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Human helminth care manual

2026-05-18T21:00:01Z

John: /* ❌ Antibiotics that may significantly reduce hookworm benefits */

{{Breadcrumb|[[Using_helminths|Using helminths]]|[[Helminth_care|Helminth care]]}}
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|description=How to care for the two species of human helminth used in helminthic therapy: Necator americanus (NA) and Trichuris trichiura (TT/TTO).
|keywords=worm care, helminth care, Necator americanus, Trichuris trichiura, NA, TT, TTO, caring for my worms
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'''PLEASE READ THIS FIRST''' 
This manual is only concerned with the two '''''human''''' helminths:
* '''Human hookworm - Necator americanus''' (NA) [https://en.wikipedia.org/wiki/Necator_americanus]
* '''Human whipworm - Trichuris trichiura''' (TT) and its ova (TTO) [https://en.wikipedia.org/wiki/Trichuris_trichiura]
For the care of the non-human helminths, TSO and HDC, see the [[Helminth_care |'''Helminth care''']] page. 
=== Key ===
The following classification codes are intended as a general guide only, because the effects of a substance can vary considerably depending on factors such as quantity, concentration, and, in the case of herbal extracts, the part of the plant used. Even the method of extraction can make a difference, and, in the case of foods, perhaps the method, temperature and duration of any cooking, [https://www.facebook.com/groups/htsupport/posts/6863122353743661?comment_id=6863149840407579&reply_comment_id=6863721660350397] so it's important to read the details for each item.

:❌ Will or may kill, or cause the loss of, human helminths.
:⚡ May cause harm to human helminths in some people.
:➿ May cause a temporary reduction in benefits from human helminths.
:❓Insufficient evidence exists to support a judgement on possible effects.
: ✅ Safe, or likely to be safe, for human helminths.

Note that where an entire section is marked with a ✅, this indicates that all the substances listed within that section are safe unless marked otherwise.

=== Using this manual ===
'''* Bookmark this page to facilitate rapid access whenever it is needed.'''

'''* To find information about a specific substance, don't scan the page visually. Instead, use the search function on your device:''' 

* '''PC''' - Control+F 
* '''Mac''' - Command+F 
* '''Mobile''' - "Find in page" in the drop-down menu from the three dots icon

'''* Anything NOT MENTIONED in this manual has never been reported to be a problem, so, unless it is a new or very unusual product/substance, it is far more likely to be safe than unsafe for therapeutic human helminths.''' 

=== General advice ===
'''NA and TT are relatively robust organisms, and most foods, drugs and other substances are safe for use while hosting them, including normal dietary amounts of most unprocessed foods, spices and herbs. However there are some foods and other substances that may harm a colony, either temporarily stunning them or even killing them.'''

Things that will or may kill, or cause the loss of, human helminths include:

* ❌ Diatomaceous earth. (See [[#Diatomaceous earth|'''full details''']].)
* ❌ Oregano. (See [[#Oregano|'''full details''']].)
* ❌ Sauerkraut. (See [[#Sauerkraut|'''full details''']].)

'''Some foods can cause harm to NA and TT in some people but not others,''' and coconut products are a good example of this. While many hosts of human helminths are able to eat normal dietary amounts of coconut products without affecting their worms, others find that some forms of this food will affect their worms sufficiently to impair their beneficial effects.

The most common food items that may affect helminths in some people but not others are:

* ⚡ Coconut products. (See [[#Coconut|'''full details''']].)
* ⚡ Fatty acids. (See [[#Fatty acids|'''full details''']].)
* ⚡ Ginger. (See [[#Ginger|'''full details''']].)
* ⚡ Honey. (See [[#Honey|'''full details''']].)
* ⚡ Papaya seeds. (See [[#Papaya|'''full details''']].)
* ⚡ Pumpkin seeds and pumpkin seed oil. (See [[#Pumpkin|'''full details''']].)
* ⚡ Digestive enzymes. (See [[#Digestive enzymes|'''full details''']].)
* ⚡ Cayenne. (See [[#Cayenne|'''full details''']].)

If hosting NA, it is best to avoid the food substances listed above until the therapy is delivering benefits, at which point their effect on one’s colony can be tested, initially in small, and then in gradually increasing, quantities to assess the level of risk they are likely to present, and how much of each substance might safely be consumed before the worms are affected.

See the rest of this page for other items marked with a ⚡ or ❌.

'''Medicinal quantities of concentrates, extracts or tinctures, especially of certain herbs, are more likely to have an adverse effect on NA and TT than the plants from which they are derived.''' For example, eating normal dietary amounts of ginger is usually fine, as is occasionally taking a ginger supplement (e.g., to treat a migraine), but taking ginger regularly as a supplement or drinking ginger beer every day may adversely affect NA.

Another example of how the concentrated form of a substance can be harmful to helminths while foods containing the same substances are not are the phytochemical compounds, '''isomyristicin''' and '''bergaptenix'''. While the ''concentrated'' forms of isomyristicin and bergaptenix have shown significant anthelmintic activity against two helminth species, the parent chemicals from which they are derived ('''myristicin''' and '''bergapten''') are both found in several of the fruits, herbs and vegetables consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, and the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

'''People who have a robust immune response to helminths are likely to notice a greater effect on their worms than others.''' These individuals are the ones who need to top up their human helminth colonies more frequently in order to maintain remission from their disease. Typically, they have Crohn's, or one of the other intestinal diseases, but a few in this group have other conditions, such as allergies. [https://www.facebook.com/groups/htsupport/permalink/966004180122204/?comment_id=966023830120239&comment_tracking=%7B%22tn%22:%22R1%22%7D]

'''It is thought to be less likely that anything will harm NA before it attaches to the gut mucosa towards the end of the third week post inoculation''', although, once NA enters the bloodstream, it does begin to feed on proteins in the blood. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.ncbi.nlm.nih.gov/pubmed/29566094]. After it arrives in the small intestine and begins feeding from the gut wall from day 21, NA will always be vulnerable to anything harmful that has entered its host's blood.

'''Substances that are applied to the skin topically in small quantities are unlikely to cause harm to human helminths, even if the substances are known to be a risk when they are ingested.'''

'''Due to the way that TT feeds and attaches to the colonic mucosa, it is not as vulnerable as NA''', as is illustrated by the fact that three times more of the anthelmintic drug, mebendazole, may be required to kill TT than to kill NA.

'''Substances listed on the internet as being "antiparasitic" may have no effect whatsoever on NA and TT.''' Helminths are only one of many different types of parasite. Among the other types, there is a wide range of responses to substances claiming to be antiparasitic, and what kills one type of parasite may not even harm another. Even substances that have shown an anthelmintic effect in test tube studies do not necessarily have an adverse affect on worms being hosted by humans. [https://www.ncbi.nlm.nih.gov/pubmed/27498843]

'''Some foods and substances can reduce the therapeutic/ prophylactic benefits of adult helminths without killing the worms or having any impact on their egg production.''' Therefore, if testing shows the presence of helminth eggs in the host’s feces after ingesting a particular substance, it does not necessarily mean that this food/ substance will not interfere with the health benefits provided by the worms. [https://www.facebook.com/groups/htsupport/posts/9561303440592192?comment_id=9562835637105639] So the details on this page may not be relevant to the practice of helminth incubation, and a tentative examination of the effect of substances on the production of hookworm eggs and larvae can be found in the page section, [[NA incubation: very detailed method by Alana#Promotion of egg viability by dietary manipulation | '''Promotion of egg viability by dietary manipulation''']].

The posts in this [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/ support group sub-thread] contain good general advice on how to manage exposure to substances that can harm human helminths.

=== Worm harm denial ===

A few people have difficulty accepting that any of the substances mentioned on this page might harm helminths, with the exception of anthelmintic drugs. They believe that the adverse effects on human helminths that have been reported by self-treaters have alternative explanations, including delusion on the part of the reporting individual. They argue that, were the claims true, there would no longer be large areas of the planet where these worms remain endemic, and that the substances/foods/spices identified by self-treaters as potentially harmful to human helminths would have become folk remedies for helminth infections. However, this position ignores the science (e.g., [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924796/ Herbal anthelmintic agents: a narrative review]) and the fact that the effect of consuming a food or product with anthelmintic effects will be much less of an issue, if it is even noticed at all, in populations that are continually exposed to helminths and therefore constantly being reinfected.

In the words of one experienced NA self-treater:
{{Quote|indent}}Respect the foods and other items in the care manual that are likely, or potentially, unsafe for helminths. I’ve learned the hard way that coconut oil/milk/flour, raw ginger, curry, etc. are no beuno for my friends on board, and as much as I enjoy those things, they are not worth knocking out my NA for a week or multiple weeks. Everybody’s different here and it’s worth testing in very small amounts. [https://www.facebook.com/groups/htsupport/posts/4395750987147489/]{{Quote|/indent}}

=== Updates & disclaimer ===
This manual is updated regularly. See the page history (via the "View history" link at the top of the page) for a list of amendments.

Although the most harmful substances have been identified, this manual continues to be a work in progress so should not be viewed as definitive. Also see the [[Helminthic Therapy wiki:General disclaimer|'''General disclaimer''']].

Details in this manual are based on first hand reports posted in the [[Helminthic_therapy_support_groups|'''Helminthic therapy support groups''']]. Additional reports and comments on this topic are welcomed, and should be posted to the [https://www.facebook.com/groups/htsupport/ Helminthic Therapy Support group] on Facebook. 
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== Pharmaceuticals ==


=== Anaesthetics (anesthetics), General [https://en.wikipedia.org/wiki/Anesthetic] ===

==== ✅Nitrous oxide (N2O) (E942) [https://en.wikipedia.org/wiki/Nitrous_oxide] ====
<blockquote>
Nitrous oxide (aka laughing gas or sweet air) was, at one time, mistakenly thought to kill hookworms. However, when this gas was used by people who wanted to terminate their hookworm colonies, their attempts met with failure. One subject reported inhaling almost a full can of whipped cream at 3 weeks post inoculation in an attempt to resolve severe side effects, but with no obvious effect on his hookworms. In another case, a balloon full of nitrous oxide failed to have any effect on a hookworm colony, which was later confirmed to be viable by a stool test. [https://www.facebook.com/groups/htsupport/permalink/759492150773409/] Then, in 2017, the notion that nitrous oxide harms NA was finally laid to rest by someone who inhaled a large quantity of the gas over the course of an hour. This individual reported that, although he did get a headache and giggled a lot, his worms were not harmed.

✅ The following forms of nitrogen are also unlikely to be a problem for hookworms.
* Nitric oxide (NO) [https://en.wikipedia.org/wiki/Nitric_oxide]
* Nitrogen dioxide (NO2) [https://en.wikipedia.org/wiki/Nitrogen_dioxide]
* Nitrate (NO3) [https://en.wikipedia.org/wiki/Nitrate]
* Pure nitrogen (N) [https://en.wikipedia.org/wiki/Nitrogen]
* Liquid nitrogen (LN2) [https://en.wikipedia.org/wiki/Liquid_nitrogen]
</blockquote>

==== Other general anaesthetics ====

<blockquote>
It has been suggested that the volatile organic compounds (VOCs) that were used in the early days of anaesthesia might be a risk to hookworms, especially if inhaled in excessive quantity, due to the possibility that they might stun them and cause them to be expelled from the gut before waking up. For example:
* ✅ [https://en.wikipedia.org/wiki/Diethyl_ether diethyl ether]
* ✅ [https://en.wikipedia.org/wiki/Chloroform chloroform]
However, a clinical scientist has reported that, while hosting both NA and TT, he worked around more organic solvents, including dichloromethane (CH2Cl2) and chloroform (CHCl3), than most people are exposed to in a lifetime, and that his hookworms and whipworms continued egg production uninterrupted.

✅ [https://en.wikipedia.org/wiki/Propofol Propofol] While propofol has been shown to adversely affect the mitochondria of roundworms in laboratory conditions, it is clear from the experience of hosts of both hookworms and whipworms that propofol does not harm human helminths in the concentrations used during surgery.

✅ [http://www.sciencedaily.com/releases/2009/08/090804145614.htm Regional nerve blocks] are worm-safe.

</blockquote>



=== Anaesthetics (anesthetics), local [https://en.wikipedia.org/wiki/Anaesthetics] ===

==== ➿ [https://en.wikipedia.org/wiki/Local_anaesthetic Local anaesthetics] ====
<blockquote>
Local anaesthetics interfere with the production of white blood cells as well as the functioning of the cells in circulation, but they appear not to affect ova production by helminths and they certainly don't kill them. While local anaesthetics can cause a temporary return of disease symptoms for up to 8 weeks, helminths generally recover after only a few days, although this varies by person, drug and dosage, making it difficult to predict exactly what will happen in any particular situation.

For dental procedures requiring a local anaesthetic, short-acting drugs are less likely to affect helminths, e.g.
* [https://en.wikipedia.org/wiki/Articaine Articaine] (articadent, astracaine forte, septanest, septocaine, ubistesin forte, ubistesin, ultracaine, zorcaine)
* [https://en.wikipedia.org/wiki/Lidocaine Lidocaine] (xylocaine, lignocaine)
These are a better choice than a longer-acting drug, such as
* [https://en.wikipedia.org/wiki/Carbocaine Mepivacaine] (carbocaine, polocaine)
* [https://en.wikipedia.org/wiki/Bupivacaine Bupivacaine] (Marcaine, Sensorcaine and Vivacaine, etc.)
and one helminth host has reported that the short-acting articaine had no adverse effect on his hookworms.

If a patient explains that they don't want to be numb for several hours, the dentist will usually use one of the short-acting drugs, or one combined with a vasoconstrictor such as epinephrine, which helps to reduce the amount of the drug that reaches the systemic circulation.

If local anaesthetics are used, it can be a good idea to arrange for a small supplementary dose of worms (e.g., 3 or 5 hookworm larvae) to be available for administration the day after exposure to the drug. This small additional inoculation usually helps to reduce the time that established helminths are out of action.
</blockquote>

==== ✅ Alternatives to local anaesthetics ====
<blockquote>
* [https://en.wikipedia.org/wiki/Opioids Opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.)
* [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed versed], etc., routinely used during colonoscopies)
* [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics]
These drugs all appear to be harmless to helminths, so, taken orally at high strength, these may be a suitable substitute for local anaesthetics in many situations. For example, one helminth host has found that 30 mg [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], taken along with 1,000 mg of [https://en.wikipedia.org/wiki/Paracetamol paracetamol (acetaminophen)] an hour or two before a dental appointment can be effective in avoiding all but a few brief moments of mild, dull pain, which he
found to be quite manageable while having a tooth drilled. This subject even found that the combination of dihydrocodeine and paracetamol (acetaminophen) provided adequate pain relief when having a tooth sculpted to take a crown. [https://en.wikipedia.org/wiki/Aspirin Aspirin] and [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] are also harmless to helminths, so, if preferred, these might provide a suitable alternative to paracetamol (acetaminophen).

Another option for completely avoiding any risk to helminths from local anaesthetics was the [https://www.facebook.com/GumEase GumEase] cryoallergenic mouthpiece. This device, which is apparently no longer available to purchase, provided pain relief for up to 20 minutes, and was appropriate for most procedures, including fillings, crowns, extractions and root canals. Previously available from two sources [http://cryodevices.ecrater.com/c/902779/gumease-products], [http://www.dentakit.com/gumease.html] this device unfortunately never caught on with dentists who are firmly wedded to the use of injectable drugs.

Another pain-free alternative is [http://www.youtube.com/watch?v=dcAwKvdqmKI laser dental surgery], which is likely to become increasingly available in the future. If more invasive dental surgery is required - where bone needs to be removed, for example - it may be best to request [https://en.wikipedia.org/wiki/Conscious_sedation conscious sedation]. This renders the patient unaware of what is taking place, but is not the same as a general anaesthetic. Conscious sedation might involve a combination of [https://en.wikipedia.org/wiki/Versed versed] (a short acting IV [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine]) and [https://en.wikipedia.org/wiki/Fentanyl fentanyl] (a short acting IV opiate), both of which are perfectly safe for worms.

</blockquote>

=== Anaesthetics (anesthetics), topical [https://en.wikipedia.org/wiki/Anaesthetics] ===

<blockquote>
✅ Topical anaesthetics (e.g., lidocaine / lignocaine) that are applied to the skin are unlikely to affect helminths within the digestive tract because not enough of the drug will get into the blood stream to affect the worms. Topical lidocaine used before blood draws, punch biopsies and the fitting of a catheter, or applied to the mucous membranes in the mouth or nose, are therefore worm-safe. However, there is a small possibility that fresh L3 NA larvae, which remain within the skin at the inoculation site for the first 40 hours, '''''may''''' be adversely affected by the use of a topical anaesthetic applied directly to this area following inoculation. [https://www.facebook.com/groups/htsupport/posts/6162787843777119/?comment_id=6163364870386083&reply_comment_id=6165161500206420] Further feedback is needed to confirm or dispel this possibility.
</blockquote>

=== Anthelmintics [https://en.wikipedia.org/wiki/Anthelmintics] ===

==== ❌ Anthelmintic drugs ====
<blockquote>
A number of drugs are used to terminate helminth infections, but the effectiveness of different anthelmintics against a single species [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250499/?report=classic varies] greatly. In [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/ one study], a triple dose of [https://en.wikipedia.org/wiki/Albendazole albendazole] (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, whereas a triple dose of [https://en.wikipedia.org/wiki/Mebendazole mebendazole] (3×500 mg over 3 consecutive days) only achieved a cure rate of 58%.

Each anthelmintic drug has varying degrees of effectiveness against different helminths. For example, while a triple dose of '''albendazole''' (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, the same regimen only achieved a 56% cure rate against whipworms [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/] and, in patients with an excessive whipworm infection, '''albendazole''' may need to be taken for 5–7 days. [http://www.ncbi.nlm.nih.gov/pubmed/14754497?dopt=AbstractPlus]

If it becomes necessary to terminate a colony of helminths, a medical doctor should be consulted, and their directions followed. However, under no circumstances should '''mebendazole''' ever be combined with '''metronidazole''' (Flagyl), and this is something about which many doctors and pharmacists may be unaware. There is a risk that this combination may [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ cause Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis].
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==== List of anthelmintics ====

* [https://en.wikipedia.org/wiki/Abamectin Abamectin]

* [https://en.wikipedia.org/wiki/Albendazole Albendazole] (Albenza, Valbazen, Zentel, etc.)

* [https://en.wikipedia.org/wiki/Aminoacetonitrile Aminoacetonitrile] derivatives

* [https://en.wikipedia.org/wiki/Arecoline Arecoline] (Arecaline, Arecholine, Arecolin, Arecoline base, Arekolin, Methylarecaidin.)

* [https://en.wikipedia.org/wiki/Artemisinin Artemisinin] (Artemisinine, qinghaosu)

* [https://en.wikipedia.org/wiki/Bephenium_hydroxynaphthoate Bephenium hydroxynaphthoate] (Alcopar, Alcopara, Befenium, Debefenium, Francin, Nemex). This is an anthelmintic agent once used to treat hookworm and roundworm infections.

* [https://en.wikipedia.org/wiki/Diethylcarbamazine Diethylcarbamazine] (DEC, Hetrazan, Carbilazine, Caricide, Cypip, Ethodryl, Notézine, Spatonin, Filaribits, Banocide Forte and Eofil)

* [https://en.wikipedia.org/wiki/Disulfiram Disulfiram] (Antabuse, Antabus, etc.). While this drug is predominantly used to treat alcoholism, it has also been reported in the scientific literature to possess anthelmintic properties, which were the main reason for its original investigation. Copper‑chelating thiuram compounds such as disulfiram have been noted to produce lethal inhibition of respiration in intestinal worms such as the whipworm Trichuris muris as well as schistosomes, with daily disulfiram treatment of T. muris‑infected animals producing malformed eggs and preventing successful colonisation of mice.

* [https://en.wikipedia.org/wiki/Emodepside Emodepside] (Monepantel) [https://pharmaphorum.com/news/bayer-drug-raises-hope-15bn-people-worm-diseases]

* [https://en.wikipedia.org/wiki/Fenbendazole Fenbendazole]

* [https://en.wikipedia.org/wiki/Flubendazole Flubendazole] (Flutelmium, Flubenol, Biovermin, Flumoxal.)

* '''Isomyristicin''' and '''bergaptenix''' are two phytochemical compounds isolated from the Bhutanese medicinal plants, Corydalis crispa and Pleurospermum amabile, which have shown significant anthelmintic activity against the helminths, Schistosoma mansoni and Trichuris muris. In concentrated form, they may therefore be harmful to other whipworms and possibly also hookworms. [http://www.ncbi.nlm.nih.gov/pubmed/27572696] However, it should be noted that myristicin (the parent chemical from which isomyristicin is derived) and bergapten are both found in very small quantities in the vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/] These chemicals are also found in ⚡ [https://en.wikipedia.org/wiki/Earl_Grey_tea Earl Grey tea], which is flavoured with bergamot oil, and one hookworm host has reported that she experienced a return of symptoms of her disease (POTS) after drinking this brew. However, there are many other NA hosts who drink this tea without any problem, including someone who drinks multiple cups each day of weak Lady Grey tea (citrus bergamot flavour) and has reported still being able to successfully incubate from her small NA colony. [https://www.facebook.com/groups/htsupport/posts/5482091725180071/?comment_id=5483270285062215]

* [https://en.wikipedia.org/wiki/Ivermectin Ivermectin] (Stromectol, Soolantra, Sklice, etc.) Used to treat [https://en.wikipedia.org/wiki/Cutaneous_larva_migrans cutaneous larva migrans] caused by various zoonotic hookworm species. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11125977/]

* [https://en.wikipedia.org/wiki/Levamisole?wprov=sfla1 Levamisole] (Decaris, Ergamisol) is an antihelmintic drug approved for use in veterinary medicine in the United States. It was once used in the treatment of rheumatoid arthritis but proved too dangerous.

* [https://en.wikipedia.org/wiki/Mebendazole Mebendazole] (MBZ, Vermox, Ovex)

* [https://en.wikipedia.org/wiki/Niclosamide Niclosamide] (Niclocide, Fenasal, Phenasal, etc.)

* [https://en.wikipedia.org/wiki/Nitazoxanide Nitazoxanide] (Alinia, Nitaxide) is a broad-spectrum antiparasitic and broad-spectrum antiviral drug used to treat various helminthic, protozoal and viral infections. It has demonstrated activity against tapeworms, [https://www.ncbi.nlm.nih.gov/pubmed/27751770] so may also have an adverse effect on hookworms and whipworms.

* [https://en.wikipedia.org/wiki/Odanacatib Odanacatib] (codenamed MK-0822) is an investigational treatment for osteoporosis and bone metastasis developed by Merck & Co., and possibly available for clinical use from 2016. Unfortunately, this drug has been shown to kill the hookworm, Ancylostoma ceylanicum, in hamsters, decreasing worm burdens by 73%. [https://www.ncbi.nlm.nih.gov/pubmed/27751770] Consequently, it is likely to be trialled as a potential alternative to albendazole and may have an adverse effect on the human hookworm as well as other helminths, so should be avoided by helminth self-treaters.

* [https://en.wikipedia.org/wiki/Oxamniquine Oxamniquine] (e.g., Vansil)

* [https://en.wikipedia.org/wiki/Oxyclozanide Oxyclozanide]

* [https://en.wikipedia.org/wiki/Penicillium_cluniae Penicillium cluniae] (a fungus species of the genus of Penicillium which produces the antinematodal and antiparasitic agents paraherquamide B, paraherquamide C, paraherquamide D, paraherquamide E, paraherquamide F, paraherquamide G, paraherquamide H.)
* [https://en.wikipedia.org/wiki/Phenothiazine Phenothiazine (PTZ)] This is considered to be the first modern anthelmintic, introduced for this purpose in 1940.

* [https://en.wikipedia.org/wiki/Piperazine Piperazine] (piperazine hydrate and piperazine citrate are anthelmintic drugs that kill 60-70% of adult roundworms) and piperazine's many [https://en.wikipedia.org/wiki/Piperazine#Piperazine_derivatives_as_drugs derivatives].

* [https://en.wikipedia.org/wiki/Piperine Piperine] has demonstrated significant anthelmintic properties against various worm species. [https://www.academia.edu/103643829/Anthelmintic_Activity_of_Piperine_from_Black_Pepper] It not only has well documented potent effects against eggs and larvae, but also shows activity against adult worms, with paralysis and death times comparable to the standard anthelmintic drug albendazole. [https://pubmed.ncbi.nlm.nih.gov/31437123/]

* [https://en.wikipedia.org/wiki/Praziquantel Praziquantel] (Biltricide etc.)

* [https://en.wikipedia.org/wiki/Pyrantel Pyrantel pamoate] (Pin-X, Combantrin, etc.)

* [https://en.wikipedia.org/wiki/Pyrvinium Pyrvinium] (Vanquin, viprynium). This anthelmintic was previously used to treat pinworm (Enterobius vermicularis) infections, but has been largely replaced by other anthelmintics, e.g., mebendazole or [https://en.wikipedia.org/wiki/Pyrantel pyrantel pamoate].

* [https://en.wikipedia.org/wiki/Salicylanilide Salicylanilide], Spiroindoles (e.g. derquantel)

* [https://en.wikipedia.org/wiki/Tiabendazole Tiabendazole] (thiabendazole, TBZ, Mintezol, Tresaderm, Arbotect, etc.)

* [https://en.wikipedia.org/wiki/Triclabendazole Triclabendazole] (Fasinex, Egaten, etc.).
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</blockquote>

==== ❓ Piperazine-derived compounds ====

<blockquote>
There is a whole raft of [https://en.wikipedia.org/wiki/Piperazine%23Piperazine_derivatives_as_drugs piperazine-derived compounds] some of which '''may potentially''' have anthelmintic effects. However, this does not mean that all piperazine derivatives will kill, or even harm, helminths. For example, ✅ [https://en.wikipedia.org/wiki/Viagra Viagra] is a piperazine derivative, but does not kill hookworms.

* These include many antidepressants including
** [https://en.wikipedia.org/wiki/Trazodone trazodone] (Depyrel, Desyrel, Molipaxin, Oleptro, Trazodil, Trazorel, Trialodine, Trittico). One self-treater has been reported to take trazodone almost every night, but continues to get "great results" from her NA. [https://www.facebook.com/groups/htsupport/posts/7313725575350001/?comment_id=7313750828680809&reply_comment_id=7313942228661669]
* antipsychotics such as
** [https://en.wikipedia.org/wiki/Olanzapine olanzapine] (Lanzek, Zypadhera, Zyprexa and [https://www.drugs.com/international/olanzapine.html numerous other names]),
** [https://en.wikipedia.org/wiki/Olanzapine prochlorperazine] (Compazine, Stemzine, Buccastem, Stemetil, Phenotil),
** [https://en.wikipedia.org/wiki/Ziprasidone ziprasidone] (Geodon, Zeldox),
* the migraine treatment
** [https://en.wikipedia.org/wiki/Migraleve Migraleve Pink],
* and antihistamines including
** [https://en.wikipedia.org/wiki/Buclizine buclizine],
** ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine),
** [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan),
** [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5),
** [https://en.wikipedia.org/wiki/Cyclizine cyclizine],
** ⚡ [https://en.wikipedia.org/wiki/Levocetirizine levocetirizine] (Xyzal) (one NA host has reported having no problems with her worms when taking this [https://www.facebook.com/groups/htsupport/permalink/3067416309980970/?comment_id=3067678586621409]),
** [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs,
** ⚡ [https://en.wikipedia.org/wiki/Dimenhydrinate dimenhydrinate] (Dramamine, Draminate, Gravol, etc.) While one NA host has reported that taking this drug had no observable effect on her worms, [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&reply_comment_id=1682358115153470&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] someone with colitis believes that it killed at least some of her NA colony.
** [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
** [https://en.wikipedia.org/wiki/Ebastine ebastine] (Evastin, Kestine, Ebastel, Aleva and Ebatrol) Listed as a [https://en.wikipedia.org/wiki/Piperidine piperidine].
* as well as antianginals, anxiolytics such as
** ⚡ [https://en.wikipedia.org/wiki/Buspirone buspirone] (Buspar), (one self-treater found that the positive effects of NA were lessened in the days following a single dose of buspirone [https://www.facebook.com/groups/htsupport/permalink/1944442368945042/])
* urologicals, e.g.
** [https://en.wikipedia.org/wiki/Sildenafil sildenafil] (Revatio, ✅ Viagra) and
** [https://en.wikipedia.org/wiki/Levitra vardenafil] (Levitra, Staxyn).
</blockquote>

Anthelmintic residues may be encountered in farmed meats, especially the livers of cattle and fowl, but it is not known whether, or to what extent, these might affect therapeutic helminths in hosts who eat this meat.

Canine anthelmintics that have been applied to a dog’s skin should not be a problem for anyone who pets a treated animal so long as they wash their hands immediately after the contact. [https://www.facebook.com/groups/htsupport/permalink/868843983171558/]

=== Antibiotics [https://en.wikipedia.org/wiki/Antibiotics] ===

(Also see [[Human helminth care manual#Natural antibiotics|'''Natural antibiotics''']].)

==== ❌ Antibiotics that may significantly reduce hookworm benefits ====
<blockquote>
* [https://en.wikipedia.org/wiki/Cefazolin Cefazolin] (Also known as cefazoline and cephazolin.) This drug is commonly administered to patients undergoing surgery, typically as a single shot of 2 grams intravenously, adjusted for weight, within 60 minutes before the surgery commences. Someone who was given a 1 gram shot of cefazolin in this situation estimates that she suffered a 60% loss of effect from her hookworms for several weeks. She began to feel better after a 3-day course of prednisone taken one month after the cefazolin exposure, and was mostly back to normal at 6 weeks. However, when [https://en.wikipedia.org/wiki/Cefalexin cefalexin] (aka cephalexin), a drug related to cefazolin within the cephalosporin class, was taken by a different hookworm host for 2 days, this appeared to have no effect on his NA colony.
* [https://en.wikipedia.org/wiki/Levaquin Levofloxacin] has been reported by one NA host as having "completely devastated" her colony. An egg count revealed only 14 ova, and she went from near total remission to a severe flare. "Back to ground zero." [https://www.facebook.com/groups/htsupport/permalink/1626974844025131/?comment_id=1627023594020256&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]
</blockquote>

==== ⚡ Antibiotics that may reduce hookworm benefits in some people ====
<blockquote>

* [https://en.wikipedia.org/wiki/Amoxicillin Amoxicillin] While two hookworm hosts have said that they did not lose their worms following treatment with amoxicillin, three others have reported losing their colonies after taking this drug, for example, [https://www.facebook.com/groups/htsupport/posts/9106626532726554/ here]. Combination drugs that contain amoxicillin e.g., [https://en.wikipedia.org/wiki/Amoxicillin/clavulanic_acid amoxicillin/clavulanic acid] (co-amoxiclav, Augmentin) can also be a threat to human helminths, as was found by a hookworm host whose colony was temporarily "knocked out" after taking amoxicillin and clindamycin together. [https://www.facebook.com/groups/htsupport/permalink/1664279276961354/?comment_id=1664541103601838&reply_comment_id=2421515414571066]

* [https://en.wikipedia.org/wiki/Azithromycin Azithromycin] (brand names include: AZIF-500, Azithral, Azithrocin, Azyth, Azin, Z pack, Zeto and Zithromax) Someone has reported losing her hookworms to a combination of [https://en.wikipedia.org/wiki/Azithromycin azithromycin] (an azalide, a type of macrolide antibiotic) and doxycycline (see below) (a broad spectrum antibiotic of the tetracycline class), whereas a whipworm host [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=892732697449353&offset=0&total_comments=12&comment_tracking=%7B%22tn%22:%22R1%22%7D did not lose her colony] from taking this same combination of drugs. Azithromycin has been used on its own to treat a child with PANDAS and a female adult with an ear infection [https://www.facebook.com/groups/htsupport/permalink/1230554160333870/?comment_id=1230564746999478&comment_tracking=%7B%22tn%22%3A%22R%22%7D] without any worm loss, although its use did result in a temporary suspension of benefits in both cases.

* [https://en.wikipedia.org/wiki/Clindamycin Clindamycin] has been suspected of possibly harming hookworms when taken in combination with amoxicillin or metronidazole, but two NA hosts who took this drug on its own have reported that it had no adverse effect on their colonies. The first took clindamycin for 10 days (starting in the first week of hosting), [https://www.facebook.com/groups/htsupport/permalink/2123829614339649/] and the second took a 7 day course (300mg taken 4 times per day) after which a float test revealed plenty of hookworm eggs. [https://www.facebook.com/groups/htsupport/permalink/2574492762606663/]

* [https://en.wikipedia.org/wiki/Doxycycline Doxycycline] (Vibramycin, Monodox, Microdox, Periostat, Vibra-Tabs, Oracea, Doryx, Vibrox, Adoxa, Doxyhexal, Doxylin, Doxoral, Doxy-1 and Atridox, etc.) is a tetracycline antibiotic that also has antiprotozoal, antibacterial and some anthelmintic effects, although the latter have been claimed to only affect filarial nematodes. In this case, the drug kills a symbiotic bacterium in the worm’s reproductive tract, thus rendering it sterile. Moreover, an eight-week course of doxycycline may be necessary to achieve this effect. One hookworm host has reported that he took doxycycline for a total of 5 weeks without noticeable effect on his worms, and others have also reported having no issues with this drug, [https://www.facebook.com/groups/htsupport/posts/24894037546892199?comment_id=24894176736878280] but another has said that her hookworms “completely stopped working” after taking doxycycline for only three days. She said that this happened “pretty much overnight”, and that, in spite of getting a supplementary dose of worms a month or so after taking the antibiotic, [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786946941361263&offset=0&total_comments=16] she didn’t feel right again for the following 6 months. [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786624918060132&offset=0&total_comments=15] (NB: doxycycline has also been found to have [http://medicalxpress.com/news/2015-03-antibiotics-unexpected-effects-mitochondria.html unexpected effects on mitochondria].)

* [https://en.wikipedia.org/wiki/Flucloxacillin Flucloxacilin], also known as floxacillin. When one hookworm host took this drug with [https://en.wikipedia.org/wiki/Probenecid probenecid] (which is sometimes used to increase the concentration of some antibiotics), she experienced a return of her disease symptoms, although these were not as severe as they had been before she began hosting NA. An incubation yielded only half the usual number of larvae, but, after taking a wake up dose of 12 NA, she was feeling much improved 3 weeks later. [https://www.facebook.com/groups/htsupport/permalink/2286252768097332/] Someone else who had a 10 day course of Flucloxacilin, firstly intravenously, and then orally, found that she lost benefits from her NA for 4-6 weeks. She knew the worms were not dead because she was able to incubate fresh larvae from her colony. On a different occasion, a shorter course of 5 days IV, then oral Flucloxacilin, had minimal impact. [https://www.facebook.com/groups/htsupport/permalink/3702475279808400/?comment_id=3703092116413383]

* ❓ [https://en.wikipedia.org/wiki/Fosfomycin Fosfomycin] (also known as phosphomycin, phosphonomycin, Monurol and Monuril) A single, one-off, 3g dose if this broad-spectrum antibiotic that was taken by a hookworm host to treat a urinary tract infection had no obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&comment_tracking=%7B%22tn%22:%22R%22%7D] However, larger doses or a longer treatment period may produce a different result.

* [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). Two hookworm hosts have reported losing their colonies to [https://en.wikipedia.org/wiki/Metronidazole metronidazole] (Flagyl), [https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1371228706266414/] which may be particularly harmful to hookworms if taken in combination with [https://en.wikipedia.org/wiki/Clindamycin clindamycin] (Dalacin, Lincocin, Daclin). '''Metronidazole''' and '''clindamycin''' are favoured by some dentists due to their proven efficacy against anaerobic bacteria. However, when take on its own, metronidazole does not always kill hookworms, as one host found when she had to take this drug along with amoxicillin for several weeks to treat septic gangrenous appendicitis, [https://www.facebook.com/groups/htsupport/permalink/1899197376802875/?comment_id=1899228090133137&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and another found when he needed to take 750mg daily for 7 days to treat SIBO. [https://www.facebook.com/groups/htsupport/permalink/2060266257362652/] A third NA host was still able to successfully incubate more larvae after taking five doses of 400mg metronidazole daily for three days. [https://www.facebook.com/groups/htsupport/posts/5993193837403188/?comment_id=5993326564056582&reply_comment_id=5993931900662715]

* [https://en.wikipedia.org/wiki/Nitroimidazole Nitroimidazoles] (metronidazole, tinidazole, nimorazole, dimetridazole).

* [https://en.wikipedia.org/wiki/Quinolone_antibiotic Quinolones.] Drugs in the quinolone family have been shown to block a detoxification pathway required by helminths for blood feeding, resulting in arrested development of L3 larvae and adversely affecting the reproductive capacity of adult worms both in vitro and in vivo. [http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006931] (NB. In 2018, the European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds, [https://www.medscape.com/viewarticle/903029] and, in 2019, fluoroquinolones were linked with heart problems. [https://www.sciencedaily.com/releases/2019/09/190910154710.htm])
</blockquote>

==== ✅ Antibiotics that appear ''not'' to affect hookworm benefits ====
<blockquote>

* [https://www.ace-pharm.nl/en/products/broxil/ Broxil] (feneticilline) is a narrow-spectrum antibiotic containing the penicillin derivative pheneticillin potassium. It is used to treat infections caused by Streptococci and certain species of Staphylococci, e.g., pharyngitis, pneumonia and skin and soft tissue infections such as impetigo or abscesses. One NA host has confirmed that a 5 day course of Broxil did not harm her colony. [https://www.facebook.com/groups/htsupport/posts/6533802496675650?comment_id=8769535843102293]

* [https://en.wikipedia.org/wiki/Mycophenolic_acid Mycophenolic acid] Also called mycophenolate mofetil (MMF, trade name CellCept) and mycophenolate sodium (trade name Myfortic), this antibiotic/immunosuppressant drug has broad-spectrum antiviral, antifungal and antibacterial properties, but has not been commercialised as an antibiotic due to its adverse effects. One hookworm host has taken CellCept (500mg x 3 per day), apparently without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1001001649955790/] [https://www.facebook.com/groups/htsupport/permalink/1978467308875881/?comment_id=1978498922206053&reply_comment_id=1979680825421196&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Rifaximin Rifaximin] (Xifaxan, Xifaxanta and Normix, etc.) This drug is poorly absorbed when taken by mouth and stays within the gastrointestinal tract, so is unlikely to affect NA, which feed directly on their host's blood, and will pass by TT while they are grazing on tissue secretions within the intestinal lining. The drug's lack of effect on NA was confirmed by one self-treater who took a 14 day course of the drug to treat SIBO and had no return of symptoms from his sinus condition, and only noticed a minimal effect on egg production by his worms. [https://helminthictherapywiki.org/wiki/Treating_SIBO_and_sinusitis_with_NA_and_TTO]

* [https://en.wikipedia.org/wiki/Roxithromycin Roxithromycin] A ten day course of this drug taken by one NA host appeared not to harm their colony. [https://www.facebook.com/groups/htsupport/posts/23875947818701182?comment_id=24167803662848928]

* [https://en.wikipedia.org/wiki/Trimethoprim Trimethoprim] (Alprim) Two hookworm hosts have reported continuing to enjoy full benefits from their worms after taking this drug to treat urinary tract infections. One took a 5 day course of 100mg Trimethoprim x2 per day, [https://www.facebook.com/groups/htsupport/posts/26349623291333610] whille the second took seven doses of 300mg. Another NA host has reported that, when used to treat UTIs, Alprim not only did not affect her hookworm colony, but did not even arrest the production of ova by her worms. [https://www.facebook.com/groups/htsupport/permalink/1009048252484463/] Also, when the [https://en.wikipedia.org/wiki/Trimethoprim/sulfamethoxazole Trimethoprim/sulfamethoxazole] combination drug, AA-Sulfatrim DS 800, was taken by a hookworm host for 10 days (160mg x2 per day), this had no effect on his NA colony and produced no gastrointestinal changes. (Private communication)
</blockquote>

==== Topical antibiotics ====
<blockquote>
: If applied to the skin, or used as eye drops, [https://en.wikipedia.org/wiki/Antibiotics Topical antibiotics] are unlikely to affect helminths in many cases. For example, four drops of 0.3% [https://www.medicines.org.uk/emc/product/836/smpc Ciloxan] ([https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin]) applied to each eye 3 times each day for 2 weeks had no effect on the colonies of two hookworm hosts, [https://www.facebook.com/groups/htsupport/permalink/874927972563159/?comment_id=875296599192963&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://en.wikipedia.org/wiki/Tobramycin tobramycin] eye drops applied 3 times each day for 2 days, and twice each day for the following 3 days, had no obvious ill effect on another hookworm colony. [https://www.facebook.com/groups/htsupport/posts/4810224872366763/]

:However, someone else has reported that, while 0.3% tobramycin appeared to have no adverse effect when applied to a stye, an ophthalmic suspension of neomycin and polymyxin B sulfates and dexsmethasone did have a mild adverse effect on her NA colony.

:{{Quote|indent}}I ran out of the abx eye drops tobramyacin .3% after 7 days (taking 3-4 times a day). And I had no issues with that. But they refilled it with “neomycin and polymyxin B sulfates and dexsmethasone ophthalmic suspension.” And it has stunned my buddies a bit... I’ve been taking it 3 times a day in one eye for 6 days. I started feeling off around day 4. [https://www.facebook.com/groups/htsupport/posts/10073095316079666?comment_id=10073376886051509&reply_comment_id=23872842805678350]{{Quote|/indent}}
</blockquote>

==== General discussion ====
<blockquote>
Short courses of most other antibiotics will typically only cause a temporary loss of benefit for between 2 and 8 weeks (e.g., ➿ [https://en.wikipedia.org/wiki/Erythromycin erythromycin] [https://www.facebook.com/groups/htsupport/permalink/770548519667772/]), although it is possible for efficacy to be reduced for longer, e.g., [https://www.facebook.com/groups/htsupport/permalink/1131267180262569/?comment_id=1134969589892328&comment_tracking=%7B%22tn%22:%22R%22%7D 4 months], and even [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=951430548246234&comment_tracking=%7B%22tn%22:%22R0%22%7D 6 months], and there is anecdotal evidence suggesting a correlation between the length of a course of antibiotics and the length of time that affected helminths are out of action. This might suggest that a single shot of antibiotic might have little or no effect on human helminths, as has been reported by one hookworm host, [https://www.facebook.com/groups/htsupport/permalink/3419833164739281?comment_id=3422186914503906] but the type of antibiotic used may be critical in this case, and some antibiotic drugs might adversely affect a helminth colony even when only a single injection is administered. This happened when one hookworm host was given a single, 1 gram shot of cefazolin. See [[#Cefazolin|Cefazolin]] for details.

It is possible that even a small dose of antibiotic could cause a return of symptoms in some people. For example, one hookworm host has reported experiencing a recurrence of significant disease symptoms after using 3 drops per day, for only 1½ days, of a solution containing [https://en.wikipedia.org/wiki/Tobramycin tobramycin] 3mg (0.3%).

In cases of dental infection that would routinely be treated by a course of an oral antibiotic, it might be possible to avoid the use of a drug if the dentist is able to use localised ozone injections. [https://www.facebook.com/groups/htsupport/permalink/1252700651452554/] [https://www.facebook.com/groups/htsupport/permalink/1518817608174189/?comment_id=1519018198154130&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

When it is essential to take oral antibiotics, the duration of their negative effect on hookworms can be significantly reduced - perhaps to as little as 2 weeks - by taking a small top-up dose of no more than 5 larvae after finishing the course of drugs. In most cases, this inoculation can be carried out 48 hours after the last dose of the drug, but it's worth asking a pharmacist exactly how long the prescribed drug will take to clear completely from the body. Different antibiotics have different biological half-lives. For example, erythromycin's half-life is only a couple of hours, whereas penicillin's can be up to 56 hours.

An alternative to taking a small top-up dose of NA would be to take 250-500 TSO. One NA host has reported that, without a helminth top-up, it usually takes her 4-6 weeks to come right after an infection. But, if she takes 500 TSO after completing the antibiotics, she recovers within about 10 days. [https://www.facebook.com/groups/htsupport/posts/7062445007144727/?comment_id=7065489936840234] In a later report, this same individual said that even taking just 250 TSO post-antibiotics will enable her to bounce back within a week or so. [https://www.facebook.com/groups/htsupport/posts/7897313170324569/?comment_id=7911601488895737] If ordered at the same time as the antibiotics are started, TSO will arrive in time to be taken after the course of the drug is completed. And, since TSO remain viable for a couple of years in a fridge, a small supply of them can be kept to hand.

It has been suggested that the reduction in the benefits derived from hosting human helminths that is seen after taking antibiotics might result, at least in part, from a loss from the gut microbiome of helpful bacterial species and
the proliferation of less beneficial ones. This suggestion, and the fact that taking probiotics alongside antibiotics has been claimed to help [http://www.sciencedaily.com/releases/2013/05/130530192404.htm offset the gastrointestinal symptoms] typically associated with these drugs, has led to the suggestion that the use of high doses (perhaps 5 or 10 times the normal dose) of good quality probiotics might help to reduce the time that helminths are out of action after using these drugs, especially if the probiotics are taken at a different time of day from the drug. And this effect has been reported by one individual. [https://www.facebook.com/groups/htsupport/permalink/1257052664350686/?comment_id=1257367554319197&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, also see [https://www.ngmedicine.com/taking-probiotics-with-antibiotics-revisited/ this article] which looks at the evidence on the use of probiotics alongside antibiotics, which is not all positive. Additional help in protecting the microbiome might be gained by supplementing with either butyrate [https://www.sciencedirect.com/science/article/pii/S2211124719303845] or charcoal [https://www.ncbi.nlm.nih.gov/pubmed/29186529] alongside an antibiotic. A fecal microbiota transplant (FMT) might also help to restore worm benefits more quickly following treatment with an antibiotic. [https://www.facebook.com/groups/htsupport/permalink/1149149175141036/?comment_id=1242073262515293&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

It is possible that the consumption of prebiotics such as galacto-oligosaccharides (GOS) may also help to restore the gut biome, since GOS has been shown to help [http://www.ncbi.nlm.nih.gov/pubmed/24925303 support the recovery of beneficial bifidobacteria] and increase the production of butyrate, after antibiotic treatment. GOS is available in the form of [https://gutsupp.com GutSupp Prebiotic Powder (formerly "Bimuno")]. Fructooligosaccharides (FOS) and xylooligosaccharides (XOS) may perform a similar function. [https://www.ncbi.nlm.nih.gov/pubmed/30113166] For more detail about the effects of a total loss of worms due to antibitoic use, and how to restore a colony, see [[Hookworm dosing and response#Colony collapse | '''Colony collapse''']].

In the case of someone needing to take antibiotics regularly, or on a long-term basis, there would be little point in them using hookworms until completely off these drugs. Some worm benefits may be maintained in users of the human whipworm, so long as doses of this organism are being taken regularly, every few weeks. Another solution for those who need to take antibiotics frequently, or for prolonged periods, would be to switch to TSO as these are less likely to be adversely affected by antibiotics. While ciprofloxacin is capable of blocking the action of TSO, other antibiotics just slow them down. [https://www.facebook.com/groups/htsupport/permalink/1343118199077465/?comment_id=1343598479029437&comment_tracking=%7B%22tn%22%3A%22R%22%7D] HDC may also be less susceptible to antibiotics than human helminths, although two users of HDC have reported that the antibiotic,
⚡ [https://en.wikipedia.org/wiki/Dapsone Dapsone] (diamino-diphenyl sulfone), causes a return of their disease symptoms.
</blockquote>

==== ➿ Antibiotics best avoided for other reasons ====
<blockquote>
Some antibiotics are best avoided for other reasons.

* [https://en.wikipedia.org/wiki/Fluoroquinolone Fluoroquinolone antibiotics] can be extremely dangerous [https://en.wikipedia.org/wiki/Quinolone_antibiotic#Adverse_effects] and can cause permanent nerve damage. [http://healthimpactnews.com/2013/warning-fluoroquinolone-antibiotics-may-cause-permanent-nerve-damage/] This group of drugs includes [https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin] (cipro), [https://en.wikipedia.org/wiki/Levaquin levofloxacin] (Levaquin, Tavanic, etc.) [https://en.wikipedia.org/wiki/Tequin gatifloxacin] (Gatiflo, Tequin and Zymar), [https://en.wikipedia.org/wiki/Gemifloxacin Gemifloxacin] (Factive), [https://en.wikipedia.org/wiki/Moxifloxacin Moxifloxacin] (Avelox, Vigamox, Moxeza, etc.), [https://en.wikipedia.org/wiki/Norfloxacin Norfloxacin] (Noroxin) and [https://en.wikipedia.org/wiki/Ofloxacin Ofloxacin] (Floxin, Ocuflox, etc.). The European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds in 2018. [https://www.medscape.com/viewarticle/903029]

* [https://en.wikipedia.org/wiki/Clarithromycin Clarithromycin] (Biaxin, etc.) has been shown to increase the risk of a fatal heart attack compared with penicillin V, especially in older people with existing cardiac risk factors, although no increased risk was seen with [https://en.wikipedia.org/wiki/Roxithromycin roxithromycin] [http://www.bmj.com/content/349/bmj.g4930]. Also see this [https://pubmed.ncbi.nlm.nih.gov/29155931/ later study].
</blockquote>

=== Anticoagulants [https://en.wikipedia.org/wiki/Anticoagulant] ===

==== ✅ Safe anticoagulants unless otherwise marked ====
<blockquote>
Anticoagulant medicines and herbs (which reduce the clotting ability of blood) do not harm helminths, but may prolong bleeding from the tiny feeding sites of hookworms, which, themselves, secrete minute amounts of anticoagulants to help their digestive process. Anticoagulant drugs include:
* [https://en.wikipedia.org/wiki/Warfarin warfarin]
* [https://en.wikipedia.org/wiki/Heparin heparin]
Other drugs that have an anticoagulant effect include
* [https://en.wikipedia.org/wiki/Aspirin aspirin] and products containing it, such as
** [https://en.wikipedia.org/wiki/Alka-Seltzer Alka-Seltzer]
** ❓ [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol].

Herbs with an anticoagulant effect include:
* [https://en.wikipedia.org/wiki/Ginkgo_biloba ginkgo biloba]

All of these compounds may prolong bleeding at hookworm feeding sites to some extent, so may potentially contribute to anaemia (anemia) in susceptible individuals, especially if several of these drugs/supplements are taken at the same time.
</blockquote>

=== Antidepressants ===

Some self-treaters use certain SSRIs alongside NA and TTO without any apparent problem, but, according to a 2018 Nature article, [https://www.nature.com/articles/s41598-017-18457-w] some SSRIs (setraline, paroxetine, and chlorpromazine) have such a powerful anthelmintic effect that the authors suggested these drugs could be used clinically as dewormers.

'''NB''' Anyone who wants to start helminthic therapy who is already taking one of the antidepressants that has a known anthelmintic effect should not stop taking the drug without first consulting their medical advisor. This is because, although helminths can eventually help in some cases of depression, the worms are unlikely to start to work immediately and may actually cause a brief initial worsening of this condition before beginning to provide relief. See [[Helminthic therapy and neuropsychiatric disorders#Depression | '''Helminthic therapy and neuropsychiatric disorders: Depression''']].

<blockquote>

* ✅ [https://en.wikipedia.org/wiki/Amitriptyline Amitriptyline] (Elavil, etc.) This tricyclic antidepressant has been taken by at least one hookworm host at 15 mg per day, without issue. [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085576868164924&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Citalopram Citalopram] (Celexa, Cipramil and [https://en.wikipedia.org/wiki/Citalopram#Brand_names numerous other names].) This selective serotonin reuptake inhibitor (SSRI) has been used by at least one hookworm host with no ill effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1994977397224872/?comment_id=1995274433861835&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Doxepin Doxepin] This tricyclic antidepressant and potent antihistamine has been marketed under many names, including Quitaxon, Aponal and Sinequan. One individual has taken Doxepin daily for several years while hosting hookworms, without noticing any adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682894431766505&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Duloxetine Duloxetine] (Cymbalta, etc.) This Serotonin–norepinephrine reuptake inhibitor (SNRI) was taken by one NA host for several years to treat generalised anxiety without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2056263424429602/?comment_id=2058009587588319&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Fluoxetine Fluoxetine] (Prozac, Sarafem, etc.) A study published in Nature reported that this selective serotonin reuptake inhibitor (SSRI) was harmful to the non-theraputic helminth species ''C. elegans'', [https://www.nature.com/articles/s41598-017-18457-w] but fluoxetine is being taken by at least two hookworm hosts without issue [https://www.facebook.com/groups/htsupport/permalink/1686522081403740/?comment_id=1687356354653646&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085350661520878&comment_tracking=%7B%22tn%22%3A%22R%22%7D].

* ❓ [https://en.wikipedia.org/wiki/Venlafaxine Venlafaxine] (Effexor, etc.) There have been no reports about this particular drug yet, but it is a serotonin-norepinephrine reuptake inhibitor (SNRI), and it is already known that duloxetine (Cymbalta, etc.), which is another SNRI, appears to be safe for use by hosts of human helminths.

* ❌ [https://en.wikipedia.org/wiki/Desvenlafaxine Desvenlafaxine] (Pristiq, Desfax, Ellefore, etc.) One hookworm host has reported that this drug wiped out his entire NA colony.

* ⚡ [https://en.wikipedia.org/wiki/Escitalopram Escitalopram] (Cipralex and Lexapro.) After taking "the smallest possible dose" of this selective serotonin reuptake inhibitor (SSRI) in the form of Lexapro for 4 weeks, one user found that she lost all the benefits previously conferred by NA, and even HDC benefits were dampened. [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=2155918287797448&comment_tracking=%7B%22tn%22%3A%22R%22%7D]. However, someone else who took Lexapro for the first 2.5 years that she hosted NA did not lose her colony as a result of this. She was already taking 30 mg per day when she first inoculated, and then lowered the dose to 20 mg 18 months later. This user does have to top up her colony with a dose of 10 NA every three months, but this level of attrition is not excessive and may not be due to the drug. [https://www.facebook.com/groups/htsupport/permalink/2301858276536781/?comment_id=2309854282403847&reply_comment_id=2311232908932651&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Others have reported taking Lexapro without any obvious adverse effect on their NA, e.g, [https://www.facebook.com/groups/htsupport/permalink/3640310742691521?comment_id=3640395312683064 this self-treater] and someone else who had hosted NA for 7 years and been taking Lexapro during this entire time (10mg for 5 years, then 5mg for 2 years, and finally 2.5mg once a week for 3 years [https://www.facebook.com/groups/htsupport/posts/2301858276536781/?comment_id=2309854282403847&reply_comment_id=4866244573431459]) and was never aware of this having any adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Paroxetine Paroxetine] (Aropax, Brisdelle, Deroxat, Paxil, Pexeva, Paxtine, Paxetin, Paroxat, Paraxyl, Sereupin, and Seroxat.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class, has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]

* ❓ [https://en.wikipedia.org/wiki/Sertraline Sertraline] (Sold under a very large number of trade names, [https://www.drugs.com/international/sertraline.html] including Zoloft.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class has shown anthelmintic effects against four widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694] However, someone who has taken doses of either 100 mg or 150 mg of Zoloft daily for 1.5 years has reported continuing benefits from his NA. [https://www.facebook.com/groups/htsupport/permalink/3054501617939106/]
</blockquote>

=== Antifungals [https://en.wikipedia.org/wiki/Antifungals] ===

==== ✅ Safe antifungals unless marked otherwise ====
<blockquote>
The following appear to be safe for use with human helminths
* [https://en.wikipedia.org/wiki/Fluconazole fluconazole] (Diflucan and Trican)
* [https://en.wikipedia.org/wiki/Nystatin nystatin] (Mycostatin, Nilstat, Nystop, etc.) This has been used for many years by one hookworm host without harming his worms. [https://www.facebook.com/groups/htsupport/permalink/1995854040470541/?comment_id=1996211143768164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
* the fatty acid [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid] also appears safe [https://www.facebook.com/groups/htsupport/permalink/935151783207444/?comment_id=935208789868410&comment_tracking=%7B%22tn%22:%22R%22%7D]. However, anyone with a coconut allergy/intolerance should note that ''caprylic acid'' is a coconut/palm kernel derivative.
* the enzyme-based anti-Candida product [https://en.wikipedia.org/wiki/Candex candex] is also worm-safe. One hookworm host took 4 ''Candex'' capsules twice a day for over a month without any obvious harm to his worms. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Chlorophyll Chlorophyll]. A chlorophyll-based solution has been found to be [https://www.researchgate.net/publication/43335937_Antimicrobial_activity_of_chlorophyll-based_solution_on_Candida_albicans_and_Enterococcus_faecalis effective against Candida albicans] and there have been no reports to suggest this might be harmful to helminths. (Also see❓[[#Chlorophyllin|Chlorophyllin]].)

* [http://www.ncbi.nlm.nih.gov/pubmed/23965638 Some probiotics] may help to control candida, especially [https://en.wikipedia.org/wiki/Saccharomyces_boulardii Saccharomyces boulardii], which significantly inhibits [http://www.ncbi.nlm.nih.gov/pubmed/20629753 adhesion by C. albicans], thus [http://www.ncbi.nlm.nih.gov/pubmed/19732158 preventing the formation of biofilms and filamentation], and it is as [http://www.ncbi.nlm.nih.gov/pubmed/23703468 effective as nystatin] in reducing fungal colonization and invasive fungal infection. '''S. boulardii''' has also been taken by at least two helminth hosts without any obvious effect on their worms. At least one strain of Lactobacillus acidophilus can reduce the population of Candida albicans in the gut microbiota. [https://www.ncbi.nlm.nih.gov/pubmed/29997616]

* [https://en.wikipedia.org/wiki/Sodium_butyrate Sodium butyrate] is a powerful antifungal that inhibits pathogenic yeast growth [http://jac.oxfordjournals.org/content/66/11/2573.long]. It is available as a food supplement and is also manufactured in the human intestines by the fermentation of vegetables. The bacteria responsible for butyrate production are vulnerable to antibiotics, but can be reintroduced, or supplemented, by means of [https://en.wikipedia.org/wiki/Fecal_bacteriotherapy fecal microbiota transplants] (FMT), or the addition of the butyrate-producing bacterial species, [https://en.wikipedia.org/wiki/Clostridium_butyricum clostridium butyricum], which generates butyrate directly in the gut. C. butyricum is available in Japan as the probiotic, Miyarisan Tablets, [https://www.facebook.com/photo.php?fbid=10152806891616155&set=p.10152806891616155&type=1&theater] which may sometimes be found online, including on eBay, and in the probiotic formulations, Bifilac and Bifilac HP. [http://www.indiamart.com/abpl/probiotic-dietary-supplements.html] C. butyricum is also available as an animal feed additive. [http://www.alibaba.com/product-detail/probiotic-clostridium-butyricum_1589202110.html] Nutrients that help to increase butyric acid concentrations in the colon include pectin [https://en.wikipedia.org/wiki/Pectin] and larch arabinogalactan [https://en.wikipedia.org/wiki/Arabinogalactan], which is available as a supplement, [https://uk.iherb.com/search?kw=arabinogalactan&cids=1855&rank=1&rawkw=arabinoglactan&refererLocation=suggestion] although arabinogalactan can worsen rheumatic conditions. [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797204570335500&offset=0&total_comments=1], [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797261090329848&offset=0&total_comments=3] When buying any butyrate supplement, it's important to check ''all'' the ingredients in each product. One NA host who took [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] likely because this product contains medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Ascorbic_acid Ascorbic acid] (vitamin C) may interfere with the yeast-to-hypha transition [http://www.ncbi.nlm.nih.gov/pubmed/25084864] of candida.

* [https://en.wikipedia.org/wiki/Apple_cider_vinegar Apple cider vinegar]. Only a single individual has ever reported believing that apple cider vinegar had an adverse effect on their hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616632618392677&reply_comment_id=2617255014997104] Since many other hookworm hosts drink apple cider vinegar without issue, [https://www.facebook.com/groups/htsupport/permalink/1516308765091740/?comment_id=1516658838390066&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] it can be considered to be worm-friendly. It has been revealed as a possible treatment for Candida species involved in denture stomatitis, [http://www.ncbi.nlm.nih.gov/pubmed/25219289] and there have been suggestions that, if ingested, vinegar might induce the body's gut defence system to help combat a Candida albicans infection. [http://www.sciencedaily.com/releases/2015/06/150608151952.htm] Advice on using apple cider vinegar as part of an anti-Candida treatment regimen can be found [http://www.onegreenplanet.org/natural-health/how-to-treat-chronic-yeast-overgrowth-with-apple-cider-vinegar/ here].

* [https://en.wikipedia.org/wiki/Iodine Iodine] appears to have antifungal properties, is worm-friendly, and has proved effective against Candida for one hookworm host.[https://gettinghealthiernow.wordpress.com/2014/11/29/iodine-protocol-destroying-candida/]

* [https://en.wikipedia.org/wiki/Vitamin_D Vitamin D] turns on genes that make antimicrobial peptides, including cathelicidin [https://en.wikipedia.org/wiki/Cathelicidin], which has been shown to kill Candida. However, dosage with this vitamin may be critical, and excessive amounts might be counter-productive [http://www.ncbi.nlm.nih.gov/pubmed/25612733]. Aiming for the optimum blood level [http://www.vitamindcouncil.org/about-vitamin-d/how-do-i-get-the-vitamin-d-my-body-needs/] of vitamin D would therefore appear to be ideal. (Vitamin D3 has been shown to extend the median lifespan of one species of roundworm by 30-40%. [http://www.vitamindcouncil.org/vitamin-d-news/new-research-finds-vitamin-d-extends-the-life-of-roundworms-08-2015/#])

* Some foods [http://www.thecandidadiet.com/candida-fighting-foods.htm], eaten in normal dietary amounts, may help support an anti-Candida programme, but see the separate notes on ⚡[[#Cayenne|cayenne]], ⚡[[#Coconut|coconut]] and ⚡[[#Ginger|ginger]]. Fresh ✅ garlic may be particularly helpful [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538912/], and dietary forms of garlic are known to be worm-safe, but see the details in the separate entry for [[#Garlic|garlic]].

* When Candida is a problem, very low carbohydrate (VLC) diets are best avoided because these cause ketosis, and yeasts love ketones.

* [https://en.wikipedia.org/wiki/Monolaurin Monolaurin] (also known as glycerol monolaurate, glyceryl laurate or 1-lauroyl-glycerol). Monolaurin is a monoglyceride - the mono-ester formed from glycerol and lauric acid. Shown in test tube studies to have antibacterial and antiviral activity, it is commonly used as a surfactant in cosmetics, including deodorants, and as an emulsifier in foods. While it is active against candida [http://www.ncbi.nlm.nih.gov/pubmed/20008774], one subject has reported that taking two teaspoons of monolaurin daily, for a few weeks, produced no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872137176175572&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872142719508351&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R4%22%7D] Another believes that she probably ingested a significant dose of monolaurin by drinking full fat coconut milk daily, but that her hookworms and whipworms both survived this. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] Others have also confirmed that monolaurin is worm-safe. [https://www.facebook.com/groups/htsupport/permalink/974642915924997/?comment_id=975547445834544&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1368090353246916/?comment_id=1369652509757367&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/posts/9279862498736289?comment_id=9280024828720056]

A very worm-friendly way to reduce Candida is to brush one's teeth after every meal instead of just once each day. This has been shown to reduce the abundance of C. albicans in the stool by 10-fold to 100-fold. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874442/] The addition of regular [https://wellnessmama.com/17951/coconut-oil-pulling/ oil pulling using coconut oil] (not to be swallowed) could further reduce the amount of candida. [https://www.facebook.com/groups/htsupport/permalink/1617823828273566/?comment_id=1618578738198075&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>

==== ❓ More antifungals ====

<blockquote>

* ❓ '''Cellular silver''' (see [[#AlternativeTherapies|Alternative therapies]] section). The manufacturers of Advanced Cellular Silver (ACS) 200 Extra Strength [http://www.resultsrna.com/products/acs_200_overview/] claim that this product achieves a 99.9989% kill against C. albicans. Although there have been no reports to date of its possible effect on human helminths, its similarity to ➿'''colloidal silver''' (see [[#AlternativeTherapies|Alternative therapies]] section) suggest that it may not kill the worms but only cause a temporary reduction of benefits.

* ❓ [https://en.wikipedia.org/wiki/Lactoferrin Lactoferrin] (also known as lactotransferrin [LTF]) is found naturally in secretory fluids, such as milk, saliva, tears and nasal secretions. It has antibacterial, antiviral, antifungal and antiparasitic properties, and is effective against candida. It’s antimicrobial properties are enhanced by the peptide, ❓[https://en.wikipedia.org/wiki/Lactoferricin lactoferricin], the anti fungal effects of which exceed those of lactoferrin. However, there have been no reports of any adverse effect on helminths, and one NA host has reported that taking 300mg of lactoferrin per day had no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/2116858295036781/]

* ❓ [https://en.wikipedia.org/wiki/Lavandula Lavender] has antifungal activity and may be of value in treating candida. [http://www.ncbi.nlm.nih.gov/pubmed/26550521]

* ❓ '''Propolis''' (see [[#NutritionalSupplements|Nutritional supplements]] section). Candida has been shown to be susceptible to propolis extract [http://www.ncbi.nlm.nih.gov/pubmed/26149083], and to red propolis alcoholic extract. [http://www.ncbi.nlm.nih.gov/pubmed/26154370]

* ❓ [https://en.wikipedia.org/wiki/Polygodial Polygodial], which has both antifungal and antimicrobial properties and is used as an insecticide, is an active constituent of
** ❓ [https://en.wikipedia.org/wiki/Tasmannia_stipitata Dorrigo pepper],
** ❓ [https://en.wikipedia.org/wiki/Tasmannia mountain pepper],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera horopito],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera_colorata mountain horopito],
** ❌ [https://en.wikipedia.org/wiki/Pseudowintera_colorata Kolorex],
** ❓ [https://en.wikipedia.org/wiki/Drimys_winteri canelo] (Drimys winteri, winter's bark)
** ❓ [https://en.wikipedia.org/wiki/Acmella_oleracea paracress] and
** ❓ [https://en.wikipedia.org/wiki/Persicaria_hydropiper water pepper].
Whilst polygodial has been shown to be effective against single-celled parasites such as protozoa, the only report so far that it might also have an adverse effect on helminths comes from a hookworm host who suspects that she killed her colony by taking '''Kolorex''', which contains a mixture of horopito and ⚡'''aniseed'''.

* ❓ [https://en.wikipedia.org/wiki/Undecylenic_acid Undecylenic Acid]. This is the common name for 10-Undecenoic Acid, which is used in the Thorne Research product, [https://www.thorne.com/products/dp/formula-sf722-reg Formula SF722]. It is a potent antifungal mono-unsaturated fatty acid extracted from coconut and the castor bean. It has been shown to be 11 times stronger than [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid], and is also claimed to have antiparasitic properties, although there have been no reports about this from hosts of therapeutic helminths.

* ⚡ [https://en.wikipedia.org/wiki/Curcumin Curcumin] inhibits candida [http://jac.oxfordjournals.org/content/63/2/337.long], even at low concentrations, but see the main entry below for [[#Turmeric|Turmeric/curcumin]] for further details.

* ❌ [https://en.wikipedia.org/wiki/Nigella_sativa Black cumin] (nigella sativa). Also known as blackseed, black seed, black caraway, fennel-flower, nutmeg flower, Roman coriander, kalonji and 'Love in the Mist'. Extracts of this herb have shown antifungal effects [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642442/] against different strains of Candida albicans, but it has also been used as an anthelmintic since ancient times. While one self-treater has reported that black cumin did not harm NA, HDC or TSO when he took them, [https://www.facebook.com/groups/htsupport/permalink/26499688856327052/] black cumin and its active component, thymoquinone, have nevertheless demonstrated anthelmintic activity against several nematode species, including Trichuris muris - a relative of the human whipworm, Trichuris trichiura - as well as two other human helminths: Ascaris lumbricoides and the blood fluke, Schistosoma mansoni. In India, today, nigella seeds are combined with various purgatives to help kill and expel intestinal parasites, and they have a synergistic effect with pharmaceutical anthelmintics. [https://www.ncbi.nlm.nih.gov/pubmed/30149818]

* ❌ [https://en.wikipedia.org/wiki/Gymnema_sylvestre Gymnema sylvestre] is effective against candida [http://www.k-state.edu/media/newsreleases/jun13/vediyappan91213.html], but hydroalcoholic extracts of this herb have been found to have anthelmintic activity against the Indian earthworm, Pheretima posthuma. [http://www.ijrap.net/admin/php/uploads/525_pdf.pdf] Even though the research worm, C. elegans, appears to be unaffected by gymnema [http://www.ncbi.nlm.nih.gov/pubmed/?term=gymnema+sylvestre+candida] and there are genetic similarities [http://www.ncbi.nlm.nih.gov/pubmed/11812491] between C. elegans and N. americanus, one helminth host suspects that gymnema was responsible for the loss of his hookworm colony.

* ❌ [https://en.wikipedia.org/wiki/Lufenuron Lufenuron] is a benzoylurea pesticide used on crops and in veterinary medicine (in flea control, heartworm treatments and other anthelmintic products). Its powerful anti-fungal effects may be due to its ability to inhibit the synthesis of chitin, which is unfortunately an important constituent of the mouthparts of the hookworm.

Some herbal antifungal products may adversely affect helminths, especially if they are in a concentrated form, so any herbal medicine that claims to have antifungal properties should be approached with caution.

Some foods are coated with edible films containing antifungal compounds such as ❓[https://en.wikipedia.org/wiki/Natamycin natamycin] (pimaricin) and ❌ '''oregano oil''' (see [[#Oregano|Oregano reference]])
but the quantities used in this application are probably insufficient to affect helminths, and there is no evidence [http://www.inchem.org/documents/jecfa/jecmono/v48je06.htm] to date that natamycin harms intestinal flora.

NB. Prolonged treatment with antifungal drugs can disrupt commensal fungal populations and cause an increase in
the severity of disease states, as seen in one study [http://www.ncbi.nlm.nih.gov/pubmed/27237365] in acute and chronic models of colitis and allergic airway
disease.
</blockquote>

=== Antihistamines ===

==== Antihistamines as marked ====

<blockquote>
* ✅ Worm-safe antihistamines are
** [https://en.wikipedia.org/wiki/Diphenhydramine diphenhydramine] -- most likely to cause drowsiness
** [https://en.wikipedia.org/wiki/Loratadine loratadine] (Claritin, Lorafix)
** [https://en.wikipedia.org/wiki/Fexofenadine fexofenadine] (Allegra, Fexidine, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo) -- least likely to cause drowsiness
* ✅ Most '''Benadryl-branded products''' sold in the '''US''' contain only diphenhydramine so are worm-safe, e.g.
** [http://www.benadryl.com/products/allergy/benadryl-ultratab-tablets Benadryl Allergy Ultratab Tablets]
** [http://www.benadryl.com/products/allergy/benadryl-liquid-gels Benadryl Allergy Dye-Free Liqui-gels]
** [http://www.benadryl.com/products/children-allergy/benadryl-allergy-liquid Children’s Benadryl Allergy Liquid]
* ⚡ except
** [https://www.benadryl.com/products/children-allergy/benadryl-allergy-and-sinus-liquid Childrens’ Benadryl Allergy Plus Congestion] which also contains ⚡ phenylephrine. (See [[#Phenylephrine|local reference]].)

'''Benadryl products''' sold in the '''UK''' all contain drugs with anthelmintic potential - either
* ⚡ cetirizine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-liquid-capsules Benadryl Allergy Liquid Release Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-one-day Benadryl One a Day Relief Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-aged-two-plus Benadryl Allergy Children’s (2+ years) 1mg/ml Oral Solution]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-children Benadryl Allergy Children’s 6+ 1mg/ml Oral Solution]
* ⚡ acrivastine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief-plus Benadryl Allergy Relief Plus Decongestant Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief Benadryl Allergy Relief Capsules]
* ❓ [https://en.wikipedia.org/wiki/Chlorphenamine Chlorphenamine] (chlorpheniramine, piriton) While we don’t yet have any confirmation of the effect on helminths of this first-generation antihistamine, it has been suggested by someone who has investigated this that it is unlikely to be harmful to worms.

* ✅ [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium, plus Gastrocrom and Intercron) This is a mast cell stabiliser which prevents the release of histamine from mast cells and is used to treat some allergic conditions. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Doxylamine Doxylamine] (Bendectin, Debendox, Diclectin, Diclegis, Dozile, Lenotan, Merbental, Restavit, Unisom, Valocordin-Doxylamine, Vicks Formula 44 and Vomentin, etc.) One hookworm host believes that an unexpected return of gut symptoms and dry skin may have been caused by taking a quarter of a tablet of this first-generation antihistamine every night for a couple of weeks. [https://www.facebook.com/groups/htsupport/permalink/927991007256855/?comment_id=1007272959328659&comment_tracking=%7B%22tn%22:%22R%22%7D] Another NA host believes that taking diclectin (doxylamine combined with pyridoxine) put her worms out of action until she stoped taking it. [https://www.facebook.com/groups/htsupport/permalink/2706737069382231/]

* ⚡ [https://en.wikipedia.org/wiki/Ketotifen Ketotifen] - This antihistamine and mast cell stabilizer, which has similar effects to cromoglicic acid (see separate listing), is sold under a large variety of trade names [https://www.drugs.com/international/ketotifen.html] that include Allerban, Allergan, Bentifen, Ketasma, Mastifen, Zaditen and Zylofen. In one study using the helminth, Trichinella spiralis, the addition of ketotifen resulted in a greater worm burden and worm size, [https://www.ncbi.nlm.nih.gov/pubmed/16886340] but in a small in vitro test, one hookworm self-treater found that exposing a sample of NA larvae to Naziden left them “a bit lethargic but alive” [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1041766029212685&comment_tracking=%7B%22tn%22:%22R8%22%7D] and they were still alive the next day. [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1042321262490495&comment_tracking=%7B%22tn%22:%22R3%22%7D] However, effects in vivo don’t always correspond with those observed in a petri dish, and ketotifen is a piperazine-related substance so it may have an adverse effect on human helminths in vivo in at least some users.

* ⚡ [https://en.wikipedia.org/wiki/Promethazine Promethazine] (Phenergan, Promethegan, Romergan, Fargan, Farganesse, Prothiazine, Avomine, Atosil, Receptozine, Lergigan, and, in the UK, Sominex). This does not appear to kill helminths, whether taken orally or by intramuscular injection, and one self-treater who needs to take oral Phenergan daily says that her NA are unaffected. [https://www.facebook.com/groups/htsupport/permalink/1597006987021917/?comment_id=1597396203649662&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another hookworm host has reported that this drug did reduce his worm benefits when it was taken orally.
</blockquote>

==== Piperazine related antihistamines ====
<blockquote>
Popular antihistamines derived from, or closely related to, the anthelmintic drug ❌ [https://en.wikipedia.org/wiki/Piperazine piperazine] (See the separate entry for [[#piperazine|piperazine]]).
These include:
* ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine)
* ⚡ [https://en.wikipedia.org/wiki/Levocetrizine_dihydrochloride levocetrizine] (Alcet, Allear, Curin, levcet, Seasonix, T-Day Syrup, Teczine, UVNIL, Vozet, Xaltec, Xozal, Xuzal, Xusal, Xyzal, Zilola, Zyxem)

* ⚡ [https://en.wikipedia.org/wiki/Phenylephrine phenylephrine] Some nasal decongestants and allergy medications contain this drug (e.g., products branded "Sudafed PE", but not those branded "Sudafed") so check the ingredients of the product you are considering using. While one hookworm host has reported using this drug without any adverse effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537715762951030] it does appear to have anthelmintic properties [http://www.ncbi.nlm.nih.gov/pubmed/6127426] and has been reported to have caused a brief return of disease symptoms in one hookworm host after a single dose.
* ⚡ [https://en.wikipedia.org/wiki/Desloratadine desloratadine] (NeoClarityn, Claramax, Clarinex, Larinex, Aerius, Dazit, Azomyr, Deselex and Delot)
* and possibly ⚡ [https://en.wikipedia.org/wiki/Acrivastine acrivastine] (Semprex-D in the US)

While some people have taken cetirizine, levocetirizine or desloratadine concurrently with helminthic therapy -
sometimes for very long periods - and had no loss of benefit from their worms (for example [https://www.facebook.com/groups/htsupport/permalink/892594554129834/?comment_id=892794274109862&offset=0&total_comments=16&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/893959107326712/?qa_ref=qd&comment_id=893959580659998&offset=0&total_comments=9&comment_tracking=%7B%22tn%22:%22R7%22%7D]), there
have been others who have suspected that these drugs have been responsible for adversely affecting or even killing their worms.

Less common antihistamines derived from, or related to ❌piperazine.
At the present time, there is no indication whether or not most of the following drugs could affect human helminths.
* ❓ [https://en.wikipedia.org/wiki/Buclizine buclizine]
* ❓ [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan)
* ❓ [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5)
* ✅/⚡ [https://en.wikipedia.org/wiki/Hydroxyzine Hydroxyzine] (Atarax, Vistaril, etc.) A parent has reported that her son’s NA were not harmed by taking this drug, but dose size and length of use in this case are not known. [https://www.facebook.com/groups/htsupport/2666963426692929/?comment_id=2667238819998723&reply_comment_id=2669051416484130&notif_id=1581006498061422&notif_t=group_comment_mention]
* ❓ [https://en.wikipedia.org/wiki/Cyclizine cyclizine]
* ❓ [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs)
* ⚡ [https://en.wikipedia.org/wiki/Dramamine dimenhydrinate] See [[#dimenhydrinate|dimenhydrinate reference]].
* ❓ [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
* ❓ [https://en.wikipedia.org/wiki/Bilastine bilastine] (Bilaxten) One NA host has reported that she had been taking bilastine on and off for 3 years - the same amount of time that she had been hosting NA - because she has found it to be very effective for her allergies, and, while the NA have sometimes seemed to be working during this time, they have mostly seemed not to be working all that well. However, she had been able to grow more NA consistently for 2 of the 3 years, thus confirming that she still had some worms, but, when she last reported her experience, she had stopped taking the Bilastine to see whether the NA work better in its absence. [https://www.facebook.com/groups/htsupport/posts/4820011088054808/?comment_id=4851343294921587]
</blockquote>

==== ✅ H2 antagonists are safe ====

<blockquote>
H2 antagonists are a separate class of drugs from '''proton-pump Inhibitors''' (see separate section).

The term, “antihistamine” is usually reserved for [https://en.wikipedia.org/wiki/H1_antagonist H1 antagonists] whose main therapeutic effect is mediated by
negative modulation of histamine receptors, but [https://en.wikipedia.org/wiki/H2_antagonist H2 histamine receptor antagonists] can also be considered to be a
type of antihistamine. H2 antagonists include
* [https://en.wikipedia.org/wiki/Ranitidine ranitidine] (Zantac) which works by blocking histamine and thus decreasing the amount of acid released by the cells of the stomach.
Other common H2 antagonists are
* [https://en.wikipedia.org/wiki/Cimetidine cimetidine] (Tagamet)
* [https://en.wikipedia.org/wiki/Famotidine famotidine] (Pepcid) One hookworm host used this drug successfully, without harm to his colony, for at least 2 months, starting with 20mg daily and titrating within a month to 3x20mg per day. [https://www.facebook.com/groups/htsupport/posts/5898386906883882?comment_id=5898568306865742&reply_comment_id=5900280486694524]
* [https://en.wikipedia.org/wiki/Nizatidine nizatidine] (Axid, Tazac).
</blockquote>

=== Antimalarials ===

<blockquote>
*⚡ [https://en.wikipedia.org/wiki/Chloroquine Chloroquine] A cross-epidemiological study of the effect of treatment for malaria in hookworm-endemic areas found that treated patients presented with reduced helminth egg burdens and worm-related pathology, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558454/] and a reduced hookworm egg count has also been reported in another set of subjects taking chloroquine. [https://pubmed.ncbi.nlm.nih.gov/9645872/]
*✅ [https://en.wikipedia.org/wiki/Hydroxychloroquine Hydroxychloroquine] (Plaquenil, etc.) There has been one tentative suggestion from a helminth self-treater that this antimalarial medication, ''might'' have harmed her hookworms, but several others have taken this drug without any adverse effect on their worms. One took Plaquenil for 5 years without harming his NA, [https://www.facebook.com/groups/htsupport/permalink/3000811316641470/?comment_id=3001544019901533] another takes 400 mg daily without any adverse effect on her hookworms, [https://www.facebook.com/groups/htsupport/posts/4823182771070973/?comment_id=4824165244306059] and two further subjects who have taken this drug, one of them in quite large quantities, had no issues with their worms. (Link expired)
No other antimalarial drug has been suspected by self-treaters of harming therapeutic helminths, including [https://en.wikipedia.org/wiki/Quinine Quinine].
</blockquote>

=== Antiprotozoals ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). This is one of three derivatives of ❌[https://en.wikipedia.org/wiki/Nitroimidazole nitroimidazole] that is used against anaerobic bacterial and parasitic, as well as protozoan, infections. One hookworm host has reported[https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] losing her colony to this drug, which should never be combined with [https://en.wikipedia.org/wiki/Mebendazole mebendazole] due a risk that, together, they may cause [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis], something about which many doctors and pharmacists may be unaware, especially in the US.
</blockquote>

=== Antipsychotics ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Chlorpromazine Chlorpromazine] (Thorazine and Largactil, etc.) This antipsychotic medication has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]
</blockquote>

=== Antivirals ===
<blockquote>
(Also see [[Human helminth care manual#Natural antivirals|'''Natural antivirals''']] for effective worm-safe antiviral treatments.)

* ✅ [https://en.wikipedia.org/wiki/Famciclovir Famciclovir] (Famvir) -- One hookworm host took Famciclovir (500mg) 3 times per day for many months without any noticeable effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/884990498223573/?comment_id=885041121551844&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir Nirmatrelvir / ritonavir] This co-packaged medication, which combines two protease inhibitors and is marketed as Paxlovid, is used as a treatment for Covid‑19. There have been no reports of it harming human helminths and one report that it did not harm one self-treater’s NA colony. [https://www.facebook.com/groups/htsupport/posts/6439043419484892/?comment_id=6439498362772731]

* ✅ [https://en.wikipedia.org/wiki/Valtrex Valaciclovir/valacyclovir] (Valtrex, Zelitrex) -- This antiviral drug was taken by one worm host for a week without any adverse effect on his hookworms or whipworms.

* ❌ Nitazoxanide (See separate entry under Anthelmintics)
</blockquote>

=== Immunoglobulin therapy (IVIG) ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Immunoglobulin_therapy Immunoglobulin therapy], also known as normal human immunoglobulin (NHIG) is compatible with helminthic therapy and has been used effectively in combination with TSO. There is no reason to think that it would harm human helminths.
</blockquote>

===Immunomodulatory drugs ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Janus_kinase_inhibitor Janus kinase inhibitors], also known as JAK inhibitor or jakinib (e.g., baricitinib, tofacitinib and upadacitinib [Rinvoq]) are immune modulating medications used in the treatment of some cancers, autoimmune and inflammatory diseases such as rheumatoid arthritis, and various skin conditions. There is no evidence indicating that these drugs might have an anthelmintic effect, [https://www.facebook.com/groups/htsupport/posts/8698182570237621?comment_id=8698286136893931&reply_comment_id=8702949483094263] and there have been no reports from self-treaters of any adverse effects on their worm colonies.
</blockquote>

=== Immunosuppressive drugs ===

<blockquote>
'''✅ Immunosuppressive drugs reported to be safe for use by hosts of human helminths are:'''
* [https://en.wikipedia.org/wiki/Cyclosporin ciclosporin] (cyclosporine, cyclosporin). See also [https://en.wikipedia.org/wiki/Cyclosporins cyclosporins].

* [https://en.wikipedia.org/wiki/Corticosteroid corticosteroids], including:
** [https://en.wikipedia.org/wiki/Prednisone prednisone] and its active metabolite, [https://en.wikipedia.org/wiki/Prednisolone prednisolone]
** [https://en.wikipedia.org/wiki/Fluticasone_propionate fluticasone propionate] Also known as Flixotide (inhalatory), Flixonase and Flonase (nasal). At least three NA hosts have used this drug without any obvious impact on their worms. [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707582379297710&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707720709283877&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707880315934583&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cyclophosphamide cyclophosphamide] (Sold as: Cytoxan, Lyophilized Cytoxan, Endoxan, Neosar, Procytox, Revimmune and Cycloblastin). This has been used repeatedly by one hookworm host who has reported that it had no adverse effect on her colony.

* the [https://en.wikipedia.org/wiki/Thiopurine thiopurines], [https://en.wikipedia.org/wiki/Azathioprine azathioprine] and [https://en.wikipedia.org/wiki/6-MP mercaptopurine]/6-MP (purinethol)

* the [https://en.wikipedia.org/wiki/TNF_inhibitor TNF inhibitors]
** [https://en.wikipedia.org/wiki/Infliximab infliximab] (Remicade)
** [https://en.wikipedia.org/wiki/Adalimumab adalimumab] (Humira)
** [https://en.wikipedia.org/wiki/Certolizumab_pegol certolizumab pegol] (Cimzia)
** [https://en.wikipedia.org/wiki/Golimumab golimumab] (Simponi)

* [https://en.wikipedia.org/wiki/Humanized_antibody humanized antibody drugs], e.g. [https://en.wikipedia.org/wiki/Omalizumab omalizumab] (Xolair)

* [https://en.wikipedia.org/wiki/Monoclonal_antibody%23.22Fully.22_human_monoclonal_antibodies humanized monoclonal antibody drugs] such as [https://en.wikipedia.org/wiki/Natalizumab natalizumab] (Tysabri)

* and [https://en.wikipedia.org/wiki/Fusion_protein recombinant fusion protein] drugs such as [https://en.wikipedia.org/wiki/Etanercept etanercept] (Enbrel)

It can be an advantage to be taking one of these drugs in the early stages of helminthic therapy because they can reduce, or even prevent, the transient side effects triggered by helminths, and their anti-inflammatory action can also help human helminths to become established. So anyone who is already taking one of these drugs should resist the temptation to stop taking it too soon after starting HT.

This applies particularly to subjects with Crohn's and other intestinal diseases, who tend to have a very vigorous immune response to helminths. Suddenly withdrawing a drug that has been keeping this response in check will likely cause a rebound effect that could result in a flare and, potentially, a loss of worms. This is explained in more detail [[Introduction to helminthic therapy#Combining helminthic therapy with drug treatments | '''here''']].
</blockquote>

=== Immunotherapy ===

<blockquote>
✅ [https://en.wikipedia.org/wiki/Allergen_immunotherapy Allergen immunotherapy] -- In the form of sublingual drops/tablets, subcutaneous injections, and [https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-shots-(immunotherapy) allergy “shots”],
this is safe to be used concurrently with helminthic therapy. In fact, many who have used the two therapies together have been very pleased with the combined effects.
</blockquote>

=== Laxatives ===
<blockquote>
Hookworms are usually able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep] using products such as polyethylene glycol (PEG), Macrogol, Colyte, Picosalax, Bisacodyl, phospho soda, sodium picosulfate, or sodium phosphate and/or magnesium citrate. Many hookworm hosts have used the standard colonoscopy bowel prep without any problems (e.g., [https://www.facebook.com/groups/htsupport/permalink/2313948658661076/?comment_id=2316622215060387&comment_tracking=%7B%22tn%22%3A%22R%22%7D]), and there has only been a single report claiming that colonoscopy prep had terminated a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2184696924919584/?comment_id=2184806188241991&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another NA host has reported that, while a colonoscopy prep didn't entirely wipe out his colony, it appeared to have weakened it because he found a much smaller number of larvae than usual when he next incubated. [https://www.facebook.com/groups/htsupport/permalink/6481648121891088/]

It is unlikely that laxatives would dislodge human whipworms once these are mature and embedded in the colonic mucosa, but laxatives could potentially flush them out before this, especially around 21-22 days post inoculation. It may therefore be best to avoid the use of laxatives around this time. After 28 days, human whipworms should not be affected at all.

Also see [[#Diarrhoea/diarrhea|'''Diarrhoea/diarrhea''']].
</blockquote>

=== [https://en.wikipedia.org/wiki/Muscle_relaxant Muscle relaxants] ===
<blockquote>
There is a theoretical risk that anything which relaxes a hookworm host may have a similar effect on their colony, especially NA, and that this might conceivably affect the ability of the worms to maintain their grip on the host’s mucosa, possibly resulting in their expulsion, although this effect would likely be dose-dependent.

Whipworms are much less likely than hookworms to be affected in this way, due to them not feeding directly from the bloodstream and the fact that they anchor themselves deeply into the colonic mucosa, so are not easily dislodged.

