a diversity of rich, bio-active compounds that we are only now beginning to understand at a chemical level. Biochemical research is supporting its recent history of traditional use. In general, bee products are emerging as important contenders in the natural products arena due their wide variety of health benefits, prevalence, traditional use, and appealing aesthetic properties as medicinal foods.