Original Article

The effect of thyme honey on anemia in hemodialysis patients


Background & Aim: Anemia is one of the most common complications of chronic renal failure, which is associated with increased fatigue, dyspnea, depression, malaise, prolonged hospitalization and mortality. Some patients are resistant to erythropoietin therapy. Therefore, the purpose of this study was to determine the effect of thyme honey on anemia in hemodialysis patients.
Methods & Materials: The present clinical trial was conducted in 2018 at Kowsar Hospital of Semnan on hemodialysis patients randomly selected with convenience sampling method within two groups of case (n=28) and control (n=27). The case group received thyme honey (33 g) daily for one month. The control group did not consume thyme honey. Blood samples were taken from the patients before and after the intervention with 10-hour fasting and then blood parameters were assessed.
Results: The mean ±SD reduction rate in hemoglobin level was 0.46±0.96 in the case group and 0.23±3.15 g/dl in the control group, but no significant difference using independent t-test (P=0.758). The mean±SD reduction rate in hematocrit percentages was 1.20±2.78 in the case group and 0.11±8.53 in the control group, but there is no significant difference between the two groups using independent t-test (P=0.590).
Conclusion: Results showed that daily administration of 33 grams of thyme honey had no effect on anemia in hemodialysis patients. Further studies are recommended with modification of the methodology regarding the type, dose, duration and instructions of honey consumption for better results.

