By Dr Isaac Flitta, Founder, Tōtika Health

What pharmacists actually ask me about Mānuka honey

The pharmacist has just finished checking a warfarin script. She picks up my jar almost as an afterthought, turns it over in her hands, and gives me the look I have come to know well.

"Okay. Help me out. I have three Mānukas on this shelf already. Why would I recommend this one instead of telling them to grab the supermarket honey and save the money?"

That is the question. Not "is it delicious." Not "is it natural." A pharmacist has watched every miracle remedy in the natural-health aisle arrive, get breathless for a season, and quietly disappear. She is not hostile. She is a filter. And the questions a pharmacist asks are not the questions a shopper asks, because she is the one who carries the liability for whatever she puts in front of a patient.

We have been selling Mānuka honey to pharmacies for years. The questions barely change. They fall into three piles, and they are worth walking through honestly, because the honest version is the only one a pharmacist respects.

Pile one: is it real?

"So what is the actual difference between this and the normal honey here, and why is this one a hundred and eighty-five bucks?"

Fair question. The difference is a compound called methylglyoxal, MGO, measured in milligrams per kilogram. It forms from DHA in the nectar of the Mānuka tree, Leptospermum scoparium, and it is what gives Mānuka its non-peroxide antibacterial activity. Professor Thomas Henle at Dresden pinned that down in 2008. The important part for a pharmacist: unlike the hydrogen peroxide activity in ordinary honey, which is fragile, MGO is stable. It does not fade on the shelf. So the number is measuring something real, and something that stays.

Then the sharper one, and I love this one: "If a patient asks me why yours is 850 or 1050, what do I actually say in English? Is that just marketing, or does it do something different?"

In English: the number is milligrams of MGO per kilogram, tested and verified by an IANZ-accredited laboratory, batch by batch. And here is the part most people get backwards. The bee does not hand the MGO over. It develops slowly inside the harvested manuka honey itself, from a precursor in the Mānuka nectar, and only if you hold the jar cool and give it years to mature. Our top grade can take upwards of five years in cold storage to reach its number. That patience, on nectar that had the potential to begin with, is most of the reason the price climbs. It is not a loyalty-card tier. It is a lab result. [Our MGO 1050+, the top of the common grading ladder, is the one that costs the hundred and eighty-five.]

"Is it heat-treated, or is it still raw? People ask me if the antibacterial thing survives the processing."

Raw and unheated, which is the point, because heat is exactly what degrades the delicate parts. And because a number on a jar means nothing without the paperwork behind it, Totika Manuka honey passes the MPI five-attribute test, the New Zealand government standard that legally defines monofloral Mānuka, four chemical markers plus one DNA marker. Our premises have a Risk Management Programme registration, BOIHS2013, that anyone can look up on the MPI register. If a pharmacist wants the full version of how to separate a real Mānuka from an expensive jar of other honey, I keep it written down.

None of that is on the front of the jar. All of it is what makes the jar worth trusting.

Pile two: is it safe?

This is where a good pharmacist gets careful, and so do I.

"Is it okay with warfarin, or other blood thinners? Or do I treat it like any other supplement and send them to their GP?"

Treat it like any other supplement. It is food, taken in normal amounts. If there is a medication picture, the answer is check with the GP or the pharmacist's own judgement, not my marketing.

"If they are diabetic and they want a healing honey, is that a flat no, or use sparingly? Where is your line?"

My line is honest: it is still honey, it is still sugar, and a diabetic patient needs to count it like sugar. I will not sell a diabetic a "healing honey" fairy tale. High MGO does not repeal the carbohydrate.

Pile three: what can I actually say?

"Can I safely tell people it is good for a sore throat, or am I wandering into claim trouble?"

For throat comfort and general wellness, a high-MGO eating honey is something I am comfortable standing behind, and so are most pharmacists. That is the ceiling, though, and it is a ceiling I hold on purpose.

Which brings me to the question that changed how I talk about all of this.

The question that sticks

A pharmacist once put it to me plainly, the way only a pharmacist can.

"Look. If this was your own mum, coming in after surgery, with a wound that will not heal. Would you genuinely recommend this honey? Or would you just stick to conventional dressings?"

I remember answering slowly, because it deserved a slow answer.

For wound care, I said, I would stay inside the evidence and the regulation. I would reach for the CE-marked, Medsafe-recognised medical honey dressings, made and sterilised for that job. Not a jar of eating honey off a shelf. There is genuine science on Mānuka in wound care, but it is science about medical-grade dressings, and my jar is not one.

For general wellness and throat comfort, yes, I am comfortable recommending a high-MGO eating honey. But I will not position it as a wound treatment, not for a patient, and not for my own mother.

The pattern in all of it

Look back at the questions. Not one of them is about taste. Not one is about the word premium. Every single one is a test of the same thing: will this survive scrutiny, and will the person selling it hold the line when it costs them something.

That is the whole game. A shopper asks what a honey does. A pharmacist asks how you know, whether it is safe, and what you are legally allowed to say, and then watches to see whether you overreach. The honey that gets recommended is the honey that answers all three without flinching and stops exactly where the evidence stops.

Mānuka honey is one of the very few natural products that can survive that. Origin, data, safety, law, all of it, picked apart by someone whose job is to be sceptical. Tōtika exists in that narrow space, and we built the whole operation to live there.

Because in a pharmacy, Mānuka honey survives on what you can put in a datasheet, not on what you can put on a billboard.