There have been two reports of possible adverse effects. In the first of these, a hookworm host suspected ❌ [https://en.wikipedia.org/wiki/Carisoprodol Carisoprodol] (Soma, Sanoma and Carisoma) of causing the loss of his hookworm population. In the second, ❌ [https://en.wikipedia.org/wiki/Cyclobenzaprine Cyclobenzaprine] (Flexeril, Amrix, etc.) was identified as the only likely cause of multiple failed attempts to incubate NA. [https://www.facebook.com/groups/htsupport/posts/24119753220987306/] However, both ✅ [https://en.wikipedia.org/wiki/Guaifenesin '''Guaifenesin'''] and a single night-time dose of 6 mg of [https://en.wikipedia.org/wiki/Tizanidine ✅ '''Tizanidine'''] [https://www.facebook.com/groups/htsupport/posts/4490377691018151/?comment_id=4490387587683828] appear to have been safe.
</blockquote>

=== [https://en.wikipedia.org/wiki/Analgesic Pain relievers (analgesics)] ===
<blockquote>
The following pain relief medications are all harmless to NA and TTO.

* ✅ [https://en.wikipedia.org/wiki/Nonsteroidal_anti-inflammatory_drug '''NSAIDs (nonsteroidal anti-inflammatory drugs''')]
: * [https://en.wikipedia.org/wiki/Aspirin Aspirin]
: * [https://en.wikipedia.org/wiki/Ibuprofen Ibuprofen]
: * [https://en.wikipedia.org/wiki/Diclofenac Diclofenac]
: * [https://en.wikipedia.org/wiki/Naproxen Naproxen]
* ✅ [https://en.wikipedia.org/wiki/Opioids '''Opioids''']
: * [https://en.wikipedia.org/wiki/Codeine Codeine]
: * [https://en.wikipedia.org/wiki/Fentanyl Fentanyl]
: * [https://en.wikipedia.org/wiki/Hydrocodone Hydrocodone]
: * [https://en.wikipedia.org/wiki/Oxycodone Oxycodone]
* ✅ [https://en.wikipedia.org/wiki/Paracetamol '''Paracetamol (acetaminophen)''']
* ✅ [https://en.wikipedia.org/wiki/Benzodiazepine '''Benzodiazepines'''] such as:
: * [https://en.wikipedia.org/wiki/Midazolam Midazolam] ([https://en.wikipedia.org/wiki/Versed Versed])
</blockquote>

=== Recreational drugs ===

==== ❌ Piperazine-based recreational drugs ====
<blockquote>
[http://www.tandfonline.com/doi/pdf/10.1080/13102818.2008.10817529 Piperazine-based recreational drugs] are a group of stimulant drugs with similar effects to ecstasy.
(See separate entry for details on [[#piperazine|piperazine]]) The main piperazine-derivatives that have been used for
recreational purposes include
* [https://en.wikipedia.org/wiki/Benzylpiperazine BZP] (Benzylpiperazine, A2, Frenzy, Nemesis)
* [https://en.wikipedia.org/wiki/Trifluoromethylphenylpiperazine TFMPP] (1-[3-(trifluoro-methyl) phenyl]piperazine)
* [https://en.wikipedia.org/wiki/Meta-Chlorophenylpiperazine mCPP] (meta-chlorophenylpiperazine, 1- [3-Chlorophenyl]-piperazine).
These drugs were frequently mixed with caffeine and a range of vitamins and binders to make party pills that were marketed as
“natural” or “herbal” highs, but were actually purely synthetic. Other piperazine-derived designer drugs include:
* '''AcBZP''' (4-Acetyl-1-benzylpiperazine, AceticBenzylPiperazine)
* [https://en.wikipedia.org/wiki/Methylbenzylpiperazine MBZP] (1-methyl-4-benzylpiperazine)
* [https://en.wikipedia.org/wiki/2C-B-BZP 2C-B-BZP] (4-Bromo-2,5-dimethoxy-1-benzylpiperazine) One user has reported that periodic use of 2C-B did not affect his colony of NA.
* [https://en.wikipedia.org/wiki/Dibenzylpiperazine DBZP] (1,4-Dibenzylpiperazine)
* [https://en.wikipedia.org/wiki/Methylenedioxybenzylpiperazine MDBZP] (3,4 Methylenedioxy-1-benzylpiperazine)
</blockquote>

==== ⚡ Yage (Ayahuasca) ====

<blockquote>
It has been opined that anything that enters the bloodstream and disorients a host has a potential to do the same to hookworms - since they feed on their host’s blood - and that, if the disorientation is excessive, it may cause the worms to lose their grip on the mucosa and possibly be flushed away from their home base in the small intestine, and be lost. Although the assumption that the worms will become inebriated by anything that inebriates their host has been questioned because the 'nervous system' of helminths is quite different from that of mammals, one recreational drug that might produce this effect and cause the loss of hookworms is the South American drug, yage, also known as ayahuasca, as well as by a number of other names. [https://en.wikipedia.org/wiki/Ayahuasca%23Nomenclature]

This psychedelic brew, which is concocted by combining a variety of plant materials, was used as part of S. American native religious rituals and, since being commercialised, has become much more mainstream. Available in Europe and N. America through "churches" set up for its import, this drug causes a deep and immersive hallucinogenic experience during a “trip” lasting 4-8 hours, or 12-18 hours if the subject is re-dosed, which is not uncommon.

"Its purgative properties are important (known as la purga or "the purge"). The intense vomiting and occasional diarrhea it induces can clear the body of worms and other tropical parasites [https://www.ncbi.nlm.nih.gov/pubmed/2656954] and harmala alkaloids themselves have been shown to be anthelmintic. [https://link.springer.com/article/10.1007%2FBF02860378] Thus, this action is twofold; a direct action on the parasites by these harmala alkaloids (particularly harmine in ayahuasca) works to kill the parasites, and parasites are expelled through the increased intestinal motility that is caused by these alkaloids." [https://en.wikipedia.org/wiki/Ayahuasca]

“Tropical plants used by South American natives produce an array of isoquinoline and tryptamine-related alkaloids that are not only hallucinogens, but powerful emetics with a wide range of other biological activities, in particular antimicrobial and anthelmintic properties… We propose that these alkaloid mixtures were initially discovered and developed by indigenous people for treatment of a variety of parasitic diseases and incorporated into religious ceremonies using psychoactivity as an effective dose marker.” [https://www.sciencedirect.com/science/article/pii/0378874182900538]

However, in spite of all this evidence for the antiparastic potential of ayahuasca, one hookworm host has noticed no apparent adverse effect on her worms as a result of taking part in more than 10 ayahuasca ceremonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523441614378445&reply_comment_id=2523573887698551] Another helminth host has confirmed anonymously that he was able to culture more NA from his colony after participating in 3 ceremonies in one year.
</blockquote>

==== ✅ Safe for human helminths unless marked ====

<blockquote>

* [https://en.wikipedia.org/wiki/Betel Betel leaves] -- The leaves of the Piper betle vine (part of the [https://en.wikipedia.org/wiki/Piperaceae Piperaceae] family, which includes pepper and ⚡kava) are used as a mild stimulant and are thought likely to be safe for human helminths, although there have been no reports from helminth hosts to confirm or contradict this.

* ❌ [https://en.wikipedia.org/wiki/Areca_nut betel nut] (or areca nut) seed of the areca palm (and also known as the areca nut palm, betel palm, Pinang palm and Indian nut) is often chewed wrapped in betel leaves - a combination known as [https://en.wikipedia.org/wiki/Paan paan] that is used for its stimulant and psychoactive effects. Betel nuts contain the anthelmintic [https://en.wikipedia.org/wiki/Arecoline arecoline] and have been used as a tapeworm remedy. Fresh betel nuts are also known to be used very effectively by Torres Straight Islanders as a treatment for all types of intestinal worm, and surveys have found that the betel chewers were almost all worm-free, while others weren't. (Prolonged use of the betel nut can create addiction and the World Health Organization classifies the betel nut as a carcinogen.)

* [https://en.wikipedia.org/wiki/Cannabis_(drug) Cannabis], [https://en.wikipedia.org/wiki/Cannabis_(drug)%23Marijuana marijuana] and [https://en.wikipedia.org/wiki/Hashish hashish] appear to be worm-friendly. A paper published in 2015 [https://www.ncbi.nlm.nih.gov/pubmed/26031406] showed that, in the group of hunter-gatherers studied, those who consume cannabis have a significantly lower rate of helminth infection, from which the researchers concluded that the Aka foragers must consume cannabis to kill parasites, even though the scientists admit that, while cannabis kills worms in a petri dish, it has not been shown to kill worms in animals. A different explanation for the correlation seen in this study could be that those individuals with the most worms feel less need to smoke cannabis, and this ties in with the experience of the many helminth hosts who have seen a reduction in anxiety while hosting worms. One host of both hookworms and human whipworms has confirmed the presence of eggs from both species after cannabis use, and another hookworm host who used 10 drops of hemp '''CBD''' ([https://en.wikipedia.org/wiki/Cannabidiol cannabidiol]) oil twice daily, plus a few drops of '''THC''' ([https://en.wikipedia.org/wiki/Tetrahydrocannabinol tetrahydrocannabinol]) oil to help with sleep, has reported that her hookworms were unaffected. [https://www.facebook.com/groups/htsupport/permalink/1037560152966606/?comment_id=1037577039631584&comment_tracking=%7B%22tn%22:%22R%22%7D] Someone else used '''CBD''' oil for several months and noticed no adverse effect on his hookworms, [https://www.facebook.com/groups/htsupport/permalink/1239928846063068/?comment_id=1240221499367136&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and this lack of any adverse effect has been confirmed by numerous other cannabis users. [https://www.facebook.com/groups/htsupport/permalink/1406977876024830/?comment_id=1407227059333245&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1059227607466527/?comment_id=1059279190794702&reply_comment_id=1407016112687673&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has even been shown that CBD extends the lifespan and arrests age-associated physiological decline in the research nematode, C. elegans, so may potentially be beneficial for the health of other helminths. [https://pubmed.ncbi.nlm.nih.gov/35445360/]

* [https://en.wikipedia.org/wiki/Cocaine Cocaine], in its pure, unadulterated state, could be added to this list of worm-safe drugs, but it is commonly adulterated with other substances that might harm helminths, particularly ❌ [https://en.wikipedia.org/wiki/Levamisole levamisole] which, according to one report, is the most popular bulking agent found in 73% of seized coke. [https://www.hotpress.com/sex-drugs/10-things-know-cocaine-specialists-guide-22803299]

* [https://en.wikipedia.org/wiki/Hypnotic Hypnotics] are generally worm-safe, e.g.
** '''propofol''' (see Anaesthetics section) is an ultrashort-acting sedative with amnesiac effects
** anything in the [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] class of drugs (e.g. [https://en.wikipedia.org/wiki/Valium valium])
** the short-acting nonbenzodiazepine hypnotic, [https://en.wikipedia.org/wiki/Zolpidem zolpidem] (e.g. Ambien [https://www.facebook.com/groups/htsupport/permalink/865157116873578/?comment_id=866638886725401&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D], Ambien CR, Intermezzo, Stilnox, Stilnoct, Sublinox, Hypnogen, Lunata, Zonadin, Sanval, Zolsana, Zolfresh)
** the [https://en.wikipedia.org/wiki/Narcotic_analgesic opioids] (e.g. [https://en.wikipedia.org/wiki/Codeine codeine], [https://en.wikipedia.org/wiki/Dextropropoxyphene dextropropoxyphene], [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], [https://en.wikipedia.org/wiki/Hydrocodone hydrocodone], [https://en.wikipedia.org/wiki/Oxycodone oxycodone], [https://en.wikipedia.org/wiki/Tramadol tramadol] and [https://en.wikipedia.org/wiki/Morphine morphine]), along with any of their synthetic or time release variants (e.g. [https://en.wikipedia.org/wiki/Fentanyl fentanyl / fentanil]); [https://www.facebook.com/groups/htsupport/permalink/1080879281968026/?comment_id=1081015631954391&reply_comment_id=1081726205216667&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓ [https://en.wikipedia.org/wiki/Mitragyna_speciosa Kratom] (aka kratum and ketum). [https://www.facebook.com/groups/htsupport/permalink/868935276495762/] [https://www.facebook.com/groups/htsupport/permalink/868935276495762/?comment_id=869019499820673&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D] Extracts and leaves of kratom are reported to have been used as intestinal deworming agents in Thailand, and the FDA has warned consumers not to use any products labeled as containing kratom. [http://www.medicalnewstoday.com/releases/304821.php] However, one human whipworm host has taken small doses without any apparent effect on his worms [https://www.facebook.com/groups/htsupport/permalink/1788272677895346/?comment_id=1796502977072316&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and a hookworm grower has reported no reduction in yield from his cultures after he took kratom.

* [https://en.wikipedia.org/wiki/Opium Opium] and [https://en.wikipedia.org/wiki/Heroin heroin] (aka diacetylmorphine, diamorphine and other names) appear to be worm-friendly.

Most other recreational drugs should be safe for use by helminth hosts, including '''tobacco''', '''nicotine''' and most forms of '''alcohol'''.

* ➿ [https://en.wikipedia.org/wiki/Alcoholic_beverage Alcohol] -- Normal social drinking should not have any adverse effect on helminths, however, alcohol acts as an antimicrobial, and substances produced by the death of gut bacteria can enter the bloodstream to cause inflammation and allergic reactions [https://www.facebook.com/groups/htsupport/permalink/3958483847540874/?comment_id=3958511057538153] which can temporarily make it appear as though therapeutic helminths have stopped working. Overindulgence in alcohol may therefore cause a temporary reduction in worm benefits in a dose-dependent manner. One individual who had successfully put his colitis and celiac disease into remission with NA has reported that, in spite of hosting the worms, drinking beer causes a return of colitis symptoms. Excessive consumption of alcohol that results in the user going into a coma due to alcohol poisoning may incur a greater risk to helminths.
** ❓ [https://en.wikipedia.org/wiki/Absinthe Absinthe] is one alcoholic drink that might present more of a risk, as it was traditionally made using herbs reported to have antiparasitic properties, including ❌'''wormwood'''. (See separate entry). However, the risk from absinthe has been questioned because it only contains the essential oil of wormwood, while the anthelmintic activity of this herb has been linked more to the bitter principles and the alkaloids, which are not included in absinthe.

* ❓ [https://en.wikipedia.org/wiki/MDMA MDMA] (ecstasy) -- As primarily a serotonin and dopamine agonist, this is thought unlikely to have much effect on helminths. However, serotonin agonism increases peristalsis, so using MDMA may not be a good idea until after the worms have attached to the intestinal mucosa. Once they are attached, the increased peristalsis alone would not dislodge them. One hookworm host has reported that he has twice rolled with MDMA and it didn't kill his worms. [https://www.facebook.com/groups/htsupport/permalink/2331685740220701/]

* [https://en.wikipedia.org/wiki/N,N-Dimethyltryptamine DMT] (N,N-Dimethyltryptamine or N,N-DMT) This psychedelic compound with powerful hallucinogenic effects has been reported by one user to be safe for use with NA.

* ❓ [https://en.wikipedia.org/wiki/LSD LSD] (Lysergic acid diethylamide) is unlikely to harm helminths, and there has been one report to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Myristicin Myristicin] -- This psychoactive drug, which is the traditional precursor for the psychedelic and empathogenic drug [https://en.wikipedia.org/wiki/MMDA_(drug) MMDA], is found in very small quantities in vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but this dietary intake is unlikely to be harmful to helminths. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

* ❓ [https://en.wikipedia.org/wiki/Peyote Peyote] (Lophophora williamsii) -- This cactus, which contains psychoactive alkaloids, including mescaline, is thought unlikely to harm helminths, but there have been no reports to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Psilocybin Psilocybin], a [https://en.wikipedia.org/wiki/Substituted_tryptamine substituted tryptamine], is a naturally occurring psychedelic compound produced by more than 200 species of mushroom. Although illegal in most countries/states, psilocybin is used for the self-treatment of cluster headaches and one hookworm host has reported using this compound for two months to treat severe migraines, without noticing any apparent effect on his worms. However, it is possible that higher doses of this hallucinogenic may disorient hookworms for long enough to cause their loss.

* [https://psychedelictimes.com/healing-tobacco-rape-tribal-snuff/ Rapé] (pronounced “ha-peh”) is a powerful snuff originally used by shamans in Brazil and Peru as part of medicinal rituals. This sacred tobacco has increased in popularity outside of the Amazon during the early twenty-first century for its medicinal properties, and two hookworm hosts have reported using rapé without adversely affecting their colonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523128767743063] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410]
</blockquote>

===Statins===
There is evidence that [https://en.wikipedia.org/wiki/Statin statins] can be directly toxic to at least some helminths at sufficiently high concentrations in vitro, with this type of drug being known to inhibit HMG‑CoA reductase, an enzyme essential to many helminths for a number of vital processes including glycosylation, energy metabolism and membrane homeostasis.

In Schistosoma mansoni, for example, multiple statins (including lovastatin and others) have been shown to kill both larval and adult worms in vitro in a concentration‑ and time‑dependent manner. Similarly, in cestodes (tapeworms), simvastatin and fluvastatin have inhibited parasite HMG‑CoA reductase to produce measurable anthelmintic effects in larvae such that statins have been suggested for possible repurposing as anthelmintics for use in controlling cestodes.

While there had been no published evidence by early 2026 that clinically used statin doses have harmed either NA or TTO in human hosts, these species do share extensive metabolic and regulatory machinery with other parasitic nematodes, so it is conceivable that typical human doses of statins might be harmful to these therapeutic worms, and one NA self-treater - a very experienced incubator of this species - reported, in Feb 2026, that taking [https://en.wikipedia.org/wiki/Atorvastatin atorvastatin] (Lipitor, etc.) resulted in the repeated failure of NA larvae to successfully colonise after she had incubated these herself and observed them to be active immediately before their application to her skin. The noticeable lack of the usual entry points indicated that these larvae, although active, were incapable of entering the skin.

===Vaccines===

Three helminth hosts have claimed that they may have lost their hookworms after receiving the ⚡ [https://en.wikipedia.org/wiki/Tetanus_vaccine tetanus vaccine], although others have had tetanus shots without any loss of worms, and several people receiving flu vaccination have reported that this had no effect on their hookworms. [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861706373885309&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861973877191892&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nothing has been reported in respect of other vaccines. Also see [[Helminthic therapy and vaccines | '''Helminthic therapy and vaccines''']].

== Miscellaneous pharmaceuticals and chemicals ==

<blockquote>
''' ✅ Safe for worms unless marked otherwise'''
* ❓ [https://en.wikipedia.org/wiki/Zovirax Aciclovir] (Cyclovir, Herpex, Acivir, Acivirax, Zovirax, Zoral, Xovir and Imavir). There have been no reported problems with this drug so far. See also the related drug, Valaciclovir/valacyclovir.

* ❌ [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) is a soil bacterium that has been engineered into food crops such as corn and rice to render them pest resistant, and residues of Bt-based insecticides have been found on fresh fruits and vegetables. [http://www.ncbi.nlm.nih.gov/pubmed/16672488] Cry5B, a pore-forming protein produced by Bt can kill intestinal worms and is highly effective against all hookworm species tested in all models [https://www.ncbi.nlm.nih.gov/pubmed/29772478]. It is also used as a natural insecticide on crops on some organic farms. However, the risk of therapeutic helminths being killed as a result of their hosts ingesting small amounts of the delta endotoxins produced by Bt is likely to be very low. When used as an insecticide, one of the many Bt strains available is selected for its specific toxicity against the target insect. The strains that produce toxins against nematodes are therefore unlikely to be used as agricultural insecticides. In addition to this, the toxins produced need to be ingested by the target organism to become active and, as proteins, they may be denatured by heat during cooking. [https://www.facebook.com/groups/htsupport/permalink/1270850719637547/?comment_id=1270971972958755&comment_tracking=%7B%22tn%22%3A%22R%22%7D] The probiotic bacterium, Bacillus subtilis, can also be engineered to express the Cry5B protein, a small dose of which has been shown to kill intestinal nematode parasites, achieving a 93 percent elimination of human hookworms in hamsters. [https://web.archive.org/web/20161005204559/https://www.asm.org/index.php/asm-newsroom2/journal-tipsheets/88-news-room/journal-tipsheets/91749-natural-pest-control-protein-effective-against-hookworm-a-billion-could-benefit], [http://www.ncbi.nlm.nih.gov/pubmed/23835175] Although researchers may be pursuing this development as a means of delivering anthelmintics via foods and food supplements, the strain of Bacillus subtilis currently used in probiotics that have been manufactured for human consumption is not known to have been modified in this way, and one hookworm host has reported that his worms were unaffected after eating a lot of natto (made using Bacillus subtilis) and taking the Bacillus subtilis-containing probiotic product, Megasporebiotic. [https://www.facebook.com/groups/htsupport/permalink/1084149894974298/?comment_id=1084177824971505&comment_tracking=%7B%22tn%22:%22R6%22%7D]

* [https://en.wikipedia.org/wiki/Baclofen Baclofen] (Kemstro, Lioresal, Liofen, Gablofen, Beklo and Baclosan) is a derivative of gamma-aminobutyric acid (GABA). One host who took 20-30mgs of baclofen daily reported no loss of worm benefits.

* ❌ [https://en.wikipedia.org/wiki/Barbiturate Barbiturates] have now largely been replaced in routine medical practice by ✅ [https://en.wikipedia.org/wiki/Benzodiazepines benzodiazepines], but they may still be encountered in general anaesthesia, for epilepsy, and in the treatment of acute migraines. These drugs depress the central nervous system, producing effects ranging from mild sedation to total anaesthesia, so, taken in sufficient quantity, they may disorient hookworms sufficiently to cause them to lose their grip on the intestinal mucosa and be flushed away from their feeding site.

* [https://en.wikipedia.org/wiki/Benzodiazepine Benzodiazepines] (BZD, benzos). There have been no reports of this type of drug having any adverse effect on helminths. The short-acting anti-anxiety drug, [https://en.wikipedia.org/wiki/Alprazolam alprazolam] (Xanax), was taken by one hookworm host (0.5 mg 3 or 4 times over the course of a month) without any apparent effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912671848788771&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912703545452268&offset=0&total_comments=4&comment_tracking=%7B%22tn%22:%22R%22%7D] Other self-treaters have found that [https://en.wikipedia.org/wiki/Clonazepam clonazepam] (Klonopin) [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912711478784808&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] and [https://en.wikipedia.org/wiki/Lormetazepam lormetazepam] are both worm-safe, as is [https://en.wikipedia.org/wiki/Lorazepam Lorazepam] (Ativan). [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=1099405830115371&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Bismuth_subsalicylate Bismuth subsalicylate] (pink bismuth, the active ingredient in various stomach-settling medications such as [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol] and Kaopectate) There has been one suggestion that bismuth may have a temporary adverse effect on human helminths, similar to that caused by local anaesthetics/anesthetics, but this has not been confirmed by others. Pepto-Bismol is [http://www.reyessyndrome.org/pdfs/medicationscontainingaspirin.pdf listed] as containing aspirin (acetylsalicylate) or an aspirin-like substance (see ✅ Anticoagulants section regarding this ingredient).

* [https://en.wikipedia.org/wiki/Bisphosphonate Bisphosphonates] This class of drugs appears to be harmless to human helminths. They are used to prevent the loss of bone density, and include [https://en.wikipedia.org/wiki/Zoledronic_acid zoledronic acid] (aka zoledronate, sold under brand names such as Reclast, Zometa, Zometa Concentrate and Aclasta). One NA host has had two infusions of Aclasta without issue. [https://www.facebook.com/groups/htsupport/posts/4932593710129878?comment_id=4934243383298244]

* ❓ [https://en.wikipedia.org/wiki/Calcium_channel_blocker Calcium channel blockers (CCBs)], also known as calcium channel antagonists or calcium antagonists. These medications, which disrupt the movement of calcium through calcium channels, and are commonly used to treat cardiovascular diseases including hypertension, have also shown activity against the non-therapeutic helminth, Schistosoma mansoni. And it has been suggested that the calcium blocking effect of these drugs might be exploited to enhance the effect of existing anthelmintic drugs, or to produce new ones. [https://www.ncbi.nlm.nih.gov/pubmed/30420417] While there have been no reports thus far of therapeutic helminths being affected by calcium channel blockers, this remains a theoretical possibility.

* [https://en.wikipedia.org/wiki/Tegretol Carbamazepine] (Tegretol, Equetro). This appears to be worm-safe. One host who took this for two weeks was still producing ample hookworm ova at the end of this period.

* [https://en.wikipedia.org/wiki/Chlorine Chlorine]. As a constituent of chlorinated water, e.g., municipal water supplies and at swimming baths, this is no threat to helminths.

* ❓[https://en.wikipedia.org/wiki/Chlorine_dioxide Chlorine dioxide] (CD, also known as MMS, CDS, CDH) is an industrial disinfectant and bleach that is used in water purification and detoxification. CD has been taken orally by people who claim that it kills parasites, and that "rope worms" are often released during CD enemas. However, when these rope-like forms have been analysed, they have been found to contain mostly human DNA, so are likely to be merely pieces of gut lining.

* [https://en.wikipedia.org/wiki/Colestyramine Colestyramine/ cholestyramin] (Trade names: Questran, Questran Light, Cholybar, Olestyr, Quantalan and Vasosan.) One self-treater has reported that this bile acid sequestrant did not harm his NA colony or his HDC. [https://www.facebook.com/groups/htsupport/posts/9602012923187910/?comment_id=9603513203037882]

* [http://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=36f623df-2ae3-4858-9783-c058097951f4&type=display Cortifoam], a hydrocortisone rectal aerosol, uses propane and isobutane as propellants, neither of which is known to have any adverse effect on helminths.

* [https://en.wikipedia.org/wiki/COX-2_inhibitors COX-2 inhibitors], e.g., [https://en.wikipedia.org/w/index.php?title=Celecoxib&redirect=no celecoxib] (Celebrex), are safe for use with helminths.

* [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium) is a mast cell stabiliser with anti-allergy effects. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Doxazosin Doxazosin] Sold under brand names such as Cardura and Carduran, this antihypertensive medication has been found to have anthelmintic properties. [https://www.mdpi.com/1424-8247/14/7/686] One hookworm self-treater had indications over a three year period that he had lost his NA colony: reappearance of pre-hookworm symptoms, eosinophil count down to "normal" and inability to incubate more larvae. Repeated re-inoculations with viable larvae failed to restore his colony, and he eventually realised that the loss of the worms had coincided with the change in antihypertensive medication, to the alpha-blocker, doxazocin. [https://www.facebook.com/groups/htsupport/posts/7047958951926666/]

* ❓ [https://en.wikipedia.org/wiki/2,3-Dimercapto-1-propanesulfonic_acid DMPS] (Dimercapto-propane sulfonate/2,3-Dimercapto-1-propanesulfonic acid) and its sodium salt, Unithiol. There have been no reports so far about possible anthelmintic effects following the use of this drug, but there do appear to be some [https://www.ncbi.nlm.nih.gov/pubmed/18568806 serious risks attached to its use].

* [https://en.wikipedia.org/wiki/Dimercaptosuccinic_acid DMSA] (Dimercaptosuccinic acid, also called succimer). The meso isomer form of this organosulfur compound is used as a chelating agent for the treatment of heavy metal toxicity. One hookworm host has taken 25 mg DMSA every 3 hours around the clock for 5 days, and repeated this every 3 weeks for a year without harming her hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=991229547599667&comment_tracking=%7B%22tn%22:%22R0%22%7D] DMSA is apparently such an effective chelator that it may deplete levels of beneficial minerals, so should arguably be used under the guidance of a practitioner. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860226537366636&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* [https://en.wikipedia.org/wiki/Dimethyl_sulfoxide DMSO] (Dimethyl sulfoxide) has been used by two hookworm hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Ethylenediaminetetraacetic_acid EDTA] (Ethylenediaminetetraacetic acid). This heavy metal chelator was taken by one NA host as a single large dose for a provoked urine test. He then took it occasionally after this, but never saw any negative effects whatsoever on his NA. [https://www.facebook.com/groups/htsupport/posts/9163602600362280?comment_id=9165019336887273]

* [https://en.wikipedia.org/wiki/Essential_oil Essential oils]. These are also known as volatile oils, ethereal oils, aetherolea, or simply as the oil of the plant from which they were extracted. Certain essential oils contain some of the most potent antimicrobial compounds available and can be considered to be [http://www.theatlantic.com/health/archive/2015/01/the-new-antibiotics-might-be-essential-oils/384247/ natural antibiotics]. For example ❌'''oregano oil''' (see [[#Oregano|Oregano reference]]) and ⚡'''peppermint oil''' (see [[#Peppermint|Peppermint reference]]) can affect human helminths if ingested. However, small quantities of most essential oils should be safe for helminths when applied topically, since not all of the oil applied will reach the bloodstream. And when essential oils are diffused into the air using a nebuliser, heated over a candle flame or burned, these should not harm helminths, even when using blends containing oregano or peppermint oil. [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=808058079250149&offset=0&total_comments=3] [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=809316062457684&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] However, one hookworm host lost most of her colony when she walked into a room where a diffuser had been left running after a child had emptied an entire bottle of peppermint essential oil into it. She only took one breath in the room before leaving, but her home incubations fell from 25-35 larvae per droplet to just 1 larva per 3 droplets. And, many months and 3 inoculations later, she was still only getting 7-8 larvae per droplet. This inhalation of diffused peppermint oil also caused blistering burns to her face, nostrils and lungs, and did significant damage to her gut microbiome. [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&reply_comment_id=2018765664846045&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Gamma-Aminobutyric_acid GABA] (gamma-aminobutyric acid). It has been reported [http://www.livestrong.com/article/216236-medications-to-treat-human-worms/] that the anthelmintic drug, ivermectin, causes paralysis in worms by increasing GABA, and a hookworm host has mentioned that she “used to do really well with GABA, but worms don't like it.” On the other hand, a child with Type 1 diabetes was given GABA (750mg x4 per day) alongside hookworm therapy without any indication that the worms were affected by this, and another hookworm host who took 20-30mgs per day of ✅'''baclofen''' (a derivative of GABA) reported no loss of worm benefits.

* ⚡ [https://en.wikipedia.org/wiki/Gabapentin Gabapentin] (Neurontin). One hookworm host has taken this without any obvious adverse effect on her colony (link expired), and another has said that she was down from 1200mg to 600mg of gabapentin per day when she first discovered helminths and was never aware of it affecting her worms. [https://www.facebook.com/groups/htsupport/posts/6576693235719909/?comment_id=6576715005717732&reply_comment_id=6576844752371424] However, two other people have reported adverse effects on their colonies. One said that she had little benefit from her NA while she was taking gabapentin (mostly about 300 mg per day, but sometime 600 mg). The other said that single doses as low as 150mg "severely upset" his NA, and that taking 3 doses in a row caused a complete loss of benefits for 4-5 days. [https://www.facebook.com/groups/htsupport/permalink/2926164447439491/]

* ❌ [https://en.wikipedia.org/wiki/Genistein Genistein] is an isoflavone (phytoestrogen) with antioxidant and anthelmintic properties that has been found to be the main substance responsible for the deworming activity of the root-tuber peel extract of Felmingia vestita, the plant traditionally used as an anthelmintic by the Khasi tribes of India. Genistein is a potent cestocide, being highly effective against several species of tapeworm, as well as a pork trematode and a sheep liver fluke. (See also: [https://www.ncbi.nlm.nih.gov/pubmed/29844617]) Given the strength of its effect against these other helminths, it is reasonable to assume that concentrated or synthesised forms of genistein (such as KBU2046 and B43-genistein) may also harm or even kill therapeutic human helminths, although there is no evidence that eating soy products might be harmful to human helminths as a result of the naturally occurring genistein they contain.

* ❓[https://en.wikipedia.org/wiki/Glucagon-like_peptide-1_receptor_agonist Glucagon-like peptide-1 receptor agonists], also known as GLP-1 receptor agonists (GLP-1-RA) or incretin mimetics, e.g., [https://en.wikipedia.org/wiki/Exenatide exenatide] (Byetta, Bydureon), [https://en.wikipedia.org/wiki/Liraglutide liraglutide] (Victoza, Saxenda), [https://en.wikipedia.org/wiki/Lixisenatide lixisenatide] (Lyxumia, Adlyxin), [https://en.wikipedia.org/wiki/Albiglutide albiglutide] (Tanzeum), [https://en.wikipedia.org/wiki/Dulaglutide dulaglutide] (Trulicity), [https://en.wikipedia.org/wiki/Semaglutide semaglutide] (Ozempic, Rybelsus, Wegovy) and [https://en.wikipedia.org/wiki/Tirzepatide tirzepatide] (Mounjaro). This type of drug, which is used to treat diabetes and obesity, has shown anthelmintic effects and has been proposed as a potential anthelmintic agent against Trichuris trichiura. [https://eprints.lancs.ac.uk/id/eprint/171826/1/2022DooleyMRes.pdf] However, no reports of any adverse effects have been posted by helminth hosts.

* [https://en.wikipedia.org/wiki/Guaifenesin Guaifenesin]. This oral expectorant and muscle relaxant is sold under various brand names, including Mucinex, and is added to many other medicines. There have been no reports of this drug having any ill effect on helminths, and one hookworm host has reported that he regularly takes between 2 and 6 x 400 mg guaifenesin tablets to treat congestion, without any apparent effect on his worms. Another NA user reports continuing to use high doses without issue. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Helium Helium] appears to be worm-safe, based on the experience of one hookworm host who deliberately inhaled a small volume of the gas (to enjoy the timbre-changing effect on his voice!) while blowing up balloons, and had no loss of effect from his worm colony.

* Hydrogen therapy. One NA host has reported that inhaling hydrogen gas and drinking hydrogen-infused water has not harmed his colony. (Link expired.)

* [https://en.wikipedia.org/wiki/Hydrogen_peroxide Hydrogen peroxide] (H2O2). This may kill helminths in a petri dish but it is so highly reactive that, if ingested, there is likely to be little left by the time it reaches the stomach. And, when inhaled, H2O2 stays largely within the lungs, with only a small amount reaching the blood. Since the amount that could be transmitted to helminths is therefore negligible, it is thought unlikely that H2O2 would be a problem for any intestinal helminth, although no one has reported on this, one way or the other.

*❓Hyoscyamine [https://en.wikipedia.org/wiki/Hyoscyamine]. (Also known as daturine and levo-atropine. Brand names include Symax, HyoMax, Anaspaz, Egazil, Buwecon, Cystospaz, Levsin, Levbid, Levsinex, Donnamar, NuLev, Spacol T/S and Neoquess.) It has been suggested that hyoscyamine is unlikely to be harmful helminths, [https://www.facebook.com/groups/htsupport/permalink/1459052987483985/?comment_id=1459076817481602&reply_comment_id=1459213767467907&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Iodine Iodine]. This appears not to have any anthelmintic effect in the case of [http://link.springer.com/article/10.1007/BF02356443?no-access=true some species of roundworm and lungworm] and no reports of adverse effects have been posted by helminth hosts who are taking iodine supplements.

* ❓ [https://en.wikipedia.org/wiki/Isotretinoin Isotretinoin] (13-cis retinoic acid, Roaccutane, Accutane, Amnesteem, Claravis, Absorica, Isotroin and Epuris) is used to treat acne and other skin conditions. Although there have been no reports of harm to helminths as a result of taking this drug, anyone considering its use might appreciate knowing that it has been linked to autoimmune disease, which is of course what many readers of this website are already dealing with. The link is controversial, but this paper [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110532/] sets out the facts.

* [https://en.wikipedia.org/wiki/Ketamine Ketamine] There have been no reports to suggest that ketamine might be harmful to human helminths, and one NA host has reported that an incubation following four 200 mg doses of this drug had yielded a bumper crop of larvae, confirming that the drug had had no adverse effect on her colony.

* [https://en.wikipedia.org/wiki/Lactulose Lactulose]. This synthetic, non-digestible sugar used in the treatment of chronic constipation and as a test for small intestine bacterial overgrowth (SIBO) has not been reported to have any untoward effects on human helminths.

* ❌ [https://en.wikipedia.org/wiki/Limonene Limonene] This has been shown to have a comparable anthelmintic effect against adult Schistosoma mansoni as the common anthelmintic drug, praziquantel, [https://pubmed.ncbi.nlm.nih.gov/23408270] (Praziquantel has a 23% cure rate in hookworms. [https://pubmed.ncbi.nlm.nih.gov/29153938]) and one hookworm host has reported experiencing a return of disease symptoms after taking 500 mg of limonene daily for a week. [https://www.facebook.com/groups/htsupport/permalink/2673526096036662/]

* [https://en.wikipedia.org/wiki/Loperamide Loperamide] (Immodium, Lopex, etc.) This drug has been taken by numerous worm hosts and there have been no reports of it harming their worms.

* [[Wikipedia:Low-dose naltrexone|Low dose naltrexone]] (LDN). This is compatible with helminthic therapy and several people have had good results from this combination, although the drug doesn’t suit everyone. More details [https://www.helminthictherapywiki.org/wiki/Helminthic_therapy_and_low-dose_naltrexone_(LDN) here].

* [https://en.wikipedia.org/wiki/Lisdexamfetamine Lisdexamfetamine / L-lysine-dextroamphetamine] (Tyvense, Elvanse, Aduvanz, Venvanse, Vyvanse) is used to treat ADHD and binge eating disorder. One hookworm host took vyvanse for several weeks without noticing any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1462105477178736/?comment_id=1462409000481717&reply_comment_id=1729076717148276&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Mepacrine Mepacrine] (quinacrine [Atabrine]). This is an antiprotozoal drug that has also been used against tapeworms, so it could harm hookworms and whipworms. No one has so far reported any problem with it, but it's likely that few, if any, helminth hosts will have taken it, especially as, "Mepacrine is not the drug of choice because side effects are common, including toxic psychosis, and may cause permanent damage."

* ❓ [https://en.wikipedia.org/wiki/Metformin Metformin] [Glucophage], [https://en.wikipedia.org/wiki/Phenformin phenformin], and [https://en.wikipedia.org/wiki/Rosiglitazone rosiglitazone] [Avandia] are [https://en.wikipedia.org/wiki/Anti-diabetic_medication anti-diabetic medications] (also known as oral hypoglycemic or antihyperglycemic agents) that have been shown to have antibiotic properties [http://www.cysonline.org/article.asp?issn=2229-5186;year=2011;volume=2;issue=4;spage=219;epage=221;aulast=Dash], so might therefore have some degree of anthelmintic effect when used in higher doses. However one NA host has been reported to have taken it with no apparent adverse effects on her worms. [https://www.facebook.com/groups/htsupport/posts/8167008430021707?comment_id=8167027486686468].

* ⚡ [https://en.wikipedia.org/wiki/Methotrexate Methotrexate]. Some people have taken methotrexate alongside HT without any problem, including one NA host who combined these two treatments for 1½ years, taking up to 15 mg methotrexate per day. [https://www.facebook.com/groups/htsupport/permalink/1262248410497778/?comment_id=1262259710496648&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1530311280358155/?comment_id=1530363560352927&reply_comment_id=1531077360281547&comment_tracking=%7B%22tn%22%3A%22R5%22%7D] However, one individual got no benefit from his hookworms for over a year, while he was taking this drug.

* ❓ [https://en.wikipedia.org/wiki/Methylene_blue Methylene blue] Only one self-treater has reported using this substance while hosting NA, apparently taking it every day for about a year without causing any problems for her worms. [https://www.facebook.com/groups/htsupport/permalink/9484774994911704/]

* [https://en.wikipedia.org/wiki/Methylphenidate Methylphenidate] (Ritalin, Concerta, etc.) This doesn’t harm NA (or HDC). [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5659285877460654&reply_comment_id=5659339337455308] [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5660377274018181]

* [https://en.wikipedia.org/wiki/Montelukast Montelukast] (Singulair, Montelo-10, Monteflo, Lukotas, Arokast and Pulmikast). This leukotriene receptor antagonist has been taken intermittently, in 10 mg doses, by one hookworm host with no apparent effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904760852913204&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904793842909905&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R%22%7D] and regularly by another. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1683751361680812&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug Non-steroidal anti-inflammatory drugs] (NSAIDS, NSAIAs or NSAIMs) e.g: [https://en.wikipedia.org/wiki/Aspirin aspirin], [https://en.wikipedia.org/wiki/Diclofenac diclofenac] (sold under many trade names [https://en.wikipedia.org/wiki/Diclofenac%23Trade_names]), [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] and [https://en.wikipedia.org/wiki/Naproxen naproxen], are safe for use with helminths, but see Anticoagulants section regarding aspirin.

* ❓ [https://en.wikipedia.org/wiki/Nintedanib Nintedanib] (Ofev and Vargatef) is a piperazine drug (piperazine is an anthelmintic), so *may* have a harmful effect on NA, and to a lesser extent on TT. Unfortunately, there have been no reports about this drug, although the absence of any previous mention of it is a hopeful indication.

* [https://en.wikipedia.org/wiki/Oxymetazoline Oxymetazoline] (Ocuclear and Drixine) This drug is available over-the-counter as a topical decongestant in the form of oxymetazoline hydrochloride in nasal sprays such as Afrin, Dimetapp, Dristan, Drixoral, Facimin, Mucinex Full Force, Nasivin, Nostrilla, Operil, Otrivin, Otrivine, Oxyspray, SinuFrin, Sudafed OM, Utabon, Vicks Sinex and Zicam. At least one NA host has used these sprays without any harm being caused to his worms.

* ❓ [https://en.wikipedia.org/wiki/Ozone Ozone]. [https://en.wikipedia.org/wiki/Ozone_therapy Ozone therapy] is used as an alternative treatment for various diseases in humans but is still controversial. Ozone is also used to kill microorganisms, in some instances being employed in place of chlorine as a bactericide. It is also used to eradicate water borne parasites such as Giardia lamblia and Cryptosporidium, and to kill insects in stored grain. So there would appear to be a potential for ozone to have an adverse effect on human helminths, although this may depend on dosage and there have been no reports to date of the use of ozone by helminth hosts, so caution would seem to be warranted until more is known.

* [https://en.wikipedia.org/wiki/Acetaminophen Paracetamol] (Called acetaminophen in the US, and also sold under the names tylenol, panadol, etc.) This is safe for use while hosting helminths, but is associated with autism when given to children under 5 years old. [https://pmc.ncbi.nlm.nih.gov/articles/PMC10814214/]

* ❌ [https://en.wikipedia.org/wiki/Pentobarbital Pentobarbital] (US), pentobarbitone (UK), e.g., Nembutal, is a short-acting '''barbiturate''' that has been used as a sleep aid, as well as to euthanise animals and to execute humans. It’s possible that the dosages used to encourage sleep might not have any deleterious effect on human helminths, but, if this drug were to disorientate hookworms, they could lose their grip on the intestinal mucosa and be flushed away. So far, there have been no reports about this drug from any helminth host, although few, if any, will have taken it.

* [https://en.wikipedia.org/wiki/Permethrin Permethrin] Permethrin is an insecticide that causes paralysis and death in insects and arachnids by disrupting sodium channels in the creatures’ nervous systems. However, voltage‑gated sodium channels are much less abundant in hookworms and, for this reason, permethrin is unlikely to pose any risk to NA. [https://www.facebook.com/groups/htsupport/posts/24419855167643775/]

* ⚡ [https://en.wikipedia.org/wiki/Piracetam Piracetam]. This nootropic, cognition- and memory-enhancing drug (Nootropil, Qropi, Myocalm, Dinagen) was suspected as the cause in one case of sudden worm loss.

* ❓ [https://en.wikipedia.org/wiki/Pregabalin Pregabalin] (Lyrica) is a gabapentinoid drug about which the only report so far has been from someone who who had taken 3 doses of 25mg Lyrica daily for several weeks, with no issues for her NA. [https://www.facebook.com/groups/htsupport/posts/4589806321075287/?comment_id=4590199551035964&reply_comment_id=4812188858837031]

* [https://en.wikipedia.org/wiki/Proton-pump_inhibitor Proton-pump inhibitors] (PPIs), including [https://en.wikipedia.org/wiki/Omeprazole omeprazole] (e.g., Losec) and [https://en.wikipedia.org/wiki/Lansoprazole lansoprazole] (e.g., Prevacid). These gastric acid inhibiting drugs appear not to be harmful to helminths, but they may kill 4% of patients who take them. [https://www.ncbi.nlm.nih.gov/pubmed/31147311]

* ❌ [https://en.wikipedia.org/wiki/Prucalopride Prucalopride] (DuphaPro, Prudac, Resolor, Resotran) This drug, which is used in the treatment of constipation has been reported by one hookworm host to have had a “pretty marked negative effect” on his worms, and, by another, to have killed theirs. [https://www.facebook.com/groups/htsupport/posts/5980593935329845?comment_id=7427760963946461&reply_comment_id=8031040043618547]

* [https://en.wikipedia.org/wiki/Pseudoephedrine Pseudoephedrine] is a stimulant nasal decongestant [https://en.wikipedia.org/wiki/Decongestant] that is sometimes added to antihistamine preparations and other products, including some formulations sold under the [https://en.wikipedia.org/wiki/Sudafed Sudafed] brand. Pseudoephedrine has not been reported to have any adverse effect on helminths.

* ➿ [https://en.wikipedia.org/wiki/Iodine-131 Radioactive iodine] (also known as radioiodine), which is used in the treatment of hyperthyroidism, can adversely affect hookworms, at least temporarily. One worm host found that '''isotope I-128''' (used in diagnostics) [https://www.facebook.com/groups/htsupport/permalink/830004963722127/ put her colony out of action for a week or two], and has suggested that '''isotope I-131''' (used to kill thyroid tissue) may have a similar effect.

* [https://www.drugs.com/rhophylac.html Rhophylac] The Rhophylac (anti-D immunoglobulin) injection, which contains human anti-D immunoglobulin, is given to pregnant women with rhesus negative blood type. One hookworm host has reported that her colony was unaffected by this injection. [https://www.facebook.com/groups/htsupport/posts/5063598083696106?comment_id=5068476199874961]

* [https://en.wikipedia.org/wiki/Rizatriptan Rizatriptan] (Maxalt, etc.) does not harm human helminths. [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348347051887903] [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348552771867331]

* [https://en.wikipedia.org/wiki/Viagra Sildenafil] (Viagra). This does not kill hookworms.

* [https://en.wikipedia.org/wiki/Simeticone Simeticone], also known as simethicone (Gas-X, Infacol, Wind-eze, WindSetlers, etc…), is an anti-foaming agent used in different dosages, and in combination with a variety of other drugs, to reduce the bloating, pain and discomfort caused by excessive intestinal gas. Simethicone has been tested directly on pig whipworm ova (TSO) and found to have no effect on them, and one hookworm host has reported taking simethicone periodically with no noticeable adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1969827113073234/?comment_id=1970814692974476&reply_comment_id=1972925246096754&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Sirolimus Sirolimus] (aka rapamycin, sold as Rapamune and Fyarro) This immunosuppressive medication was suspected by one NA host of having negatively impacted his worms for several weeks after he took a single dose of the drug.

* [https://en.wikipedia.org/wiki/Sodium_oxybate Sodium oxybate] (Xyrem, Alcover) is the sodium salt of [https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric_acid γ-hydroxybutyric acid] (GHB), which is unlikely to harm helminths because it’s an endogenous substance found naturally in the human body [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815965665126057&offset=0&total_comments=23&comment_tracking=%7B%22tn%22:%22R%22%7D], and one hookworm/whipworm host has confirmed that it did not affect her worms. [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815975511791739&offset=0&total_comments=24&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Steroid_hormone Steroid hormones]. One host of both hookworms and whipworms takes [https://en.wikipedia.org/wiki/Dehydroepiandrosterone DHEA], [https://en.wikipedia.org/wiki/Progesterone progesterone] and [https://en.wikipedia.org/wiki/Testosterone testosterone] with [https://www.facebook.com/groups/htsupport/permalink/824719590917331/?comment_id=825008124221811&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D no adverse effect on her worms].

* [https://en.wikipedia.org/wiki/Tauroursodeoxycholic_acid Tauroursodeoxycholic acid (TUDCA)] This ambiphilic bile acid has been taken by two NA hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2743109875744950/?comment_id=2744212012301403] [https://www.facebook.com/groups/htsupport/posts/7602581533131069/?comment_id=7614652755257280]

* ❌ [https://en.wikipedia.org/wiki/Turpentine Turpentine]. Also known as spirit of turpentine, oil of turpentine, wood turpentine and, colloquially, turps, this is distilled from pine tree resins. If applied topically to the skin - for example as a treatment for lice - it is unlikely to harm helminths. However, it has been used traditionally as an anthelmintic, so it may be harmful to human helminths if taken internally. It may also be toxic to humans!

* [http://www.netdoctor.co.uk/lung-problems/medicines/vicks-first-defence.html Vicks First Defence]. This cold preventative nasal spray does not contain antiviral chemicals, but forms a microgel that coats the lining of the nose to trap the cold virus and prevent this from reaching, and infecting, the cells within the nose. The microgel also reduces the pH inside the nose, which further helps by making it harder for the cold virus to multiply. It seems unlikely that any of this product’s ingredients [https://www.vicks.co.uk/products/early-cold-treatments/vicks-first-defence-nasal-spray] would harm helminths, although there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Volatile_Organic_Compounds Volatile Organic Compounds] (VOCs), as found in paints, felt tip markers, etc., are unlikely to harm helminths. One helminth host who regularly worked with organic solvents (including CH2Cl2 and CHCl3) has reported that his helminths have not been affected.

* [https://en.wikipedia.org/wiki/Xylometazoline Xylometazoline] Also spelled xylomethazoline, and branded as Otrivin and Otrivine, etc., this decongestant drug is safe for use with human helminths. [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537912206264719]
</blockquote>

== Medical procedures ==

<blockquote>
''' ✅ Safe for human helminths unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Botulinum_toxin Botulinum toxin] Also known as botulinum neurotoxin, and commonly called botox. One NA self-treater has reported receiving cosmetic botox injections with no adverse effect on her worm colony.

* [https://en.wikipedia.org/wiki/Colonoscopy Colonoscopy] As whipworms live in the colon, they may be at some risk of being struck by a colonoscope, but much of their body is embedded in the soft mucosa, and they are well lubricated with mucus, so few, if any, are likely to be damaged. Hookworms should not be affected by colonoscopy at all because they live in the small intestine, which is much higher up the GI tract. Hookworms might possibly be seen during a colonoscopy, but only if the colonoscope is advanced into the terminal ileum, and only then if any hookworms have taken up residence in the ileum, which is not common as they normally concentrate in the upper part of the jejunum, which is above the ileum, and is shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum Anaesthesia for colonoscopy is likely to involve the use of [https://en.wikipedia.org/wiki/Opioids opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.), [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed Versed], etc.) and/or [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics], all of which appear to be harmless to helminths. See also [[Human helminth care manual#Laxatives | Laxatives]] regarding [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep].

* [https://en.wikipedia.org/wiki/Colon_cleansing Colon cleansing] This will not harm hookworms and is unlikely to harm whipworms unless the fluid used contains something to which the whipworms are vulnerable.

* [https://en.wikipedia.org/wiki/Detoxification Detoxification] The use of [https://en.wikipedia.org/wiki/Infrared_sauna infrared saunas] and infrared heating pads is safe for helminths, [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860231720699451&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3617910068264922/] and [https://en.wikipedia.org/wiki/Chelation_therapy chelation therapy] using the [http://www.livingnetwork.co.za/chelationnetwork/chelation-the-andy-cutler-protocol/ Andy Cutler protocol] has been used by one hookworm host with no obvious adverse effect [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860208537368436&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R1%22%7D] on her colony. (Also see ❓'''DMPS''', ✅'''DMSA''' and❓'''EDTA'''.)

* [https://en.wikipedia.org/wiki/Enema Enemas] These will not affect hookworms at all, and the liquid used is unlikely to have any adverse effect on whipworms unless this contains something to which they are susceptible.

* [https://en.wikipedia.org/wiki/Endoscopy Endoscopy] A standard upper endoscopy (via the mouth) will not reach past the duodenum, and probably only as far as the second of the four parts of this section of the small intestine. It would therefore not harm hookworms or even allow a doctor to see the jejunum, which is the predominant location of hookworms by 20 weeks post-inoculation, shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum For information about the anaesthetics used during an endoscopy, see the [[#Anaesthetics|general anaesthetics]] section.

* [https://en.wikipedia.org/wiki/Epidural_opioid_analgesia Epidural opioid analgesia] Opioids such as [https://en.wikipedia.org/wiki/Fentanyl fentanyl] are generally safe for helminths, and one hookworm host has reported that her colony was fine following epidural analgesia administered during labour. [https://www.facebook.com/groups/htsupport/permalink/1960341670688445/?comment_id=1960403224015623&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] If an anaesthetic is added to the epidural, the effects of this may be similar to those of other local anaesthetics. (See the [[#localAnaesthetics|local anaesthetics]] section).
* [https://en.wikipedia.org/wiki/Magnetic_resonance_imaging Magnetic resonance imaging] An MRI is unlikely to harm helminths, but it can cause a temporary adverse reaction in the patient which may overshadow the benefits being provided by their helminths. [https://www.facebook.com/groups/htsupport/permalink/1296754897047129/] The❓gadolinium-based contrast agents used for MRI may also have adverse effects on the patient, [https://www.ncbi.nlm.nih.gov/pubmed/28368880] and there has been one report by a hookworm host who had two MRIs using gadolinium within the same week and experienced a subsequent return of her disease symptoms. [https://www.facebook.com/groups/htsupport/permalink/3934276469961612/]

* ❌ [https://en.wikipedia.org/wiki/Radiation_therapy Radiation therapy] (also known as radiotherapy, and abbreviated as RT, RTx, or XRT) is a treatment for cancer that used ionizing radiation. It had been thought unlikely that this would harm helminths [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1074160752639879&comment_tracking=%7B%22tn%22:%22R%22%7D] but one hookworm host appears to have lost her colony after radiotherapy for breast cancer. [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1240655962657023&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Radiology Radiology] Radiological procedures (e.g., [https://en.wikipedia.org/wiki/Radiography radiography] using [https://en.wikipedia.org/wiki/X-ray X-rays]) and the contrast materials used in these (e.g., [https://en.wikipedia.org/wiki/Barium barium] and [https://en.wikipedia.org/wiki/MRI_contrast_agent%23Gadolinium_.28Gd.29:_Paramagnetic gadolinium]) have been found to be worm-safe by several hookworm users, [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014377761951512&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014821705240451&comment_tracking=%7B%22tn%22:%22R%22%7D] but also see the comments about gadolinium in the previous entry, above, for magnetic resonance imaging.

* [https://en.wikipedia.org/wiki/Ultrasound Ultrasound] At least two hookworm hosts have had ultrasound examinations without their colonies being affected. [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334208813301727&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334224499966825&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



== Alternative therapies ==

=== Natural antibiotics ===
<blockquote>

* ➿ [https://en.wikipedia.org/wiki/Colloidal_silver Colloidal silver]. Some sources have claimed that, if taken orally, this may kill parasite eggs and possibly harm adult worms, but many helminth hosts have taken colloidal silver and there have been no reports of worms being lost as a result. Colloidal silver appears to be the most worm-friendly of the more effective natural antimicrobials, and it has also been shown to have no significant effect on the biodiversity of species in the gut microbiome. [https://www.ncbi.nlm.nih.gov/pubmed/26525505]. Although it can reduce helminthic benefits in a dose-dependent manner while it is being taken, the benefits soon return after its use is discontinued - usually in a matter of days. (Use of this [https://web.archive.org/web/20161227234345/http://www.silversafety.org/autocalculator.php Silver Safety Auto-calculator] will ensure that total silver intake remains at a safe level.)

* ❓ '''Cellular silver'''. The manufacturers of [http://www.resultsrna.com/products/acs_200_overview/ Advanced Cellular Silver (ACS) 200 Extra Strength] claim that it is “...effective against an enormous array of disease causing organisms; literally oxidizing the cell wall of gram positive and gram negative bacteria, spirochetes, virus, fungus, parasites and more without harming healthy flora or damaging human tissue”. Research[http://www.townsendletter.com/Jan2015/silver0115.html] shows that this form of silver may be more effective than ➿'''colloidal silver''' (see Colloidal silver, immediately above), but, so far, there have been no reports from helminth hosts to suggest what effect, if any, it might have on human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Grapefruit_seed_extract Grapefruit seed extract] (GSE). Also known as citrus seed extract and grapefruit seed oil, and often labelled as citrus seed oil. It is used in herbalism and natural therapies as an antibiotic and preservative, and is claimed to be a powerful broad spectrum bactericide, fungicide and antiviral that is effective against a large number of single-celled and multi-celled parasites. However, research has shown that [http://cms.herbalgram.org/press/2012/Many_GFSE_Adulterated_Says_Nonprofit_Research_Consortium.html many “natural” GSE products are adulterated] with undeclared synthetic chemicals, commercially available preservatives and disinfectants, such as [https://en.wikipedia.org/wiki/Triclosan triclosan] and [https://en.wikipedia.org/wiki/Benzethonium_chloride benzethonium chloride]. Some versions of GSE [http://www.ncbi.nlm.nih.gov/pubmed/17468864 may not contain any authentic grapefruit seed extracts] whatsoever, such that its sale may well be one of the most insidious herbal product scams ever. Even if genuinely pure, natural GSE could be found - which, given the evidence, seems doubtful - there may be little point in taking it as an antimicrobial because pure GSE has been shown to have no intrinsic antimicrobial action. And, as the makeup of proprietary GSE products varies so widely, these can not be recommended for worm hosts due to the possibility that one or more of the undeclared ingredients may harm human helminths. (NB. The flesh of grapefruit will not harm helminths.) Also see [[#Grape seed extract|Grape seed extract]], which is safe for use by hosts of human helminths.
</blockquote>

=== Natural antivirals ===
<blockquote>
✅ ''' Antiviral nutraceuticals that are safe for human helminths unless marked otherwise'''

:'''Vitamin C'''

::Taken in large quantities, vitamin C (ascorbic acid) has proved to be very effective against the common cold virus. When volunteers in one study were given 8 grams (8,000 mg) on the first day of a cold, 46% were cold free the next day. [http://www.ncbi.nlm.nih.gov/pubmed/4601508]

::In a study involving 700 students, those taking doses of I gram (1,000 mg) of vitamin C each hour for the first 6 hours and then 1 gram three times daily thereafter reported an 85% decrease in cold symptoms compared to those receiving conventional cold and flu treatment. [http://www.ncbi.nlm.nih.gov/pubmed/10543583]

::The ideal amount of vitamin C for colds or flu varies between individuals, but can be established in each case by taking ascorbic acid to ‘bowel tolerance’. Physicians have suggested starting with 3 grams immediately, then taking 1 gram each hour. Once this causes diarrhoea, the dose is reduced.

::In respect of the coronavirus, SARS-CoV-2, and the disease it manifests (COVID-19), see the following articles.

::* [https://www.mdpi.com/2075-1729/11/11/1166/htm Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence]

::* [https://pubmed.ncbi.nlm.nih.gov/32636851/ Quercetin and Vitamin C: An Experimental, Synergistic Therapy for the Prevention and Treatment of SARS-CoV-2 Related Disease (COVID-19)] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/pdf/fimmu-11-01451.pdf PDF]

::One UK doctor recommends treating coronavirus with 10 grams of vitamin C in 500 ml of water every hour until the patient gets diarrhoea. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::In March 2020, the government in Shanghai, China, officially began recommending high-dose intravenous vitamin C for the treatment of COVID-19. Dosage recommendations varied with the severity of illness, ranging from 50 to 200 mg per kg of body weight per day. [http://orthomolecular.org/resources/omns/v16n16.shtml] In the same month, hospitals in New York also began treating coronavirus patients with vitamin C. [https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/]

::'''Vitamin C dosing for children'''. Authorities on the use of vitamin C recommend dosing children by body weight, giving a proportion of the adult dose commensurate with the child’s weight as a proportion of the weight of the average adult. In one placebo-controlled study, the majority of subjects were infants and children under five years of age with severe pneumonia. They were given 200 mg vitamin C per day, which is equivalent to a modest adult dose of 2,000-3,000 mg per day. The authors of this study concluded that, even at this dose, "Vitamin C is effective in reducing duration of severe pneumonia in children less than five years of age. Oxygen saturation was improved in less than one day." [http://www.journalrmc.com/volumes/1405749894.pdf] Also see, [http://orthomolecular.org/resources/omns/v18n05.shtml Vitamin C and Infants: Determining dose].

::'''Liposomal vitamin C'''. This form of vitamin C is absorbed by a different mechanism, in the gut. The liposomes containing vitamin C can bind directly to the gut cells to release their content of vitamin C which therefore does not require active transport. Thus the maximum level achievable with oral doses of liposomal vitamin C is higher than for regular vitamin C. However, since the absorption mechanism for liposomal vitamin C differs from the active transport of regular vitamin C, both forms can be taken together to increase the level in the bloodstream (up to 400-600 μM), greater than either oral form alone. (Levy TE (2011) Primal Panacea. Medfox Pub. ISBN-13: 978-0983772804)

:'''Vitamin D'''

::This vitamin acts as a natural antibiotic, working against every type of microbe, including viruses, bacteria, fungi and parasites, but it does not harm therapeutic helminths.

::The flu can be treated effectively with a 1-time dose of 50,000 IU vitamin D3, or with 10,000 IU 3 times daily for 2 to 3 days. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/]

:: Some functional medicine practitioners advise that it is relatively safe to increase vitamin D intake to as much as 50,000 IU per day during times of virus exposure. John Cannell, MD, of the Vitamin D Council, suggests that 50,000 IU should be taken once each day for three days at the first sign of a cold or the flu. [https://web.archive.org/web/20211221125912/https://preventdisease.com/news/13/102213_Vitamin-D-Proven-More-Effective-Anti-Viral-Drugs-Vaccines-Preventing-Flu.shtml] David Brownstein, MD, recommends taking 50,000 IU per day for 4 days (link expired) and Dr Stephen Gundry suggests taking as much as 150,000 IU daily for 3 days to treat a respiratory infection. [https://mnchiropractors.com/uncategorized/dr-gundry-on-boosting-immunity-for-coronavirus/]

::* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9653496/ Association between vitamin D supplementation and COVID-19 infection and mortality]

::::Vitamin D supplementation produced a statistically significant reduction in the risk of COVID-19 infection and of the infection ending in death within 30-days. Patients receiving higher cumulative dosages and higher average daily dosages showed a greater reduction in COVID-19 infection rates than patients receiving lower dosages. "As a widely available, inexpensive, and safe treatment, vitamin D3 could be a helpful tool for reducing the spread of COVID-19 infection."

::* [https://www.ncbi.nlm.nih.gov/pubmed/32377965 The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality]

::* [https://www.psychologytoday.com/us/blog/the-fallible-mind/202202/striking-link-between-vitamin-d-levels-and-omicron A “Striking” Link Between Vitamin D Levels and Omicron]

:'''Hydrogen peroxide (H2O2)'''

::Daily use, for 1 minute, of a 1% hydrogen peroxide solution as a mouthwash and throat gargle, and the daily use, for 1 minute, of a 0.5% solution as a nasal rinse, have been found to provide effective protection against SARS-CoV-2 infection. The fact that hydrogen peroxide is safe, inexpensive and readily available led this study’s authors to recommend it for the protection against COVID-19 of healthcare workers, inpatients and all vulnerable groups. And, since H2O2 used in this way will not be swallowed or inhaled, it should not harm helminths.

::* [https://pubmed.ncbi.nlm.nih.gov/35594985/ Further observations on hydrogen peroxide antisepsis and COVID-19 cases among healthcare workers and inpatients] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/pdf/main.pdf PDF]

: '''Lysine'''

:: Lysine appears to be highly suppressive of viral replication. Approximately 80% of acute stage Covid-19 patients given lysine displayed a minimum 70% reduction in symptoms in the first 48 hours. Treatment times varied from 2 days to 3.5 weeks (excluding long term symptomatic subjects), and patients who started lysine in the hospital were discharged an average of 3 days after starting treatment.

::* [https://www.researchgate.net/publication/344210822_Lysine_Therapy_for_SARS-CoV-2 Lysine Therapy for SARS-CoV-2]

:'''Elderberry'''

::Eating elderberries and taking their extracts can help minimise influenza symptoms. [https://www.sciencedirect.com/science/article/abs/pii/S1756464619300313] But note the following.

::* "Patients with autoimmune diseases like rheumatoid arthritis, celiac, hashimoto’s, and lupus need to consult a physician before taking elderberry because it will stimulate their immune system. Elderberry interferes with medications that suppress the immune system and medications used to treat autoimmune diseases.” [https://web.archive.org/web/20190918211012/http://www.mensahmedical.com/elderberry-benefits-dangers-patients/]

::* While elderberry extract is considered to be effective against flu, it works, as many other immune boosters do, by increasing the cytokine response. [https://www.ncbi.nlm.nih.gov/pubmed/11399518] Since COVID-19 (aka SARS-CoV-2) kills primarily by initiating a cytokine storm, elderberry is probably best not relied upon as a stand-alone option against the new coronavirus, and, if used at all, would be best combined with one or more of the other effective anti-pathogenic treatments mentioned in this section.

'''Other worm-safe nutraceuticals with antiviral effects'''

:* [https://www.sciencedirect.com/science/article/pii/S0033062020300372 Nutraceuticals have potential for boosting the type 1 interferon response to RNA viruses including influenza and coronavirus] (ferulic acid, lipoic acid, spirulina, N-Acetylcysteine, selenium, glucosamine, zinc, yeast beta-glucan and elderberry)

:* [http://orthomolecular.org/resources/omns/v16n04.shtml Nutrients recommended by the International Society for Orthomolecular Medicine to prevent and minimise symptoms of viral infection]

:* Virus-Specific nutraceutical and botanical agents listed by the Institute for Functional Medicine. [https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/] [https://www.ifm.org/news-insights/functional-medicine-approach-covid-19-additional-research-nutraceuticals-botanicals/]

:* [https://blog.nutrigold.co.uk/2020/03/09/nutritional-support-for-immunity-against-viruses-including-the-coronavirus/ Nutritional Support for Immunity Against Viruses Including the Coronavirus]

:* [https://cf5e727d-d02d-4d71-89ff-9fe2d3ad957f.filesusr.com/ugd/adf864_cc5004cfa84a46d3b1a0338d4308c42c.pdf A Novel Approach to Treating COVID-19 Using Nutritional and Oxidative Therapies] (Vitamin A, vitamin C [Ascorbate], vitamin D3, Iodine, Nebulized ❓Hydrogen Peroxide and Intramuscular ❓Ozone.)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428453/ Be well: A potential role for vitamin B in COVID-19]

:* [http://www.ncbi.nlm.nih.gov/pubmed/25400245 Bifidobacterium longum MM-2 improves defence against flu virus]

:* [https://www.ncbi.nlm.nih.gov/pubmed/32179788 Ginkgolic acid inhibits fusion of enveloped viruses]

::"Thus, in light of the antiviral effect of ginkgolic acids (GA) on established viral infections of permissive cells, GA potentially could be used to treat acute viral infections (e.g. Coronavirus (COVID-19), EBOV, ZIKV, IAV and measles)."

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929665/ Uncaria tomentosa (Cat’s claw) has an antiviral effect against SARS-CoV-2]

:* [http://orthomolecular.org/resources/omns/v16n22.shtml Sulforaphane as a Treatment for COVID-19]

:* [https://onlinelibrary.wiley.com/doi/10.1002/fsn3.3034 Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies] (Full text) | [https://onlinelibrary.wiley.com/doi/epdf/10.1002/fsn3.3034 PDF]. Also see [https://www.news-medical.net/news/20220908/The-role-of-some-important-antioxidants-in-major-clinical-outcomes-of-subjects-with-COVID-19.aspx this article about the study].

::"It seems that antioxidants, especially vitamins C and D, selenium, and zinc, can improve multiple COVID-19 clinical outcomes."

:* [https://www.sciencedaily.com/releases/2020/04/200429105907.htm Link identified between dietary selenium and outcome of COVID-19 disease]

:* [https://pubmed.ncbi.nlm.nih.gov/32754164/ The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/pdf/fimmu-11-01712.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32388476/ Is copper beneficial for COVID-19 patients?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/pdf/main.pdf PDF]

:* [https://www.europeanreview.org/wp/wp-content/uploads/4062-4063.pdf?fbclid=IwAR0AxUqV9FaHNcaHwlUuzOW9MOYe_1Z3OiHIzVvDJD6J8h3DubgTZGESOGY Are probiotics effective adjuvant therapeutic choice in patients with COVID-19?]

:* [https://pubmed.ncbi.nlm.nih.gov/32733907/ Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/pdf/fmed-07-00389.pdf PDF] (Probiotics)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649937/ N-Acetylcysteine to Combat COVID-19: An Evidence Review]

:* [https://pubmed.ncbi.nlm.nih.gov/34653660/ The Effect of Melatonin on Thrombosis, Sepsis and Mortality Rate in COVID-19 Patients] -- [https://www.sciencedirect.com/science/article/pii/S1201971221007980 Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506572/pdf/main.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32574327/ Therapeutic Algorithm for Use of Melatonin in Patients With COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/pdf/fmed-07-00226.pdf PDF]

:* [https://wrightacademia.org/articles/jscc/jscc-1-002.php?jid=jscc Free Fatty Acids from Fish Oil Inactivate SARS-CoV-2]

::"… free fatty acids in fish oil may have potential as mouth/throat wash to reduce concentration of SARS-CoV-2 viruses in saliva and upper respiratory mucosa and reduce transmission."

'''Plant medicines recommended for the treatment of coronavirus'''

:* [https://www.stephenharrodbuhner.com/wp-content/uploads/2020/08/covid-19-2.update.txt.pdf?fbclid=IwAR3sm7OYMH8_RBH0xjrQM984_SFoSZupSOw5IqSes_n6s4JemMjvyLCCEug SARS-CoV-2 (COVID-19): Herbal protocols for the treatment of infection and post-coronavirus syndrome] (PDF) This is a very detailed treatise on the use of herbs in this context. Individual herbs suggested should be checked for possible anthelmintic effects by searching for them in the rest of this Care Manual.

'''Inhaled treatments - safe for human helminths unless marked otherwise'''

:'''Iodine'''

::Iodine kills all single-celled microbes on contact and can be introduced into the airways by inhalation from a salt pipe or face mask, or via home-made iodine oil. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::* Salt pipe. Two drops of Lugol’s iodine 12% or 15% dripped into the mouthpiece of a salt pipe (or simply applied to a piece of cotton wool) can be sniffed up into the nose and inhaled 2-3 times a day, or even every 2 hours. 15 - 20 sniffs provides an adequate dose.
::* Face mask. 2-4 drops of Lugol’s iodine 15% can be applied to a face mask, and reapplied 3 times a day.
::* Iodine oil. This can be made with 10 parts coconut oil to 1 part Lugol’s Iodine 15%, and applied around the nose and upper lip three times each day. The iodine does stain the skin yellow temporarily, but it is a good way to treat children who may not be able to manage a salt pipe or tolerate a mask.

:: “After the 1918 Influenza Pandemic which killed an estimated 30 million people, governments financed research on the Pandemic’s causes. Over 25 years, influenza viruses were isolated and methods for killing them with various agents discovered. Iodine was the most effective agent for killing viruses, especially influenza viruses. Aerosol iodine was found to kill viruses in sprayed mists, and solutions of iodine were equally effective. In 1945, Burnet and Stone found that putting iodine on mice snouts prevented the mice from being infected with live influenza virus in mists. They suggested that impregnating masks with iodine would help stop viral spread. They also recommended that medical personnel have iodine-aerosol-treated rooms for examination and treatment of highly infected patients. Current methods of dealing with influenza infection are isolation, hand washing, antiviral drugs, and vaccinations. All of these methods can be improved by incorporating iodine into them. When impregnated with iodine, masks become much more effective, and hand washing is more effect when done with mild iodine solutions. Isolation techniques coupled with aerosol iodine would make them safer for patients, medical personnel, and all persons working with the public. Public health authorities could organize the distribution of iodine and at the same time educate the public in the effective use of iodine. Oral iodine might also boost body defense mechanisms in the upper oral and respiratory mucus. Conclusion: Iodine incorporated into masks, solutions, aerosols, and oral preparations could help to kill influenza viruses and fight off an H1N1 Pandemic.” [https://www.drlowe.com/thyroidscience/reviews/derry/Derry.flu.iodine.9.19.09.pdf]

:'''Ascorbic acid (vitamin C)'''

::Nebulisation (atomisation) delivers vitamin C directly to where it is needed in the case of a respiratory infection such as COVID-19, and it is known to be at least as, and possibly more, effective as a method of delivery than intravenous infusion.
::'''Materials''': a nebuliser (or atomiser), ascorbic acid and sodium bicarbonate (which is needed because ascorbic acid on its own is too acidic for the airways).
::'''Method''': Mix 100 grams of ascorbic acid powder with 50 grams of bicarbonate of soda in one litre of filtered/spring water. Once the mixture has stopped bubbling, a very slightly cloudy 10% solution of sodium ascorbate will be left. This contains 500 mg of vitamin C per 10 ml of liquid.
::Nebulising 10 ml of this solution (one dose) will deliver 500 mg, or 0.5 gram, of vitamin C. Start with one dose every 2 hours.
::If the nebulised vitamin C does not provide benefits, the airways can be opened up by nebulising magnesium sulphate (Epsom salts), which is also anti-inflammatory. [https://www.cochrane.org/CD003898/AIRWAYS_inhaled-magnesium-sulfate-safe-and-effective-treatment-people-asthma-attacks] Dissolve 50 grams of Epsom salts in 500 ml of filtered/spring water and nebulise 10 ml of this 1% magnesium solution at a time. This will deliver 1 gram of magnesium, and can be done immediately before nebulising the vitamin C.

:'''Hypertonic saline'''

::A simple solution of salt in water could arguably be the simplest and most readily accessible, side-effect free, worm-friendly antiviral prophylaxis and treatment available. It is suitable for use via a nasal spray to reduce viral load in the airways and thereby minimize the severity of COVID-19 in the early stages of infection. It can also be used in a nebuliser to help treat already established or more severe cases affecting the lungs, and as a gargle to reduce viral load in the mouth. The extra salt from the hypertonic solution accumulates in the viral cells, forcing them to expend ATP in order to re-balance the electrolyte gradient, and this activity limits the amount of ATP available for viral replication. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442612/] And there is a simplified report of this research [https://medicalxpress.com/news/2021-09-reveals-saline-solution-inhibit-replication.html here].

:❓'''Hydrogen peroxide (H2O2)''' (See [[#Hydrogen peroxide|Hydrogen peroxide]].)

:: "Viral syndromes start or are strongly supported by ongoing viral replication in the naso- and oropharynx. When appropriate agents are nebulized (into a fine spray) and this viral presence is quickly eliminated, the rest of the body "mops up" quite nicely the rest of the viral presence. The worst viral infections are continually fed and sustained by the viral growth in the pharynx. Probably the best and most accessible agent to nebulise would be 3% hydrogen peroxide (1 to 5 cc of 3% peroxide with volume brought up to 10 to 12 cc with filtered water) for 15 to 30 minutes several times daily." [http://orthomolecular.org/resources/omns/v15n16.shtml] Also see [http://orthomolecular.org/resources/omns/v16n43.shtml Curing Viruses with Hydrogen Peroxide].

: '''DMSO'''

:: "DMSO can be readily combined with other anti-pathogen agents, such as sodium ascorbate (vitamin C) and magnesium chloride. Anecdotally, this DMSO-vitamin C-magnesium chloride combination has proven to be very effective in clearing biofilms and their underlying pathogen colonies. This can be done with 1 to 5 cc of 99.9% DMSO brought up to 10 to 12 cc (for nebulisation) with a combination solution of vitamin C and magnesium chloride. Precise concentrations are not critical, and the combination solution can be quickly and easily made by adding about 2 teaspoons of sodium ascorbate powder and 2 teaspoons of magnesium chloride powder to about a half cup of water. Since the sodium ascorbate will oxidize over several hours as it turns yellow, it can be made separately from the magnesium chloride solution, which remains very stable and does not significantly deteriorate over time." [http://orthomolecular.org/resources/omns/v15n16.shtml]

: '''Hyperbaric oxygen'''

:: "...hyperbaric oxygen therapy (HBOT) would be an excellent treatment adjunct against severe COVID-19 and a superior alternative to ventilators, which have been shown to cause harm in many patients and increase the risk of death. (Link expired)

: '''Grapefruit seed extract (GSE) and xylitol'''

::Nasal sprays containing GSE and xylitol (e.g., [https://xlear.com/xlear-sinus-care/ Xlear Sinus Care]) may prevent the spread of viral respiratory infections including SAR-CoV-2 and H1N1. GSE significantly reduces the viral load while xylitol prevents attachment of the virus to cell walls. [https://www.biorxiv.org/content/10.1101/2020.12.02.408575v3.full]

'''Other considerations when fighting viral infections'''

:* [https://www.sciencedaily.com/releases/2019/02/190212094839.htm How '''sleep''' can fight infection]

:* [https://www.ncbi.nlm.nih.gov/pubmed/31732517 '''Ketogenic diet''' activates protective γδ T cell responses against influenza virus infection]

:* [https://nutrition.bmj.com/content/early/2022/06/30/bmjnph-2022-000462 Association of '''periodic fasting''' with lower severity of COVID-19 outcomes in the SARS-CoV-2 prevaccine era]

:* [https://www.medicalnewstoday.com/articles/two-cases-suggest-fecal-transplants-may-treat-sars-cov-2-infection Two cases suggest '''fecal transplants''' may treat SARS-CoV-2 infection]

:* [https://journals.lww.com/anesthesia-analgesia/Fulltext/2021/04000/Aspirin_in_Coronavirus_Disease_2019_Related_Acute.1.aspx '''Aspirin''' in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome: An Old, Low-Cost Therapy With a Strong Rationale]

:* [https://www.sciencedaily.com/releases/2019/07/190702112834.htm Pharmaceutical antibiotics weaken flu defences in the lung]

:* [https://www.bmj.com/content/368/bmj.m1182/rr-10?fbclid=IwAR1wHVgtmbbjQ4zcno5d4zjlnmC97fyrrLv7jUuXBtZGpGawQwf6OJat5YU Cholesterol-lowering treatment may worsen the outcome of a COVID-19 infection]
</blockquote>

=== Ayurvedic remedies [https://en.wikipedia.org/wiki/Ayurvedic] ===

:❓ [https://en.wikipedia.org/wiki/Aegle_marmelos Aegle marmelos] (also known as Bael, Bengal quince, golden apple, Japanese bitter orange, Sirphal, stone apple and wood apple) has culinary uses and is employed as an ayurvedic remedy in Indian traditional medicine to treat various illnesses, including irritable bowel syndrome and ulcerative colitis. Sandu bilagyl, a herbal tea combining Aegle marmelos and sugar, is claimed on several commercial websites to have anthelmintic effects, [https://herbalukstore.co.uk/sandu-bilagyl.html] but this characteristic is not mentioned in more detailed articles found online, [https://hort.purdue.edu/newcrop/CropFactSheets/bael.html] where Aegle marmelos is only reported to have pesticidal properties. This may have have been extrapolated by vendors to suggest a possible anthelmintic effect, but there is so far no evidence that it harms intestinal worms, and no self-treaters have reported their experience with it.

<blockquote>
The following ayurvedic remedies are used, in combination, to treat pinworms, so may also have an adverse effect
on other helminths:
* ⚡[https://en.wikipedia.org/wiki/Vidanga vidanga] (Embelia ribes)
* ⚡[https://en.wikipedia.org/wiki/Gurmar Gymnema sylvestre] (cowplant, cowplant, gurmari, gurmarbooti, gurmar, periploca of the woods, meshasringa, Bedki cha pala and miracle fruit)
* ⚡[http://ayurveda-foryou.com/ayurveda_herb/trikatu.html trikatu] - a combination of (see Spices section)
** ⚡[https://en.wikipedia.org/wiki/Black_pepper black pepper] (Piper nigrum - (see[[#Black pepper| Black pepper]])
** ⚡[https://en.wikipedia.org/wiki/Indian_Long_Pepper long pepper] (Piper longum)
** ⚡'''ginger''' (Zingiber officinale - see [[#Ginger|local reference]])

* ⚡[https://en.wikipedia.org/wiki/Triphala Triphala]. This is an Ayurvedic herbal formula combining three myrobalans: Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica/Terminalia bellerica), and Haritaki (Terminalia chebula). The latter two of these are reported to be anthelmintic, but they also have laxative properties, and it may be this characteristic, rather than actual worm killing ability, that is the source of any ‘anthelmintic’ effects.
</blockquote>

=== Chinese herbal medicines [https://en.wikipedia.org/wiki/Chinese_Herbal_Medicine] ===

==== ❌ Anthelmintic Chinese herbs ====

<blockquote>
* Bing Lang (Semen arecae). Used against roundworms and flukes.
* Chuan Lian Gen Pi (Cortex meliae radicis). Used against roundworms.
* Da Huang (Radix et rhizoma rhei). Used in combination remedies to treat flukes.
* Guan Zhong (Rhizoma dryopteris crassirhizomae). Used in combination remedies to treat hookworms.
* Ku Lian Gen Pi (Cortex meliae radicis). Used to treat pinworms, and in combination remedies to treat hookworms.
* Lei Wan (Sclerotium omphaliae). Used specifically to treat hookworms.
* Qian Niu Zi (Semen pharbitidis). Used in combination remedies to treat flukes.
* Qu Hui Wan (Dispel Roundworms Pill). Used against roundworms.
* Shi Jun Zi (Fructus quisqualis). Used against pinworms.
* Tu Jing Jie (Herba chenopodii ambrosioidis). Used in combination remedies to treat hookworms.
* Wu Mei Wan / Wu-Mei Wan (Mume Pill). A 10-herb classical formula used to treat intestinal parasite infections, including roundworms.
* Zi Su Ye (Folium perillae). Used in combination remedies to treat hookworms.
</blockquote>

=== Homeopathic remedies ===

✅ Most homeopathic remedies are unlikely to have any adverse effect on human helminths. For example, the influenza remedy, [https://en.wikipedia.org/wiki/Oscillococcinum Oscillococcinum], has been taken occasionally by one hookworm host without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1590515217671094/?comment_id=1590860620969887&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

==== ❌ Antiparasitic homeopathic remedies [https://en.wikipedia.org/wiki/Homeopathy] ====

<blockquote>
* Cina (a homeopathically potentised form of Eurasian wormwood - [https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina])
* Cuprum oxidatum nigrum
* Indigoz
* Podophyllum
* Sabadilla
* Santoninum
* Spigelia
* Stanum
* Teucrium marum
</blockquote>

=== Light therapy===

No reports have been received about adverse effects on human helminths of any form of [https://en.wikipedia.org/wiki/Light_therapy light therapy] ([https://en.wikipedia.org/wiki/Low-level_laser_therapy#Red_light_therapy red light therapy], near-infrared, far-infrared, etc.), and one NA host has reported regularly using a red light full body bed without issue. [https://www.facebook.com/groups/htsupport/posts/7155942991128261/?comment_id=7156873597701867]

=== Phage therapy [https://en.wikipedia.org/wiki/Phage_therapy] ===

</blockquote>
❓ While it is unlikely that bacteriophages will harm helminths, one hookworm host who took a short course of doses of a cocktail of several phages has reported experiencing a slight temporary reduction in worm benefits following this treatment. The product he took included preservatives (8-hydroxyquinoline sulfate-0,0001 g / ml [calculated content]; or 8-hydroxyquinoline sulfate monohydrate in terms of 8-hydroxyquinoline sulfate-0.0001 g / ml [calculated content]) which may have been responsible for this effect. [https://www.facebook.com/groups/htsupport/permalink/2619124714810134/?comment_id=2619284978127441]
</blockquote>

=== Electromagnetic therapy ===

✅ Several forms of electromagnetic stimulation have been used by hosts of human helminths, including [https://en.wikipedia.org/wiki/Magnet_therapy Magnet Therapy], [https://en.wikipedia.org/wiki/Pulsed_electromagnetic_field_therapy Pulsed Electromagnetic Field (PEMF) therapy] and [https://en.wikipedia.org/wiki/Transcutaneous_electrical_nerve_stimulation Transcutaneous Electrical Nerve Stimulation (TENS)], none of which appear to have had any obvious effect on the worms. [https://www.facebook.com/groups/htsupport/permalink/3123210597734874/] [https://www.facebook.com/groups/htsupport/posts/7903061716416381/?comment_id=7903306649725221&reply_comment_id=7903872713001948]

== Foods, supplements, spices, herbs and fungi ==

There are lists on the internet claiming that common foods and spices such as pumpkin seeds, turmeric, and even carrots, will kill helminths, but '''normal dietary amounts of most ''unprocessed'' foods, spices and herbs, will not harm helminths.'''

For example, carrots and sweet potatoes are both claimed to be 'antiparasitic' in some online lists, but one individual who eats 400 g (14 oz) of one or other of these vegetables every day, is still able to maintain a thriving hookworm colony, and there are others who have eaten far more than this without harming their worms.

The only problem that is likely to arise with foods, spices or herbs is when these, and particularly herbs, are artificially concentrated or processed to create extracts or tinctures. Any herbal medicine that claims to have antiparasitic, or even antibacterial or antifungal properties may present a potential risk to human helminths and should therefore be approached with caution. The ultimate potency of these substances will depend on a number of factors, including, in the case of plants, the part used, the season it was picked, [https://pubmed.ncbi.nlm.nih.gov/37596334/] the method of extraction, [http://www.ncbi.nlm.nih.gov/pubmed?term=21110041] and the extent of concentration and/or processing, as well as dosage.

The effect of such substances also appears to vary between individuals, probably due to differences in the strength of their immune response to helminths, and some people, particularly those who have more difficulty holding on to a viable helminth colony and therefore need more frequent top-ups (especially a subset of patients with IBD or coeliac disease, and some with allergies) may find that ingesting certain substances that have no effect on the worms of other hosts may tip the balance in their case and cause a temporary dip in worm benefits, or even a loss of worms. For example, one helminth host has reported taking peppermint oil continuously without any apparent adverse effect on his worms, yet another individual could not keep a worm colony at all while taking peppermint oil.

In the case of some foods and herbs, a single part of the plant, usually a part that is not normally eaten - perhaps the bark or root - may have antiparasitic properties, while other parts of the same plant may be perfectly safe to eat. For example, the seeds of pomegranates are safe to eat, while the bark of the stems of this plant contains an anthelmintic compound, and the bark of the root contains an even more potent form of this alkaloid, which is used to treat roundworms, pinworms and tapeworms.

'''So, while bearing in mind the general principles set out in the Introduction and the last few paragraphs above, and using the details in the list below, helminth hosts need to observe their own responses and learn what they, as individuals, can and cannot safely consume while hosting helminths.'''

There will often be a warning indication whenever one's worms are not happy. This may be a general loss of wellbeing, or a return of specific symptoms. For example, one person always gets a marked increase in nasal congestion if something compromises the health of his worms.

=== Foods ===
<blockquote>
'''✅ Food items considered safe unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Atemoya Atemoya] The fruit, atemoya, is a hybrid of two other fruits – the sugar-apple (Annona squamosa) and the cherimoya (Annona cherimola). Atemoya is also known as "pineapple sugar apple", anón, chirimorinon, achta and stafeli dogo ("mini soursop"). An NA host has reported that eating the flesh of this fruit appeared not to harm his colony, [https://www.facebook.com/groups/htsupport/posts/7681355011920387/?comment_id=7681459525243269] but that there are neurotoxic compounds, called annonacins, in the seeds, bark, leaves and skin of this plant that may be anthelmintic. While there are also annonacins in the fruit, they are present in much smaller quantities than in the plant’s other parts.

* [https://en.wikipedia.org/wiki/Momordica_charantia Bitter melon] (Momordica charantia) Also known as Momordica chinensis, goya, karela, ampalaya, bitter apple, bitter gourd, bitter squash and balsam-pear. This cucumber-shaped vegetable is found in Asian markets, and aqueous extracts of its leaves and seeds have both been shown to have a dose-dependent adverse effect on one type of adult non-therapeutic helminth (Strongyloides) in test tube studies [https://www.researchgate.net/publication/242567254_In_vitro_anthelmintic_efficacy_of_some_indegeneous_medicinal_plants_against_gastrointestinal_nematodes] and both fruit and seeds have been, and still are, used in a number of countries to treat pinworm infections, and for expelling parasites generally. However, the quantities of fruit and seeds that are quoted as being necessary in order to eradicate worms are rather large, for example two whole melons each day for seven to ten days, repeated after two months. It is therefore unlikely that normal dietary amounts of bitter melon fruit will adversely affect therapeutic helminths, and one hookworm self-treater has reported that bitter melon is a regular part of her diet, but has never adversely affected her worms. [https://www.facebook.com/groups/htsupport/posts/4373320642723857/?comment_id=4376043225784932]

* ⚡ [https://en.wikipedia.org/wiki/Breast_milk Breast milk] (human). There has been one report of a child with severe eczema who was inoculated with hookworms while still being breastfed, and who received only moderate benefits from the worms until breast feeding was suspended. Thereafter, the benefits increased markedly, suggesting that something in the breast milk was inhibiting the worms, possibly the lauric acid which is also found in [[#Coconut|coconut]] products. [https://www.facebook.com/groups/htsupport/permalink/2241418522580757/]

* [https://en.wikipedia.org/wiki/Carrot Carrot] (Daucus carota, subsp. sativus). The taproot of the carrot is rich in beta carotene, a precursor for vitamin A, which has been claimed to increase resistance to penetration by larvae. Carrots have also been claimed to be offensive to all parasites and valuable in the elimination of threadworms, but normal dietary amounts are not harmful to therapeutic helminths, and many helminth hosts have regularly eaten significant quantities of this vegetable (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without adversely affecting their worms.