1. Nugent RA, Fathima SF, Feigl AB, Chyung D. The burden of chronic kidney disease on developing nations: a 21st century challenge in global health. Nephron Clinical Practice. 2011;118(3):c269-77.
2. Levey AS, De Jong PE, Coresh J, Nahas ME, Astor BC, Matsushita K, et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report. Kidney international. 2011;80(1):17-28
3. Asghari MR, Soleimani M. Intensive care in ICU,CCU and Dialysis Wards. 31th ed. Tehran, Boshra, 2018: 548-50.
4. Fresenius Medical Care.annual report 2018-Fresenius, available at: URL: http://www.fersenius.com/media/FME-Annual-repoert-2018.PDF.Accessed August 13,2019 .
5. Iran Dialysis Consortium. A comprehensive report on the status of patients with renal failure in the world and Iran. Iran: Iran Dialysis Consortium; 2017.
6. Stauffer ME, Fan T. Prevalence of anemia in chronic kidney disease in the United States. PloS one. 2014 Jan 2;9(1):1-4.
7. Kutuby F, Wang S, Desai C, Lerma EV. Anemia of chronic kidney disease. Disease-a-month: DM. 2015 Oct;61(10):421.
8. van der Weerd NC, Grooteman MP, Blankestijn PJ, Mazairac AH, van den Dorpel MA, den Hoedt CH, Nubé MJ, Penne EL, van der Tweel I, ter Wee PM, Bots ML. Poor compliance with guidelines on anemia treatment in a cohort of chronic hemodialysis patients. Blood purification. 2012;34(1):19-27.
9. Babitt JL, Lin HY. Mechanisms of anemia in CKD. Journal of the American Society of Nephrology. 2012 Oct 1;23(10):1631-4.
10. Rivera RF, Alibrandi MT, Di Lullo L, Floccari F, De Pascalis A, Bellassi A, Ronco C. The cardiorenal anemia syndrome. Part one: epidemiology and clinical aspects. Giornale di Tecniche Nefrologiche e Dialitiche. 2017 Jul;29(3):196-202.
11. Singh AK. What is causing the mortality in treating the anemia of chronic kidney disease: erythropoietin dose or hemoglobin level?. Current opinion in nephrology and hypertension. 2010 Sep 1;19(5):420-4.
12. Locatelli F, Bárány P, Covic A, De Francisco A, Locatelli F, Bárány P, Covic A, De Francisco A, Del Vecchio L, Goldsmith D, Hörl W, London G, Vanholder R, Van Biesen W. Kidney Disease: Improving Global Outcomes guidelines on anaemia management in chronic kidney disease: A European Renal Best Practice position statement. Nephrology Dialysis Transplantation. 2013 Jun 1;28(6).
13. Bissinger R, Bhuyan AA, Qadri SM, Lang F. Oxidative stress, eryptosis and anemia: a pivotal mechanistic nexus in systemic diseases. The FEBS journal. 2019 Mar 1;286(5):826-54.
14. Erejuwa OO, Sulaiman SA, Ab Wahab MS. Honey: a novel antioxidant. Molecules. 2012 Apr;17(4):4400-23.
15. Ajibola A. Novel insights into the health importance of natural honey. The Malaysian journal of medical sciences: MJMS. 2015 Sep;22(5):7.
16. Ahmed S, Sulaiman SA, Ibrahim M, Rasul A, Yasir M, Waqas AA, Afzaal M, Ahmed MZ, Hayati N. Effect of Daily Supplementation of Malaysian Jungle Tualang Honey and Australian/New Zealand Manuka honey on Hematological and Some Biochemical Variables in Female Rats. Annals of Life Sciences. 2018;2(5):10-22.
17. Fihri AF, Al-Waili NS, El-Haskoury R, Bakour M, Amarti A, Ansari MJ, Lyoussi B. Protective effect of morocco carob honey against lead-induced anemia and hepato-renal toxicity. Cellular Physiology and Biochemistry. 2016;39(1):115-22.
18. Aliyu M, Odunola OA, Owumi SE, Gbadegesin MA, Choudhary MI, Farooq AD, Rasheed H, Erukainure OL, Ahmed S. Daily consumption of honey: effects on male wister albino rats. International Journal of Food Nutrition and Safety. 2012;1(2):66-74.
19. Ajibola A, Chamunorwa JP, Erlwanger KH. Nutraceutical values of natural honey and its contribution to human health and wealth. Nutrition & metabolism. 2012;9(1):61
20. Bogdanov S. Short history of honey in medicine. Bee Product Sci 2012.
21. Abdulrhman MA, Hamed AA, Mohamed SA, Hassanen NA. Effect of honey on febrile neutropenia in children with acute lymphoblastic leukemia: A randomized crossover open-labeled study. Complementary therapies in medicine. 2016 Apr 1;25:98-103.
22. Solayman M, Islam MA, Paul S, Ali Y, Khalil MI, Alam N, Gan SH. Physicochemical properties, minerals, trace elements, and heavy metals in honey of different origins: a comprehensive review. Comprehensive Reviews in Food Science and Food Safety. 2016 Jan;15(1):219-33.
23. Karabagias IK, Louppis AP, Kontakos S, Papastephanou C, Kontominas MG. Characterization and geographical discrimination of Greek pine and thyme honeys based on their mineral content, using chemometrics. European Food Research and Technology. 2017;243(1):101-13
24. León-Ruiz V, González-Porto AV, Al-Habsi N, Vera S, San Andrés MP, Jauregi P. Antioxidant, antibacterial and ACE-inhibitory activity of four monofloral honeys in relation to their chemical composition. Food & function. 2013;4(11):1617-24.
25. Atayoglu AT,Soylu M, Silici S, Inanc N. Glycemic index values of monofloral Turkish honeys and the effect oftheir consumption on glucose metabolism. Turkish journal of medical sciences. 2016 Feb 17;46(2):483-8.
26. Münstedt K, Hoffmann S, Hauenschild A, Bülte M, von Georgi R, Hackethal A. Effect of honey on serum cholesterol and lipid values. J Med Food 2009; 12: 624-8.
27. Aazza S, Lyoussi B, Antunes D, Miguel MG. Physicochemical characterization and antioxidant activity of 17 commercial Moroccan honeys. International Journal of Food Sciences and Nutrition. 2014;65(4):449-57
28. Jankowska M, Rutkowski B, Dębska-Ślizień A. Vitamins and microelement bioavailability in different stages of chronic kidney disease. Nutrients. 2017;9(3):282
29. Haroon S, Davenport A. Choosing a dialyzer: What clinicians need to know. Hemodialysis International. 2018 Oct;22(S2):S65-74.
30. Erejuwa OO, Sulaiman SA, Wahab M. Honey-a novel antidiabetic agent. Int J Biol Sci 2012; 8: 913-934.
31. Liakopoulos V, Roumeliotis S, Gorny X, Dounousi E, Mertens PR. Oxidative stress in hemodialysis patients: a review of the literature. Oxidative medicine and cellular longevity. 2017;2017
IssueVol 7 No 2 (2020): Spring QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/npt.v7i2.2738
anemia; hemodialysis; thyme honey

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How to Cite
Mousavi Kiasari SA, Nobahar M, Ghorbani R, Tamaddon MR. The effect of thyme honey on anemia in hemodialysis patients. NPT. 2020;7(2):151-160.