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Acupuncture is gaining popularity around the world as a harmless, if unproven, alternative method of pain relief. But are some people taking the practice too far by using bee stings instead of needles?

A 55-year-old Spanish woman died after receiving live bee acupuncture, according to a case study published in the Journal of Investigational Allergology and Clinical Immunology. The cause of death was a severe allergic reaction to the venom, though she had previously attended about 24 sessions. She is believed to be the first person to die from the therapy despite previously showing no signs of an allergic reaction.

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Here’s everything you need to know about live bee acupuncture, and why some doctors are warning against it.

What is live bee acupuncture?

Apitherapy is the use of substances from honeybees to relieve various medical conditions. Some practices use honey or royal jelly, while live bee acupuncture uses the venom.