* ❌ [https://en.wikipedia.org/wiki/Chicory Chicory] (Cichorium intybus). This is well known for its toxicity to intestinal parasites, and studies have indicated that ingestion of chicory by farm animals results in reduced worm burdens. This plant contains volatile oils similar to those found in plants in the related genus Tanacetum, which includes ❌'''Tansy''', and is said to be similarly effective in eliminating intestinal worms. One hookworm host has reported that eating 2 tsp of chicory powder (pesumably ground chicory root) terminated her colony. [https://www.facebook.com/groups/htsupport/posts/8036790633043488?comment_id=8058118634244021] However another NA self-treater has reported that drinking "loads of chickory coffee for a while" had no negative effects on his colony. [https://www.facebook.com/groups/htsupport/posts/9496946530361217?comment_id=9497703880285482] This difference in results was likely due to the high heat used to roast the raw plant material to produce chicory "coffee". This processing destroys or transforms many of the original plant oils present in raw chicory root, with the result that roasted chicory contains little to none of the volatile oils found in the fresh plant. [https://orleanscoffee.com/what-is-chicory/]

* [https://en.wikipedia.org/wiki/Citron Citron] (Citrus medica). Alcoholic extracts of the rind of citron have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. These extracts may therefore also have an adverse effect on other helminths, though there is no evidence that eating normal dietary amounts of the flesh of this fruit might harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Coconut Coconut]. Coconut products contain [[#Medium-chain triglycerides|medium-chain-triglycerides]] (MCT), some of which have been shown to be effective against many parasites including giardia, other protozoa, and also tapeworms. (Also see, [[#Fatty acids|Fatty acids]].) The fats in '''coconut oil''' are 40% lauric acid (lipid number: C12), the MCT most well-known for its antibacterial, antimicrobial and antiviral properties, and the one most likely to be responsible for any adverse effect on helminths. '''Fractionated coconut oil''' contains primarily caprylic acid (C8) and capric acid (C10) [https://web.archive.org/web/20190122225059/https://www.healthline.com/nutrition/fractionated-coconut-oil] which appear not to harm helminths. One hookworm host who routinely consumes 3 to 10 tablespoons daily of MCT oil containing 55% caprylic acid and 35% capric acid has reported that this has no adverse effect on his colony, and that he is able to incubate more NA using eggs from this colony. [https://www.facebook.com/groups/678894952216125/permalink/2965258846913046/?comment_id=2966781426760788] '''Coconut fiber''', especially in the form of dried or ground coconut flesh (desiccated coconut, coconut flour) has long been used to expel intestinal worms, both in humans [https://www.facebook.com/groups/htsupport/permalink/1412001672189117/] and animals, [https://www.ncbi.nlm.nih.gov/pubmed/21120531] [https://www.ncbi.nlm.nih.gov/pubmed/24271156] and becomes more effective as the quantity increases. Eating an entire cake baked with coconut flour brought a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/946802485375707/] Most helminth hosts find that they can eat normal dietary amounts of coconut products without adversely affecting their worms, as can be seen in these examples. [https://www.facebook.com/groups/htsupport/permalink/877714092284547/?comment_id=880956541960302&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026771657378789&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026788797377075&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&reply_comment_id=2214230838632859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nevertheless, coconut products do have a potential to affect human hookworms in some individuals, especially '''coconut oil''' and '''coconut milk''', and the effect is often dose-dependent. For example, one hookworm host who checks the egg output of his worms has reported that they twice produced zero eggs for a period of time after he drank coconut milk. Another hookworm host gets increased pain a few hours after ingesting coconut milk or powder. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] Someone else found that, while consuming 200 mg of coconut milk caused a temporary return of mild symptoms of his disease, he regularly eats coconut oil without any obvious problem, but other hookworm hosts have reported a return of disease symptoms after consuming coconut oil. [https://www.facebook.com/groups/htsupport/permalink/1446457812076836/] [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409474272441857&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3536097503112846/] A hookworm grower has reported that he can consume coconut products "somewhat regularly" and still be able to incubate plenty of larvae, [https://www.facebook.com/groups/678894952216125/permalink/1407193439386269/?comment_id=1407718306000449&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but another grower has found that, while his colony continues to thrive and produce eggs when he takes 3 tablespoons of coconut oil each day, [https://www.facebook.com/groups/htsupport/permalink/1084278171628137/?comment_id=1088696887852932&comment_tracking=%7B%22tn%22:%22R%22%7D] about ⅓ of any larvae produced will be dead, and the rest “less energetic”, so he normally restricts himself to 2 tablespoons per day. '''Coconut water''' may also adversely affect a hookworm colony, as one host found after drinking 1 litre of coconut water, [https://www.facebook.com/groups/htsupport/permalink/1051741958215092/] and another found after drinking coconut water kefir, [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but one NA host has found that the [https://www.lacroixwater.com coconut essence-flavoured sparkling water produced by La Croix] had no ill effect on his worms. [https://www.facebook.com/groups/htsupport/posts/4820278211361429/] One hookworm host finds that '''all coconut products''' have an adverse effect, [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409105045812113&comment_tracking=%7B%22tn%22%3A%22R%22%7D] while two others have said that even small amounts of coconut quickly result in a loss of benefits. [https://www.facebook.com/groups/htsupport/permalink/1331489750240310/?comment_id=1339469669442318&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1526713510717932/?comment_id=1529128360476447&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Some '''CBD oils''' for vaping are suspended in coconut oil. However, most of these are only a 3% suspension, so *may* be safe for use while hosting human helminths. '''Coconut sugar''' should not carry the same degree of risk because, whereas coconut milk, oil and flour are all obtained from the flesh of mature coconuts, and coconut water is also from inside the fleshy part of the coconut, coconut sugar comes from the sap of coconut palm flower buds and consists largely of sugars. The seasoning sauce, '''Coconut Aminos''', is also made from coconut tree sap, and at least one hookworm host has used this regularly without issue. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1697083593680922&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cranberry Cranberry] (Vaccinium macrocarpon). This is claimed by some sources to contain antiparasitic enzymes, and cranberry powder is sometimes included in proprietary antiparasitic formulations, although evidence for its effectiveness in this context is lacking, and there have never been any reports of any form of cranberry having an adverse effect on therapeutic helminths. Cranberry juice was used traditionally to treat urinary tract infections (UTIs), but it works by changing the bacteria in ways that [http://www.medicalnewstoday.com/articles/198711.php prevent bacterial adhesion] rather than killing them. While drinking 15 fl oz of cranberry juice per day is claimed to help arrest a mild urinary infection, [http://www.medicalnewstoday.com/articles/306498.php cranberry powder capsules are more effective] and '''D-mannose''', a cranberry derivative, is even more effective than the powder.

* ❓ [https://en.wikipedia.org/wiki/Rub_(syrup) Date syrup], also known as “rub”. Laboratory tests have revealed that [http://www.sciencedaily.com/releases/2015/03/150330213949.htm some forms of date syrup may have antibacterial activity], possibly due to the presence of phenolic compounds that form naturally in the dates as they mature. Significantly, the syrup was able to inhibit the growth of bacteria faster than ⚡'''Manuka honey''', which several people have suspected of having adversely affected their worms. However, [https://www.facebook.com/groups/htsupport/permalink/811693292219961/?comment_id=811695265553097&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D eating dates is unlikely to be harmful to helminths].

* [https://en.wikipedia.org/wiki/Dietary_fiber Dietary fibre] (fiber). Some sources claim that eating a lot of fibre may reduce the number of intestinal worms, but fibre consumed as an integral part of a normal diet has not been reported to be a problem for human helminths.

* ❓ [https://en.wikipedia.org/wiki/Durian Durian] There are several species of fruit-producing durian trees, the most common of which is [https://en.wikipedia.org/wiki/Durio_zibethinus Durio zibethinus] So far, there have been no reports about durian from self-treaters, but [https://en.wikipedia.org/wiki/Bombax_ceiba Bombax malabaricum] - another member of the Bombacaceae plant family within which durian is classified - has shown significant anthelmintic activity against one flatworm species. [https://pubmed.ncbi.nlm.nih.gov/21853226/]

* ⚡[https://en.wikipedia.org/wiki/Fatty_acid Fatty acids]. Research on the direct effect of fatty acids on helminths is limited. However, the poly-unsaturated fatty acid (PUFA), linoleic acid, has shown in vitro nematocidal activity against both C. elegans [https://pubmed.ncbi.nlm.nih.gov/8202563/] [https://pubmed.ncbi.nlm.nih.gov/32674325/] and H. contortus, [https://pubmed.ncbi.nlm.nih.gov/20075977/] and it has been proposed that unsaturated fatty acids are likely to play a role in the natural attrition of S. mansoni and S. haematobium lung-stage larvae. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It has been hypothesised elsewhere that exposure to some fatty acids could cause lethal damage to helminths by interacting with, and compromising, the integrity of the organisms's cuticle, [https://pubmed.ncbi.nlm.nih.gov/34149425/] and in vitro exposure to arachidonic acid has been shown to cause disintegration of the surface membranes of the trematode, Schistosoma spp., eventually leading to parasite death. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It is likely that the undoubted adverse effect of some coconut products on NA - and possibly also TTO - in ''some'' hosts is due to the fatty acids these products contain, especially lauric acid (C12), and the evidence from the studies presented here suggests that other fatty acids may have an adverse effect on therapeutic helminths in a similar dose-dependent manner, influenced also by the strength of the host's immune response to helminths. People who are hosting NA, in particular, who are not experiencing the benefits they expected should therefore consider the possible effect of any fatty acids they consume, and experiment accordingly. (Also see [[#Medium-chain triglycerides|medium-chain triglycerides]] and [[#Coconut|⚡coconut]].)

* '''Guayusa tea''' ([https://en.wikipedia.org/wiki/Ilex_guayusa ilex guayusa]). The leaves of this Amazonian holly tree are brewed to make a caffeinated drink. One hookworm host who regularly drinks this tea has not noticed any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2248121518577124/?comment_id=2248562038533072&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Genetically_modified_foods Genetically modified foods] (GMOs). Some food crops, such as corn and rice, have been genetically modified to produce ❌'''Cry5B''', a protein that can kill intestinal worms, including the human hookworm. [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt), the bacterium that produces Cry5B, is also applied as a [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php natural insecticide] on crops on some organic farms, but there is no indication yet that GM foods are a potential threat to human helminths.

* [https://en.wikipedia.org/wiki/Grapefruit Grapefruit] (citrus paradisi). The flesh of the common grapefruit is perfectly safe to eat while hosting helminths, although ⚡'''grapefruit seed extract''' does have a potential to harm helminths due to the typical addition of synthetic adulterants. Also potentially harmful are some extracts of the rind of ❌'''Citrus decumana''', a close relative of the grapefruit.

* [https://en.wikipedia.org/wiki/Hibiscus Hibiscus]. One hookworm host has drunk many litres of strong, homemade hibiscus tea over the years without ever harming her colony. [https://www.facebook.com/groups/htsupport/permalink/2647270255328913/?comment_id=2647328495323089]

* ⚡ [https://en.wikipedia.org/wiki/Honey Honey]. Honey can contain antivirals [http://www.ncbi.nlm.nih.gov/pubmed/25333699] and powerful antimicrobials [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074369/], some of which can have effects comparable with those of antibiotics such as clarithromycin, and certain types of honey have particularly potent antimicrobial activity. Several people have suspected that [https://en.wikipedia.org/wiki/M%C4%81nuka_honey '''Manuka''' honey] (which inhibits dental plaque as effectively as chlorhexidine mouthwash [http://www.ncbi.nlm.nih.gov/pubmed/22114423]) has adversely affected their worms, while a few others have reported that '''raw''' honey reduces the benefits from their worms, [https://www.facebook.com/groups/htsupport/permalink/2517832904939316/?comment_id=2524053750983898] in one case causing increased pain several hours after ingestion, [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] and someone else, who had a few teaspoons of '''raw''' honey on two occasions, 4 days apart, has reported that some of his symptoms made a limited return for a day after each ingestion. [https://www.facebook.com/groups/htsupport/posts/5132147986841115/] Research reported in 2014 may explain why '''raw''' honey might have this effect. [http://www.sciencedaily.com/releases/2014/09/140908093741.htm] However, one hookworm host, who regularly takes a '''manuka''' honey/apple cider vinegar combination, has not noticed any loss of benefits, and another two have reported no apparent adverse effect on their worms after consuming '''raw''' honey. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] One of these individuals reports having eaten quite large amounts of '''raw''' honey continuously during his first 3 years with NA and never noticed anything untoward. [https://www.facebook.com/groups/htsupport/permalink/1802586329797314/?comment_id=1807740622615218&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Regular honey appears to be generally worm-safe, [https://www.facebook.com/groups/htsupport/permalink/1223658601023426/?comment_id=1224392167616736&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and, demonstrating the experience of many others, one hookworm host has said that she can consume 2-4 teaspoons of regular honey daily without any issues, but that manuka and any honey labeled as "raw" causes problems. (Identification of the different types of honey: '''Manuka''' honey, which is very viscous with a dark cream to dark brown colour, is produced by bees foraging specifically on the mānuka tree; '''Wild''' honey is often sourced from free-range hives, rather than box hives, by native gatherers who only remove larger honeycomb impurities; '''Raw''' honey is typically only strained to remove physical impurities such as beeswax and dead bees. '''Regular honey''' usually goes through additional processing including finer filtration to remove all debris and air bubbles, and pasteurisation to destroy yeasts. Regular honey may also be subject to utrafiltration, which further refines the product to make it more transparent and smooth, but also removes beneficial nutrients like pollen, enzymes and antioxidants.)

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_emblica Indian gooseberry]. (Phyllanthus emblica, also known as Emblica officinalis, emblic, emblic myrobalan, myrobalan, Malacca tree and amla.) While there are websites online that claim anti-parasitic effects for P. emblica, and one study found that P. emblica exerted toxic effects on a parasitic flat worm, [https://pubmed.ncbi.nlm.nih.gov/19819626/] there is no compelling evidence in the scientific literature for a possible adverse effect on hookworms. Neither have any reports of an adverse effect on their worms been posted by any NA self-treaters, and one study found that a traditional Thai preparation containing P. emblica actually extended the life of the research worm, C. elegans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693129/]

* [https://en.wikipedia.org/wiki/Kefir Kefir]. Although kefir has been claimed online to kill “parasites”, it will not harm hookworms unless it is made with coconut milk. (See [[#Coconut milk |details for coconut milk]].) There has also been a single report of an NA colony possibly being killed after drinking kefir made from coconut water. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (See [[#Coconut water |details for coconut water]].)

* [https://en.wikipedia.org/wiki/Kombucha Kombucha] (Medusomyces gisevii, also called tea mushroom, tea fungus or Manchurian mushroom.) This fermented drink does not harm helminths. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616509485071657]

* [https://en.wikipedia.org/wiki/Lime_(fruit) Lime] (Citrus acida). While alcoholic extracts of the rind of limes have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], and extracts of the rind may have an adverse effect on other helminths, there is no reason to believe that eating the flesh of limes will harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Medium-chain_triglyceride Medium-chain triglycerides] (MCTs) are extracted from ⚡'''coconut oil''', amongst other things, and can be divided into four groups: 1. caproic acid (C6), 2. caprylic acid (C8), 3. capric acid (C10) and 4. lauric acid (C12). [https://blog.bulletproof.com/the-definitive-guide-to-mcts/] Of these, lauric acid is the most well-known for its antibacterial, antimicrobial and antiviral properties, which may explain why coconut oil (which is 40-50% lauric acid) appears more likely to affect human helminths than products containing a mixture of all four types of MCT, such as the milk of cows, sheep and goats, the fatty acids in which contain 10-20% mixed MCTs. (Also see [[#Fatty acids|⚡fatty acids]] and [[#Coconut|⚡coconut]].) One NA host who took the "postbiotic" product, [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] has reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] and the only ingredient in this product that is known to be a potential problem is medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Onion Onion] (Allium cepa). This is used as an ingredient in some proprietary deworming formulations and has been claimed to create an 'uninhabitable environment' for intestinal worms and to help eradicate tapeworms in particular. However, if eaten in normal dietary quantities, onion should not harm therapeutic human helminths.

* [https://en.wikipedia.org/wiki/Organic_foods Organic foods]. While these are less likely to be contaminated with chemicals, some organic farmers apply [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) to their crops as a natural insecticide. This bacterium produces ❌'''Cry5B''', a protein that can kill intestinal worms, [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php including human hookworms]. However many hosts of human helminths have eaten organic foods without them affecting their worms.


* [https://en.wikipedia.org/wiki/Papaya Papaya] (Carica papaya, also known as or papaw, pawpaw or paw paw). The fruit and leaves contain both antiseptic and antiparasitic compounds, including one called [https://en.wikipedia.org/wiki/Carpaine carpaine], which is claimed to kill and expel intestinal worms. Papaya latex has been shown to be an [http://www.ncbi.nlm.nih.gov/pubmed/26343287 effective anthelmintic] against a variety of nematode parasites. However, it is unlikely that eating normal dietary amounts of the flesh of the fruit will adversely affect human helminths and, when someone who grows his own hookworms added a large amount of papaya - comparable to a human eating 2 or 3 pawpaws - to a petri dish full of larvae, these were unaffected. However, ⚡'''Papaya seeds''' are also rich in caricin which is reportedly effective in expelling roundworms. A randomized, placebo-controlled study found that a 20 ml dose of a mixture of air-dried papaya seeds and "natural" honey was effective against various types of human intestinal parasite, although the honey may have contributed to this effect. The mixture demonstrated 100% efficacy in clearing TT, and 80% efficacy against NA. [http://www.ncbi.nlm.nih.gov/pubmed/17472487] Also see [https://www.ncbi.nlm.nih.gov/pubmed/30526582 this paper].

* [https://en.wikipedia.org/wiki/Pomegranate Pomegranate] (Punica granatum). ✅The '''flesh and seeds''' of the pomegranate fruit have not been reported to harm human helminths. However, ❌'''pomegranate extracts''' should be avoided because the bark and stems of this plant contain an anthelmintic compound, punicine, and the bark of the root contains an even more potent form of this alkaloid. [https://www.ncbi.nlm.nih.gov/pubmed/32411422] Extracts of the bark of both the root and stems, and extracts of the rind/peel of the fruit, have a strong anthelmintic effect and are used as traditional remedies to treat roundworms, pinworms and tapeworms, to which they are said to be highly toxic. Alcoholic extracts of the rind/peel have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [https://www.ncbi.nlm.nih.gov/pubmed/1158424] These extracts may therefore have an adverse effect on other helminths, and one hookworm host has reported losing benefits from her colony after accidentally consuming a small amount of pomegranate extract. [https://www.facebook.com/groups/htsupport/permalink/1166864270036193/] Pomegranate peel is used in small quantities in dietary supplements and food preservatives and may not be a significant threat to human helminths in this form. However, ❌'''pomegranate peel powder''', which is available for purchase as a remedy for certain health conditions, might be harmful to helminths if it is used in quantity, for example as an ingredient in smoothies. One hookworm host found that while one company’s pomegranate '''''fruit''''' powder is produced from only the dried pomegranate arils (the seeds and their red fleshy coatings), and not including any peel, the same company’s pomegranate '''''juice''''' powder is produced from the whole fruit - both the seeds/arils and the peel. Neither product carries details on their packaging of which part of the pomegranate they contain, and this self-treater had only realised there was a difference when taking the latter product caused a return of his disease symptoms.

* ✅ [https://en.wikipedia.org/wiki/Pumpkin Pumpkin] and ⚡ [https://en.wikipedia.org/wiki/Pumpkin_seed Pumpkin seeds] (Cucurbita species). This is also referred to as squash or gourd, depending on species, variety and local parlance. Eating the flesh of the pumpkin/squash/gourd is unlikely to have any adverse effect on any human helminth. ⚡'''Pumpkin ''seeds''''' contain an antiparasitic compound called [https://en.wikipedia.org/wiki/Cucurbitacin curcurbitacin] and they were used traditionally as a remedy for tapeworms and roundworms. However, their effect is likely to be dose-dependent, and large amounts are recommend by herbalists for deworming, e,g., up to 25 ounces for adults. Some hookworm hosts have reported no adverse effect on their colony after eating pumpkin seeds, [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2889359654453304] [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2890447241011212&reply_comment_id=2895457573843512] while others have experienced either a temporary return of disease symptoms or even a loss of their colony. For example one found that eating a daily salad for a week with a mixed seed/nut topping containing pumpkin seeds killed her entire colony. [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2888764874512782] Another NA host has reported that taking 1000 mg of ⚡'''pumpkin seed oil''' daily for 2 months significantly reduced the fecundity of his NA, resulting in incubations producing only a handful of L3 larvae after having previously always yielded hundreds of larvae per incubation over a 7 year period. [https://www.facebook.com/groups/htsupport/permalink/1635384559850826/?comment_id=1635389889850293&reply_comment_id=1635944229794859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Since this individual is not treating a disease, but only acting as a reservoir donor, it is not known whether this amount of pumpkin seed oil might affect disease remission.

* [https://en.wikipedia.org/wiki/Radish Radish] (Raphanus sativus). This has been used as an alternative treatment for intestinal parasites, and is included as an ingredient in some proprietary deworming formulations, but it is unlikely to have any adverse effect on human helminths if eaten as part of a normal diet.

* ❌ [https://en.wikipedia.org/wiki/Sauerkraut Sauerkraut] Sauerkraut will not kill human helminths, but it can trigger significant digestive upset in some people, sufficient to cause a setback in the course of their treatment, and including diarrhoea severe enough to flush hookworms from the gut. Two hookworm hosts have reported experiencing significant upset stomach, “gut issues” and diarrhoea after eating only 2 and 3 forkfuls of sauerkraut respectively [https://www.facebook.com/groups/htsupport/permalink/1440317759357508/?comment_id=1440394666016484&reply_comment_id=1443382035717747][https://www.facebook.com/groups/htsupport/permalink/2726061500783121/?comment_id=3607483215974274] and another NA host lost his entire colony due to extreme diarrhoea following his first encounter with sauerkraut. [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓[https://en.wikipedia.org/wiki/Seaweed Seaweed] (macroalgae). Five poly-unsaturated fatty acids (PUFAs) identified in two Nordic seaweeds (S. latissima and L. digitata) were found to have in vitro effects against helminths in swine (Ascaris suum) and sheep (Teladorsagia circumcincta), with a clear synergistic effect being apparent when selected compounds were tested in combination. “Collectively, our data reveal that fatty acids may have a previously unappreciated role as natural anti-parasitic compounds, which suggests that seaweed products may represent a viable option for control of intestinal helminth infections.” [https://pubmed.ncbi.nlm.nih.gov/34149425/] However, there have been no reports so far of NA or TTO being adversely affected by the consumption of seaweed products. (Also see, [[#Fatty acids|⚡fatty acids]].)

* [https://en.wikipedia.org/wiki/Soy_sauce Soy sauce / soya sauce] This liquid condiment made with fermented soybeans is safe for use with human helminths.

* [https://en.wikipedia.org/wiki/Squash_(plant) Squash]. See '''Pumpkin''' above.

* [https://en.wikipedia.org/wiki/Sweet_potatoes Sweet potato] (Ipomoea batatas). Like the carrot, this root vegetable is rich in beta carotene, a precursor for vitamin A, which it has been claimed can increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat significant amounts of sweet potato (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without any adverse effect on their worms.

* [https://en.wikipedia.org/wiki/Tea Tea]. The aromatic beverage prepared by pouring hot or boiling water over cured or fresh leaves of the [https://en.wikipedia.org/wiki/Camellia_sinensis Camellia sinensis] plant, e.g., [https://en.wikipedia.org/wiki/Green_tea green tea], [https://en.wikipedia.org/wiki/Black_tea black tea], [https://en.wikipedia.org/wiki/White_tea white tea] and [https://en.wikipedia.org/wiki/Oolong oolong tea], is generally harmless to therapeutic helminths. However, there ''may'' be a risk of harm to human helminths if ❓medicinal quantities of concentrates, extracts or tinctures made from green tea are consumed. [https://www.researchgate.net/publication/5449030_Potential_anthelmintics_Polyphenols_from_the_tea_plant_Camellia_sinensis_L_are_lethally_toxic_to_Caenorhabditis_elegans]

* ⚡ [https://en.wikipedia.org/wiki/Thai_curry Thai curry]. One hookworm host found that a strong green Thai curry upset his colony to the extent that he needed to add a top-up dose to recover the benefits he had enjoyed previously. [https://www.facebook.com/groups/htsupport/permalink/2259967414059201/?comment_id=2260424784013464&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Juglans_regia Walnut], English (Juglans regia). Also known as the Persian, common, California, or Carpathian walnut. This does not appear to have gained a reputation as an anthelmintic, unlike the ⚡'''black walnut'''.

* [https://en.wikipedia.org/wiki/Watermelon Watermelon] flesh is not a problem for either NA or TTO, but there has been one report from an NA host that eating a "bunch" of ⚡watermelon seeds at a barbecue caused a loss of all worm benefits after about three days. [https://www.facebook.com/groups/htsupport/posts/6765576206831610?comment_id=6765885696800661]

* [https://en.wikipedia.org/wiki/Xylitol Xylitol]. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/833127066743250/?comment_id=833225923400031&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] that he takes xylitol daily in place of sugar and has not noticed any effect on his colony.

* [https://en.wikipedia.org/wiki/Yam_(vegetable) Yam] ([https://en.wikipedia.org/wiki/Dioscorea Dioscorea]). Like carrot and sweet potato, the yam is rich in beta carotene, a precursor for vitamin A which is thought to increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat this vegetable without adversely affecting their worms.
</blockquote>



=== Nutritional supplements ===

<blockquote>
'''✅ Supplements safe for human helminths, unless marked otherwise'''

* [https://en.wikipedia.org/wiki/5-Hydroxytryptophan 5-HTP] (5-Hydroxytryptophan, also known as oxitriptan and marketed under trade names such as Cincofarm, Levothym, Levotonine, Oxyfan, Telesol, Tript-OH and Triptum) This is used as an antidepressant, appetite suppressant and sleep aid. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/811459492243341/?comment_id=811659322223358&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] taking 5-HTP without any adverse effect on her worms.

* [https://en.wikipedia.org/wiki/Acetylcarnitine Acetylcarnitine] (Acetyl-L-carnitine, ALCAR or ALC) is produced naturally by the body, and has been taken by at least two hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1701750936547521&reply_comment_id=1702741433115138&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1702716603117621&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Acetylcysteine Acetylcysteine] (also known as N-acetylcysteine, N-acetyl-L-cysteine and NAC). Three hookworm hosts have reported taking this without causing any problems for their colonies. [https://www.facebook.com/groups/htsupport/permalink/832123420176948/?comment_id=832517453470878&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3049676998421568/?comment_id=3049740311748570] [https://www.facebook.com/groups/htsupport/posts/4840382556017661/?comment_id=4841276152594968]

* [https://en.wikipedia.org/wiki/Activated_charcoal_(medication) Activated charcoal] (also known as activated carbon). There have been no reports of this harming human helminths and three reports confirming that it does not harm NA. [https://www.facebook.com/groups/htsupport/posts/7846458328743387?comment_id=7847087392013814][https://www.facebook.com/groups/htsupport/permalink/513613715361255/?comment_id=514186115304015&comment_tracking=%7B%22tn%22:%22R0%22%7D][https://www.facebook.com/groups/htsupport/permalink/792437597478864/?comment_id=792881060767851&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R3%22%7D]

* [https://en.wikipedia.org/wiki/Lipoic_acid Alpha lipoic acid] (ALA), also known as Lipoic acid (LA), α-lipoic acid and thioctic acid. This organosulphur compound is made naturally in animals, where it is essential for aerobic metabolism. Because of its antioxidant properties, it is also sold as a dietary supplement and is available in some countries as a pharmaceutical drug. One host of both hookworms and human whipworms has taken between 300 and 600 mg of alpha lipoic acid per day without any harm befalling their worms.

* [https://en.wikipedia.org/wiki/Amine_oxidase Amine oxidase] (also known as diamine oxidase, DAO and histaminase). This enzyme, which is involved in the metabolism of histamine, is produced by the body and found in high concentrations in the digestive tract and placenta. It has therefore been suggested [https://www.facebook.com/groups/htsupport/permalink/883903308332292/?comment_id=883916171664339&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] that it is unlikely to be harmful to helminths, although there are not yet any reports to confirm this.

* [https://aseaglobal.com ASEA] Redox Supplement. This “catalytically processed” saline solution should not harm helminths, a fact confirmed by one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/2127858607270083/?comment_id=2129186490470628&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://atrantil.com/ Atrantil] contains three active botanicals: M. balsamea Willd (peppermint) leaf extract, quebracho extract and conker tree extract. While ⚡'''peppermint oil''' has proved to be a problem for some hosts of human helminths (see [[#Peppermint|peppermint reference]]), it is possible that the leaf extract may be worm-safe. However, quebracho extract has been shown to effectively reduce worm burdens in sheep. [http://www.fao.org/docs/eims/upload/agrotech/1905/R7424%20(04)%20Embu%20proceedings.pdf]

* ❓ Avocado seed extract. Extracts of the seeds of the avocado - also known as alligator pear or avocado pear ([https://en.wikipedia.org/wiki/Avocado Persea americana]) - may have an adverse effect on NA. While there have been no reports so far of this effect from self treaters who host either NA or TTO, caution is recommended when trying these extracts because there is scientific evidence suggesting that they possess broad spectrum anthelmintic activity against several other nematode species.

* [https://en.wikipedia.org/wiki/Bee_pollen Bee pollen]. One hookworm host has reported that eating small amounts of this has had no obvious adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Beta-Sitosterol beta-Sitosterol] has demonstrated anthelmintic effects [https://www.ncbi.nlm.nih.gov/pubmed/12587699] and three hookworm hosts have reported a return of their disease symptoms after taking beta-Sitosterol. (expired link), [https://www.facebook.com/groups/htsupport/permalink/1143218725734081/?comment_id=1146128268776460&comment_tracking=%7B%22tn%22:%22R0%22%7D], [https://www.facebook.com/groups/htsupport/posts/7569548336434389/]

* [http://www.webmd.com/vitamins-supplements/ingredientmono-312-BETAINE%20HYDROCHLORIDE.aspx?activeIngredientId=312&activeIngredientName=BETAINE%20HYDROCHLORIDE Betaine hydrochloride]. Two hookworm hosts have reported using betaine HCL without noticing any loss of benefits from their worms. [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106534052735882&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106538649402089&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://www.facebook.com/groups/htsupport/permalink/2070288819693729/?comment_id=2070391136350164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Boron Boron] and [https://en.wikipedia.org/wiki/Borax Borax]. Boron is a chemical element and a trace element in human and plant nutrition. Only small amounts of boron are required for health and an excess can be toxic. It is unlikely to have an adverse effect on helminths when consumed in dietary quantities. Borax is a mineral containing boron which has antifungal properties and also certain [https://en.wikipedia.org/wiki/Borax#Toxicity health risks]. One hookworm host has reported taking 1/2 teaspoon borax per day for 6-7 weeks without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/1232677046788248/?comment_id=1404263146296303&reply_comment_id=1404577376264880&comment_tracking=%7B%22tn%22%3A%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1404253479630603/?comment_id=1404658099590141&reply_comment_id=1405046696217948&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/BPC-157 Bpc 157] This pentadecapeptide, also known as PL 14736, was taken intranasally over 4 days by one NA host who has reported no negative effect on his colony in that time. [https://www.facebook.com/groups/htsupport/posts/6283059368416632/?comment_id=6283148771741025]

* [https://en.wikipedia.org/wiki/Chlorella Chlorella]. One hookworm host took ½ teaspoon of this single-cell green algae daily for a year without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1037512569638031/?comment_id=1037568506299104&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Chlorophyllin Chlorophyllin]. This semi-synthetic derivative of chlorophyll is used as a food colouring agent (e.g., E number E141) and as a treatment aimed at reducing various bodily odours, but its suitability for use by helminth hosts has been questioned because of its apparent [https://www.ncbi.nlm.nih.gov/pubmed/19009310 ability to kill mosquito larvae and other small animals] at low concentrations, although this effect appears to be dependent on the presence of sunlight. (Also see ✅[[#Chlorophyll|Chlorophyll]].)

* [https://en.wikipedia.org/wiki/Chondroitin_sulfate Chondroitin Sulfate]. In an animal study, chondroitin sulfate was shown to prevent threadworms from establishing in the digestive system, but one NA host has taken 900 mg daily for several years without any adverse effect on his worms.

* [https://en.wikipedia.org/wiki/Colostrum Colostrum]. A hookworm host has taken this without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1145589722163648/?comment_id=1145807582141862&comment_tracking=%7B%22tn%22:%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/Mannose D-mannose]. This naturally occurring simple sugar is the ingredient in cranberries that makes their juice effective against urinary tract infections. Pure D-mannose is 10-50 times stronger than cranberry juice, making it more suitable for stubborn cases of UTI, and it reportedly resolves more than 90% of all UTIs within 1-2 days. [https://web.archive.org/web/20210211080155/http://www.tahomaclinicblog.com/d-mannose-for-bladder-and-kidney-infections/], [http://www.townsendletter.com/May2014/gaby0514.html] Taking steps to make the urine less acidic (e.g., by taking Tums[https://www.tums.com/]) might [http://www.sciencedaily.com/releases/2015/06/150625161623.htm make cranberry-based treatments even more effective]. D-mannose is non-toxic, produces no adverse effects and, while there have been no reports to confirm it’s lack of adverse effects on human helminths, it is unlikely to do them any harm.

* ⚡ [https://en.wikipedia.org/wiki/Digestive_enzymes Digestive enzymes], such as papain and bromelain, are said to make the intestinal tract inhospitable to parasites by dissolving their outer layers. In particular, papain - the milky juice of the unripe papaya - is claimed to be a powerful agent for destroying roundworms. One subject has reported a return of symptoms after taking a product containing papain, bromelain, protease, lipase and amylase for several weeks, and another individual has reported losing their entire hookworm colony after taking ''Healthy Origins Broad Spectrum Digestive Enzymes'' [https://healthyoriginseurope.com/products/digestive-enzymes-nec-broad-spectrum?variant=31997110714427] (amylase, protease, peptidase, alpha-galactosidase, glucoamylase, acid maltase, cellulase, pectinase, protease, lipase, lactase, beta-glucanase, invertase and hemicellulase). However, several other hookworm hosts have taken digestive enzymes, including ''Terranova's Quercetin Nettle Complex'' which contains bromelain, without any obvious effect on their worms, [https://www.facebook.com/groups/htsupport/permalink/888731831182773/?comment_id=888738757848747&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] and one of these has regularly taken pancreatin-based products from different manufacturers, mostly from ''Pure Encapsulations'', but also a lipase product by ''Integrative Therapeutics''. Another hookworm host who regularly takes digestive enzymes but has never noticed any adverse effect on his colony, generally avoids papain and bromelain, but regularly takes pancreatin, lipase, ''Acid Ease'', and occasionally ''Udo's Choice'' enzymes. Udo's Choice brand does contain some bromelain, but only a small amount. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] One NA host has reported that 500 mg bromelain twice daily appeared to be well tolerated by his hookworms, and someone else noticed no adverse effect on his NA colony after taking ''Enzymedica Digest Spectrum Multiple Food Intolerance Formula'' (amylase, xylanase, protease, alpha galactosidase, glucoamylase, lactase, lipase, maltase, cellulase, invertase, pectinase and hemicellulase). [https://www.facebook.com/groups/htsupport/posts/4876772765711973?comment_id=4879285832127333] And two other NA hosts have taken a product containing lipase (40,000 USP units), protease (126,000 USP units) and amylase (168,000 USP units) without issue. [https://www.facebook.com/groups/htsupport/posts/6285531644836071/?comment_id=6285909298131639]See also ✅[[#Papaya|Papaya]], and, for a brief explanation of how to stimulate one’s own natural enzyme production using a simple form of micro-massage, see [https://www.foodsmatter.com/nutrition_micronutrition/miscellaneous/articles/free_digestive_enzymes.html this article].

* [https://en.wikipedia.org/wiki/3,3%27-Diindolylmethane Diindolylmethane (DIM)]. 3,3′-Diindolylmethane has never been mentioned by hosts of human helminths as being harmful to their worm colonies, which is unsurprising because it’s a natural compound that is created in the body from the digestion of cruciferous vegetables such as cauliflower, broccoli and Brussels sprouts. Supplements containing DIM are simply a concentrated form of this natural substance.

* [https://en.wikipedia.org/wiki/Folic_acid Folic Acid] has been claimed to help prevent the proliferation of intestinal parasites at a dosage of 400 - 800 mcg (0.4 - 0.8 mg) per day. However, this is not a problem for human helminths because they do not proliferate within their hosts, and there have been no reports of adverse effects from hosts of human worms. One subject has taken a daily vitamin B-complex supplement containing 400 mcg of folic acid without any apparent effect on his hookworms, and another has taken 800 mcg of folate (as calcium L-5 methyltetrahydrofolate) every day for over 4 years with no adverse effect on his hookworms.

* [https://en.wikipedia.org/wiki/Fructooligosaccharide FOS] (fructooligosaccharide) is said to inhibit parasites from attaching to the intestines but no helminth host has reported any problem with this so far.

* [https://en.wikipedia.org/wiki/Fulvic_acid Fulvic acid]. This is a form of [https://en.wikipedia.org/wiki/Humic_acid humic acid] which two hookworm hosts have taken without any apparent adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/] [https://www.facebook.com/groups/htsupport/permalink/1132472786808675/?comment_id=1132930603429560&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Ginseng Ginseng]. Members of the genus, [https://en.wikipedia.org/wiki/Panax Panax], appear not to be harmful to human helminths, and one hookworm host has reported taking ginseng without noticing any untoward effect. [https://www.facebook.com/groups/htsupport/permalink/1453317641390853/?comment_id=1453345564721394&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Glucosamine Glucosamine] may be beneficial for roundworms. Applying this amino sugar experimentally to one roundworm species caused the treated worms to live around 5% longer than their untreated counterparts. [http://www.medicalnewstoday.com/releases/275263.php]

* [https://en.wikipedia.org/wiki/Glutathione Glutathione]. One hookworm host who has taken [https://en.wikipedia.org/wiki/Liposome liposomal glutathione] says he’s confident that this did not harm his worms, [https://www.facebook.com/groups/htsupport/permalink/803451913044099/?comment_id=803468529709104&offset=0&total_comments=6] and several people who have taken other oral glutathione supplements have reported no adverse effects. A hookworm host who received intravenous injections containing glutathione experienced no adverse effect on her NA colony. [https://www.facebook.com/groups/htsupport/permalink/1668651476524134/?comment_id=1668819739840641&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Grape_seed_extract Grape seed extract]. After taking 4 capsules of a product containing 200mg grape extract, 200mg grape seed extract and 200mg Muscadine grape every day for 2 weeks, one hookworm host carried out a successful incubation, indicating that the product had not adversely affected her colony. [https://www.facebook.com/groups/htsupport/permalink/2233069223415687/?comment_id=2282502821805660&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (Also see [[#Grapefruit seed extract (GSE)|Grapefruit seed extract (GSE)]], which can adversely affect human helminths in some people.)

* [https://en.wikipedia.org/wiki/Inulin Inulin] Knowing that chicory can have an adverse effect on human hookworms, a few hookworm hosts have been concerned when finding "inulin from chicory" listed among the ingredients in some supplements. However, while chicory root is a common source of inulin, its commercial processing removes everything but the fructose-based polysaccharide - the dietary fibre which is used in food supplements and to sweeten, or otherwise improve the nutritional value of, manufactured food products. Inulin is therefore not considered to be a threat to human helminths.

* [https://en.wikipedia.org/wiki/Iron Iron]. Supplementary iron taken orally does not harm helminths, but one hookworm host has reported having apparently lost her worms on two occasions after receiving ❓intravenous iron infusions. [https://www.facebook.com/groups/htsupport/permalink/2033546613367950/?comment_id=2033644093358202&reply_comment_id=2033832696672675&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓Lumbricus Tonic. This discontinued [https://www.nutricology.com Nutricology] product contained a powdered earthworm extract as well as ⚡'''sweet flag''' root extract. The herb was last on the list of ingredients however, and there had been no reports by hosts of therapeutic helminths to suggest that the product might be a problem for worms.

* [https://en.wikipedia.org/wiki/Melatonin Melatonin]. This hormone, which is commonly used as a sleep aid, has been taken by many helminth hosts, none of whom have reported any adverse effects on their worm colonies.

* [https://en.wikipedia.org/wiki/Modified_citrus_pectin Modified citrus pectin] (also known as citrus pectin, Pecta-Sol, PectaSol and MCP) is a complex carbohydrate extracted from citrus fruits using a chemical extraction process that makes it soluble, absorbable and more digestible. This is unlikely to have any effect on helminths.

* [https://en.wikipedia.org/wiki/Moringa_oleifera Moringa] (Moringa oleifera, also known as drumstick tree, horseradish tree, ben oil tree and benzoil tree) Although described as a “natural anthelmintic”, moringa has been taken by two helminth self-treaters with no apparent adverse effect on their hookworms. The first takes a 500 mg capsule of 10 to 1 extract (from 5000 mg of Moringa olifeira) twice a week, [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1039406139448674&reply_comment_id=1039533526102602&comment_tracking=%7B%22tn%22:%22R4%22%7D] while the second grows and harvests her own moringa. [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1040747242647897&comment_tracking=%7B%22tn%22:%22R%22%7D] Whatever anthelmintic properties moringa might have may depend on the part of the plant used.

*❓[https://en.wikipedia.org/wiki/Methylsulfonylmethane MSM] (Methylsulfonylmethane) is claimed by one source to be effective against many types of intestinal worm including Enterobius (pinworm [US], threadworm [UK]) and the roundworm, Ascaris. It is suggested that MSM blocks the interface between the parasite and the host by competing with the parasite for binding sites at the surface of the mucous membrane, and that the parasites may find the resulting MSM 'film' impenetrable. However, it may be necessary to take 10,000 mg of MSM per day for three or four weeks to achieve this effect, and one helminth host has reported that he has occasionally taken up to 1 heaped tablespoon of MSM while hosting helminths to treat eczema flare-ups, and has not noticed any loss of worm benefits. Someone else who takes a heaped teaspoonful of equine MSM every other day has also reported observing no adverse effects on her NA. [https://www.facebook.com/groups/htsupport/posts/4170339756355281?comment_id=4174905152565408]

* [https://en.wikipedia.org/wiki/Nattokinase Nattokinase] This serine protease (or serine endopeptidase), which is taken as a nutritional supplement, is an enzyme that cleaves peptide bonds in proteins. Two NA hosts have reported taking 200 mg and 500 mg respectively twice daily with no adverse effect on their hookworm colonies.

* [https://en.wikipedia.org/wiki/Omega-3_fatty_acid Omega-3 fatty acid] supplements are taken regularly by a large number of people, and have not been reported to be harmful to any helminth species. Indeed, omega-3 fatty acids have been found to extend the lifespan of some worms. [https://pubmed.ncbi.nlm.nih.gov/28772063/]

*❓[https://en.wikipedia.org/wiki/Seaprose_S Oryzin] (Aspergillus alkaline proteinase, aspergillopeptidase B, API 21, aspergillopepsin B, aspergillopepsin F, Aspergillus candidus alkaline proteinase, Aspergillus flavus alkaline proteinase, Aspergillus melleus semi-alkaline proteinase, Aspergillus oryzae alkaline proteinase, Aspergillus parasiticus alkaline proteinase, Aspergillus serine proteinase, Aspergillus sydowi alkaline proteinase, Aspergillus soya alkaline proteinase, Aspergillus melleus alkaline proteinase, Aspergillus sulphureus alkaline proteinase, prozyme, P 5380, kyorinase, seaprose S, semialkaline protease, sumizyme MP, prozyme 10, onoprose, onoprose SA, protease P, promelase.) There have been no reports as yet about the possible effects on human helminths of taking this mould/mold-derived proteinase.

* [https://en.wikipedia.org/wiki/Palmitoylethanolamide Palmitoylethanolamide] (PEA) This is unlikely to harm NA, and one NA host who took it for a number of weeks has confirmed that it didn’t harm his worms. [https://www.facebook.com/groups/htsupport/posts/6318336784888890/?comment_id=6318488838207018]

* [https://en.wikipedia.org/wiki/Probiotic Probiotics]. There are many hosts of the human helminths, NA and TTO, who take probiotics regularly, in some cases several different ones each day, [https://www.facebook.com/groups/htsupport/permalink/2644164455639493/?comment_id=2645824198806852] yet there have been no reports by any of them that their worms have been adversely affected. [https://en.wikipedia.org/wiki/Akkermansia_muciniphila Akkermansia muciniphila] was initially suspected in two cases of having caused a loss of hookworms, but these events were more likely to have been the result of the extended adverse reaction that can often be experienced to this particular probiotic when it is first taken, can last for several weeks [https://www.facebook.com/groups/htsupport/posts/8333525306703351/?comment_id=8456943157694898&reply_comment_id=8459002264155654] and, in one case, may have lasted for a couple of months. [https://www.facebook.com/groups/htsupport/posts/8333525306703351?comment_id=8456943157694898&reply_comment_id=8459072834148597] It is known that a number of probiotics - predominantly Lactobacillus species - can have strain-specific effects on certain “parasites”, and, while most of these are not helminths, [https://www.hindawi.com/journals/jpr/2011/610769/] there is some evidence that the milk-based probiotics, lactobacilli and bifidobacteria, may reduce the benefits of HDC. [https://helminthictherapywiki.org/wiki/Self-treating_with_HDC#Probiotics] It is known that some bacteria are capable of mobilizing nematode-trapping fungi, [http://www.nature.com/articles/ncomms6776] and that Saccharomyces boulardii can have an adverse effect on the dog roundworm, Toxocara canis, [http://www.ncbi.nlm.nih.gov/pubmed/26971490] but S. boulardii and soil-based organisms are likely to be OK for HDC, and S. boulardii has been taken by at least two hookworm hosts without any obvious effect on their worms.

*❓[https://en.wikipedia.org/wiki/Propolis Propolis]. An apitherapist speaking at the 2010 International [http://www.bterfoundation.org BTeR Foundation] Conference on Biotherapy had spoken about the antiparasitic properties of this bee product, and suggested that it might harm helminths. Then, a paper published in 2020 revealed that Brazilian red propolis exhibits antiparasitic properties both in vitro and in vivo, and reduces worm burdens and egg production in a mouse model of infection by the helminth, Schistosoma mansoni. [https://pubmed.ncbi.nlm.nih.gov/32918996/] While this new research does not prove that propolis will be harmful to therapeutic helminths, it does make this possibility look more likely. However, one NA host has reported consuming propolis in the form of a dark brown chewing gum, without any obvious effect on his colony. He also reports that the content of propolis varies widely depending on the plants growing around the hive. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3465063380216259] This variation in constituents also results in propolis from different locations having different colours, and it's possible that the different colours might have differing effects on helminths, with green propolis ''possibly'' being the safest. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3703669629688965]

* [https://en.wikipedia.org/wiki/Psyllium Psyllium] appears not to harm hookworms, and one NA host has reported taking 4 rounded tsp of Metamucil (containing powdered psyllium seed husks) every day without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/3363462447043020?comment_id=3364793813576550]. However, psyllium is said to be effective in helping to remove parasite eggs from, and preventing parasites "taking root" in, the gut [https://gutbliss.com/psyllium-husk-a-complete-guide/] and there are indications from one TT host that his regular use of psyllium may be reducing his TT colony and preventing him from culturing this species.

* [https://en.wikipedia.org/wiki/Pyrroloquinoline_quinone Pyrroloquinoline quinone (PQQ)] This enzyme cofactor has been taken by several hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248812458508040&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248893555166597&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Quercetin Quercetin]. Although identified as a promising lead candidate for development as an anthelmintic product, [https://www.nature.com/articles/s41598-025-34049-5] self-treaters have reported that, if taken on its own, quercetin does not harm therapeutic helminths. [https://www.facebook.com/groups/htsupport/permalink/2403427306379877/?comment_id=2404196192969655] [https://www.facebook.com/groups/htsupport/posts/5173747102681203?comment_id=5173760879346492] However, if it is combined with a digestive enzyme - as it often is, to improve absorption - helminths may be adversely affected. See entry for ⚡[[#Digestive enzymes|Digestive enzymes]].

* [https://intelligenceofnature.com/pages/restore Restore]. This supplement, the active ingredient in which is Terrahydrite, was used by someone reporting that her colony is normally particularly sensitive, but was unaffected when she took Restore for long periods. [https://www.facebook.com/groups/htsupport/permalink/1967905053265440/?comment_id=1967995116589767&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Resveratrol Resveratrol]. This may have an adverse effect on some helminths, [http://www.ncbi.nlm.nih.gov/pubmed/19562377] but this is likely to depend on dose size, and three hosts of human helminths who regularly take this compound report no adverse effect on their worms. One has taken “Perfect Resgrape Max” (400 mg trans-resveratrol) daily for many months with no apparent ill effects on her NA. [https://www.facebook.com/groups/htsupport/permalink/1803160683073212/?comment_id=1803255516397062&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (People with MS might want to avoid resveratrol anyway. [http://medicalxpress.com/news/2013-09-resveratrol-red-wine-worsens-ms-like.html])

* [https://en.wikipedia.org/wiki/S-Adenosyl_methionine S-Adenosyl methionine] (SAM, also known as SAMe, SAM-e or AdoMet) has only been reported on by one hookworm host, who observed no adverse effect on his worms after taking 200-400mg SamE per day for several months.

* [https://en.wikipedia.org/wiki/Serratiopeptidase Serrapeptase] (also known as serratiopeptidase, Serratia E-15 protease, serralysin, serratiapeptase, serratia peptidase, serratio peptidase, or serrapeptidase). This proteolytic enzyme (protease) has been taken occasionally by one TTO host two or three times per day over a 4 year period to treat intestinal spasm, without affecting her worms. [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357766200945998&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357787397610545&reply_comment_id=1385081271547824&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has also been taken (at 160k SPU [80mg] per day) for prolonged periods by a hookworm host with no apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&reply_comment_id=2244261005629842&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Spirulina_(dietary_supplement) Spirulina]. This cyanobacterium is [http://www.ncbi.nlm.nih.gov/pubmed/25599112 an effective anti-inflammatory] that is being used by a number of hosts of human helminths without causing any harm to their worms. One hookworm host takes 10 grams of spirulina every day without noticing any deleterious effects on his colony. [https://www.facebook.com/groups/htsupport/permalink/2041940819195196/?comment_id=2043585499030728&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, it is worth noting that a significant proportion of algae-derived products tested in one study were found to contain an unhealthy amount of cyanotoxins caused by overgrowth of cyanobacteria due to the dumping of agricultural fertilisers into waterways. These bacterial products might not harm helminths, but they can contribute to neurological disorders like ALS in humans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371831/]

* [https://en.wikipedia.org/wiki/Sulforaphane Sulforaphane / sulphoraphane] This organosulfur compound, which is obtained from cruciferous vegetables such as broccoli, Brussels sprouts and cabbages, has been taken in large amounts by one hookworm host without it affecting his colony. [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&reply_comment_id=1724935230895758&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Taurine Taurine] is an organic acid that occurs naturally in food, especially seafood and meat (in which form it is no threat to helminths) but it is also produced synthetically and included in a number of products such as health drinks. In this form, it has been linked to a number of [https://web.archive.org/web/20201030111526/https://healthiertalk.com/dangers-taurine-commonly-found-energy-drinks-0996/ health problems], and has consequently been banned in some countries. It has also been shown to have anthelmintic effects, but only against a non-therapeutic helminth [http://www.ncbi.nlm.nih.gov/pubmed/23832642 in mice]. One helminth self-treater has taken 3 grams of taurine per day without any adverse effect on her hookworms. [https://www.facebook.com/groups/htsupport/permalink/2178145842241359/]

* [https://en.wikipedia.org/wiki/Theanine Theanine] This amino acid analogue is commonly known as L-theanine and sometimes L-gamma-glutamylethylamide or N5-ethyl-L-glutamine. It is not to be confused with threonine (a distinct amino acid), theine (an ancient name for caffeine) or thiamine (a B vitamin). Theanine is safe for use by helminth hosts. [https://www.facebook.com/groups/htsupport/posts/8722883501100861/?comment_id=8723517234370821]

* [https://en.wikipedia.org/wiki/Zinc Zinc] is said to inhibit the proliferation of intestinal parasites by stimulating various aspects of the immune system in the digestive tract that counteract parasites. In one animal study [http://jn.nutrition.org/content/130/5/1412S.full] the rodent nematode worm, H. polygyrus, was found to be better able to survive in mice which had been deliberately made deficient in zinc. Those who claim that zinc is an effective antiparasitic in humans suggest a dosage of 15-50 mg per day, but several helminth hosts have taken supplements containing this amount of zinc, in some cases continuously, without issue. One hookworm host takes 10 mg on alternate days, [https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930318850357404&comment_tracking=%7B%22tn%22:%22R0%22%7D],[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930807120308577&comment_tracking=%7B%22tn%22:%22R%22%7D] another has taken 15 mg zinc gluconate or zinc picolinate daily for several years, while yet another has taken 23 mg zinc gluconate/citrate plus 18.75 mg zinc acetate daily, and previously took 30mg zinc picolinate daily[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=943449092377713&comment_tracking=%7B%22tn%22%3A%22R%22%7D], all without any apparent adverse effect on their worms. However, someone who was trying to grow his own hookworms had no success with incubation while he was taking a zinc supplement, the dose of which he had increased slowly to a maximum of 130 mg/day. Three weeks after he stopped all zinc intake, he found NA larvae in his incubations for the first time. [https://www.facebook.com/groups/678894952216125/posts/4716370328468547] ❌[https://en.wikipedia.org/wiki/Zinc_oxide%23ZnO_nanostructures Zinc oxide nanoparticles (ZnO NPs)] have shown strong anthelmintic effects, in vitro, against several gastrointestinal nematodes encountered in veterinary medicine. [http://www.ncbi.nlm.nih.gov/pubmed/26177503] [https://www.ncbi.nlm.nih.gov/pubmed/29975659] [https://www.ncbi.nlm.nih.gov/pubmed/31931890] As well as their topical use in sunscreens and cosmetics, zinc oxide nanoparticles are also used in some food products (in spite of the fact that they can cause DNA damage), but the amounts used in this application may be too small to harm human helminths.

* [https://en.wikipedia.org/wiki/Vitamin_A Vitamin A]. Supplementation with this vitamin has no adverse effect on helminths [https://www.ncbi.nlm.nih.gov/pubmed/25127885] but a vitamin A deficiency may reduce colonisation by worms. [https://www.ncbi.nlm.nih.gov/pubmed/24458645]

* [https://en.wikipedia.org/wiki/Vitamin_C Vitamin C]. This does not harm helminths, even in high doses.

* Xuezikhang, a [https://en.wikipedia.org/wiki/Red_yeast_rice red yeast rice] product, appears to be harmless to hookworms. [https://www.facebook.com/groups/htsupport/permalink/1347982335257718/?comment_id=1348392021883416&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



=== Spices and culinary herbs ===
<blockquote>

* ❓ [https://en.wikipedia.org/wiki/Annatto Annatto / roucou] (Bixa orellana). One in vitro study found that higher concentrations of extracts of B. orellana seeds were effective against the earthworm species, Eisenia fetida, [https://www.researchgate.net/publication/356635196_Evaluation_of_Antihelminthic_Activity_of_Bixa_orellana] but it was not tested in intestinal helminths. There has been a single claim [https://www.reddit.com/r/HelminthicTherapy/comments/wmm6im/caution_annatto_can_harm_na] by an NA host of a return of disease symptoms shortly after starting to take an annatto and rice dietary supplement containing a high concentration of delta-tocotrienol, a form of vitamin E: [https://tricutis-shop.de/DeltaTop-delta-Tocotrienol DeltaTop delta-Tocotrienol].

* ❓ [https://en.wikipedia.org/wiki/Asafoetida Asafoetida] has been used as an anthelmintic in traditional medicine in several parts of the world [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459456/] but there has only been one report to date of its use by someone hosting therapeutic helminths, and this user says that he hasn’t noticed any ill effect on his hookworms after occasionally consuming foods that list asafoetida as an ingredient.

* ✅ [https://en.wikipedia.org/wiki/Basil Basil] Ocimum basilicum, also called great basil, is a culinary herb in the family Lamiaceae (mints) used in cuisines worldwide. In Western cuisine, the generic term "basil" refers to the variety also known as Genovese basil or sweet basil, of which there are many cultivars, including Napolitano basil, also known as Napoletano basil, Neapolitan basil, Mammoth basil, Bolloso Napoletano basil, Napolitano Mammoth-Leafed basil and Italian Large-Leaf basil. Several hookworm hosts have eaten basil and drunk tea made from it without any harm befalling their worms [https://www.facebook.com/groups/htsupport/permalink/872768092779147/?comment_id=872772372778719&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7987286861327199?comment_id=7987574677965084] [https://www.facebook.com/groups/htsupport/posts/7987286861327199/?comment_id=7992929767429575] ❓[https://en.wikipedia.org/wiki/Ocimum_tenuiflorum '''Holy basil'''] (Ocimum tenuiflorum, also known as Ocimum sanctum, tulsi and tulasi/thulasi) is claimed online to be antiparasitic. There is also evidence showing that its essential oil has potent anthelmintic activity, including against the research worm, C. elegans, [http://www.ncbi.nlm.nih.gov/pubmed/11543966] and it has shown some activity against the malaria parasite, [http://www.ncbi.nlm.nih.gov/pubmed/21643655] but there is no indication yet as to how Holy Basil might affect human helminths. Holy Basil is used for religious purposes, in traditional medicine and Ayurveda. It is also used for its essential oil and is widely used as an herbal tea.

* ⚡ [https://en.wikipedia.org/wiki/Black_pepper Black pepper] (Piper nigrum). This is often used as an ingredient in proprietary parasite cleanses due to its established antiparasitic effects. It could therefore have an adverse effect on human helminths, though this is likely to be dependent on the dosage and on the form taken. So, while use of the whole spice in small quantities as a condiment is unlikely to present a problem, taking medicinal quantities of black pepper may harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Bunium_bulbocastanum Bunium bulbocastanum] This vegetable/spice, which is commonly called black cumin, great pignut, black zira or earthnut, is thought to be harmless to helminths when consumed in dietary quantities.

* ⚡ [https://en.wikipedia.org/wiki/Cayenne_pepper Cayenne] (Cayenne pepper is a type of [https://en.wikipedia.org/wiki/Capsicum_annuum Capsicum annuum], and cayenne powder is generally made from [https://en.wikipedia.org/wiki/Bird%27s_eye_chili bird's eye chili peppers], which are classified as [https://archive.org/details/spiceshenry00ridlrich/page/360/mode/2up?view=theater Capsicum minimum] and often mistaken for the similar-looking [https://en.wikipedia.org/wiki/Capsicum_frutescens Capsicum frutescens], cultivar [https://en.wikipedia.org/wiki/Siling_labuyo siling labuyo], the fruits of which are generally smaller and grow in an upwards direction.) Cayenne is claimed to irritate parasites, and often appears as an ingredient in proprietary parasite cleansing products for pets and humans. There have been a couple of reports of an adverse effect on hookworms, including from someone who says that even a smidgen of cayenne causes her to temporarily lose the benefits from her worms. [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1063030367086251&reply_comment_id=1063315093724445&comment_tracking=%7B%22tn%22:%22R1%22%7D] Someone else who has reported a loss of benefits after taking a "lot" of cayenne, has said that their benefits also returned after they stopping taking the cayenne. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1951836918205587&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1956996454356300&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another cayenne user who reported that, in her early days with NA, she topped some meals with about ⅛ tsp of cayenne, has said that, in her case, the worms seemed to be unaffected. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1952375724818373&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Chili_pepper Chili pepper] (chile, chile pepper, chilli pepper, or chilli). While this is used worldwide as a treatment of certain parasites, and has been demonstrated effective against fascioliasis in animals, evidence that chili might be a problem for therapeutic helminths is lacking. One hookworm host has reported that, while cayenne has had negative responses for him, chilli peppers have not been a problem in his experience, [https://www.facebook.com/groups/htsupport/posts/892904287432194?comment_id=6868887949833768] and nor have jalapenos, whether fresh or pickled. [https://www.facebook.com/groups/htsupport/posts/6863122353743661/?comment_id=6868980269824536] Another hookworm host has been reported [https://www.facebook.com/groups/htsupport/permalink/892904287432194/?comment_id=892912737431349&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] to have eaten a HUGE amount of chili during 4 years as a worm host, without any obvious adverse effect on his colony.

* ⚡ [https://en.wikipedia.org/wiki/Cinnamon Cinnamon] is antimicrobial, as well as being claimed to be effective against parasites, including some parasitic worms, and it appears in lists of ingredients in proprietary parasite cleansing products. The main antimicrobial component of cinnamon is ⚡[https://en.wikipedia.org/wiki/Cinnamaldehyde cinnamaldehyde], and this is most concentrated in cinnamon essential oil and cinnamon oleoresins (solid resin extracts produced using solvents) which can be very high in cinnamaldehyde. Forms containing somewhat less cinnamaldehyde are raw cinnamon and cinnamon tinctures which are dissolved in alcohol and about half the strength of raw cinnamon. As cinnamaldehyde is steam-volatile and not water soluble, aqueous extracts of cinnamon should contain less of this substance, and dehydrated/powdered extracts (the form most likely to be encountered in dietary supplements) may contain little, if any at all, so should be less of a threat to helminths. [https://www.facebook.com/groups/htsupport/permalink/2225192197536723/?comment_id=2226458237410119&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Generally, the stronger the taste, the more cinnamaldehyde is likely to be present. While the raw spice is generally safe for use in cooking, there has been one report of someone with helminths relapsing after taking an unspecified supplement containing cinnamon, (link expired) and another report of a return of symptoms after eating a rice pudding made with cinnamon. (Link expired)

* ⚡ [https://en.wikipedia.org/wiki/Clove Clove] (Syzygium aromaticum/Eugenia caryophyllus). Clove oil, which was used traditionally to kill intestinal worms and is claimed to anesthetize fish, contains several powerful antimicrobial agents. While one of these, [https://en.wikipedia.org/wiki/Eugenol eugenol], is claimed to be anthelmintic, its use didn't produce any loss of benefit in one helminth host who applied it liberally to a dry socket following a difficult tooth extraction, and this was in spite of swallowing and breathing eugenol and a related compound called guaiacol.

* ✅ [https://en.wikipedia.org/wiki/Cumin Cumin] (Cuminum cyminum) also known as Roman caraway. While the essential oil derived from this spice has shown efficacy against [https://en.wikipedia.org/wiki/Anisakis Anisakis], a nematode that parasitises fish and marine mammals, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130707/] dietary use of the spice is thought to be harmless to human helminths. But see also, ❌ [[#Bitter cumin|Bitter cumin]], ❌ [[#Black cumin|Black cumin]] and Bunium bulbocastanum (sometimes also called black cumin).

* ❓[https://en.wikipedia.org/wiki/Elwendia_persica Elwendia persica] (aka Bunium persicum, a close relative of Bunium bulbocastanum). The possible effect of this plant on helminths is as yet unknown.

* ✅ [https://en.wikipedia.org/wiki/Fennel Fennel] (Foeniculum vulgare). Fennel seed has a long history of use against pinworms and other parasites, with some authorities suggesting that the herb digests parasite eggs and intoxicates parasites. The leaves and oil are both used as dewormers, but one subject has reported no adverse effect from repeated consumption of dietary amounts of fennel seeds (link expired) and another has reported [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ no loss of worm benefits] after consuming significant quantities of fennel.

* ⚡ [https://en.wikipedia.org/wiki/Fenugreek Fenugreek] (Trigonella foenum-graecum). Both the leaves and seeds of fenugreek have been reported to have anthelmintic properties. Alcoholic extracts of the seeds have shown a dose-dependent inhibition of motility (paralysis) in earthworms, [https://www.researchgate.net/publication/49600762_In_vitro_anthelmintic_activity_of_Fenugreek_seeds_extract_against_Pheritima_posthuma] and an aqueous extract of fenugreek leaves has also shown noteworthy anthelmintic activity against earthworms. [https://www.researchgate.net/publication/303787324_In-vitro_anthelmintic_activity_of_fenugreek_leaves_aqueous_extract_in_Indian_earthworms] After taking half a teaspoon of powdered fenugreek seeds every day for a week, one hookworm host found that his allergies returned with a vengeance. [https://www.facebook.com/groups/htsupport/permalink/1426906954031922/] However, another hookworm host ate about 150 grams of fenugreek leaves in a 2 week period without affecting his worms. [https://www.facebook.com/groups/htsupport/permalink/1406562676066350/?comment_id=1406580359397915&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Garam_masala Garam Masala] The constituents of this blend of ground spices vary between geographical regions, but the majority of the commonly used ingredients do not have anthelmintic properties, thus minimising the anthelmintic potential of any blend that might include one or two items that could be harmful to worms when used on their own. So garam masala is very unlikely to harm helminths.

* ✅ Garlic (Allium sativum). Garlic compounds have demonstrated anthelmintic activity against flatworms in mice, [https://www.ncbi.nlm.nih.gov/pubmed/28536879] garlic oil extract has shown anthelmintic effects against Schistosoma mansoni in mice [http://www.sciencedirect.com/science/article/pii/S1995764515002011] and allicin, the active principle of garlic extract, has also been shown to have anthelmintic properties, although one hookworm host has reported that taking a stabilized allicin extract for several weeks did not kill her worms. [https://www.facebook.com/groups/htsupport/permalink/859756094080347/?comment_id=1146360268753260&comment_tracking=%7B%22tn%22:%22R3%22%7D] Alcoholic extracts of garlic have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424]. However, the exact amount of garlic needed to kill intestinal parasites in humans has not been established. Some sources suggest 1,000 - 4,000 mg per day, using concentrated garlic capsules or tablets, and fresh garlic is said to be more effective than capsules. While chewing three cloves of garlic each day is recommended by some online sources as a treatment for ‘parasites’ in humans, the ingestion of 9 to 14 g of raw garlic daily (54 g total) or 15 to 21 g daily (89 g total) had no evident effect on the egg output of NA in one host, [http://www.ajtmh.org/content/journals/10.4269/ajtmh.1969.18.920] so hookworms may in fact be able to withstand up to 21 grams (approximately 10 cloves) of garlic per day. This means that garlic is unlikely to be an effective killer of mature worms, and its main anthelmintic effect may be to reduce the viability of ova. Cooking may reduce its effect against parasite eggs and larvae, but neither cooked or raw garlic appears to have any adverse effect on the efficacy of a therapeutic hookworm colony.


* ⚡ [https://en.wikipedia.org/wiki/Ginger Ginger] (Zingiber officinale) contains a chemical called zingibain (aka. zingipain, or ginger protease) that has been claimed to dissolve some parasites and their eggs, and numerous hookworm hosts have reported adverse effects after consuming ginger. One subject reported that fresh ginger drinks depress the egg production of his worms and increase his disease symptoms, and another has reported that eating a LOT of ginger 6 weeks post-inoculation caused her hookworm side effects to disappear for a few days, but that these eventually returned. A similar response was noted by someone who was in the habit of adding ginger to sushi platters. She found that this seemed to knock the worms out for a while but that they eventually recovered. [https://www.facebook.com/groups/htsupport/permalink/2249000525155890/?comment_id=2266705326718743&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another hookworm host has found that, while consuming powdered or cooked ginger isn’t a problem for him, drinking ginger tea, or any form of kombucha made with raw ginger will stun his worms badly and result in a return of disease symptoms the next day. [https://www.facebook.com/groups/htsupport/posts/4390196884369566/?comment_id=4395716387150949] Someone else, who said that his favorite brand of ginger beer was “pretty spicy”, so was probably made from raw, or only very briefly pasteurized, ginger juice, reported that, after going on a fairly significant binge of the stuff, his worms stopped producing eggs and their benefits diminished. Yet another worm host, who was putting at least a thumb-sized piece of fresh ginger in a smoothie every day, believes this was responsible for actually killing her hookworms. Others have also had issues with ginger, e.g., [https://www.facebook.com/groups/htsupport/permalink/2337067596349182/] [https://www.facebook.com/groups/htsupport/posts/9292445040811368?comment_id=9295039130551959]. However, one subject has reported eating lots of fresh ginger (mostly cooked) without any problems, and several others have reported a similar lack of issues with ginger. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/1568726056516677/?comment_id=1568873536501929&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1763989756990305/?comment_id=1764057080316906&comment_tracking=%7B%22tn%22%3A%22R%22%7D] One hookworm host says that she regularly takes dried ginger in 1g doses to help with migraines and has not noticed any problems with her worms, [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1062777610444860&reply_comment_id=1062782733777681&comment_tracking=%7B%22tn%22:%22R%22%7D] and another routinely takes 550 mg of ginger root powder every morning without any obvious effect on either his hookworms or his human whipworms.

* ❓ [https://en.wikipedia.org/wiki/Horseradish Horseradish] (Amoracia rusticana) has been claimed to be antiparasitic, and it does contain volatile oils, notably [https://en.wikipedia.org/wiki/Mustard_oil mustard oil], which has antibacterial properties and is used as an antiparasitic by some farmers, but evidence about the effects of its use by helminth hosts is lacking.

* ❓ [https://en.wikipedia.org/wiki/Mustard_(condiment) Mustard]. This condiment is claimed to be effective against intestinal worms, including roundworms and threadworms and, in India, [https://en.wikipedia.org/wiki/Mustard_oil mustard oil] is used as an antiparasitic by some farmers. However, its action is probably more as a laxative that helps to flush out worms rather than to kill them, and hookworms spend much of their time firmly attached to the gut mucosa. One hookworm host has reported taking about 2 grams of ground mustard seeds most days, with no adverse effect on his worms or their egg production. [https://www.facebook.com/groups/htsupport/permalink/1958129950909617/?comment_id=1958255070897105&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nutmeg Nutmeg] (Myristica fragrans, or fragrant nutmeg). This spice, which is obtained by grinding the seed of this tree, (mace is produced from the seed covering) is not harmful to helminths when used as a culinary flavour.


* ❌ [https://en.wikipedia.org/wiki/Oregano Oregano] (Origanum vulgare). Oregano oil, which contains isomeric phenols (primarily carvacrol but also including thymol and limonene), can destroy a number of bacteria, fungi and viruses in dilutions as low as 1/50,000, and is also antiparasitic. It is reported to be effective against protozoan parasites in particular as well as roundworm larvae, and somewhat effective against tapeworms. In one study [http://www.chirochat.org/article_files/Article-2953.pdf], 57 per cent of adults with intestinal parasites who were treated with 600 mg of oregano oil daily for six weeks experienced total eradication of their parasites. Several hosts of therapeutic helminths have reported adverse effects on their worms after ingesting oregano oil and, in at least two cases, it has resulted in a total loss of worms. However, one subject, who took oil of ''wild'' oregano sublingually twice each day for 2 weeks had a stool test sometime after this that was positive for hookworms, so perhaps either the wild form of the herb, or the sublingual route, helped reduce the effect on the worms in this case. Some foods, particularly soft cheeses, may be coated with an [http://www.sciencedaily.com/releases/2014/11/141127082311.htm antimicrobial film incorporating oregano oil] to increase their lifespan, but the amount of oregano involved in this application is unlikely to be a serious threat to helminths. A few '''oregano ''leaves''''' eaten with food are less likely to be harmful to human helminths [https://www.facebook.com/groups/htsupport/permalink/2545907775465162/?comment_id=2545955292127077], but one host of both hookworms and whipworms has reported that, while there was no immediate effect on his worms when he applied a ''heavy'' sprinkling of oregano leaf powder to his food a couple of times in a day, he was later plunged into such a self-critical and depressed mood that, before eventually regaining his usual mental balance, he struggled to do any work for several days.

* ✅ [https://en.wikipedia.org/wiki/Saffron Saffron] This spice is derived from the flower of crocus sativus, commonly known as the "saffron crocus". (See separate entry for this herb.) One hookworm host took a supplement containing turmeric and saffron for 6 weeks without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/]

* ✅ [https://en.wikipedia.org/wiki/Thyme Thyme] (Thymus vulgaris). This is also known as Common Thyme, Garden Thyme. Extracts of the leaves, flowering tops and stems are used to kill hookworms, roundworms, threadworms and skin parasites. However, these are unlikely to harm helminths when eaten in reasonable amounts as part of a normal diet. One helminth host has [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ eaten significant quantities of thyme] without noticing any adverse effect on her hookworm or whipworm populations.


* ✅ [https://en.wikipedia.org/wiki/Turmeric Turmeric] (Curcuma longa), also known as tumeric, generally does not harm human helminths when eaten in food in its natural, whole form, which only contains 3% of the active ingredient, curcumin, [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] or when it is taken in capsules, e.g., as a daily dose of 25 g turmeric (delivering 700 mg curcumin), [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/] or as a dose of 580 mg turmeric extract delivering 551 mg curcuminoids daily. [https://www.facebook.com/groups/htsupport/permalink/3303438489712083/?comment_id=3304307169625215] There have only been two reports of food quantities of turmeric affecting hookworms. The first of these is [https://www.facebook.com/groups/htsupport/permalink/1084044901651464/?comment_id=1084640204925267&comment_tracking=%7B%22tn%22:%22R%22%7D here], and the second was by an individual who boiled and ground turmeric powder into a paste and twice drank a large quantity of this (2 tbsp) in her tea. She subsequently experienced a return of her old symptoms, all of which persisted. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] There is much more chance of helminths being harmed when ⚡[https://en.wikipedia.org/wiki/Curcumin curcumin] is extracted from the turmeric and taken in medicinal quantities. It has been reported that 300 mg of curcumin extract has killed some types of parasites in test tube and animal studies, and that it may temporarily reduce the number of helminth eggs produced. One hookworm host believes that she may have lost her colony as a result of taking a curcumin supplement. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=794226897299934&offset=0&total_comments=11] However, another hookworm host has reported experiencing a very enjoyable “bounce” (indicating a healthy NA colony) after inoculating, in spite of taking 250 mg of curcumin daily. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/] As with other substances that can affect hookworms, the effect of curcumin may depend to some extent on the strength of the individual host’s immune response, as well as on the form of curcumin used. Nano-emulsified curcumin appears to be more effective, therapeutically, [https://www.sciencedaily.com/releases/2014/11/141106113204.htm] so may also have an increased detrimental impact on helminths. Another high-potency form of curcumin is BCM-95, which has been shown to be 6.93 times more bioavailable than normal curcumin, [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792534/] and this product may have been responsible for a sudden return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=808508489205108&offset=0&total_comments=21&comment_tracking=%7B%22tn%22:%22R1%22%7D] The beneficial effect of curcumin can be increased 5- to 10-fold by adding ascorbic acid (vitamin C) [http://www.sciencedirect.com/science/article/pii/S0308814612001744] so taking this vitamin along with curcumin might make it possible to use curcumin therapeutically in much smaller doses (ascorbic acid does not harm helminths), although this vitamin may increase curcumin's adverse effect on helminths if the quantity of the spice is not reduced proportionately.

* ❓ [https://en.wikipedia.org/wiki/Wild_Turmeric Turmeric, Wild] (Curcuma aromatica). While alcoholic extracts of the rhizomes of wild turmeric have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in [http://www.ncbi.nlm.nih.gov/pubmed/1158424 test tube studies] and extracts of the rhizomes may therefore also have an adverse effect on other helminths, it is likely that consuming dietary amounts of this spice will do no harm to human helminths, though this has not yet been confirmed.
</blockquote>

=== Herbs and medicinal plants===

The majority of the herbs listed below have been reported, or claimed, to be antiparasitic, although clinical evidence for this effect is lacking in many cases. Furthermore, where they are indeed antiparasitic, herbs may be more effective against types of parasite other than helminths, although this is not to say that they may not also have some detrimental effect on helminths.

Where a herb is effective against helminths, quite large quantities may be required to dislodge or kill the worms, but consuming some of these herbs on a regular basis, or in the form of concentrates, extracts, tinctures and oils that are directed at the gastrointestinal tract may weaken therapeutic helminths, making them less effective.

It should not be assumed, from a cursory glance at the following list, that most herbs are potential threats to human helminths. This list only contains those herbs that have been mentioned specifically by self-treaters, and there are less than 100 herbs in the entire list. Many thousands of compounds are used in herbal medicine, so it will usually be possible to find a more hookworm-friendly alternative for whatever purpose one has in mind.

Many of the herbs listed below are used to treat a number of conditions in addition to parasite infections, so might be encountered in a range of herbal remedies. It may therefore be advisable for any helminth host who contemplates taking any herbal remedy to check its ingredients against the list below and, where an ingredient appears to have antiparasitic properties, to seek an alternative, if possible.

When taking herbs, an additional risk arises from the fact that the majority of herbal products [http://www.medicalnewstoday.com/releases/267363.php contain unlisted ingredients], in view of which it would seem wise to employ a cautious approach with all herbal products.

==== List of herbs and medicinal plants ====

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* ⚡ [https://en.wikipedia.org/wiki/Acacia Acacia]. Also known as thorntree, [https://en.wikipedia.org/wiki/Whistling_thorn whistling thorn], or wattle. One example of this genus of shrubs and trees, ([https://en.wikipedia.org/wiki/Acacia_mollissima Acacia mearnsii], previously known as Acacia molissima) contains tannin extracts that have been found to have an [http://www.sciencedirect.com/science/article/pii/S0377840107003641 anthelmintic effect] on Haemonchus contortus and Trichostrongylus colubriformis in lambs. For a more detailed consideration of the possible effects of tannins on nematodes, see these papers: [https://www.ncbi.nlm.nih.gov/pubmed/28426037] [https://pubmed.ncbi.nlm.nih.gov/36344622/].

* ❌ [https://en.wikipedia.org/wiki/Ajwain Ajwain] contains thymol (see separate reference), which appears to be the primary constituent of the essential oil extracted from ajwain "seeds" (actually a seed-like fruit). Ajwain may therefore be harmful to human helminths if consumed in the form of ajwain "seeds" or the oil extracted from them, but it ''may'' be less harmful if only the leaves are eaten.

* ⚡ [https://en.wikipedia.org/wiki/Albizia_lebbeck Albizia lebbeck]. Alcoholic extracts of the bark of Albizia lebbeck have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the bark may also have an adverse effect on other helminths.

* ✅ [https://en.wikipedia.org/wiki/Aloe_vera Aloe vera]. This contains an antimicrobial agent, [https://en.wikipedia.org/wiki/Saponin saponin], and the laxative chemical, [https://en.wikipedia.org/wiki/Aloin aloin]. Aloe is perhaps the best known laxative in history, and it may be this, rather than any actual anthelmintic property, that is the source of its reputation for expelling parasites. While extracts have been reported as showing inhibitory effects on two roundworm species, these only affected the hatching of eggs and the development of larval stages. One aloedrinking helminth host has reported that his habit has had no obvious detrimental effect on his worms, and another hookworm host failed to notice any adverse effects after drinking pure aloe juice or gel daily for a week or two, or after drinking one of the 16oz sweetened/flavored drinks. [https://www.facebook.com/groups/htsupport/permalink/803451913044099/]

* ⚡ [https://en.wikipedia.org/wiki/Alpinia Alpinia calcaratta]. Alcoholic extracts of the rhizomes of Alpinia calcaratta have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Alpinia_galanga Alpinia galanga]. Alcoholic extracts of the rhizomes of Alpinia galanga have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of these rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Andrographis_paniculata Andrographis paniculata] (also known as creat, green chiretta; active component: andrographolide). Alcoholic extracts of Andrographis paniculata have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [http://www.ncbi.nlm.nih.gov/pubmed/1158424] Andrographolide has also shown significant ovicidal and larvicidal activity against the human hookworm, [[Ancylostoma duodenale | '''Ancylostoma duodenale''']]. [https://pubmed.ncbi.nlm.nih.gov/30763693/]

* ⚡ [https://en.wikipedia.org/wiki/Anise Anise] (Pimpinella anisum). Also known as aniseed. Anise oil may have modest antiparasitic effects and has been recommended by some practitioners as a treatment for mild intestinal parasite infections, but there have not been any reports about this from helminth hosts.

* ❌ [https://en.wikipedia.org/wiki/Arecoline Arecoline]. This odourless oily liquid derived from the areca nut, fruit of the areca palm ([https://en.wikipedia.org/wiki/Areca_catechu Areca catechu]), has long been used medicinally as an anthelmintic.

* ✅ [https://en.wikipedia.org/wiki/Ashwagandha Ashwagandha] (Withania somnifera). Also known as Indian ginseng, poison gooseberry, and winter cherry. Several hookworm self-treaters have reported using ashwagandha without issue. One NA host has reported that taking 380mg ashwagandha root and 95mg ashwagandha root extract twice each day for a month appeared not to affect her worms. [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832855323437081&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Someone else takes 450 mg ashwagandha x2 per day and reports that his NA are fine, [https://www.facebook.com/groups/htsupport/permalink/2416283988427542/?comment_id=2431728343549773&reply_comment_id=2432787723443835] and a third hookworm host has taken 500mg ashwagandha twice a day without any adverse effect on their worms. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] A naturopathic doctor has also reported that ashwagandha is OK to take while hosting hookworms, [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832031526852794&reply_comment_id=1833267093395904&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and someone who is self-treating with human whipworms (TT) has reported that taking a teaspoon of ashwagandha every day did not have any apparent effect on this species. (Also see the list of concerns and contraindications regarding Ashwagandha in [https://www.facebook.com/groups/htsupport/posts/6319449901444245/ this Facebook post].)

*❓ [https://en.wikipedia.org/wiki/Astragalus Astragalus]. A chloroform extract of the Astragalus species, [https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:477246-1 Astragalus ecbatanus], has been shown to have anthelmintic effects against the protoscoleces (the scoleces of the larval form of tapeworms) of the helminth, [https://en.wikipedia.org/wiki/Echinococcus_granulosus Echinococcus granulosus]. [https://pubmed.ncbi.nlm.nih.gov/36457771/]. However, there have been no reports that either of the forms of astragalus that are sold as food supplements ([https://en.wikipedia.org/wiki/Astragalus_propinquus Astragalus membranaceus/Astragalus propinquus] and Astragalus mongholicus) has had an adverse effect on any of the therapeutic helminths.

* ✅ Bacognize. One hookworm host has taken 300 mg daily of this [https://en.wikipedia.org/wiki/Bacopa_monnieri Bacopa monnieri] whole herb extract, standardized to 12% bacopa glycosides, without any adverse effect on his colony.

* ⚡ [http://www.botanical.com/botanical/mgmh/b/balmon04.html Balmony] (Chelone glabra) A decoction or tincture prepared with all parts of the plant is said to be a highly effective remedy for parasites, including intestinal worms. It was used traditionally by Native Americans to expel worms and is used today in proprietary parasite cleansing preparations.

* ⚡ [https://en.wikipedia.org/wiki/Barberry Barberry] (Berberis vulgaris) contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_bellirica Beleric] (Terminalia bellirica/Terminalia bellerica). Also known as bastard myrobalan or Bahera. This herb is said to be anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ⚡ [https://en.wikipedia.org/wiki/Berberine Berberine] is an amebicide which, in concentrated form, has been shown to kill various parasites such as tapeworms and giardia and to have anti adhesive effects which prevent pathogens from adhering to intestinal mucosal cells. One hookworm host who took one gram of berberine three times a day has reported being pretty sure that this killed his worms. [https://www.facebook.com/groups/htsupport/permalink/1803353316387282/?comment_id=1807383979317549&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Bidens_alba Bidens alba] has been reported as not being a problem for helminths.

* ✅ [https://species.wikimedia.org/wiki/Nymphaea_nouchali Blue Lotus]. Nymphaea nouchali - an aquatic flower also known as red and blue water lily, blue star water lily and star lotus - and its varieties, Nymphaea caerulea (blue Egyptian water lily) and Nelumbo nucifera (Indian lotus, sacred lotus, bean of India, lotus) are not thought to be harmful to helminths. These plants do contain various bioactive compounds such as alkaloids, flavonoids and glycosides, some of which may have antimicrobial or antiparasitic properties against bacteria, fungi, or protozoa, but there is no direct evidence to suggest that any of these compounds might be specifically harmful to helminths.

* ❌ [https://biocidin.com/products/biocidin-liquid-formula Biocidin] is a proprietary herbal blend that includes oregano oil and black walnut, both of which are known to have anthelmintic effects. See the separate entries for these two herbs.

* ❌ [http://scialert.net/fulltext/?doi=ijp.2013.211.226 Bitter cumin] (Centratherum anthelminticum). As its Latin name suggests, the seeds of this member of the daisy family are considered anthelmintic.

* ⚡ [https://en.wikipedia.org/wiki/Bitter_melon Bitter melon] (Momordica charantia) is used as a folk medicine to treat gastrointestinal diseases, and extracts have shown activity against the nematode worm C. elegans in test tube studies[http://www.sciencedirect.com/science/article/pii/S0378874104003770].

* ⚡ [https://en.wikipedia.org/wiki/Juglans_nigra Black walnut] (Juglans nigra). Also known as eastern black walnut. This nut has been claimed to be one of the best overall dewormers for humans, killing both the adult and developmental stages of at least 100 parasites. However, according to the American Cancer Society, available scientific evidence does not support claims that the hulls of the black walnut remove intestinal parasites. Although this nut has a strong flavour, it is actually quite rare, as its shell is hard and difficult to remove. It is therefore only likely to be encountered in expensive baked goods. Most commercially available walnuts are hybrids of the ✅'''English walnut'''. "Commerically-sold walnuts will be English unless specified. The taste and appearance of black walnuts is different too." [https://www.facebook.com/groups/htsupport/posts/7955684137820805/?comment_id=7955710474484838] "Black walnuts are very, VERY rare to find in stores, and 100% this will be specified. 'Walnuts' are ALWAYS English walnuts unless otherwise stated." [https://www.facebook.com/groups/htsupport/posts/7955684137820805?comment_id=7955725021150050]

* ✅ [https://en.wikipedia.org/wiki/Boswellia Boswellia] is a fragrant resin, extracts of which are used in pharmacology, particularly as anti-inflammatories. There have been no suggestions that boswellia might be a problem for helminths, and its anti-inflammatory action could be supportive of the beneficial effects that helminths produce, as demonstrated in Crohn’s disease in this study. [http://www.ncbi.nlm.nih.gov/pubmed/11215357]

*❓[https://en.wikipedia.org/wiki/Bougainvillea_spectabilis Bougainvillea spectabilis.] Also known as great bougainvillea, this plant, which is used to make a tea, has shown dose-dependent anthelmintic effects against the earthworm, Pheretima posthuma. [https://ijppr.humanjournals.com/wp-content/uploads/2020/04/2-IN-VITRO-ANTHELMINTIC-ACTIVITY-OF-CRUDE-EXTRACT-OF-FLOWERS-OF-BOUGAINVILLEA-SPECTABILIS-WILD-AGAINST-PHERETIMA-POSTHUMA.pdf] This effect is thought to result from the plant’s phytochemical constituents, which are believed to damage the mucopolysaccharide layer of worms, leading to paralysis and death. However, while this effect has been demonstrated in a laboratory, bougainvillea does not appear to have been used traditionally as an anthelmintic, and there have been no reports from helminthic therapy self-treaters of any adverse effect on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Breadfruit Breadfruit] (Artocarpus altilis)) A methanol-water fraction of this plant has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 9.5 hours, compared with 35 hours taken by albendazole. Aqueous methanol extracts took 49 hours. [https://www.researchgate.net/publication/21072595]

* ❌ [https://en.wikipedia.org/wiki/Acorus_calamus Calamus/Sweet Flag] (Acorus calamus) The bitter element in sweetflag, acorin, is claimed to have anthelmintic properties, and the standardised rhizome extract of A. calamus has been shown to have significant dose-dependent effects against the rat tapeworm, Hymenolepis diminuta, so may also harm other helminths. [https://www.ncbi.nlm.nih.gov/pubmed/27757269]

* ✅ [https://en.wikipedia.org/wiki/Castor_oil Castor oil]. This will not kill helminths, though it may help to expel worms after eradication, and this is probably the reason for its antiparasitic reputation and it's use in para-cleanse products.

* ✅ [https://en.wikipedia.org/wiki/Cat's_claw Cat’s Claw] is a common name for several plants, but it appears to be applied particularly to two species - [https://en.wikipedia.org/wiki/Uncaria_tomentosa Uncaria tomentosa] (samento), most commonly used in the US, and [https://en.wikipedia.org/wiki/Uncaria_guianensis Uncaria guianensis], typically used in Europe. Medicines made from the root and bark of these species have been claimed online to facilitate the elimination of intestinal parasites, but WebMD states that there is insufficient evidence for its effectiveness against parasites, [http://www.webmd.com/vitamins-supplements/ingredientmono-395-CAT'S%20CLAW.aspx?activeIngredientId=395&activeIngredientName=CAT%27S%20CLAW] and one hookworm host has taken up to 2000-2500 mg of Uncaria tomentosa daily in raw form for months with no adverse effects on his NA. He was even able to incubate fresh larvae from his colony during this period. [https://www.facebook.com/groups/htsupport/posts/4013894361999822?comment_id=4014662455256346]

* ⚡ [https://en.wikipedia.org/wiki/Larrea_tridentata Chaparral] (Larrea tridentata). Some cultures customarily bathe with chaparral annually to eliminate skin parasites, but use of the leaves of Larrea species is not advised, due to the possibility of damage to the liver and kidneys.

