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There are different ways in which the terms medical grade or pharmaceutical grade can be perceived, particularly when referring to honey.  Most Manuka honey that is sold in retail stores is table grade.  However, some might refer to active Manuka honey as medical grade to differentiate it from inactive honey.  Another perception of medical grade honey pertains to honey (usually Manuka honey) that has been gamma irradiated, classifying it as sterile.  

Referring to honey (Manuka or otherwise) as being sterile can be somewhat confusing.  The term sterile is defined as being free of germs or microorganisms.  Despite the FDA’s refusal of recognizing honey of any kind as being antimicrobial, scientific evidence suggests that it is.  However, the potential for botulism spores in some honeys makes gamma irradiation a process that some feel is necessary in order to refer to it as being truly sterile.  

Since honey is heat-sensitive, gamma irradiation is the only way to sterilize it without diminishing its properties.  However, it is unclear as to whether or not it is necessary to sterilize honey.  The presence of botulism in honey is harmless to individuals over the age of 1 year old.  Infants under the age of 12 months old have not yet fully developed their immune system, and therefore, cannot ward off these spores.  

Some might say that the only purpose of gamma irradiating honey is to make it safe for infants to ingest.  Although, doctors who may want to use Manuka honey for wounds seem to get a warm and fuzzy feeling when using a product that they consider to be sterile.  Either way, the use of Manuka honey that has not been gamma irradiated on wounds or for other conditions has been found to be perfectly safe.