A 31-year-old Brighton woman who took capsules of the natural beehive product collapsed after an asthma attack and needed intensive care for what doctors described as life-threatening respiratory distress. Previously royal jelly - so-called because it is a food for queen bees produced by workers - had been linked to the death of an 11-year-old girl in Australia.
Five other cases of similar adverse reactions to royal jelly among asthmatics and people with allergies have also been reported. Now the medical toxicology unit at Guy's Hospital, formerly the National Poisons Unit, is asking doctors for notifications of any similar cases.
Virginia Murray, consultant toxicologist at the unit, which is investigating the safety of traditional remedies, says all packaging of royal jelly should carry health warnings to alert people at risk who are tempted by the suggestion that the jelly has youth-enhancing properties.
"I believe there should be warning labels, which would be a good way forward to try to minimise similar cases," Dr Murray said.
"They would warn that if you are allergic to beestings or bees, honey, or any other related products, you should think twice about taking royal jelly. These cases merit such a warning and manufacturers may now want to consider it.
"The reaction in the woman in Brighton was life-threatening. One of the problems is getting over messages that some traditional remedies can have side-effects.According to a report in the British Medical Journal by the doctors who treated her, the woman in the Brighton case was taken to the Royal Sussex County Hospital with severe respiratory distress 40 minutes after taking two royal jelly capsules.
Similar cases have been documented in Australia. One report recounted how five asthmatics had suffered adverse reactions. A 34-year-old woman stopped breathing and had to be ventilated.
The most serious case was that reported in Australia of an 11-year-old girl who died of what was diagnosed as an asthma attack. When she took a double dose of royal jelly she developed a wheeze and severe diarrhoea, started having bronchial spasms, and was taken to hospital.
She failed to respond to treatment "The death of the 11-year-old urgently re-emphasises the fact that royal jelly constitutes a major and life-threatening risk to patients with a known history of asthma or related allergies," said Alain Rohan, a drug reaction specialist, in a letter to the Medical Journal of Australia. "Natural substances such as royal jelly, in which the protein content is very high, appear to pose the greatest antigenic threat of all such compounds."
Sonal Ghelani, marketing manager for Regina, a leading supplier of royal jelly, said: "It comes as a surprise. It is a fresh, natural product with no side-effects, and does no harm to anyone. When someone takes royal jelly, they are not taking it in isolation. Capsules, for instance, can contain emulsifiers. People who take health supplements would know of their allergies."Reuse content