* ❌ Chicken weed ([https://en.wikipedia.org/wiki/Salvia_serotina Salvia serotina]), also known as Littlewoman, has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 20 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ✅ [https://en.wikipedia.org/wiki/Fallopia_multiflora Chinese knotweed] (Fallopia multiflora, also known as Reynoutria multiflora (Thunb.) Moldenke, Polygonum multiflorum Thunb., tuber fleeceflower) has been shown to make one nematode live longer. [https://www.sciencedaily.com/releases/2018/10/181009102529.htm]

* ❌ [https://en.wikipedia.org/wiki/Cinnamomum_verum Cinnamomum verum]. This was previously known as ⚡''C. zeylanicum'' and also referred to as ⚡"true cinnamon", ⚡''Ceylon cinnamon'' or ⚡''Sri Lanka cinnamon''. Alcoholic extracts of the bark of ⚡''C. verum'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the bark may also have an adverse effect on other helminths. The spice, ⚡'''cinnamon''' is typically derived from related species within the genus, '''Cinnamomum'''.

* ❌ [https://en.wikipedia.org/wiki/Citrus_decumana Citrus decumana]. Alcoholic extracts of the rind of Citrus decumana have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rind may also have an adverse effect on other helminths. Citrus decumana is a relative of the common ✅[https://en.wikipedia.org/wiki/Grapefruit grapefruit] (citrus paradisi) and, while commercially available forms of ⚡'''grapefruit seed extract''' have a potential to harm human helminths (due to the typical addition of synthetic adulterants), there is no evidence that the flesh of the grapefruit has any adverse effect on helminths.

* ✅ Coffee fruit extract. ([https://en.wikipedia.org/wiki/Coffea_arabica Coffea arabica]) This is harmless to helminths.

* ❓ [https://en.wikipedia.org/wiki/Crocus_sativus Crocus sativus]. Also known as autumn crocus and saffron crocus, this plant is best known for the spice saffron, which is produced from parts of the plant's flowers. (See separate entry for the spice.) Two important bioactive compounds of Crocus sativus (crocin and safranal), and some semi-synthetic derivatives of safranal, have been found to be [http://www.ncbi.nlm.nih.gov/pubmed/25766747 effective against some types of parasite] (Helicobacter pylori, the malaria parasite, plasmodium, and Leishmania). However, there have been no reports of adverse effects on therapeutic helminths.

* ⚡ '''Curled/Curly Mint''' (Mentha spicata variety crispii/Mentha crispa/Mentha crispata). This cultivar of [https://en.wikipedia.org/wiki/Spearmint Spearmint] (Mentha spicata), and close relative of Peppermint (Mentha piperita) (see [[#Peppermint|Peppermint reference]]), may be effective against giardia and amoeba infections, and may have anthelmintic properties. It was once listed on a website under, “herbs that your health care provider might consider using to treat intestinal parasites.” [https://web.archive.org/web/20070918071439/http://health.kernan.org/altmed/articles/intestinal-parasites-000097.htm]

* ❌ [https://en.wikipedia.org/wiki/Desmodium_triflorum Desmodium triflorum]. Alcoholic extracts of Desmodium triflorum have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so it’s extracts may also have an adverse effect on other helminths, possibly due to it containing a significant amount of a powerful psychedelic substance which might cause hookworms to lose their grip and be expelled.

* ✅ [https://en.wikipedia.org/wiki/Echinacea Echinacea]. This is not a single plant but a genus containing several different species. In the case of medicinal products labelled as echinacea, these are likely to have been obtained from one or more of the following sources: E. purpurea, E. angustifolia or E. pallida. Such products may also be either extracts, or the expressed juice of, different plant organs (e.g., roots and leaves) resulting in different products having very different chemical compositions. However, there have been no reports of human helminths being harmed by taking any echinacea products. As the polysaccharides found in Echinacea purpurea roots have been [http://www.ncbi.nlm.nih.gov/pubmed/26190752 shown to have anti-inflammatory effects], water extracts of these roots may be of benefit to helminth hosts who require a supplementary anti-inflammatory.

* ❌ [https://en.wikipedia.org/wiki/Elecampane Elecampane.] (Inula helenium, also known as alant, aster helenium, aster officinalis, aunée, aunée Officinale, elfdock, elfwort, enule campagne, grande aunée, helenio, helenium grandiflorum, horse-elder, horseheal, horse-heal, Indian elecampane, inule aulnée, inule aunée, inule hélénie, &OElig;il-de-cheval, scabwort, velvet dock, wild sunflower and yellow starwort.) According to WebMD, this herb can be used to kill intestinal worms, including hookworms and whipworms. [https://www.webmd.com/vitamins/ai/ingredientmono-2/elecampane] One hookworm host who took some drops containing several herbs that included elecampane suffered “vicious” diarrhoea for 16 hours, after which she reportedly lost the benefits from her worms.

* ❌ [https://en.wikipedia.org/wiki/Epazote Epazote]. See [[#Wormseed|Wormseed]].

* ❌ [http://it.wikipedia.org/wiki/Ceterach_officinarum Erba ruggine] (Ceterach officinarum) is listed on one website under, “Herbals that may kill and expel worms.” [https://web.archive.org/web/20160215131104/http://www.altmd.com/Articles/Worms--Encyclopedia-of-Alternative-Medicine]

* ❓ [https://en.wikipedia.org/wiki/Eurycoma_longifolia Eurycoma longifolia] (commonly called tongkat ali, pasak bumi or malaysian ginseng). The root of the plant is used in Indonesia and Malaysia as a health tonic, the benefits of which are claimed to include the treatment of intestinal worm infections. However, one hookworm host has reported using 100mg tongkat ali extract, containing 10% eurycomanone, for 60 days without any adverse effect on his worm colony. [https://www.facebook.com/groups/htsupport/posts/6839629756092921/?comment_id=6839701856085711]

* ❓ [https://en.wikipedia.org/wiki/Frankincense Frankincense] (olibanum). This aromatic resin is used in incense and perfumes, and is obtained from trees in the Boswellia genus. There have been no reports about it having any effect on helminths.

* ❌ [https://en.wikipedia.org/wiki/Gentian_root Gentian root]. The root and underground stem of [https://en.wikipedia.org/wiki/Gentiana_lutea Gentiana lutea] (yellow gentian) are said to assist in expelling 'harmful organisms'. One subject has reported that taking a form of gentian in large quantity on a daily basis for sinus inflammation was responsible for the loss of his whipworms, although possibly not his hookworms.

* ✅ [https://en.wikipedia.org/wiki/Ginkgo_biloba Ginkgo biloba]. There has been a single hint that ginkgo may have caused a mild reduction in hookworm benefits, but this was by no means certain, and three other helminth hosts have reported taking ginkgo regularly with no apparent adverse effect on their worms. (Also see Anticoagulants.)

* ⚡ [https://en.wikipedia.org/wiki/Goldenseal Goldenseal] (Hydrastis canadensis). This contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Coptis_chinensis Goldenthread/Chinese goldthread] (Coptis chinensis) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Goosefoot Goosefoot] (Chenopodium ambrosioides) is widely used to deworm animals, and the Japanese make a dewormer tea with the leaves. Goosefoot oil is a highly efficient anthelmintic, and extremely toxic. Human consumption of this herb has often produced strong side effects such as nausea and headaches, and even death in some cases.

* ⚡ [https://en.wikipedia.org/wiki/Hagenia Hagenia] (Hagenia abyssinica). Also known as African redwood, brayera, cusso, hagenia, and kousso, hagenia has been used as a treatment for the pork tapeworm (Taenia solium), but is often only partially effective in this case.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_chebula Haritaki] (Terminalia chebula). Also known as Yellow Myrobalan, Chebulic Myrobalan, Kadukkai, Silikha, Himmej, Karakkaya and A-ru-ra. The fruits are reportedly anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ❌ [https://en.wikipedia.org/wiki/Houttuynia_cordata Houttuynia cordata Thunb] (HCT), also known as fish mint, fish leaf, rainbow plant, chameleon plant, heart leaf, fish wort, Chinese lizard tail, and bishop's weed. The leaf extract of this Thai herb, which is used as an anti-inflammatory medication in the treatment of rheumatoid arthritis [https://www.ncbi.nlm.nih.gov/pubmed/26170903] has shown anthelmintic activity against Hymenolepis diminuta, especially the adult worms. [https://www.ncbi.nlm.nih.gov/pubmed/23024502/] The entire Saururaceae plant family is considered to have anthelmintic properties and is used by the Naga tribes in Northeast India to treat intestinal worm infections in general. It may therefore also have a potentially harmful effect on other therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Hydnocarpus_wightiana Hydnocarpus wightiana]. Alcoholic extracts of the seeds have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the seeds may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Hyssopus_officinalis Hyssop] (Hyssopus officinalis). The leaf contains an essential oil with antiseptic properties that has been claimed to have anthelmintic effects, but, if eaten as a herb, hyssop is unlikely to harm helminths.

* ❌ [https://en.wikipedia.org/wiki/Ipecac Ipecac], syrup of. Alkaloids in ipecac, including [https://en.wikipedia.org/wiki/Emetine emetine], are reported to kill several types of parasite, particularly amoebae, but also pinworms and tapeworms, although the amounts needed to produce these effects in humans are generally high and can lead to severe side effects. Emetine and the somewhat safer form, [https://en.wikipedia.org/wiki/Dihydroemetine Dehydroemetine], are usually reserved for rare cases of people infected with amoebae who are not cured by using anti-amoeba drugs.

* ⚡ [https://en.wikipedia.org/wiki/Juniper Juniper] (Juniperus communis) is a very effective natural antibiotic which is also said to have deworming properties, notably against liver fluke, and is used to treat worm infestations in animals. Juniper is also used as the primary flavouring in gin, but there have been no reports of any harm coming to helminths as a result of drinking gin.

* ❌ [https://en.wikipedia.org/wiki/Kaempferia_galanga Kaempferia galanga]. Alcoholic extracts of the rhizomes have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rhizomes may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Kava Kava/ kava-kava] (Piper methysticum). Studies have shown that kava can have potentially harmful effects on helminths by disrupting their neuromuscular function. Kavalactones, the active compounds in kava, produce psychoactive, analgesic, euphoric and sedative effects and, in the case of the roundworm, C. elegans, kavalactones have been found to cause muscle hypercontraction, epileptic-like convulsions and paralysis. One constituent of kava, Kavain, specifically induced worm paralysis without convulsions. [https://pmc.ncbi.nlm.nih.gov/articles/PMC5462554/] While this evidence does not relate directly to therapeutic helminths, and there have not been any reports to date of any adverse effects of kava on therapeutic worms, it is sufficient reason to treat kava with a degree of caution, especially in hookworm self-treaters who are known to have a more aggressive immune response, thus putting their worms under increased duress.

* ❓[https://en.wikipedia.org/wiki/Lactuca_virosa Lactuca virosa] Also known as wild lettuce, bitter lettuce, laitue vireuse, opium lettuce, poisonous lettuce, tall lettuce, great lettuce and rakutu-karyumu-so. While this herb is claimed by a few sources online to have an anthelmintic effect (e.g., [https://herbu.org/wp-content/uploads/2018/09/8-Wild-Lettuce-5pgs.pdf] (PDF)), there have been no reports of it having an adverse effect on either NA or TT. However, it is worth noting that Lactuca virosa can cause toxic effects in those who consume it. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031874/]

* ❓[https://en.wikipedia.org/wiki/Lemon_balm Lemon balm] (Melissa officinalis), a member of the mint family also known as balm, common balm or balm mint. This has been found to exhibit high nematicidal activity against the roundworm, Meloidogyne incognita [https://www.ncbi.nlm.nih.gov/pubmed/20527965] and, when included with other herbs, to help reduce the number of pigs infected with the roundworm, Ascaris suum. [https://www.ncbi.nlm.nih.gov/pubmed/19954891]. It is also listed as a vermifuge on some herbal websites, but there have been no reports thus far of lemon balm having adversely affected either NA to TT, and one NA host has reported using it almost daily for over a year, both as a tea and a tincture, without it causing any issues for her worms. [https://www.facebook.com/groups/htsupport/posts/7626177840771438/]

* ⚡ [https://en.wikipedia.org/wiki/Lemongrass Lemongrass] (Cymbopogon citratus) essential oil has shown [http://www.academia.edu/3999135/Evaluation_of_in_vitro_anthelmintic_activity_of_Cymbopogon_citratus_lemon_grass_extract anthelmintic activity against earthworms]. However, one individual has consumed lemongrass tea [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ without adverse effect] on her hookworm or whipworm colonies.

* ✅ [https://en.wikipedia.org/wiki/Liquorice Liquorice/licorice], the root of Glycyrrhiza glabra. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/798992926823331/?comment_id=799022316820392&offset=0&total_comments=2] taking “lots” of [https://en.wikipedia.org/wiki/Deglycyrrhizinated_licorice deglycyrrhizinated licorice] (DGL) with no ill effect on his worms. And another NA host has reported taking liquorice extract without any problems. [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Liquorice extracts may be useful as an adjunctive therapy [http://www.ncbi.nlm.nih.gov/pubmed/26383911 for psoriasis, for colitis] and possibly other autoimmune diseases, but excessive consumption of liquorice containing glycyrrhizin/glycyrrhizic acid [http://www.sciencedaily.com/releases/2015/03/150302081147.htm may not be wise]. The World Health Organization's recommended daily maximum for liquorice is 2 mg/kg.

* ❌ [https://en.wikipedia.org/wiki/Lippia_nodiflora Lippia nodiflora]. Alcoholic extracts of this have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other worms.

* ❌ Love weed ([https://plants.jstor.org/compilation/cuscuta.americana Cuscuta americana]) extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 2 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ⚡ [https://en.wikipedia.org/wiki/Male_fern Male fern] (Dryopteris filix mas). Also once known as worm fern! The rhizomes and young shoots (fiddleheads) of the male fern have antiparasitic properties and the root has been used to treat tapeworms. However, this herb is seldom used today due to its side effects (e.g. headaches and nausea) and because large doses are extremely poisonous and may induce liver damage. The North American equivalent of the male fern is the evergreen [https://en.wikipedia.org/wiki/Dryopteris_marginalis marginal shield-fern] (Dryopteris marginalis).

* ✅ [https://en.wikipedia.org/wiki/Mastic_(plant_resin) Mastic gum] Mastic (plant resin), also known as tears of Chios, is excreted by the resin glands of certain trees. One NA host has reported chewing mastic gum every day for a couple of months, and said that even chewing it until it dissolved had no harmful effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/6291172814271954/]

* ✅ [https://en.wikipedia.org/wiki/Milk_thistle Milk Thistle] (Silybum marianum). Also known as cardus marianus, blessed milk thistle, Marian Thistle, Mary Thistle, Saint Mary's Thistle, Mediterranean milk thistle, variegated thistle and Scotch thistle. There have been no adverse reports about this herb from worm hosts, and there are no reasons to believe that it might harm human helminths.

* ❌ [https://en.wikipedia.org/wiki/Mimosa_pudica Mimosa pudica] Also known as shy plant, sensitive plant, sleepy plant, action plant, touch-me-not, and shameplant, this popular houseplant is a tropical fern, whose leaves close rapidly when touched. Aqueous methanol extracts of the leaves of this plant showed a similar ability as the anthelmintic drug, levamisole, to inactivate larvae of the helminth, Strongyloides stercoralis. [https://www.researchgate.net/publication/21072595] While there have been no reports to date of this plant having a harmful effect on any of the therapeutic helminths, it has been used extensively as an anti-parasitic agent in traditional and Ayurvedic medicine, so clearly has significant potential as an anthelmintic.

* ✅ [https://en.wikipedia.org/wiki/Miswak Miswak] The miswak is a tooth-cleaning twig obtained from the [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] tree. In addition to this oral hygiene use being documented within traditional medicine systems, parts of the S. persica tree have also been reported to show evidence of anthelmintic activity. [https://pmc.ncbi.nlm.nih.gov/articles/PMC8347844/] However, this evidence comes from test-tube or animal studies, not trials on humans, and the concentrations tested would not necessarily correlate with those encountered during typical miswak stick chewing. So far, there have been no reports of any adverse effects on the helminth colonies of miswak-chewing self-treaters, and at least one hookworm host uses a miswak exclusively for oral hygiene. [https://www.facebook.com/groups/htsupport/permalink/1259998900722729/]

* ❌ [https://en.wikipedia.org/wiki/Morinda_citrifolia Morinda citrifolia], also known as great morinda, Indian mulberry, beach mulberry and cheese fruit). Alcoholic extracts of the tender leaves of ''M. citrifolia'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], so the same extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Mugwort Mugwort] (Artemisia vulgaris). Also known as Moxa, Common Wormwood, Traveler's Herb and Felon Herb, and a relative of wormwood (Artemisia Absinthium). While less effective than anthelmintic drugs, mugwort extracts, and especially the essential oils, are at least moderately effective natural anthelmintics against a range of nematodes and some cestodes. The herb can disrupt helminth neuromuscular function and interfere with energy metabolism, potentially leading to helminth paralysis and death, and it is said to make short work of roundworms, pinworms and tapeworms.

*❓ [https://en.wikipedia.org/wiki/Myrciaria_dubia Myrciaria dubia] (Commonly known as camu-camu, camu camu, camocamo, caçari and araçá-d'água.) This plant’s seed extracts have shown antischistosomicidal activity, [https://www.sciencedirect.com/science/article/pii/S0963996920303598?via%3Dihub] but nothing has been reported about possible adverse effects on any of the therapeutic worms.

* ⚡ [https://en.wikipedia.org/wiki/Myrrh Myrrh]. This has antiparasitic effects against various schistosome species and the liver fluke, Fasciola hepatica.

* ❌ [https://en.wikipedia.org/wiki/Neem Neem] (Azadirachta indica). Also known as margosa, nimtree and Indian lilac. Ayurvedic medicine holds that Neem is the best herb for treating worms and other parasites and that a simple decoction of Neem leaves can kill all parasites present in the intestines. Neem extract has also been shown to be [http://www.banglajol.info/index.php/DUJBS/article/view/8836 more effective against rodent helminths] than standard chemotherapy with albendazole or mebendazole.

* ✅ [https://en.wikipedia.org/wiki/Urtica_dioica Nettle, stinging] (Urtica dioica) Stinging nettle was found to have anthelmintic effects in one study [https://benthamopen.com/contents/pdf/TOPHARMCJ/TOPHARMCJ-3-38.pdf] but this was carried out ''in vitro'', using a nettle ''extract'', and in a non-therapeutic worm (the Indian earthworm) so these findings are not directly applicable to humans using human-adapted helminths. There have been no reports of any adverse effect on human helminths after their hosts have drunk nettle tea, and one hookworm host has reported regularly eating nettles without issue. [https://www.facebook.com/groups/htsupport/permalink/1265558373500115/?comment_id=1265700353485917&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Noni Noni] (Morinda citrifolia). See the separate entry for Morinda citrifolia, above. A test tube study [https://pubmed.ncbi.nlm.nih.gov/1158424/] found that noni helps to eliminate the roundworm, Ascaris lumbricoides, but, so far, no one hosting therapeutic helminths has reported using this.

* ❌ [https://en.wikipedia.org/wiki/Olive_leaf Olive leaf extract] (Olea europaea). Known as 'nature's antibiotic', this extract contains a component called oleuropein that is able to degrade pathological microorganisms of all kinds, and inhibit or kill many types of intestinal parasites including flatworms, hookworms, roundworms and tapeworms. Two subjects have reported losing their helminths after taking this.

* ⚡ [https://en.wikipedia.org/wiki/Oregon_grape Oregon grape] (Berberis aquifolium/mahonia aquifolium) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Oroxylum_indicum Oroxylum indicum] (also known as broken bones plant, Indian calosanthes, Indian trumpet flower, kampong, midnight horror and tree of Damocles). The bark extract of O. indicum [http://www.ncbi.nlm.nih.gov/pubmed/26660694 produces concentration-dependent effects against both larval and adult H. diminuta worms] so may also affect other helminths.

* ❌ [https://en.wikipedia.org/wiki/Palmarosa Palmarosa] (Cymbopogon martinii). Also known as Indian geranium, gingergrass and rosha or rosha grass. This may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Passionflower Passion flower] (Passiflora). This will not harm helminths.

* ❓ [https://en.wikipedia.org/wiki/Handroanthus Pau d’arco]. Also known as lapacho, red lapacho or taheebo, pau d'arco is a tea made from the inner bark of Handroanthus impetiginosus (Pink Ipê), which is claimed to have antiparasitic effects. Its main active ingredients are lapachol, quercetin and other flavonoids. Having expectorant properties, it is used as a herbal remedy for colds, flu and smoker's cough. However, lapachol is rather toxic and is more often used topically, for example as as antibacterial or pesticide. There have been no reports from helminthic therapy self-treaters to suggest what effect, if any, drinking pau d'arco might have on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Mentha_pulegium Pennyroyal] (Mentha pulegium). A member of the mint family, also known as European pennyroyal, pennyrile, squaw mint, mosquito plant and pudding grass. This plant has anthelmintic properties. [https://www.ncbi.nlm.nih.gov/pubmed/32002775]


* ⚡ [https://en.wikipedia.org/wiki/Peppermint Peppermint] (Mentha piperita, aka M. balsamea Willd) is used as an ingredient in some antiparasitic preparations. Several helminth hosts have strongly suspected that peppermint oil killed their worms, and one found he could not establish a worm colony at all while taking peppermint oil. Even eating a lot of peppermints caused a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/948433751879247/?comment_id=948595591863063&comment_tracking=%7B%22tn%22:%22R%22%7D] However, a number of others, who have used peppermint oil as a treatment for IBS, have noticed nothing untoward, and one subject has reported taking peppermint oil continuously without issue. Only the oil has been implicated. Eating ✅''peppermint leaves'', or drinking tea made from them, should not be a problem, as was found by two hookworm hosts who have reported drinking lots of peppermint tea without hurting their worms. [https://www.facebook.com/groups/htsupport/permalink/1986080694781209/?comment_id=1986669308055681&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7433421123380445/?comment_id=7434211146634776] ''Peppermint extract'' has also been reported not to be a problem for another hookworm host. [https://www.facebook.com/groups/htsupport/permalink/3042115625844372/?comment_id=3048690678520200]

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_niruri Phyllanthus niruri], also known as gale of the wind, stonebreaker, shatter stone, seed-under-leaf, carry-me-seed, quebra pedra, chanca piedra and chance pierre. This has been used traditionally to treat intestinal worms, and an extract of the plant has shown anthelmintic potential against a type of parasitic flatworm. [https://jffk.unram.ac.id/index.php/sjp/article/view/245] However, there have been no reports so far of any effects on therapeutic helminths.

* ❌ '''Pollia serzogonian'''. Alcoholic extracts of the rhizomes of ⚡''P. serzogonian'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [http://www.starchild.co.uk/products/6564_3590_quassia-root-chips.aspx Quassia] (Picrasma excelsa) has, anecdotally, been used successfully to treat threadworms and roundworms, as well as giardiasis, especially when used as an enema. It is a favoured botanical anthelmintic because of its low toxicity.

* ✅ [https://en.wikipedia.org/wiki/Rhodiola_rosea Rhodiola rosea]. Two hookworm hosts have reported taking rhodiola without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/995774170478538/?comment_id=996296763759612&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Rosemary Rosemary] has been reported not to be a problem for helminths.

* ❌ [https://en.wikipedia.org/wiki/Salvia_officinalis Sage] (Salvia officinalis) was used traditionally as a treatment for intestinal worms and some forms of sage are still often included as an ingredient in modern proprietary antiparasitic remedies. Also one NA host has reported that drinking sage-containing teas stunned his colony for nearly a month. [https://www.facebook.com/groups/htsupport/posts/3505446409511289/?comment_id=5274927742563138&reply_comment_id=5275387002517212] However, the use of sage leaves as a culinary herb may not pose a problem for helminths, but there has not yet been sufficient feedback to be certain about this. [https://en.wikipedia.org/wiki/Sage_oil Sage oil] is likely to be much more of a problem for helminths, and one helminth provider cautions against the use of any concentrated form of sage.

* ❌ [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] (also known as arak, jhak, pīlu, Salvadora indica, toothbrush tree and mustard tree). Extracts of the root of this plant have been found to have powerful anthelmintic activity in a model worm. [https://www.ncbi.nlm.nih.gov/pubmed/31516352]

* ✅ [https://en.wikipedia.org/wiki/Sambucus_nigra Sambucus nigra], also known as European elderberry, European black elderberry, elder, European elder, elderberry, black elder, and the branded product, Sambucol. Several NA hosts have taken different forms of black elderberry liquid with no harm to their NA. [https://www.facebook.com/groups/htsupport/posts/2546894892033117/] Elderberry is known to stimulate the immune system, so might increase the symptoms of autoimmune diseases [https://www.webmd.com/vitamins-supplements/ingredientmono-434-elderberry.aspx?activeingredientid=434&activeingredientname=elderberry] [https://www.mskcc.org/cancer-care/integrative-medicine/herbs/elderberry-01#references-7] which may give the impression that it has affected a worm colony when it hasn't. Also see the comments [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570536949668921&comment_tracking=%7B%22tn%22%3A%22R0%22%7D here] and [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570537809668835&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

* ❌ [https://en.wikipedia.org/wiki/Santonin Santonin] is extracted from the dry buds of the desert plant ''Eurasian wormwood'' ([https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina]). It acts against most parasites except Echinococcus, and is used to treat roundworms.

* ⚡ [https://en.wikipedia.org/wiki/Saw_palmetto Saw palmetto] (Serenoa repens). Also known simply as Serenoa, or Sabal serrulatum. One individual has reported an inability to maintain a hookworm colony while taking this herb, but had success once the herb was discontinued.

* ✅ [https://en.wikipedia.org/wiki/Shilajit Shilajit] (mumijo). One hookworm host has taken this without any apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/]

* ❓ [https://en.wikipedia.org/wiki/Ulmus_rubra Slippery elm] (ulmus rubra, also known as ulmus fulva). This is listed on at least one website [http://www.livestrong.com/article/395900-herbal-home-remedy-for-hookworms-in-a-human/] as a herb that may be helpful in treating various types of parasitic worms, including hookworms, but the only report [https://www.facebook.com/groups/htsupport/permalink/796860063703284/?comment_id=796869800368977&offset=0&total_comments=2] so far was from a hookworm host who said that she used a small amount of slippery elm powder on a few occasions without noticeably affecting her worms.

* ❓ [https://en.wikipedia.org/wiki/Soursop Soursop]. This is also called graviola, guyabano and guanábana, and is the fruit of the Annona muricata tree. A. muricata has demonstrated nematicidal activity against several roundworms, including Meloidogyne incognita [https://pubmed.ncbi.nlm.nih.gov/37552644/], Trichinella spiralis [https://pubmed.ncbi.nlm.nih.gov/34515021/] and Haemonchus contortus. [https://pubmed.ncbi.nlm.nih.gov/31455460/] [https://pubmed.ncbi.nlm.nih.gov/23583362/] Since NA are nematodes, there is a possibility of A. muricata also producing an adverse effect on this species, but there have been no reports yet by helminth self-treaters.

* ⚡ [https://en.wikipedia.org/wiki/Southernwood Southernwood] (Artemisia abrotanum) This European flowering plant has demonstrated effects against some helminths. It is also known as old man, boy's love, oldman wormwood, lover's plant, appleringie, garderobe, Our Lord's wood, maid's ruin, garden sagebrush, European sage, sitherwood and lemon plant. Spondias (Spondias mombin or Spondias purpurea var. lutea) This tropical fruit, which is also known as hog plums, Spanish plums, libas in Bikol, golden apples and mombins, may have anthelmintic effects.

* ✅ [https://en.wikipedia.org/wiki/Hypericum_perforatum St. John’s Wort] (Hypericum perforatum). It had been considered conceivable that some of the constituents of hypericum might have an adverse effect on helminths if taken in isolation and in large quantities (e.g., hyperforin, which has demonstrated some antibacterial properties, and hypericin, which has shown both antibacterial and antiviral activity), but there have been no reports of adverse effects on human helminths from any hypericum product in more than a decade.

* ⚡ [https://en.wikipedia.org/wiki/Artemisia_annua Sweet Annie] (Artemisia annua). Also known as sweet wormwood, sweet sagewort and annual wormwood. Both the herb and the pure form of its active ingredient, the sesquiterpene lactone, [https://en.wikipedia.org/wiki/Artemisinin artemisinin], have been used traditionally to treat malaria and intestinal parasites. Artemisinin is a potent anthelmintic and has been shown to be effective against [https://en.wikipedia.org/wiki/Schistosoma schistosomes]. [https://www.ncbi.nlm.nih.gov/pubmed/29727708]

* ❌ [https://en.wikipedia.org/wiki/Tansy Tansy] (Tanacetum vulgare), also known as common tansy, cow bitter, bitter buttons and golden buttons, is highly toxic to intestinal parasites and, for centuries, tansy tea has been prescribed by herbalists to expel worms. One study found that both the crude hydroalcoholic extract of T. Vulgare, and its essential oils, possess significant activity against adult S. mansoni worms, and the activity of the essential oils may be related, at least in part, to monoterpene thujones, which were detected as major constituents of the essential oils. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929489/]

* ⚡ [https://en.wikipedia.org/wiki/Tea_tree_oil Tea tree oil] (Melaleuca alternifolia) has been claimed to kill intestinal worms, including roundworms, tapeworms and hookworms, and its anthelmintic activity has been investigated. [https://pubmed.ncbi.nlm.nih.gov/33503761/] The use of tea tree products may therefore have adverse effects on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Tephrosia_purpurea Tephrosia purpurea]. Alcoholic extracts of ⚡''T. purpurea'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Thymol Thymol]. This is a monoterpene phenol found in [https://en.wikipedia.org/wiki/Thyme%23Medicinal_use oil of thyme] and ''oregano oil'' (see separate reference), as well as ''[https://en.wikipedia.org/wiki/Ajwain ajwain] oil'' and ajwain "seeds" (actually the seed-like fruit from which the oil is extracted). Thymol has antimicrobial and antifungal properties and is said to be highly effective against hookworms. It can also be toxic and has caused fatalities in children.

* ⚡ [https://en.wikipedia.org/wiki/Usnea Usnea] are lichen species with powerful antibiotic and antifungal properties. [http://species.wikimedia.org/wiki/Usnea_florida Usnea florida] extract has been found to have a dose-dependent anthelmintic effect against the nematode worm, [https://en.wikipedia.org/wiki/Trichinella_spiralis Trichinella spiralis].

* ❓ [https://en.wikipedia.org/wiki/Arctostaphylos_uva-ursi Uva-ursi]. (Arctostaphylos uva-ursi). One of several related species referred to as bearberry, uva-ursi contains the glycoside [https://en.wikipedia.org/wiki/Arbutin arbutin], which has antimicrobial properties. There are claims online that uva-ursi is also anthelmintic, but, so far, there have been no reports of its effect on therapeutic helminths.

* ✅ [https://en.wikipedia.org/wiki/Valerian_(herb) Valerian] (Valeriana officinalis). One hookworm host has reported taking valerian tincture without noticing any interaction with her worms. [https://www.facebook.com/groups/htsupport/permalink/1300794123309873/?comment_id=1301681973221088&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Vasaka Vasaka] (Justicia adhatoda). Also known as Malabar Nut, Adulsa, Adhatoda and Vasa. From the same family as Adhatoda zeylanica. The leaves (which contain [https://en.wikipedia.org/wiki/Vasicine vasicine], an alkaloid with significant antimicrobial activity), root, bark, fruit, and flowers are all said to help in removing intestinal parasites.

* ❌ [https://en.wikipedia.org/wiki/Vernonia_amygdalina Vernonia amygdalina] Wild Mahale chimpanzees control parasite-related diseases by ingesting the pith of this plant, [https://pubmed.ncbi.nlm.nih.gov/7878093/] and some human tribal communities use concoctions of the plant for the same purpose. [https://en.wikipedia.org/wiki/Vernonia_amygdalina#Medicinal]

* ❌ Vervine ([https://en.wikipedia.org/wiki/Stachytarpheta_jamaicensis Stachytarpheta jamaicensis]) (Also known as, blue porterweed, blue snake weed, bastard vervain, Brazilian tea, Jamaica vervain and light-blue snakeweed. Vervine extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 81.5 hours - not much more than the anthelmintic drug, thiabendazole, which took 74 hours. [https://www.researchgate.net/publication/21072595]

* ✅ Vitaxyn. Alcoholic herbal concoctions with this name, or referred to as "Tancosan", are thought unlikely to be a problem if taken at the recommended dosage and unless they contain some other ingredient that is known to be harmful to helminths. A product called "Tancosan" was taken by one hookworm host for over 2 years without any obvious adverse effect on her worms.

* ✅ [https://en.wikipedia.org/wiki/Vitex_agnus-castus Vitex agnus-castus]. Also known as vitex, chaste tree, chasteberry, Abraham's balm, lilac chastetree and monk's pepper. One hookworm host has taken 1000 mg of dried vitex agnus castus each day for many months without any noticeable ill effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/986939411362014/?comment_id=986984301357525&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Juglans_cinerea White walnut] (Juglans cinerea). Also known as Butternut. This nut has been used to expel rather than kill worms, although both root bark and leaves have been used in combination with an equal amount of ❌''Mugwort'' to treat worms in children.

* ❌ [https://en.wikipedia.org/wiki/Wild_rue Wild rue] (Peganum harmala). Also known as Esfand, Syrian rue, African rue and harmal. Its powdered seeds were used traditionally to expel tapeworms.

* ❌ [https://en.wikipedia.org/wiki/Stachys_officinalis Wood betony] (Stachys officinalis). Also known as betony, purple betony, bishopwort, or bishop's wort. A tea made from this may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Woodsorrel Woodsorrel] (Oxalis) has been reported[https://www.facebook.com/groups/htsupport/permalink/544122108977082/] as not being a problem for worm hosts when eaten as a food.

* ❌ [https://en.wikipedia.org/wiki/Dysphania_ambrosioides Wormseed] (Dysphania ambrosioides, formerly Chenopodium ambrosioides). Also known as epazote, goosefoot, Jesuit's Tea, Mexican Tea, Herba Sancti Mariae and paico. Wormseed is a traditional herbal remedy used in the tropics for expelling roundworms, hookworms and tapeworms. The oil, leaves or whole plants can be used, but one study[http://www.ncbi.nlm.nih.gov/pubmed/?term=Studies+on+the+traditional+herbal+anthelmintic+Chenopodium+ambrosioides+L.:+Ethnopharmacological+evaluation+and+clinical+field+trials] found that the powdered herb did not effectively eradicate hookworms, roundworms, or whipworms.

* ❌ [https://en.wikipedia.org/wiki/Artemisia_absinthium Wormwood] (Artemisia Absinthium). Also known as common wormwood, green ginger or grand wormwood, this herb was used traditionally as an anthelmintic. Other members of the genus, artemisia, that were traditionally used as anthelmintics include white wormwood ([https://en.wikipedia.org/wiki/Artemisia_herba-alba Artemisia herba-alba]), Eurasian wormwood (Artemisia cina) commonly known as santonica, Levant wormseed and wormseed, and Russian wormwood (Artemisia vestita) also known as Buer, Chamariya, Drubsha, Ganga Tulsi, Kubsha, Kundiyaa, Kundja and Seski. [https://pubmed.ncbi.nlm.nih.gov/36985759/]

* ✅ [https://en.wikipedia.org/wiki/Yerba_mate Yerba mate] (also known as erva-mate). No adverse reports have appeared so far about the effect of this herb on human helminths, or of the beverage made from it, known as mate, maté, Chimarrão, cimarrón, Tererê or Tereré.

* ❌ [https://en.wikipedia.org/wiki/Zingiber_zerumbet Zingiber zerumbet]. Alcoholic extracts of the rhizomes of Z. zerumbet have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

{{Columns}}

=== Fungi ===
<blockquote>
* ❓ [https://en.wikipedia.org/wiki/Amanita_muscaria Amanita muscaria] is a psychoactive and poisonous fungus with several known variations, or subspecies. One hookworm host has reported eating "a couple of hats (5-6 max)" on a few occasions without any effect on his NA that he can remember. [https://www.facebook.com/groups/htsupport/posts/2485762264813047/?comment_id=5343576092364969&reply_comment_id=5374046685984576]

* ❌ [https://en.wikipedia.org/wiki/Inonotus_obliquus Chaga mushroom] (Inonotus obliquus). This fungus, which grows singly on birch and other trees, is claimed, in several places online, to be effective against intestinal parasites, and it has been used for this purpose in the traditional folk medicine of Russia and Eastern Europe. One hookworm host thinks that drinking tea made from chaga mushrooms may have caused the failure of several hookworm incubations, [https://www.facebook.com/groups/htsupport/permalink/810579668997990/?comment_id=810664495656174&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R4%22%7D] however, another NA host has taken 200 mg+ daily of the chaga-containing Sacred 7 Mushroom Extract Powder blend (chaga, cordyceps, lion's mane, maitake, reishi, shiitake, & turkey tail) with no apparent ill effect on his NA. [https://www.facebook.com/groups/htsupport/permalink/4610641158991803/?comment_id=4611955338860385&reply_comment_id=4887932381262678]

* ✅ [https://en.wikipedia.org/wiki/Cordyceps Cordyceps] One NA host took 1/4-1/2 teaspoon cordyceps 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ❌ [https://en.wikipedia.org/wiki/Fomitopsis_betulina Fomitopsis betulina]. This edible fungus, which is usually found on birch trees, was previously known as Piptoporus betulinus, and is commonly known as the birch polypore, birch bracket, or razor strop. Wikipedia reports that F. betulina has been widely used in traditional medicines, and a paper referenced in the Wikipedia article suggests that polyporenic acid, found in the fruit body of the fungus, may be poisonous to the human whipworm, Trichuris trichiura (TT). [https://en.wikipedia.org/wiki/Fomitopsis_betulina#Research_on_chemical_constituents] F. betulina also contains toxic resins and an active compound, agaric acid, which are powerful purgatives that can result in strong though short-lived bouts of diarrhoea. [https://sci-hub.hk/10.1016/S0140-6736(05)79939-6]

* ✅ [https://en.wikipedia.org/wiki/Lingzhi_mushroom Lingzhi mushroom] (also known as Reishi). Several self-treaters have taken Reishi mushrooms or their extracts, e.g, [https://www.facebook.com/groups/htsupport/permalink/1301004239955528/?comment_id=1973652139357398], and there have been no reports of any adverse effects on NA or TT. One user says he consumes moderate doses of reishi [https://www.facebook.com/groups/htsupport/permalink/316642988391663/?comment_id=936181859771103] and another has even successfully used Reishi (Reishi Mushroom extract powder, 1000 mg 2x daily) to treat “worm flu”. [https://www.facebook.com/groups/htsupport/permalink/1461731890549428/?comment_id=1461830860539531]

* ✅ [https://en.wikipedia.org/wiki/Hericium_erinaceus Lion’s mane mushroom] (Hericium erinaceus) Also known as yamabushitake (= ‘mountain priest mushroom’), bearded tooth fungus and bearded hedgehog. One NA host took 1/4-1/2 teaspoon lion's mane 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ✅ [https://en.wikipedia.org/wiki/Wolfiporia_extensa Wolfiporia extensa] (also known as hoelen, poria, tuckahoe, China root, fu ling and matsuhodo) is a species of fungus in the family Polyporaceae. One hookworm host has reported drinking Fu Ling herb daily (E-Fong brand extract powder) with no issues for his colony. [https://www.facebook.com/groups/htsupport/posts/10041354979253700/?comment_id=10050698938319304]
</blockquote>

== Miscellaneous ==
{{Columns|2}}
* ✅ [https://en.wikipedia.org/wiki/Apitherapy Bee venom therapy] appears to be safe for worms. [https://www.facebook.com/groups/htsupport/permalink/876826799039943/?comment_id=876902382365718&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R2%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Diatomaceous_earth Diatomaceous earth (DE)]. This is made from the fossilized remains of tiny, aquatic organisms called diatoms which are mined from ancient sea beds and ground into a fine powder to produce food grade or medical grade diatomite. The finer grade diatomites are used as an insecticide and are also employed to deworm pets and humans. They are believed to work by dehydrating the organism, although the sharp edges of the particles may also be damaging to tiny creatures. A daily dose of one heaped teaspoon of DE has been claimed to be effective for human worm control, and one hookworm host has reported that three doses, of approximately one teaspoon each, quickly wiped out her colony and caused the return of all the symptoms of her disease. Someone who actually wanted to terminate a hookworm colony has said that small amounts of DE did not do this for her, but that taking 1 tablespoon each day for three days did completely eradicate a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/3759836894072238/]

* ❓ [https://en.wikipedia.org/wiki/Clay Clay] (bentonite, kaolin, etc.) Some clays have antibacterial properties [https://www.ncbi.nlm.nih.gov/pubmed/26743034] [https://www.sciencedaily.com/releases/2018/08/180821112029.htm] that vary by type, and some have been claimed to be natural parasite preventives that inhibit the reproduction of organisms. One helminth provider at one time advised against the use of clay while hosting worms, but clay is now thought much less likely to harm human hookworms and whipworms than it is tapeworms, and it may in fact not have any adverse effect at all on any type of ''therapeutic'' helminth. Someone has reported taking a "scant soup spoonful" of [https://en.wikipedia.org/wiki/Montmorillonite montmorillonite clay] slurry daily for quite long periods up to 3 or 4 months with no obvious adverse effect on her NA. [https://www.facebook.com/groups/htsupport/posts/5297777343611511/?comment_id=5298086576913921]

* ✅/❌ [https://en.wikipedia.org/wiki/Diarrhea Diarrhoea/diarrhea] While it is possible to lose hookworms to diarrhoea, this is only likely if the diarrhoea is very severe, or if it is severe and prolonged, i.e., lasting for several weeks. There is a description of one individual’s experience of losing a hookworm colon to very severe diarrhoea [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

:People who get diarrhoea/diarrhea as a side effect following their first inoculation with hookworms do not lose all their worms as a result of this, and hookworms are able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep]. See [[Human helminth care manual#Laxatives | '''Laxatives''']].

:It would seem logical to assume that hookworms might be better able to resist being flushed out after the point at which they attach to the gut wall, which is towards the end of the third week post inoculation.

:While adult hookworms do move around to feed, and are therefore theoretically more likely to be lost if diarrhoea strikes while they are on the move, this is unlikely to lead to any significant loss.

:Human whipworms are unlikely to be dislodged by diarrhoea once these are mature and embedded in the colonic mucosa, but they could could potentially be flushed out before this, especially around 21-22 days post inoculation. After 28 days, human whipworms should not be affected at all by diarrhoea.

* ✅ [https://en.wikipedia.org/wiki/Fasting Fasting]. This [https://www.facebook.com/groups/htsupport/permalink/812582472131043/?comment_id=813100818745875&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D will not harm human helminths] because they feed from their host’s blood (hookworms), or from their intestinal tissue (whipworms). Fasting is also unlikely to have any detrimental effect on the rat tapeworm, Hymenolepis diminuta (HDC), even though this species normally lives on carbohydrates consumed by their host. HDC can apparently also live off glycoproteins secreted in the gut.

* ✅ [https://en.wikipedia.org/wiki/Fever Fever]. Running a fever for several days will not harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Hyperbaric_oxygen Hyperbaric oxygen]. This is safe for use alongside helminthic therapy. [https://www.facebook.com/groups/htsupport/permalink/1281704005218885/?comment_id=1284905411565411&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/678894952216125/permalink/2543377009101234/?comment_id=2543517345753867] [https://www.facebook.com/groups/htsupport/posts/4319514804771108?comment_id=4320113668044555]

* ✅ [https://en.wikipedia.org/wiki/Infrared_sauna Infrared sauna]. Two hookworm hosts used an infrared sauna regularly for over 15 years without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2106930399362904/?comment_id=2107487372640540&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Ketosis Ketosis] is a metabolic state in which most of the body's energy supply comes from ketone bodies in the blood. This state is often induced deliberately by fasting or the adoption of a low-carbohydrate diet as a intervention in various medical conditions. One commenter has suggested that ketosis should not be harmful to helminths because, like fungi, they have mitochondria so can metabolise fat and therefore utilise ketones as a food source, unlike bacteria and viruses which require carbohydrates to survive. [https://www.facebook.com/groups/htsupport/permalink/1077988932257061/?comment_id=1078025565586731&comment_tracking=%7B%22tn%22:%22R0%22%7D] For more on keptogenic diets, see [http://perfecthealthdiet.com/2011/02/ketogenic-diets-i-ways-to-make-a-diet-ketogenic/ here].

* ❓ [http://rifevideos.com/index.html Rife machines]. These devices are claimed to be capable of killing or "devitalizing" worms when set to 2,400 Hz. Therefore, assuming that they are able to do what is claimed (and this is a [https://en.wikipedia.org/wiki/Royal_Rife contentious issue]) it would seem sensible to avoid this particular frequency if using these machines.

* ✅ [https://en.wikipedia.org/wiki/Spermidine Spermidine]. When fed to worms, this simple polyamine (found in large quantities in human sperm and grapefruit) significantly prolonged their lifespan. [http://www.rsc.org/chemistryworld/News/2009/October/04100901.asp]

* ✅ Steam. Saunas, hot tubs and hot baths do not harm helminths because the body's core temperature remains relatively constant while the skin sweats.

* ✅ [https://en.wikipedia.org/wiki/Wim_Hof Wim Hof] breathing techniques. Someone who hosts hookworms and has done these exercises on and off for about a year has reported having no issues as a result of combining the two treatments. [https://www.facebook.com/groups/htsupport/permalink/1417893248266626/?comment_id=1417961461593138&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Zeolite Zeolite] Zeolites are microporous, aluminosilicate minerals that are used widely in water purification systems. One hookworm host has reported taking 1 zeolite tablet daily for a week with no adverse affect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/?comment_id=2168119789910631]

{{Columns}}

== Additional scientific studies ==

* 2011 Mar 1 [https://hdl.handle.net/1843/BUOS-8G3LVD Avaliação dos efeitos de fármacos imunomoduladores na infecção de Hamsters, Mesocricetus auratus, POR Ancylostoma ceylanicum (Evaluation of the effects of immunomodulatory drugs on the infection of hamsters, Mesocricetus auratus, by Ancylostoma ceylanicum) (Loss, 1911)] (Thesis, Minas Gerais, Portuguese)

Microscope selection and use

2026-05-17T12:12:18Z

John:

__NOTOC__
{{SEO 
|title=Microscope selection and use
|description=
|keywords=
|og:image=}}This page was written by Alana, author of the following two helminth incubation methods:
* [[NA incubation: very detailed method by Alana | '''NA incubation: very detailed method by Alana''']]
* [[TTO incubation: very detailed method by Alana | '''TTO incubation: very detailed method by Alana''']] 
There were a number of options I had to consider when purchasing a microscope for use in incubating Necator americanus hookworm larvae and Trichuris trichiura whipworm ova.
* '''A good lighting system''' was important. A mirror lighting system wouldn’t have been adequate, and a ‘scope with either a halogen or LED light source was likely to be best. A good iris and concentrator system were also important, as was a rheostat for dimming the light.
* '''A binocular microscope''' would cause me less eye fatigue and be easier to use, whereas a monocular one would be cheaper. A mechanical stage would make using the ‘scope easier for me, but one without a stage would be cheaper.
* I mainly use '''40X magnification'''. Sometimes I may use '''100x magnification''' for a closer look. It would be very unusual for me to need any stronger than this.
** I’ve seen it claimed online that '''200x magnification''' is best for egg counting and larva identification, but I’ve never needed to do either of these. Egg counting is not necessary in order to incubate hookworm larvae, and, since I already know that the only species of worm I host is Necator americanus, there would be no point in attempting to determine the species of the the larvae that I’m culturing. Apart from this, I wouldn’t know how to encourage the larvae to turn and smile for the camera so that I could check their mouth parts!
** It’s been suggested online that working with trichuris species requires '''100x magnification''', but I use my lowest magnification '''(40x)''' for virtually everything I do, which is to count hookworm larvae and whipworm eggs. It has also been suggested that a microscope with the lens looking up from the bottom might be a better option, although the author of this comment may actually have been thinking of an upward-facing ''mirror'' rather than a light. However, I’ve only ever used a lens looking down from above, and always found this to be perfectly adequate.
* A very similar model to this one was recommended on a helminthic therapy discussion forum and is reasonably similar to the older scope that I have: [http://stores.ebay.com.au/Precision-World/_i.html?_nkw=Professional+Biological+Compound+Microscope&submit=Search Professional Biological Compound Microscope, from Precision World, 40X-1600X, AmScope, Model# B230A], for £170 ($260.00., €200) (see graphic 1A).
* An example of a much cheaper model - one that I considered using, and which ''might'' have worked - would be the [http://stores.ebay.com.au/Precision-World/_i.html?_nkw=1000X+Student+Monocular+Biological+Compound+Microscope&submit=Search&_sid=65375763 1000X Student Monocular Biological Compound Microscope], for about £55.00 ($80.00, €60) However, this model doesn't have a moveable stage, which would make it ''much'' easier to focus on the larvae and pick them up using a pipette. (see graphic 1B).

<div style="margin:12px">
[[file:NA-Inc001.jpg|link=]]
</div>

[http://gxoptical.com/html/gxm_stereo_microscopes.html GX Optical] may have the largest choice of stereo microscopes in Europe, and claim to be the largest independent
microscope supplier in the UK.

==== Microscope case ====

I wasn’t sure a microscope case would be necessary, but eventually decided to get one. Various sites suggested that
I could save money and yet make a decent case from a tool box with a very inexpensive inner lining made from a
one person-sized (approximately 90-96 cm x 190-193 cm [36-38” x 75-76”]) egg crate foam mattress pad (e.g.,
[http://www.greatscopes.com/act018.htm Make a Carry Case for Your Microscope]) I used a tool box similar in dimensions to a Plano 22 inch, extra deep, model
701, along with the egg crate foam. For the foam, I found a source similar to these:
[http://www.amazon.co.uk/Eggcrate-Wheelchair-Cushion-40-64-45-72/dp/B0009RKETQ/ref=sr_1_7?ie=UTF8&qid=1319912628&sr=8-7and Eggcrate Wheelchair Cushion 40.64 cm x 45.72 cm x 7.62 cm by Wheelchairs]
/ [http://www.amazon.co.uk/Acoustic-Blister-Foam-3-Pc/dp/B002KYDZN8/ref=sr_1_2?ie=UTF8&qid=1319912628&sr=8-2 Sound insulation foam (3 pieces) by CONRAD]. When I got the
toolbox home, I had to use pliers-type wire cutters to cut off two internal projections that came down from the lid.
Adding a few pieces of Styrofoam filled out the foam internal padding (see graphic 1C).

==== Digital Microscopes ====

Other options might include using a
* [http://www.amazon.co.uk/Plugable-Microscope-Flexible-Observation-Magnification/dp/B00XNYXQHE/ref=sr_1_2?ie=UTF8&qid=1440861739&sr=8-2&keywords=Plugable+USB+2.0+Handheld+Digital+Microscope+with+Stand Plugable USB 2.0 Handheld Digital Microscope] (see graphic 1D, and further details [http://boingboing.net/2015/06/16/usb-microscope-a-zoom-func.html here]),
* or a slightly more up-market version such as the [http://www.amazon.co.uk/DBPOWER-Megapixels-20X-300X-Microscope-Magnifier/dp/B00RYF65IA/ref=sr_1_1?ie=UTF8&qid=1440861193&sr=8-1&keywords=DBPOWER+5MP+20-300X+USB+Digital+Microscope+Magnifier DBPOWER 5 Megapixels 20X-300X USB Microscope Plugable Digital Magnifier with 8 LED Lights and Stand] (see graphic 1E)

Another alternative could be to make a digital microscope
* [http://www.instructables.com/id/10-Smartphone-to-digital-microscope-conversion/ using a smart phone] for as little as $10 (see graphic 1F),
* or a [http://www.cnet.com/uk/news/sub-1-3d-printed-microscope-turns-smartphones-into-instruments-of-science/ 3D Printed Microscope] with a mobile device for pennies (see graphic 1G).

USB devices could develop electronic and/or software faults that traditional microscopes will never have, and compound microscopes are preferred by the majority of helminth growers. Most of the USB scopes that have been tested so far have had problems, including poor optics and camera quality, as well as a lack of bottom illumination. The only exception has been the [https://www.carson.com/products/eflex-mm-840/ Carson MM-840 eFlex], which one user has found to be satisfactory, albeit with some limitations.

{{Quote|indent}}I used one last week for counting NA. It was quite cheap to buy, and I wanted something easy on the eye. I could use it without needing my reading glasses. It was quite easy to use, and you can take photos and video. Basically, it was just fine to use for counting the worms but I would have liked a little more magnification so I could have seen them up close. I wouldn't have been able to use it for counting eggs. I found it a little wobbly - it needed to be set up and then not touched, just move the slide. Another issue was that the worms all had shadows because of the white base. So what looked like two worms moving in exact unison was just one worm with a shadow! [https://www.facebook.com/groups/678894952216125/permalink/1558359727602972/?comment_id=1559499294155682&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

==== Microscope use advice ====

Here's a basic video guide to using a microscope.

* [https://www.youtube.com/watch?v=SUo2fHZaZCU&feature=youtu.be Basic Microscope Setup and Use]

And further tips from the hive mind.

* [https://ask.metafilter.com/121785/Optical-microscope-tips-I-want-to-see-with-both-eyes Optical microscope tips: I want to see with both eyes!]

A good source to consult if I have microscope problems is [http://www.cldavis.org/cgi-bin/download.cgi?pid=481 Fecal Flotation: Common Problems With Microscopy] (Download).

When using a microscope, it is essential to be comfortable.

{{Quote|indent}}I found that seating and posture is very important. I got a stool with the proper height and supported myself on the table while leaning in. With this I found that I could spend much more time focusing on trying to find eggs rather than thinking about how uncomfortable I was. [https://www.facebook.com/groups/678894952216125/permalink/1458115670960712/?comment_id=1458328594272753&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

And here's a note for spectacle wearers.

{{Quote|indent}}If you wear glasses, beware when looking into the microscope, I scratched my lenses! [https://www.facebook.com/groups/678894952216125/permalink/2728642923907974/]{{Quote|/indent}}

==== Microscope supplies ====

<div style="margin:12px">
[[file:NA-Inc002.jpg|link=]]
</div>

* '''Microscope optics cleaning kit''' e.g., [http://www.sciencecompany.com/Optical-Lens-Cleaning-Kit-P16159.aspx Optical Lens Cleaning Kit] (see graphic 2A) / [http://www.amazon.co.uk/Matin-Lens-Cleaning-Kit-Camcorders/dp/B005HQYWHE Matin Lens Cleaning Kit].

* '''Microscope slides, with box''' e.g. 
** [http://www.microscopeworld.com/p-375-microscope-slides-blank.aspx Microscope World SKU: BMS50]
** [http://www.amazon.co.uk/Bresser-Microscope-Accessory-Slides-Coverslips/dp/B00140J34E/ref=sr_1_2?ie=UTF8&qid=1318520706&sr=8-2 Bresser microscope accessories slides and cover glasses]
** [http://www.amazon.co.uk/Bresser-Accessory-Type-Microscope-Slides/dp/B000NG2MHK/ref=sr_1_3?ie=UTF8&qid=1318520706&sr=8-3 Bresser microscope accessories slides] (see graphic 2B).

* '''Microscope slides, plain glass, 72/pack''' e.g., [http://www.hometrainingtools.com/microscope-slides-plain-glass-70-pack Item# MS-SLIDP72] (see graphic 2C).

* '''Slide storage box, 25 slides''' e.g., Item# MS-SLBOX (see graphic 2D).

==== See also ====
* [[Microscope selection notes | '''Microscope selection notes''']]
* [[Stool testing (Equipment)#Microscopes | '''Selection and use of microscopes for stool testing''']]

Helminthic therapy and eosinophils

2026-05-13T17:47:22Z

John: /* Potentially adverse effects of excessive eosinophilia */

{{Breadcrumb|[[Effects_of_helminthic_therapy|Effects of helminthic therapy]]}}
{{SEO 
|title=Helminthic therapy and eosinophils
|description=
|keywords=
|og:image=}}
== What are eosinophils? ==

Eosinophils, sometimes called eosinophiles, eosinocytes, or less commonly, acidophils or acidophilic leukocytes, are a variety of white blood cells and one of the immune system components responsible for combatting multicellular parasites and certain infections in vertebrates. Along with mast cells and basophils, they also control mechanisms associated with allergy and asthma. [https://en.wikipedia.org/wiki/Eosinophil]

== The positive role of eosinophils ==

Eosinophil numbers usually increase following exposure to helminths, but this is not an undesirable development. The interactions between eosinophils and intestinal worms are now recognised to be complex and, rather than being detrimental, eosinophils may in fact be an essential component in immunity. They have an important role in cell growth and cell-to-cell interactions. They synthesise, store and secrete cytokines, chemokines, and growth factors, as well as stimulating T cells, interacting with B cells, functioning as antigen-presenting cells, and regulating processes associated with both T1 and T2 immunity. [http://www.ncbi.nlm.nih.gov/pubmed/26690368] They also perform many other essential biological functions.

{{Quote|indent}}… besides their roles in Th2 responses, eosinophils also regulate homeostatic processes at steady state, thereby challenging the exclusive paradigm of the eosinophil as a destructive and inflammatory cell. Indeed, under baseline conditions, eosinophils rapidly leave the bloodstream to enter tissues, mainly the gastrointestinal tract, lungs, adipose tissue, thymus, uterus, and mammary glands, where they regulate a variety of important biological functions, such as immunoregulation, control of glucose homeostasis, protection against obesity, regulation of mammary gland development, and preparation of the uterus for pregnancy. [https://www.ncbi.nlm.nih.gov/pubmed/28744457]{{Quote|/indent}}

One of the contributions made to immune regulation by eosinophils is the production of the cytokine Interleukin-5 (II-5 cytokine) which induces the body’s T-cell front-line defences and has, itself, been shown to be an effective treatment for autoimmune disease. [http://newsroom.unsw.edu.au/news/health/injection-offers-hope-treating-auto-immunedisease] Eosinophils may act as mediators of inflammatory resolution, [https://www.ncbi.nlm.nih.gov/pubmed/28008805] have a crucial role in the prevention of autoimmune diseases such as colitis, [http://www.ncbi.nlm.nih.gov/pubmed/26174763] and contribute to the control of excessive inflammation and tissue damage in solid organ transplants. [https://www.ncbi.nlm.nih.gov/pubmed/31647606]

Small intestinal eosinophils play a pivotal role in the maintenance of intestinal homeostasis, [https://www.ncbi.nlm.nih.gov/pubmed/28261019] including by the regulation of Th17 cells via production of IL-1Ra. [http://www.ncbi.nlm.nih.gov/pubmed/26951334]

Hookworm-induced eosinophils may contribute to a reduced prevalence of latent TB infection. [https://www.ncbi.nlm.nih.gov/pubmed/30619265]

An absence of eosinophils may have a significant impact on the nature of the endogenous gut microflora and responses to gut pathogens, notably Clostridium difficile. [https://www.ncbi.nlm.nih.gov/pubmed/27549754]

{{Quote|indent}}... although all the beneficial roles of eosinophils have yet to emerge, eosinophils, on balance, must be considered friends and not foes. [https://www.ncbi.nlm.nih.gov/pubmed/30197067]{{Quote|/indent}}

== The eosinophil response to helminths ==

In the case of helminth infection, eosinophils are produced by the body to try to rid itself of the invader. The helminths then respond by secreting chemicals to counter the eosinophils and thus protect themselves from being ejected. This produces a typical pattern of firstly increased, and then decreased, eosinophil counts. However, there is not always an eosinophil response to helminths.

{{Quote|indent}}Neither 30 HDC biweekly nor low doses of HW caused increased Eosinophils. My Eosinophils always remained low normal. (Link expired)
Raised eosinophil numbers should always be investigated because they can be a sign of pathology other than a reaction to an allergen or parasite.

Where eosinophil levels had been raised prior to inoculation with helminths, for example in response to harmless substances such as food proteins, these will typically also be controlled eventually by the action of the worms. Once helminths have been hosted continuously for a period of time, eosinophil numbers usually decline and can eventually disappear with chronic helminth exposure, although they usually remain slightly elevated indefinitely in helminth hosts.

{{Quote|indent}}My eos were elevated for a while, but they did eventually go back to normal. [https://www.facebook.com/groups/htsupport/permalink/1427417583980859/?comment_id=1428623633860254&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had elevated eosinophils for a while (4-5 months) and then it dropped down to normal range. I have continued to inoculate with hookworms for the next 4 months and my eosinophils are still not elevated. [https://www.facebook.com/groups/htsupport/posts/4290369437685645/]{{Quote|/indent}}

Eosinophil levels vary according to the species and number of helminths being hosted, the length of time they've been present in the host and the host's genetics. In the case of NA, they usually begin to rise from week 2 following inoculation, then rise more rapidly from week 4 and peak at around weeks 6-7, before reducing gradually again and returning to normal at around 14 weeks, or remaining slightly elevated thereafter. The lower eosinophil levels seen at 14 weeks and beyond are an indication that the worms are doing their job and moderating the body's immune response.

[[file:Initial eosinophil counts in NA hosts.jpg]]

(From: [https://www.researchgate.net/publication/6674179_Dose-ranging_study_for_trials_of_therapeutic_infection_with_necator_Americanus_in_humans Dose-ranging study for trials of therapeutic infection with Necator americanus in humans])

Measurement scales vary according to geographic location, and someone from the US reported that, after his first inoculation with hookworms, his eosinophil counts rose from a baseline of about 300 to a peak of 4100 at 5 weeks, dropped to 2300 at 12 weeks, and then reduced to 1300 at 14 weeks. After a 2nd inoculation, his eosinophils rose to 2300 at week 8, dropped back to 2100 at week 12, and then down to 1300 at week 14. Following a 3rd inoculation, his eosinophils reached 1700 at 7 weeks before falling to 600 at week 11.

Someone else has reported that, eight months before introducing NA, they had an eosinophil level of 300/mm3. Nine weeks after their first dose of NA (and while also taking HDC), their eosinophils had increased to 2449/mm3 and, by 22 weeks, they had reduced to 1360/mm3. At almost 15 weeks after a second dose, their eosinophils had risen back up to 2900/mm3. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1475888832467067&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

An eosinophil count of, say, 600, prior to infection with helminths, might be indicative of allergies, but counts in the thousands are more suggestive of the presence of helminths. However, a high eosinophil level does not necessarily indicate that a person is currently infected with helminths, only that they may have been exposed to helminths within the last few weeks or months.

Having an eosinophil level somewhat elevated above 'normal' values does not automatically lead to adverse symptoms.

{{Quote|indent}}Last time I had mine tested they were about double the normal level - and I'm feeling better all the time. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476193139103303&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

{{Quote|indent}}I've been at 6x normal levels and felt no worse than usual. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476229052433045&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

And the increase in eosinophil counts seen in helminth hosts is no reason for concern.

{{Quote|indent}}When I first went to my doctor and he noted a high eosinophilic count he said it was nothing to worry about and could be caused by all sorts of triggers. [https://www.facebook.com/groups/htsupport/posts/5368629826526262?comment_id=5368682726520972&reply_comment_id=5369644643091447]{{Quote|/indent}}

Once human helminths (NA or TT) have been established for three months, the immune response to them, whether to those already in place, or to supplementary doses, is reduced and, the larger the number of worms being hosted, the smaller the resulting rise in eosinophils will be. This is probably the reason why one study found that, out of a total of 621 cases of helminth infection, only 66 cases (10.6%) had related eosinophilia. [http://www.ncbi.nlm.nih.gov/pubmed/26393130]

This is also why side effects - which are dependent on the host’s immune response - are much less likely and, if they do occur, are so much milder, with subsequent doses when compared with the first dose.

One self-treater, whose eosinophil numbers had always been in the normal range prior to hosting helminths, found that they rose appropriately during several years of hosing NA. But, when he then took a break from the therapy for 3 years, his eosinophil count continued to remain outside the upper limit of normal. [https://www.facebook.com/groups/htsupport/permalink/3566326000089996?comment_id=3581529191903010]

== Potentially adverse effects of excessive eosinophilia ==

Some non-therapeutic helminth species are known to cause hypereosinophilia. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7604902/] [https://pubmed.ncbi.nlm.nih.gov/40575422/] However, the therapeutic helminths (TSO, TTO, NA and HDC) do not do this unless used in excessively large doses. The only recorded case of this reported that much larger doses of NA than are recommended had resulted in hypereosinophilia that caused (reversible) organ damage.
* [[media:Symptomatic_hypereosinophilia_associated_with_Necator_americanus_self-inoculation.pdf | Symptomatic hypereosinophilia associated with Necator americanus self-inoculation]]

== See also ==

* [http://www.medicalnewstoday.com/articles/311601.php Eosinophils: All You Need to Know]

* [https://www.ncbi.nlm.nih.gov/pubmed/31977298 Contributions of Eosinophils to Human Health and Disease]

* [http://www.pharmaceutical-journal.com/learning/learning-article/drug-inducedeosinophilia/20000049.article Drug-induced eosinophilia]

*[https://pubmed.ncbi.nlm.nih.gov/34733292/ Emerging Role of Eosinophils in Resolution of Arthritis] — [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/pdf/fimmu-12-764825.pdf PDF]

* [[Mechanisms underlying helminth colonization#Eosinophils | '''Mechanisms underlying helminth colonization: Eosinophils''']]

* [[Helminthic therapy and eosinophilic esophagitis (EE / EoE) | '''Helminthic therapy and eosinophilic esophagitis (EE / EoE)''']]

* [[Helminthic therapy and neutrophils | '''Helminthic therapy and neutrophils''']]

Helminthic therapy and eosinophils

2026-05-13T17:40:54Z

John: /* Potentially adverse effects of excessive eosinophilia */

{{Breadcrumb|[[Effects_of_helminthic_therapy|Effects of helminthic therapy]]}}
{{SEO 
|title=Helminthic therapy and eosinophils
|description=
|keywords=
|og:image=}}
== What are eosinophils? ==

Eosinophils, sometimes called eosinophiles, eosinocytes, or less commonly, acidophils or acidophilic leukocytes, are a variety of white blood cells and one of the immune system components responsible for combatting multicellular parasites and certain infections in vertebrates. Along with mast cells and basophils, they also control mechanisms associated with allergy and asthma. [https://en.wikipedia.org/wiki/Eosinophil]

== The positive role of eosinophils ==

Eosinophil numbers usually increase following exposure to helminths, but this is not an undesirable development. The interactions between eosinophils and intestinal worms are now recognised to be complex and, rather than being detrimental, eosinophils may in fact be an essential component in immunity. They have an important role in cell growth and cell-to-cell interactions. They synthesise, store and secrete cytokines, chemokines, and growth factors, as well as stimulating T cells, interacting with B cells, functioning as antigen-presenting cells, and regulating processes associated with both T1 and T2 immunity. [http://www.ncbi.nlm.nih.gov/pubmed/26690368] They also perform many other essential biological functions.

{{Quote|indent}}… besides their roles in Th2 responses, eosinophils also regulate homeostatic processes at steady state, thereby challenging the exclusive paradigm of the eosinophil as a destructive and inflammatory cell. Indeed, under baseline conditions, eosinophils rapidly leave the bloodstream to enter tissues, mainly the gastrointestinal tract, lungs, adipose tissue, thymus, uterus, and mammary glands, where they regulate a variety of important biological functions, such as immunoregulation, control of glucose homeostasis, protection against obesity, regulation of mammary gland development, and preparation of the uterus for pregnancy. [https://www.ncbi.nlm.nih.gov/pubmed/28744457]{{Quote|/indent}}

One of the contributions made to immune regulation by eosinophils is the production of the cytokine Interleukin-5 (II-5 cytokine) which induces the body’s T-cell front-line defences and has, itself, been shown to be an effective treatment for autoimmune disease. [http://newsroom.unsw.edu.au/news/health/injection-offers-hope-treating-auto-immunedisease] Eosinophils may act as mediators of inflammatory resolution, [https://www.ncbi.nlm.nih.gov/pubmed/28008805] have a crucial role in the prevention of autoimmune diseases such as colitis, [http://www.ncbi.nlm.nih.gov/pubmed/26174763] and contribute to the control of excessive inflammation and tissue damage in solid organ transplants. [https://www.ncbi.nlm.nih.gov/pubmed/31647606]

Small intestinal eosinophils play a pivotal role in the maintenance of intestinal homeostasis, [https://www.ncbi.nlm.nih.gov/pubmed/28261019] including by the regulation of Th17 cells via production of IL-1Ra. [http://www.ncbi.nlm.nih.gov/pubmed/26951334]

Hookworm-induced eosinophils may contribute to a reduced prevalence of latent TB infection. [https://www.ncbi.nlm.nih.gov/pubmed/30619265]

An absence of eosinophils may have a significant impact on the nature of the endogenous gut microflora and responses to gut pathogens, notably Clostridium difficile. [https://www.ncbi.nlm.nih.gov/pubmed/27549754]

{{Quote|indent}}... although all the beneficial roles of eosinophils have yet to emerge, eosinophils, on balance, must be considered friends and not foes. [https://www.ncbi.nlm.nih.gov/pubmed/30197067]{{Quote|/indent}}

== The eosinophil response to helminths ==

In the case of helminth infection, eosinophils are produced by the body to try to rid itself of the invader. The helminths then respond by secreting chemicals to counter the eosinophils and thus protect themselves from being ejected. This produces a typical pattern of firstly increased, and then decreased, eosinophil counts. However, there is not always an eosinophil response to helminths.

{{Quote|indent}}Neither 30 HDC biweekly nor low doses of HW caused increased Eosinophils. My Eosinophils always remained low normal. (Link expired)
Raised eosinophil numbers should always be investigated because they can be a sign of pathology other than a reaction to an allergen or parasite.

Where eosinophil levels had been raised prior to inoculation with helminths, for example in response to harmless substances such as food proteins, these will typically also be controlled eventually by the action of the worms. Once helminths have been hosted continuously for a period of time, eosinophil numbers usually decline and can eventually disappear with chronic helminth exposure, although they usually remain slightly elevated indefinitely in helminth hosts.

{{Quote|indent}}My eos were elevated for a while, but they did eventually go back to normal. [https://www.facebook.com/groups/htsupport/permalink/1427417583980859/?comment_id=1428623633860254&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had elevated eosinophils for a while (4-5 months) and then it dropped down to normal range. I have continued to inoculate with hookworms for the next 4 months and my eosinophils are still not elevated. [https://www.facebook.com/groups/htsupport/posts/4290369437685645/]{{Quote|/indent}}

Eosinophil levels vary according to the species and number of helminths being hosted, the length of time they've been present in the host and the host's genetics. In the case of NA, they usually begin to rise from week 2 following inoculation, then rise more rapidly from week 4 and peak at around weeks 6-7, before reducing gradually again and returning to normal at around 14 weeks, or remaining slightly elevated thereafter. The lower eosinophil levels seen at 14 weeks and beyond are an indication that the worms are doing their job and moderating the body's immune response.

[[file:Initial eosinophil counts in NA hosts.jpg]]

(From: [https://www.researchgate.net/publication/6674179_Dose-ranging_study_for_trials_of_therapeutic_infection_with_necator_Americanus_in_humans Dose-ranging study for trials of therapeutic infection with Necator americanus in humans])

Measurement scales vary according to geographic location, and someone from the US reported that, after his first inoculation with hookworms, his eosinophil counts rose from a baseline of about 300 to a peak of 4100 at 5 weeks, dropped to 2300 at 12 weeks, and then reduced to 1300 at 14 weeks. After a 2nd inoculation, his eosinophils rose to 2300 at week 8, dropped back to 2100 at week 12, and then down to 1300 at week 14. Following a 3rd inoculation, his eosinophils reached 1700 at 7 weeks before falling to 600 at week 11.

Someone else has reported that, eight months before introducing NA, they had an eosinophil level of 300/mm3. Nine weeks after their first dose of NA (and while also taking HDC), their eosinophils had increased to 2449/mm3 and, by 22 weeks, they had reduced to 1360/mm3. At almost 15 weeks after a second dose, their eosinophils had risen back up to 2900/mm3. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1475888832467067&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

An eosinophil count of, say, 600, prior to infection with helminths, might be indicative of allergies, but counts in the thousands are more suggestive of the presence of helminths. However, a high eosinophil level does not necessarily indicate that a person is currently infected with helminths, only that they may have been exposed to helminths within the last few weeks or months.

Having an eosinophil level somewhat elevated above 'normal' values does not automatically lead to adverse symptoms.

{{Quote|indent}}Last time I had mine tested they were about double the normal level - and I'm feeling better all the time. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476193139103303&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

{{Quote|indent}}I've been at 6x normal levels and felt no worse than usual. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476229052433045&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

And the increase in eosinophil counts seen in helminth hosts is no reason for concern.

{{Quote|indent}}When I first went to my doctor and he noted a high eosinophilic count he said it was nothing to worry about and could be caused by all sorts of triggers. [https://www.facebook.com/groups/htsupport/posts/5368629826526262?comment_id=5368682726520972&reply_comment_id=5369644643091447]{{Quote|/indent}}

Once human helminths (NA or TT) have been established for three months, the immune response to them, whether to those already in place, or to supplementary doses, is reduced and, the larger the number of worms being hosted, the smaller the resulting rise in eosinophils will be. This is probably the reason why one study found that, out of a total of 621 cases of helminth infection, only 66 cases (10.6%) had related eosinophilia. [http://www.ncbi.nlm.nih.gov/pubmed/26393130]

This is also why side effects - which are dependent on the host’s immune response - are much less likely and, if they do occur, are so much milder, with subsequent doses when compared with the first dose.

One self-treater, whose eosinophil numbers had always been in the normal range prior to hosting helminths, found that they rose appropriately during several years of hosing NA. But, when he then took a break from the therapy for 3 years, his eosinophil count continued to remain outside the upper limit of normal. [https://www.facebook.com/groups/htsupport/permalink/3566326000089996?comment_id=3581529191903010]

== Potentially adverse effects of excessive eosinophilia ==

Some non-therapeutic helminth species are known to cause hypereosinophilia. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7604902/] [https://pubmed.ncbi.nlm.nih.gov/40575422/] However, the therapeutic helminths (TSO, TTO, NA and HDC) do not do this unless used in excessively large doses. For example, much larger doses of NA than are recommended were reported in one isolated case to have caused hypereosinophilia resulting in (reversible) organ damage.
* [[media:Symptomatic_hypereosinophilia_associated_with_Necator_americanus_self-inoculation.pdf | Symptomatic hypereosinophilia associated with Necator americanus self-inoculation]]

== See also ==

* [http://www.medicalnewstoday.com/articles/311601.php Eosinophils: All You Need to Know]

* [https://www.ncbi.nlm.nih.gov/pubmed/31977298 Contributions of Eosinophils to Human Health and Disease]

* [http://www.pharmaceutical-journal.com/learning/learning-article/drug-inducedeosinophilia/20000049.article Drug-induced eosinophilia]

*[https://pubmed.ncbi.nlm.nih.gov/34733292/ Emerging Role of Eosinophils in Resolution of Arthritis] — [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/pdf/fimmu-12-764825.pdf PDF]

* [[Mechanisms underlying helminth colonization#Eosinophils | '''Mechanisms underlying helminth colonization: Eosinophils''']]

* [[Helminthic therapy and eosinophilic esophagitis (EE / EoE) | '''Helminthic therapy and eosinophilic esophagitis (EE / EoE)''']]

* [[Helminthic therapy and neutrophils | '''Helminthic therapy and neutrophils''']]

Helminthic therapy and eosinophils

2026-05-13T17:39:48Z

John: /* Various */

{{Breadcrumb|[[Effects_of_helminthic_therapy|Effects of helminthic therapy]]}}
{{SEO 
|title=Helminthic therapy and eosinophils
|description=
|keywords=
|og:image=}}
== What are eosinophils? ==

Eosinophils, sometimes called eosinophiles, eosinocytes, or less commonly, acidophils or acidophilic leukocytes, are a variety of white blood cells and one of the immune system components responsible for combatting multicellular parasites and certain infections in vertebrates. Along with mast cells and basophils, they also control mechanisms associated with allergy and asthma. [https://en.wikipedia.org/wiki/Eosinophil]

== The positive role of eosinophils ==

Eosinophil numbers usually increase following exposure to helminths, but this is not an undesirable development. The interactions between eosinophils and intestinal worms are now recognised to be complex and, rather than being detrimental, eosinophils may in fact be an essential component in immunity. They have an important role in cell growth and cell-to-cell interactions. They synthesise, store and secrete cytokines, chemokines, and growth factors, as well as stimulating T cells, interacting with B cells, functioning as antigen-presenting cells, and regulating processes associated with both T1 and T2 immunity. [http://www.ncbi.nlm.nih.gov/pubmed/26690368] They also perform many other essential biological functions.

{{Quote|indent}}… besides their roles in Th2 responses, eosinophils also regulate homeostatic processes at steady state, thereby challenging the exclusive paradigm of the eosinophil as a destructive and inflammatory cell. Indeed, under baseline conditions, eosinophils rapidly leave the bloodstream to enter tissues, mainly the gastrointestinal tract, lungs, adipose tissue, thymus, uterus, and mammary glands, where they regulate a variety of important biological functions, such as immunoregulation, control of glucose homeostasis, protection against obesity, regulation of mammary gland development, and preparation of the uterus for pregnancy. [https://www.ncbi.nlm.nih.gov/pubmed/28744457]{{Quote|/indent}}

One of the contributions made to immune regulation by eosinophils is the production of the cytokine Interleukin-5 (II-5 cytokine) which induces the body’s T-cell front-line defences and has, itself, been shown to be an effective treatment for autoimmune disease. [http://newsroom.unsw.edu.au/news/health/injection-offers-hope-treating-auto-immunedisease] Eosinophils may act as mediators of inflammatory resolution, [https://www.ncbi.nlm.nih.gov/pubmed/28008805] have a crucial role in the prevention of autoimmune diseases such as colitis, [http://www.ncbi.nlm.nih.gov/pubmed/26174763] and contribute to the control of excessive inflammation and tissue damage in solid organ transplants. [https://www.ncbi.nlm.nih.gov/pubmed/31647606]

Small intestinal eosinophils play a pivotal role in the maintenance of intestinal homeostasis, [https://www.ncbi.nlm.nih.gov/pubmed/28261019] including by the regulation of Th17 cells via production of IL-1Ra. [http://www.ncbi.nlm.nih.gov/pubmed/26951334]

Hookworm-induced eosinophils may contribute to a reduced prevalence of latent TB infection. [https://www.ncbi.nlm.nih.gov/pubmed/30619265]

An absence of eosinophils may have a significant impact on the nature of the endogenous gut microflora and responses to gut pathogens, notably Clostridium difficile. [https://www.ncbi.nlm.nih.gov/pubmed/27549754]

{{Quote|indent}}... although all the beneficial roles of eosinophils have yet to emerge, eosinophils, on balance, must be considered friends and not foes. [https://www.ncbi.nlm.nih.gov/pubmed/30197067]{{Quote|/indent}}

== The eosinophil response to helminths ==

In the case of helminth infection, eosinophils are produced by the body to try to rid itself of the invader. The helminths then respond by secreting chemicals to counter the eosinophils and thus protect themselves from being ejected. This produces a typical pattern of firstly increased, and then decreased, eosinophil counts. However, there is not always an eosinophil response to helminths.

{{Quote|indent}}Neither 30 HDC biweekly nor low doses of HW caused increased Eosinophils. My Eosinophils always remained low normal. (Link expired)
Raised eosinophil numbers should always be investigated because they can be a sign of pathology other than a reaction to an allergen or parasite.

Where eosinophil levels had been raised prior to inoculation with helminths, for example in response to harmless substances such as food proteins, these will typically also be controlled eventually by the action of the worms. Once helminths have been hosted continuously for a period of time, eosinophil numbers usually decline and can eventually disappear with chronic helminth exposure, although they usually remain slightly elevated indefinitely in helminth hosts.

{{Quote|indent}}My eos were elevated for a while, but they did eventually go back to normal. [https://www.facebook.com/groups/htsupport/permalink/1427417583980859/?comment_id=1428623633860254&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had elevated eosinophils for a while (4-5 months) and then it dropped down to normal range. I have continued to inoculate with hookworms for the next 4 months and my eosinophils are still not elevated. [https://www.facebook.com/groups/htsupport/posts/4290369437685645/]{{Quote|/indent}}

Eosinophil levels vary according to the species and number of helminths being hosted, the length of time they've been present in the host and the host's genetics. In the case of NA, they usually begin to rise from week 2 following inoculation, then rise more rapidly from week 4 and peak at around weeks 6-7, before reducing gradually again and returning to normal at around 14 weeks, or remaining slightly elevated thereafter. The lower eosinophil levels seen at 14 weeks and beyond are an indication that the worms are doing their job and moderating the body's immune response.

[[file:Initial eosinophil counts in NA hosts.jpg]]

(From: [https://www.researchgate.net/publication/6674179_Dose-ranging_study_for_trials_of_therapeutic_infection_with_necator_Americanus_in_humans Dose-ranging study for trials of therapeutic infection with Necator americanus in humans])

Measurement scales vary according to geographic location, and someone from the US reported that, after his first inoculation with hookworms, his eosinophil counts rose from a baseline of about 300 to a peak of 4100 at 5 weeks, dropped to 2300 at 12 weeks, and then reduced to 1300 at 14 weeks. After a 2nd inoculation, his eosinophils rose to 2300 at week 8, dropped back to 2100 at week 12, and then down to 1300 at week 14. Following a 3rd inoculation, his eosinophils reached 1700 at 7 weeks before falling to 600 at week 11.

Someone else has reported that, eight months before introducing NA, they had an eosinophil level of 300/mm3. Nine weeks after their first dose of NA (and while also taking HDC), their eosinophils had increased to 2449/mm3 and, by 22 weeks, they had reduced to 1360/mm3. At almost 15 weeks after a second dose, their eosinophils had risen back up to 2900/mm3. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1475888832467067&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

An eosinophil count of, say, 600, prior to infection with helminths, might be indicative of allergies, but counts in the thousands are more suggestive of the presence of helminths. However, a high eosinophil level does not necessarily indicate that a person is currently infected with helminths, only that they may have been exposed to helminths within the last few weeks or months.

Having an eosinophil level somewhat elevated above 'normal' values does not automatically lead to adverse symptoms.

{{Quote|indent}}Last time I had mine tested they were about double the normal level - and I'm feeling better all the time. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476193139103303&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

{{Quote|indent}}I've been at 6x normal levels and felt no worse than usual. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476229052433045&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

And the increase in eosinophil counts seen in helminth hosts is no reason for concern.

{{Quote|indent}}When I first went to my doctor and he noted a high eosinophilic count he said it was nothing to worry about and could be caused by all sorts of triggers. [https://www.facebook.com/groups/htsupport/posts/5368629826526262?comment_id=5368682726520972&reply_comment_id=5369644643091447]{{Quote|/indent}}

Once human helminths (NA or TT) have been established for three months, the immune response to them, whether to those already in place, or to supplementary doses, is reduced and, the larger the number of worms being hosted, the smaller the resulting rise in eosinophils will be. This is probably the reason why one study found that, out of a total of 621 cases of helminth infection, only 66 cases (10.6%) had related eosinophilia. [http://www.ncbi.nlm.nih.gov/pubmed/26393130]

This is also why side effects - which are dependent on the host’s immune response - are much less likely and, if they do occur, are so much milder, with subsequent doses when compared with the first dose.

One self-treater, whose eosinophil numbers had always been in the normal range prior to hosting helminths, found that they rose appropriately during several years of hosing NA. But, when he then took a break from the therapy for 3 years, his eosinophil count continued to remain outside the upper limit of normal. [https://www.facebook.com/groups/htsupport/permalink/3566326000089996?comment_id=3581529191903010]

== Potentially adverse effects of excessive eosinophilia ==

Some non-therapeutic helminth species are known to cause hypereosinophilia. [https://pmc.ncbi.nlm.nih.gov/articles/PMC7604902/] [https://pubmed.ncbi.nlm.nih.gov/40575422/] However, the therapeutic helminths (TSO, TTO, NA and HDC) do not do this unless used in excessively large doses. For example, much larger doses of NA than are typically recommended were reported in one isolated case to have caused hypereosinophilia resulting in (reversible) organ damage.
* [[media:Symptomatic_hypereosinophilia_associated_with_Necator_americanus_self-inoculation.pdf | Symptomatic hypereosinophilia associated with Necator americanus self-inoculation]]

== See also ==

* [http://www.medicalnewstoday.com/articles/311601.php Eosinophils: All You Need to Know]

* [https://www.ncbi.nlm.nih.gov/pubmed/31977298 Contributions of Eosinophils to Human Health and Disease]

* [http://www.pharmaceutical-journal.com/learning/learning-article/drug-inducedeosinophilia/20000049.article Drug-induced eosinophilia]

*[https://pubmed.ncbi.nlm.nih.gov/34733292/ Emerging Role of Eosinophils in Resolution of Arthritis] — [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/pdf/fimmu-12-764825.pdf PDF]

* [[Mechanisms underlying helminth colonization#Eosinophils | '''Mechanisms underlying helminth colonization: Eosinophils''']]

* [[Helminthic therapy and eosinophilic esophagitis (EE / EoE) | '''Helminthic therapy and eosinophilic esophagitis (EE / EoE)''']]

* [[Helminthic therapy and neutrophils | '''Helminthic therapy and neutrophils''']]

Helminthic therapy and eosinophils

2026-05-13T16:36:29Z

John: /* Various */

{{Breadcrumb|[[Effects_of_helminthic_therapy|Effects of helminthic therapy]]}}
{{SEO 
|title=Helminthic therapy and eosinophils
|description=
|keywords=
|og:image=}}
== What are eosinophils? ==

Eosinophils, sometimes called eosinophiles, eosinocytes, or less commonly, acidophils or acidophilic leukocytes, are a variety of white blood cells and one of the immune system components responsible for combatting multicellular parasites and certain infections in vertebrates. Along with mast cells and basophils, they also control mechanisms associated with allergy and asthma. [https://en.wikipedia.org/wiki/Eosinophil]

== The positive role of eosinophils ==

Eosinophil numbers usually increase following exposure to helminths, but this is not an undesirable development. The interactions between eosinophils and intestinal worms are now recognised to be complex and, rather than being detrimental, eosinophils may in fact be an essential component in immunity. They have an important role in cell growth and cell-to-cell interactions. They synthesise, store and secrete cytokines, chemokines, and growth factors, as well as stimulating T cells, interacting with B cells, functioning as antigen-presenting cells, and regulating processes associated with both T1 and T2 immunity. [http://www.ncbi.nlm.nih.gov/pubmed/26690368] They also perform many other essential biological functions.

{{Quote|indent}}… besides their roles in Th2 responses, eosinophils also regulate homeostatic processes at steady state, thereby challenging the exclusive paradigm of the eosinophil as a destructive and inflammatory cell. Indeed, under baseline conditions, eosinophils rapidly leave the bloodstream to enter tissues, mainly the gastrointestinal tract, lungs, adipose tissue, thymus, uterus, and mammary glands, where they regulate a variety of important biological functions, such as immunoregulation, control of glucose homeostasis, protection against obesity, regulation of mammary gland development, and preparation of the uterus for pregnancy. [https://www.ncbi.nlm.nih.gov/pubmed/28744457]{{Quote|/indent}}

One of the contributions made to immune regulation by eosinophils is the production of the cytokine Interleukin-5 (II-5 cytokine) which induces the body’s T-cell front-line defences and has, itself, been shown to be an effective treatment for autoimmune disease. [http://newsroom.unsw.edu.au/news/health/injection-offers-hope-treating-auto-immunedisease] Eosinophils may act as mediators of inflammatory resolution, [https://www.ncbi.nlm.nih.gov/pubmed/28008805] have a crucial role in the prevention of autoimmune diseases such as colitis, [http://www.ncbi.nlm.nih.gov/pubmed/26174763] and contribute to the control of excessive inflammation and tissue damage in solid organ transplants. [https://www.ncbi.nlm.nih.gov/pubmed/31647606]

Small intestinal eosinophils play a pivotal role in the maintenance of intestinal homeostasis, [https://www.ncbi.nlm.nih.gov/pubmed/28261019] including by the regulation of Th17 cells via production of IL-1Ra. [http://www.ncbi.nlm.nih.gov/pubmed/26951334]

Hookworm-induced eosinophils may contribute to a reduced prevalence of latent TB infection. [https://www.ncbi.nlm.nih.gov/pubmed/30619265]

An absence of eosinophils may have a significant impact on the nature of the endogenous gut microflora and responses to gut pathogens, notably Clostridium difficile. [https://www.ncbi.nlm.nih.gov/pubmed/27549754]

{{Quote|indent}}... although all the beneficial roles of eosinophils have yet to emerge, eosinophils, on balance, must be considered friends and not foes. [https://www.ncbi.nlm.nih.gov/pubmed/30197067]{{Quote|/indent}}

== The eosinophil response to helminths ==

In the case of helminth infection, eosinophils are produced by the body to try to rid itself of the invader. The helminths then respond by secreting chemicals to counter the eosinophils and thus protect themselves from being ejected. This produces a typical pattern of firstly increased, and then decreased, eosinophil counts. However, there is not always an eosinophil response to helminths.

