Helminthic therapy and anaphylaxis

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Certain helminth species have been reported in the medical literature to provoke anaphylactic reactions, but others provide protection against anaphylaxis.

• An enteric helminth infection protects against an allergic response to dietary antigen -- Full text | PDF

• Helminth infection protects mice from anaphylaxis via IL-10-producing B cells -- Full text | PDF

• Modulation of anaphylaxis by helminth-derived products in animal models

Although therapeutic helminths have been available for self-treatment since 2003, and the number of individuals using helminthic therapy was estimated in 2015 to be between 6,000 and 7,000 [1] there have been no reports of the treatment causing a severe anaphylactic reaction. There have been three reports of large doses of hookworms causing moderate anaphylactic reactions, but none of these required emergency treatment.

In my experience, taking larger doses (over 25 hookworms) can cause too much systemic inflammation and at my worst caused symptoms of an anaphylactic reaction: scratchy itchy throat, sensation of tingling of mouth and tongue, effort to swallow. [2] [3]

I started getting HIVES, yes welts all over. I’ve only had this happen before when I was in anaphylaxis... Then my throat started constricting, as well as (experiencing) major impending doom. This is my code word of anaphylaxis. I’m a very cool cucumber even in duress so if I get that impending doom feeling and my throat is being affected I know it’s anaphylaxis. [4]

I had anaphylaxis like reaction to hookworm, I have MCAS and my dose was too high (25), a lower dose of 5-10 was well tolerated. My reaction was loss of blood pressure and passing out, along with cramping and diarrhea. [5] (Also, while not hosting helminths) I've had mild ANA to allergy shots, sulfa drugs and (the) moderna (COVID-19) vaccine. [6]

There have been several reports from self-treaters confirming success in preventing anaphylaxis.

Several months into the TSO therapy, my son, for the first time in his life, accidently ate a pecan cookie. Pecans are the nuts that he is most allergic to, both by blood test score and by our experience with him. He had absolutely no reaction of any kind. [7]

For more accounts of success with anaphylaxis, see the following page section.

• Personal stories: Anaphylaxis

A number of people have reported that, while hosing helminths, their reactions to insect stings have been greatly reduced. This effect may be of value to someone who is prone to developing anaphylaxis after being stung.

I got stung by 7 wasps yesterday. Hands, neck, shoulder. It did hurt. It swelled up immediately like it usually does but… 30 minutes later there were almost no traces left! The inflammatory response was very limited and only for a short time. 24 hours later I can barely tell where I was stung. This is not the first time I got stung. But it IS the first time with such a small reaction... I have been taking TSO every 2 weeks since November 2020 (for 8-9 months). [8]

I noticed also very small reaction to mosquito bites this year with wormies on board! [9]

Anyone with anaphylaxis who decides to self-treat with helminths should continue to ALWAYS carry at least one epinephrine auto-injector, even if the treatment proves to be effective, because of the possibility of an unexpected reduction in protection due to something harming, or even killing, their worms.

In the case of the non-human worms, HDC and TSO, which need to be re-dosed frequently, there may be a reduction in the level of protection if a dose is forgotten or delayed. Several people who are using HDC have reported a return of disease symptoms due to issues with supply, or simply due to forgetting to take a dose on time. [10] Obviously, a failure to adequately maintain one's helminth colony will increase the chance of an anaphylactic reaction and the risk of fatality.

It is also possible for a reduction in protection from the human helminths, NA and TT, if the self-treater is exposed to something that kills or stresses their colony (see the Human helminth care manual) or if the colony is not actively maintained by the regular addition of supplementary doses. (See Hookworm dosing and response: Supplementary doses.)