Live bee acupuncture therapy, touted as a way to promote “natural” healing and pain relief, is “unsafe and unadvisable,” according to researchers who studied the case of a 55-year-old Spanish woman who died of complications from severe anaphylaxis weeks after a treatment session.

Live bee acupuncture is typically performed by non-medical practitioners in private health and wellness centres. The head of a live bee is squeezed repeatedly with a metal instrument until its stinger protrudes. The sting is then applied to various skin sites. The bee dies after its venom is released into the patient.

The practice is perhaps the most extreme form of apitherapy, a branch of alternative medicine that uses substances from honeybees to relieve medical conditions. Other more sedate practices use honey, pollen or royal jelly.

Celebrity backers like Gwyneth Paltrow credit bee venom for making an old injury “disappear,” and Kate, the Duchess of Cambridge, is reported to be a fan of US$250 bee-venom facials.

“Death due to live bee acupuncture apitherapy” is the title of the case study published in the Journal of Investigational Allergology and Clinical Immunology. Its authors caution against using bee stings for medical purposes, and question the benefits of other bee-related treatments.

“Although some benefits of apitherapy have been reported, published evidence of its effectiveness and safety is limited, scarce and heterogeneous,” wrote Paula Vazquez-Revuelta and Ricardo Madrigal-Burgaleta of Spain’s Ramon y Cajal University Hospital.

They warn that bee venom can act as an allergen that causes a spectrum of allergic reactions ranging from “mild, local swelling, to severe systemic reactions, anaphylactic shock, or even death.”

Even “sensitized” individuals who have undergone multiple apitherapy treatments are not immune to these effects – as was the case with the 55-year-old Spanish woman who died, the authors point out.

Vazquez-Revuelta and Madrigal-Burgaleta said the woman had attended apitherapy sessions every four weeks for two years with “good tolerance.” They note that she did not have a clinical record of diseases such as asthma or heart disease, or other significant risk factors, when she experienced the reaction that eventually caused her death.

“During an apitherapy session, she developed wheezing, dyspnea, and sudden loss of consciousness immediately after a live bee sting,” the authors wrote. “An ambulance was called, although it took 30 minutes to arrive. The apitherapy clinic personnel administered methylprednisolone (a medication used to suppress the immune system and decrease inflammation). No adrenaline was available.”

Epinephrine autoinjectors, or EpiPens, that deliver an adrenaline solution are widely used to reverse severe anaphylaxis reactions brought on by bee stings or peanut allergies.

By the time the ambulance arrived, the Spanish woman’s blood pressure had dropped and her heart was pounding at a rapid pace of 110 beats per minute. A scan at the hospital revealed a stroke. She died weeks later of “multiogran failure.”

“To our knowledge, this is the first reported case of death by bee venom apitherapy due to complications of severe anaphylaxis in a confirmed sensitized patient who was previously tolerant,” the authors wrote.

Vazquez-Revuelta and Madrigal-Burgaleta suggest apitherapy practitioners take steps to ensure patients can be rapidly treated or rushed to an intensive care unit if they experience an adverse reaction, but ultimately conclude the risk is not worth any potential reward.

“These measures may not be possible,” they wrote. “Therefore, the risks of undergoing apitherapy may exceed the presumed benefits, leading us to conclude that this practice is both unsafe and unadvisable.”