{{Quote|indent}}Neither 30 HDC biweekly nor low doses of HW caused increased Eosinophils. My Eosinophils always remained low normal. (Link expired)
Raised eosinophil numbers should always be investigated because they can be a sign of pathology other than a reaction to an allergen or parasite.

Where eosinophil levels had been raised prior to inoculation with helminths, for example in response to harmless substances such as food proteins, these will typically also be controlled eventually by the action of the worms. Once helminths have been hosted continuously for a period of time, eosinophil numbers usually decline and can eventually disappear with chronic helminth exposure, although they usually remain slightly elevated indefinitely in helminth hosts.

{{Quote|indent}}My eos were elevated for a while, but they did eventually go back to normal. [https://www.facebook.com/groups/htsupport/permalink/1427417583980859/?comment_id=1428623633860254&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had elevated eosinophils for a while (4-5 months) and then it dropped down to normal range. I have continued to inoculate with hookworms for the next 4 months and my eosinophils are still not elevated. [https://www.facebook.com/groups/htsupport/posts/4290369437685645/]{{Quote|/indent}}

Eosinophil levels vary according to the species and number of helminths being hosted, the length of time they've been present in the host and the host's genetics. In the case of NA, they usually begin to rise from week 2 following inoculation, then rise more rapidly from week 4 and peak at around weeks 6-7, before reducing gradually again and returning to normal at around 14 weeks, or remaining slightly elevated thereafter. The lower eosinophil levels seen at 14 weeks and beyond are an indication that the worms are doing their job and moderating the body's immune response.

[[file:Initial eosinophil counts in NA hosts.jpg]]

(From: [https://www.researchgate.net/publication/6674179_Dose-ranging_study_for_trials_of_therapeutic_infection_with_necator_Americanus_in_humans Dose-ranging study for trials of therapeutic infection with Necator americanus in humans])

Measurement scales vary according to geographic location, and someone from the US reported that, after his first inoculation with hookworms, his eosinophil counts rose from a baseline of about 300 to a peak of 4100 at 5 weeks, dropped to 2300 at 12 weeks, and then reduced to 1300 at 14 weeks. After a 2nd inoculation, his eosinophils rose to 2300 at week 8, dropped back to 2100 at week 12, and then down to 1300 at week 14. Following a 3rd inoculation, his eosinophils reached 1700 at 7 weeks before falling to 600 at week 11.

Someone else has reported that, eight months before introducing NA, they had an eosinophil level of 300/mm3. Nine weeks after their first dose of NA (and while also taking HDC), their eosinophils had increased to 2449/mm3 and, by 22 weeks, they had reduced to 1360/mm3. At almost 15 weeks after a second dose, their eosinophils had risen back up to 2900/mm3. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1475888832467067&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

An eosinophil count of, say, 600, prior to infection with helminths, might be indicative of allergies, but counts in the thousands are more suggestive of the presence of helminths. However, a high eosinophil level does not necessarily indicate that a person is currently infected with helminths, only that they may have been exposed to helminths within the last few weeks or months.

Having an eosinophil level somewhat elevated above 'normal' values does not automatically lead to adverse symptoms.

{{Quote|indent}}Last time I had mine tested they were about double the normal level - and I'm feeling better all the time. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476193139103303&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

{{Quote|indent}}I've been at 6x normal levels and felt no worse than usual. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476229052433045&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

And the increase in eosinophil counts seen in helminth hosts is no reason for concern.

{{Quote|indent}}When I first went to my doctor and he noted a high eosinophilic count he said it was nothing to worry about and could be caused by all sorts of triggers. [https://www.facebook.com/groups/htsupport/posts/5368629826526262?comment_id=5368682726520972&reply_comment_id=5369644643091447]{{Quote|/indent}}

Once human helminths (NA or TT) have been established for three months, the immune response to them, whether to those already in place, or to supplementary doses, is reduced and, the larger the number of worms being hosted, the smaller the resulting rise in eosinophils will be. This is probably the reason why one study found that, out of a total of 621 cases of helminth infection, only 66 cases (10.6%) had related eosinophilia. [http://www.ncbi.nlm.nih.gov/pubmed/26393130]

This is also why side effects - which are dependent on the host’s immune response - are much less likely and, if they do occur, are so much milder, with subsequent doses when compared with the first dose.

One self-treater, whose eosinophil numbers had always been in the normal range prior to hosting helminths, found that they rose appropriately during several years of hosing NA. But, when he then took a break from the therapy for 3 years, his eosinophil count continued to remain outside the upper limit of normal. [https://www.facebook.com/groups/htsupport/permalink/3566326000089996?comment_id=3581529191903010]

== Various ==

The cases described in the following paper involved helminth species that are not used in helminthic therapy.

* 2025 Jun 26 [https://pubmed.ncbi.nlm.nih.gov/40575422/ Eosinophilic myocarditis due to parasitic infection: A case-based minireview]

== See also ==

* [http://www.medicalnewstoday.com/articles/311601.php Eosinophils: All You Need to Know]

* [https://www.ncbi.nlm.nih.gov/pubmed/31977298 Contributions of Eosinophils to Human Health and Disease]

* [http://www.pharmaceutical-journal.com/learning/learning-article/drug-inducedeosinophilia/20000049.article Drug-induced eosinophilia]

*[https://pubmed.ncbi.nlm.nih.gov/34733292/ Emerging Role of Eosinophils in Resolution of Arthritis] — [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/pdf/fimmu-12-764825.pdf PDF]

* [[Mechanisms underlying helminth colonization#Eosinophils | '''Mechanisms underlying helminth colonization: Eosinophils''']]

* [[Helminthic therapy and eosinophilic esophagitis (EE / EoE) | '''Helminthic therapy and eosinophilic esophagitis (EE / EoE)''']]

* [[Helminthic therapy and neutrophils | '''Helminthic therapy and neutrophils''']]

Helminthic therapy and eosinophils

2026-05-13T15:59:11Z

John: /* Various */

{{Breadcrumb|[[Effects_of_helminthic_therapy|Effects of helminthic therapy]]}}
{{SEO 
|title=Helminthic therapy and eosinophils
|description=
|keywords=
|og:image=}}
== What are eosinophils? ==

Eosinophils, sometimes called eosinophiles, eosinocytes, or less commonly, acidophils or acidophilic leukocytes, are a variety of white blood cells and one of the immune system components responsible for combatting multicellular parasites and certain infections in vertebrates. Along with mast cells and basophils, they also control mechanisms associated with allergy and asthma. [https://en.wikipedia.org/wiki/Eosinophil]

== The positive role of eosinophils ==

Eosinophil numbers usually increase following exposure to helminths, but this is not an undesirable development. The interactions between eosinophils and intestinal worms are now recognised to be complex and, rather than being detrimental, eosinophils may in fact be an essential component in immunity. They have an important role in cell growth and cell-to-cell interactions. They synthesise, store and secrete cytokines, chemokines, and growth factors, as well as stimulating T cells, interacting with B cells, functioning as antigen-presenting cells, and regulating processes associated with both T1 and T2 immunity. [http://www.ncbi.nlm.nih.gov/pubmed/26690368] They also perform many other essential biological functions.

{{Quote|indent}}… besides their roles in Th2 responses, eosinophils also regulate homeostatic processes at steady state, thereby challenging the exclusive paradigm of the eosinophil as a destructive and inflammatory cell. Indeed, under baseline conditions, eosinophils rapidly leave the bloodstream to enter tissues, mainly the gastrointestinal tract, lungs, adipose tissue, thymus, uterus, and mammary glands, where they regulate a variety of important biological functions, such as immunoregulation, control of glucose homeostasis, protection against obesity, regulation of mammary gland development, and preparation of the uterus for pregnancy. [https://www.ncbi.nlm.nih.gov/pubmed/28744457]{{Quote|/indent}}

One of the contributions made to immune regulation by eosinophils is the production of the cytokine Interleukin-5 (II-5 cytokine) which induces the body’s T-cell front-line defences and has, itself, been shown to be an effective treatment for autoimmune disease. [http://newsroom.unsw.edu.au/news/health/injection-offers-hope-treating-auto-immunedisease] Eosinophils may act as mediators of inflammatory resolution, [https://www.ncbi.nlm.nih.gov/pubmed/28008805] have a crucial role in the prevention of autoimmune diseases such as colitis, [http://www.ncbi.nlm.nih.gov/pubmed/26174763] and contribute to the control of excessive inflammation and tissue damage in solid organ transplants. [https://www.ncbi.nlm.nih.gov/pubmed/31647606]

Small intestinal eosinophils play a pivotal role in the maintenance of intestinal homeostasis, [https://www.ncbi.nlm.nih.gov/pubmed/28261019] including by the regulation of Th17 cells via production of IL-1Ra. [http://www.ncbi.nlm.nih.gov/pubmed/26951334]

Hookworm-induced eosinophils may contribute to a reduced prevalence of latent TB infection. [https://www.ncbi.nlm.nih.gov/pubmed/30619265]

An absence of eosinophils may have a significant impact on the nature of the endogenous gut microflora and responses to gut pathogens, notably Clostridium difficile. [https://www.ncbi.nlm.nih.gov/pubmed/27549754]

{{Quote|indent}}... although all the beneficial roles of eosinophils have yet to emerge, eosinophils, on balance, must be considered friends and not foes. [https://www.ncbi.nlm.nih.gov/pubmed/30197067]{{Quote|/indent}}

== The eosinophil response to helminths ==

In the case of helminth infection, eosinophils are produced by the body to try to rid itself of the invader. The helminths then respond by secreting chemicals to counter the eosinophils and thus protect themselves from being ejected. This produces a typical pattern of firstly increased, and then decreased, eosinophil counts. However, there is not always an eosinophil response to helminths.

{{Quote|indent}}Neither 30 HDC biweekly nor low doses of HW caused increased Eosinophils. My Eosinophils always remained low normal. (Link expired)
Raised eosinophil numbers should always be investigated because they can be a sign of pathology other than a reaction to an allergen or parasite.

Where eosinophil levels had been raised prior to inoculation with helminths, for example in response to harmless substances such as food proteins, these will typically also be controlled eventually by the action of the worms. Once helminths have been hosted continuously for a period of time, eosinophil numbers usually decline and can eventually disappear with chronic helminth exposure, although they usually remain slightly elevated indefinitely in helminth hosts.

{{Quote|indent}}My eos were elevated for a while, but they did eventually go back to normal. [https://www.facebook.com/groups/htsupport/permalink/1427417583980859/?comment_id=1428623633860254&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had elevated eosinophils for a while (4-5 months) and then it dropped down to normal range. I have continued to inoculate with hookworms for the next 4 months and my eosinophils are still not elevated. [https://www.facebook.com/groups/htsupport/posts/4290369437685645/]{{Quote|/indent}}

Eosinophil levels vary according to the species and number of helminths being hosted, the length of time they've been present in the host and the host's genetics. In the case of NA, they usually begin to rise from week 2 following inoculation, then rise more rapidly from week 4 and peak at around weeks 6-7, before reducing gradually again and returning to normal at around 14 weeks, or remaining slightly elevated thereafter. The lower eosinophil levels seen at 14 weeks and beyond are an indication that the worms are doing their job and moderating the body's immune response.

[[file:Initial eosinophil counts in NA hosts.jpg]]

(From: [https://www.researchgate.net/publication/6674179_Dose-ranging_study_for_trials_of_therapeutic_infection_with_necator_Americanus_in_humans Dose-ranging study for trials of therapeutic infection with Necator americanus in humans])

Measurement scales vary according to geographic location, and someone from the US reported that, after his first inoculation with hookworms, his eosinophil counts rose from a baseline of about 300 to a peak of 4100 at 5 weeks, dropped to 2300 at 12 weeks, and then reduced to 1300 at 14 weeks. After a 2nd inoculation, his eosinophils rose to 2300 at week 8, dropped back to 2100 at week 12, and then down to 1300 at week 14. Following a 3rd inoculation, his eosinophils reached 1700 at 7 weeks before falling to 600 at week 11.

Someone else has reported that, eight months before introducing NA, they had an eosinophil level of 300/mm3. Nine weeks after their first dose of NA (and while also taking HDC), their eosinophils had increased to 2449/mm3 and, by 22 weeks, they had reduced to 1360/mm3. At almost 15 weeks after a second dose, their eosinophils had risen back up to 2900/mm3. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1475888832467067&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

An eosinophil count of, say, 600, prior to infection with helminths, might be indicative of allergies, but counts in the thousands are more suggestive of the presence of helminths. However, a high eosinophil level does not necessarily indicate that a person is currently infected with helminths, only that they may have been exposed to helminths within the last few weeks or months.

Having an eosinophil level somewhat elevated above 'normal' values does not automatically lead to adverse symptoms.

{{Quote|indent}}Last time I had mine tested they were about double the normal level - and I'm feeling better all the time. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476193139103303&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

{{Quote|indent}}I've been at 6x normal levels and felt no worse than usual. [https://www.facebook.com/groups/htsupport/permalink/1475865499136067/?comment_id=1476166482439302&reply_comment_id=1476229052433045&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

And the increase in eosinophil counts seen in helminth hosts is no reason for concern.

{{Quote|indent}}When I first went to my doctor and he noted a high eosinophilic count he said it was nothing to worry about and could be caused by all sorts of triggers. [https://www.facebook.com/groups/htsupport/posts/5368629826526262?comment_id=5368682726520972&reply_comment_id=5369644643091447]{{Quote|/indent}}

Once human helminths (NA or TT) have been established for three months, the immune response to them, whether to those already in place, or to supplementary doses, is reduced and, the larger the number of worms being hosted, the smaller the resulting rise in eosinophils will be. This is probably the reason why one study found that, out of a total of 621 cases of helminth infection, only 66 cases (10.6%) had related eosinophilia. [http://www.ncbi.nlm.nih.gov/pubmed/26393130]

This is also why side effects - which are dependent on the host’s immune response - are much less likely and, if they do occur, are so much milder, with subsequent doses when compared with the first dose.

One self-treater, whose eosinophil numbers had always been in the normal range prior to hosting helminths, found that they rose appropriately during several years of hosing NA. But, when he then took a break from the therapy for 3 years, his eosinophil count continued to remain outside the upper limit of normal. [https://www.facebook.com/groups/htsupport/permalink/3566326000089996?comment_id=3581529191903010]

== Various ==

The cases described in the following paper refer to helminth species that are not used in helminthic therapy.

* 2025 Jun 26 [https://pubmed.ncbi.nlm.nih.gov/40575422/ Eosinophilic myocarditis due to parasitic infection: A case-based minireview]

== See also ==

* [http://www.medicalnewstoday.com/articles/311601.php Eosinophils: All You Need to Know]

* [https://www.ncbi.nlm.nih.gov/pubmed/31977298 Contributions of Eosinophils to Human Health and Disease]

* [http://www.pharmaceutical-journal.com/learning/learning-article/drug-inducedeosinophilia/20000049.article Drug-induced eosinophilia]

*[https://pubmed.ncbi.nlm.nih.gov/34733292/ Emerging Role of Eosinophils in Resolution of Arthritis] — [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8558534/pdf/fimmu-12-764825.pdf PDF]

* [[Mechanisms underlying helminth colonization#Eosinophils | '''Mechanisms underlying helminth colonization: Eosinophils''']]

* [[Helminthic therapy and eosinophilic esophagitis (EE / EoE) | '''Helminthic therapy and eosinophilic esophagitis (EE / EoE)''']]

* [[Helminthic therapy and neutrophils | '''Helminthic therapy and neutrophils''']]

Hookworm dosing and response

2026-05-13T15:56:52Z

John: /* Larger doses may potentially cause organ damage in rare cases */

{{Breadcrumb|[[Using_helminths|Using helminths]]}}
{{SEO 
|title=
|description=A guide to the therapeutic use of the human hookworm, Necator americanus (NA). How to minimise initial side effects and maximise long-term benefits.
|keywords=
|og:image=}}
This page discusses the therapeutic use of the human hookworm, Necator americanus (NA) [https://en.wikipedia.org/wiki/Necator_americanus].
The other species of human hookworm, [[Ancylostoma duodenale | '''Ancylostoma duodenale''']] is not suitable for general therapeutic use because it causes up to 10 times more blood loss than Necator, can infect a foetus by crossing the placenta, and is also able to migrate via breast milk.

== Therapeutic response ==

=== The success of hookworm therapy cannot be predicted ===

At the present time, it is not possible to predict who will benefit from hookworm therapy, nor to what extent a condition might respond, but factors that favour a better outcome include:

* being young
* having been ill for a shorter period of time
* having a less severe form of a disease

The severity of skin response to the initial inoculation is not a reliable guide to the likely extent of success with the therapy.
{{Quote|indent}}My first dose I had quite a severe reaction at the site, blisters & marks that lasted for ever (but, in three years) I have had no benefits to my allergies at all. [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/topics/9666] {{Quote|/indent}}

=== Early benefits are possible but not common, and they may fluctuate ===

A few people may begin to see benefits at an early stage, but these don't become consistent until at least 12 weeks.

{{Quote|indent}}… within less than a day, I felt almost giddy and stronger and was breathing so much better. I started eating foods that I had so sorely missed and had very minimal reactions. [https://helminthictherapywiki.org/wiki/Treating_SIBO_and_metal_allergy_with_helminthic_therapy]{{Quote|/indent}}
{{Quote|indent}}I had significant relief from chronic nasal congestion on the day after I first inoculated with NA. [https://www.facebook.com/groups/htsupport/permalink/2132622226793721/?comment_id=2133017796754164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I felt incredible the first days, like I didn't in years. [https://www.facebook.com/groups/htsupport/permalink/2132622226793721/?comment_id=2133006080088669&reply_comment_id=2133531650036112&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}At 19 days it was like a miracle for me. I felt better than I had in years. But it took a lot longer (and additional inoculations) before I got to 95% better.” [https://www.facebook.com/groups/htsupport/permalink/1018040368251918/?comment_id=1018165394906082&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}
{{Quote|indent}}Six weeks for me. [https://www.facebook.com/groups/htsupport/permalink/1797195290336418/?comment_id=1798066173582663&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I saw results for asthma relief at 8 weeks after my first dose of NA. [https://www.facebook.com/groups/htsupport/permalink/1784511358271478/?comment_id=1785730818149532&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I started getting improvement at around 8 - 10 weeks.” [https://www.facebook.com/groups/htsupport/permalink/898919560164000/?comment_id=899034503485839&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}

=== Disease symptoms may worsen before improving ===

Disease symptoms frequently worsen during the first few months before beginning to improve. One individual, who had had daily headaches and frequent migraines for many years, saw his symptoms worsen slightly in the first 4
months after his first dose. [http://www.foodsmatter.com/natural_medicine_comp_therapies/helminthic_therapy/articles/headache_migraine.html]

=== Consistent improvement can begin anytime from 3 to 24 months ===

For the majority of those who do eventually respond, significant benefits do not usually materialise until at least 3 months after the first inoculation, with most people only seeing improvement in their condition between 3 and 6 months.

{{Quote|indent}}I had no benefit at all until about 14 or 15 weeks, and it took until 23 weeks for anything significant to improve. [https://www.facebook.com/groups/htsupport/permalink/1130105977045356/?comment_id=1130218810367406&reply_comment_id=1130309123691708&comment_tracking=%7B%22tn%22:%22R9%22%7D]{{Quote|/indent}}
{{Quote|indent}}I had chronic idiopathic urticaria and it took 5 and a half months from first NA dose until I was able to come off all meds. [https://www.facebook.com/groups/htsupport/permalink/878299078892715/?comment_id=878319992223957&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

'''Some only start to improve between 6 and 12 months.'''

{{Quote|indent}}It took nine months before I saw improvement of my eczema. [https://www.facebook.com/groups/htsupport/permalink/2069397123116232/?comment_id=2069688246420453&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I have food intolerances IBS and Graves' disease. Inoculated 9 months ago and am now starting to see an improvement with IBS and food intolerance. (Link expired){{Quote|/indent}}

{{Quote|indent}}Did not see positive results until 9th or 10th month. [https://www.facebook.com/groups/htsupport/permalink/2192416407480969/?comment_id=2193017184087558&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}My daughter was under a year when we started and it took 10 months to see consistent results. In between that there were improvements on and off. Though it felt like forever at the time, the 10 months really isn’t much time for the amazing quality of her life now. 2½ years later, she improves more and more. [https://www.facebook.com/groups/htsupport/permalink/2305032642886011/?comment_id=2305581779497764&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

'''Others have to wait for more than a year.'''

{{Quote|indent}}It definitely takes a while! I'm in month 14 and I had my fair share of doubt and periods that felt quite bad. But things have been incredibly stable and calm for long periods of time and I can now safely say that I'm seeing amazing benefits. [https://www.facebook.com/groups/htsupport/permalink/2726061500783121?comment_id=3922843074438285]{{Quote|/indent}}

{{Quote|indent}}At 16½ months, I think my hookworms and whipworms are really starting to work! Since (two weeks ago), I have had only 3 loose stools… I have more periods of relief than periods of exacerbation from my nasal inflammation and asthma. [https://www.facebook.com/groups/htsupport/permalink/1211935162195770/]{{Quote|/indent}}

{{Quote|indent}}It took a good 12-18 months to be able to say, yep, **definitely** much better and staying better. [https://www.facebook.com/groups/htsupport/permalink/1273694002686552/?comment_id=1273850562670896&reply_comment_id=1274363265952959&comment_tracking=%7B%22tn%22%3A%22R9%22%7D]{{Quote|/indent}}

{{Quote|indent}}18 month update. After hitting the one year mark with no improvement I was starting to get discouraged… Finally, a couple weeks ago, everything changed. I was able to eat regular foods again. [https://www.facebook.com/groups/htsupport/permalink/1035915279797760/]{{Quote|/indent}}

{{Quote|indent}}I was about 20 months into treatment before seeing really significant gains. [https://www.facebook.com/groups/htsupport/permalink/1215678598488093/?comment_id=1215696118486341&comment_tracking=%7B%22tn%22%3A%22R4%22%7D]{{Quote|/indent}}

'''In a few cases, the wait has stretched to around 2 years.'''

{{Quote|indent}}I was a year and a half into HT and flaring. My GI wouldn't do my colonoscopy because I was so inflamed he thought I would perf. He thought I should be admitted for IV steroids and started on Remicade. But (at almost 2 years) I have been in complete remission for the past two months and have never felt as good. [https://www.facebook.com/groups/htsupport/permalink/855123671210256/]{{Quote|/indent}}

{{Quote|indent}}I was close to giving up on my little worms, since I saw no discernible improvement for a year and a half (but) I’m glad I stuck with it. One of my most burdensome allergies was oral allergy syndrome and (at nearly 2 years) I can now eat raw food with NO reaction! Blueberries, strawberries, spinach, broccoli... Delicious! I'm the healthiest I've ever been. (A private message, Sept 2013.){{Quote|/indent}}

{{Quote|indent}}It took my (NA) colony a couple of years before feeling my new normal! [https://www.facebook.com/groups/htsupport/posts/5592069827515593/?comment_id=5593646684024574&reply_comment_id=5598549840200925]{{Quote|/indent}}

{{Quote|indent}}I got improvement in about 3 months but my eczema wasn't gone until I'd had NA for a couple years or so. [https://www.facebook.com/groups/htsupport/permalink/3576993069023289/?comment_id=3577189242337005&reply_comment_id=3577828172273112]{{Quote|/indent}}

{{Quote|indent}}I was diagnosed with a scorching case of ankylosing spondylitis. The therapy (NA) cleared up my allergies and asthma quickly but I felt like it would never remedy my extreme soreness that I felt daily. I almost gave up at one point but then, about two years in, I just couldn’t believe it but I started feeling better and better, and ever since then the soreness hasn’t returned. Now I just take low doses of NA for maintenance. [https://www.facebook.com/groups/htsupport/posts/7144790215576872?comment_id=7147425841979976]{{Quote|/indent}}

=== Diseases may continue to flare occasionally up to 18 months ===

Even when benefits appear early in the process, diseases can continue to flare periodically for no apparent reason until around 18 months.

=== The emergence of benefits can be a gradual process ===

The appearance of benefits can be a very gradual process in some people, and follows a natural progression in which '''the amount of time that worms have been hosted can be more important than the number of worms inoculated'''.

{{Quote|indent}}It happened slowly (from 3-6 months post inoculation) and just kind of snuck up on her. [https://www.facebook.com/groups/htsupport/permalink/1562209463835003/?comment_id=1562214417167841&reply_comment_id=1562215200501096&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}I have Hashimoto’s… My thyroid antibodies started slowly decreasing two years ago, when I started HT, first with TSO and then about a year ago with NA. Every time I measured, they were lower. Today for the first time, they are normal. [https://www.facebook.com/groups/htsupport/permalink/1569946083061341/]{{Quote|/indent}}

{{Quote|indent}}It was like day by day I felt better and stopped even thinking about it. Later I looked back and couldn't remember feeling sick. It was just being normal. [https://www.facebook.com/groups/htsupport/permalink/1421002861288998/?comment_id=1421480264574591&reply_comment_id=2013439808711964&comment_tracking=%7B%22tn%22%3A%22R3%22%7D]{{Quote|/indent}}

In another example, someone who had been unable to eat any normal foods for more than a decade began to tolerate a few foods for the first time at 12 weeks, but tolerance to other foods was only regained very gradually, over a period of 18 months. [https://www.helminthictherapywiki.org/wiki/Wriggling_out_of_total_food_intolerance,_M.E._and_Crohns_disease]

Provided that the colony is regularly refreshed, improvements often continue to appear into the third year, and even beyond that, albeit at a gradually slowing rate. The first comment below was written by someone with MS and food sensitivities after hosting hookworms for over 2½ years.

{{Quote|indent}}Of all my food sensitivities, the loss of butter in my life was the most difficult. The last time I tried it was about 6 months ago, and within an hour had a crushing headache, brain fog and fatigue. But last night while I was baking for my dad I just couldn't resist and tried a little butter. And... I was fine! So I tried some more - still ok! And a bit more at breakfast - still no reaction! Yay!!! It looks like butter is back on the menu! In the past few months I was also able to start eating eggs again, and I finally am noticing diminished nerve pain in my fingers - there's still some, but it's noticeably better. [https://www.facebook.com/groups/htsupport/permalink/1522943511094932/] [https://www.facebook.com/groups/htsupport/permalink/1522943511094932/?comment_id=1522960744426542&reply_comment_id=1522964277759522&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}It took 2.5 years before I could eat eggs (which I’d been sensitive to before hookworms). (Link expired){{Quote|/indent}}

{{Quote|indent}}I've recently seen improvements in my reaction to gluten almost 3 years since my first dose of NA. [https://www.facebook.com/groups/htsupport/permalink/1550071498382133/?comment_id=1550216811700935&reply_comment_id=1550949181627698&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1541212462601370/]{{Quote|/indent}}

{{Quote|indent}}I am in 3rd year of therapy now … the improvements are still adding on in terms of overall benefits. (A patient with Crohn's disease.){{Quote|/indent}}

{{Quote|indent}}I’m over 3 years in & I still am able to observe small changes over time. [https://www.facebook.com/groups/htsupport/posts/5375412745847970/?comment_id=5375578435831401]{{Quote|/indent}}

{{Quote|indent}}I have been using NA for 6 years and have noticed greater benefits in the last 2 years. I haven't even had a cold in 2 years and my grass allergy has been cured 100%. I have had no allergy symptoms this year, previously the results were around 80%. [https://www.facebook.com/groups/htsupport/posts/7858221117567108/]{{Quote|/indent}}

{{Quote|indent}}I have been on NA for 6 years now and feel I get better all the time. [https://www.facebook.com/groups/htsupport/posts/7858221117567108?comment_id=7858913214164565]{{Quote|/indent}}

=== Different conditions in the same host may respond at different times ===

Where someone has more than one condition, these may take different lengths of time to respond. One subject experienced an unusually early response when his nasal congestion began to ease on the day after his first inoculation, but his Restless Leg Syndrome only began to reduce during week 5, and took 19 weeks to resolve completely. And, while a few of his food intolerances began to ease at 12 weeks, it was 18 months before he was able to eat all foods again.

A child with “terrible contact dermatitis and severe eczema from multiple food allergies” had mostly clear skin by 9 months after her first inoculation with hookworms, but her food allergies only began to disappear at 19 months. [https://www.facebook.com/groups/htsupport/permalink/2253235874732355/]

=== People with several conditions may not see improvement in all of them ===

{{Quote|indent}}I do HT for severe food intolerance and I achieved almost full remission, although it didn't do anything for my runny nose and only a little for the CFS. [https://www.facebook.com/groups/htsupport/permalink/795036227219001/?comment_id=799437026778921&offset=0&total_comments=41] {{Quote|/indent}}

=== Response may vary from one inoculation to another ===

{{Quote|indent}}I have found my response to each inoculation to be different. Some caused few symptoms, some caused a complete melt down. And some resulted in little or no improvement, some brought immediate improvement, some brought very slow incremental change. I’m on my 9th dose and it’s been rough, while the 8th was easy. [https://www.facebook.com/groups/htsupport/permalink/1915345108521435/?comment_id=1915353551853924&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

The self-treater who reported this, added that, in her case, new symptoms which appear after an inoculation can last anywhere from a couple of days to 6 months. [https://www.facebook.com/groups/htsupport/permalink/1915345108521435/?comment_id=1915353551853924&reply_comment_id=1915361221853157&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

=== For benefits to last, a hookworm colony needs regular maintenance ===

Although it appears that a few individuals may be able to enjoy a continuation of some benefits after hookworms are lost, [https://www.facebook.com/groups/htsupport/permalink/1083130855076202/] benefits will only continue in the vast majority of cases for as long as the colony is actively maintained by adding periodic top-up doses.

{{Quote|indent}}Needing to stay topped up with the worms is a lesson I have had to learn the hard way… I had taken 3 doses over a period of 9 months. Then no new worms for 5-6 months… Nearly all of my old symptoms have returned fairly quickly. At first, I thought I had killed them off. But they are aging. [https://www.facebook.com/groups/htsupport/permalink/1475611862494764/?comment_id=1475874509135166&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

=== See also ===

For more detail about what to expect at each stage of hookworm therapy, see the following page.

* [[Hookworm_timeline|'''Hookworm Timeline''']]

== Introduction to hookworm dosing ==

Hookworm dosing cannot be reduced to a formula because everyone is different in how they respond to helminths.

It is not necessary to use the large doses that were advocated by the early pioneers of this therapy, typically starting with a dose of 25 or 35 hookworm larvae, followed in some cases by even larger supplementary doses.

'''A dose of 5 larvae has proved to be an effective introduction, and this number minimises the side effects that are a common feature of the early experience of hookworm therapy.'''

For more detail about the possible side effects, see the following page.

* [[Hookworm side effects|'''Hookworm side effects''']].

If starting with 5 larvae, most hookworm hosts should be free from side effects by 12 weeks, so would be able to add a further dose at this point. However, more worms should not be added until all the side effects caused by the first dose have completely subsided, along with any exacerbation of symptoms of the disease being treated. Otherwise, there could be an aggregation, or "stacking", of side effects from both doses. Apart from the host having to endure these side effects, along with any disease exacerbations caused by the introduction of hookworms, the increased inflammation caused by adding too many worms too quickly may be sufficient to prevent at least some of the new worms from attaching to the gut lining.

For someone who is very sick, it can be tempting to try to speed up the therapy process in the early stages by adding more worms as quickly as possible, but this can be counterproductive, possibly causing such severe side effects that it would be necessary to terminate the colony and start over.

'''Disease remission is brought about not so much by the number of worms being hosted as by the length of time that worms have been present. There is nothing to be gained by attempting to reach a notional maximum number of worms in any particular time frame. All that is required is that the colony is refreshed by periodic top-ups.'''

{{Quote|indent}}Time is your best friend when it comes to autoimmune disease and HT. [https://www.facebook.com/groups/htsupport/permalink/333269553395673/?comment_id=1569246259797990&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

Once disease remission is achieved, the size and frequency of doses can be determined more accurately by observing how long it takes for signs of one’s disease to return after a dose, and using this information to establish a dosing regimen that will maintain uninterrupted remission. A period of experimentation is usually required, and '''hookworm hosts should keep a record of the size and dates of all their doses'''.

{{Quote|indent}}I now realise that the dosage, intervals and maintenance of HT is ongoing and requires lots of attention, which if I’m being honest I wasn’t expecting.{{Quote|/indent}}

{{Quote|indent}}I've been doing it for 5 years and still learning and trying to figure out my dosing. [https://www.facebook.com/groups/htsupport/posts/4558046087584644/?comment_id=4558173157571937&reply_comment_id=4561086870613899]{{Quote|/indent}}

{{Quote|indent}}I'm still figuring out the number of worms best for me, 5 years into this. For some of us, it's much more complicated than ‘take worms, get better'.{{Quote|/indent}}
<div style="background-color:#FFF5FA; border:1px solid #F2CEDD; padding:8px; padding-left:8px; margin-bottom:12px;">

== '''Hookworm dosing in a nutshell''' ==

1. Start with between 3 and 5 NA larvae. (For children, see [[Hookworm dosing and response#Hookworm dosing in children | '''Hookworm dosing in children''']] below.)
:Anyone who is hypersensitive or has one of [[Helminthic therapy safety#Conditions that require a modified approach to helminth dosing | '''several particular conditions''']], should start with between 1 and 3 larvae.

:Doses larger than these are not necessary and may cause undue [[Hookworm side effects | '''side effects''']], or may result in the flaring of symptoms of an existing disease, either of which might require termination of the colony and a fresh start. Too many larvae may even cause [[Hookworm dosing and response#Excessive hookworm doses have caused long-term harm in a few cases | '''long-term harm''']].

:The risk of side effects from the initial dose of NA can be further reduced by taking a few small doses of TSO - perhaps just 250 ova every two weeks - before introducing the NA. [https://www.facebook.com/groups/htsupport/posts/24319389764356983?comment_id=24325028723793087&reply_comment_id=24325068290455797] For more about this, see [[Selecting a therapeutic helminth#To modulate the severity of an NA inoculation rash | '''here''']] and [[Self-treating with TSO#Dividing doses | '''here''']].

2. Supplementary doses can be added at intervals of no less than 12 weeks, but not until all side effects from the previous dose have resolved.

:It can be tempting to quickly increase the number of hookworms being hosted by escalating the number in each dose, but [[Hookworm dosing and response#Just 3-5 larvae can be surprisingly effective | '''doses of 5 NA will do everything that is needed''']] in the first 6 months, and [[Hookworm dosing and response#Some people need to restrict supplementary doses to 5 larvae or less | '''10 can be too many for some people''']].

:Once small doses are well tolerated, the number of larvae in subsequent doses can, if necessary, be increased '''''gradually''''' while being careful to avoid overdosing, which can cause side effects.

:There is [[Hookworm dosing and response#Colony size | '''no need to aim for any particular colony size''']]. All that is necessary is to regularly add fresh doses to ensure that there are always vibrant young adult worms present in the gut.

3. Once benefits have appeared ([[Hookworm dosing and response#Consistent improvement can begin anytime from 3 to 24 months|'''beginning between 3 and 24 months''']]), experiment to find the number of worms per dose, and the interval between doses, that will [[Hookworm dosing and response#Long-term dosing is based on individual user experience | '''optimise those benefits''']].

:The ideal long-term dose size and frequency [[Hookworm dosing and response#Long-term dosing in practice | '''vary between self-treaters by a factor of 10''']].

4. Keep dosing under review indefinitely because the need for worms can change over time, requiring [[Hookworm dosing and response#Dose size and frequency may need adjustment over time | '''re-optimisation of the dosing regimen''']].

5. It is essential to continue to maintain a colony indefinitely, without breaks, because hookworms can only provide health benefits while they are present in the gut.

'''See the rest of this page for full details about each of the above steps'''.

</div>

== The evolution of hookworm dosing ==

'''The early providers had limited evidence on which to base dosing'''

When the first company to sell hookworms online was established in 2007, researchers working with hookworms were still at the stage of carrying out preliminary experiments, including on themselves, in an attempt to establish what number of NA larvae might be suitable for use in reintroducing this species into helminth-naive subjects for experimental purposes. Their preliminary research had established that introductory doses of 50 NA were too much for the recipients, [http://www.dailymail.co.uk/health/article-434226/Madman-hero-The-medical-maverick-let-50-hookworms-burrow-arm.html] but found that 10 larvae were well tolerated and elicited a modest host eosinophil response. [https://www.ncbi.nlm.nih.gov/pubmed/17123987] Beyond these experiments, there was little information to help the commercial hookworm providers in deciding what doses they should recommend to their customers.

The two individuals behind the first online hookworm vendor separated early in their association to form two separate companies - Autoimmune Therapies (AIT) and Worm Therapy - which recommended different doses for those commencing hookworm therapy. In the case of AIT, a first dose of 35 larvae was followed by two doses of 50 larvae at 12 week intervals. Worm Therapy started their new clients with a dose of 25 larvae, and based the size and timing of subsequent doses on the recipient’s response to their first dose.

Numerous early hookworm self-treaters who used these two regimens reported significant side effects from the doses they were supplied, especially clients of AIT. One self-treater had to contend with 19 weeks of intermittent diarrhoea from weeks 5 to 24 following an initial dose of 35 larvae, and someone who used AIT’s full 35/50/50 sequence was hospitalised with organ damage that required medical treatment. ([[media:Symptomatic_hypereosinophilia_associated_with_Necator_americanus_self-inoculation.pdf|PDF]])

For the first few years after hookworms became available commercially, the only online discussion about helminthic therapy was in a Yahoo forum created and run by AIT, where this company’s approach to dosing was accepted, largely without question.

'''The online community refined dosing based on collective experience'''

After the creation, in 2012, of the independent [https://www.facebook.com/groups/htsupport/ Helminthic Therapy Support group] on Facebook, reports began to emerge of members who appeared to have inoculated with too many hookworms, causing a loss of benefits and a decline in health that necessitated termination of their hookworm colonies. In some cases, the resulting destabilisation of health caused ramifications that lasted for many months, and even [[Hookworm dosing and response#Excessive hookworm doses have caused long-term harm in a few cases| '''several years for a few individuals''']].

As more reports began to emerge of adverse side effects following the dosing protocols that were still in use, particularly by AIT, warnings were issued to Support group members about the risks of inoculating with too many hookworms, especially for those who have one of the conditions that are now listed as [[Helminthic therapy safety#Conditions that require a modified approach to helminth dosing | '''requiring a modified approach to helminth dosing''']].

When this Helminthic Therapy Wiki was founded, in January 2017, this Hookworm Dosing and Response page became the repository for all the details about hookworm dosing that had been collected from posts to the Support group and elsewhere. This material showed very clearly that the previous approach to hookworm dosing had been flawed, and that not only are much smaller introductory doses preferable from the point of view of minimising side effects, but that they can often produce the same level of efficacy as larger introductory doses, and provide a solid foundation for longterm dosing which might, for some self-treaters, eventually include much larger supplementary doses.

'''New providers embraced the new approach to dosing'''

In 2014, a new breed of hookworm provider began to emerge, beginning with Wormswell (2014-2018), and followed by Symmbio (2016), YourSymbionts (2018) and Au NAturel (2019). These companies not only introduced a more user-friendly, pay-per-dose business model, but also worked more closely with the online community of helminth self-treaters than previous companies had done.

Once this wiki was available, the newer providers all recognised the site as the definitive database of information about all aspects of helminthic therapy, and contributed to the site's development. As the knowledge about hookworm dosing evolved, these companies adopted an increasingly more conservative approach in line with the evidence presented on this page.

AIT continued to apply their introductory 35/50/50 dosing protocol until 2017, except in the case of clients with fibromyalgia, whom they had come to realise require much lower doses. After the company’s attention was drawn to this page, they adopted a new dosing regimen and, by late 2017, had begun to introduce newcomers to the therapy with a dose sequence of 5/5/10/10/20/20 larvae. Worm Therapy, meanwhile, continued to start most of their new clients on a dose of 25 larvae, and persisted with this practice into at least the early part of 2019, even after their attention had been drawn to the data on this page, which they dismissed as being "merely anecdotal". The Llamas Clinic, which was closely associated with Worm Therapy between 2008 and 2018, also prefers to supply doses of 25 NA, and has refused to provide some clients with smaller numbers. In one case, the clinic did agree to send a client a dose of 3 NA, after initially being reluctant to do this, but then [[Helminth provider reviews#The Llamas Clinic | '''actually shipped a dose of 10''']].

Reports received by this wiki in 2020 and 2021 revealed that AIT had by that time reverted to recommending, and routinely supplying, doses of up to 50 NA larvae, even though dosing at this level had previously put at least one of their clients in hospital [[media:Symptomatic hypereosinophilia associated with Necator americanus self-inoculation.pdf | with potentially fatal side effects]]. AIT have apparently even suggested that some of their clients should take supplementary doses of up to 100 larvae if they have failed to achieve the results they had hoped for. Usually, in this situation, most providers of NA will recommend the addition of a different species - typically either TSO or HDC - rather than the use of an excessive number of hookworms, but AIT only sells NA, and appear to rely on this species alone rather than suggesting the use of any other.

'''Obsolete dosing practice is perpetuated outside the online community'''

Medical practitioners with an interest in helminthic therapy who follow the conversation in the Helminthic Therapy Support group had mostly modified their approach to hookworm dosing by the start of 2019, and the majority were starting new patients on a dose of 5 larvae. A few, however, continued to operate in isolation from the online community, and were not keeping up to date via this wiki. Consequently unaware of the reports of severe side effects experienced by some self-treaters, these doctors continued to use a variety of idiosyncratic dosing protocols that often involved excessively large doses, for example, introducing new patients to the therapy with between one and three doses of 25 larvae.

In late 2018, one naturopathic doctor was still starting most of his patients on an initial dose of 25-35 larvae, followed by 2 or 3 doses of 20 larvae at three month intervals and then 5-10 larvae at 2 month intervals, a schedule that is diametrically opposed to what is suggested by user experience, as reported on this page.

In late 2020, another naturopathic doctor who was obviously aware of the need to start with much smaller doses, was nevertheless introducing too many doses in the first 12 weeks. Starting her patients with a single larva, she was adding a second one a week later, then following these with a further 5 larvae every two weeks until a colony of 20 was reached in the tenth week.

There are some self-treaters who are not working with a doctor and who fail to find, or decide to overlook, the advice available on this page, and turn instead to obsolete information found on assorted sites across the internet, which leads them to seek larger hookworm doses than are advisable. Unfortunately, these individuals sometimes even turn a deaf ear to attempts by providers to encourage them to be more conservative in their dosing choices.

'''Hookworm dosing in research centres'''

The hookworm self-treaters who are members of the online community far outnumber the subjects who have taken part in the few formal clinical trials that have been mounted to investigate the therapeutic potential of hookworms, and the researchers involved in these studies have consequently had access to far less data to inform their understanding of the effects of different dose sizes.

Prior to 2006, researchers at Nottingham University had carried out a small dose-ranging study to identify a suitable dose size for their trials of therapeutic infection with NA in humans. [https://www.ncbi.nlm.nih.gov/pubmed/17123987] They concluded from this study that a dose of 10 NA larvae is well tolerated, elicits a modest eosinophilic and antibody response, and was potentially suitable for use in preliminary clinical therapeutic trials. However, after trials using single doses of 10 NA, the team at Nottingham then employed a single dose of 25 NA in their Worms in Relapsing Remitting Multiple Sclerosis (WiRMS) trial that ran from 2011 to 2016. [https://pubmed.ncbi.nlm.nih.gov/32539079/] Other centres investigating the therapeutic effects of hookworms have used doses ranging from 10 to 40 larvae. [https://www.clinicaltrials.gov/ct2/show/NCT00671138] [https://www.clinicaltrials.gov/ct2/show/NCT01661933] [https://www.clinicaltrials.gov/ct2/show/NCT02754609]

The information on this page, condensed from the experience of thousands of citizen scientists in the online community, could be invaluable to medical researchers, if they chose to utilise it. For example, they would come to appreciate the need for implementation of a dose-finding scheme to establish the ideal dose for each individual trial subject, and they would discover the importance of maintaining a hookworm colony by continuing to add supplementary doses at appropriate intervals. Unfortunately, however, medical research has largely ignored the experience of helminth self-treaters and the data presented here.

'''Socio-medical research confirms established best dosing practice'''

Socio-medical research first published in 2020 [https://pubmed.ncbi.nlm.nih.gov/34737071] confirmed what had been learned by self-treaters over the previous decade, viz., that there is such wide variation between individuals in their ability to tolerate helminths, as well as in their therapeutic response to them, that the use of individualised dosing is essential. By 2020, this was already appreciated by the majority of helminth suppliers and those physicians who provide information to self-treaters, and the use of an initial dose-finding approach was being widely recommended and practised in preference to attempting therapy with a standard dose applied to all individuals.

As is explained in detail on the rest of this page, the dose-finding approach used initially in hookworm-naive individuals entails starting with a dose of 3-5 NA larvae and then ''gradually'' working up to higher doses until either symptoms are relieved or adverse side effects indicate a need to reduce dosage. Failure to start with low exposure levels of NA was described by one of the physicians interviewed by the researchers as being irresponsible and fraught with problems.

If future clinical trials are to effectively test the potential of helminthic therapy, they must address the challenge of implementing dose-finding schemes in their subject cohorts. And, if self-treaters are to be guided towards reaping the greatest benefits from this therapy without incurring undue side effects, all helminth providers and advising physicians must also adopt the dose-finding approach.

== The perils of excessive hookworm dosing ==

===Those who began with a dose of 50 or more NA have usually regretted it!===

Early pioneers who inoculated with 50 larvae eventually wished they hadn’t! Prof David Pritchard of Nottingham University School of Pharmacy could not cope with a single inoculation of 50 hookworm larvae, [http://www.dailymail.co.uk/health/article-434226/Madman-hero-The-medical-maverick-let-50-hookworms-burrow-arm.html] and Dr James Logan from the London School of Hygiene and Tropical Medicine, who inoculated with 50 hookworm larvae for a UK TV documentary, had to abort the experiment after 60 days, saying, "I just can't live with the symptoms and the stomach pains.” [https://www.theguardian.com/technology/2013/dec/01/extreme-science-hookworms-james-logan]

Others have expressed similar sentiments.

{{Quote|indent}}I let myself be convinced, without doing my homework, it was OK to inoculate 50 NA at first dose... At 5½ weeks, the asthma-like symptoms and cough are going away, but to be replaced by a dull but unrelenting belly pain and diarrhea that get pretty bad for a while after meals, and waves of mild nausea and unbelievable gas. Day 45, about 6½ weeks... belly ache is nearly gone, but the diarrhea and gas remain... uncomfortable and embarrassing (I can't remember smelling such awful gas or soiling underpants three times in a week before). [https://www.facebook.com/groups/htsupport/permalink/930067010382588/] [https://www.facebook.com/groups/htsupport/permalink/930067010382588/?comment_id=932748006781155&comment_tracking=%7B%22tn%22:%22R2%22%7D] [https://www.facebook.com/groups/htsupport/permalink/930067010382588/?comment_id=936308153091807&comment_tracking=%7B%22tn%22:%22R1%22%7D]{{Quote|/indent}}
{{Quote|indent}}I inoculated with 50 NA 15 weeks ago. Side effects have been really rough... [https://www.facebook.com/groups/htsupport/permalink/1176957935693493/]{{Quote|/indent}}

{{Quote|indent}}I did 50 my first dose too. Not the smartest thing I've ever done... Gut pain until around 12 weeks... ended up killing off my colony and starting over. I did 6, then 6 more after 18 weeks. I'm doing much better now... [https://www.facebook.com/groups/htsupport/permalink/930067010382588/?comment_id=936369313085691&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/930067010382588/?comment_id=936376339751655&reply_comment_id=936397679749521&comment_tracking=%7B%22tn%22:%22R4%22%7D]{{Quote|/indent}}

{{Quote|indent}}They give me migraines for two weeks at a full 50, but a quarter of that is far better for me. [https://www.facebook.com/groups/htsupport/posts/5264181010304478/?comment_id=5265729790149600]{{Quote|/indent}}

{{Quote|indent}}I started with 70, and that was a big mistake. Had to take steroids for 2 months just to tolerate the epigastric pain and increase in immune response. [https://www.facebook.com/groups/htsupport/permalink/840032952719328/?comment_id=840049002717723&offset=0&total_comments=43&comment_tracking=%7B%22tn%22:%22R9%22%7D]{{Quote|/indent}}

=== Doses of 30 or 35 larvae can cause severe side effects ===

{{Quote|indent}}After inoculation (with 30 HW), the joint pain worsened so severely that at some points I could hardly walk or move.” [https://www.facebook.com/groups/htsupport/permalink/884562471599709/]{{Quote|/indent}}
{{Quote|indent}}I started with an initial dose of 30, which gave me horrible side effects and put me out of commission for 3 months. Would not recommend. [https://www.facebook.com/groups/htsupport/permalink/2160599497329327/?comment_id=2162083133847630&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I had to kill my first dose of 35 HW because the GI symptoms were unbearable.{{Quote|/indent}}
{{Quote|indent}}I received a dose of 35 HW about 3 weeks ago and last night I awoke gasping for air because my throat had closed up. It was a harrowing experience that lasted about a minute as I was unable to breathe.” [https://www.facebook.com/groups/htsupport/permalink/884562471599709/]{{Quote|/indent}}
{{Quote|indent}}I am 6 weeks post first inoculation (with 35 hookworms) and experiencing extreme exacerbation of my RA symptoms. It's hard to deal with while wondering if this will actually be worth it. [https://www.facebook.com/groups/htsupport/permalink/884794694909820/?comment_id=885183704870919&offset=0&total_comments=9&comment_tracking=%7B%22tn%22:%22R1%22%7D]{{Quote|/indent}}
{{Quote|indent}}Inoculated with (35) HW 6 weeks ago... I've been getting my ass kicked by worm flu! Week 4 assorted gastric issues, week 5- radical nausea, stomach aches & fatigue. My naturopath prescribed me prednisone (10 days reducing), 3 days left. Not getting better…
(Link expired){{Quote|/indent}}

=== Doses of 20 or 25 larvae can cause very unpleasant effects ===

{{Quote|indent}}I inoculated myself 2 months ago with 25 NA... I am having serious side effect since 2 weeks. Mainly stomach/upper belly pain to the point I am barely able to work. Today I bought mebendazole as I am considering terminating my NA. [https://www.facebook.com/groups/htsupport/permalink/1057160664339888/?comment_id=1058018160920805&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I dosed with 25 NA. I only had a reaction for about 24 hours. Then at 3-4 weeks all hell broke loose and it was horrible for the next 10-12 weeks. I reacted to almost all food. [https://www.facebook.com/groups/htsupport/permalink/1123870124335608/?comment_id=1123955960993691&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I was out of work - unpaid - for 3 weeks (after a dose of 25 NA) because of unbearable agonising stomach pains... I was taking them for allergies, and am otherwise quite healthy (no IBD or anything), so I wasn't expecting serious side effects... As it was I nearly had to terminate them. [https://www.facebook.com/groups/htsupport/permalink/1103921262997161/?comment_id=1104315352957752&comment_tracking=%7B%22tn%22:%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1103921262997161/?comment_id=1104319082957379&comment_tracking=%7B%22tn%22:%22R5%22%7D]{{Quote|/indent}}
{{Quote|indent}}My husband is on day 63 with 25 NA. For the last two weeks he's had intermittent achy body/joint pain, daily diarrhea with stomach pain and last night a low grade fever. It has been getting progressively worse. This morning, for the first time, he said that he was close to his breaking point. [https://www.facebook.com/groups/htsupport/permalink/1179342208788399/]{{Quote|/indent}}
{{Quote|indent}}Exactly 5 days post inoculation (with 25 NA), I awoke in the middle of the night thinking someone was choking me. My throat was burning and closing up fast, causing my breath to rasp in my chest. [http://www.thewayofalpha.com/blog-1/2017/10/10/hook-me-up-treating-autoimmune-disease-with-hookworm-inoculation]{{Quote|/indent}}
{{Quote|indent}}I inoculated with 20 NA (to treat seasonal allergies) and found weeks 5-12 incredibly hard. The stomach pain never resolved itself. I had to up my Prednisone dose and take it almost every day. It's hard to function with that pain. I finally had to take Albenazole (and) my body is now pain free again. I will start again w 5 and go from there… [https://www.facebook.com/groups/htsupport/permalink/1347249521997666/?comment_id=1350891278300157&reply_comment_id=1382441121811839&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1347249521997666/?comment_id=1350030368386248&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}
{{Quote|indent}}My colony was about 30. Then I did 25 thinking I would be fine. Well not the case. I went down hill very fast and eventually had to terminate. [https://www.facebook.com/groups/htsupport/permalink/2074731292582815/?comment_id=2076379749084636&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

=== Too many hookworms may cause Löffler’s (Loeffler's) syndrome ===
The side effects caused by large hookworm doses mostly affect the gastrointestinal tract, causing the typical diarrhoea, cramping and gas, etc., but, sometimes, they may involve the chest, and possibly result in [http://en.wikipedia.org/wiki/L%C3%B6ffler's_syndrome Löffler’s (Loeffler's) syndrome], a type of eosinophilic pneumonia (inflammation of the lung) that is caused by the immune system attacking the larvae during their transit through the lungs. This reaction is similar to those that occur at the site of inoculation on the skin, and in the gut.

Löffler’s Syndrome is most likely to be seen in those with a history of asthma or allergy, and it can manifest as a productive cough and shortness of breath, but possibly also as sinus and other upper respiratory issues. These may last for several weeks, but not necessarily continuously, and, while they do not usually require treatment, they can be very unpleasant. It may therefore be wise to avoid the use of doses of 35 larvae or more in order to obviate the risk of inducing Löffler’s Syndrome.

{{Quote|indent}}I have asthma, and my first inoculation (10 HW) went fine. I inoculated a second time with 35 and kicked off Loffler's Syndrome - the worst bout of respiratory distress I've ever had. My difficulty breathing began around 2 weeks after inoculation, and continued for about 8 weeks. It then subsided, and recently came back again. I have been using inhaled steroids twice a day for the last few months. [https://www.facebook.com/groups/htsupport/permalink/1854741221248491/?comment_id=1855736474482299&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

It is also possible to experience Loffler’s syndrome following inoculation with much smaller doses of NA, especially in those with certain pre-existing conditions - particularly those affecting the lungs - or with certain genetic profiles.

Someone with pulmonary hypertension and interstitial lung disease associated with scleroderma, in addition to a pre-existing [https://en.wikipedia.org/wiki/Strongyloides_stercoralis Strongyloides] infection, developed Loffler’s syndrome after taking a dose of 15 NA following previous doses of 5 and 10, both of which had been side effect-free and produced some improvements in health. All three doses were taken at 12 week intervals. Following the third dose, this individual became so ill that she was hospitalised and required high dose prednisone, even after termination of her NA colony. [https://www.facebook.com/michael.mcevoy.3557/posts/10158246226984281?comment_id=10158427499019281] [https://www.facebook.com/groups/htsupport/permalink/3004108712978397/?comment_id=3004549139601021&reply_comment_id=3005815739474361]

Someone else who developed Loffler’s syndrome following inoculation with NA subsequently discovered, as a result of extensive genetic testing, that she is essentially defenceless against most parasites, so needs to restrict the number of helminths she hosts. [https://www.facebook.com/groups/678894952216125/permalink/2657062394399361/?comment_id=2657069104398690&reply_comment_id=2657219631050304] (Amongst other genetic anomalies, she has an adverse variation of the LTF gene [https://www.genecards.org/cgi-bin/carddisp.pl?gene=LTF&keywords=LTF]. Her testing was carried out by GeneSavvy and reviewed by a doctor experienced in interpreting such tests.)

The latter individual was unaware of her genetic predisposition when she began helminthic therapy, and there will inevitably be others with similar genetic variations who may face severe effects from adding just a few too many NA. Her case is further evidence for why everyone who starts therapy with hookworms should commence with no more than the recommended 3-5 larvae, and should proceed thereafter with caution, only increasing the size of supplementary doses ''very gradually''.

See also

* 2026 Jan [https://pubmed.ncbi.nlm.nih.gov/41161022/ Parasitic-induced Loeffler's syndrome: A systematic review based on clinical reports]

=== Excessive hookworm doses have caused long-term harm in a few cases ===

{{Quote|indent}}As a survivor of the old days when large hookworm doses were common, I STRONGLY recommend starting with small doses. If the recipient has no adverse reaction, it’s easy to increase the next dose. But recovering from doses that are too large is not as simple as just taking some albendazole. I never fully recovered from the effects of my overdoses.

I had undiagnosed MCAS, which was quite mild when I started with NA. My first dose was supposed to be 35, but the provider (AIT) accidentally sent me 50. I was desperate to start because I didn’t want further permanent damage from my MS, so I inoculated with them.

It was a very rough ride, with zero benefits. I added a second dose of 40 on schedule at 12 weeks and all hell broke loose. But… about 11 weeks after that dose I started to see a glimmer of improvement. I wanted to just stick with that for awhile, but my provider insisted I needed my third dose on schedule.

So I took 35 more, and my health went downhill within hours. And I never fully recovered. I ended up with severe eosinophilic pneumonia, a terrible exacerbation of my MS, and MCAS that, to this day, is very difficult to control.

I took albendazole and wiped them all out, with zero improvement. I re-dosed with 6 and started a little recovery, but after a few more small doses, all of the overdose symptoms returned, and I again had to wipe them all out.

I definitely had more benefits from a larger colony, but now my immune system can’t tolerate more than 10-12 NA on board at any one time. I’m 7 years into this therapy, so my acquired hypersensitivity to NA appears to be permanent. I’m quite confident that if I’d taken smaller doses to start with, I could have gotten all the benefits of this therapy without the permanent damage. (Link expired){{Quote|/indent}}

{{Quote|indent}}I started helminthic therapy with hookworms for severe food intolerance. When I began, there were about 10 foods I could more or less tolerate. After 6 months (and with only 10 worms on board) I was back to 40 foods and at the end of the year I could eat 75 foods (and stopped counting). I then had 2 wonderful years eating virtually everything I wanted, but when I again began to experience reactions to foods, and turned to my provider (AIT) for a supplementary dose, they advised me to take 25 hookworms. 10 days after inoculating with them, I crashed. I became very ill and every attempt to eat went wrong. It has taken several years since then for me to be able to tolerate even a very small number of hookworms and I am still far from well. (Via email){{Quote|/indent}}

=== Larger doses may potentially cause organ damage in rare cases ===

There has been one report in the scientific literature of a case of reversible damage to the heart myocardium (in addition to Loeffler’s syndrome affecting the lungs) as a result of hypereosinophilia following inoculation over 7 months with three excessively large doses (35/50/50) of NA.
* [[media:Symptomatic_hypereosinophilia_associated_with_Necator_americanus_self-inoculation.pdf | Symptomatic hypereosinophilia associated with Necator americanus self-inoculation]]

===Prolonged side effects can mask other developing conditions===
Apart from having to cope with the side effects of larger doses of hookworms, there is also a risk that these symptoms could mask other conditions that might develop during a prolonged side effect period, as happened in the following case.
{{Quote|indent}}... the eosinophilia from the worms totally masked my diabetes symptoms for 6 months and would have done so for much longer if i had not aborted them. The extreme thirst, pain in the muscles of the lower leg and lower arm, malaise, overheating, brain fog, etc., are all symptoms of both conditions. Aborting the hookworms got rid of about 80% of the symptoms and I was just about to take a second dose of worming tablets because i thought the remaining symptoms were due to some survivors, when in fact this is what the diabetes was causing. There was no way i could have noticed the diabetes while suffering the extreme reaction I had from HWs.{{Quote|/indent}}

== The first dose ==

===The first dose of NA is best restricted to a maximum of 5 larvae ===

In the first decade of self-treatment with hookworms (2007-2017), introductory doses of up to 35 larvae were recommended by helminth providers, but this quantity often causes severe side effects. Even a dose of 5 NA can produce some side effects, but these are usually manageable at this dosage.

{{Quote|indent}}After my initial dose of 10 Na, I suffered severe UC symptoms. I almost terminated but grunted through. It was tough!! Gut pain and issues were weeks 6-13... After the symptoms subsided, I lowered subsequent dose to 5 then two doses of 10 all about 6 months apart. I had no further negative symptoms. [https://www.facebook.com/groups/htsupport/posts/1650792824976666?comment_id=5171609132895000]{{Quote|/indent}}

{{Quote|indent}}Started with 8 - too many for my system. Should have gone with the recommended 5! [https://www.facebook.com/groups/htsupport/posts/4945535888835660?comment_id=4946346215421294&reply_comment_id=4947381861984396]{{Quote|/indent}}

{{Quote|indent}}I chose to start low and slow, with two doses of 5 NA three months apart (and) I’m so glad I did, because even a small number of NA have caused quite a bit of discomfort, mainly a worsening of autoimmune symptoms. [https://www.facebook.com/groups/htsupport/permalink/2070557689666842/?comment_id=2070606102995334&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

Not only do very small doses keep any side effects to a minimum, but 5, or even 3, NA, are also effective, and start the process of bringing the host's immune system back into balance.

=== Patients with some conditions need to start with 3 larvae or less ===

Anyone with an increased level of sensitivity should start with no more than 3 larvae, especially if they have one of the conditions listed in the following page section.

* [[Helminthic therapy safety#Conditions that require a modified approach to helminth dosing | '''Conditions that require a modified approach to helminth dosing''']]

Here are just two examples of the difficulties experienced by people with hypersensitivities who inoculate with too many hookworms.

Someone with mastocytosis who inoculated with 30 NA ended up in hospital after increasingly high doses of prednisone failed to relieve muscle spasms that were so severe and constant she was literally screaming. She could not even roll over in bed. [https://www.evernote.com/client/snv?noteGuid=43d1c690-4e17-4c43-a29e-6b84dc2df540&noteKey=ba2b70313f14c4003e2645ecfc4b7f0d&sn=https%3A%2F%2Fwww.evernote.com%2Fshard%2Fs229%2Fsh%2F43d1c690-4e17-4c43-a29e-6b84dc2df540%2Fba2b70313f14c4003e2645ecfc4b7f0d&title=Helminthic%2Btherapy%2Bfor%2Bmasto]

And someone with narcolepsy reported as follows.

{{Quote|indent}}I had 10 HW to start and thought I was going to die. But I could do 3. And then another 3. And then I could stand 5.{{Quote|/indent}}

One therapist who works with hypersensitive patients has reported that a dose of 2 larvae appears to give the same benefit as 3, but that this even smaller number produces less of an initial dip in the individual's overall condition before they start to improve. [https://www.facebook.com/groups/htsupport/posts/5798710370184870?comment_id=5842642902458283&reply_comment_id=5846637452058828] The effect of using doses of just 1 larva have been reported to be more "hit and miss". [https://www.facebook.com/groups/htsupport/posts/5798710370184870/?comment_id=5842642902458283&reply_comment_id=5850357621686811]

=== Even 3-5 larvae can cause significant side effects in some people ===

A first dose of 5 larvae can cause significant transient side effects in some people, and not only those who are hypersensitive.

{{Quote|indent}}I had huge side effects from my first dose of 5 NA. I had to take a few days off at the worst moment... I don't have CFS, but I have fatigue and I tire easily. [https://www.facebook.com/groups/htsupport/permalink/1121353877920566/?comment_id=1121581877897766&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}Horrible fatigue today after inoculation for CFS. (At 2 days with 5 NA) [https://www.facebook.com/groups/htsupport/permalink/2092455257477085/]{{Quote|/indent}}

{{Quote|indent}}On the evening of day 3 post inoculation with 5 NA (my first) i started feeling a bit of a headache as I went to bed. I woke up after sleeping about 2 hours with a searing headache and growing nausea. This lasted all night and all the next day. It was very intense and I couldn’t function all day. Around 8pm, however, the headache and nausea suddenly subsided and I was able to eat again and feel pretty normal. [https://www.facebook.com/groups/htsupport/permalink/1694070157315599/?comment_id=1694175967305018&reply_comment_id=1695252557197359&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I started with a five hw dose four days ago. Wasn't sure about starting that low… But joint pain and muscle fatigue started to kick in yesterday and then today with a vengeance… I'm so glad now it was just five I started
with. [https://www.facebook.com/groups/htsupport/permalink/646383922084233/]{{Quote|/indent}}

{{Quote|indent}}After 3 weeks of 5 NA I had an intense reaction. My depression flared, got really sick, had a huge rash break out on my face, lost my appetite and developed hypersomnia. [https://www.facebook.com/groups/htsupport/permalink/3478972928825304/?comment_id=3488684371187493&reply_comment_id=3488858387836758]{{Quote|/indent}}

{{Quote|indent}}I had quite a lot of difficult symptoms from weeks 3-10 post inoculation (with 5 NA): stomach pain, bloating, feeling feverish & really tired. I got through it just, but since I was ill anyway, holding down a job with all that was hard. [https://www.facebook.com/groups/htsupport/permalink/1765694283486519/]{{Quote|/indent}}

{{Quote|indent}}Currently at week four with 5NA. Woah, finding the side effects difficult. Joint and muscle stiffness and pain, exhaustion, sore chest and cough, and I think poor mood. Symptoms come and go in severity. [https://www.facebook.com/groups/htsupport/posts/4691024117620173/]{{Quote|/indent}}

{{Quote|indent}}I inoculated about 4 weeks ago with 5 NA. The last ten days have been rough. I've been experiencing cold/flu symptoms for the past ten days that started to clear up and then came back with a vengeance, plus some other symptoms more in line with a flare. Fatigue, deep and persistent coughing, insomnia, post nasal drip, congestion, constant acid reflux, random itching all over my body/skin sensitivity, swelling, worsening of my existing skin problems, trouble regulating my body temperature, neuropathy in hands, and food cravings. I also had a migraine last week for the first time since I started treating my autoimmune disease with plaquenil. I'm going to a clinic tomorrow to ask for prednisone. (Link expired){{Quote|/indent}}

{{Quote|indent}}I also took 5 NA and started getting HORRIBLE stomach pains at Day 28. Like my insides were shredding. I am at Day 41 now, still having intense pain, but taking Benadryl (antihistamine in US) has helped a lot... [https://www.facebook.com/groups/htsupport/permalink/1381206295268655/?comment_id=1381812371874714&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Too much fatigue, can't stand any more. This is simply unbearable… I should have taken just 3... (Reported at 4.5 weeks) [https://www.facebook.com/groups/htsupport/permalink/2135581166497827/?comment_id=2135584446497499&reply_comment_id=2135609303161680&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2135581166497827/?comment_id=2135691013153509&reply_comment_id=2135695096486434&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (Reported by a patient with CFS/ME, after inoculating with 5 NA.){{Quote|/indent}}

{{Quote|indent}}I had side effects with my first 5 NA, feeling pain and a sense of unwellness for a week or two a few weeks in. Given the pain I had from my first 5, I'm very glad I didn't start with more. [https://www.facebook.com/groups/htsupport/posts/4764851116904139?comment_id=4765652516823999]{{Quote|/indent}}

{{Quote|indent}}Since week five (with 5 NA) I've had some pretty rough side effects. Constant fatigue, brain fog, and some depression... I can't eat much of anything right now. [https://www.facebook.com/groups/htsupport/permalink/1412378752151409/?comment_id=1448660711856546&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I'm 5 weeks in (with 3 - 5 NA) and having an explosion of eczema around my swollen, sore eyes. I am determined to hang in but holy heck, it's not much fun! [https://www.facebook.com/groups/htsupport/posts/4691024117620173/?comment_id=4752490558140195&reply_comment_id=4760223237366927]{{Quote|/indent}}

{{Quote|indent}}I had painful tingling in my fingers, legs, arms and feet (almost like thousands of piranha’s nibbling under my skin.) I also noted "a jumpiness that feels cellular". Along with... severe joint pain. Lower back, ankles, neck and one knee. The worst of all of this started around week 8 after my first ever inoculation with 5 NA.[https://www.facebook.com/groups/htsupport/permalink/1207083356014284/?comment_id=1209858305736789&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}This is Day 61 (with 5 NA). Having a hard time with the stomach pains, nausea, and now very strong muscle pains. All of my muscles are so tight. Feels like EVERY single muscle. [https://www.facebook.com/groups/htsupport/permalink/1335248503197768/?comment_id=1388003157922302&comment_tracking=%7B%22tn%22%3A%22R9%22%7D]{{Quote|/indent}}

{{Quote|indent}}Day 70 post first inoculation (with 5 NA). I have intestinal cramps, huge diarrhoea again, anxiety. It fits with the timeline but NA is clearly not a cakewalk. [https://www.facebook.com/groups/htsupport/posts/4381230565266198/?comment_id=4603801953009057]{{Quote|/indent}}

{{Quote|indent}}After my first dose of 5HW I experienced extreme fatigue. It wasn't until my third dose that things began to make a big shift. [https://www.facebook.com/groups/htsupport/permalink/856163037772986/?comment_id=856646297724660&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}

Even a first dose of 3 NA can be a challenge for a few self-treaters, including some who are not on the hypersensitive spectrum.

{{Quote|indent}}I had bad worm flu from my first dose which was I believe 3 worms. I won’t lie to you. It was really bad for 2 to 3 months. [https://www.facebook.com/groups/htsupport/posts/24319389764356983/?comment_id=24324666410495985]{{Quote|/indent}}

{{Quote|indent}}I am treating mainly neuropsychiatric issues, but 3NA was almost unbearable at points, in the mental effects it had. There was about a week and a half where I was so depressed it was hard to function. I think even 5 would have been too much for me! (Link expired.){{Quote|/indent}}

{{Quote|indent}}I am very thankful that I only had 3 NA For my first dose. I am almost done with the week five and the anxiety I am feeling is truly challenging me. [https://www.facebook.com/groups/htsupport/posts/5073693309353250]{{Quote|/indent}}

{{Quote|indent}}I'm glad I only took 3 NA because the fatigue from the eosinophils is no joke. [https://www.facebook.com/groups/htsupport/posts/6542392999149933/?comment_id=6851277161594847]{{Quote|/indent}}

=== Just 3-5 larvae can be surprisingly effective ===

It can be difficult to imagine that very small numbers of tiny hookworms would be capable of producing much benefit in a host many times their size, but it is clear that they are.

{{Quote|indent}}3 little (hook)worms can have a huge impact on a 91kg guy! I used only 3 HW end 2015 and again 3 a month ago (Feb 2017). I can tell you that they can have incredible impact on me. Both times I had a [[The helminthic therapy bounce | bounce]]. [https://www.facebook.com/groups/htsupport/permalink/1258218517567434/?comment_id=1259170570805562&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}At 10 weeks post inoculation with 5 NA for CFS/ME and chronic migraine, in the past two days I suddenly have many times more energy than usual for winter. Vastly more. Last winter a weekly trip to the grocery store would wipe me out to the point of being able to do NOTHING (no work, no housework, no cooking, nothing but resting) the entire rest of the week and I struggled to stay awake past 7 pm no matter how much I rested during the day. Yesterday, I cleaned the kitchen, batch cooked for half of the day, vacuumed, changed the bed linens and stayed up until 10 pm. Today I'm mopping, cleaning the bathrooms, doing laundry and cooking a bit more. This energy is in addition to the early improvements I've had in brain fog, joint pain, plantar fasciitis and increased tolerance to high FODMAP foods. [https://www.facebook.com/groups/htsupport/permalink/1040952539294034/]{{Quote|/indent}}

{{Quote|indent}}My 11 year old son developed a bad dog dander allergy - he couldn’t be near our dogs without wheezing and getting skin blotches. He was inoculated with 5 HW. He is now (6 months later) free from his allergy, he can roll around with the dogs and rub his face on them with no issues!! [https://www.facebook.com/groups/htsupport/permalink/1025648674157754/?comment_id=1025956247460330&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}I started using hookworm in 2011 (for Rheumatoid Arthritis). I only had one dose of 5. I was symptom free within 4 months and stayed symptom free for 5 years. (Edited from two posts in this [https://www.facebook.com/groups/htsupport/permalink/1025648674157754/ thread].){{Quote|/indent}}

{{Quote|indent}}My daughter (age 16) suffers from terrible allergies. She gets asthmatic symptoms and needs an inhaler. Eight weeks ago she inoculated with 5NA. She is at this time much relieved. I would estimate by about 70% or more. She has a clear nose and has not needed her inhaler for over a month. Last night she spent the night at a friends house who had a cat. She was fine. I am surprised that only 5 seemed to provide such relief. [https://www.facebook.com/groups/htsupport/permalink/1710428945679720/]{{Quote|/indent}}

{{Quote|indent}}I started my first dose of 5 NA 5 weeks ago (and) I've had great improvement in severe allergy symptoms (rhinitis, plugged ears, itchy throat, asthma and eczema) while landscaping outdoors. [https://www.facebook.com/groups/htsupport/posts/5277962722259640/]{{Quote|/indent}}

{{Quote|indent}}I started NA for Crohn’s disease and Sweet syndrome. I was not in a good way. I was told I was going to die due to inflammation in my bowel, and I was in hospital 4 times, each for 2-3 weeks and tried every medicine available… I’ve taken doses of 3, 3 and 5 hookworms so far, at around 10 weeks between each dose. I had a specialist appointment on Friday and, for the first time in 20 years, my blood work is fabulous. My CRP is 7 and my cal protectin is 50. My CRP has never been below 280 and my cal protectin was normally around 6000. So I have no signs of disease in my blood and I'm no longer an extreme surgical case. I'm not even sick as far as doctors are concerned. [https://www.facebook.com/groups/htsupport/posts/5137991819590065]{{Quote|/indent}}

{{Quote|indent}}My first dose was only 11 weeks ago with 5 HW. Even though it is very early in my HW treatment I have had great success. Right now I have only a few patches of eczema, which is a vast improvement. The psoriasis around my ankles is slowly clearing up. Who knew 5 worms could do so much?! [https://www.facebook.com/groups/htsupport/permalink/757508230971801/?comment_id=757654774290480&offset=0&total_comments=29]{{Quote|/indent}}

:This last individual then increased the size of her next two doses, but this brought no additional benefit.
:{{Quote|indent}}I did fine at 5HWs so went to 10 and then 25. My best benefit was at 5 so went back down. [https://www.facebook.com/groups/htsupport/permalink/1252173938171892/?comment_id=1252311141491505&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]{{Quote|/indent}}

=== The absence of a rash may not indicate a failed inoculation ===

For full details, see the following page.

* [[The hookworm inoculation rash | '''The hookworm inoculation rash''']]

===Other helminth species should not be added alongside a ''first'' dose of NA===

Beginning helminthic therapy with more than one species of worm presents an increased challenge to the host’s immune system, resulting in a greater risk of side effects.
* [[Helminth inoculation#The first inoculation should be with a single species | '''The first inoculation should be with a single species''']]

Once a host's immune system has become accustomed to the presence of one species, the addition of further species may provide extra benefits.
* [[Selecting a therapeutic helminth#Hosting multiple worm species | '''Hosting multiple worm species''']]

== Supplementary doses ==

Helminthic therapy is not a one-dose fix. To reap the benefits offered by helminths, self-treaters need to maintain exposure to them indefinitely. The first dose is just the starter.

A supplementary dose can usually be added 12 weeks after the first dose, but only if all side effects from the first dose have ceased. In a few cases, side effects can persist beyond 12 weeks.

{{Quote|indent}}Took my initial dose of 5 NA near six months to fully settle, pretty sure I'd have had to terminate if I’d introduced another 5 after 3 months. [https://www.facebook.com/groups/htsupport/permalink/2455345161188091/?comment_id=2461065180616089]{{Quote|/indent}}

Once side effects have settled, and the first cohort of worms has been in place for at least 12 weeks, these mature worms will help to modulate the immune system’s response to the second dose. This will result in less side effects unless there is a large increase in the size of the second dose which would make side effects more likely, in a dose-dependent manner. It is therefore recommended that all self-treaters who are using NA should proceed cautiously and only increase the size of supplementary doses gradually, selecting the number of larvae in each new dose based on their experience with the previous dose.

'''If the first dose was 5, and side effects were absent or minimal during the first 12 weeks, the second dose might be 10. However, if a first dose of 5 larvae causes significant side effects, this should be followed by a further dose of 5, and this should only be added once the side effects from the first dose have subsided. The response to the second dose should then be assessed during the following 12 weeks before deciding on the size of the third dose, and so on until side effects are no longer being experienced.'''

'''The amount of time that worms have been hosted is more important for the treatment than the number of worms that have been inoculated, and there is therefore no urgency to reach any particular total number.'''

After a few doses have been added, side effects should cease to appear altogether, if they have appeared at all beyond the first dose. However, supplementary doses may occasionally continue to trigger a recurrence of the disease being treated, as happened in the following case after each of the first four doses.
{{Quote|indent}}Whenever I add more NA, my asthma comes back... not as bad as before I started NA. But then after 8 weeks, the asthma goes away entirely. [https://www.facebook.com/groups/htsupport/permalink/1526717137384236/?comment_id=1529107580478525&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1526717137384236/?comment_id=1529174360471847&reply_comment_id=1529193553803261&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

Once supplementary doses are no longer causing side effects or exacerbating the disease being treated, the size of doses can be '''''gradually'' and ''cautiously''''' increased, while remaining vigilant for any return of adverse effects.

===A ''few'' NA hosts may ''eventually'' tolerate doses of between 35 and 50 larvae===

After the first few doses, a '''''few''''' hosts do best with larger supplementary doses in the long term, and tolerate them well.

{{Quote|indent}}I've done 35 with no issues multiple times. [https://www.facebook.com/groups/htsupport/permalink/1667035473352401/?comment_id=1667459139976701&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}I am now certain that a smaller dose does nothing for my SIBO. The effect of dosing with 40 HW... is so remarkable and so quick that my friends and family are quick to tell me that my worms are alive. lol. I take 40 NA every 3 months. [https://www.facebook.com/groups/htsupport/permalink/1640500539339228/?comment_id=1645532662169349&reply_comment_id=1646337038755578&comment_tracking=%7B%22tn%22%3A%22R9%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1422151061174178/?comment_id=1422155307840420&comment_tracking=%7B%22tn%22%3A%22R5%22%7D]{{Quote|/indent}}

{{Quote|indent}}I need to take 50 every 6 months.{{Quote|/indent}}

=== Supplementary doses of 35 or more larvae may cause side effects ===
Even subjects who have been hosting hookworms for many years may continue to experience significant and quite long-lasting side effects following supplementary doses of 35 or more larvae.
{{Quote|indent}}I find that every time I inoculate (always with 35 HW) I get a bad round of gas. This normally starts around 2 weeks after inoculating, but it settles down after a while if I don't reinoculate, and is gone by around 4½ months. (Edited from two posts: [https://www.facebook.com/groups/htsupport/permalink/885486351507321/?comment_id=886095694779720&offset=0&total_comments=12&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/885486351507321/?comment_id=886527388069884&offset=0&total_comments=14&comment_tracking=%7B%22tn%22:%22R%22%7D]){{Quote|/indent}}
{{Quote|indent}}My reaction to HW is about the same now as it was when I began. Hookworms, in my case, cause a strong, long lasting negative response once I inoculate (with doses of between 35 and 50). I don't get the “bounce.” My mood plummets, brain fog occurs, my IBD related arthritis flares and I have general tiredness. I need to get sleep. Smaller dosing lessen my response. This lasts for 4 to 6 weeks then I start feeling better. (Edited from two posts: [https://www.facebook.com/groups/htsupport/permalink/898417033547586/?comment_id=898558830200073&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R%22%7D][https://www.facebook.com/groups/htsupport/permalink/898417033547586/?comment_id=898604600195496&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D]){{Quote|/indent}}
{{Quote|indent}}I give myself 50 once a year and have some mild side effects. These are actually worse than my initial dose gave me.{{Quote|/indent}}
{{Quote|indent}}I had diarrhoea for 2.5 months once when my dose was too high. Didn't realise what it was until it cleared up almost exactly 3 months after inoculation. [https://www.facebook.com/groups/htsupport/permalink/861747150547908/?comment_id=861782887211001&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R4%22%7D]{{Quote|/indent}}

=== Supplementary doses may be best kept under 20 or 25 ===
For most of those who are not in the [[Helminthic therapy safety#Conditions that require a modified approach to helminth dosing | '''higher risk category''']], keeping supplementary doses below 25 larvae will reduce the risk of significant side effects.
{{Quote|indent}}Started with 25 HW, then 50 for the next batch which sent my immune system mad, needed prednisone...{{Quote|/indent}}
{{Quote|indent}}Anything more than 25 (hookworms) and I suffer from brain fog and lethargy, achy joints that could last a few weeks. [https://www.facebook.com/groups/htsupport/permalink/915314868524469/?comment_id=915320581857231&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}
{{Quote|indent}}In my experience, taking larger doses (over 25 hookworms) can cause symptoms (similar to those) of an anaphylactic reaction. Scratchy itchy throat, sensation of tingling of mouth and tongue, effort to swallow. From armpit to elbow was very swollen and hot (around the inoculation site), more so than any other previous inoculation. Also, I can't prove this, but my shingles began following this bad reaction to 25 hookworms. [https://www.facebook.com/groups/htsupport/permalink/1663305817058700/?comment_id=1663640043691944&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1663305817058700/?comment_id=1663685477020734&reply_comment_id=1663689400353675&comment_tracking=%7B%22tn%22%3A%22R4%22%7D]{{Quote|/indent}}
{{Quote|indent}}Started with 15, then 30, then 30, and most recently 20 because I experienced symptoms that were too much to handle. [https://www.facebook.com/groups/htsupport/permalink/1016630521726236/?comment_id=1016974145025207&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}In my experience, taking smaller doses (under 20) of hookworm is best. [https://www.facebook.com/groups/htsupport/permalink/916465445076078/?comment_id=916755838380372&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I dropped from 25 to 15 worms and the side effects were significantly less! [https://www.facebook.com/groups/htsupport/permalink/1558504957538787/?comment_id=1558579560864660&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I used to top up with 25-30 NA's but my provider suggested topping up with fewer. I used around 10 on my last 2 dosing and it worked great! [https://www.facebook.com/groups/htsupport/permalink/1978467308875881/?comment_id=1978498922206053&reply_comment_id=1979702842085661&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I can never tolerate more than 10-15 at a time and I mitigated one dose of 20 (bad decision) with low dose prednisone.[https://www.facebook.com/groups/htsupport/permalink/1868023383253608/]{{Quote|/indent}}
{{Quote|indent}}I've inoculated with doses of 5, 5, 10, 25, and then a final 25 about 9 weeks ago, with each dose at least 12 weeks apart. The last two doses of 25 each have caused significant side effects without much added benefit. And the benefit I did get from the 25 was no greater than that of the dose of 5 or 10. [https://www.facebook.com/groups/htsupport/permalink/2000592956663316/]{{Quote|/indent}}

===Some people need to restrict supplementary doses to 5 larvae or less===

Some self-treaters have found that they need to continue to use very small doses, and that these provide them with all the benefits they require. This is particularly true for those on the hypersensitivity spectrum, who should continue to inoculate with very low numbers for at least the first few doses, and possibly indefinitely. It is also true for a small number of individuals who are helminth permissive, so have a reduced ability to control helminths, probably due to their genetic profile. Often unaware that they have this characteristic, they accumulate worms rather than losing them to the attrition that limits worm numbers in most people.

{{Quote|indent}}I did 5 and did well for 5 months then did 10 and caused massive CFS/ME flare. [https://www.facebook.com/groups/htsupport/permalink/1286104968112122/?comment_id=1286147761441176&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had 3 inoculations - 5/15/10. All was well after the first 2, then all hell broke loose after the third one. It has been 9 weeks now and there is no reprieve. (Link expired){{Quote|/indent}}

{{Quote|indent}}I started with 3 then 5 but when the time came for my 3rd dose I was incubating my own so, based on my belief I had had no negative side effects, decided to dose 8. Now I wish I hadn't as I then started to develop symptoms that I had not experienced before. [https://www.facebook.com/groups/htsupport/posts/5162192033836710?comment_id=5162552833800630]{{Quote|/indent}}

{{Quote|indent}}I started out with a dose of 5 HWS, then went to 10, a couple dose of 25, then back down to 10 before realizing the optimal dose is only 5. At the higher doses I actually had an increase of some symptoms for a while. [https://www.facebook.com/groups/htsupport/permalink/1149149175141036/?comment_id=1149171338472153&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Going from 5-10 caused a HOST of problems including an extreme sensitivity to just about every food imaginable. It’s been a few years and the effects did eventually go away, but definitely always dose with the lowest dose possible. [https://www.facebook.com/groups/htsupport/permalink/2639527966103142/?comment_id=2639795659409706&reply_comment_id=2640762222646383]{{Quote|/indent}}

{{Quote|indent}}5 or less will be my go-to dose from now on. [https://www.facebook.com/groups/htsupport/permalink/1583270575062225/?comment_id=1583328135056469&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

{{Quote|indent}}I decided to ignore the advice that my next dose should be back to 5, and not to increase it to 10, so, after twelve weeks, I applied 10 larvae as my 4th dose. Everything went fine into week 6 or 7 when my face caught fire!!! I developed painful inflamed red itchy scaly patches under my eyes, either side of my nose, above my eyebrows, down the groove either side of my cheeks. I was a mess… 14 weeks after that 4th inoculation, my face is back to normal. [https://www.facebook.com/groups/htsupport/posts/4983577991698116?comment_id=5293029117419667]{{Quote|/indent}}

{{Quote|indent}}I’m on my second dose (5/10 NA). No side effects last time, so I thought I’d be fine, but apparently not. Diarrhoea started in week 2. [https://www.facebook.com/groups/htsupport/posts/5318514761537769?comment_id=5318565791532666&reply_comment_id=5319561001433145] [https://www.facebook.com/groups/htsupport/posts/5318514761537769/?comment_id=5318565791532666]{{Quote|/indent}}

===A few people may need to pause treatment after just one or two doses===

People with a helminth-permissive immune system do not need to add a supplementary dose routinely every 12 weeks.

{{Quote|indent}}I've got my second dose of 10 NA after 5 yrs. Mainly because the symptoms started to come back gently, after long years of total remission. [https://www.facebook.com/groups/htsupport/posts/7815523915170162/]{{Quote|/indent}}

Dosing every 12 weeks can be counter-productive for some hypersensitive, as well as helminth-permissive, individuals.

{{Quote|indent}}I did three NA and did relatively ok. After three months, I did three more, but this second dose made my symptoms about 10 times worse. I was sicker then ever before, with even more symptoms that I’d never had previously. So I terminated. (Via private message.){{Quote|/indent}}

{{Quote|indent}}After the first inoculation with 5 NA, my 18 year-old with IBS and M.E. started feeling better at around the 3-month mark so we inoculated again with another 5NA. Now I wish we had just done 1 or 2 NA. His fatigue has been very bad and now he is having a great deal of trouble sleeping as well as being a bit constipated. He hasn't slept at all for the last 48 hours or longer. [https://www.facebook.com/groups/htsupport/posts/5459362024119708/]{{Quote|/indent}}

{{Quote|indent}}I had 3 inoculations - 5/15/10. All was well after the first 2, then all hell broke loose after the third one. It has been 9 weeks now and there is no reprieve. (Link expired){{Quote|/indent}}

{{Quote|indent}}My body seems extraordinarily sensitive to hw, so it’s very easy for me to overdose... When I started over (after termination) it was with doses of mostly 5-6 at a time, usually 6 months apart. [https://www.facebook.com/groups/htsupport/permalink/2599777423411530/?comment_id=2599896376732968] [https://www.facebook.com/groups/htsupport/permalink/2599777423411530/?comment_id=2599896376732968&reply_comment_id=2600025980053341]{{Quote|/indent}}

== Dosing in the long term ==

===Hookworm survival===

The length of time that hookworm hosts can go between doses in the long term depends on three factors.

# The rate of attrition, which is dependent on the strength of the host’s unique immune response to helminths. This is greatest in people with IBD and other intestinal disorders involving inflammation, and is partly determined by host genetics. [https://www.ncbi.nlm.nih.gov/pubmed/25858116] [https://www.ncbi.nlm.nih.gov/pubmed/11921085].

::The authors of one very small study that was reported in 2001 hypothesised that the longevity of adult hookworms is probably determined more by parasite genetics than by host immunity. [https://www.ncbi.nlm.nih.gov/pubmed/11585781] However, this opinion was based on research carried out in a ''far'' smaller sample than that available in the helminthic therapy community, where many hundreds of NA self-treaters have inoculated with larvae from the same stock, but reported losing their worms after widely differing lengths of time. This strongly suggests that host immunity is the major determinant of hookworm longevity.

# The extent of any use of substances that impact the health of the worms. For details of these, see the [[Human helminth care manual | '''Human helminth care manual''']].
# The number of hookworms that were previously inoculated may also affect the length of time before symptoms begin to return.

Hookworms are reported to survive for 3-10 years [http://www.ncbi.nlm.nih.gov/pubmed/627275] but to be capable of living for up to 15 years, [http://www.parasitesinhumans.org/hookworms.html] and possibly even 18 years. [http://www.ncbi.nlm.nih.gov/pubmed/3189697] One hookworm self-treater was able to enjoy remission from his disease for more than 5 years after a single inoculation.

{{Quote|indent}}I started using hookworm in 2011. I only had one dose of 5. I was symptom free within 4 months and stayed symptom free for 5 years. (Edited from two posts: [https://www.facebook.com/groups/htsupport/permalink/1025648674157754/?comment_id=1025781867477768&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1025648674157754/?comment_id=1025781867477768&reply_comment_id=1025790644143557&comment_tracking=%7B%22tn%22:%22R1%22%7D]){{Quote|/indent}}

Another self-treater was able to enjoy eight years of remission after a series of inoculations during the first year.

{{Quote|indent}}I initially inoculated myself with NA about 8 years ago. I had doses of 5, 5, 10, 10, 10 in the first year, after which I have enjoyed 8 years being completely free of asthma. (Edited from two posts: [https://www.facebook.com/groups/htsupport/posts/9042441929145015/], [https://www.facebook.com/groups/htsupport/posts/9042441929145015?comment_id=9042781412444400&reply_comment_id=9044232358965972]){{Quote|/indent}}

However, the experience of most self-treaters suggests that hookworms typically only survive for between 1 and 3 years.

{{Quote|indent}}I inoculated with 10 NA a year and a half ago and had about 14 months of amazing relief. [https://www.facebook.com/groups/htsupport/permalink/2057412794314665/]{{Quote|/indent}}

Some hosts, especially those with digestive diseases, can lose their hookworms in as little as 2 or 3 months.

===Long-term dosing is based on individual user experience===

The frequency with which NA hosts need to reinoculate varies widely between individuals.

{{Quote|indent}}It appears I lose my worms every three months. My relative went about five months before her symptoms returned. [https://www.facebook.com/groups/htsupport/permalink/1550216578367625/?comment_id=1550314855024464&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

The size of doses required also varies considerably between individual users.

'''In order for hookworm hosts to establish the ideal dose size and dosing frequency for them, they should keep a record of the size and dates of all their doses while they are gradually introducing larvae within their individual tolerance. Once they have achieved remission, they should pause dosing and note the length of time that it takes between their last inoculation and the reappearance of symptoms of their disease. This will provide the best guide to the frequency with which they will need to re-inoculate in the long term in order to maintain uninterrupted remission.'''

{{Quote|indent}}I can tell when the NA die off and I need to take another dose because my gluten sensitivity flares up, my headaches are worse and my aches and pains are worse. [https://www.facebook.com/groups/htsupport/permalink/2490868600969080/?comment_id=2491288504260423]{{Quote|/indent}}
{{Quote|indent}}My previous dose (10 NA) was 5.5 months ago, and some of the baseline symptoms of my so-far "benign MS" were reoccurring… [https://www.facebook.com/groups/htsupport/permalink/1484899438232673/]{{Quote|/indent}}
{{Quote|indent}}One of the symptoms we watch to tell us when the colony is not working at 100% is arthritic knees. Another is dry eye. [https://www.facebook.com/groups/htsupport/permalink/976957299026892/?comment_id=977770718945550&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}… one of the first ways I knew my old colony was dying off was that I was having stomach issues on Monday mornings, after we had our usual Sunday roast dinner and wine etc. [https://www.facebook.com/groups/htsupport/permalink/1276571042398848/?comment_id=1604202039635745&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

People who have several conditions may find that, when their colony begins to need reinforcements, symptoms of these conditions may begin to return at different stages. As soon as there is an indication that one condition is returning, and it is clear that the symptoms are not being caused by something else, a top-up dose is likely to be required.
{{Quote|indent}}I know my body well and now know the subtle symptoms of my autoimmunity. When this happens I need to top-up on helminths because my colony is too small to suppress my autoimmune response. [https://www.facebook.com/groups/htsupport/permalink/793033264085964/?comment_id=807794845943139&offset=0&total_comments=10]{{Quote|/indent}}

Waiting until disease symptoms begin to return is not usually a problem with hookworms because attrition is a gradual process, and a proportion of the colony should still be alive when symptoms begin to reappear. These existing residents will usually maintain a degree of immune modulation while a new cohort becomes established, and will themselves be perked up by the arrival of the newcomers, with the result that most people see a fairly rapid return of full benefits.

Once it has been established how long a dose will last (this may vary somewhat according to the size of the dose), future top-up doses should be added in time to prevent a recurrence of symptoms, and a reminder to do this should be set in a diary or phone. Otherwise, mild symptoms may not be recognised as an indication of the need to top up one's colony and could be overlooked, with the result that the self-treater might find themselves in desperate need of a dose.

{{Quote|indent}}The benefits wore off exactly 12 months after first inoculation. I panicked because flare ups came back stronger than ever. Talked to her doctor and we decided to innoculate 20 more immediately, 3 months later she was back to base, we needed azithro during those months to protect her until the helminths were able to kick back in. [https://www.facebook.com/groups/htsupport/permalink/1068326963223258/?comment_id=1763994130323201&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

=== Long-term dosing in practice ===

'''After a period of personal experimentation, the majority of hookworm hosts settle on a long-term re-inoculation rate ''equivalent'' to 1 or 2 larvae per week, added at intervals ranging from weekly to twice each year, e.g., 1 or 2 weekly, 2-4 fortnightly, 4-8 monthly, 12-25 quarterly, or 25-50 every six months. A few outliers at either end of the spectrum find that they need to add the ''equivalent'' of only 1 larva every 2 weeks, or as many as 5 larvae each week, but with a maximum of 50 larvae per dose.'''

The following comments illustrate the range of dose sizes and dosing frequency being used, and show that many self-treaters top up at least every 3-6 months.

<blockquote>
'''12 months'''
{{Quote|indent}}Unless I take something that kills them, I probably only need 3 or so, once a year. [https://www.facebook.com/groups/htsupport/permalink/3077027792353155/?comment_id=3077049905684277&reply_comment_id=3077177339004867]{{Quote|/indent}}

'''5-6 months'''
{{Quote|indent}}I inoculate with 15 each 5 months, because I swear my baseline symptoms start to return at about 6 months post-inoculation. [https://www.facebook.com/groups/htsupport/permalink/1990194231036522/?comment_id=1990736610982284&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I need to re-dose every 20 weeks. If I wait longer, symptoms return and I go through worm flu again (though diminished). If I re-dose every 20 weeks, results are more consistent. [https://www.facebook.com/groups/htsupport/permalink/1784511358271478/?comment_id=1784929798229634&reply_comment_id=1785466151509332&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I need 25 every six months.{{Quote|/indent}}
{{Quote|indent}}I inoculate with 30 about every 6 months. [https://www.facebook.com/groups/htsupport/permalink/1019138634808758/?comment_id=1019147878141167&reply_comment_id=1019335101455778&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I need to take 50 every 6 months.{{Quote|/indent}}

'''3-4 months'''
{{Quote|indent}}I find 1-3 NA ok. Five is ok if (my colony is) low. But more than that I have symptoms... I will probably do 2 every 3 months as a topup. [https://www.facebook.com/groups/htsupport/permalink/1783444368378177/?comment_id=1783972631658684&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I now take about 7-10 hookworms every 3-4 months. [https://www.facebook.com/groups/htsupport/permalink/1868023383253608/]{{Quote|/indent}}
{{Quote|indent}}I dose 20 NA at about 3 month Intervals. [https://www.facebook.com/groups/htsupport/permalink/1355341874521764/?comment_id=1358034104252541&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I need 25 every 3 months. [https://www.facebook.com/groups/htsupport/permalink/1422151061174178/?comment_id=1422180437837907&comment_tracking=%7B%22tn%22%3A%22R3%22%7D]{{Quote|/indent}}
{{Quote|indent}}I have to redose every three months also. 35 is my magic number. [https://www.facebook.com/groups/htsupport/permalink/1422151061174178/?comment_id=1422278597828091&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I take 40 NA every 3 months. [https://www.facebook.com/groups/htsupport/permalink/1422151061174178/?comment_id=1422155307840420&comment_tracking=%7B%22tn%22%3A%22R5%22%7D]{{Quote|/indent}}

'''2-3 months'''
{{Quote|indent}}I do best at 2-3 month redoses. If I wait longer, I wish I hadn't. [https://www.facebook.com/groups/htsupport/permalink/1550216578367625/?comment_id=1550226671699949&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]{{Quote|/indent}}
{{Quote|indent}}I tried 20 NA every 3 months - it gave me worm flu. Now i've gone to 10 NA every 2 months, and it seems to work better for me personally. [https://www.facebook.com/groups/htsupport/permalink/3345728918816373/?comment_id=3347513468637918]{{Quote|/indent}}
{{Quote|indent}}I need 40 NA every 8 weeks, for now. [https://www.facebook.com/groups/678894952216125/permalink/2547577475347854/]{{Quote|/indent}}
{{Quote|indent}}I now dose with 40 every 2.5 months. I need a frequent high dose to keep my Crohn's under control. (Link expired){{Quote|/indent}}
{{Quote|indent}}The effects from my NA always wear off at week 9. I inoculate every 10 weeks. [https://www.facebook.com/groups/htsupport/posts/9634033553319180?comment_id=9640160816039787]{{Quote|/indent}}

'''1-2 months'''
{{Quote|indent}}My brother is now doing 3 NA every 4 weeks and that seems to be good for him as at 10-12 weeks he has return of symptoms. [https://www.facebook.com/groups/htsupport/permalink/1818402868215660/?comment_id=2078031412252803&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}
{{Quote|indent}}I have to dose with 5 NA per month to stay healthy. I kill them off quicker than most people. [https://www.facebook.com/groups/htsupport/permalink/3810264849029442?comment_id=3810326995689894]{{Quote|/indent}}
{{Quote|indent}}I switched to a monthly dosage of 15 NA and that seems to solve the problems. [https://www.facebook.com/groups/helminthes/posts/271247065154284/?comment_id=508584721420516]{{Quote|/indent}}
{{Quote|indent}}I take 5-10 NA every 7-8 weeks. [https://helminthictherapywiki.org/wiki/Migraine,_depression_and_autoimmunity_relieved_by_TSO_and_NA]{{Quote|/indent}}
{{Quote|indent}}I do 5 NA every 7 weeks. If I do it more often, I feel sick and flared up. If I space it out more, my autoimmune symptoms return. I listen to my body and this is what it needs at this point. I journal my symptoms so I’m able to see the patterns. [https://www.facebook.com/groups/htsupport/permalink/3271274592928473?comment_id=3272967132759219]{{Quote|/indent}}
{{Quote|indent}}I’m having good results so far with 1 hookworm every 8 weeks. [https://www.facebook.com/groups/htsupport/posts/5389503087772269?comment_id=5390808964308348]{{Quote|/indent}}

'''1-2 weeks'''

Several people who began to increase the frequency of doses, while reducing the number of larvae in each dose, have continued this process until they were dosing every one or two weeks.

Someone who is treating ankylosing spondylitis went first from dosing quarterly to adding 10-15 NA every other month. [https://www.facebook.com/groups/htsupport/permalink/1150956801626940/?comment_id=1152010544854899&comment_tracking=%7B%22tn%22:%22R1%22%7D] Then, finally, she changed to adding 6 NA every two weeks. [https://www.facebook.com/groups/htsupport/permalink/2033965626659382/?comment_id=2034247119964566&reply_comment_id=2034346819954596&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

Someone who had begun inoculating with 30 NA roughly every 6 months, eventually tried adding 5 every month.

{{Quote|indent}}I've recently experimented with 5 every month. I've found that this new schedule is much better at keeping my sinuses clear. I'm beginning to think that the number of larva is much less important than the frequency of inoculation. [https://www.facebook.com/groups/htsupport/permalink/1258218517567434/]{{Quote|/indent}}

After noting the improvements gained from more frequent dosing, he adopted a fortnightly regimen.

{{Quote|indent}}I've recently started 2-3 hookworm every 2 weeks and am getting much better results than I did with 30 every 6 months. [https://www.facebook.com/groups/htsupport/permalink/1355341874521764/?comment_id=1357764114279540&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1422151061174178/?comment_id=1423257967730154&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

And he has since changed to weekly dosing with just one larva.

'''The additional exposure to migrating larvae facilitated by more frequent inoculations may provide increased immune stimulation.'''

{{Quote|indent}}… the larval phase of infection rather than the persisting egg-laying adult worms may be largely responsible for the cytokine production and so responders may be the more frequently/more recently exposed individuals. [https://www.ncbi.nlm.nih.gov/pubmed/16232230]{{Quote|/indent}}
</blockquote>

=== Trickle dosing, and sensitisation to NA ===

In his book, [http://www.amazon.com/Epidemic-Absence-Understanding-Allergies-Autoimmune/dp/1439199396/ref=sr_1_1?ie=UTF8&qid=1425239128&sr=8-1&keywords=An+Epidemic+of+Absence An Epidemic of Absence], Moises Velasquez-Manoff mentions that light, transitory, hookworm infections may prime allergic disease, and some other commentators have suggested that trickle dosing with hookworms (adding one or two larvae every week or fortnight) could present a potential risk of increased sensitisation to them, perhaps reducing the maximum number that can successfully colonise. However, feedback from self-treaters suggests that regular trickle dosing does not cause sensitisation in someoe with an established colony, but that the addition of too many worms too quickly can do, especially in hypersensitive individuals when first hosting NA or when re-stocking after a colony collapse.

{{Quote|indent}}My immune system has become extremely sensitive to NA. I can’t tolerate taking even 3 to 5 NA. My guess this has happened because I took large doses of them when I began… in the early days (12 years ago) when helminthic therapy was new. (Link expired){{Quote|/indent}}

{{Quote|indent}}(After starting hookworm therapy with doses of 50, 40 and 35 NA) my immune system now can’t tolerate more than 10-12 NA on board at any one time. I’m 7 years into this therapy, so my acquired hypersensitivity to NA appears to be permanent. I’m quite confident that if I’d taken smaller doses to start with, I could have gotten all the benefits of this therapy without the permanent damage. [https://www.facebook.com/groups/htsupport/posts/5070971286292119?comment_id=5073216279400953&reply_comment_id=5073891886000059]{{Quote|/indent}}

{{Quote|indent}}My wife lost her colony due to an 8 days treatment of antibiotics. As we were in a hurry to replenish her colony, and so inoculating 20 every 20 days, she became sensitized to them. [https://www.facebook.com/groups/htsupport/permalink/795036227219001/?comment_id=796617140394243&offset=0&total_comments=17]{{Quote|/indent}}

The individual whose experience is described in this last quote found that, in her case, re-inoculating with 8-10 NA larvae every 6-8 weeks following the loss of her colony also resulted in sensitisation to the worms. Foods then began to cause the symptoms that she experienced prior to first using NA, and which she associates with allergy: brain fog, blurry vision, tiredness, grumpiness and lack of motivation.

The risk of sensitisation to hookworms as a result of introducing too many larvae too soon, either when first commencing the treatment or following a colony collapse is likely to be highest in hypersensitive subjects and those with allergies, and this is one of the reasons why it is important to start hookworm therapy with no more than 5 larvae (just 3, or less, for the hypersensitive and those with [[Helminthic therapy safety#Conditions that require a modified approach to helminth dosing | '''certain other conditions''']]), and then only to increase the size of supplementary doses very gradually so that any side effects that do develop will appear at a manageable rate rather than become suddenly so severe that termination is needed.

Trickle dosing can work well for those who built their colonies gradually, either in the beginning or after a colony collapse.

{{Quote|indent}}I’m having good results so far with 1 hookworm every 8 weeks. [https://www.facebook.com/groups/htsupport/posts/5389503087772269?comment_id=5390808964308348]{{Quote|/indent}}

{{Quote|indent}}Trickle dosing seems very effective for many, even just 2 or 3 NA but taken every week. [https://www.facebook.com/groups/htsupport/posts/6780353308687233?comment_id=6785745858147978]{{Quote|/indent}}

It might be assumed that those who choose to dose every week or fortnight would have an almost continuous rash, but the rash caused by 1-3 larvae is usually minimal. [https://www.facebook.com/groups/htsupport/permalink/1355341874521764/?comment_id=1357807520941866&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

{{Quote|indent}}I currently inoculate with 1 hookworm larva every week, so my initial itch is muted enough that it doesn't tell me for sure if the larva made it. But the [[The helminthic therapy bounce | bounce]] that night does. And I get a small itchy rash a couple days later that confirms it. [https://www.facebook.com/groups/htsupport/permalink/1465250213530929/?comment_id=1465263893529561&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

===Finding a dosing "sweet spot" can be difficult for some people===

{{Quote|indent}}I use the bare amount of NA to keep the major symptoms of my Lupus vasculitis at bay… When I have a sufficient worm population, I do not need blood transfusions, so the worms protect me from my anemia, which is severe. When I have a low dose of worms, I can get a Hg of 7 on my own and remain stable with my blood counts. I have ongoing skin issues constantly, whether that’s the worms plus my disease, or what, I don’t know, but if I have too many worms, it definitely makes it worse. It is a very fine balance. [https://www.facebook.com/groups/htsupport/posts/24230090869953540/]{{Quote|/indent}}

===Dose size and frequency may need adjustment over time===

Response to helminths may change over time, requiring some adjustment to dosing.
{{Quote|indent}}After 10 years of using helminths my body has changed and reactions to helminths have changed. I find hookworms cause more symptoms at smaller doses (so) my treatment requires tweaking of dosage, timing,
amounts. [https://www.facebook.com/groups/htsupport/permalink/977396905649598/?comment_id=977549362301019&comment_tracking=%7B%22tn%22:%22R9%22%7D]{{Quote|/indent}}

{{Quote|indent}}I’ve been using hookworms for 7 years, mostly for MS, with overall good success. I found I did well with VERY low doses, sometimes adding only 3 in a year. Then, two years ago, I got a back injury that wouldn’t heal, and finally decided the back pain may be autoimmune. With a section of my lumbar spine trying to fuse, I’m going with ankylosing spondylitis, and I’m now finding that I need to dose more frequently. Still experimenting, but it’s looking like 1 or 2 new hookworms every 8 weeks might be my new dosing schedule. I’m getting 80-90% improvements in back pain within 24 hours after a dose, but the effects fade in 8-9 weeks, even though I have a colony that seems healthy and is producing plenty of larvae. (Edited from [https://www.facebook.com/groups/htsupport/posts/5345265455529366?comment_id=5346763752046203 this post].){{Quote|/indent}}

Some people may even experience seasonal changes in their response that also require adjustments to dosing.
{{Quote|indent}}Time of year also makes a difference for me. My autoimmunity is stronger in the winter months. [https://www.facebook.com/groups/htsupport/permalink/977396905649598/?comment_id=977549362301019&comment_tracking=%7B%22tn%22:%22R9%22%7D]{{Quote|/indent}}

== Colony size ==

It is impossible to determine how many hookworms are being hosted at any given time because there is no reliable test for this. Neither can the size of a colony be ascertained by adding up the doses that have been inoculated previously, because attrition is constantly taking its toll on intestinal worms, killing them at widely varying rates in different individuals. '''So, rather than aiming for any notional colony size, the best approach is for individuals to observe their response to each of the doses they add over time and to use this knowledge to determine what size and frequency of top-up doses will enable them to keep their disease in remission'''.

{{Quote|indent}}Don't worry too much about colony size. I take 10 NA every 3 to 4 months and TTO every 2 weeks. The first year, my symptoms returned after I waited too long to take more NA, so I think the key is to just get that regular influx every few months. [https://www.facebook.com/groups/htsupport/permalink/2058945780828033/?comment_id=2060499587339319&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}The regularity by which I inoculate is more important than the exact figure, and the once a month suits me much better. It might be the process the body undergoes when newly infected, or young NA may ooze different molecules, I don’t know, but I find there is something to that, rather than making sure I have an established colony of x amount of NA. [https://www.facebook.com/groups/htsupport/posts/3697257550330173/?comment_id=4769197606469490&reply_comment_id=4770227353033182&notif_id=1645266893425480&ref=notif&notif_t=group_threaded_same_level_comment_reply]{{Quote|/indent}}

Since a few hookworm hosts may not achieve remission for up to 2 years, it may not be possible for them to see any obvious connection during this time between the number of worms inoculated and their effects, so a lack of benefits within this period may not necessarily indicate a need to add more worms. However, people with a higher attrition rate may lose their worms long before they reach 2 years, so it is essential during this period to maintain the colony by adding supplementary doses as discussed above.

Some people do extremely well with a relatively small number of hookworms.
{{Quote|indent}}For the last 2 weeks my son has been able to stroke and even hug the dogs without getting a severe allergic reaction. Plus he hasn’t needed to use anti-histamines for weeks now - by just hosting 5 hookworms!! [https://www.facebook.com/groups/htsupport/permalink/922126054510017/?comment_id=962841063771849&comment_tracking=%7B%22tn%22:%22R5%22%7D]{{Quote|/indent}}

{{Quote|indent}}I took one batch of 25 NA last year because I was experiencing pain and swelling every day from Graves and Hashimoto's diseases. I had a dramatic reduction in swelling and pain (and) lost about 15lbs of water weight. A few months later, I got pregnant, and did not have a miscarriage (I had 3 earlier that might have had something to do with the thyroid diseases). My TSH, T3 & T4 levels stabilized right before the pregnancy, they followed the "textbook" levels through the pregnancy and stabilized right after as well. My antibody levels for both diseases dropped. My Endo ... said - ‘the improvements are real - and they are unexpected.’ [https://www.facebook.com/groups/htsupport/permalink/912545925468030/]{{Quote|/indent}}

Others have claimed they needed to establish a colony of between 100 and 150, and even as many as 200 hookworms. However, since there is no reliable way to establish how many worms are being hosted, and since attrition rates vary widely between individuals, it cannot be assumed that someone who has inoculated with 4 doses of 25 NA over a year will have a colony of 100 at the end of that period. Any improvement in such cases is much more likely to have been the result of the length of time that these individuals had been hosting worms, rather than the number inoculated. The benefits of hosting hookworms can continue to accrue gradually during the first two years, whatever dosing schedule has been employed.

===Overdosing on hookworms===

There is a risk that attempting to increase the size of a colony without an obvious need to do so may cause a loss of benefits.
{{Quote|indent}}I tried NA for many years but after initial success I crashed completely due to overdosing and never got back on track. [https://www.facebook.com/groups/htsupport/permalink/2166466753409268/?comment_id=2166516453404298&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I dosed up to around 100 hookworms (for total food intolerance) and lost all my tolerance to foods again. We killed the hookworms off and I've had 3 new doses so I now have 35 hookworms. It took a while but I am back to eating a lot broader range of foods. So when it comes to hookworm dosing, It seems (for me anyway) that a smaller amount of worms works better. [https://www.facebook.com/groups/htsupport/permalink/915392701850019/?comment_id=1558513684204581&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I have lost 80% of benefits in the 14 weeks since (my third) dose. [https://www.facebook.com/groups/htsupport/permalink/951907411531881/?comment_id=954799641242658&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

This loss of benefits as a result of exceeding a personal dosing limit is seen particularly, but not exclusively, in those on the hypersensitivity spectrum.
{{Quote|indent}}For me too many worms causes exactly the same symptoms as no worms at all! After being able to eat everything I wanted for 2 amazing years, cracks started to appear and eventually I crashed and was back to just 10 foods. It took a long time to work out that this was the result of too many worms rather than too few. After killing my previous colony I started afresh. About 4 weeks after the second inoculation I could again eat everything I wanted! (Post now deleted.){{Quote|/indent}}

In addition to a loss of benefits caused by overdosing on hookworms, there can also be excessive side effects.

{{Quote|indent}}I definitely had an aggravation from too many hookworms (at six months into my treatment, and after a dose of 50) and I think that I may have been able to get into a much better place by knocking the hookworms back. I had felt so good on them at their best I was very hesitant to eliminate them. I did the abendazole 100mg caps twice per day for three days but doubt I killed them all… now my aggravation symptoms (anxiety and diarrhea) are greatly diminished. [https://www.facebook.com/groups/htsupport/permalink/986981108024511/?comment_id=986992398023382&comment_tracking=%7B%22tn%22:%22R3%22%7D]{{Quote|/indent}}

In some cases, side effects - especially diarrhoea - can persist for some time after a colony has been terminated.

===Reducing the size of a hookworm colony===

If too many worms have been added, resulting in unmanageable side effects, it may not be necessary to terminate the entire colony. Carrying out a partial cull should reduce the severity of the side effects while leaving some worms to continue the therapy.

A partial cull can be achieved by using any of the substances categorised in the [[Human helminth care manual | '''Human helminth care manual''']] as being potentially lethal to human helminths (marked with an ❌), although the effects of these substances will not be as predictable as those of an anthelmintic drug. The details on the [[Terminating a helminth infection | '''Terminating a helminth infection''']] page can be used to tailor a cull to meet the individual self-treater’s particular needs. For example, a single 500mg dose of mebendazole may kill approximately 30% of a colony of NA and, if this doesn't provide sufficient relief from the side effects, further doses of the drug can be taken as required.

===Is there a constitutive limit on colony size?===

Croese, et al., observed that the size of hookworm colony returned to the pre-inoculation level by week 21 and, even though this study using capsule endoscopy had involved only two subjects, it’s authors opined that there is a colony size status quo that is constitutively set by the host.

* [http://www.ncbi.nlm.nih.gov/pubmed/16890593 Allergy controls the population density of Necator americanus in the small intestine]

This assertion by Croese, et al., appears to be contradicted by the findings of a more recent study in which a colony of NA observed in a patient was described as "massive".

* [https://www.ncbi.nlm.nih.gov/pubmed/25926209 Obscure overt gastrointestinal bleeding due to Necator americanus diagnosed by double-balloon enteroscopy]

There may also be different degrees of predisposition to hookworm infection in different groups, e.g., young/old, male/female, [https://www.ncbi.nlm.nih.gov/pubmed/29382360] and other influences on colony size may include blood group. [https://www.ncbi.nlm.nih.gov/pubmed/23286203]

Before these more recent studies were published, the earlier paper by Croese, et al., had prompted the following discussion in the Helminthic Therapy Support group on Facebook.
{{Expando|Read the full discussion...}}
'''DD'''
{{Quote|indent}}It has recently come to my attention that two Australian researchers, Drs Croese and Speare, inoculated with hookworm and then did capsule endoscopy (swallowed a pill camera). It seems that no matter how many they inoculated with (50-100), Dr. Croese always ended up with 6-9 living adult worms and Dr. Speare always ended up with about 16.{{Quote|/indent}}
'''TC'''
{{Quote|indent}}this doesn't quite made sense to me. we already know many people in countries where hookworm are endemic have too many of them, to the point of becoming anemic.{{Quote|/indent}}
'''LE'''
{{Quote|indent}}It doesn't really make sense to me either, but OTOH, anecdotally, I've read similar things, that maybe the established worms have a way of preventing new ones from doing well. There is a lot of contradictory information. The other issue is that people in the developing world can be getting inoculated on a daily basis. It doesn't seem to me that a pill camera would necessarily image every square millimeter of intestine, though.{{Quote|/indent}}
'''DD'''
{{Quote|indent}}I understand that most people 'in the wild' have a small number too. It is only a few who can't seem to control the number and have enough for anemia. This could also explain why nobody is reporting anemia among us users even though several have inoculated with relatively large doses. I agree LE, that perhaps some could be missed by pill cam. But I wouldn't think it would be many.{{Quote|/indent}}
'''LE'''
{{Quote|indent}}Then the issue, too, if you start out low and slow is what is the carrying capacity going to be? If you only got 7, maybe your carrying capacity is 15. Or is it going to lock at 7 because that's what you started with? My daughter definitely seems better after a significant top off, the rest of us, it's hard to see much difference yet.{{Quote|/indent}}
'''DD'''
{{Quote|indent}}I suspect that if your carrying capacity was 15 then it wouldn't change if you started with 7. I imagine it could change though based on other factors. For instance, I suspect it might grow with age as our immune systems become less robust.{{Quote|/indent}}
'''KK'''
{{Quote|indent}}since it was only two guys who did the pill cam, that is not a very big representation of any population. u all have seen so many variables amongst us all, and wherein, for example, some seem to only be able to carry their worms for a relatively short time period and then they die, repeatedly, that this could just be an individual thing that these two men happened to share.{{Quote|/indent}}
'''BS'''
{{Quote|indent}}It is a fascinating thing to speculate on how many we actually have and whether our immune systems or the worms themselves regulate our worm carrying capacity.

If this is the rule for hookworm, though, such that a dose of 15 or 50 or 100 or repeated top up doses all result in the same worm load, I wonder how to account for a few things from the historical record.

1) The Italians building the Gotthard tunnel in the late 19th century - they not only got very sick, but many of them died of congestive heart failure. If the worm load is independent of repeated doses and only depends on the individual's predetermined load based on genetics or whatever, what would explain such an epidemic? The tunnel workers likely mostly already had hookworm (how else would it have got into the tunnel in the first place?), so if repeated doses did not increase their loads, why did they go from asymptomatic as a group to sick enough to lead to the discovery of AD?

2) I have the same question for the history of the southern US and NA. Hookworm overloading due to repeated dosing was supposed to be significant enough to cause anemia in enough people to decimate the economy and motivate founding of the rockefeller commission to combat it. Moreover, if repeated dosing does not increase the worm load for most of the population, why was the rockefeller solution, which primarily involved latrines to limit re-infection, so effective that the whole economy was successfully recovered. They did not give everyone multiple doses of mebendazole, so it's not like hookworm was being eliminated. The effect could only be due to reduced worm loads. If the ultimate equilibrium load is not affected by repeated dosing, how can it then go down so profoundly merely be stopping the repeat dosing?

If either hookworm species really behaves in such a benign way, it would also be unique among parasitic eukaryotes.

I suppose it's also possible that even if the adult equilibrium population is independent of dosing magnitude and frequency, that the therapeutic effect may still depend more on how many helminths you are dosed with than how many survive.

Then the situation with NA would be more analogous to TSO - in TSO it the immune response to the attempted infestation that must be doing the trick as there is no persistent infection with adult TS? The effects we get with NA may be similarly be related to the transit of larvae

So it does not follow that even if equilibrium worm load remains the same that it is useless to top up or that larger doses are not more effective.

But I still am skeptical that worm load is a zero order function with respect to dose magnitude and frequency. I'm sure it's not perfectly linear, but there is no other way to account for populations being devastated by poor sanitation than that there is some increase in load with increasing area under the curve for dose....

There is a way that I might trust to actually count worms and it would not be that hard to do. One could make a monoclonal antibody to NA and then bind it to radioactive technetium. Lay down under a gamma camera and you might be able to resolve the number of worms if they were somewhat spread out.

I am a bit skeptical that a pill cam will see them all, given the size of colonic lesions I've seen missed by colonoscopy.

And then there is the Pritchard dose ranging study. Although the numbers were small, the people getting larger doses were pretty reliably sicker and had larger immune responses to match. One would have to believe that the worms were having attrition well after the establishment of enteritis-causing adults in the gut - an attrition that is proportional to the initial dose. More than proportional to the initial dose, actually.

IOW, the immune response is more than proportional to the initial dose, but does not prevent adults attaching to the mucosa long enough to cause eosinophilic enteritis.

And then one would have to further believe that most of the adults attached to the mucosa are then later successfully eliminated, and that the higher the initial dose, the higher fraction of worms are killed by the immune system. Otherwise, the higher the initial dose, the higher the ultimate worm load and we are back to square one.{{Quote|/indent}}
'''JL'''
{{Quote|indent}}Whether new worms displace old ones has been documented in those with Crohn's taking very large doses (50 at a shot), but I doubt it occurs in anyone without either Crohn's, Coeliac or UC. Or intestinal allergies and perhaps IBS, too.{{Quote|/indent}}
'''MD'''
{{Quote|indent}}I did read the Croese paper quite a long time ago but really did not take much notice of it for the following reasons. I can not see how HW could pose any sort of risk to health in environments where infection is uncontrolled if there were some mechanism which allowed the body to keep numbers so low.

So if we are capable of limiting HW number it is clear that even in someone who was malnourished the presence of approx 20 HW is going to have almost no effect, therefore either the observation that HW have historically been a major cause of morbidity and mortality is incorrect, and people were developing anaemia and other health problems attributed to HW but actually due to other causes.

Or final HW numbers are a direct result of the number of exposures and there is no limiting factor to the final population, allowing numbers that are large enough to cause or contribute to pathology. If this is the case, which I believe it is, there must simply be some factor or variable in Croese's experiments that resulted in numbers being limited. Just because something gets into print does not mean that it is not open to mistakes (experimental) and misinterpretation of experimental data.{{Quote|/indent}}
{{Expando}}

== Colony collapse ==

Occasionally, hookworm hosts may experience the total loss of their colony, possibly as a result of taking certain antibiotics or consuming one of the other substances that are capable of harming hookworms. (For more details, see the [[Human helminth care manual | '''Human Helminth Care Manual''']].) Colony collapse is uncommon, as is the need to deliberately terminate a colony and start over, but, if it does occur, disease symptoms may return rapidly.

{{Quote|indent}}When I took antibiotics, my symptoms returned within 2 days. It was incredibly eye opening and scary. I forgot how much they were helping. [https://www.facebook.com/groups/htsupport/permalink/3098056870250247/?comment_id=3109154112473856]{{Quote|/indent}}

{{Quote|indent}}When I lost mine, it was apparent the next day. [https://www.facebook.com/groups/htsupport/permalink/1003791383010150/] I felt as though I had been hit by a truck ... and it didn't go away. [https://www.facebook.com/groups/htsupport/permalink/1003791383010150/?comment_id=1003868963002392&reply_comment_id=1003870503002238&comment_tracking=%7B%22tn%22:%22R5%22%7D]{{Quote|/indent}}

{{Quote|indent}}When they (NA) died off, and I didn’t reinoculate for a month because the shipment was late, I completely relapsed. [https://www.facebook.com/groups/htsupport/permalink/3028113193911282/?comment_id=3029321047123830&reply_comment_id=3029767700412498]{{Quote|/indent}}

Some subjects have reported a more gradual loss of benefits after a colony collapse, this difference perhaps being due to these individuals having hosted worms for a longer period.
{{Quote|indent}}During about 5 weeks after the Albendazole, she felt OK but little by little allergy symptoms started to appear. [https://www.facebook.com/groups/htsupport/permalink/1005760636146558/]{{Quote|/indent}}
{{Quote|indent}}I gradually began to notice increased brain fog, my lips became drier than usual and my skin slightly more itchy. Then, at around three weeks after the severe diarrhoea (induced by excessive binging on sauerkraut), I began to experience a return of nasal congestion... Daily headaches also returned around this time, my appetite was non-existent, and food tolerance was somewhat reduced... My concentration got worse and I was needing more sleep again... Then, I noticed definite hints of Restless Leg Syndrome when I took a nap, and my gut began to become sore after eating. [https://www.facebook.com/groups/htsupport/permalink/385931704796124/?comment_id=386773128045315&offset=0&total_comments=27]{{Quote|/indent}}

When a colony is lost before any benefits have been experienced, the host may not know that their worms have succumbed. This is one reason why it's important to continue to add supplementary doses at 12 week intervals until benefits have become obvious.

=== Restocking after a loss of hookworms ===

In the absence of any existing worms to modulate the immune response to a replacement dose following a colony collapse, this dose should be of an appropriately limited size, perhaps similar to the dose that was used at the very beginning of treatment, if this proved to be effective without causing undue side effects.

A full return of benefits may take a while, and the length of time varies between individuals.

{{Quote|indent}}After only 2 and half weeks of adding back 5 NA since I killed my colony, my asthma is so much better and my cracked heels are starting to heal. [https://www.facebook.com/groups/htsupport/posts/8265511920171357/]{{Quote|/indent}}

{{Quote|indent}}I killed off my colony with 5 days at albendazole. I inoculated with 20 about a week later and got results in 6-7 weeks. [https://www.facebook.com/groups/htsupport/posts/4777138182342099?comment_id=4777576998964884]{{Quote|/indent}}

{{Quote|indent}}It’s now 10 weeks after my new colony was started and my legs (Restless Legs syndrome) have been mostly calm for about 2 weeks. [https://www.facebook.com/groups/htsupport/permalink/2691889877533617/?comment_id=2692808750775063&reply_comment_id=2693035944085677]{{Quote|/indent}}

{{Quote|indent}}The benefits returned 12 weeks after my first inoculation after this (colony collapse) happened, even though it took about 8 months to get benefits the first time. [https://www.facebook.com/groups/htsupport/permalink/2526516047404335/?comment_id=2526543394068267]{{Quote|/indent}}

{{Quote|indent}}It took a solid 20 weeks to recover and see most of the symptoms go away, and another 4-8 weeks after that to eat some gluten and nightshades. [https://www.facebook.com/groups/htsupport/permalink/3028113193911282/?comment_id=3029321047123830&reply_comment_id=3029767700412498]{{Quote|/indent}}

{{Quote|indent}}It has taken easily 6 months to get back to where I was. [https://www.facebook.com/groups/htsupport/permalink/3098056870250247/?comment_id=3109154112473856]{{Quote|/indent}}

Some benefits may return more quickly than others.

{{Quote|indent}}I experienced small but noticeable benefit within 10 days. However it took another year to approach the benefits that I had just begun to experience before my third dose. [https://www.facebook.com/groups/htsupport/permalink/2599777423411530/?comment_id=2599896376732968]{{Quote|/indent}}

{{Quote|indent}}Almost two weeks after the new team of worms went in, I was again enjoying a degree of relief, though I still had some way to go before I was back to my usual wormy bliss. I was still getting a little nasal congestion, some brain fog and a lot of headaches, but I was once again free from the Restless Leg Syndrome. The last symptom to go was nasal congestion, which continued to be a problem until 12 weeks, when it became significantly easier, though it didn't go completely until almost week 20, at which point I was pretty much back to how I had been before the explosive diarrhoea (induced by excessive binging on sauerkraut) that had flushed out my worms. [https://www.facebook.com/groups/htsupport/permalink/385931704796124/?comment_id=386773128045315&offset=0&total_comments=27]{{Quote|/indent}}

==Hookworm dosing in children==

Children are usually introduced to hookworms with a first dose of 3 larvae, or possibly 5, but no more than 3 if they have one of the [[Helminthic therapy safety#Conditions that require a modified approach to helminth dosing | '''conditions that require a modified approach to helminth dosing''']]. Some parents have chosen to start with just 1 or 2 larvae.

{{Quote|indent}}My son was born with severe allergies to cows milk protein (bleeding rectally at 4 months) and developed really horrible eczema. First dose I gave him was 3 HW and it got rid of his eczema. Second dose was at age 4, 3rd at age 5. Up until the age of 5 he was given no more than 3hw at a time once a year and it worked. As he grew older, he needed more. At age 5, I gave him 5 worms, if i recall correctly, and dosed 2x a year. [https://www.facebook.com/groups/htsupport/permalink/3764345383621389/?comment_id=3765533550169239]{{Quote|/indent}}

{{Quote|indent}}I did 3NA every 3 months 2x (for a baby with severe eczema), then 5 NA every 3 months until clear skin (3 doses). Then, when my daughter was 4 or 5, I went up to 7NA once a year for maintenance dose. The side effects were minimal, but I did use benedryl cream to get her through the itchy dosing phase. [https://www.facebook.com/groups/htsupport/posts/23871765609119403/?comment_id=23872265762402721]{{Quote|/indent}}

Based on the child’s experience with the first dose, subsequent doses can be increased gradually, if required, using the approach described above in the [[Hookworm dosing and response#Supplementary doses | '''Supplementary doses''']] section.

Some children '''''may''''' eventually be able to tolerate doses of up to 25 larvae, and might benefit from being given these larger numbers, once they have a well established hookworm colony.

{{Quote|indent}}We gave him 5, 5, 10, and 25, over 18 months. He would flare up after a while so we always figured the worms had stopped working. And sure enough once he’d had another dose, three months later he’d be perfect skin again. So the final dose of 25 has lasted us much longer and seems like he just needed higher numbers. [https://www.facebook.com/groups/htsupport/permalink/1992070807515531/?comment_id=2002078103181468&reply_comment_id=2005571822832096&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

Also see the following page.

* [[Helminthic therapy and children | '''Helminthic therapy and children''']]

==See also==

* [[Hookworm timeline | '''Hookworm timeline''']]
* [[Hookworm side effects | '''Hookworm side effects''']]
* [[Helminthic therapy FAQ#How long does helminthic therapy take to effect a cure? | '''How long does helminthic therapy take to effect a cure?''']]

Helminthic therapy in the media

2026-05-10T00:26:27Z

John: /* Articles */

{{Breadcrumb}}
{{SEO 
|title=
|description=Media coverage of helminthic therapy. Lists of articles, videos, YouTube channels, podcasts, webinars, books and a lecture concerned with helminthic therapy.
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|og:image=[[File:wiki.png]]}}
This page lists various forms of media coverage relating to helminthic therapy and closely related topics.

<div style="background-color:#FFF5FA;border: 1px solid #F2CEDD; padding:8px; padding-left:8px; margin-bottom:12px;">
'''NB. There are details at some of the links on this page that are out of date or factually incorrect, especially in some of the pieces by journalists, but also in a few of the comments made by scientists and clinicians. Therefore, before acting on anything gleaned from these sources, readers are advised to compare the details with those on relevant pages in this wiki or to ask about them in the [https://www.facebook.com/groups/htsupport/ Helminthic Therapy Support group] on Facebook.''' </div>

__TOC__

<div style="background-color:#F5FAFF; border: 1px solid #CEDFF2; padding:8px; padding-left:8px; margin-bottom:26px;margin-top:26px;">
<div style="border:1px solid #A3B0BF;background-color:#CEDFF2;padding-left:8px;"><h2 style = "margin-top:10px;border:0px solid #CEDFF2;">Featured media</h2></div>

===Featured articles===

* [https://theconversation.com/they-might-sound-gross-but-intestinal-worms-can-actually-be-good-for-you-49868 '''They might sound gross, but intestinal worms can actually be good for you'''] - William Parker, The Conversation
Dr Parker is currently visiting professor in the Department of Psychology and Neuroscience at the University of North Carolina Chapel Hill. The Conversation is a well-respected outlet for researchers to write about their work for a general audience.

* [https://www.wired.com/2012/11/whipworm-immune-regulation/ '''The Potential Health Benefits of Parasitic Gut Worms'''] - Brandon Keim, Wired

===Featured videos===
2025 Jul 29 - [https://www.youtube.com/watch?v=H7uAdP8ER48 '''Helminthic Therapy for IBD: Personal Story + Medical Perspective'''] - Dr. Mark Davis and Dr. Natalie Scheeler from Foundational Medicine in discussion with Kyla Fuller, YouTube - '''69.46 minutes''' 
<youtube>hhttps://www.youtube.com/watch?v=H7uAdP8ER48</youtube>
2023 Jul 6 - [https://www.youtube.com/watch?v=28phztp-uG8 '''What is helminthic therapy?'''] - William Parker, YouTube - '''2.21 minutes''' 
Dr Parker is currently visiting professor in the Department of Psychology and Neuroscience at the University of North Carolina Chapel Hill.
<youtube>https://www.youtube.com/watch?v=28phztp-uG8</youtube>
2021 Nov 14 - [https://www.youtube.com/watch?v=SbT2EzMNphY '''Could a dose of worms be the answer to treating incurable autoimmune diseases?'''] - TVNZ Sunday - '''16.17 minutes''' 
An interview with two delighted users of helminthic therapy, and a scientist investigating the treatment.
<youtube>https://www.youtube.com/watch?v=SbT2EzMNphY</youtube>
2021 April 18 - [https://www.youtube.com/watch?v=oB8wFNYfDgY '''Translating Helminths to the Clinic'''] - William Parker, BTER Foundation, You Tube - '''61.17 minutes''' 
Dr Parker is currently visiting professor in the Department of Psychology and Neuroscience at the University of North Carolina Chapel Hill.
<youtube>https://www.youtube.com/watch?v=oB8wFNYfDgY</youtube>
2018 Jan 25 - [https://www.youtube.com/watch?v=qD6fmHUXBEg '''Why You Might Want Parasitic Worms'''] - Hank Green, SciShow, YouTube - '''6.08 minutes''' 
A video by Complexly, the education channel created by educators and writers John and Hank Green.
<youtube>https://www.youtube.com/watch?v=qD6fmHUXBEg</youtube>
2016 Nov 29 - [https://youtu.be/sm5DcdZbnGA '''Worming your way to good health'''] - Paul Giacomin, TEDxJCUCairns - '''12.52 minutes''' 
Dr Giacomin is currently Senior Research Fellow in the Australian Institute of Tropical Health & Medicine at James Cook University in Cairns.
<youtube>https://youtu.be/sm5DcdZbnGA</youtube>
</div>

==Articles==

'''2026'''

* 2026 Apr 15 [https://helminthictherapy.substack.com/p/multiple-sclerosis-blame-our-steppe Multiple Sclerosis: Blame Our Pontian-Caspian Steppe Ancestors and the Disappearance of Helminths] - Jacques Le Marois, Substack

* 2026 Mar 23 [https://www.medscape.com/viewarticle/parasitic-worms-provide-insights-rsv-prevention-2026a10008ob?form=fpf Parasitic Worms Provide Insights on RSV Prevention] - Heidi Splete, Medcape

* 2026 Mar 19 [https://medicalxpress.com/news/2026-03-gut-microbiome-fiber-tapeworms.html Gut microbiome thrives on fiber—tapeworms confirm it] - Medical Express. (Also reported by [https://scitechdaily.com/the-surprising-diet-rule-that-makes-good-parasites-work/ SciTechDaily].)

'''2025'''

* 2025 Sep 29 [https://www.pew.org/en/research-and-analysis/articles/2025/09/29/a-small-worm-offers-big-clues-about-the-human-immune-system A Small Worm Offers Big Clues About the Human Immune System] - Pew

* 2025 Aug 29 [https://www.freethink.com/biotech/worms-immune-system We purged worms from our bodies — and may have made ourselves sick] - Namir Khaliq, Freethink

* 2025 Jun 3 [https://knowablemagazine.org/content/article/health-disease/2025/worm-inspired-treatments-inch-toward-clinic Worm-inspired treatments inch toward the clinic] - Amber Dance, Knowable Magazine

* 2025 Apr 12 [https://www.dailymail.co.uk/health/article-14602249/Why-people-infecting-parasitic-WORMS-cure-chronic-illnesses.html Why people are deliberately infecting themselves with parasitic WORMS to 'cure' chronic illnesses... and how it might actually work] - Jo MacFarlane, Daily Mail

'''2024'''

* 2024 Aug 23 [https://scitechdaily.com/beyond-the-gross-factor-the-healing-powers-of-parasitic-worms/ Beyond the Gross Factor: The Healing Powers of Parasitic Worms]

* 2024 Jan 6 [https://www.rnz.co.nz/news/in-depth/506122/infection-with-benefits-how-playing-host-to-hookworms-could-be-good-for-you?fbclid=IwAR1jVIsdoYBwHIdSIdHHjwuRdo-_qeMpTOJWiV_fO9LpeOgbSvV1VwlPjVM Infection with benefits: How playing host to hookworms could be good for you] - Farah Hancock, Radio New Zealand (RNZ)

* 2024 Jan [[media:Could_these_parasitic_worms_be_good_for_your_health%3F.pdf | Could these parasitic worms be good for your health?]] - Cate Montana, What Doctors Don’t Tell You

'''2023'''

* 2023 Aug 31 [https://www.9news.com.au/national/illegal-and-unsafe-tga-warns-against-selfinfecting-with-worms-bought-online/a05cdb1d-17d1-4990-8a05-efad12b7fabe 'Illegal and unsafe': TGA warns against self-infecting worms trend] - Emily McPherson, 9news.au
:: (For a more balanced appraisal of this article and its subject matter, see [[media:Medical researchers abandon therapy with living worms.pdf | '''this rebuttal''']].)

* 2023 Aug 23 [https://www.ausdoc.com.au/news/why-patients-are-self-infecting-with-hookworms-bought-on-the-internet/ Why patients are self-infecting with hookworms bought on the internet] - Rachel Fieldhouse, Australian Doctor
:: (For a more balanced appraisal of this article and its subject matter, see [[media:Medical researchers abandon therapy with living worms.pdf | '''this rebuttal''']].)

* 2023 Aug 1 [https://www.abc.net.au/news/2023-08-01/research-finds-live-hookworm-safe-promising-diabetes/102670418 Clinical trial into use of hookworms for diabetes prevention produces encouraging results] - Christopher Testa, ABC News

* 2023 Jul 26 [https://www.health.com/hookworms-for-ulcerative-colitis-7565498 Could Infecting People With Hookworms Help Treat Ulcerative Colitis Someday?] - Sarah Sloat, Health News

'''2022'''

* 2022 Jul 12 [https://www.tweaktown.com/news/87338/new-custom-engineered-parasites-seek-out-and-destroy-cancer-cells/index.html New 'custom' engineered parasites seek out and destroy cancer cells] - Adam Hunt, TweakTown

* 2022 Jun 27 [https://www.verywellhealth.com/helminth-therapy-5225248 Everything You Need to Know About Helminth Therapy] - Adrienne Dellwo, Verywell Health
:: (This article is written from a medical and parasitological perspective by an author who is clearly unaware of how this therapy is practiced in the real world. There are also several significant factual errors, for example, "thorny-headed" worms are not used in this therapy, and the treatment is never delivered by injection.)

* 2022 May 29 [https://youarethehealer.org/parasitic-helminths-protect-organ-transplants/ Parasitic Helminths Protect Organ Transplants] - Dr Sharol, You Are The Healer

* 2022 Feb 16 [https://www.malaghan.org.nz/news-and-reports/news/in-focus-making-friends-with-enemies-unexpected-solutions-to-our-allergy-epidemic Making friends with enemies, unexpected solutions to our allergy epidemic] - In focus, Malaghan Institute News

* 2022 Jan 3 [https://michellesblog.co.uk/hidden-healers-parasitic-worms/ Hidden healers – parasitic worms?] - Michelle Berridale Johnson, Foods Matter

'''2021'''

* 2021 Dec 1 [https://www.the-scientist.com/features/return-of-the-worms-69427 Return of the worms] - Catherine Offord, The Scientist

* 2021 Nov 22 [https://metabolichealing.com/parasites-lost-helminths-pleiotropy-and-the-prevention-of-dementia/ Parasites lost: helminths, pleiotropy, and the prevention of dementia] - Michael McEvoy, Metabolic Healing

* 2021 Oct 26 [https://medicine.wustl.edu/news/hookworms-have-potential-to-protect-soldiers-from-chemical-biological-weapons/ Hookworms have potential to protect soldiers from chemical, biological weapons] - Julia Evangelou Strait, Washington University School of Medicine

* 2021 Oct 2 [https://globalbiodefense.com/2021/10/02/protective-biosystems-parasites-to-fight-chemical-and-biological-weapons/ Protective Biosystems: Parasites to Fight Chemical and Biological Weapons] - Global Biodefense

* 2021 Aug 12 [https://metabolichealing.com/maladaptive-genetics-evolutionary-mismatches-helminthic-therapy-complex-disease-in-the-modern-era/ Maladaptive Genetics: Evolutionary Mismatches, Helminthic Therapy & Complex Disease in the Modern Era] - Michael McEvoy, Metabolic Healing

* 2021 Jul 29 [https://web.archive.org/web/20221128194039/https://medicine.wustl.edu/news/hookworms-have-potential-to-protect-soldiers-from-chemical-biological-weapons/ Research using parasitic worms to protect troops from bio weapon] - 1 News, Television New Zealand

* 2021 Jul 20 [https://www.medicalnewstoday.com/articles/helminth-therapy What to know about helminth therapy] - Mathieu Rees, Medical News Today

* 2021 May 6 [https://www.news-medical.net/health/Immunotherapy-and-Helminthic-Therapy.aspx Immunotherapy and Helminthic Therapy] - Sally Robertson, News Medical

* 2021 Apr 15 [https://www.thenakedscientists.com/articles/interviews/parasites-and-ageing-process Parasites and the ageing process] - Chris Smith interviews Bruce Zhang for The Naked Scientists

* 2021 Apr 8 [https://www.nationalgeographic.com/science/article/parasites-are-going-extinct-heres-why-we-need-to-save-them Parasites are going extinct. Here's why we need to save them.] - Erika Engelhaupt, National Geographic

* 2021 Apr 4 [https://www.news-medical.net/news/20210204/Research-shows-intestinal-parasite-infestations-reduce-COVID-19-severity.aspx? Research shows intestinal parasite infestations reduce COVID-19 severity] - Liji Thomas MD, News Medical

* 2021 Feb 14 [https://www.telegraph.co.uk/news/2021/02/14/parasitic-worms-could-hold-key-anti-ageing-researchers-suggest/ Parasitic worms could hold key to anti-ageing, researchers suggest] - Lizzie Roberts, The Telegraph

* 2021 Feb 12 [https://studyfinds.org/parasitic-worms-are-the-key-to-a-longer-life-scientists-say-they-can-actually-help-slow-aging/ Parasitic worms are the key to a longer life? Scientists say they can actually help slow aging] - John Anderer, StudyFinds

* 2021 Feb 2 [https://www.sciencedaily.com/releases/2021/02/210202113730.htm Could playing host to hookworms help prevent aging?] - Science Daily

'''2020'''

* 2020 Nov 19 [https://optimalhealthnutrition.co.uk/helminthic-therapy/ Helminthic Therapy] - Daisy Ilchovska interviews Judy Chinitz for Optimal Health Nutrition

* 2020 Oct 30 [https://metabolichealing.com/helminthic-therapy-cirs-could-this-be-the-missing-link Helminthic Therapy and CIRS: Could this be the Missing Link?] - Michael McEvoy, Metabolic Healing

* 2020 Oct 30 [https://web.archive.org/web/20220516224132/https://communique.uccs.edu/?p=128160 Cepon-Robins illustrates how immune responses to intestinal parasites could reduce severity of COVID-19] - Anna Squires, Communique

* 2020 Aug 22 (accessed on) [https://drwillcole.com/autoimmune-health/helminthic-therapy-could-this-be-the-secret-treatment-for-autoimmunity Helminthic Therapy: Could This Be The Secret Treatment For Autoimmunity?] - Dr Will Cole

* 2020 Aug 17 [https://www.genengnews.com/news/allergies-asthma-copd-treatments-may-worm-their-way-into-development/ Allergies, Asthma, COPD Treatments May Worm Their Way into Development] - Genetic Engineering & Biotechnology News

* 2020 Jul 8 [https://theconversation.com/how-parasitic-worms-could-lead-to-new-treatments-for-asthma-141572 How parasitic worms could lead to new treatments for asthma] - Henry McSorley & Danielle Smyth, The Conversation

* 2020 Jun 18 [https://www.sciencedaily.com/releases/2020/06/200618150223.htm Hookworm trial offers new hope to MS patients] - Science Daily

'''2019'''

* 2019 Sept 10 [https://www.acsh.org/news/2019/09/10/guess-ill-go-eat-some-worms-14261 Guess I'll Go Eat Some Worms] - Chuck Dinerstein, American Council on Science and Health

* 2019 Sept 5 [https://medicalxpress.com/news/2019-09-helminthic-infections-beneficial-hiv-.html Helminthic infections may be beneficial against HIV-1] Medical Xpress

* 2019 Jul 30 [https://web.archive.org/web/20200207190930/https://www.newsroom.co.nz/2019/07/30/701634/what-gut-worms-could-do-for-cancer What gut worms could do for cancer] - Farah Hancock, Newsroom. (Also see this [[Graham Le Gros and helminthic therapy | '''Graham Le Gros and helminthic therapy''']].)

* 2019 Jul 20 [https://web.archive.org/web/20190721123358/https://www.stuff.co.nz/national/health/114332185/kiwi-researchers-given-green-light-for-worldfirst-human-trial-exploring-the-health-potential-of-parasitic-worms Kiwi researchers to start world-first human trial exploring the health potential of parasitic worms] - Ruby Macandrew, Stuff NZ (Also see this [https://helminthictherapywiki.org/wiki/images/4/4d/Graham_Le_Gros_and_Helminthic_Therapy.pdf rebuttal of Prof Le Gros’ comments].)

* 2019 Jun 26 [https://www.spectrumnews.org/features/deep-dive/supplements-worms-stool-families-trying-game-gut-treat-autism-traits/ Supplements, worms and stool: How families are trying to game the gut to treat autism traits] - Leah Shaffer, Spectrum

* 2019 May 28 [https://aeon.co/essays/gut-worms-were-once-a-cause-of-disease-now-they-are-a-cure We need worms] - William Parker, Aeon

* 2019 May 25 (accessed on) [https://blog.paleohacks.com/can-parasites-heal-autoimmune-diseases/ Can Parasites Heal Autoimmune Diseases?] - Aimee McNew, PaleoHacks

* 2019 Apr 30 [https://web.archive.org/web/20220528014843/https://asm.org/Articles/2019/April/Helminths-and-Health-Finding-Purpose-in-Our-Old-Fr Helminths and Health: Finding Purpose in Our Old Friends] - Erica Bizzell, American Society for Microbiology

* 2019 Apr 21 [https://us.cnn.com/2019/04/19/health/bolivia-heart-disease-chasing-life-gupta/index.html Life lessons from the native tribe with the healthiest hearts in the world] - Dr Sanjay Gupta, CNN

* 2019 Mar 19 [https://doctordoni.com/2019/03/hookworm-for-your-health-benefits/ Hookworm Therapy for Autoimmune, Allergy and Asthma Relief] - Dr Doni Wilson

* 2019 Feb (accessed in) [https://www.ifm.org/news-insights/gut-hygiene-hypothesis-helminth-treatments/ The Hygiene Hypothesis & Helminth Treatments With Parasitic Worms] The Institute for Functional Medicine

* 2019 Feb [https://experiencelife.com/article/the-parasite-paradox/amp/ The Parasite Paradox] - Pamela Weintraub, Experience L!fe

* 2019 Jan 12 (Updated 2021 Apr 19) [https://web.archive.org/web/20230605022419/https://www.verywellhealth.com/using-hookworms-to-treat-celiac-disease-562299 Using Hookworms To Treat Celiac Disease] - Jane Anderson, Verywell Health (via the WayBack Machine)

* 2019 Jan 12 (accessed on) [https://blog.bulletproof.com/helminthic-therapy-autoimmune-disease/ Helminthic Therapy for Autoimmune Disease (Or, Why I Gave Myself Parasites on Purpose)] - Dave Asprey, Bulletproof Blog

* 2019 Jan 9 [https://web.archive.org/web/20190123191306/https://www.noted.co.nz/health/health/parasitic-worms-solution-asthma-eczema-coeliac-disease/ Parasitic worms could be the solution to asthma, eczema and coeliac disease] - Nicky Pellegrino, New Zealand Listener

* 2019 Jan (accessed in) [https://goop.com/wellness/health/can-parasites-cure-autoimmune-diseases/ Can Parasites Cure Autoimmune Diseases?] - A Q&A with Will Cole, Goop

'''2018'''

* 2018 Oct 02 [https://bengreenfieldfitness.com/article/why-i-eat-tapeworms-whipworms-every-two-weeks-the-fascinating-world-of-helminthic-therapy/ Why I Eat Tapeworms & Whipworms Every Two Weeks: The Fascinating World Of Helminthic Therapy] - Ben Greenfield, Fitness
* 2018 Sept 20 [https://www.iflscience.com/health-and-medicine/should-you-deliberately-infect-yourself-with-an-intestinal-worm-for-your-health/all/ Should You Deliberately Infect Yourself With An Intestinal Worm For Your Health?] - Rosie McCall, IFLScience
* 2018 Jul 13 [https://helminthictherapywiki.org/wiki/images/2/2d/Hookworms_Make_Us_Human-_The_Microbiome%2C_Eco-immunology%2C_and_a_Probiotic_Turn_in_Western_Health_Care.pdf Hookworms Make Us Human: The Microbiome, Eco-immunology, and a Probiotic Turn in Western Health Care] (PDF) - Jamie Lorimer, Medical Anthropology Quarterly
* 2018 Jul 2 [https://kids.frontiersin.org/article/10.3389/frym.2018.00032 Eating Worms to Treat Autoimmune Diseases?] - Nerissa Ora Zyskind Tunnessen and Michael H. Hsieh, Frontiers for Young Minds
* 2019 Jul [https://www.naturalmedicinejournal.com/journal/2018-07/exploring-helminthic-therapy Exploring Helminthic Therapy] - Karolyn Gazella interviews Sidney Baker, MD, for Natural Medicine Journal
* 2018 May 30 [[Why doctor working in New Zealand infected himself with hookworms | Why doctor working in New Zealand infected himself with hookworms]] - Sarah Wilson, New Zealand Herald
* 2018 May [https://www.ifm.org/news-insights/hygiene-hypothesis-helminth-treatments/ The Hygiene Hypothesis & Helminth Treatments With Parasitic Worms] - Insights, the Institute for Functional Medicine
* 2018 Apr 27 [http://www.malaghan.org.nz/news/the-worms-within-us-how-parasites-could-help-beat-disease/ The worms within us: How parasites could help beat disease] - Republication by the Malaghan Institute of Medical Research of an article by Jamie Morton, first published in the New Zealand Herald.
* 2018 Mar 22 [https://www.acsh.org/news/2018/03/22/parasitic-worms-block-high-fat-diet-induced-obesity-mice-12744 Parasitic Worms Block High Fat Diet-Induced Obesity In Mice] - Alex Berezow, American Council on Science and Health
* 2018 Mar 2 [https://newatlas.com/tapeworms-inflammatory-bowel-disease/53649/ Could tapeworms prevent bowel disease in children?] - Ben Coxworth, New Atlas
* 2018 Feb 7 [http://www.abc.net.au/news/2018-02-07/hookworm-infection-could-help-solve-gluten-intolerance/9404770?sf181502307=1 Hookworms... could solve gluten intolerance] - Kathy Sundstrom and Annie Gaffney, ABC Sunshine Coast

'''2017'''
* 2017 Oct/Nov [https://acrobat.adobe.com/link/track?uri=urn%3Aaaid%3Ascds%3AUS%3A0e05a9f7-e7c5-4cf5-8996-29c504aee1b5&viewer%21megaVerb=group-discover Helminthic therapy and autism: a promising treatment with a PR problem] - William Parker, Autism File
* 2017 Oct 11 [https://helminthictherapywiki.org/wiki/Hook_me_up!_Treating_autoimmune_disease_with_hookworms Hook me up! Treating Autoimmune Disease with Hookworms] - (Originally published on) The Way of Alpha
* 2017 Aug 20 [http://www.healthline.com/health-news/why-people-subject-themselves-to-worm-therapy-treatments#1 Why Do People Subject Themselves to ‘Worm Therapy’ Treatments?] - Heather Cruickshank, HealthLine
* 2017 Aug 14 [http://www.healthline.com/health-news/patients-resorting-to-worm-therapy-to-treat-autoimmune-diseases#1 Patients Resorting to ‘Worm Therapy’ to Treat Autoimmune Diseases] - Constance Gustke, HealthLine
* 2017 Aug 7 [https://www.newscientist.com/article/2142925-i-tried-ingesting-rat-tapeworm-parasites-and-my-poo-turned-green/ I tried ingesting rat tapeworm parasites and my poo turned green] - Andy Coghlan, New Scientist Daily News
* 2017 Aug 7 [https://www.newscientist.com/article/2142897-parasitic-worm-eggs-may-soon-be-legally-sold-as-food-in-germany/?utm_campaign=RSS%7CNSNS&utm_source=NSNS&utm_medium=RSS&utm_content=life&campaign_id=RSS%7CNSNS-life Parasitic worm eggs may soon be legally sold as food in Germany] - Andy Coghlan, New Scientist Daily News
* 2017 July 28 [http://www.popsci.com/can-intestinal-worms-treat-autoimmune-disease Scientists are trying to treat autoimmune disease with intestinal worms] - Kate Baggaley, Popular Science
* 2017 May 30 [http://www.dailymail.co.uk/health/article-4553130/Would-swallow-glassful-worms-banish-allergies.html Would YOU swallow a glassful of worms to banish your allergies?] - Helen Thomson, Daily Mail
* 2017 Apr 24 [http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=11843946 Infected with hookworms to help cure gluten allergies] - Gabrielle Stuart, NZ Herald
* 2017 Apr 19 [http://www.dailymail.co.uk/health/article-4422218/Autistic-boy-4-road-recovery-thanks-WORMS.html Severely autistic boy, 4, is on the road to recovery after undergoing worm therapy despite being told he would never lead a normal life] - Stephen Matthews, Mail Online
* 2017 Feb 23 [[media:Parasites, ghosts and mutualists- a relational geography of microbes for global health.pdf | Parasites, ghosts and mutualists - a relational geography of microbes for global health]] (PDF) - Jamie Lorimer, Transactions of the Institute of British Geographers, Royal Geographical Society.
* 2017 Feb 16 [https://medicalxpress.com/news/2017-02-parasites-clue-allergies-common-countries.html Parasites clue to why allergies are more common in developed countries] - Emma Rayner, MedicalXpress
* 2017 Feb 13 [https://www.businesslive.co.za/bd/life/2017-02-13-how-dr-wriggly-wormed-himself-into-the-affection-of-the-ill/ How Dr Wriggly wormed himself into the affection of the ill] - Shaun Smillie, Business Day
* 2017 Feb 8 [http://www.brisbanetimes.com.au/queensland/coeliac-disease-study-to-open-in-queensland-using-hookworms-20170208-gu8ksq.html Coeliac disease study to open in Queensland using hookworms] - Felicity Caldwell, Brisbane Times
* 2017 Jan 20 [http://darwinian-medicine.com/can-worms-cure-disease-17-questions-with-dr-william-parker/ Can Worms Cure Disease? 17 Questions With Dr William Parker] - Eirik Garnas, Darwinian Medicine

'''2016'''

* 2016 Dec 27 [https://www.yahoo.com/news/germs-dirt-hookworms-boost-health-145951749.html How Germs, Dirt and Hookworms Can Boost Your Health] - Ruben Castaneda, Yahoo News
* 2016 Dec 21 [https://www.nature.com/nature/journal/v540/n7634_supp/full/540S103a.html Worm charmer] - Neil Savage, Nature (Q&A with the late Joel Weinstock on his interpretation of the mechanisms by which helminths exert control over the immune system, with special reference to IBD.)
* 2016 Dec 20 [http://undark.org/article/helminths-ibs-worm-parasite-auto-immune/ Old Friends: The Promise of Parasitic Worms] - Leah Shaffer, Undark Magazine
* 2016 Oct 27 [http://www.huffingtonpost.co.uk/entry/hookworm-saliva-can-treat-asthma-and-allergies-study_uk_5811eccde4b0672ea687edad Asthma And Allergies May Find An Unlikely Treatment In Hookworm Saliva] - Oscar Williams, Huffpost Tech
* 2016 Oct 26 [http://www.chicagotribune.com/lifestyles/health/ct-hookworms-asthma-20161026-story.html Bloodsucking parasitic hookworms could help treat asthma] - Sarah Kaplan, Chicago Tribune
* 2016 Oct 26 [http://www.sciencemag.org/news/2016/10/protein-found-hookworm-soup-could-fight-asthma-other-autoimmune-diseases Protein found in hookworm ‘soup’ could fight asthma, other autoimmune diseases] - Jennifer Couzin-Frankel, Science
* 2016 Oct 6 [http://www.radionz.co.nz/national/programmes/nights/audio/201819018/hookworms-to-treat-coeliac-disease Hookworms to treat coeliac disease?] - Includes a linked podcast from Nights, Radio New Zealand
* 2016 Sept 28 [https://bigthink.com/surprising-science/how-parasites-are-used-in-modern-medicine/ How Parasites Are Used in Modern Medicine] - Philip Perry, The Big Think
* 2016 Sept 4 [https://web.archive.org/web/20221123192408/https://www.huffpost.com/entry/fecal-transplants-and-parasitic-infections-how-far_b_57bc6570e4b007f18199c7e5 Fecal Transplants And Parasitic Infections: How Far Would You Go To Get Your Life Back?] - Crohn, Health for Human
* 2016 Aug 20 [https://www.buzzfeed.com/stephaniemlee/crohns-experiment This Guy Swallowed Parasitic Worms On Purpose - Then Became A Published Scientist] BuzzFeedNews
* 2016 Aug 12 [http://www.npr.org/sections/goatsandsoda/2016/08/12/489619045/could-worms-in-your-gut-cure-your-allergies Could Worms In Your Gut Cure Your Allergies?] - Michaeleen Doucleff, NPR Goats and Soda
* 2016 Jul 6 [http://www.news-medical.net/news/20160706/New-research-highlights-need-to-abandon-modern-hygiene-hypothesis.aspx New research highlights need to abandon modern hygiene hypothesis] - News Medical
* 2016 Jul 5 [http://www.rheumatologynetwork.com/rheumatoid-arthritis/helminth-therapy-ra Helminth Therapy in RA] - Stephanie Pappas, Rheumatology Network
* 2016 Jul 1 [http://blogs.biomedcentral.com/bugbitten/2016/07/01/friend-foe-probiotic-power-of-helminths/ Friend or Foe; the probiotic power of helminths can prevent Crohn’s Disease] - Anouk Gouvras, BugBitten
* 2016 Jul 1 [http://www.sciencealert.com/scientists-think-parasitic-worms-could-be-the-key-to-treating-multiple-sclerosis Scientists want to use parasitic worms to treat multiple sclerosis] - Jacinta Bowler, ScienceAlert
* 2016 Jun 29 [http://www.news-medical.net/health/Old-Friends-Hypothesis.aspx Old Friends Hypothesis] - Yolanda Smith, News Medical
* 2016 Jun 16 [http://www.moisesvm.com/2016/06/16/notes-on-parasite-underground/ Notes on Parasite Underground] - Moises Velasquez-Manoff’s blog
* 2016 Jun 16 [http://www.nytimes.com/2016/06/19/magazine/the-parasite-underground.html?rref=collection/sectioncollection/health&action=click&contentCollection=health&region=stream&module=stream_unit&version=latest&contentPlacement=1&pgtype=sectionfront&_r=1 The Parasite Underground] - Moises Velasquez-Manoff, New York Times Magazine ([https://web.archive.org/web/20160616120611/https://www.nytimes.com/2016/06/19/magazine/the-parasite-underground.html archive.org version])
* 2016 Jun 3 [http://www.nytimes.com/2016/06/05/opinion/sunday/educate-your-immune-system.html Educate Your Immune System: Our bodies are confused by this 21st-century world] - Moises Velasquez-Manoff, New York Times
* 2016 May 17 [http://www.news-medical.net/news/20160517/Could-worm-infection-counter-IBD-An-interview-with-Dr-Loke-and-Dr-Cadwell.aspx Could worm infection counter IBD? An interview with Dr Loke and Dr Cadwell] - April Cashin-Garbutt, News Medical
* 2016 May 1 [[media:Gut Buddies - Multispecies Studies and the Microbiome.pdf | Gut Buddies - Multispecies Studies and the Microbiome]] - Jamie Lorimer, Duke University Press
* 2016 Apr 21 [http://pamplinmedia.com/pt/9-news/302838-180108-hooked-on-hookworms-and-other-parasites Hooked on hookworms (and other parasites)] - Peter Korn, Portland Tribune
* 2016 Apr 17 [https://web.archive.org/web/20221026183835/https://www.stuff.co.nz/life-style/well-good/teach-me/78818294/ive-got-parasitic-worms-living-inside-me-and-its-great I've got parasitic worms living inside me, and it's great] - Adam Dudding, Stuff NZ
* 2016 Apr 15 [http://www.medicaldaily.com/gut-microbiome-parasitic-worms-crohns-disease-381987?utm_source=internal&utm_campaign=right&utm_medium=related1 Parasitic Worms May Restore Balance To Gut Microbiome In People With Crohn's Disease] - Ed Cara, Medical Daily
* 2016 Apr 14 [https://www.sciencemag.org/news/2016/04/parasitic-worms-may-prevent-crohn-s-disease-altering-bacterial-balance Parasitic worms may prevent Crohn’s disease by altering bacterial balance] - Mitch Leslie, Science
* 2016 Apr 11 [http://www.forbes.com/sites/quora/2016/04/11/meet-the-parasites-that-might-cure-crohns-disease-ms-and-more/#381fe6722e3f Meet The Parasites That Might Cure Crohn's Disease, MS, And More] - Tirumalai Kamala, Forbes and Quora. (multiple sclerosis)
* 2016 Mar 31 [http://www.nytimes.com/2016/04/05/science/tapeworms-and-other-parasites-can-make-good-guests.html?_r=0 Tapeworms and Other Parasites Can Make Good Guests] - Carl Zimmer, The New York Times
* 2016 Mar 21 [http://www.seeker.com/life-sucking-parasites-can-help-save-species-1771085975.html Life-Sucking Parasites Can Help Save Species] - Talal Al-Khatib, Discovery
* 2016 Mar 11 [http://blogs.biomedcentral.com/bugbitten/2016/03/11/parasites-pigs-primates-origin-demography-trichuris-whipworms/ Parasites, pigs and primates – the origin and demography of Trichuris whipworms] - Anouk Gouvras, Bug Bitten
* 2016 Feb 8 [https://www.theguardian.com/lifeandstyle/2016/feb/08/why-a-diet-of-worms-could-be-good-for-you Why a diet of worms could be good for you] - David Kohn, The Guardian
* 2016 Jan 13 [https://theconversation.com/if-being-too-clean-makes-us-sick-why-isnt-getting-dirty-the-solution-50572 If being too clean makes us sick, why isn’t getting dirty the solution?] - William Parker, The Conversation

'''2015'''

* 2015 Dec 3 [http://www.healthline.com/health-news/parasites-in-your-intestines-may-actually-be-good-for-you-120315 Parasites in Your Intestines May Actually Be Good for You] - Ann Pietrangelo, Healthline
* 2015 Nov 13 [https://theconversation.com/what-do-parasitic-worms-and-our-increasing-allergies-have-in-common-50032 What do parasitic worms and our increasing allergies have in common?] - Graham Rook, The Conversation
* 2015 Nov 11 [http://www.sciencealert.com/40-patients-are-about-to-be-infected-with-hookworms-to-treat-gluten-intolerance?utm_source=Article&utm_medium=Website&utm_campaign=InArticleReadMore 40 patients are about to be infected with hookworms to treat gluten intolerance] - Peter Dockrill, Science Alert
* 2015 Nov 11 [https://blogs.scientificamerican.com/guest-blog/want-a-stronger-defense-system-against-diseases-add-some-worms/ Want a Stronger Defense System Against Diseases? Add Some Worms] - Sheena Faherty, Scientific American
* 2015 Nov 10 [http://www.abc.net.au/news/2015-11-10/hookworm-larvae-injected-into-coeliacs-gluten-intolerance/6926286 Hookworm larvae to be injected into coeliacs in bid to treat gluten intolerance] - ABC News
* 2015 Oct 30 [https://theconversation.com/they-might-sound-gross-but-intestinal-worms-can-actually-be-good-for-you-49868 They might sound gross, but intestinal worms can actually be good for you] - William Parker, The Conversation
* 2015 Oct 29 [http://www.the-scientist.com/?articles.view/articleNo/44372/title/An-Evolutionary-Basis-for-Allergies/ An Evolutionary Basis for Allergies] - Karen Zusi, The Scientist
* 2015 Sept [http://www.dukechronicle.com/article/2015/09/duke-scientists-treat-depression-with-intestinal-worms Duke scientists treat depression with intestinal worms] Teresa Meng, The Chronicle
* 2015 Sept (accessed on) [https://web.archive.org/web/20170726160347/http://www.sicb.org/students/dohenyb.php The “Old Friends” hypothesis: Reopening a can of worms] - Brenna Doheny, Society for Integrative and Comparative Biology
* 2015 Aug 3 [http://www.philly.com/philly/education/test-prep/20150802_The_Worm_Turns.html The Worm Turns] - Sheena Faherty, Philadelphia Inquirer
* 2015 Jul 20 [https://today.duke.edu/2015/07/wormsonthebrain Gut Worms Protect Babies' Brains From Inflammation] - Robin Ann Smith, Duke Today
* 2015 Jul 16 [http://motherboard.vice.com/read/parasites-by-post-the-online-black-market-for-therapeutic-worms?utm_source=mbtwitter Parasites by Post: The Online Black Market for Therapeutic Worms] - Daniel Viola, Motherboard
* 2015 Jun 23 [https://www.listland.com/top-10-facts-about-hookworms-and-autoimmune-disease/ Top 10 Facts about Hookworms and Autoimmune Disease] - Dave Anderson, Listland
* 2015 Jun 3 [https://www.smithsonianmag.com/smart-news/can-hookworms-cure-hayfever-180955516/ Can Hookworms Cure Hayfever?] - Helen Thompson, Smithsonian Magazine
* 2015 May 31 [http://theprepperpages.com/should-preppers-eat-parasites/ Can Eating Worms Help Treat Allergies & Autoimmune Diseases?] - Ryan Chamberlin, The Prepper Pages
* 2015 May 29 [http://www.yourwildlife.org/2015/05/ecological-medicine-can-parasitic-worms-cure-us-of-our-modern-pandemics/ Ecological Medicine: Can intestinal worms cure us of our modern pandemics?] - Rob Dunn, Your Wild Life
* 2015 May 28 [https://web.archive.org/web/20191029201612/http://discovermagazine.com/2015/july-aug/4-take-worms-call-me DIY Parasite Infection Treats Autoimmune Disorders] - Leah Shaffer, Discover
* 2015 Apr 6 [http://www.medscape.com/viewarticle/842500_2 The Hygiene Hypothesis -- Redefine, Rename, or Just Clean It Up?] - Linda Brookes and Laurence Cheng, Medscape (Includes mention of the promotion of barrier integrity by parasites.)
* 2015 Apr [https://research.jcu.edu.au/bmdt/publications/publications-1/giacomin-australian-science-april-2015 Can Hookworms Cure Coeliac Disease?] - Paul Giacomin, Australasian Science
* 2015 Mar 26 [https://web.archive.org/web/20210805183941/https://rheumatoidarthritis.net/living/a-miracle-cure-with-scientific-promise/ A “Miracle Cure” With Scientific Promise?] - Mariah Z. Leach, RheumatoidArthritis.net
* 2015 Mar 23 [http://dralexrinehart.com/lifestyle-benefits/hygiene-hypothesis-hookworm-infections-autoimmune-and-allergic-disease/ Parasitic Hookworm Infections and Autoimmune and Allergic Disease] - Dr Alexander Rinehart
* 2015 [https://www.autism.org/helminths-as-a-cause-or-a-potential-treatment-for-autism/ Helminths: ASD Cause or Potential Treatment] - William Parker, Autism Research Institute
* 2015 [https://www.sfari.org/funded-project/testing-the-use-of-helminth-worm-ova-in-treating-autism/ Testing the use of helminth worm ova in treating autism] - Eric Hollander, Simons Foundation

'''2014'''

* 2014 Dec 14 [https://www.israel21c.org/using-parasites-to-fight-autoimmune-diseases/ Using parasites to fight autoimmune diseases] - Ruthie Blum, Israel21c
* 2014 Nov 14 [http://www.theglobeandmail.com/life/health-and-fitness/health/intestinal-parasites-could-help-the-immune-system-researchers-say/article21592779/ Intestinal parasites may help the immune system, researchers say] - Sharon Oosthoek, The Globe and Mail
* 2014 Aug 12 [http://www.futurity.org/hookworm-autoimmune-diseases-745302/ ‘Wormy’ pills might fend off autoimmune diseases] - Glynis Smalley, Futurity
* 2014 Aug 8 [http://sciencenotes.ucsc.edu/2014/pages/hookworm/hookworm.html Health by Hookworm] - Julia Calderone, Science Notes
* 2014 Jul 23 [https://www.eurekalert.org/pub_releases/2014-07/cifa-ipa072314.php Intestinal parasites are 'old friends,' researchers argue] - Canadian Institute for Advanced Research (anemia)
* 2014 May 12 [https://blogs.scientificamerican.com/guest-blog/parasitic-worms-wiggle-into-modern-medicine-q-amp-a/ Parasitic Worms Wiggle Into Modern Medicine] - Julia Calderone interviews William C. Gause for Scientific American Blogs
* 2014 Feb 19 [http://www.bbc.co.uk/programmes/b03vrwj8 Infested: Living with Parasites] - Michael Mosley, BBC
* 2014 Jan 23 [http://www.the-scientist.com/?articles.view/articleNo/38977/title/Vitamin-Deficit-Can-Boost-Innate-Immunity/ Vitamin Deficit Can Boost Innate Immunity] - Laasya Samhita, The Scientist
* 2014 Jan 21 [http://www.marksdailyapple.com/are-parasites-primal/ Are Parasites Primal?] - Mark Sisson, Mark's Daily Apple
* 2014 Jan 7 [http://ndnr.com/gastrointestinal/helminthic-therapy/ Helminthic Therapy: An Emerging Intervention in the Era of Immune Dysregulation] - Mark Davis, Naturopathic Doctor, News and Review

'''2013'''

* 2013 Dec 1 [https://www.theguardian.com/technology/2013/dec/01/extreme-science-hookworms-james-logan Extreme science: diet of hookworms to tackle a bread allergy] - Josh Davis, The Guardian
* 2013 Oct 24 [https://web.archive.org/web/20171224183840/https://health.clevelandclinic.org/2013/10/pig-whipworm-smoothie-may-help-crohns/ Pig Whipworm ‘Smoothie’ May Help Crohn’s Digestive] - Health Team, Health Essentials
* 2013 Sep [https://www.foodsmatter.com/natural_medicine_comp_therapies/helminthic_therapy/articles/diabetes-scott-09-13.html Diabetes – could helminths be relevant?] - Foods Matter
* 2013 Apr 22 [http://www.bbc.com/future/story/20130422-feeling-ill-swallow-a-parasite Worm Therapy: Why Parasites May Be Good For You] - Rachel Nuwer, BBC Future
* 2013 Feb 26 [http://www.saturdayeveningpost.com/2013/02/26/in-the-magazine/health-in-the-magazine/good-bacteria.html Why We Need Germs] - Sharon Begley, The Saturday Evening Post
* 2013 Feb 21 [https://www.cell.com/ccbio/pdf/S1074-5521(13)00049-5.pdf Parasites R Us: Coronado Biosciences Recruits Parasitic Worms to Treat Autoimmune Disease] (PDF) - Wendy Wolfson, Chemistry & Biology Innovations
* 2013 Jan 15 [https://web.archive.org/web/20190928145542/http://humanfoodproject.com/can-parasites-prevent-autoimmune-diabetes/ Can parasites prevent autoimmune diabetes?] - Moises Velasquez-Manoff, The Human Food Project
* 2013 Jan 10 [http://www.moisesvm.com/2013/01/10/what-do-breast-milk-and-parasites-have-in-common/ What do breast milk and parasites have in common?] - Moises Velasquez-Manoff’s blog

'''2012'''

* 2012 Nov 21 [http://www.menshealth.com/health/immune-system-worms?fullpage=true The New (Ancient) Cure for Immune Disorders] - Jim Thornton, Men’s Health
* 2012 Nov 20 [https://www.wired.com/2012/11/whipworm-immune-regulation/ The Potential Health Benefits of Parasitic Gut Worms] - Brandon Keim, Science
* 2012 Nov 17 [http://www.clinicaleducation.org/resources/reviews/autoimmunity-and-the-worm/ Autoimmunity and the Worm] - Michael Ash, Clinical Education
* 2012 Nov 17 [https://www.blastocystis.net/2012/11/amelioration-of-colitis-by-parasites-or.html Amelioration of Colitis by Parasites - or "An Elliott & Weinstock Special] - Blastocystis Parasite Blog
* 2012 Aug 29 [https://sante.lefigaro.fr/actualite/2012/08/29/18902-parasites-contre-maladie-crohn Des parasites contre la maladie de Crohn] - Damien Mascret, Le Figaro (French)
* 2012 Aug 25 [http://www.nytimes.com/2012/08/26/opinion/sunday/immune-disorders-and-autism.html An Immune Disorder at the Root of Autism] - Moises Velasquez-Manoff, New York Times
* 2012 Jun 25 [https://www.ksl.com/article/20838871/man-infects-self-with-hookworms-to-treat-severe-allergies Man infects self with hookworms to treat severe allergies] - Mel Borup Chandler, KSL.com
* 2012 Apr 18 [https://www.medicalnewstoday.com/articles/244238.php Hookworms And Allergies - Doctor Infects Himself For Experiment] - Catharine Paddock, Medical News Today
* 2012 Mar 2 [http://www.healthline.com/health/crohns-disease/hook-worms Hook Worms as a Treatment for Crohn’s Disease] - Stephanie Faris, Healthline
* 2012 Mar [https://www.helminthictherapywiki.org/wiki/The_Amazing_Dr_Wriggly The Amazing Dr Wriggly] - John Scott
* 2012 Feb 14 [http://www.wsj.com/articles/SB10001424052970204795304577220993641557460 In a Squeaky-Clean World, a Worm Might Help Fight Disease] - Shirley S Wang, Wall Street Journal
* 2012 Jan 27 [http://www.njspotlight.com/stories/12/0126/2250/ At UMDNJ, Researchers Seek Healing Powers from Parasites] - Beth Fitzgerald, NJSpotlight

* 2012 Jan 15 [http://www.livescience.com/17923-parasitic-worms-wound-healing.html Swallowing Parasitic Worms May Heal Your Ails] - Christopher Wanjek, Live Science

'''2011'''

* 2011 Aug 6 [https://www.doi.org/10.1016/S0262-4079(11)61868-X One sugar or two with your parasites?] - Ferris Jabr, The New Scientist
* 2011 Aug 6 [https://www.doi.org/10.1016/s0262-4079(11)61858-7 Let them eat worms] - Editorial, The New Scientist
* 2011 Jul [http://www.foodsmatter.com/natural_medicine_comp_therapies/helminthic_therapy/articles/headache_migraine.html Helminths Give Chronic Headaches the Old Heave-ho] - John Scott, Foods Matter
* 2011 Jun 28 [http://www.wsj.com/articles/SB10001424052702304314404576413303666083390 Parasitic Worms May Offer Hope on MS] - Sten Stovall, Wall Street Journal (multiple sclerosis)
* 2011 Jun 5 [http://thesmartset.com/article05061101/ Take Two Hookworms and Call Me in the Morning] - Jennifer Fisher Wilson, The Smart Set
* 2011 May 26 [https://www.psychologytoday.com/blog/evolutionary-psychiatry/201105/the-parasite-ate-your-depression The Parasite Ate Your Depression] - Emily Deans, Psychology Today
* 2011 Mar [https://web.archive.org/web/20240815011744/https://www.foodsmatter.com/natural_medicine_comp_therapies/energy_medicine/articles/worms_eft.html Don't let worms give you the squirms!] (Web Archive copy) - John Scott, Foods Matter. A more recent version is here: [https://www.helminthictherapywiki.org/wiki/Overcoming_worm_phobia Overcoming worm phobia].
* 2011 Feb 1 [https://www.the-scientist.com/features/opening-a-can-of-worms-42771 Opening a Can of Worms] - Bob Grant, The Scientist
* 2011 Jan 21 [https://onlinelibrary.wiley.com/doi/10.1002/scin.5591790323 Worming your way to better health: To battle autoimmune disease and allergy, scientists tune in to the tricks of parasites] - Nathan Seppa, Science News
* 2011 Jan [https://web.archive.org/web/20250119103014/https://www.foodsmatter.com/asthma_respiratory_conditions/hay_fever/articles/nasal_allergies_nuked_by_worms.html Nasal Allergies Nuked by Worms] (Web Archive copy) - John Scott, Foods Matter

'''2010'''

* 2010 Dec 1 [http://articles.latimes.com/2010/dec/01/news/la-heb-worm-healing-20101201 New hints on how helminth worms heal ulcerative colitis] - Thomas H. Maugh II, Los Angeles Times
* 2010 Dec 1 [https://www.scientificamerican.com/article/helminthic-therapy-mucus/ For the Good of the Gut: Can Parasitic Worms Treat Autoimmune Diseases?] - Ferris Jabr, Scientific American
* 2010 Jun 10 [http://www.the-scientist.com/?articles.view/articleNo/29085/title/New-gut-ecosystem-model-/ New gut ecosystem model?] - Bob Grant, The Scientist
* 2010 May 23 [https://www.theguardian.com/lifeandstyle/2010/may/23/parasitic-hookworm-jasper-lawrence-tim-adams Gut instinct: the miracle of the parasitic hookworm] - Tim Adams, The Guardian (UK)
* 2010 May 20 [https://www.bloomberg.com/news/articles/2010-05-20/a-new-prescription-parasite-eggs A New Prescription: Parasite Eggs] - Elizabeth Lopatto, Bloomberg Businessweek
* 2010 May 17 [http://www.wsj.com/articles/SB10001424052748703315404575250390129070502 Can Dirt Do a Little Good?] - Melinda Beck, Wall Street Journal
* 2010 Apr 9 [https://www.technologyreview.com/s/418389/fighting-allergies-by-mimicking-parasitic-worms/ Fighting Allergies by Mimicking Parasitic Worms] - Emily Singer, MIT Technology Review
* 2010 Apr 2 [http://www.scotsman.com/news/medicines-made-from-worms-could-cure-asthma-and-arthritis-1-797492 Medicines made from worms 'could cure asthma and arthritis'] - The Scotsman
* 2010 Mar 24 [http://www.slate.com/articles/double_x/doublex_health/2010/03/which_dirt_should_your_baby_eat.html Which Dirt Should Your Baby Eat?] - Amanda Schaffer, Slate
* 2010 Mar 10 [https://mywikis-eu-wiki-media.s3.eu-central-2.wasabisys.com/htwiki/Why_a_parasite_cleanse_can_make_you_worse.pdf Why a Parasite Cleanse Can Make You Worse] - Karen Vaughan, Natural Health
* 2010 Mar 3 [https://www.psychologytoday.com/blog/the-imprinted-brain/201003/dirt-disease-and-depression-the-hygiene-hypothesis-clears-diametric Dirt, Disease, and Depression: the hygiene hypothesis clears up a diametric difficulty] - Christopher Badcock, Psychology Today

'''2009'''

* 2009 Nov [https://web.archive.org/web/20250118063254/https://www.foodsmatter.com/allergy_intolerance/food_intolerance/articles/worms_for_food_intolerance.html Wriggling out of Food Intolerance] (Web Archive copy) - John Scott, Foods Matter
* 2009 Oct 22 [http://www.abc.net.au/news/2009-10-22/worms-linked-to-coeliac-relief/1113232 Worms linked to coeliac relief] - Dina Rosendorff, News Online, ABC Australia
* 2009 Aug [[Media:Can_parasites_be_good.pdf | Can Parasites Be Good For You?]] - David Pritchard, The Biochemical Society
* 2009 Jul 31 [http://www.acupuncturebrooklyn.com/uncategorized/our-symbionts-ourselves Our Symbionts Ourselves] - Karen Vaughan, Natural Health
* 2009 Jul 31 [https://www.sciencedaily.com/releases/2009/07/090706171542.htm Parasites May Have Had Role In Evolution Of Sex] - Science Daily
* 2009 Jul 22 [https://web.archive.org/web/20201109000844/http://www.discovermagazine.com/health/are-hookworms-the-next-claritin Are Hookworms the Next Claritin?] - Boonsri Dickinson, Discover Magazine Blog
* 2009 Jul 22 [https://web.archive.org/web/20160822231420/http://www.dana.org/News/Details.aspx?id=42985 Immune Gene Evolution May Be Driven By Parasites] - Kayt Sukel, The Dana Foundation
* 2009 Apr 27 [https://www.wired.com/2009/04/goodparasites/ Parasites Could Be Good for You] - Brandon Keim, Science
* 2009 Jan 29 [http://news.bbc.co.uk/2/hi/health/7856095.stm Are worms vital to human health?] - Diane Roberts, BBC
* 2009 Jan 29 [https://web.archive.org/web/20170705143757/http://www.nhs.uk/news/2009/01January/Pages/WormsImmuneSystem.aspx Are worms key to health?] - NHS Choice
* 2009 Jan 28 [http://www.telegraph.co.uk/news/health/news/4375170/Infecting-patients-with-worms-could-hold-key-to-treating-asthma.html Infecting patients with worms 'could hold key to treating asthma'] - Kate Devlin, The Daily Telegraph
* 2009 [https://web.archive.org/web/20240815011747/https://www.foodsmatter.com/natural_medicine_comp_therapies/helminthic_therapy/articles/helminthic_therapy.html Replacing lost worms to regain health] (Web Archive copy) - John Scott, Foods Matter

'''2008'''

* 2008 Sept 15 [https://cdn.mdedge.com/files/s3fs-public/issues/articles/71051_main_2.pdf Helminth Exposure Tied to Immune Regulation] - Nancy Walsh, International Medecine News
* 2008 Jul 10 [https://evmedreview.com/pig-worms-and-multiple-sclerosis-the-unintended-consequences-of-hygiene/ Pig worms and multiple sclerosis: the unintended consequences of hygiene] - Stephen Stearns, Evolution and Medicine Review
* 2008 Jul 1 [https://web.archive.org/web/20180429035224/http://www.nytimes.com/2008/07/01/health/research/01prof.html?_r=3&oref=slogin&oref=slogin&oref=slogin The Worms Crawl In] - Elizabeth Svoboda, New York Times
* 2008 Jun 29 [http://www.nytimes.com/2008/06/29/magazine/29wwln-essay-t.html?_r=1 The Worm Turns] - Moises Velasquez-Manoff, New York Times
* 2008 Jun [https://web.archive.org/web/20240815011745/https://www.foodsmatter.com/natural_medicine_comp_therapies/helminthic_therapy/articles/appetite_worms.html An Appetite for Worms] (Web Archive copy) - John Scott, Foods Matter
* 2008 Mar 16 [http://www.washingtonpost.com/wp-dyn/content/article/2008/03/14/AR2008031403386.html Diseases like mine are a growing hazard] - Donna Jackson Nakazawa, Washington Post
* 2008 Mar 4 [http://www.washingtonpost.com/wp-dyn/content/article/2008/03/03/AR2008030303200.html Immune systems increasingly on attack] - Rob Stein, Washington Post

'''2007'''

* 2007 Winter [https://web.archive.org/web/20181223184925/http://emerald.tufts.edu/alumni/magazine/winter2007/features/good-worms.html The Good Worms] - Bruce Morgan, Tufts University Magazine
* 2007 Dec 31 [http://archive.boston.com/news/science/articles/2007/12/31/his_parasite_theory_stirs_a_revolution/ His parasite theory stirs a revolution] - Billy Baker, The Boston Globe
* 2007 Nov 30 [https://www.sciencedaily.com/releases/2007/11/071130223834.htm Could Stem Cells Be Used To Cure Crohn's Disease?] - Science Daily
* 2007 Sept 15 [https://www.theguardian.com/science/2007/sep/15/healthandwellbeing Scientists recruit worms for fight against asthma] - James Randerson, The Guardian
* 2007 Sept 15 [https://web.archive.org/web/20131012085805/http://news.bioscholar.com/2007/09/blood-sucking-hookworms-may-harbour-asthma-cure.html Blood-sucking hookworms may harbour asthma cure] - BioScholar

'''2005'''

* 2005 Nov 2 [http://www.wormdigest.org/content/view/157/2/ Worm Therapy: a New Treatment for IBD?] - Patrick Perry, Saturday Evening Post c/o EarthWormDigest.org (Scroll down page to locate article.)

'''2004'''

* 2004 Jul 9 [https://www.science.org/doi/abs/10.1126/science.305.5681.170 Can Worms Tame the Immune System?] - Ingrid Wickelgren, Science

'''2003'''

* 2003 Dec 3 [http://news.bbc.co.uk/1/hi/health/3287733.stm Eat worms - feel better] - Anna Glanz takes TSO to treat ulcerative colitis, BBC

'''1999'''

* 1999 Dec 21 [https://www.letemps.ch/societe/parasites-viennent-secours-intestins-malades Quand les parasites viennent au secours des intestins malades] - Anton Vos, Le Temps (Suisse) (French)
* 1999 Aug 31 [https://web.archive.org/web/20090515230524/https://www.nytimes.com/1999/08/31/health/in-pursuit-of-autoimmune-worm-cure.html In Pursuit of Autoimmune Worm Cure] - Andy Newman, New York Times

== Videos ==
* 2025 Oct 6 [https://www.youtube.com/watch?v=0-WwjzdO80Y I infected myself with parasites... And it saved my life!] - Josh Marcy, YouTube (30.21 mins)
* 2025 Jul 29 [https://www.youtube.com/watch?v=H7uAdP8ER48 Helminthic Therapy for IBD: Personal Story + Medical Perspective] - Dr. Mark Davis and Dr. Natalie Scheeler from Foundational Medicine in discussion with Kyla Fuller, YouTube (1.09.46)
* 2025 March 10 [https://www.youtube.com/watch?v=TqtmzjK-yag How a Parasite (Helminths) Can Heal Inflammatory Bowel Disease and More] - Kyla Marie interviewed by Liev Dalton for Beyond Terrain, YouTube
* 2024 Dec [https://www.youtube.com/watch?v=WhgYJNMGuYo Helminthic Therapy FAQ with Dr. William Parker] Kyla Fuller of [https://www.instagram.com/stories/letshealibd/3524638052654703296/ - letshealIBD] in conversation with Prof William Parker, YouTube
* 2024 Sept [https://www.youtube.com/watch?v=jNQkaJL9P6s Clinical remission of Crohn's disease with helminthic therapy] - Ben Adams talks to Kyla Fuller, YouTube - 56:55 minutes
* 2023 Nov [https://www.youtube.com/watch?v=O0igw8oyBPw Se soigner avec des parasites une drôle d'idée et pourquoi pas nous dit Victor] - J Labescat talking to Victor Pache, YouTube (French)
* 2023 Jun 10 [https://www.youtube.com/watch?v=nOk2mMcPB7Q Bringing TSO and helminthic therapy for autoimmune diseases to the masses] - Ben Adams talks to Detlev Goj, YouTube
* 2023 May 21 [https://www.youtube.com/watch?v=Rm_UmQAgd0U How worms changed my life. Helminthic therapy for colonic Crohn's disease] - Ben Adams talks to Tracy Cu, YouTube - 56:55 minutes
* 2023 May 17 [https://iview.abc.net.au/show/monsters-or-medicine Monsters or medicine?] - ABC iview
* 2023 Apr [https://www.youtube.com/watch?v=2FwsMAuQ1yI&t=4026s Why Worms Matter - Helminthic Therapy for Autoimmune Diseases] - Ben Adams talks to Jane Puckey, YouTube
* 2023 Mar 13 [https://www.youtube.com/watch?v=JxJffIti4MM Quest to Save the Parasites] - Scientific American, YouTube
* 2021 Nov 14 [https://www.youtube.com/watch?v=SbT2EzMNphY Could a dose of worms be the answer to treating incurable autoimmune diseases?] - TVNZ Sunday
* 2021 May 26 [https://www.youtube.com/watch?v=oB8wFNYfDgY Translating Helminths to the Clinic for Inflammatory Diseases.] - William Parker, BioTherapeutics, Education & Research Foundation, You Tube
* 2021 Feb 1 [https://www.youtube.com/watch?v=eh6eVF8_gzs Necator Americanus: Days 6-14 - The Bounce]
* 2021 Jan 1 [https://www.youtube.com/watch?v=gW46y5iTSaw Necator Americanus: Days 2-5 - Migration & Recapitulation]
* 2020 Nov 1 [https://www.youtube.com/watch?v=rvqA4nTHU8o Necator Americanus: Choosing an Inoculation Site]
* 2020 Oct 21 [https://www.youtube.com/watch?v=R3OYGcFaEmw Comment j'ai hacké mes intestins (5/6)] - Dora Moutot interviews two researchers, a helminthic therapy self-treater and a helminth provider. In French and English.
* 2020 Oct 1 [https://www.youtube.com/watch?v=O0fXIigxQcs Necator Americanus: Treating Side Effects/Flares and the Itch]
* 2020 Sept 1 [https://www.youtube.com/watch?v=1sCZIZmo9Q4 Guide to Dosing with Therapeutic Helminths]
* 2020 Aug 1 [https://www.youtube.com/watch?v=0b8vaN9ujxE Helminthic Therapy User's Guide To Bitcoin - Full Coinbase Tutorial]
* 2019 Nov 1 [https://www.youtube.com/watch?v=iwOA-etpvAM Acquiring Therapeutic Helminths: Choosing a Provider]
* 2019 Nov 1 [https://www.youtube.com/watch?v=MEkauFOxAfo Necator Americanus: Day 1 - Skin Reaction (Hookworm Timeline)]
* 2019 Oct 1 [https://www.youtube.com/watch?v=IAq4emJPHuI Choosing a Species of Therapeutic Helminths]
* 2020 Sept 1 [https://www.facebook.com/103486901462299/posts/123585832785739/?vh=e&extid=sTKJ4GjtuyUxE73a&d=n Food sensitivities] - Sean Murphy MD, Helminth Radio
* 2019 Sept 1 [https://www.youtube.com/watch?v=oijNZOAkTzU Intro to Helminthic Therapy] - A good introduction to this therapy
* 2019 Aug 30 [https://www.youtube.com/watch?v=k-MfF2u5GR0 Helminths for Celiac Disease, Multiple Sclerosis, and Other Autoimmune Diseases] - Mark Davis
* 2018 Apr 9 [https://www.youtube.com/watch?v=48vpU7UtsPA Microbiology of Helminths & Immunity] - Microbiology Videos, Educator.com, YouTube
* 2018 Jan 25 [https://www.youtube.com/watch?v=qD6fmHUXBEg Why You Might Want Parasitic Worms] - Hank Green, SciShow, YouTube
* 2017 Aug 4 [https://www.youtube.com/watch?v=fMIILJ_C7uQ Worm eggs could become food supplement] - New Scientist, YouTube
* 2017 Jun 8 [https://www.youtube.com/watch?v=CL-trN00s2Y Worms inside us: Lecture on therapeutic helminths to the North Carolina Science Museum] (Intended for children but great for adults too!) - William Parker, YouTube
* 2017 Mar 15 [https://youtu.be/AIwp1P8V3so Israeli ‘worm treatment’ successfully fights autoimmune disease] - World Israel News
* 2017 Feb 8 [https://www.facebook.com/abcnews24.au/videos/1467000060000199/ Crawler cure: hookworms used to alleviate coeliac symptoms] - ABC New 24
* 2016 Nov 29 [https://youtu.be/sm5DcdZbnGA Worming your way to good health] - Paul Giacomin, TEDxJCUCairns
* 2016 Nov [http://lifeonus.vhx.tv Life On Us: A Microscopic Safari]. A two hour, two-part documentary. The second part has a segment on helminths and helminthic therapy starting from 15 minutes. - VHX (Free on Amazon Prime) Watch a [https://vimeo.com/887347677?fbclid=IwAR22UhwvvhveAvcqPUm1JpEEwPRDBh7bDZjvqGh6Lf74f0Qo0tTqAO0IArk 3 minute teaser] of Life On Us (Vimeo).
* 2016 Aug 10 [https://www.youtube.com/watch?v=bOjHCaLq7Kk My Experience With Helminthic Therapy] - Sisters Undercover
* 2016 Jun 6 [https://www.youtube.com/watch?v=l9lVjF9BPKc&list=PLcvEcrsF_9zKLSoCLErh0PKLfk7egWtHy&index=3 Is a hookworm good for you?] - Clip from [https://www.youtube.com/playlist?list=PLcvEcrsF_9zKLSoCLErh0PKLfk7egWtHy Infested! Living with Parasites], BBC Teach (Crohn's disease)
* 2016 May 20 [https://youtu.be/kDhB_kQjjYA Sid Baker: Beetlejuice! Beetlejuice! Beetle Larvae? – #311] - Dave, Bulletproof (autism)
* 2016 Apr 21 [https://youtu.be/pQd1RkgJGjM Worm infection counters intestinal inflammation by changing gut microbiome] - Rowann Bowcutt, the Cadwell and Loke Labs, YouTube
* 2016 Mar 23 [https://youtu.be/xk-YBevOJiE Parasites, Autoimmunity & Allergies] - Moises Velasquez Manoff, High Intensity Health
* 2015 Jul 9 [https://www.youtube.com/watch?v=cmG27XasIB4 The Science of Hay Fever... Are Parasitic Worms The Cure?] - Kate Mulcahy, The Royal Institution.
* 2014 Sept 28 [https://youtu.be/JUVNKOcXQC0 Biome normalization using Hymenolepis diminuta (HDC)] - Judith Chinitz, CDePalma (autism)
* 2014 Sept 22 [https://www.educator.com/biology/microbiology/carpenter/helminths-+-immunity.php Helminths & Immunity] - Catherine Carpenter, Educator.com
* 2014 May 6 [https://youtu.be/UfyE0pHHKt0 Parasites Lost: The Journey from Woeful Worms to Helpful Monsters] - Christopher Blanar, TEDxNSU
* 2014 Apr 1 [https://youtu.be/zoOscroun5A Reshaping the immune system] - Moises Velazquez-Manoff, TEDxCibeles
* 2014 Jan 29 [https://youtu.be/5jtTDSP3BOo Rachel Clarke on conscious infestation of the gut with worms] (Parkinson’s disease)
* 2013 Aug 1 [https://youtu.be/A3s3NRtssS8 Why Parasites May Not Be All That Bad] - Trace Dominguez, DNews
* 2012 Feb 2 [https://www.youtube.com/watch?v=cuZXy3VdMhU&fbclid=IwAR1b8t7opBOlotAs5tjRvh3KDrSApQi7roHpcFjmYLN-_lSUDQFqZxpA4S8 Trichuris suis ova Clinical Trial] - Media Library Inc, YouTube
* 2011 Feb 10 [https://youtu.be/AdEvISZFGUE The Worm Crew] - the late Joel Weinstock on studying the effects of helminths on IBD
* 2010 Mar 12 [https://youtu.be/llyCGNB9smg Medical Alert: Worms Used As Therapy] - Donna Hamilton, WBAL-TV 11 Baltimore
* 2010 Feb 18 [https://web.archive.org/web/20181213004519/http://www.abc.net.au/catalyst/stories/2823795.htm Hook Worms] (transcript only) - Jonica Newby, Catalyst (coeliac disease)
* 2009 May 26 [https://youtu.be/rl-mbGF2fys Helminthic therapy allergies asthma] - Interviews with scientists and patients using helminthic therapy to control allergies and asthma
* 2009 Mar 15 [https://youtu.be/v3oTHKUac-E Todd Troutman Interview, Part 2] - A patient finds relief from severe allergies, YouTube
* 2009 Mar 15 [https://youtu.be/2rSA3uAtP7U Todd Troutman Interview, Part 1] - A patient finds relief from severe allergies, YouTube
* 2009 [https://web.archive.org/web/20160111220108/http://parasites-film.com/ Parasites: A User's Guide (long trailer)] - Sharon Shattuck, Sweet Fern Productions
* 2009 [https://youtu.be/C2LbuJEbtIQ?t=18m5s Bang Goes the Theory, Season 4 Episode 6] (Starts at 20.25 minutes) YouTube
* 2008 May 24 [https://youtu.be/uzEI5wKO13Y Helminth Therapy] - Video about helminthic therapy by Asphelia Pharmaceuticals
* 2008 Mar 14 [https://youtu.be/qlHzLSRKfBI Helminthic therapy - Autoimmune Therapies] - Jasper Lawrence collects hookworms from Cameroon
* 2007 Oct 10 [https://www.youtube.com/watch?v=r_R_sHV8H9o Autism/TSO Presentation Part 1] - Stewart Johnson on the use of TSO as a treatment for certain symptoms of autism, Mt. Sinai Autism Conference, 2007, YouTube
* 2007 Oct 10 [https://www.youtube.com/watch?v=4_O7Dp2Gud4 Autism/TSO Presentation Part 2] - Stewart Johnson on the use of TSO as a treatment for certain symptoms of autism, Mt. Sinai Autism Conference, 2007, YouTube
* 2007 Oct 10 [https://www.youtube.com/watch?v=oFnJZsFovuM Autism/TSO Presentation Part 3] - Stewart Johnson on the use of TSO as a treatment for certain symptoms of autism, Mt. Sinai Autism Conference, 2007, YouTube

== YouTube channels ==

* [https://www.youtube.com/channel/UCG3QapW4Lv5tno9KVFCh1Iw Helminthic Therapy] Incubating, and inoculating with, the human hookworm, Nector americanus.

* [https://www.youtube.com/@letshealIBD @letshealIBD] Kyla Marie details her successful self-treatment of severe Crohn's disease with Trichuris suis ova (TSO) and Necator americanus (NA) larvae.

* [https://www.youtube.com/@benadamsnz Ben Adams] Ben documents his journey of discovery as he seeks a solution to his psoriasis.

* [https://www.youtube.com/@macolonie2249 Macolonie] An exploration of helminthic therapy in the French language.

* [https://www.youtube.com/@BTERFoundation BTERFoundation] The channel of the United States BioTherapeutics, Education and Research (BTER) Foundation.

== Podcasts ==
* 2025 Jul 22 [https://open.spotify.com/episode/5n8yGCIAHxIvZgEDLzLMqD? Worm Therapy for Autoimmunity and Optimal Health] - Bradey Coffey talks to Jane Puckey
* 2025 Jul 18 (accessed on) [https://www.thesibodoctor.com/2023/10/25/dr-mark-davis-exploring-helminth-therapies/ Exploring Helminth Therapies] - Dr. Nirala Jacobi interviews Dr. Mark Davis for The SIBO Doctor Podcast (#104)
* 2025 March 10 [https://open.spotify.com/episode/503xfKNZ8TKIuH9AI44QBM?si=V_9sSSl4QbSkzBDqx9BAMA&nd=1&dlsi=c5760b7e2c3c4a82 How a Parasite (Helminths) Can Heal Inflammatory Bowel Disease and More] - Kyla Marie interviewed by Liev Dalton for Beyond Terrain, Spotify
* 2023 Nov 7 [https://www.buzzsprout.com/2042385/14039741 Old friends treat autoimmune disease: a patient story] - Jane Puckey interviewed by naturopath Daniel Baden
* 2023 Sept 4 [https://www.abc.net.au/listen/programs/healthreport/healing-potential-of-worms/102811078?fbclid=IwAR3UBBWOnBFLEz4ddKq8Ru6YskcU6RXiRBV91vcvUtacj9p28qQja8sYKlc The healing potential of worms] (7.00 to 13.00 minutes) - Hosted by Tegan Taylor for ABC Listen
* 2021 Dec 9 [https://www.youtube.com/watch?v=bRaDQv_53LY Rosemary's Story: From Food Intolerant to Foodie with Helminthic Therapy] - The Sensitive One
* 2021 Sept 9 [https://www.youtube.com/watch?v=gv-2v7DzWCE&t=29s Could Worms Cure Coeliac Disease?] - Dr Paul Giacomin, The Sensitive One. (Also see this [[media:Email_to_P_Giacomin_21-10.pdf | response to Dr Giacomin's comments]].)
* 2021 Jun 13 [https://www.rnz.co.nz/national/programmes/sunday/audio/2018799500/could-hosting-parasitic-worms-prevent-ageing Could hosting parasitic worms prevent ageing?] - Dr Tom Mules interviewed for Sunday Morning on Radio New Zealand. (Also see, [[Helminthic therapy safety#Could there be dog hookworm larvae in NA doses from providers? | '''Could there be dog hookworm larvae in NA doses from providers?''']])
* 2021 May 5 [https://www.rnz.co.nz/national/programmes/nights/audio/2018794285/hookworms-to-heal Hookworms to Heal] - Dr Tom Mules interviewed for Sunday Morning on Radio New Zealand. (Also see, [[Helminthic therapy safety#Could there be dog hookworm larvae in NA doses from providers? | '''Could there be dog hookworm larvae in NA doses from providers?''']])
* 2019 Dec 18 (updated 2022 May 7) [https://feedmephoebe.com/helminth-therapy/ Critters That Cure: Helminth Therapy & Why Worms Might Be the Key to Overcoming Autoimmune Disease.] - Interview with Dr. William Parker for SIBO Made Simple (Episode 29) Feed Me Phoebe
* 2019 Jul 24 [https://web.archive.org/web/20210225193102/https://www.newstalkzb.co.nz/on-air/simon-barnett-and-phil-gifford-afternoons/audio/professor-graham-le-gros-hookworms-could-have-huge-potential-for-health/ Professor Graham Le Gros: Hookworms could have huge potential for health] - Simon Barnett and Phil Gifford, NewstalkZB. (Also see [[Graham Le Gros and helminthic therapy | '''Graham Le Gros and helminthic therapy''']].)
* 2019 Jul 22 [https://web.archive.org/web/20211207173358/https://www.rnz.co.nz/national/programmes/afternoons/audio/2018705196/human-hookworms-potential-to-help-inflammatory-diseases Human hookworms: potential to help inflammatory diseases] - Jesse Mulligan, Radio New Zealand. (Also see [[Graham Le Gros and helminthic therapy | '''Graham Le Gros and helminthic therapy''']].)
* 2018 Mar [https://drruscio.com/self-administering-helminth-therapy-with-dr-nancy-ohara/ Guidelines for Self-Administering Helminth Therapy (using HDC)] - Michael Ruscio interviews Dr Nancy O'Hara, Dr Ruscio Radio
* 2018 Jan 27 [https://www.radionz.co.nz/national/programmes/saturday/audio/2018629676/dr-kara-filbey-lessons-from-parasitic-worms Lessons from parasitic worms] - Kim Hill interviews Dr Kara Filbey for Saturday Morning, Radio New Zealand
* 2018 Jan 8 [https://www.youtube.com/watch?v=Fd8Rn567xWQ Worm Therapy with Dr William Parker] - Ben Weitz DC interviews William Parker, Rational Wellness
* 2018 Jan [https://drruscio.com/healthy-worms-with-garin-aglietti/ Healthy Worms to Repair the Gut & Immune System] - Michael Ruscio interviews Garin Aglietti, Dr Ruscio Radio
* 2017 Dec [https://drruscio.com/worms-the-next-probiotics-with-dr-william-parker/ Are Worms the Next Probiotic?] - Michael Ruscio interviews William Parker, Dr Ruscio Radio
* 2017 Oct 13 [http://www.bbc.co.uk/programmes/w3csv3f2 Can We Worm Our Way Into Better Health?] Crowd Science, BBC World Service
* 2017 June 5 [http://www.abc.net.au/radionational/programs/healthreport/hookworms-against-diabetes!/8590092 Hookworms against diabetes!] - Norman Swan interviews Robyn McDermott on Health Report, Radio National
* 2016 Dec 28 [http://undark.org/2016/12/28/undark-podcast-helminth-hackers/ The Helminth Hackers] - David Corcoran interviews Leah Shaffer for the Undark Podcast (#10)
* 2016 Oct 6 [http://www.radionz.co.nz/national/programmes/nights/audio/201819018/hookworms-to-treat-coeliac-disease Hookworms to treat coeliac disease?] - Nights, Radio New Zealand
* 2016 July 1 [http://www.kcrw.com/news-culture/shows/to-the-point/the-re-education-of-the-immune-system The Re-education of the Immune System] (9.00 to 42.00 minutes) - To the Point, KCRW, with Moises Velazquez-Manoff, Dave Elliot, Mikael Knip and Shabaana Khader. Click on the Mini-Player button at top right, to jump straight in at 9.00 minutes.
* 2015 Nov 2 [http://www.carrytheoneradio.com/2015/11/65-enemy-of-my-enemy.html The Enemy of my Enemy, Part 2: A Can of Worms] - Sam Ancona Esselmann interviews Moises Velasquez Manoff for Carry the One Radio
* 2015 Jun 19 [https://www.voiceamerica.com/episode/85967/the-future-of-healing-the-immune-system-biome-reconstitution The Future of Healing the Immune System: Biome Reconstitution] - Neil Nathan interviews William Parker for The Cutting Edge of Health, and Wellness Today
* 2012 Jan 25 [http://www.autismone.org/content/got-bugs-dr-william-parker-phd Got Bugs!] - William Parker, AutismOne
* 2010 Apr 2 [http://www.radiolab.org/story/91951-an-update-on-hookworms/ An update on hookworms] - Pat Walters, Radiolab
* 2010 Apr 2 [https://www.thisamericanlife.org/404/enemy-camp-2010/act-three-0 Enemy Camp 2012: Act Three. As The Worm Turns] - This American Life
* 2009 Sept [http://www.radiolab.org/story/91691-sculptors-of-monumental-narrative/ Sculptors of Monumental Narrative] - Dickson Despommier and Pat Walters, Radiolab

== Webinars ==

* 2021 May 26 [https://www.youtube.com/watch?v=oB8wFNYfDgY Translating Helminths to the Clinic for Inflammatory Diseases.] - William Parker, BioTherapeutics, Education & Research Foundation, You Tube

* 2016 Jan 20 [https://www.autism.org/webinars/autism-helminths-the-good-the-bad-and-the-rumors/ Autism & Helminths: The Good, the Bad, and the Rumors] - William Parker, Autism Research Institute

* 2015 May 6 [https://youtu.be/yGqTPM10wrY Microbiome Research in Autism Spectrum Disorders] - William Parker (Helminths mentioned from 34 minutes)

== Books ==

* 2025 Oct [https://www.amazon.com/Hooked-Gut-Health-Autoimmune-Disease-ebook/dp/B0FYLNCJYB/ref=sr_1_1 Hooked on Gut Health: The Truth About Autoimmune Disease and How to Heal] - Jane Puckey

* 2023 Apr (Free e-book) [https://drive.google.com/file/d/18H9CYGLe9WJiaxFKgBJPiGGc4jc3luwz/view Microbiome madness: using mild pulses of electricity, probiotic worms and microbiome rebalancing to reverse auto-immune disease] - Hemal Vasant
* 2020 Nov 3 [https://www.amazon.com/Probiotic-Planet-Using-Life-Manage/dp/B08PMP853X/ref=sr_1_1?crid=3UV20L2HLGQ8M&keywords=The+Probiotic+Planet%3A+Using+Life+to+Manage+Life&qid=1705780898&sprefix=the+probiotic+planet+using+life+to+manage+life+%2Caps%2C208&sr=8-1 The Probiotic Planet: Using Life to Manage Life] - Jamie Lorimer
* 2017 Mar 11 [https://www.amazon.com/kindle/dp/B06XK56T1G The Worms Inside Me: My experiment with helminthic therapy] - Beth Anderson
* 2016 [http://www.springer.com/gb/book/9783319297149?wt_mc=ThirdParty.SpringerLink.3.EPR653.About_eBook Evolutionary Thinking in Medicine: From Research to Policy and Practice.] Ed: Alvergne, Jenkinson and Faurie. This book, which is [https://www.amazon.com/Evolutionary-Thinking-Medicine-Research-Behaviour/dp/3319297147/ref=sr_1_1?ie=UTF8&qid=1468875756&sr=8-1&keywords=Evolutionary+Thinking+in+Medicine available from Amazon], contains a chapter by Jorge Correale (“Helminth Immunoregulation and Multiple Sclerosis Treatment”) and one by Gabriele Sorci, et al., entitled, “Microbes, Parasites and Immune Diseases” (page 211 in Part VI: Immunology). This latter chapter is available, in full, as a FREE download via a link in the Table of Contents on [http://link.springer.com/book/10.1007/978-3-319-29716-3 this page].
* 2015 Dec 1 [https://www.amazon.com/Body-Darwin-Evolution-Transforms-Medicine/dp/022605988X/ref=sr_1_1?s=books&ie=UTF8&qid=1449074923&sr=1-1&keywords=Body+by+Darwin:+How+Evolution+Shapes+Our+Health+and+Transforms+Medicine Body by Darwin: How Evolution Shapes Our Health and Transforms Medicine] - Jeremy Taylor. There’s an extended excerpt of this book on Live Science, [http://www.livescience.com/52953-how-parasitic-worms-and-microbes-keep-you-healthy.html here].
* 2012 Sept 4 [https://www.amazon.com/Epidemic-Absence-Understanding-Allergies-Autoimmune/dp/1439199388/ An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases] - Moises Velasquez-Manoff
* 2011 Jun 21 [https://www.amazon.com/The-Wild-Life-Our-Bodies/dp/006180648X/ref=sr_1_1?ie=UTF8&qid=1402855367&sr=8-1&keywords=rob+dunn The Wild Life of Our Bodies: Predators, Parasites, and Partners That Shape Who We Are Today] - Rob Dunn
* 2009 Sept 18 [https://www.amazon.com/Hypothesis-Darwinian-Medicine-Progress-Inflammation/dp/3764389028/ref=sr_1_8?ie=UTF8&qid=1332700157&sr=8-8 The Hygiene Hypothesis and Darwinian Medicine (Progress in Inflammation Research)] Edited by Graham Rook
* 2007 Apr 2 [https://www.amazon.com/Riddled-Life-Friendly-Ladybug-Parasites/dp/0151012253/ref=sr_1_1?ie=UTF8&qid=1402855886&sr=8-1&keywords=Riddled+With+Life:+Friendly+worms,+ladybug+sex+and+the+parasites+that+make+us+who+we+are Riddled with Life: Friendly Worms, Ladybug Sex, and the Parasites That Make Us Who We Are] - Marlene Zuk

== Lecture ==

* 2014 [https://web.archive.org/web/20211205035906/http://ndt-educational.org/shoenfeld_slide_2014.html Infections and autoimmunity; how to harness nature to treat autoimmunity] - Yehuda Shoenfeld. This is an Internet Archive copy from which the sildes are missing but the text is complete.

Wriggling out of total food intolerance, M.E. and Crohns disease

2026-05-09T23:42:02Z

John: /* A glimpse of possibilities */

{{Breadcrumb|[[Helminthic_therapy_personal_stories|Personal stories]]|[[Helminthic_therapy_personal_stories#Detailed stories|Detailed stories]]}}
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===My story so far===

For my story up until this point, see: [https://web.archive.org/web/20250804103038/https://www.foodsmatter.com/allergy_intolerance/total_food_intolerance/articles/tfa.html Total Food Intolerance - A Medical Black Hole]. (Web Archive copy)

===A glimpse of possibilities===

Taking part in the short [http://www.foodsmatter.com/natural_medicine_comp_therapies/helminthic_therapy/articles/appetite_worms.html Hookworms for Crohn's Disease trial] at Nottingham University in 2007 had provided me with a brief but tantalising glimpse of how my health might be improved by hosting a small colony of benign intestinal worms, and I was determined to acquire a long-term infection as soon as possible.

To this end, I had secured the agreement of my gastroenterologist, who referred me back to the trial team for reinfection. However, in spite of an earlier indication that they would be willing to provide me with a further dose of hookworms, the trial coordinator then told me that this would not be possible until the study was complete.

This was a considerable disappointment because the trial was taking an inordinately long time - probably due to difficulty finding sufficient volunteers willing to host a small worm colony - and it became clear that the trial would not be complete until the middle of 2009.

In the meantime, I had required further bowel surgery, to repair yet more Crohn's-related intestinal strictures, and I was still unable to eat any normal foods due to multiple allergies and overwhelming food intolerance, not to mention having a number of other long-term health problems, including M.E.

I was becoming impatient, not least because the only food that I was able to tolerate was a solitary hypoallergenic formula prescribed by my GP, and I realised that, were I to lose my tolerance to this also, I might well follow in the footsteps of those, such as [https://web.archive.org/web/20240302135021/https://www.foodsmatter.com/allergy_intolerance/total_food_intolerance/articles/annabel_senior.html Annabel Senior (Web Archive copy)], who have lost their lives as a result of medicine's failure to engage with total food intolerance.

Even if this particular aspect of my health proved not to be amenable to the help of a group of helminthic [http://evmedreview.com/?p=103 'old friends’], there was considerable evidence suggesting that I should at least benefit from a reduction in allergic symptoms, and an attenuation, or perhaps even cessation, of the development of intestinal strictures.

===As one door closes…===

It was extremely frustrating to know that a possible solution to at least some of my health problems was wriggling in a laboratory at Nottingham University, just a few miles down the road from where I live, and that I was being denied access to them. What I needed was a source that would deliver worms direct to my home, and I knew of only one such supplier, a company called Ovamed (since replaced by [http://www.tanawisa.com Tanawisa]) who sold pig whipworm eggs, but at a price that was beyond my reach.

More out of desperation than hope, I turned once more to the internet, where, miraculously, I found that there are [http://helminthictherapywiki.org/wiki/Helminth_providers companies that sell the hookworm, Necator americanus (NA)] - the worm that was used in the Nottingham trials - and at a much more realistic price than the porcine product.

I soon discovered that there was already a small community of helminthic therapy self-treaters with far more knowledge about the therapeutic use of helminths than I had been able to glean from talking to the researchers who are working with the worms in the clinical trial.

The Nottingham scientists had only looked at the safety aspects of using ten worms in patients with only a couple of diseases, and the trials had been too short to assess efficacy in either case. In contrast, the members of the online helminthic therapy community were using worms to treat a wide range of autoimmune conditions, and a growing body of knowledge was building as a result.

Unfortunately, understanding about how best to dose with hookworms was still in its infancy at that time, and the company I purchased from recommended I start with 35 NA. This was far more than are needed, and I would subsequently have to deal with prolonged gastrointestinal side effects as a result of this excessive dose.

===The experiment begins===

My new team of little wrigglers arrived at my home in two tiny vials, each containing only a couple of millilitres of clear, colourless liquid. These few precious drops held the microscopic hookworm larvae which, after being carefully dispensed onto a dressing and placed on my arm, began the synchronised burrowing that would commence the journey which I hoped would ultimately bring me so much relief.

On the second day after my new gut buddies moved in, their ministrations brought significant relief from the nasal congestion that I had had, on and off, for most of my life. The only relief that I had been able to obtain previously had come from taking drugs, but all of these had presented unpleasant side effects, such as the migraine headaches that invariably followed the use of steroid nasal sprays.

An itchy rash, which had developed rapidly at the site on my arm where my invisible friends had entered their new home, began to reduce somewhat in intensity on the third day. Tiny bright red dots then became visible within the main central area and the itch continued with a vengeance, though, fortunately, this responded well to generous applications of Benadryl cream.

The bright red dots intensified on the 4th day and became quite raised, remaining till the seventh day, after which the redness, bumpiness and itching all began to subside. By the second week, the rash was flat, fading and no longer itchy.

Towards the end of the second week, my nose became clearer than ever, and the third week brought a distinct sense of perkiness - a quality that had been sadly missing from my life for many years, buried deep beneath the thick blanket of M.E.

Both the clearer nose and the perkiness continued for another three days, until I was eventually plunged back into the much more familiar continuous exhaustion, beginning a see-saw fluctuation in symptoms that would continue for the next few months.

===Ups and downs===

At the start of week four, I had a day without any headache - a departure that was extremely rare for me - and my nose was so clear that I began to find myself breathing through both nostrils at once. Again, this was something quite new - something I hadn't done much since I was a child.

Such was the depth of exhaustion to which I had grown accustomed, it would normally take an inordinate act of will in order for me to initiate any movement at the start of each new day. However, on the fourth day of the fourth week, I woke to find myself raring to go! For the first time in many, many moons, I couldn't wait to get up and greet the day.

As it happened, I was to have visitors that day - something that would usually wipe me out for several days at least, yet, on this occasion, I not only survived the visit unscathed, but actually had moments during the day that brought back distant memories of what it felt like to be well.

I began the next day by celebrating a distinctly less severe level of exhaustion than I would have expected to experience after a visit, but, then, I noticed a change in my bowel habit. My normal, single daily defecation was replaced by several smaller ones, and the warning sensations before these were more like those I associate with impending diarrhoea.

This gastrointestinal sea change continued with a sudden increase in gas production, and was accompanied by periods of queasiness and even a couple of unexpected spells of sweating.

In spite of having Crohn's disease and, over time, developing strictures that have required surgery, I had been spared the worst gastrointestinal symptoms, so these new digestive developments were obviously due to the presence of my little friends.

The diarrhoea began at the end of week four, accompanied by nausea, more gas and sweats - no doubt all due to my body's attempt to rid itself of what it perceived to be 'invaders'. But, undaunted by the onslaught against them, my already highly treasured companions continued their ministrations and, at the start of week five, delivered another headache-free day.

===Chilling out===

One of several weird symptoms that have manifested as part of my experience of M.E. is poor temperature control, and this had been a problem for me for many years. During this time, I had to carefully control the temperature of my environment in order to remain comfortable, and, in spite of installing numerous thermostatic heating controls, it had still been necessary to resort to frequent adjustments to clothing during the day, and to bed clothes at night, in order to maintain comfort.

Half way through week five, I began to realise that I was able to tolerate a slightly lower ambient temperature, and found that I could keep the temperature in both my lounge and bedroom half a degree Celsius lower than I would have needed previously - an insignificant change for a healthy person, but a major improvement for me. And whereas, previously, it would have taken me over an hour to cool down sufficiently after a shower to be able to put my usual clothes back on, I was now able to get fully dressed less than half an hour after showering.

Having been unable to eat normal food for many years, it was fortunate that, during most of this time, I was not really interested in normal food. I could inhale the aroma of other people's cooking, but not feel any desire to eat what was being cooked. Now, at almost the sixth week since inoculation, I found myself suddenly taking an interest in any cooking smells that assailed my nostrils, and I began to have yearnings to eat whatever foods were being prepared - my first experience of real hunger in years.

Then, just as I was beginning to adjust my thinking towards the possibility of maybe trying some normal food again, I began to get stronger abdominal cramps and more diarrhoea as week six began.

From then on, diarrhoea, gut ache, nausea and intestinal rumblings began to be the norm on about three days out of every seven, interrupted only by occasional constipation, and accompanied by increased fatigue. The latter, however, was not so much my usual ‘weary-but-wired’ fatigue as an almost pleasant, very relaxed, languorous state, and I was actually feeling quite perky again in spite of this. And my headaches were also now significantly less severe than hitherto, so there was plenty to feel grateful for while sitting on the loo!

===Profound change===

Early in week six, I began to feel pleasurably better than I had for a very long time, with a new buoyancy and optimism. I also realised that the eczema in my ears, which used to itch more or less constantly, unless regularly creamed, was now somewhat less itchy than it had been for many years, having been improving gradually for the previous couple of weeks.

During week seven, it dawned on me that I was no longer being woken during the night by the intractable catarrhal throat irritation that had dogged my nights for countless years. What an absolute joy it was, finally to be free of that particular symptom!

Week eight brought another headache-free day and, in week nine, I had a truly remarkable encounter with my osteopath.

He and I had often discussed M.E. while he worked on my back and, having told me that M.E. is a condition that he sees in a significant number of patients, he had explained that he doesn't need a patient to tell him that they have this illness because its presence is clearly revealed by the quality of their tissues.

On this particular occasion, which was prior to me telling him about my hookworm experiment, he said that not only was there a marked improvement in the longstanding problem with over-tight ligaments in my lower back, but the quality of my tissues was now also quite different, and no longer what he would expect to find in someone with M.E!

Then, I was promptly brought back down to earth by several days of feeling quite lousy, as if I had an infection. Yet I recognised this as potentially another positive development, because an absence of infections had long been a feature of my condition. Others around me would drop like ninepins when bugs were going around, but never me! My immune system was apparently in permanent overdrive.

If the sudden light-headedness, weakness, runny nose and sore throat that I now had were indeed the symptoms of an infection, then perhaps this was evidence that my immune system was at last being brought back into line by my accomplished companions.

For the following few weeks, the gut symptoms held sway and I continued to experience frequent nausea, general abdominal discomfort, diarrhoea and increased fatigue. All of this could have been reduced, or even avoided entirely, had I introduced my 35 little wrigglers in stages, rather than all at once.

Even though I was now on a roller coaster that would one day lift me to the heights and then, the next, plunge me back towards the depths, there was already SO much to be grateful for, and I had absolutely no regrets. I knew that the gastrointestinal upheaval would eventually be over and my carefully chosen companions would re-establish their ancient role and keep their covenant with my species. So I dug in and looked forward to that day.

===Not just a dream===

I don't normally remember dreams but, eleven weeks and five days after my new 'old friends' moved in, I woke suddenly in the night with an extremely vivid recollection of a dream.

I was in an oriental take-away (not my usual haunt, of course!) trying to decide what, if anything, I could safely eat, when I became aware of someone telling me that I could have rice, meat and vegetables.

Could this, I wondered, be a message from my little hookies that they had subdued my immune system sufficiently for me to resume eating these normal foods?

Bizarre though the idea might be, this dream did appear at just the time when allergies typically begin to respond to helminthic therapy, so, over the next few days, I began, very gingerly at first, to try a little chicken and, as that was OK, some rice, and then potato. That I coped with all of this without any adverse reaction was utterly amazing after so many years of overwhelming food allergy and food intolerance.

As I experimented, I found a few foods that brought on some of the old symptoms, although not so much the abdominal pain, which had been the worst feature of my reactions to food, and I eventually established a list of foods that I could tolerate, including a good selection of proteins (white fish, goat's milk products and eggs); starches (rice, potatoes, buckwheat and polenta); root vegetables (carrot, parsnip and sweet potato) and several fruits (apple, pear, peach and raspberries). And chocolate, which I just HAD to try and, to my delight, found I could also now tolerate!

From week 13 onwards, I began to feel generally rather good and, by 18 weeks, my boon companions were treating me to meals consisting of gradually increasing portions of a variety of normal foods, along with a correspondingly reduced quantity of my formula feed. At week 20, I counted 45 foods that I could tolerate and, by week 24, I was meeting half my nutritional needs with normal food.

At week 26, I had my first meal in 16 years without any of the special feed, and, the following week, had three entirely normal meals in a row, although this revealed that, while I was able to tolerate the food, my gut was not coping as well as it might with the additional bulk, having only had to deal with a highly refined, low-residue diet for so many years.

===So much to celebrate!===

The diarrhoea, which had continued as an intermittent backdrop to all the other developments, finally petered out at week 24, at which point I calculated that I had had a total of 47 days of diarrhoea during 19 weeks. As this was the only major 'side effect' I had experienced, it seemed a very small price to pay when viewed alongside all the benefits that were now evident.

As well as the really quite astonishing fact that, after such a short space of time, I was now able to eat a sufficiently large range of foods to be able to enjoy what was beginning to look like a normal diet, there had also been several other improvements, as a result of the considerable control that my resident technicians were exerting over my longtime errant immune system.

As I took stock of the events of these momentous months and reviewed the detailed diary I had kept, it became clear that, during the time between starting to eat normal foods again and finally waving goodbye to the diarrhoea, several additional aspects of my health had gradually been improving, in many cases imperceptibly.

I had recently felt able to trim the small hedge at the front of my house - something I had had to get others to do for me for such a long time - and, although exhausted afterwards, I didn't need several days in bed to recover, as I would have done in the past. Admittedly, I was weak and wobbly the next day, but I felt remarkably well at the same time, and exhilarated that I had achieved so much.

Whereas exhaustion had previously encompassed and pervaded every aspect of my life and been inescapable, it was, by now, far less extensive and much more clearly defined. It would still come and go, but now started from a higher base line, so I actually got to have moments without it, and it was easier to manage with judicious resting.

I found that I no longer needed to go back to bed for a couple of hours in the middle of the day in order to prevent myself from sinking into extreme exhaustion, and a brief rest in a chair was now all that was required to recharge my battery. Perhaps this was related to the positive changes in my tissues detected by the osteopath, and which he has since confirmed are continuing, towards normality.

After years without a single headache-free day, I was now enjoying periods of up to nine days in a row without this affliction, in addition to the greatly improved temperature control, and the generally much clearer nose.

Even the Restless Legs Syndrome that would often interrupt my rest, meditation and sleep, had ceased to be a problem. Also, the excruciating itches that would frequently develop on my hands, feet and back without any obvious sign on my skin, and which, in spite of treatment, would persist for two or three days, had almost disappeared.

===Looking forward===

There were still fluctuations in my health, foods that I couldn't yet eat, and the M.E. was still evident, although improved, but it was also still quite early in the long process of readjustment between my new companions and my immune system.

Based on the available information, I didn't expect a final equilibrium to be reached until my helminthic helpers and I had been together for approaching a year, and the experience of the few others who had trodden this path before me suggested that the beneficial changes could even continue to accrue beyond that point. Obviously, the magnitude of any additional benefits would gradually reduce as time passed, but it was clearly not unrealistic to hope for yet further improvement.

My situation at this point had become very similar to what it had been 20 years previously, when I had been forced to take very early retirement due to the M.E. and had already lost a number of foods from my diet as a result of the encroaching food allergy and food intolerance. Now, however, thanks to just 35 tiny worms, I was moving in the opposite direction - a truly incredible result!

One of the developments that I consider most significant was my regained tolerance for herbs and food supplements. After having been unable to tolerate any supplements for a number of years, I was already reintroducing several, and looking forward to once again being able to use food-derived 'medicines' to treat any illnesses that I might develop in the future. I hoped that I would also be able to more effectively treat whatever degree of M.E. I might be left with when my wonderful companions had done as much as they could to restore my health.

Looking back eight months, to when I decided to take the plunge and acquire some health-promoting helpmates, I remember feeling a surprisingly strong sense of urgency that drove me to make the final decision quite quickly, in spite of the cost involved.

I am '''''so''''' pleased that I responded positively to this urgent prompting, because the particular hypoallergenic feed that was the only form of food I could tolerate for several years, had recently been discontinued, and I was coming to the end of my remaining stock of this lifeline.

Had I not decided to employ a team of time-served technicians to tinker continuously with my immune system, there would eventually have been no food left that I could eat, and my survival would clearly have been in doubt. As things had turned out, however, I could now look forward to the future with considerable confidence and optimism.

===Seventeen month review===

Seventeen months after I acquired a small team of tiny hookworms to keep my errant immune system in check, I am still 'over the moon' with the results - very much enjoying having more energy and being able to eat many normal foods again.

Although my food sensitivity had become global by the time I got the worms, the range of foods that I can eat has continued to increase since getting them. I was able to begin eating normal food again at 11 weeks post inoculation with the first 35 hookworms. At 20 weeks, I could tolerate 45 foods, and, at 30 weeks, about 63 foods. I then added a further 10 hookworms at 53 weeks, and yet another 10 at 67 weeks. At 70 weeks, there are only a few foods left that I'm still unable to tolerate.

I am eating a full range of foods again and really loving it. As I type this update, I am munching my way through a turkey salad containing cucumber, parsley, lettuce, fresh garden peas, spring onions and home-grown mung bean sprouts, all doused in olive oil. I'm also drinking a pint of fresh raw veg juice (carrot, parsnip, beetroot, broccoli and kale) - not bad for a guy who hasn't been able to eat any fruit or veg for about 20 years!

In addition to the miraculous reversal of the food intolerance, my 'true', IgE-mediated allergies have all disappeared as well, so that I can now spend all day outdoors, when the pollen count is at its height, without even the slightest hint of a sniffle. The rhinitis has completely gone and the sinusitis is gradually diminishing, along with the eczema. The antihistamine/nasal spray routine has become a thing of the past!

My headaches are hugely reduced, both in frequency and severity, and my dodgy temperature control has completely normalised. I am now actually enjoying the hot weather for the first time in many years. I had had to have air conditioning installed years previously because I wasn't able to cope with the heat in summer, but I’ve rarely had it on in months at this point.

Although the results have been truly spectacular, the remedy was of course not really a 'remedy' at all, in the normal sense of the word, but simply a return to sharing life with a few symbiotic microorganisms that mankind has travelled with for many millions of years, until Western man summarily dismissed them when he adopted modern hygienic practices.

The 'illness' that I’d had for the previous thirty years (with so many manifestations that doctors couldn't get their heads around them, and preferred to dismiss as psychosomatic) was probably not really 'allergies', food intolerance', 'MCS', 'migraine', 'M.E.' or 'Crohn's disease', etc., at all, but simply Helminth Deficiency Syndrome - an as yet undiscovered reality on a par with vitamin deficiency.

On the strength of my experience thus far, others with similar problems have begun to take the plunge and get 'hooked' themselves. A very good friend who has the same extreme degree of food intolerance, as well as MS, has also inoculated with hookworms and, after a rather rough ride with the temporary gastric symptoms that occur in the first few weeks after inoculation with this species, she was already feeling better than she had for many years and had already been able to resume eating normal foods again. [https://helminthictherapywiki.org/wiki/Travels_with_10_hookworms._Treating_total_food_intolerance,_food_allergy_and_MS]

What amazed me, when she and I compared notes, was how uncannily similar her progress had been to my own, with milestones being passed in the same sequence, and at very close to the same timing.

I began to experience a sense of well-being for the first time at about 30 days post inoculation with hookworms, my friend at 43 days. I began suddenly and unexpectedly to take an interest in cooking smells for the first time in many years at day 39, and she observed herself responding unusually positively to seeing food on the TV at 47 days. I experienced real hunger for the first time at 43 days, and she reported feeling the first pangs of hunger at 60 days - and described herself as 'ravenous'! It’s the same pattern, just delayed by a couple of weeks in her case, and she later also said that her temperature control has been a lot better since week 6, and that she no longer needs as much sleep, which, again, mirrors my own experience.

===Loss of worms at 3 years===

In December, 2011, almost three years after I first adopted hookworms, I saw some sauerkraut for sale. Never having had this before and looking to benefit from the bacterial "old friends" that this fermented form of cabbage offers, I bought a jar of the stuff.

I cautiously ate a very small amount on each of the next two days, and found I very much enjoyed the taste. As I didn't notice any untoward effect, I then ate a rather large amount late in the evening on the third day, following which my stomach began to feel decidedly uncomfortable.

The gut discomfort continued throughout the night and the following day, until the evening, when I began passing copious quantities of bloody diarrhoea - and I'm not swearing! Even though I have Crohn's disease, I've never seen so much blood as there was in the toilet that night! Black, tarry stools had been the hallmark of my Crohn's when it was at its worst, in the days before I discovered helminths, but fresh, bright red blood was something I don't remember ever passing before, at any time in my life.

The episode was so violent that I couldn't leave the bathroom and was so distracted that I didn't even think about taking loperamide, or rehydrating myself, with the result that I lost consciousness several times.

As I gradually recovered over the next couple of days, I wondered if I'd lost any of my worms, but I didn't have any return of symptoms, initially, so assumed that there must be sufficient worms left to maintain my remission.

However, I gradually began to notice increased brain fog, my lips became drier than usual and my skin slightly more itchy. Then, at around three weeks after the sauerkraut incident, I began to experience a return of nasal congestion, forcing me to reinstate daily nasal irrigations in order to have a clear nose during the night.

Daily headaches also returned around this time, my appetite was non-existent, and food tolerance was about 50% worse than it had been before I ate the sauerkraut. I could still tolerate all fruits and vegetables, meats and all food supplements, but tolerance to dairy was poor, with milk products worsening my nasal congestion and my favourite Stilton blue cheese causing migraines.

My concentration got worse and I was needing more sleep again, up to 10 hours where I would normally be fine with only 8. Then, I noticed definite hints of Restless Leg Syndrome when I took a nap, and my gut began to become sore after eating.

Maybe the very slow return of symptoms was due to my having had worms for nearly three years, but, when I realised that I was now in a worse state than when I had originally had just 10 worms on the Nottingham Crohn's trial, I knew that I needed to take action, so quickly requisitioned a fresh dose.

Luckily, my stamina didn't suffer too badly after the loss of my worms, and I was able to continue to use my exercise bike every day, something I would never have been able to do before I first got worms.

Almost two weeks after a new team of hookworms went in, I was again enjoying a degree of relief, though I still had some way to go before I was back to my usual wormy bliss. I was still getting a little nasal congestion, some brain fog and a lot of headaches, but I was once again free from the Restless Leg Syndrome.

I wondered whether my new worms would cause any diarrhoea, as this was a marked feature of my first encounter with a therapeutic dose of hookworms. Back then, the gastric upheaval and diarrhoea had begun on the 5th day of the 4th week and, demonstrating remarkable punctuality, my new worms triggered diarrhoea at the very same time - week 4, day 5! I then had some semi-diarrhoea and other mild gastrointestinal symptoms in the following couple of weeks.

The last symptom to go was nasal congestion, which continued to be a problem until 12 weeks, when it became significantly easier (and I added another dose of hookworms), though it didn't go completely until almost week 20, at which point I was pretty much back to how I had been before the sauerkraut incident.

===Sixteen year review===

At sixteen years since all this began, I continue to maintain my hookworm colony and I’m still enjoying the benefits reported above. However, now that I’m close to entering my ninth decade of life, age is beginning to take its toll. I’m no longer as sprightly as I once was, and the acuity of some of my senses is diminishing somewhat. Nevertheless, I can still eat everything I want to, and my Crohn’s disease, allergies, sinusitis, chemical sensitivity and [[Restless legs syndrome yields completely to hookworms | '''Restless Legs Syndrome''']] are all still in remission.

 By [[John Scott and helminthic therapy | '''John Scott''']]. (Some of the above was originally published in November 2009 on the Foods Matter website. [https://www.foodsmatter.com/allergy_intolerance/food_intolerance/articles/worms_for_food_intolerance.html])

== See also ==

Here are a few of John’s more detailed articles about specific aspects of his helminthic therapy experience.
* [[Hookworms give chronic headaches the old heave-ho | '''Hookworms give chronic headaches the old heave-ho''']]
* [[Nasal allergies nuked by worms | '''Nasal allergies nuked by worms''']]
* [[Restless legs syndrome yields completely to hookworms | '''Restless legs syndrome yields completely to hookworms''']]

And here are reports by others who used helminthic therapy to effectively treat overwhelming food hypersensitivity.
* [[A life saved at the eleventh hour by worms | '''A life saved at the eleventh hour by worms''']]
* [https://www.youtube.com/watch?v=0-WwjzdO80Y I infected myself with parasites... And it saved my life!] - YouTube (30.21 mins)
* [[Hookworms transform a food intolerant and food allergic patient into a foodie | '''Hookworms transform a food intolerant and food allergic patient into a foodie''']]

Helminthic therapy and neuropsychiatric disorders

2026-05-09T16:11:49Z

John: /* Temporarily increased anxiety */

{{Breadcrumb|[[Effects_of_helminthic_therapy|Effects of helminthic therapy]]}}
{{SEO 
|title=Helminthic therapy and neuropsychiatric disorders
|description=
|keywords=
|og:image=[[File:wiki.png]]}}
Helminths are capable of improving neuropsychiatric function, and all four species of therapeutic helminth appear to make a positive contribution to psychological wellbeing.

{{Quote|indent}}Socio-medical studies of humans "self-treating" with helminths as well as limited studies in animal models strongly suggest that helminth therapy may be a productive approach toward treating a range of neuropsychiatric disorders, including chronic fatigue, migraine headaches, depression and anxiety disorders. [https://www.ncbi.nlm.nih.gov/pubmed/29402395]{{Quote|/indent}}

Helminths appear to act through several pathways:
* Modifying the gut microbiota, reducing pathogenic bacteria and stimulating the development of bacteria that produce short-chain fatty acids
* Restoring the intestinal barrier and the blood brain barrier
* Moderating inflammation and neuroinflammation
* Stimulating the production of endocannabinoids and serotonin

==The scientific evidence==

* 2026 Jan 16 [https://pubmed.ncbi.nlm.nih.gov/41513004/ Trained ILC2 prevent IL-17-associated lung injury during helminth infection through a serotonin-dependent mechanism]
:{{Quote|indent}}Trained ILC2 serve as a major source of 5-HT in hookworm infected lungs that limits tissue injury and prevents dysregulated inflammation.{{Quote|/indent}}

* 2021 Oct 20 [https://pubmed.ncbi.nlm.nih.gov/34745091/ Parasite-Derived Excretory-Secretory Products Alleviate Gut Microbiota Dysbiosis and Improve Cognitive Impairment Induced by a High-Fat Diet] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564115/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564115/pdf/fimmu-12-710513.pdf PDF]
:{{Quote|indent}}The present study revealed for the first time that the parasite-derived ESPs alleviate gut microbiota dysbiosis and improve cognitive impairment induced by a high-fat diet.{{Quote|/indent}}

* 2021 Jan 12 [https://pubmed.ncbi.nlm.nih.gov/33440138/ IL-33 Changes Our "Gut Feelings" about Serotonin] -- [https://www.cell.com/immunity/fulltext/S1074-7613(20)30535-5#body-ref-sref10-1 Full text]

* 2020 Nov 20 [https://pubmed.ncbi.nlm.nih.gov/33220232/ Interleukin-33 promotes serotonin release from enterochromaffin cells for intestinal homeostasis] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC7856083/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC7856083/pdf/nihms-1642557.pdf PDF]

* 2020 May 28 [https://escholarship.org/uc/item/3cb5b8jp#article_main Endocannabinoid Regulation of Helminth Induced Hypophagia] -- [https://escholarship.org/content/qt3cb5b8jp/qt3cb5b8jp.pdf PDF] (Capstone project)

* 2020 Jan [https://www.ncbi.nlm.nih.gov/pubmed/31352539 Potential application of helminth therapy for resolution of neuroinflammation in neuropsychiatric disorders]

* 2019 Sep [https://www.journals.uchicago.edu/doi/10.1086/705038 Invisible Designers: Brain Evolution Through the Lens of Parasite Manipulation]

* 2019 [http://www.jneuropsychiatry.org/peer-review/parasitic-worms-for-the-treatment-of-neurodegeneration-12989.html Parasitic Worms for the Treatment of Neurodegeneration] -- [http://www.jneuropsychiatry.org/peer-review/parasitic-worms-for-the-treatment-of-neurodegeneration.pdf PDF]
:{{Quote|indent}}In mice with LPS-induced inflammation and infected with the parasite, the neurodegenerative changes are accompanied by poorer scores of depression, and these were also present in genetically predisposed APPSWE mice.{{Quote|/indent}}

* 2018 Oct 25 [https://pubmed.ncbi.nlm.nih.gov/30104215/ Host- and Helminth-Derived Endocannabinoids That Have Effects on Host Immunity Are Generated during Infection] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6204704/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6204704/pdf/e00441-18.pdf PDF] (media coverage "[https://news.ucr.edu/articles/2018/08/22/getting-high-worms Getting high on worms]")

* 2018 Sep 20 [https://pubmed.ncbi.nlm.nih.gov/30177522/ Modulation of the immune response by helminths: a role for serotonin?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6148219/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6148219/pdf/bsr-38-bsr20180027.pdf PDF]

* 2018 Aug 15 [https://www.ncbi.nlm.nih.gov/pubmed/29402395 Intestinal worms eating neuropsychiatric disorders? Apparently so] -- [[media:Intestinal_worms_eating_neuropsychiatric_disorders%3F_Apparently_so.pdf | PDF]]

* 2016 Sep [https://pubmed.ncbi.nlm.nih.gov/27436048/ The Microbiota, Immunoregulation, and Mental Health: Implications for Public Health] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5763918/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5763918/pdf/nihms-804488.pdf PDF]

* ✅ ⚡ 2016 May 31 [http://www.ncbi.nlm.nih.gov/pubmed/27240605 Practices and outcomes of self-treatment with helminths based on physicians' observations] -- [[media:Practices_and_outcomes_of_self-treatment_with_helminths_based_on_physicians_observations.pdf | PDF]]. The first study to probe, through the eyes of their physicians, the practices and experiences of those who are self-treating with helminths.

* 2014 Jun [http://www.ncbi.nlm.nih.gov/pubmed/24997041 Microbiota, immunoregulatory old friends and psychiatric disorders]

* 2014 [https://ru.dgb.unam.mx/items/57dc729c-ff0f-4148-be6d-cdfc09753d41 Estudio de la permeabilidad de la barrera hematoencefálica en un modelo murino de infección con taenia crassiceps] (Licence, Mexico, Spanish)
:{{Quote|indent}}The second phase was characterized by an increase in the cytokine IL-4, characteristic of the Th2 anti-inflammatory response. A gradual decrease in BBB permeability was observed, associated with increased expression of adhesion molecules (VCAM-1) and increased TGF-β in the BBB{{Quote|/indent}}

* 2012 Aug [https://pubmed.ncbi.nlm.nih.gov/22521209/ The role of parasites and pathogens in influencing generalised anxiety and predation-related fear in the mammalian central nervous system]

* 2012 Jun [https://www.researchgate.net/publication/246961346_MICROBIAL_OLD_FRIENDS_IMMUNOREGULATION_AND_PSYCHIATRIC_DISORDERS Microbial "Old Friends", immunoregulation and psychiatric disorders]

* 2012 May [https://pubmed.ncbi.nlm.nih.gov/22507593/ Can we vaccinate against depression?]

See also [https://www.qimrb.edu.au/researchers-and-labs/mucosal-immunology The Mucosal Immunology group] research team (QIMR Berghofer Medical Research Institute, Queensland, Australia). Current project:
:* Amelioration of behavioural alterations induced by the chronic social defeat model of major depressive disorder with a hookworm recombinant protein (see [[Mechanisms underlying helminth colonization#Hookworm Anti-inflammatory protein (AIP) alias Tissue inhibitor of metalloprotease (TIMP) | AIP-2]])

Negative effect (with a pro-inflammatory species not used in therapy)

* 2026 Feb 5 [https://pubmed.ncbi.nlm.nih.gov/41644553/ The gut microbiota mediates depression-like behaviors in mice with chronic Echinococcus multilocularis infection]

Negative effect (hypothesised). This paper should be read in conjunction with [[Deworming debunked |'''Deworming debunked''']].

* 2017 Jan 10 [https://pubmed.ncbi.nlm.nih.gov/28073356/ Gut microbiota disturbance during helminth infection: can it affect cognition and behaviour of children?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5225537/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5225537/pdf/12879_2016_Article_2146.pdf PDF]

See also
* [[Helminthic therapy and autism | '''Helminthic therapy and autism''']]
* [[Helminthic therapy and neurodevelopmental disorders | '''Helminthic therapy and neurodevelopmental disorders''']]
* [[Helminthic therapy and neurodegenerative diseases | '''Helminthic therapy and neurodegenerative diseases''']]
* [[Helminthic therapy and neurological disorders | '''Helminthic therapy and neurological disorders''']]
* [[Helminthic therapy research | '''Helminthic therapy research''']]

== Scientific papers not directly related ==

These are pathways involved in neuropsychiatric disorders on which helminths act.

=== Microbiota-gut-brain axis ===

* 2026 Feb [https://pubmed.ncbi.nlm.nih.gov/41260033/ The gut microbiota in post-stroke depression: A systematic review of microbial mechanisms and therapeutic targeting of neuroinflammation]

* 2025 Dec 17 [https://pubmed.ncbi.nlm.nih.gov/41418890/ Fructose malabsorption induces dysbiosis and increases anxiety in male human and animal models]

* 2025 Dec [https://pubmed.ncbi.nlm.nih.gov/40690011/ Modulating depression through the gut-brain axis: the role of gut microbiota in therapeutic interventions]

* 2025 Nov 17 [https://pubmed.ncbi.nlm.nih.gov/41300676/ The Pediatric Microbiota-Gut-Brain Axis: Implications for Neuropsychiatric Development and Intervention]

* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40937571/ Role of the gut-brain axis in neurological diseases: Molecular connections and therapeutic implications (Review)]

* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40930337/ Gut microbiome and mitochondrial crosstalk in Schizophrenia, a mental disability: Emerging mechanisms and therapeutic targets] -- [https://www.sciencedirect.com/science/article/abs/pii/S0149763425003720?via%3Dihub Full text]
{{Expando|40+ scientific papers (Tap to expand / minimize)}}
* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40804450/ Beyond the gut: decoding the gut-immune-brain axis in health and disease] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12575876/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12575876/pdf/41423_2025_Article_1333.pdf PDF]

* 2025 Oct 29 [https://pubmed.ncbi.nlm.nih.gov/41160236/ Gut bacteria-derived metabolites and their implications in mental health and neurological diseases]

* 2025 Oct 1 [https://pubmed.ncbi.nlm.nih.gov/41103441/ Akkermansia muciniphila alleviates cognitive impairment and neuroinflammation induced by blunt chest trauma] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12521121/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12521121/pdf/fimmu-16-1657524.pdf PDF]

* 2025 Sep 25 [https://pubmed.ncbi.nlm.nih.gov/41080562/ The microbiota-gut-brain axis in depression: unraveling the relationships and therapeutic opportunities] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12507892/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12507892/pdf/fimmu-16-1644160.pdf PDF]

* 2022 Sep 21 [https://pubmed.ncbi.nlm.nih.gov/36232412/ The Gut-Immune-Brain Axis: An Important Route for Neuropsychiatric Morbidity in Inflammatory Bowel Disease] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/pdf/ijms-23-11111.pdf PDF]

* 2025 Sep [https://pubmed.ncbi.nlm.nih.gov/40908772/ The Microbiota-Gut-Brain Connection: A New Horizon in Neurological and Neuropsychiatric Disorders]

* 2025 Aug 29 [https://pubmed.ncbi.nlm.nih.gov/41007667/ Gut Microbiota in Psychiatric and Neurological Disorders: Current Insights and Therapeutic Implications]

* 2025 Aug 27 [https://www.mdpi.com/2073-4409/13/17/1436 Gut-Brain Axis: Role of Microbiome, Metabolomics, Hormones, and Stress in Mental Health Disorders]

* 2025 Aug 20 [https://pubmed.ncbi.nlm.nih.gov/40909294/ Role of the microbiota in inflammation-related related psychiatric disorders]

* 2025 Aug [https://pubmed.ncbi.nlm.nih.gov/40234288/ Microbiome Gut-Brain-Axis: Impact on Brain Development and Mental Health]

* 2025 Jul 27 [https://pubmed.ncbi.nlm.nih.gov/40870405/ Gut Feelings: Linking Dysbiosis to Depression-A Narrative Literature Review] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12388225/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12388225/pdf/medicina-61-01360.pdf PDF]

* 2025 May 30 [https://pubmed.ncbi.nlm.nih.gov/40442386/ Microbiome: A Key Regulator of Body-Brain Interactions] (Chapter of Brain-Body Connections)

* 2024 Aug 19 [https://pubmed.ncbi.nlm.nih.gov/39165553/ Dietary inflammatory index and its impact on severity and recurrence of Tourette syndrome in children] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11331388/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11331388/pdf/WJP-14-1208.pdf PDF]

* 2024 Jul 10 [https://dumas.ccsd.cnrs.fr/MEM-UNIV-BORDEAUX/dumas-04642929v1 Le microbiote intestinal, la clé de notre santé mentale ? Implication de l'axe intestin-cerveau dans la physiopathologie de la dépression et de la maladie de Parkinson] -- [https://dumas.ccsd.cnrs.fr/dumas-04642929v1/file/Pharmacie_2024_Quimeby.pdf PDF] (French, pharma thesis)

* 2025 Jul [https://pubmed.ncbi.nlm.nih.gov/40369368/ Gut microbiota and the tryptophan-kynurenine pathway in anxiety: new insights and treatment strategies]

* 2024 May 26 [https://pubmed.ncbi.nlm.nih.gov/38891970/ Human Gut Microbiota for Diagnosis and Treatment of Depression] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11171505/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11171505/pdf/ijms-25-05782.pdf PDF]

* 2024 Mar 15 [https://pubmed.ncbi.nlm.nih.gov/38489352/ Gut bacteria–derived serotonin promotes immune tolerance in early life] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11328322/ Full text]

* 2024 [https://pubmed.ncbi.nlm.nih.gov/37962812/ Microbiota-Gut-Brain Axis and Antidepressant Treatment] (Book chapter of Emerging Neurobiology of Antidepressant Treatments)

* 2024 [https://pubmed.ncbi.nlm.nih.gov/38531341/ Mind over Microbes: Investigating the Interplay between Lifestyle Factors, Gut Microbiota, and Brain Health] -- [https://karger.com/ned/article/58/6/426/898000/Mind-over-Microbes-Investigating-the-Interplay Full text]

* 2023 Apr [https://pubmed.ncbi.nlm.nih.gov/36796440/ Associations between fecal short-chain fatty acids, plasma inflammatory cytokines, and dietary markers with depression and anxiety: Post hoc analysis of the ENGAGE-2 pilot trial] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC10273083/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC10273083/pdf/main.pdf PDF]

* 2022 Sep 21 [https://pubmed.ncbi.nlm.nih.gov/36232412/ The Gut-Immune-Brain Axis: An Important Route for Neuropsychiatric Morbidity in Inflammatory Bowel Disease] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/pdf/ijms-23-11111.pdf PDF]

* 2023 [https://pubmed.ncbi.nlm.nih.gov/36949312/ Microbiota-Gut-Brain Axis in Major Depression: A New Therapeutic Approach] (Book chapter of Neuroinflammation, Gut-Brain Axis and Immunity in Neuropsychiatric Disorders)

* 2023 [https://pubmed.ncbi.nlm.nih.gov/35947354/ Evolutionary Aspects of Diverse Microbial Exposures and Mental Health: Focus on "Old Friends" and Stress Resilience] --[https://pmc.ncbi.nlm.nih.gov/articles/PMC9918614/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9918614/pdf/nihms-1849066.pdf PDF]

* 2022 Oct 28 [https://pubmed.ncbi.nlm.nih.gov/36389228/ The interplay between the gut-brain axis and the microbiome: A perspective on psychiatric and neurodegenerative disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC9650127/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9650127/pdf/fnins-16-1030694.pdf PDF]

* 2022 Mar 25 [https://link.springer.com/chapter/10.1007/978-3-030-91051-8_10 The Influence of the Microbiota on Brain Structure and Function: Implications for Stress-Related Neuropsychiatric Disorders] (chapter of Evolution, Biodiversity and a Reassessment of the Hygiene Hypothesis)

* 2019 Jul 19 [https://pubmed.ncbi.nlm.nih.gov/31379879/ The Role of Inflammation in Depression and Fatigue] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6658985/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6658985/pdf/fimmu-10-01696.pdf PDF]

* 2021 Jul [https://pubmed.ncbi.nlm.nih.gov/34243604/ Role of microbiota-derived short-chain fatty acids in nervous system disorders]

* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33252574/ Understanding the role of gut microbiota in the pathogenesis of schizophrenia]

* 2020 [https://www.microbiotajournal.com/article/201 The microbiota-gut-brain axis in gastrointestinal inflammation and neurological comorbidities] -- [https://www.microbiotajournal.com/wp-content/uploads/sites/7/2020/01/e201-The-microbiota-gut-brain-axis-in-gastrointestinal-inflammation-and-neurological-comorbidities.pdf PDF]

* 2019 Jun 28 [https://pubmed.ncbi.nlm.nih.gov/31316375/ Microbiome and Cognitive Impairment: Can Any Diets Influence Learning Processes in a Positive Way?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6609888/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6609888/pdf/fnagi-11-00170.pdf PDF]

* 2019 [https://pubmed.ncbi.nlm.nih.gov/29870270/ Impact of gut microbiota on neurological diseases: Diet composition and novel treatments] -- [https://www.tandfonline.com/doi/full/10.1080/10408398.2018.1484340?scroll=top&needAccess=true Full text]

* 2018 Oct [https://pubmed.ncbi.nlm.nih.gov/30066368/ Short-chain fatty acids: microbial metabolites that alleviate stress-induced brain-gut axis alterations] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6187046/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6187046/pdf/TJP-596-4923.pdf PDF]

* 2018 May 3 [https://pubmed.ncbi.nlm.nih.gov/29743938/ Dysbiotic drift and biopsychosocial medicine: how the microbiome links personal, public and planetary health] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5932796/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5932796/pdf/13030_2018_Article_126.pdf PDF]

* 2017 Oct 1 [https://pubmed.ncbi.nlm.nih.gov/28242013/ Targeting the Microbiota-Gut-Brain Axis: Prebiotics Have Anxiolytic and Antidepressant-like Effects and Reverse the Impact of Chronic Stress in Mice]

* 2017 Jul [https://pubmed.ncbi.nlm.nih.gov/28727115/ The microbiota-gut-brain axis as a key regulator of neural function and the stress response: Implications for human and animal health]

* 2017 May 10 [https://pubmed.ncbi.nlm.nih.gov/28219800/ Variations in gut microbiota and fecal metabolic phenotype associated with depression by 16S rRNA gene sequencing and LC/MS-based metabolomics]

* 2016 Mar 16 [http://elib.bvuict.in/moodle/pluginfile.php/427/mod_resource/content/0/Gut%20Microbiome.pdf Gut microbiome and brain activity] (B.Sc. Biotechnology)

* 2015 Oct 14 [https://pubmed.ncbi.nlm.nih.gov/26528128/ Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4604320/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4604320/pdf/fncel-09-00392.pdf PDF]

* 2014 [https://link.springer.com/chapter/10.1007/978-1-4939-0897-4_16 Microbiota-Gut-Brain Axis and Cognitive Function] (Book chapter of Microbial Endocrinology: The Microbiota-Gut-Brain Axis in Health and Disease)
{{Expando}}

=== Inflammation and neuroinflammation ===

* 2025 Dec [https://pubmed.ncbi.nlm.nih.gov/41314100/ Therapeutic prospects of modulating TLR4/MAPK/ROS signalling in obesity-associated neuroinflammation] -- [https://www.sciencedirect.com/science/article/pii/S0753332225009990?via%3Dihub Full text]

* 2025 Nov 28 [https://pubmed.ncbi.nlm.nih.gov/41313410/ Nrf2/Keap1 Signaling Axis in the Brain: Master Regulator of Oxidative Stress in Neurodegenerative and Psychiatric Disorders]

* 2025 Nov 20 [https://pubmed.ncbi.nlm.nih.gov/41357230/ The critical role of Th17 cells and IL-17A in autoimmune and inflammation-associated neurological diseases: mechanisms and therapeutic perspectives] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12676946/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12676946/pdf/fimmu-16-1656422.pdf PDF]

* 2025 Aug [https://pubmed.ncbi.nlm.nih.gov/40683090/ The role of neuroinflammation in schizophrenia: Focus on Th17 cells functions] -- [https://www.sciencedirect.com/science/article/abs/pii/S1876201825002722?via%3Dihub Full text]

* 2025 May [https://pubmed.ncbi.nlm.nih.gov/39592709/ Dural Tregs driven by astrocytic IL-33 mitigate depression through the EGFR signals in mPFC neurons]

* 2024 Dec [https://pubmed.ncbi.nlm.nih.gov/39660880/ IL-17A Mediates Depressive-Like Symptoms by Inducing Microglia Activation in Psoriasiform Dermatitis Mice]

* 2024 Jul 2 [https://pubmed.ncbi.nlm.nih.gov/38956051/ Cytokine expression profiles in children and adolescents with tic disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11219894/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11219894/pdf/41598_2024_Article_62121.pdf PDF]

* 2024 Jun 12 [https://pubmed.ncbi.nlm.nih.gov/38866753/ Decoding the inflammatory signature of the major depressive episode: insights from peripheral immunophenotyping in active and remitted condition, a case–control study] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11169351/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11169351/pdf/41398_2024_Article_2902.pdf PDF]

* 2023 Aug 22 [https://pubmed.ncbi.nlm.nih.gov/37614669/ Transient anxiety-and depression-like behaviors are linked to the depletion of Foxp3-expressing cells via inflammasome in the brain]

* 2023 May 8 [https://pubmed.ncbi.nlm.nih.gov/37156764/ T cells: an emerging cast of roles in bipolar disorder] -- [https://www.nature.com/articles/s41398-023-02445-y Full text]

* 2023 Apr 28 [https://pubmed.ncbi.nlm.nih.gov/37187752/ The inflammatory injury in the striatal microglia-dopaminergic-neuron crosstalk involved in Tourette syndrome development] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC10175669/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC10175669/pdf/fimmu-14-1178113.pdf PDF]

* 2023 Apr 28 [https://pubmed.ncbi.nlm.nih.gov/37106375/ Th17 cells sense microbiome to promote depressive-like behaviors] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC10142784/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC10142784/pdf/40168_2022_Article_1428.pdf PDF]

* 2023 Jan 10 [https://pubmed.ncbi.nlm.nih.gov/36704001/ Anti-inflammatory properties of commonly used psychiatric drugs]
:{{Quote|indent}}As researchers, clinicians, and patients become increasingly aware of the role of inflammation in brain health, it is reassuring that these psychiatric drugs may also abrogate this inflammation, in addition to their effects on neurotransmission. Further studies are required to determine whether inflammation is a driver of disease pathogenesis, and therefore should be a therapeutic target in future clinical trials.{{Quote|/indent}}

* 2022 May [https://pubmed.ncbi.nlm.nih.gov/34809994/ Modulating neuroinflammation in COVID-19 patients with obsessive-compulsive disorder]

* 2022 Jan 11 [https://pubmed.ncbi.nlm.nih.gov/35087475/ Changes of Cytokines in Children With Tic Disorder] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC8787115/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC8787115/pdf/fneur-12-800189.pdf PDF]

* 2022 Jan [https://pubmed.ncbi.nlm.nih.gov/34592888/ T helper cells in depression: central role of Th17 cells]

* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33197496/ IL-10 normalizes aberrant amygdala GABA transmission and reverses anxiety-like behavior and dependence-induced escalation of alcohol intake]

* 2019 Feb [https://pubmed.ncbi.nlm.nih.gov/29752710/ Inflammation in psychiatric disorders: what comes first?]

* 2018 Feb 13 [https://pubmed.ncbi.nlm.nih.gov/29433523/ A clinical approach to new-onset psychosis associated with immune dysregulation: the concept of autoimmune psychosis] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5809809/ Full text] | [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809809/pdf/12974_2018_Article_1067.pdf PDF]

* 2016 Jan 13 [https://pubmed.ncbi.nlm.nih.gov/26757726/ Cyclic AMP is a key regulator of M1 to M2a phenotypic conversion of microglia in the presence of Th2 cytokines] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4711034/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4711034/pdf/12974_2015_Article_463.pdf PDF]

* 2016 Jan [https://pubmed.ncbi.nlm.nih.gov/26472628/ Microglial Activity in People at Ultra High Risk of Psychosis and in Schizophrenia: An (11)C PBR28 PET Brain Imaging Study] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4821370/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4821370/pdf/emss-67512.pdf PDF] (Media coverage BBC [https://www.bbc.com/news/health-34540363 Immune clue to preventing schizophrenia]

* 2011 Oct 1 [https://pubmed.ncbi.nlm.nih.gov/21641581/ Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4071300/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4071300/pdf/nihms-519864.pdf PDF]

=== Various ===

* 2025 Apr [https://pubmed.ncbi.nlm.nih.gov/39672518/ Intestinal Epithelial Serotonin as a Novel Target for Treating Disorders of Gut-Brain Interaction and Mood]

* 2022 Feb 14 [https://pubmed.ncbi.nlm.nih.gov/35237195/ Autoimmune Encephalitis With Psychotic Manifestations and Cognitive Impairment Presenting as Schizophrenia: Case Report and Literature Review] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC8882583/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC8882583/pdf/fpsyt-13-827138.pdf PDF]

* 2019 Mar 20 [https://pubmed.ncbi.nlm.nih.gov/30949074/ Autoimmune Diseases and Psychotic Disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6435494/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6435494/pdf/fpsyt-10-00131.pdf PDF]

* 2019 Jan 1 [https://pubmed.ncbi.nlm.nih.gov/30122288/ Associations Between Non-neurological Autoimmune Disorders and Psychosis: A Meta-analysis] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6269125/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6269125/pdf/main.pdf PDF]

* 2017 Nov [https://pubmed.ncbi.nlm.nih.gov/28704576/ Psychosis: an autoimmune disease?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5629440/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5629440/pdf/IMM-152-388.pdf PDF]

* 2017 Jan [https://pubmed.ncbi.nlm.nih.gov/27965002/ Prevalence and clinical characteristics of serum neuronal cell surface antibodies in first-episode psychosis: a case-control study] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5890880/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5890880/pdf/emss-76791.pdf PDF] (Media coverage on BBC News [https://www.bbc.com/news/health-38220610 Some psychosis cases an 'immune disorder'])

* 2015 Oct [https://pubmed.ncbi.nlm.nih.gov/26044086/ Depression as sickness behavior? A test of the host defense hypothesis in a high pathogen population]

* 2015 Jun [https://pubmed.ncbi.nlm.nih.gov/26004665/ Maternal history of autoimmune disease and later development of tourette syndrome in offspring]

* 2014 [https://www.ncbi.nlm.nih.gov/pubmed/24557049 Searching for the immune basis of obsessive-compulsive disorder] -- [https://www.karger.com/Article/FullText/356554 Full text] | [https://www.karger.com/Article/Pdf/356554 PDF]

* 2013 Apr 5 [https://pubmed.ncbi.nlm.nih.gov/22765923/ Updating the mild encephalitis hypothesis of schizophrenia]

* 2001 Nov 13 [https://www.ncbi.nlm.nih.gov/pubmed/11760984 Is obsessive–compulsive disorder an autoimmune disease?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/pdf/20011113s00026p1353.pdf PDF]

==Depression==

* [https://www.huffpost.com/entry/depression-and-inflammation_b_1071714 The Depression-Inflammation Connection] (Andrew Weil, HuffPost, Nov 4, 2011)

For further accounts of how helminthic therapy has reduced depression, see the following.
* [[media:Practices_and_outcomes_of_self-treatment_with_helminths_based_on_physicians_observations.pdf | Practices and outcomes of self-treatment with helminths based on physicians' observations]] (PDF) (In particular, see Table 1)

===Reduced depression / improved mood===

HDC is mentioned a lot in this context, and, since HDC is taken regularly, usually every 2 weeks, its users can benefit from a repeated post-inoculation [[The helminthic therapy bounce | 'bounce’]]. This is a brief period of temporary symptom relief accompanied by a sudden feeling of unusual wellness, perhaps with a strong sense of calm, focus, happiness and lightheartedness.

{{Quote|indent}}I like how it puts me in a good mood for a day or two when I first take it.{{Quote|/indent}}

{{Quote|indent}}I also experienced a significantly elevated mood that night after taking just 10 HDC, the elevated mood lasted until the end of the next day. [https://www.facebook.com/groups/htsupport/permalink/882220201833936/?comment_id=885859204803369&offset=0&total_comments=16&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}

For some people, this effect may be repeated after every dose.

{{Quote|indent}}... every dose of HDC's is followed by a delightful stream of energy that lasts almost a week. [https://www.facebook.com/groups/263818550462551/permalink/468678839976520/?comment_id=473949269449477&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Within 24 hours of taking HDC I feel much calmer. That feeling lasts a few days, before it lets up a bit, but I still continue feeling calmer than usual up to 30 days after dosing, when their effects completely wear off… If I could regularly dose, say, weekly, I probably would see my anxiety completely resolved. [https://www.facebook.com/groups/htsupport/permalink/1526704624052154/?comment_id=1535606909828592&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

In other cases, this effect may reduce over time.

{{Quote|indent}}The first day I take HDC it usually puts me in a really nice mood, especially the first time I did it. It's not exactly euphoric but I noticed it and counted on it… First time, (it lasted) 48 hours. Second time, 24 hours. Third time, 12 hours. Fourth time, 12 hours.{{Quote|/indent}}

However, this effect on neuropsychiatric function is not unique to HDC. It is also seen with TSO, NA and TTO.

{{Quote|indent}}My mood was the first indicator that TSO was working. I became calmer and happier despite my physical symptoms. [https://www.facebook.com/groups/htsupport/permalink/861668620555761/?comment_id=862075060515117&offset=0&total_comments=13&comment_tracking=%7B%22tn%22:%22R%22%7D] I find TSO is the best for mood and general feeling of well being as well as increased energy. Hookworm and (human) whipworm both work as well, it just takes longer. [https://www.facebook.com/groups/htsupport/permalink/1620673674655248/?comment_id=1666993650023250&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}My daughter started TSO last week and we are already seeing an improvement in her mood and energy on a low dose of 500 ova. [https://www.facebook.com/groups/htsupport/permalink/862879650434658/?comment_id=862906407098649&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}TSO cured a mood disorder I didn't realize I had until it was gone. [https://www.facebook.com/groups/htsupport/posts/4461359747253279/]{{Quote|/indent}}

{{Quote|indent}}I would like to confirm positive effect of TSO on mood stabilization as well. Even with low dose in my case (300 ova bi-weekly). [https://www.facebook.com/groups/htsupport/posts/4461359747253279/?comment_id=4464894023566518]{{Quote|/indent}}

{{Quote|indent}}I didn't have depression, just a generally negative view of life, but NA has (unexpectedly) made me a whole lot more positive and even happy. [https://www.facebook.com/groups/htsupport/posts/6145556122166958/?comment_id=6150417601680810] It's noticeable enough that I would continue with them even if that was the only benefit. [https://www.facebook.com/groups/htsupport/posts/6562813033774596/?comment_id=6575864549136111]{{Quote|/indent}}

The following comment was made 6 weeks after inoculation with 25 hookworm larvae.

{{Quote|indent}}What is already interesting is my steady and calm mind.{{Quote|/indent}}

More reports:

The first report is more detailed than the quotes that follow it.

:* [[Migraine, depression and autoimmunity relieved by TSO and NA | '''Migraine, depression and autoimmunity relieved by TSO and NA''']]

* "The worms have removed my crippling depression and fuzzy head so I'm very happy." (Reported in a private discussion, Jan 2012)

* "I second getting some mood benefits from HT, which many others have noted as well." (Link expired)

* "The thing that surprised me most about the therapy is an increase in general well being. I sleep less, am more alert, am able to think more clearly, and have a brighter mood. I jokingly say that I wasn't depressed prior to worms, and I'm even more not depressed now." (Link expired)

* “I inoculated with hookworm hoping that it would help my chronic sinus issues... But I wasn't expecting any changes in personality, so they came as a shock. My lifelong battle with depression and anxiety seems to be over. And I'm also smarter again (like when I was a kid).”

* “I'd say hookworm has improved my mood… I wasn't actively depressed when I started hookworm but I definitely noticed a reduction in how much I had to use CBT-style challenging of my thinking.” [https://www.facebook.com/groups/htsupport/permalink/924060764316546/?comment_id=924235834299039&comment_tracking=%7B%22tn%22:%22R0%22%7D]

* “I have been depressed most of my life. That eased a bit with IV magnesium. But it changed dramatically about 20 weeks after starting hookworms. My mood improved dramatically and I just felt happy - my psychological issues just disappeared.”

* “The crippling morning depression I would experience has all but completely vanished. When I now wake up in the morning, I feel positive about getting up and optimistic without feeling drained or as if I had just gone to sleep an hour ago.” (Written after 5 months with hookworms and two months of taking TSO for systemic lupus.) [https://www.facebook.com/groups/htsupport/permalink/940503262672296/]

* “I have good days now (after hosting NA for five years) when I never had good days for years, and sometimes I actually feel incredibly happy, something else that never really happened.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1088327351223219&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “My depression and anxiety and brain fog have disappeared on NA.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “I can attest to a huge improvement in my anxiety and depression within just a few weeks of my first NA dose (off all meds now) but I'd say I still have some mild residual symptoms.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&reply_comment_id=1089756711080283&comment_tracking=%7B%22tn%22:%22R8%22%7D]

* "Hookworms took about 24 weeks to begin to make a dent in depression - now about 2.5 years into helminths, I have some days where I'm downright optimistic. Not many, but after decades of depression it's a huge change." [https://www.facebook.com/groups/htsupport/permalink/1515697631819520/?comment_id=1515980121791271&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

* ☹️ “I have anxiety and depression and have not really noticed any differences.” [https://www.facebook.com/groups/htsupport/permalink/1515697631819520/?comment_id=1516504428405507&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* "My diagnosed anxiety/depression went down to zero. I can't get unhappy if I try. If this was the only good effect (of using HDC) it would be enough." (Link expired)

* “NA has definitely helped with depression, although I do not feel that my depression is severe, compared to that of others. It is definitely seasonal… After about 6 months, I began to notice improvement in mood.” [https://www.facebook.com/groups/htsupport/permalink/1803006713088609/?comment_id=1803101086412505&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “As pretty much a lifelong depression sufferer (since onset of puberty anyway), I generally never liked the flat emotional effect I got from antidepressants, and always felt my depression was very much related (coincidentally at least) to my severe seasonal allergy symptoms. By the time I started hosting HW, I had given up on antidepressants for several years, and had just resigned myself to pushing through life without psych meds. About a year into hosting NA for severe allergies and asthma, I unexpectedly noticed nearly total resolution of my depressive symptoms.” [https://www.facebook.com/groups/htsupport/permalink/2190363854352891/?comment_id=2194958800560063&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “NA resolved my chronic depression - it was one of those weird, gradual, unexpected benefits.” [https://www.facebook.com/groups/htsupport/permalink/2206914002697876/?comment_id=2333833590005916&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “HDC (I take 10 every three weeks) have a positive impact on my mood. My case may be different from others, but... PANS is what leads to my low mood. In PANS, autoantibodies attach to dopamine and glutamate receptors in the basal ganglia, which blocks their transmission in normal amounts. I think my good mood when I take HDC is likely because it helps whatever is leading to those autoantibodies being in the wrong place (my basal ganglia receptors), so more dopamine and glutamate can reach their proper destination. Not sure if these mechanics apply to many other disorders, though.” [https://www.facebook.com/groups/htsupport/permalink/2296657347056874/?comment_id=2334347929954482&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “I thought the NA didn't do much for my mental health. But it's clear to me now that they were helping me. I got rid of my NA as part of an experiment to see if they were contributing to a sudden and consistent drop in energy I've been experiencing since May. I find that I am more depressed without them. Small problems can now push me over into the realm of crying spells and panic attacks. The HDC was helping with social anxiety and OCD, but it seems the NA was supporting a higher baseline of mental health and stability. More NA on the way to restock.” [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=3042523755803559]

* “I’ve had so much success from the two types of friends... it’s the miracle I’ve been searching for (for 18 years) since 2001. I can’t even tell you how much happier I am now that my depression, fatigue, and extreme food sensitivities are pretty much resolved. I think the NA have been the most helpful for me, with TSO as a great backup.” [https://www.facebook.com/groups/htsupport/permalink/2490868600969080/?comment_id=2491288504260423]

* "I’ve been previously diagnosed with depression, anxiety, PTSD, panic disorder, and a mood disorder, and for 10 or more years, life had seemed like a foggy dream. But after almost two years with NA, I realized that HT has significantly helped me with my mental health. It’s given me a sense of clarity that I haven’t had in years. I continue to require therapy as needed, and I’ve been treated with a wide range of medications over the years, but I’m currently only on one anxiety medication. I continue to be so thankful for HT. It’s life altering." (Edited from this post: [https://www.facebook.com/groups/htsupport/permalink/3610564992332763/].)

* “I am pretty sure that my NA have dealt with my insomnia, probably part of what remains the biggest, and unexpected, benefit of taking on these wonderful companion animals: an end to depression and anxiety of a level such that I had to take tricyclic antidepressants to function.” [https://www.facebook.com/groups/htsupport/posts/4465083816880872/?comment_id=4467760283279892]

* "TSO was the magic mood machine for me." [https://www.facebook.com/groups/htsupport/posts/5219928144729765?comment_id=5220568117999101&reply_comment_id=5221503187905594]

* "I've been doing HDC for five months now. Started with five every three weeks. I expected no results for at least a week, but noticed an improvement in energy and mood in two days. While mood and energy are up, joint pain is down." [https://www.facebook.com/groups/htsupport/posts/4470230976366156?comment_id=5507026999353210]

* "My mental health has been way better since starting helminth as I was pretty low on and off for a long time before that and especially bad when I was low in energy or sick, like when I had covid. After dosing with 3 NA, then 5, and now 3 NA every 3 months, I haven’t experienced that depression except for 1 day following another covid infection. I’m feeling like seeing people which I couldn’t face last year until well down the track." (Edited from [https://www.facebook.com/groups/htsupport/posts/6271627282893174/ this post].)

===Temporarily ''increased'' depression===

Occasionally, depression may increase temporarily following initial inoculation with helminths. This is usually, but not necessarily, the result of using doses that are too high.

{{Quote|indent}}After first small group of NA, I became much more depressed for about 10-12 weeks, then got back to previous mood level. [https://www.facebook.com/groups/htsupport/permalink/1526355860753697/?comment_id=1526618564060760&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I have hit a patch of depression here at week 9 of my first inoculation with 3NA and I am feeling very bleak. [https://www.facebook.com/groups/htsupport/permalink/1814806755241938/]{{Quote|/indent}}

{{Quote|indent}}I also feel quite depressed, will be 9 weeks for me on Tuesday. [https://www.facebook.com/groups/htsupport/permalink/1814806755241938/?comment_id=1815580378497909&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}After first small group of NA, I became much more depressed for about 10-12 weeks, then got back to previous mood level. [https://www.facebook.com/groups/htsupport/permalink/1526355860753697/?comment_id=1526618564060760&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I experience plummeting mood following an NA inoculation. Dosing amounts are important with NA. [https://www.facebook.com/groups/htsupport/permalink/1936169449772334/?comment_id=1936702619719017&reply_comment_id=1936765523046060&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}When I used HDC, I found that a high dose made me agitated, where a low dose would lift my depression within hours from the moment of taking it. [https://www.facebook.com/groups/htsupport/posts/6666593640063201/?comment_id=6666843226704909]{{Quote|/indent}}

{{Quote|indent}}My wife, who suffers from clinical depression, took 1 NA each month for 3 months. Then the Dr. told her to take 5 at once despite us asking multiple times if this would cause depression. We were told no each time. So my wife took the 5 at once as the doctor had suggested. A few days later, she began to get depressed and could not get out of bed for about 7-10 days. Cried all day. We killed the colony about 4 days later to prevent my wife from going to hospital because the depression was that bad. It was about another 2 weeks before she felt better again. (Edited from two posts: [https://www.facebook.com/groups/htsupport/posts/4830265563696027/?comment_id=5217548054967774] [https://www.facebook.com/groups/htsupport/posts/5219928144729765?comment_id=5220044041384842&reply_comment_id=5220058691383377].){{Quote|/indent}}

{{Quote|indent}}3.5 years in, I now have times where I even feel positive and optimistic, which is a huge improvement over a lifetime of clinical depression. But it’s also the first symptom to return, especially if I take a dose of NA that’s a little too much. Last dose was 7, and 3 days later I started 9 days of deep despair. I know it’s temporary, so I just hang on and get through it, but now I know 7 is too many. [https://www.facebook.com/groups/htsupport/permalink/1936169449772334/?comment_id=1936702619719017&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}… the participant abruptly halted his antidepression medications and began taking HDCs. Although confident in his actions because of the effects of HDCs on his adult daughter and a friend, the outcome was severe depression. The participant resumed his medication and, fortunately, recovered rapidly. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

=== Alternative approaches: Omega-3 fatty acids and uridine for depression ===

According to [https://en.wikipedia.org/wiki/Uridine Wikipedia], Harvard researchers have reported that giving rats a combination of omega-3 fatty acids and uridine, two substances in foods such as fish, walnuts, molasses and sugar beets, prevented depression as effectively as antidepressant drugs. [https://news.harvard.edu/gazette/story/2005/02/food-ingredients-may-be-as-effective-as-antidepressants/] [https://pubmed.ncbi.nlm.nih.gov/15705349/]

Uridine is produced by at least 3 helminth species amongst their excretory/secretory products: Nippostrongylus brasiliensis, Trichuris muris and Ancylostoma duodenale. [https://pubmed.ncbi.nlm.nih.gov/40391223/][https://pubmed.ncbi.nlm.nih.gov/38927075/] [https://pubmed.ncbi.nlm.nih.gov/39816468/]

Although no peer‑reviewed reports could be found at the time of writing that describe the secretion of uridine by any of the therapeutic helminths (TSO, TTO, HDC or NA), this may be due to the literature on helminth excretory/secretory metabolites tending to focus on proteins, glycans and lipids rather than small molecules.

==Anxiety==

=== Reduced anxiety ===

* "My symptoms of anxiety continue to get gradually better." (Link expired)

* "... the hookworms... kicked in about 24 weeks after inoculation, which ended my 15 month nightmare with the anxiety." (Link expired)

* "I thought i am getting crazy... visited a psychologist ... they even made a CT scan. But with the right diet and helminthic therapy... i am much more balanced now. (Link expired)

* “One of the best benefits now is relief from anxiety and muscular tension. I’m waking up feeling rested, with a very relaxed back and legs, and am drowsy enough to take naps, which creates a virtuous cycle.” [http://gettinghealthiernow.wordpress.com/2012/01/02/hookworm-only-starting-over/]

* "My worms have seemingly completely zapped my anxiety. It takes a lot for me to feel anxious and it's a huge relief after having anxiety and panic attacks starting in early childhood… They have also dramatically reduced my daughter's anxiety. It was always bad, from infancy, but … she's had the best school year ever, socially. She's ten thousand times better, a completely unanticipated improvement. Our school psychologist said it was like she was a different kid." (Reported in a private discussion, Mar 2012)

* "My younger son also had severe anxiety issues which evaporated after HW. He was on medication in fact for 2 years for it but hasn't been on it in years now." (Reported to the Facebook Helminthic Therapy Support Group [https://www.facebook.com/groups/htsupport/], Mar 2012)

* "He felt much less anxiety and much more social than he would normally. (I have noticed this effect as well and wonder now how much anxiety and a desire not to be social is related to inflammation…)" [http://turnotheworm.blogspot.co.uk/2012/03/update-part-iv-from-worlds-worst.html]

* "My anxiety is still significantly reduced from pre-inoculation. Things just do not bother me the way that they did. I really feel as though my anxiety just completely vanished with the first inoculation. It is a great feeling after dealing with a lot of anxiety my entire life." [http://turnotheworm.blogspot.co.uk/2012/03/march-25-2012-saved-myself-for-last.html]

* “This therapy can be fantastic for anxiety reduction and we've seen it in every member of our family. My poor little girl had rampaging anxiety and nothing made it better. She had so much pain all the time that she was constantly anticipating more pain and very defensive. She couldn't stand to listen to a story with anything scary (she didn't want to listen to Mr. Rogers telling the story of Goldilocks and the Three Bears, that's how bad it was). Then she got hookworm. Her anxiety vaporized completely, possibly for the first time in her entire life. She completely changed. Last year, she read all of the Harry Potter books and watched all the movies -- that's how much lower her anxiety and pain are now.” [https://www.facebook.com/groups/htsupport/permalink/396703530385608/?qa_ref=qd&comment_id=397436063645688&offset=0&total_comments=17&comment_tracking=%7B%22tn%22:%22R2%22%7D]

* “I noticed the relaxed feeling with HW as well. They gave me an overall good feeling and relieved debilitating anxiety that kept me from doing things that I love doing and from seeing friends.” [https://www.facebook.com/groups/htsupport/permalink/474883185900975/?comment_id=475139555875338&offset=0&total_comments=17]

* “The HW also had a fairly dramatic effect on my anxiety levels." (Reported to a closed group, Aug 2013)

* “I inoculated with hookworm hoping that it would help my chronic sinus issues. I still can't believe how much better my sinuses are. But I wasn't expecting any changes in personality, so they came as a shock. My lifelong battle with depression and anxiety seems to be over. And I'm also smarter again (like when I was a kid).” [https://www.facebook.com/groups/263818550462551/permalink/476388752538862/?comment_id=476417832535954&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “After hosting hookworm I no longer have bouts of depression and anxiety.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1088294924559795&comment_tracking=%7B%22tn%22:%22R0%22%7D]

* “My depression and anxiety and brain fog have disappeared on NA.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “I can attest to a huge improvement in my anxiety and depression within just a few weeks of my first NA dose (off all meds now) but I'd say I still have some mild residual symptoms.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&reply_comment_id=1089756711080283&comment_tracking=%7B%22tn%22:%22R8%22%7D]

* “His anxiety is almost completely gone and the OCD is still there but not as profound. He is back at school after missing most of last year due to anxiety/school refusal. I highly recommend trying HDC's. It really has been the treatment that has brought our (12 year old) son back.” [https://www.facebook.com/groups/htsupport/permalink/1067321983323756/?comment_id=1263018683754084&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

* ☹️ “I have anxiety and depression and have not really noticed any differences.” [https://www.facebook.com/groups/htsupport/permalink/1515697631819520/?comment_id=1516504428405507&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “Within 24 hours of taking HDC I feel much calmer. That feeling lasts a few days, before it lets up a bit, but I still continue feeling calmer than usual up to 30 days after dosing, when their effects completely wear off… If I could regularly dose, say, weekly, I probably would see my anxiety completely resolved.” (Link expired)

* “Now 5 months in, I have seen the most dramatic change in anxiety symptoms. Also brain fog has just slipped away… So I do feel hookworm has been instrumental in bringing down the symptoms of anxiety to where it is now.” [https://www.facebook.com/groups/htsupport/permalink/2239015116154431/?comment_id=2239742029415073&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “Wormy update after 3 months: I am now on 50 HDC. I see just mild improvement in food allergies, but I feel calm, no anxiety! Anxiety was always a big issue for me and the antidepressants were not helping enough. Now I feel much better so that I can exercise every day.” [https://www.facebook.com/groups/htsupport/permalink/2408900369165904/]

* “In 2013 I was diagnosed with anxiety resulting in extended time off work and medication. I first tried HDC in 2016 after exhausting every other avenue outside of medication that I could think of. I found instant relief from my anxiety symptoms and I still take them every 2 or 3 weeks to help keep my anxiety at bay.” (Received via email, Feb 2020.)

* “I’ve had autoimmune disease, allergies, anxiety and digestion issues for 4 years. After having a severe panic attack at work, I saw a doctor and a naturopath, and have tried allopathic and natural medicines as well as dietary changes. I was skeptical, but after reading the extensive research and about the therapeutic effects of helminths, I tried it for myself and it worked. After being on HDC for 1 month (10 fresh HDCs every 2 weeks), my allergies disappeared and I had no side effects. Other symptoms improved 70%. It was a huge relief for me, dramatically reducing my anxiety and making a significant difference to my gut health and digestion in the first 3 months. This is faster and more effective than anything else I have ever tried. My family were skeptical and assumed it would be unsafe, but even they could notice the difference!” (Received via email, Feb 2020.)

* “I’m micro-dosing with (TSO). I notice that my anxiety peeks up for several days when it’s time to take them again. And an hour after taking them, I feel this calmness that’s difficult to describe. For someone with chronic anxiety it’s lovely.” [https://www.facebook.com/groups/htsupport/permalink/2255349147854361?comment_id=3547191695336760]

* “My daughter's anxiety was much reduced (by TSO). She has inflammation related autism. When she was anxious she would go into obsessions for hours, so the effect was pretty obvious.” [https://www.facebook.com/groups/htsupport/posts/4461359747253279/?comment_id=4465078650214722&reply_comment_id=4466404240082163]

* "The two things that really helped with my anxiety and depression were magnesium and hookworms. The mg got me out of the black depths where I was hardly functional, and the hookworms improved my symptoms several notches beyond just functional." [https://www.facebook.com/groups/htsupport/posts/4746858228703428/?comment_id=4746936282028956]

* "It was quite fast. For example the first day of TSO, it was regulating my anxiety & insomnia." [https://www.facebook.com/groups/htsupport/posts/4887558924633357/?comment_id=4889396131116303]

* "I haven’t experienced any anxiety symptoms since starting in 2018 (six years ago). I usually dose 3 x 25 NA each year. Coeliac with UC in remission. [https://www.facebook.com/groups/htsupport/posts/7008571109198784/?comment_id=7029129507142944]

* "I have digestive issues and most likely MCAS. The NA worms actually make me happy. My reaction after the first dose was an overwhelming sense of euphoria and joy. No anxiety as a side effect with me." [https://www.facebook.com/groups/htsupport/posts/9707125946009940?comment_id=9737523312970203]

For further accounts of how helminthic therapy has reduced anxiety, see the following paper.
* [[media:Practices_and_outcomes_of_self-treatment_with_helminths_based_on_physicians_observations.pdf | Practices and outcomes of self-treatment with helminths based on physicians' observations]] (PDF) (In particular, see Table 1)

=== Temporarily ''increased'' anxiety ===

There have been a few reports of anxiety increasing following initial inoculation with NA, TTO or HDC, but this increase is usually temporary and often related to dose size.

{{Quote|indent}}I think it aggravated the anxiety component for me. Not sure why. (After dosing with HDC){{Quote|/indent}}

{{Quote|indent}}Around day 15 (after an initial dose of 10 NA), I had severe anxiety for 2 days straight but nothing since. [https://www.facebook.com/groups/htsupport/permalink/1820079598047987/?comment_id=1835175879871692&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I got lots of anxiety as a side effect from 2 and then even 1 hookworm. I used theanine (up to 10 grams a day). I needed it three times day for two-three months, then used as needed. The anxiety subsided after my second round of worms. [https://www.facebook.com/groups/htsupport/posts/26603659245930012/?comment_id=26620751237554146&notif_id=1778307094213020&notif_t=group_comment_follow]{{Quote|/indent}}

{{Quote|indent}}I had mild/moderate diffuse anxiety for about a week at ~19-20 weeks. (After a supplementary dose of '''''65''''' NA!){{Quote|/indent}}

{{Quote|indent}}My anxiety and more-so paranoia seems to have increased significantly after hosting. Its a strange feeling but I "feel" like its the worms interacting with me somehow.{{Quote|/indent}}

{{Quote|indent}}I had a major increase in anxiety when I started whipworm (TT). But with hookworm my anxiety has improved greatly. I terminated the whipworm after 6 or 8 weeks when my reaction to them still hadn't eased, so I can't say if that feeling would have persisted or eventually passed.{{Quote|/indent}}

{{Quote|indent}}I am very thankful that I only had 3 NA For my first dose. I am almost done with the week five, and the anxiety I am feeling is truly challenging me. [https://www.facebook.com/groups/htsupport/posts/5073693309353250/]{{Quote|/indent}}

If anxiety does arise, or worsen, after introducing helminths, this should eventually resolve along with any other symptoms that appear during the initial side effect period. Resolution is usually complete by the end of the 14th week and, if it recurs at all following supplementary inoculations, it typically becomes gradually less troublesome over time.

{{Quote|indent}}I have severe anxiety, including PTSD & panic attacks etc. When I initially began treating (with NA) I would notice an increase in anxiety for several days. It would be a bit uncomfortable & high doses of D3, Benadryl, & magnesium would help. I’m honestly not sure when it stopped. Likely when the bounce stopped, so a year in? Now, the opposite occurs and I get very calm & fall asleep after treating. This usually lasts for several days.
[https://www.facebook.com/groups/htsupport/posts/4141870795868844?comment_id=4148225755233348&reply_comment_id=4149349751787615]{{Quote|/indent}}

In a few rare cases, anxiety can persist for a longer period of time, leading one individual to terminate their colony.

{{Quote|indent}}Increase in energy and exuberance the first month, restlessness the second month, worsening anxiety/OCD third and 4th month, increased to day-long panic attacks fifth month. Directly due to hookworms as symptoms are 90% improved after 3 days of albendazole.{{Quote|/indent}}

== Combining helminth species to treat anxiety and depression ==

Some individuals have found that a combination of helminth species has given them the best longterm effects.

{{Quote|indent}}For me, TSO plus NA is the magic combo for anxiety and depression. [https://www.facebook.com/groups/htsupport/posts/6145556122166958?comment_id=6146089748780262]{{Quote|/indent}}

== Alcohol dependence ==

See also

* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33197496/ IL-10 normalizes aberrant amygdala GABA transmission and reverses anxiety-like behavior and dependence-induced escalation of alcohol intake]

== Autism ==

See [[Helminthic therapy and autism | '''Helminthic therapy and autism''']]

== Schizophrenia ==

{{Quote|indent}}Has not been hospitalized in 9 months. Has dropped medications 50%. Looks better, bright eyes. Energy. Hopefulness. Pleasure in life. (After one year of treating with NA.)[https://m.facebook.com/groups/htsupport/permalink/5567854796603763/?mibextid=Nif5oz]
{{Quote|/indent}}

See also

* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40930337/ Gut microbiome and mitochondrial crosstalk in Schizophrenia, a mental disability: Emerging mechanisms and therapeutic targets] -- [https://www.sciencedirect.com/science/article/abs/pii/S0149763425003720?via%3Dihub Full text]
* 2025 Aug [https://pubmed.ncbi.nlm.nih.gov/40683090/ The role of neuroinflammation in schizophrenia: Focus on Th17 cells functions] -- [https://www.sciencedirect.com/science/article/abs/pii/S1876201825002722?via%3Dihub Full text]
* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33252574/ Understanding the role of gut microbiota in the pathogenesis of schizophrenia]

{{Quote|indent}}Inflammation, particularly of a low-grade nature, is a consistent pathological finding in schizophrenia… [https://www.ncbi.nlm.nih.gov/pubmed/22765923/] [https://www.ncbi.nlm.nih.gov/pubmed/21641581/]{{Quote|/indent}}
* [https://psychcentral.com/schizophrenia/is-schizophrenia-autoimmune What's The Connection Between Schizophrenia and Autoimmune Diseases?]
* [https://www.youtube.com/watch?v=BmdMUyUY7Xo Inflammation and Schizophrenia], YouTube
* [http://www.bbc.co.uk/news/health-34540363 Immune clue to preventing schizophrenia]
* [http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2015.14101358 Microglial Activity in People at Ultra High Risk of Psychosis and in Schizophrenia: An (11C)PBR28 PET Brain Imaging Study] (PDF)
* [http://psychcentral.com/news/2016/03/01/reducing-inflammation-may-improve-cognition-in-schizophrenia/99836.html Reducing Inflammation May Improve Cognition in Schizophrenia]

== Bipolar disorder ==

HDC has been found to help in several cases of bipolar disorder.

{{Quote|indent}}(Before treatment), in my 30’s, I was diagnosed with depression and anxiety. In my 50’s, I was diagnosed as bipolar. Since the beginning of self-treatment (with HDC), my symptoms have subsided. My wellbeing has improved 100%. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

{{Quote|indent}}(After treatment, I have) less anxiety and am able to think clearer. The helminths (HDC) seemed to help in areas that were positive but unexpected. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

{{Quote|indent}}When I get angry I used to (before helminth therapy) have thoughts of killing the person that made me angry or maybe just hurting them severely, but now (after therapy with HDC) I am not angry often, or depressed. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

And there are further reports of success with this disorder in the following paper.
* [[media:Overcoming_Evolutionary_Mismatch_by_Self-Treatment_with_Helminths.pdf | Overcoming Evolutionary Mismatch by Self-Treatment with Helminths: Current Practices and Experience]] (PDF)

See also

* 2025 Nov 22 [https://pubmed.ncbi.nlm.nih.gov/41275106/ Cognitive impairment in bipolar disorder associated with abnormal serum short-chain fatty acids and cytokines]
* 2023 May 8 [https://pubmed.ncbi.nlm.nih.gov/37156764/ T cells: an emerging cast of roles in bipolar disorder] -- [https://www.nature.com/articles/s41398-023-02445-y Full text]

== Psychosis ==

{{Quote|indent}}There are several lines of evidence to suggest that a proportion of psychotic illnesses have a plausible autoimmune component.[https://pubmed.ncbi.nlm.nih.gov/30949074/],[https://pubmed.ncbi.nlm.nih.gov/30122288/]{{Quote|/indent}}
== Obsessive-compulsive disorder (OCD) ==

* 2014 [https://www.ncbi.nlm.nih.gov/pubmed/24557049 Searching for the immune basis of obsessive-compulsive disorder] -- [https://www.karger.com/Article/FullText/356554 Full text] | [https://www.karger.com/Article/Pdf/356554 PDF]

* 2001 Nov 13 [https://www.ncbi.nlm.nih.gov/pubmed/11760984 Is obsessive–compulsive disorder an autoimmune disease?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/pdf/20011113s00026p1353.pdf PDF]

== Post-stroke depression ==

See also

* 2026 Feb [https://pubmed.ncbi.nlm.nih.gov/41260033/ The gut microbiota in post-stroke depression: A systematic review of microbial mechanisms and therapeutic targeting of neuroinflammation]

== Tourette Syndrome ==

The findings of several studies collectively indicate that inflammation plays a significant and crucial role in the development and progression of Tourette's syndrome. [https://pubmed.ncbi.nlm.nih.gov/38956051/] [https://pubmed.ncbi.nlm.nih.gov/37187752/] [https://pubmed.ncbi.nlm.nih.gov/39165553/] Researchers have also discussed the potential contribution of immunological dysfunction as well as inflammatory processes in TS [https://pubmed.ncbi.nlm.nih.gov/35087475/] and the following study found that autoimmune disease in the mother was associated with a 29% increased incidence rate of Tourette’s syndrome in male offspring, suggesting that neuroimmunological disorders may act as a component in the etiology of a subset of TS.
* 2015 Jun [https://www.ncbi.nlm.nih.gov/pubmed/26004665 Maternal History of Autoimmune Disease and Later Development of Tourette Syndrome in Offspring]

== See also ==

* [[Helminthic therapy and neurodevelopmental disorders | '''Helminthic therapy and neurodevelopmental disorders''']]

* [[Helminthic therapy and neurological disorders | '''Helminthic therapy and neurological disorders''']]

* [[Helminthic therapy and neurodegenerative diseases | '''Helminthic therapy and neurodegenerative diseases''']]

* [[The helminthic therapy bounce | '''The helminthic therapy bounce''']]

* [[Helminthic therapy for well people#Cognitive dysfunction | '''Helminthic therapy as a potential prophylaxis for cognitive dysfunction''']]

Helminthic therapy and neuropsychiatric disorders

2026-05-09T16:10:19Z

John: /* Temporarily increased anxiety */

{{Breadcrumb|[[Effects_of_helminthic_therapy|Effects of helminthic therapy]]}}
{{SEO 
|title=Helminthic therapy and neuropsychiatric disorders
|description=
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Helminths are capable of improving neuropsychiatric function, and all four species of therapeutic helminth appear to make a positive contribution to psychological wellbeing.

{{Quote|indent}}Socio-medical studies of humans "self-treating" with helminths as well as limited studies in animal models strongly suggest that helminth therapy may be a productive approach toward treating a range of neuropsychiatric disorders, including chronic fatigue, migraine headaches, depression and anxiety disorders. [https://www.ncbi.nlm.nih.gov/pubmed/29402395]{{Quote|/indent}}

Helminths appear to act through several pathways:
* Modifying the gut microbiota, reducing pathogenic bacteria and stimulating the development of bacteria that produce short-chain fatty acids
* Restoring the intestinal barrier and the blood brain barrier
* Moderating inflammation and neuroinflammation
* Stimulating the production of endocannabinoids and serotonin

==The scientific evidence==

* 2026 Jan 16 [https://pubmed.ncbi.nlm.nih.gov/41513004/ Trained ILC2 prevent IL-17-associated lung injury during helminth infection through a serotonin-dependent mechanism]
:{{Quote|indent}}Trained ILC2 serve as a major source of 5-HT in hookworm infected lungs that limits tissue injury and prevents dysregulated inflammation.{{Quote|/indent}}

* 2021 Oct 20 [https://pubmed.ncbi.nlm.nih.gov/34745091/ Parasite-Derived Excretory-Secretory Products Alleviate Gut Microbiota Dysbiosis and Improve Cognitive Impairment Induced by a High-Fat Diet] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564115/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564115/pdf/fimmu-12-710513.pdf PDF]
:{{Quote|indent}}The present study revealed for the first time that the parasite-derived ESPs alleviate gut microbiota dysbiosis and improve cognitive impairment induced by a high-fat diet.{{Quote|/indent}}

* 2021 Jan 12 [https://pubmed.ncbi.nlm.nih.gov/33440138/ IL-33 Changes Our "Gut Feelings" about Serotonin] -- [https://www.cell.com/immunity/fulltext/S1074-7613(20)30535-5#body-ref-sref10-1 Full text]

* 2020 Nov 20 [https://pubmed.ncbi.nlm.nih.gov/33220232/ Interleukin-33 promotes serotonin release from enterochromaffin cells for intestinal homeostasis] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC7856083/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC7856083/pdf/nihms-1642557.pdf PDF]

* 2020 May 28 [https://escholarship.org/uc/item/3cb5b8jp#article_main Endocannabinoid Regulation of Helminth Induced Hypophagia] -- [https://escholarship.org/content/qt3cb5b8jp/qt3cb5b8jp.pdf PDF] (Capstone project)

* 2020 Jan [https://www.ncbi.nlm.nih.gov/pubmed/31352539 Potential application of helminth therapy for resolution of neuroinflammation in neuropsychiatric disorders]

* 2019 Sep [https://www.journals.uchicago.edu/doi/10.1086/705038 Invisible Designers: Brain Evolution Through the Lens of Parasite Manipulation]

* 2019 [http://www.jneuropsychiatry.org/peer-review/parasitic-worms-for-the-treatment-of-neurodegeneration-12989.html Parasitic Worms for the Treatment of Neurodegeneration] -- [http://www.jneuropsychiatry.org/peer-review/parasitic-worms-for-the-treatment-of-neurodegeneration.pdf PDF]
:{{Quote|indent}}In mice with LPS-induced inflammation and infected with the parasite, the neurodegenerative changes are accompanied by poorer scores of depression, and these were also present in genetically predisposed APPSWE mice.{{Quote|/indent}}

* 2018 Oct 25 [https://pubmed.ncbi.nlm.nih.gov/30104215/ Host- and Helminth-Derived Endocannabinoids That Have Effects on Host Immunity Are Generated during Infection] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6204704/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6204704/pdf/e00441-18.pdf PDF] (media coverage "[https://news.ucr.edu/articles/2018/08/22/getting-high-worms Getting high on worms]")

* 2018 Sep 20 [https://pubmed.ncbi.nlm.nih.gov/30177522/ Modulation of the immune response by helminths: a role for serotonin?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6148219/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6148219/pdf/bsr-38-bsr20180027.pdf PDF]

* 2018 Aug 15 [https://www.ncbi.nlm.nih.gov/pubmed/29402395 Intestinal worms eating neuropsychiatric disorders? Apparently so] -- [[media:Intestinal_worms_eating_neuropsychiatric_disorders%3F_Apparently_so.pdf | PDF]]

* 2016 Sep [https://pubmed.ncbi.nlm.nih.gov/27436048/ The Microbiota, Immunoregulation, and Mental Health: Implications for Public Health] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5763918/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5763918/pdf/nihms-804488.pdf PDF]

* ✅ ⚡ 2016 May 31 [http://www.ncbi.nlm.nih.gov/pubmed/27240605 Practices and outcomes of self-treatment with helminths based on physicians' observations] -- [[media:Practices_and_outcomes_of_self-treatment_with_helminths_based_on_physicians_observations.pdf | PDF]]. The first study to probe, through the eyes of their physicians, the practices and experiences of those who are self-treating with helminths.

* 2014 Jun [http://www.ncbi.nlm.nih.gov/pubmed/24997041 Microbiota, immunoregulatory old friends and psychiatric disorders]

* 2014 [https://ru.dgb.unam.mx/items/57dc729c-ff0f-4148-be6d-cdfc09753d41 Estudio de la permeabilidad de la barrera hematoencefálica en un modelo murino de infección con taenia crassiceps] (Licence, Mexico, Spanish)
:{{Quote|indent}}The second phase was characterized by an increase in the cytokine IL-4, characteristic of the Th2 anti-inflammatory response. A gradual decrease in BBB permeability was observed, associated with increased expression of adhesion molecules (VCAM-1) and increased TGF-β in the BBB{{Quote|/indent}}

* 2012 Aug [https://pubmed.ncbi.nlm.nih.gov/22521209/ The role of parasites and pathogens in influencing generalised anxiety and predation-related fear in the mammalian central nervous system]

* 2012 Jun [https://www.researchgate.net/publication/246961346_MICROBIAL_OLD_FRIENDS_IMMUNOREGULATION_AND_PSYCHIATRIC_DISORDERS Microbial "Old Friends", immunoregulation and psychiatric disorders]

* 2012 May [https://pubmed.ncbi.nlm.nih.gov/22507593/ Can we vaccinate against depression?]

See also [https://www.qimrb.edu.au/researchers-and-labs/mucosal-immunology The Mucosal Immunology group] research team (QIMR Berghofer Medical Research Institute, Queensland, Australia). Current project:
:* Amelioration of behavioural alterations induced by the chronic social defeat model of major depressive disorder with a hookworm recombinant protein (see [[Mechanisms underlying helminth colonization#Hookworm Anti-inflammatory protein (AIP) alias Tissue inhibitor of metalloprotease (TIMP) | AIP-2]])

Negative effect (with a pro-inflammatory species not used in therapy)

* 2026 Feb 5 [https://pubmed.ncbi.nlm.nih.gov/41644553/ The gut microbiota mediates depression-like behaviors in mice with chronic Echinococcus multilocularis infection]

Negative effect (hypothesised). This paper should be read in conjunction with [[Deworming debunked |'''Deworming debunked''']].

* 2017 Jan 10 [https://pubmed.ncbi.nlm.nih.gov/28073356/ Gut microbiota disturbance during helminth infection: can it affect cognition and behaviour of children?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5225537/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5225537/pdf/12879_2016_Article_2146.pdf PDF]

See also
* [[Helminthic therapy and autism | '''Helminthic therapy and autism''']]
* [[Helminthic therapy and neurodevelopmental disorders | '''Helminthic therapy and neurodevelopmental disorders''']]
* [[Helminthic therapy and neurodegenerative diseases | '''Helminthic therapy and neurodegenerative diseases''']]
* [[Helminthic therapy and neurological disorders | '''Helminthic therapy and neurological disorders''']]
* [[Helminthic therapy research | '''Helminthic therapy research''']]

== Scientific papers not directly related ==

These are pathways involved in neuropsychiatric disorders on which helminths act.

=== Microbiota-gut-brain axis ===

* 2026 Feb [https://pubmed.ncbi.nlm.nih.gov/41260033/ The gut microbiota in post-stroke depression: A systematic review of microbial mechanisms and therapeutic targeting of neuroinflammation]

* 2025 Dec 17 [https://pubmed.ncbi.nlm.nih.gov/41418890/ Fructose malabsorption induces dysbiosis and increases anxiety in male human and animal models]

* 2025 Dec [https://pubmed.ncbi.nlm.nih.gov/40690011/ Modulating depression through the gut-brain axis: the role of gut microbiota in therapeutic interventions]

* 2025 Nov 17 [https://pubmed.ncbi.nlm.nih.gov/41300676/ The Pediatric Microbiota-Gut-Brain Axis: Implications for Neuropsychiatric Development and Intervention]

* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40937571/ Role of the gut-brain axis in neurological diseases: Molecular connections and therapeutic implications (Review)]

* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40930337/ Gut microbiome and mitochondrial crosstalk in Schizophrenia, a mental disability: Emerging mechanisms and therapeutic targets] -- [https://www.sciencedirect.com/science/article/abs/pii/S0149763425003720?via%3Dihub Full text]
{{Expando|40+ scientific papers (Tap to expand / minimize)}}
* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40804450/ Beyond the gut: decoding the gut-immune-brain axis in health and disease] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12575876/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12575876/pdf/41423_2025_Article_1333.pdf PDF]

* 2025 Oct 29 [https://pubmed.ncbi.nlm.nih.gov/41160236/ Gut bacteria-derived metabolites and their implications in mental health and neurological diseases]

* 2025 Oct 1 [https://pubmed.ncbi.nlm.nih.gov/41103441/ Akkermansia muciniphila alleviates cognitive impairment and neuroinflammation induced by blunt chest trauma] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12521121/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12521121/pdf/fimmu-16-1657524.pdf PDF]

* 2025 Sep 25 [https://pubmed.ncbi.nlm.nih.gov/41080562/ The microbiota-gut-brain axis in depression: unraveling the relationships and therapeutic opportunities] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12507892/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12507892/pdf/fimmu-16-1644160.pdf PDF]

* 2022 Sep 21 [https://pubmed.ncbi.nlm.nih.gov/36232412/ The Gut-Immune-Brain Axis: An Important Route for Neuropsychiatric Morbidity in Inflammatory Bowel Disease] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/pdf/ijms-23-11111.pdf PDF]

* 2025 Sep [https://pubmed.ncbi.nlm.nih.gov/40908772/ The Microbiota-Gut-Brain Connection: A New Horizon in Neurological and Neuropsychiatric Disorders]

* 2025 Aug 29 [https://pubmed.ncbi.nlm.nih.gov/41007667/ Gut Microbiota in Psychiatric and Neurological Disorders: Current Insights and Therapeutic Implications]

* 2025 Aug 27 [https://www.mdpi.com/2073-4409/13/17/1436 Gut-Brain Axis: Role of Microbiome, Metabolomics, Hormones, and Stress in Mental Health Disorders]

* 2025 Aug 20 [https://pubmed.ncbi.nlm.nih.gov/40909294/ Role of the microbiota in inflammation-related related psychiatric disorders]

* 2025 Aug [https://pubmed.ncbi.nlm.nih.gov/40234288/ Microbiome Gut-Brain-Axis: Impact on Brain Development and Mental Health]

* 2025 Jul 27 [https://pubmed.ncbi.nlm.nih.gov/40870405/ Gut Feelings: Linking Dysbiosis to Depression-A Narrative Literature Review] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12388225/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12388225/pdf/medicina-61-01360.pdf PDF]

* 2025 May 30 [https://pubmed.ncbi.nlm.nih.gov/40442386/ Microbiome: A Key Regulator of Body-Brain Interactions] (Chapter of Brain-Body Connections)

* 2024 Aug 19 [https://pubmed.ncbi.nlm.nih.gov/39165553/ Dietary inflammatory index and its impact on severity and recurrence of Tourette syndrome in children] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11331388/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11331388/pdf/WJP-14-1208.pdf PDF]

* 2024 Jul 10 [https://dumas.ccsd.cnrs.fr/MEM-UNIV-BORDEAUX/dumas-04642929v1 Le microbiote intestinal, la clé de notre santé mentale ? Implication de l'axe intestin-cerveau dans la physiopathologie de la dépression et de la maladie de Parkinson] -- [https://dumas.ccsd.cnrs.fr/dumas-04642929v1/file/Pharmacie_2024_Quimeby.pdf PDF] (French, pharma thesis)

* 2025 Jul [https://pubmed.ncbi.nlm.nih.gov/40369368/ Gut microbiota and the tryptophan-kynurenine pathway in anxiety: new insights and treatment strategies]

* 2024 May 26 [https://pubmed.ncbi.nlm.nih.gov/38891970/ Human Gut Microbiota for Diagnosis and Treatment of Depression] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11171505/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11171505/pdf/ijms-25-05782.pdf PDF]

* 2024 Mar 15 [https://pubmed.ncbi.nlm.nih.gov/38489352/ Gut bacteria–derived serotonin promotes immune tolerance in early life] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11328322/ Full text]

* 2024 [https://pubmed.ncbi.nlm.nih.gov/37962812/ Microbiota-Gut-Brain Axis and Antidepressant Treatment] (Book chapter of Emerging Neurobiology of Antidepressant Treatments)

* 2024 [https://pubmed.ncbi.nlm.nih.gov/38531341/ Mind over Microbes: Investigating the Interplay between Lifestyle Factors, Gut Microbiota, and Brain Health] -- [https://karger.com/ned/article/58/6/426/898000/Mind-over-Microbes-Investigating-the-Interplay Full text]

* 2023 Apr [https://pubmed.ncbi.nlm.nih.gov/36796440/ Associations between fecal short-chain fatty acids, plasma inflammatory cytokines, and dietary markers with depression and anxiety: Post hoc analysis of the ENGAGE-2 pilot trial] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC10273083/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC10273083/pdf/main.pdf PDF]

* 2022 Sep 21 [https://pubmed.ncbi.nlm.nih.gov/36232412/ The Gut-Immune-Brain Axis: An Important Route for Neuropsychiatric Morbidity in Inflammatory Bowel Disease] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9570400/pdf/ijms-23-11111.pdf PDF]

* 2023 [https://pubmed.ncbi.nlm.nih.gov/36949312/ Microbiota-Gut-Brain Axis in Major Depression: A New Therapeutic Approach] (Book chapter of Neuroinflammation, Gut-Brain Axis and Immunity in Neuropsychiatric Disorders)

* 2023 [https://pubmed.ncbi.nlm.nih.gov/35947354/ Evolutionary Aspects of Diverse Microbial Exposures and Mental Health: Focus on "Old Friends" and Stress Resilience] --[https://pmc.ncbi.nlm.nih.gov/articles/PMC9918614/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9918614/pdf/nihms-1849066.pdf PDF]

* 2022 Oct 28 [https://pubmed.ncbi.nlm.nih.gov/36389228/ The interplay between the gut-brain axis and the microbiome: A perspective on psychiatric and neurodegenerative disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC9650127/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC9650127/pdf/fnins-16-1030694.pdf PDF]

* 2022 Mar 25 [https://link.springer.com/chapter/10.1007/978-3-030-91051-8_10 The Influence of the Microbiota on Brain Structure and Function: Implications for Stress-Related Neuropsychiatric Disorders] (chapter of Evolution, Biodiversity and a Reassessment of the Hygiene Hypothesis)

* 2019 Jul 19 [https://pubmed.ncbi.nlm.nih.gov/31379879/ The Role of Inflammation in Depression and Fatigue] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6658985/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6658985/pdf/fimmu-10-01696.pdf PDF]

* 2021 Jul [https://pubmed.ncbi.nlm.nih.gov/34243604/ Role of microbiota-derived short-chain fatty acids in nervous system disorders]

* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33252574/ Understanding the role of gut microbiota in the pathogenesis of schizophrenia]

* 2020 [https://www.microbiotajournal.com/article/201 The microbiota-gut-brain axis in gastrointestinal inflammation and neurological comorbidities] -- [https://www.microbiotajournal.com/wp-content/uploads/sites/7/2020/01/e201-The-microbiota-gut-brain-axis-in-gastrointestinal-inflammation-and-neurological-comorbidities.pdf PDF]

* 2019 Jun 28 [https://pubmed.ncbi.nlm.nih.gov/31316375/ Microbiome and Cognitive Impairment: Can Any Diets Influence Learning Processes in a Positive Way?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6609888/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6609888/pdf/fnagi-11-00170.pdf PDF]

* 2019 [https://pubmed.ncbi.nlm.nih.gov/29870270/ Impact of gut microbiota on neurological diseases: Diet composition and novel treatments] -- [https://www.tandfonline.com/doi/full/10.1080/10408398.2018.1484340?scroll=top&needAccess=true Full text]

* 2018 Oct [https://pubmed.ncbi.nlm.nih.gov/30066368/ Short-chain fatty acids: microbial metabolites that alleviate stress-induced brain-gut axis alterations] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6187046/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6187046/pdf/TJP-596-4923.pdf PDF]

* 2018 May 3 [https://pubmed.ncbi.nlm.nih.gov/29743938/ Dysbiotic drift and biopsychosocial medicine: how the microbiome links personal, public and planetary health] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5932796/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5932796/pdf/13030_2018_Article_126.pdf PDF]

* 2017 Oct 1 [https://pubmed.ncbi.nlm.nih.gov/28242013/ Targeting the Microbiota-Gut-Brain Axis: Prebiotics Have Anxiolytic and Antidepressant-like Effects and Reverse the Impact of Chronic Stress in Mice]

* 2017 Jul [https://pubmed.ncbi.nlm.nih.gov/28727115/ The microbiota-gut-brain axis as a key regulator of neural function and the stress response: Implications for human and animal health]

* 2017 May 10 [https://pubmed.ncbi.nlm.nih.gov/28219800/ Variations in gut microbiota and fecal metabolic phenotype associated with depression by 16S rRNA gene sequencing and LC/MS-based metabolomics]

* 2016 Mar 16 [http://elib.bvuict.in/moodle/pluginfile.php/427/mod_resource/content/0/Gut%20Microbiome.pdf Gut microbiome and brain activity] (B.Sc. Biotechnology)

* 2015 Oct 14 [https://pubmed.ncbi.nlm.nih.gov/26528128/ Breaking down the barriers: the gut microbiome, intestinal permeability and stress-related psychiatric disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4604320/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4604320/pdf/fncel-09-00392.pdf PDF]

* 2014 [https://link.springer.com/chapter/10.1007/978-1-4939-0897-4_16 Microbiota-Gut-Brain Axis and Cognitive Function] (Book chapter of Microbial Endocrinology: The Microbiota-Gut-Brain Axis in Health and Disease)
{{Expando}}

=== Inflammation and neuroinflammation ===

* 2025 Dec [https://pubmed.ncbi.nlm.nih.gov/41314100/ Therapeutic prospects of modulating TLR4/MAPK/ROS signalling in obesity-associated neuroinflammation] -- [https://www.sciencedirect.com/science/article/pii/S0753332225009990?via%3Dihub Full text]

* 2025 Nov 28 [https://pubmed.ncbi.nlm.nih.gov/41313410/ Nrf2/Keap1 Signaling Axis in the Brain: Master Regulator of Oxidative Stress in Neurodegenerative and Psychiatric Disorders]

* 2025 Nov 20 [https://pubmed.ncbi.nlm.nih.gov/41357230/ The critical role of Th17 cells and IL-17A in autoimmune and inflammation-associated neurological diseases: mechanisms and therapeutic perspectives] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC12676946/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC12676946/pdf/fimmu-16-1656422.pdf PDF]

* 2025 Aug [https://pubmed.ncbi.nlm.nih.gov/40683090/ The role of neuroinflammation in schizophrenia: Focus on Th17 cells functions] -- [https://www.sciencedirect.com/science/article/abs/pii/S1876201825002722?via%3Dihub Full text]

* 2025 May [https://pubmed.ncbi.nlm.nih.gov/39592709/ Dural Tregs driven by astrocytic IL-33 mitigate depression through the EGFR signals in mPFC neurons]

* 2024 Dec [https://pubmed.ncbi.nlm.nih.gov/39660880/ IL-17A Mediates Depressive-Like Symptoms by Inducing Microglia Activation in Psoriasiform Dermatitis Mice]

* 2024 Jul 2 [https://pubmed.ncbi.nlm.nih.gov/38956051/ Cytokine expression profiles in children and adolescents with tic disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11219894/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11219894/pdf/41598_2024_Article_62121.pdf PDF]

* 2024 Jun 12 [https://pubmed.ncbi.nlm.nih.gov/38866753/ Decoding the inflammatory signature of the major depressive episode: insights from peripheral immunophenotyping in active and remitted condition, a case–control study] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC11169351/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC11169351/pdf/41398_2024_Article_2902.pdf PDF]

* 2023 Aug 22 [https://pubmed.ncbi.nlm.nih.gov/37614669/ Transient anxiety-and depression-like behaviors are linked to the depletion of Foxp3-expressing cells via inflammasome in the brain]

* 2023 May 8 [https://pubmed.ncbi.nlm.nih.gov/37156764/ T cells: an emerging cast of roles in bipolar disorder] -- [https://www.nature.com/articles/s41398-023-02445-y Full text]

* 2023 Apr 28 [https://pubmed.ncbi.nlm.nih.gov/37187752/ The inflammatory injury in the striatal microglia-dopaminergic-neuron crosstalk involved in Tourette syndrome development] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC10175669/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC10175669/pdf/fimmu-14-1178113.pdf PDF]

* 2023 Apr 28 [https://pubmed.ncbi.nlm.nih.gov/37106375/ Th17 cells sense microbiome to promote depressive-like behaviors] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC10142784/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC10142784/pdf/40168_2022_Article_1428.pdf PDF]

* 2023 Jan 10 [https://pubmed.ncbi.nlm.nih.gov/36704001/ Anti-inflammatory properties of commonly used psychiatric drugs]
:{{Quote|indent}}As researchers, clinicians, and patients become increasingly aware of the role of inflammation in brain health, it is reassuring that these psychiatric drugs may also abrogate this inflammation, in addition to their effects on neurotransmission. Further studies are required to determine whether inflammation is a driver of disease pathogenesis, and therefore should be a therapeutic target in future clinical trials.{{Quote|/indent}}

* 2022 May [https://pubmed.ncbi.nlm.nih.gov/34809994/ Modulating neuroinflammation in COVID-19 patients with obsessive-compulsive disorder]

* 2022 Jan 11 [https://pubmed.ncbi.nlm.nih.gov/35087475/ Changes of Cytokines in Children With Tic Disorder] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC8787115/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC8787115/pdf/fneur-12-800189.pdf PDF]

* 2022 Jan [https://pubmed.ncbi.nlm.nih.gov/34592888/ T helper cells in depression: central role of Th17 cells]

* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33197496/ IL-10 normalizes aberrant amygdala GABA transmission and reverses anxiety-like behavior and dependence-induced escalation of alcohol intake]

* 2019 Feb [https://pubmed.ncbi.nlm.nih.gov/29752710/ Inflammation in psychiatric disorders: what comes first?]

* 2018 Feb 13 [https://pubmed.ncbi.nlm.nih.gov/29433523/ A clinical approach to new-onset psychosis associated with immune dysregulation: the concept of autoimmune psychosis] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5809809/ Full text] | [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809809/pdf/12974_2018_Article_1067.pdf PDF]

* 2016 Jan 13 [https://pubmed.ncbi.nlm.nih.gov/26757726/ Cyclic AMP is a key regulator of M1 to M2a phenotypic conversion of microglia in the presence of Th2 cytokines] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4711034/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4711034/pdf/12974_2015_Article_463.pdf PDF]

* 2016 Jan [https://pubmed.ncbi.nlm.nih.gov/26472628/ Microglial Activity in People at Ultra High Risk of Psychosis and in Schizophrenia: An (11)C PBR28 PET Brain Imaging Study] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4821370/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4821370/pdf/emss-67512.pdf PDF] (Media coverage BBC [https://www.bbc.com/news/health-34540363 Immune clue to preventing schizophrenia]

* 2011 Oct 1 [https://pubmed.ncbi.nlm.nih.gov/21641581/ Meta-analysis of cytokine alterations in schizophrenia: clinical status and antipsychotic effects] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC4071300/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC4071300/pdf/nihms-519864.pdf PDF]

=== Various ===

* 2025 Apr [https://pubmed.ncbi.nlm.nih.gov/39672518/ Intestinal Epithelial Serotonin as a Novel Target for Treating Disorders of Gut-Brain Interaction and Mood]

* 2022 Feb 14 [https://pubmed.ncbi.nlm.nih.gov/35237195/ Autoimmune Encephalitis With Psychotic Manifestations and Cognitive Impairment Presenting as Schizophrenia: Case Report and Literature Review] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC8882583/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC8882583/pdf/fpsyt-13-827138.pdf PDF]

* 2019 Mar 20 [https://pubmed.ncbi.nlm.nih.gov/30949074/ Autoimmune Diseases and Psychotic Disorders] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6435494/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6435494/pdf/fpsyt-10-00131.pdf PDF]

* 2019 Jan 1 [https://pubmed.ncbi.nlm.nih.gov/30122288/ Associations Between Non-neurological Autoimmune Disorders and Psychosis: A Meta-analysis] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC6269125/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC6269125/pdf/main.pdf PDF]

* 2017 Nov [https://pubmed.ncbi.nlm.nih.gov/28704576/ Psychosis: an autoimmune disease?] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5629440/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5629440/pdf/IMM-152-388.pdf PDF]

* 2017 Jan [https://pubmed.ncbi.nlm.nih.gov/27965002/ Prevalence and clinical characteristics of serum neuronal cell surface antibodies in first-episode psychosis: a case-control study] -- [https://pmc.ncbi.nlm.nih.gov/articles/PMC5890880/ Full text] | [https://pmc.ncbi.nlm.nih.gov/articles/PMC5890880/pdf/emss-76791.pdf PDF] (Media coverage on BBC News [https://www.bbc.com/news/health-38220610 Some psychosis cases an 'immune disorder'])

* 2015 Oct [https://pubmed.ncbi.nlm.nih.gov/26044086/ Depression as sickness behavior? A test of the host defense hypothesis in a high pathogen population]

* 2015 Jun [https://pubmed.ncbi.nlm.nih.gov/26004665/ Maternal history of autoimmune disease and later development of tourette syndrome in offspring]

* 2014 [https://www.ncbi.nlm.nih.gov/pubmed/24557049 Searching for the immune basis of obsessive-compulsive disorder] -- [https://www.karger.com/Article/FullText/356554 Full text] | [https://www.karger.com/Article/Pdf/356554 PDF]

* 2013 Apr 5 [https://pubmed.ncbi.nlm.nih.gov/22765923/ Updating the mild encephalitis hypothesis of schizophrenia]

* 2001 Nov 13 [https://www.ncbi.nlm.nih.gov/pubmed/11760984 Is obsessive–compulsive disorder an autoimmune disease?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/pdf/20011113s00026p1353.pdf PDF]

==Depression==

* [https://www.huffpost.com/entry/depression-and-inflammation_b_1071714 The Depression-Inflammation Connection] (Andrew Weil, HuffPost, Nov 4, 2011)

For further accounts of how helminthic therapy has reduced depression, see the following.
* [[media:Practices_and_outcomes_of_self-treatment_with_helminths_based_on_physicians_observations.pdf | Practices and outcomes of self-treatment with helminths based on physicians' observations]] (PDF) (In particular, see Table 1)

===Reduced depression / improved mood===

HDC is mentioned a lot in this context, and, since HDC is taken regularly, usually every 2 weeks, its users can benefit from a repeated post-inoculation [[The helminthic therapy bounce | 'bounce’]]. This is a brief period of temporary symptom relief accompanied by a sudden feeling of unusual wellness, perhaps with a strong sense of calm, focus, happiness and lightheartedness.

{{Quote|indent}}I like how it puts me in a good mood for a day or two when I first take it.{{Quote|/indent}}

{{Quote|indent}}I also experienced a significantly elevated mood that night after taking just 10 HDC, the elevated mood lasted until the end of the next day. [https://www.facebook.com/groups/htsupport/permalink/882220201833936/?comment_id=885859204803369&offset=0&total_comments=16&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}

For some people, this effect may be repeated after every dose.

{{Quote|indent}}... every dose of HDC's is followed by a delightful stream of energy that lasts almost a week. [https://www.facebook.com/groups/263818550462551/permalink/468678839976520/?comment_id=473949269449477&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Within 24 hours of taking HDC I feel much calmer. That feeling lasts a few days, before it lets up a bit, but I still continue feeling calmer than usual up to 30 days after dosing, when their effects completely wear off… If I could regularly dose, say, weekly, I probably would see my anxiety completely resolved. [https://www.facebook.com/groups/htsupport/permalink/1526704624052154/?comment_id=1535606909828592&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

In other cases, this effect may reduce over time.

{{Quote|indent}}The first day I take HDC it usually puts me in a really nice mood, especially the first time I did it. It's not exactly euphoric but I noticed it and counted on it… First time, (it lasted) 48 hours. Second time, 24 hours. Third time, 12 hours. Fourth time, 12 hours.{{Quote|/indent}}

However, this effect on neuropsychiatric function is not unique to HDC. It is also seen with TSO, NA and TTO.

{{Quote|indent}}My mood was the first indicator that TSO was working. I became calmer and happier despite my physical symptoms. [https://www.facebook.com/groups/htsupport/permalink/861668620555761/?comment_id=862075060515117&offset=0&total_comments=13&comment_tracking=%7B%22tn%22:%22R%22%7D] I find TSO is the best for mood and general feeling of well being as well as increased energy. Hookworm and (human) whipworm both work as well, it just takes longer. [https://www.facebook.com/groups/htsupport/permalink/1620673674655248/?comment_id=1666993650023250&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}My daughter started TSO last week and we are already seeing an improvement in her mood and energy on a low dose of 500 ova. [https://www.facebook.com/groups/htsupport/permalink/862879650434658/?comment_id=862906407098649&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}TSO cured a mood disorder I didn't realize I had until it was gone. [https://www.facebook.com/groups/htsupport/posts/4461359747253279/]{{Quote|/indent}}

{{Quote|indent}}I would like to confirm positive effect of TSO on mood stabilization as well. Even with low dose in my case (300 ova bi-weekly). [https://www.facebook.com/groups/htsupport/posts/4461359747253279/?comment_id=4464894023566518]{{Quote|/indent}}

{{Quote|indent}}I didn't have depression, just a generally negative view of life, but NA has (unexpectedly) made me a whole lot more positive and even happy. [https://www.facebook.com/groups/htsupport/posts/6145556122166958/?comment_id=6150417601680810] It's noticeable enough that I would continue with them even if that was the only benefit. [https://www.facebook.com/groups/htsupport/posts/6562813033774596/?comment_id=6575864549136111]{{Quote|/indent}}

The following comment was made 6 weeks after inoculation with 25 hookworm larvae.

{{Quote|indent}}What is already interesting is my steady and calm mind.{{Quote|/indent}}

More reports:

The first report is more detailed than the quotes that follow it.

:* [[Migraine, depression and autoimmunity relieved by TSO and NA | '''Migraine, depression and autoimmunity relieved by TSO and NA''']]

* "The worms have removed my crippling depression and fuzzy head so I'm very happy." (Reported in a private discussion, Jan 2012)

* "I second getting some mood benefits from HT, which many others have noted as well." (Link expired)

* "The thing that surprised me most about the therapy is an increase in general well being. I sleep less, am more alert, am able to think more clearly, and have a brighter mood. I jokingly say that I wasn't depressed prior to worms, and I'm even more not depressed now." (Link expired)

* “I inoculated with hookworm hoping that it would help my chronic sinus issues... But I wasn't expecting any changes in personality, so they came as a shock. My lifelong battle with depression and anxiety seems to be over. And I'm also smarter again (like when I was a kid).”

* “I'd say hookworm has improved my mood… I wasn't actively depressed when I started hookworm but I definitely noticed a reduction in how much I had to use CBT-style challenging of my thinking.” [https://www.facebook.com/groups/htsupport/permalink/924060764316546/?comment_id=924235834299039&comment_tracking=%7B%22tn%22:%22R0%22%7D]

* “I have been depressed most of my life. That eased a bit with IV magnesium. But it changed dramatically about 20 weeks after starting hookworms. My mood improved dramatically and I just felt happy - my psychological issues just disappeared.”

* “The crippling morning depression I would experience has all but completely vanished. When I now wake up in the morning, I feel positive about getting up and optimistic without feeling drained or as if I had just gone to sleep an hour ago.” (Written after 5 months with hookworms and two months of taking TSO for systemic lupus.) [https://www.facebook.com/groups/htsupport/permalink/940503262672296/]

* “I have good days now (after hosting NA for five years) when I never had good days for years, and sometimes I actually feel incredibly happy, something else that never really happened.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1088327351223219&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “My depression and anxiety and brain fog have disappeared on NA.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “I can attest to a huge improvement in my anxiety and depression within just a few weeks of my first NA dose (off all meds now) but I'd say I still have some mild residual symptoms.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&reply_comment_id=1089756711080283&comment_tracking=%7B%22tn%22:%22R8%22%7D]

* "Hookworms took about 24 weeks to begin to make a dent in depression - now about 2.5 years into helminths, I have some days where I'm downright optimistic. Not many, but after decades of depression it's a huge change." [https://www.facebook.com/groups/htsupport/permalink/1515697631819520/?comment_id=1515980121791271&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

* ☹️ “I have anxiety and depression and have not really noticed any differences.” [https://www.facebook.com/groups/htsupport/permalink/1515697631819520/?comment_id=1516504428405507&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* "My diagnosed anxiety/depression went down to zero. I can't get unhappy if I try. If this was the only good effect (of using HDC) it would be enough." (Link expired)

* “NA has definitely helped with depression, although I do not feel that my depression is severe, compared to that of others. It is definitely seasonal… After about 6 months, I began to notice improvement in mood.” [https://www.facebook.com/groups/htsupport/permalink/1803006713088609/?comment_id=1803101086412505&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “As pretty much a lifelong depression sufferer (since onset of puberty anyway), I generally never liked the flat emotional effect I got from antidepressants, and always felt my depression was very much related (coincidentally at least) to my severe seasonal allergy symptoms. By the time I started hosting HW, I had given up on antidepressants for several years, and had just resigned myself to pushing through life without psych meds. About a year into hosting NA for severe allergies and asthma, I unexpectedly noticed nearly total resolution of my depressive symptoms.” [https://www.facebook.com/groups/htsupport/permalink/2190363854352891/?comment_id=2194958800560063&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “NA resolved my chronic depression - it was one of those weird, gradual, unexpected benefits.” [https://www.facebook.com/groups/htsupport/permalink/2206914002697876/?comment_id=2333833590005916&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “HDC (I take 10 every three weeks) have a positive impact on my mood. My case may be different from others, but... PANS is what leads to my low mood. In PANS, autoantibodies attach to dopamine and glutamate receptors in the basal ganglia, which blocks their transmission in normal amounts. I think my good mood when I take HDC is likely because it helps whatever is leading to those autoantibodies being in the wrong place (my basal ganglia receptors), so more dopamine and glutamate can reach their proper destination. Not sure if these mechanics apply to many other disorders, though.” [https://www.facebook.com/groups/htsupport/permalink/2296657347056874/?comment_id=2334347929954482&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “I thought the NA didn't do much for my mental health. But it's clear to me now that they were helping me. I got rid of my NA as part of an experiment to see if they were contributing to a sudden and consistent drop in energy I've been experiencing since May. I find that I am more depressed without them. Small problems can now push me over into the realm of crying spells and panic attacks. The HDC was helping with social anxiety and OCD, but it seems the NA was supporting a higher baseline of mental health and stability. More NA on the way to restock.” [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=3042523755803559]

* “I’ve had so much success from the two types of friends... it’s the miracle I’ve been searching for (for 18 years) since 2001. I can’t even tell you how much happier I am now that my depression, fatigue, and extreme food sensitivities are pretty much resolved. I think the NA have been the most helpful for me, with TSO as a great backup.” [https://www.facebook.com/groups/htsupport/permalink/2490868600969080/?comment_id=2491288504260423]

* "I’ve been previously diagnosed with depression, anxiety, PTSD, panic disorder, and a mood disorder, and for 10 or more years, life had seemed like a foggy dream. But after almost two years with NA, I realized that HT has significantly helped me with my mental health. It’s given me a sense of clarity that I haven’t had in years. I continue to require therapy as needed, and I’ve been treated with a wide range of medications over the years, but I’m currently only on one anxiety medication. I continue to be so thankful for HT. It’s life altering." (Edited from this post: [https://www.facebook.com/groups/htsupport/permalink/3610564992332763/].)

* “I am pretty sure that my NA have dealt with my insomnia, probably part of what remains the biggest, and unexpected, benefit of taking on these wonderful companion animals: an end to depression and anxiety of a level such that I had to take tricyclic antidepressants to function.” [https://www.facebook.com/groups/htsupport/posts/4465083816880872/?comment_id=4467760283279892]

* "TSO was the magic mood machine for me." [https://www.facebook.com/groups/htsupport/posts/5219928144729765?comment_id=5220568117999101&reply_comment_id=5221503187905594]

* "I've been doing HDC for five months now. Started with five every three weeks. I expected no results for at least a week, but noticed an improvement in energy and mood in two days. While mood and energy are up, joint pain is down." [https://www.facebook.com/groups/htsupport/posts/4470230976366156?comment_id=5507026999353210]

* "My mental health has been way better since starting helminth as I was pretty low on and off for a long time before that and especially bad when I was low in energy or sick, like when I had covid. After dosing with 3 NA, then 5, and now 3 NA every 3 months, I haven’t experienced that depression except for 1 day following another covid infection. I’m feeling like seeing people which I couldn’t face last year until well down the track." (Edited from [https://www.facebook.com/groups/htsupport/posts/6271627282893174/ this post].)

===Temporarily ''increased'' depression===

Occasionally, depression may increase temporarily following initial inoculation with helminths. This is usually, but not necessarily, the result of using doses that are too high.

{{Quote|indent}}After first small group of NA, I became much more depressed for about 10-12 weeks, then got back to previous mood level. [https://www.facebook.com/groups/htsupport/permalink/1526355860753697/?comment_id=1526618564060760&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I have hit a patch of depression here at week 9 of my first inoculation with 3NA and I am feeling very bleak. [https://www.facebook.com/groups/htsupport/permalink/1814806755241938/]{{Quote|/indent}}

{{Quote|indent}}I also feel quite depressed, will be 9 weeks for me on Tuesday. [https://www.facebook.com/groups/htsupport/permalink/1814806755241938/?comment_id=1815580378497909&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}After first small group of NA, I became much more depressed for about 10-12 weeks, then got back to previous mood level. [https://www.facebook.com/groups/htsupport/permalink/1526355860753697/?comment_id=1526618564060760&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I experience plummeting mood following an NA inoculation. Dosing amounts are important with NA. [https://www.facebook.com/groups/htsupport/permalink/1936169449772334/?comment_id=1936702619719017&reply_comment_id=1936765523046060&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}When I used HDC, I found that a high dose made me agitated, where a low dose would lift my depression within hours from the moment of taking it. [https://www.facebook.com/groups/htsupport/posts/6666593640063201/?comment_id=6666843226704909]{{Quote|/indent}}

{{Quote|indent}}My wife, who suffers from clinical depression, took 1 NA each month for 3 months. Then the Dr. told her to take 5 at once despite us asking multiple times if this would cause depression. We were told no each time. So my wife took the 5 at once as the doctor had suggested. A few days later, she began to get depressed and could not get out of bed for about 7-10 days. Cried all day. We killed the colony about 4 days later to prevent my wife from going to hospital because the depression was that bad. It was about another 2 weeks before she felt better again. (Edited from two posts: [https://www.facebook.com/groups/htsupport/posts/4830265563696027/?comment_id=5217548054967774] [https://www.facebook.com/groups/htsupport/posts/5219928144729765?comment_id=5220044041384842&reply_comment_id=5220058691383377].){{Quote|/indent}}

{{Quote|indent}}3.5 years in, I now have times where I even feel positive and optimistic, which is a huge improvement over a lifetime of clinical depression. But it’s also the first symptom to return, especially if I take a dose of NA that’s a little too much. Last dose was 7, and 3 days later I started 9 days of deep despair. I know it’s temporary, so I just hang on and get through it, but now I know 7 is too many. [https://www.facebook.com/groups/htsupport/permalink/1936169449772334/?comment_id=1936702619719017&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}… the participant abruptly halted his antidepression medications and began taking HDCs. Although confident in his actions because of the effects of HDCs on his adult daughter and a friend, the outcome was severe depression. The participant resumed his medication and, fortunately, recovered rapidly. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

=== Alternative approaches: Omega-3 fatty acids and uridine for depression ===

According to [https://en.wikipedia.org/wiki/Uridine Wikipedia], Harvard researchers have reported that giving rats a combination of omega-3 fatty acids and uridine, two substances in foods such as fish, walnuts, molasses and sugar beets, prevented depression as effectively as antidepressant drugs. [https://news.harvard.edu/gazette/story/2005/02/food-ingredients-may-be-as-effective-as-antidepressants/] [https://pubmed.ncbi.nlm.nih.gov/15705349/]

Uridine is produced by at least 3 helminth species amongst their excretory/secretory products: Nippostrongylus brasiliensis, Trichuris muris and Ancylostoma duodenale. [https://pubmed.ncbi.nlm.nih.gov/40391223/][https://pubmed.ncbi.nlm.nih.gov/38927075/] [https://pubmed.ncbi.nlm.nih.gov/39816468/]

Although no peer‑reviewed reports could be found at the time of writing that describe the secretion of uridine by any of the therapeutic helminths (TSO, TTO, HDC or NA), this may be due to the literature on helminth excretory/secretory metabolites tending to focus on proteins, glycans and lipids rather than small molecules.

==Anxiety==

=== Reduced anxiety ===

* "My symptoms of anxiety continue to get gradually better." (Link expired)

* "... the hookworms... kicked in about 24 weeks after inoculation, which ended my 15 month nightmare with the anxiety." (Link expired)

* "I thought i am getting crazy... visited a psychologist ... they even made a CT scan. But with the right diet and helminthic therapy... i am much more balanced now. (Link expired)

* “One of the best benefits now is relief from anxiety and muscular tension. I’m waking up feeling rested, with a very relaxed back and legs, and am drowsy enough to take naps, which creates a virtuous cycle.” [http://gettinghealthiernow.wordpress.com/2012/01/02/hookworm-only-starting-over/]

* "My worms have seemingly completely zapped my anxiety. It takes a lot for me to feel anxious and it's a huge relief after having anxiety and panic attacks starting in early childhood… They have also dramatically reduced my daughter's anxiety. It was always bad, from infancy, but … she's had the best school year ever, socially. She's ten thousand times better, a completely unanticipated improvement. Our school psychologist said it was like she was a different kid." (Reported in a private discussion, Mar 2012)

* "My younger son also had severe anxiety issues which evaporated after HW. He was on medication in fact for 2 years for it but hasn't been on it in years now." (Reported to the Facebook Helminthic Therapy Support Group [https://www.facebook.com/groups/htsupport/], Mar 2012)

* "He felt much less anxiety and much more social than he would normally. (I have noticed this effect as well and wonder now how much anxiety and a desire not to be social is related to inflammation…)" [http://turnotheworm.blogspot.co.uk/2012/03/update-part-iv-from-worlds-worst.html]

* "My anxiety is still significantly reduced from pre-inoculation. Things just do not bother me the way that they did. I really feel as though my anxiety just completely vanished with the first inoculation. It is a great feeling after dealing with a lot of anxiety my entire life." [http://turnotheworm.blogspot.co.uk/2012/03/march-25-2012-saved-myself-for-last.html]

* “This therapy can be fantastic for anxiety reduction and we've seen it in every member of our family. My poor little girl had rampaging anxiety and nothing made it better. She had so much pain all the time that she was constantly anticipating more pain and very defensive. She couldn't stand to listen to a story with anything scary (she didn't want to listen to Mr. Rogers telling the story of Goldilocks and the Three Bears, that's how bad it was). Then she got hookworm. Her anxiety vaporized completely, possibly for the first time in her entire life. She completely changed. Last year, she read all of the Harry Potter books and watched all the movies -- that's how much lower her anxiety and pain are now.” [https://www.facebook.com/groups/htsupport/permalink/396703530385608/?qa_ref=qd&comment_id=397436063645688&offset=0&total_comments=17&comment_tracking=%7B%22tn%22:%22R2%22%7D]

* “I noticed the relaxed feeling with HW as well. They gave me an overall good feeling and relieved debilitating anxiety that kept me from doing things that I love doing and from seeing friends.” [https://www.facebook.com/groups/htsupport/permalink/474883185900975/?comment_id=475139555875338&offset=0&total_comments=17]

* “The HW also had a fairly dramatic effect on my anxiety levels." (Reported to a closed group, Aug 2013)

* “I inoculated with hookworm hoping that it would help my chronic sinus issues. I still can't believe how much better my sinuses are. But I wasn't expecting any changes in personality, so they came as a shock. My lifelong battle with depression and anxiety seems to be over. And I'm also smarter again (like when I was a kid).” [https://www.facebook.com/groups/263818550462551/permalink/476388752538862/?comment_id=476417832535954&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “After hosting hookworm I no longer have bouts of depression and anxiety.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1088294924559795&comment_tracking=%7B%22tn%22:%22R0%22%7D]

* “My depression and anxiety and brain fog have disappeared on NA.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&comment_tracking=%7B%22tn%22:%22R%22%7D]

* “I can attest to a huge improvement in my anxiety and depression within just a few weeks of my first NA dose (off all meds now) but I'd say I still have some mild residual symptoms.” [https://www.facebook.com/groups/htsupport/permalink/1087706324618655/?comment_id=1089572444432043&reply_comment_id=1089756711080283&comment_tracking=%7B%22tn%22:%22R8%22%7D]

* “His anxiety is almost completely gone and the OCD is still there but not as profound. He is back at school after missing most of last year due to anxiety/school refusal. I highly recommend trying HDC's. It really has been the treatment that has brought our (12 year old) son back.” [https://www.facebook.com/groups/htsupport/permalink/1067321983323756/?comment_id=1263018683754084&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

* ☹️ “I have anxiety and depression and have not really noticed any differences.” [https://www.facebook.com/groups/htsupport/permalink/1515697631819520/?comment_id=1516504428405507&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “Within 24 hours of taking HDC I feel much calmer. That feeling lasts a few days, before it lets up a bit, but I still continue feeling calmer than usual up to 30 days after dosing, when their effects completely wear off… If I could regularly dose, say, weekly, I probably would see my anxiety completely resolved.” (Link expired)

* “Now 5 months in, I have seen the most dramatic change in anxiety symptoms. Also brain fog has just slipped away… So I do feel hookworm has been instrumental in bringing down the symptoms of anxiety to where it is now.” [https://www.facebook.com/groups/htsupport/permalink/2239015116154431/?comment_id=2239742029415073&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* “Wormy update after 3 months: I am now on 50 HDC. I see just mild improvement in food allergies, but I feel calm, no anxiety! Anxiety was always a big issue for me and the antidepressants were not helping enough. Now I feel much better so that I can exercise every day.” [https://www.facebook.com/groups/htsupport/permalink/2408900369165904/]

* “In 2013 I was diagnosed with anxiety resulting in extended time off work and medication. I first tried HDC in 2016 after exhausting every other avenue outside of medication that I could think of. I found instant relief from my anxiety symptoms and I still take them every 2 or 3 weeks to help keep my anxiety at bay.” (Received via email, Feb 2020.)

* “I’ve had autoimmune disease, allergies, anxiety and digestion issues for 4 years. After having a severe panic attack at work, I saw a doctor and a naturopath, and have tried allopathic and natural medicines as well as dietary changes. I was skeptical, but after reading the extensive research and about the therapeutic effects of helminths, I tried it for myself and it worked. After being on HDC for 1 month (10 fresh HDCs every 2 weeks), my allergies disappeared and I had no side effects. Other symptoms improved 70%. It was a huge relief for me, dramatically reducing my anxiety and making a significant difference to my gut health and digestion in the first 3 months. This is faster and more effective than anything else I have ever tried. My family were skeptical and assumed it would be unsafe, but even they could notice the difference!” (Received via email, Feb 2020.)

* “I’m micro-dosing with (TSO). I notice that my anxiety peeks up for several days when it’s time to take them again. And an hour after taking them, I feel this calmness that’s difficult to describe. For someone with chronic anxiety it’s lovely.” [https://www.facebook.com/groups/htsupport/permalink/2255349147854361?comment_id=3547191695336760]

* “My daughter's anxiety was much reduced (by TSO). She has inflammation related autism. When she was anxious she would go into obsessions for hours, so the effect was pretty obvious.” [https://www.facebook.com/groups/htsupport/posts/4461359747253279/?comment_id=4465078650214722&reply_comment_id=4466404240082163]

* "The two things that really helped with my anxiety and depression were magnesium and hookworms. The mg got me out of the black depths where I was hardly functional, and the hookworms improved my symptoms several notches beyond just functional." [https://www.facebook.com/groups/htsupport/posts/4746858228703428/?comment_id=4746936282028956]

* "It was quite fast. For example the first day of TSO, it was regulating my anxiety & insomnia." [https://www.facebook.com/groups/htsupport/posts/4887558924633357/?comment_id=4889396131116303]

* "I haven’t experienced any anxiety symptoms since starting in 2018 (six years ago). I usually dose 3 x 25 NA each year. Coeliac with UC in remission. [https://www.facebook.com/groups/htsupport/posts/7008571109198784/?comment_id=7029129507142944]

* "I have digestive issues and most likely MCAS. The NA worms actually make me happy. My reaction after the first dose was an overwhelming sense of euphoria and joy. No anxiety as a side effect with me." [https://www.facebook.com/groups/htsupport/posts/9707125946009940?comment_id=9737523312970203]

For further accounts of how helminthic therapy has reduced anxiety, see the following paper.
* [[media:Practices_and_outcomes_of_self-treatment_with_helminths_based_on_physicians_observations.pdf | Practices and outcomes of self-treatment with helminths based on physicians' observations]] (PDF) (In particular, see Table 1)

=== Temporarily ''increased'' anxiety ===

There have been a few reports of anxiety increasing following initial inoculation with NA, TTO or HDC, but this increase is usually temporary and often related to dose size.

{{Quote|indent}}I think it aggravated the anxiety component for me. Not sure why. (After dosing with HDC){{Quote|/indent}}

{{Quote|indent}}Around day 15 (after an initial dose of 10 NA), I had severe anxiety for 2 days straight but nothing since. [https://www.facebook.com/groups/htsupport/permalink/1820079598047987/?comment_id=1835175879871692&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I got lots of anxiety as a side effect from 2 and then even 1 hookworm. I used theanine (up to 10 grams a day). I needed it three times day for two-three months, then used as needed. The anxiety subsided after my second round of worms.{{Quote|/indent}}

{{Quote|indent}}I had mild/moderate diffuse anxiety for about a week at ~19-20 weeks. (After a supplementary dose of '''''65''''' NA!){{Quote|/indent}}

{{Quote|indent}}My anxiety and more-so paranoia seems to have increased significantly after hosting. Its a strange feeling but I "feel" like its the worms interacting with me somehow.{{Quote|/indent}}

{{Quote|indent}}I had a major increase in anxiety when I started whipworm (TT). But with hookworm my anxiety has improved greatly. I terminated the whipworm after 6 or 8 weeks when my reaction to them still hadn't eased, so I can't say if that feeling would have persisted or eventually passed.{{Quote|/indent}}

{{Quote|indent}}I am very thankful that I only had 3 NA For my first dose. I am almost done with the week five, and the anxiety I am feeling is truly challenging me. [https://www.facebook.com/groups/htsupport/posts/5073693309353250/]{{Quote|/indent}}

If anxiety does arise, or worsen, after introducing helminths, this should eventually resolve along with any other symptoms that appear during the initial side effect period. Resolution is usually complete by the end of the 14th week and, if it recurs at all following supplementary inoculations, it typically becomes gradually less troublesome over time.

{{Quote|indent}}I have severe anxiety, including PTSD & panic attacks etc. When I initially began treating (with NA) I would notice an increase in anxiety for several days. It would be a bit uncomfortable & high doses of D3, Benadryl, & magnesium would help. I’m honestly not sure when it stopped. Likely when the bounce stopped, so a year in? Now, the opposite occurs and I get very calm & fall asleep after treating. This usually lasts for several days.
[https://www.facebook.com/groups/htsupport/posts/4141870795868844?comment_id=4148225755233348&reply_comment_id=4149349751787615]{{Quote|/indent}}

In a few rare cases, anxiety can persist for a longer period of time, leading one individual to terminate their colony.

{{Quote|indent}}Increase in energy and exuberance the first month, restlessness the second month, worsening anxiety/OCD third and 4th month, increased to day-long panic attacks fifth month. Directly due to hookworms as symptoms are 90% improved after 3 days of albendazole.{{Quote|/indent}}

== Combining helminth species to treat anxiety and depression ==

Some individuals have found that a combination of helminth species has given them the best longterm effects.

{{Quote|indent}}For me, TSO plus NA is the magic combo for anxiety and depression. [https://www.facebook.com/groups/htsupport/posts/6145556122166958?comment_id=6146089748780262]{{Quote|/indent}}

== Alcohol dependence ==

See also

* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33197496/ IL-10 normalizes aberrant amygdala GABA transmission and reverses anxiety-like behavior and dependence-induced escalation of alcohol intake]

== Autism ==

See [[Helminthic therapy and autism | '''Helminthic therapy and autism''']]

== Schizophrenia ==

{{Quote|indent}}Has not been hospitalized in 9 months. Has dropped medications 50%. Looks better, bright eyes. Energy. Hopefulness. Pleasure in life. (After one year of treating with NA.)[https://m.facebook.com/groups/htsupport/permalink/5567854796603763/?mibextid=Nif5oz]
{{Quote|/indent}}

See also

* 2025 Nov [https://pubmed.ncbi.nlm.nih.gov/40930337/ Gut microbiome and mitochondrial crosstalk in Schizophrenia, a mental disability: Emerging mechanisms and therapeutic targets] -- [https://www.sciencedirect.com/science/article/abs/pii/S0149763425003720?via%3Dihub Full text]
* 2025 Aug [https://pubmed.ncbi.nlm.nih.gov/40683090/ The role of neuroinflammation in schizophrenia: Focus on Th17 cells functions] -- [https://www.sciencedirect.com/science/article/abs/pii/S1876201825002722?via%3Dihub Full text]
* 2021 Apr [https://pubmed.ncbi.nlm.nih.gov/33252574/ Understanding the role of gut microbiota in the pathogenesis of schizophrenia]

{{Quote|indent}}Inflammation, particularly of a low-grade nature, is a consistent pathological finding in schizophrenia… [https://www.ncbi.nlm.nih.gov/pubmed/22765923/] [https://www.ncbi.nlm.nih.gov/pubmed/21641581/]{{Quote|/indent}}
* [https://psychcentral.com/schizophrenia/is-schizophrenia-autoimmune What's The Connection Between Schizophrenia and Autoimmune Diseases?]
* [https://www.youtube.com/watch?v=BmdMUyUY7Xo Inflammation and Schizophrenia], YouTube
* [http://www.bbc.co.uk/news/health-34540363 Immune clue to preventing schizophrenia]
* [http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2015.14101358 Microglial Activity in People at Ultra High Risk of Psychosis and in Schizophrenia: An (11C)PBR28 PET Brain Imaging Study] (PDF)
* [http://psychcentral.com/news/2016/03/01/reducing-inflammation-may-improve-cognition-in-schizophrenia/99836.html Reducing Inflammation May Improve Cognition in Schizophrenia]

== Bipolar disorder ==

HDC has been found to help in several cases of bipolar disorder.

{{Quote|indent}}(Before treatment), in my 30’s, I was diagnosed with depression and anxiety. In my 50’s, I was diagnosed as bipolar. Since the beginning of self-treatment (with HDC), my symptoms have subsided. My wellbeing has improved 100%. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

{{Quote|indent}}(After treatment, I have) less anxiety and am able to think clearer. The helminths (HDC) seemed to help in areas that were positive but unexpected. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

{{Quote|indent}}When I get angry I used to (before helminth therapy) have thoughts of killing the person that made me angry or maybe just hurting them severely, but now (after therapy with HDC) I am not angry often, or depressed. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf]{{Quote|/indent}}

And there are further reports of success with this disorder in the following paper.
* [[media:Overcoming_Evolutionary_Mismatch_by_Self-Treatment_with_Helminths.pdf | Overcoming Evolutionary Mismatch by Self-Treatment with Helminths: Current Practices and Experience]] (PDF)

See also

* 2025 Nov 22 [https://pubmed.ncbi.nlm.nih.gov/41275106/ Cognitive impairment in bipolar disorder associated with abnormal serum short-chain fatty acids and cytokines]
* 2023 May 8 [https://pubmed.ncbi.nlm.nih.gov/37156764/ T cells: an emerging cast of roles in bipolar disorder] -- [https://www.nature.com/articles/s41398-023-02445-y Full text]

== Psychosis ==

{{Quote|indent}}There are several lines of evidence to suggest that a proportion of psychotic illnesses have a plausible autoimmune component.[https://pubmed.ncbi.nlm.nih.gov/30949074/],[https://pubmed.ncbi.nlm.nih.gov/30122288/]{{Quote|/indent}}
== Obsessive-compulsive disorder (OCD) ==

* 2014 [https://www.ncbi.nlm.nih.gov/pubmed/24557049 Searching for the immune basis of obsessive-compulsive disorder] -- [https://www.karger.com/Article/FullText/356554 Full text] | [https://www.karger.com/Article/Pdf/356554 PDF]

* 2001 Nov 13 [https://www.ncbi.nlm.nih.gov/pubmed/11760984 Is obsessive–compulsive disorder an autoimmune disease?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC81631/pdf/20011113s00026p1353.pdf PDF]

== Post-stroke depression ==

See also

* 2026 Feb [https://pubmed.ncbi.nlm.nih.gov/41260033/ The gut microbiota in post-stroke depression: A systematic review of microbial mechanisms and therapeutic targeting of neuroinflammation]

== Tourette Syndrome ==

The findings of several studies collectively indicate that inflammation plays a significant and crucial role in the development and progression of Tourette's syndrome. [https://pubmed.ncbi.nlm.nih.gov/38956051/] [https://pubmed.ncbi.nlm.nih.gov/37187752/] [https://pubmed.ncbi.nlm.nih.gov/39165553/] Researchers have also discussed the potential contribution of immunological dysfunction as well as inflammatory processes in TS [https://pubmed.ncbi.nlm.nih.gov/35087475/] and the following study found that autoimmune disease in the mother was associated with a 29% increased incidence rate of Tourette’s syndrome in male offspring, suggesting that neuroimmunological disorders may act as a component in the etiology of a subset of TS.
* 2015 Jun [https://www.ncbi.nlm.nih.gov/pubmed/26004665 Maternal History of Autoimmune Disease and Later Development of Tourette Syndrome in Offspring]

== See also ==

* [[Helminthic therapy and neurodevelopmental disorders | '''Helminthic therapy and neurodevelopmental disorders''']]

* [[Helminthic therapy and neurological disorders | '''Helminthic therapy and neurological disorders''']]

* [[Helminthic therapy and neurodegenerative diseases | '''Helminthic therapy and neurodegenerative diseases''']]

* [[The helminthic therapy bounce | '''The helminthic therapy bounce''']]

* [[Helminthic therapy for well people#Cognitive dysfunction | '''Helminthic therapy as a potential prophylaxis for cognitive dysfunction''']]

Human helminth care manual

2026-05-09T03:47:39Z

John: /* List of herbs and medicinal plants */

{{Breadcrumb|[[Using_helminths|Using helminths]]|[[Helminth_care|Helminth care]]}}
{{SEO 
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|description=How to care for the two species of human helminth used in helminthic therapy: Necator americanus (NA) and Trichuris trichiura (TT/TTO).
|keywords=worm care, helminth care, Necator americanus, Trichuris trichiura, NA, TT, TTO, caring for my worms
|og:image=}}
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'''PLEASE READ THIS FIRST''' 
This manual is only concerned with the two '''''human''''' helminths:
* '''Human hookworm - Necator americanus''' (NA) [https://en.wikipedia.org/wiki/Necator_americanus]
* '''Human whipworm - Trichuris trichiura''' (TT) and its ova (TTO) [https://en.wikipedia.org/wiki/Trichuris_trichiura]
For the care of the non-human helminths, TSO and HDC, see the [[Helminth_care |'''Helminth care''']] page. 
=== Key ===
The following classification codes are intended as a general guide only, because the effects of a substance can vary considerably depending on factors such as quantity, concentration, and, in the case of herbal extracts, the part of the plant used. Even the method of extraction can make a difference, and, in the case of foods, perhaps the method, temperature and duration of any cooking, [https://www.facebook.com/groups/htsupport/posts/6863122353743661?comment_id=6863149840407579&reply_comment_id=6863721660350397] so it's important to read the details for each item.

:❌ Will or may kill, or cause the loss of, human helminths.
:⚡ May cause harm to human helminths in some people.
:➿ May cause a temporary reduction in benefits from human helminths.
:❓Insufficient evidence exists to support a judgement on possible effects.
: ✅ Safe, or likely to be safe, for human helminths.

Note that where an entire section is marked with a ✅, this indicates that all the substances listed within that section are safe unless marked otherwise.

=== Using this manual ===
'''* Bookmark this page to facilitate rapid access whenever it is needed.'''

'''* To find information about a specific substance, don't scan the page visually. Instead, use the search function on your device:''' 

* '''PC''' - Control+F 
* '''Mac''' - Command+F 
* '''Mobile''' - "Find in page" in the drop-down menu from the three dots icon

'''* Anything NOT MENTIONED in this manual has never been reported to be a problem, so, unless it is a new or very unusual product/substance, it is far more likely to be safe than unsafe for therapeutic human helminths.''' 

=== General advice ===
'''NA and TT are relatively robust organisms, and most foods, drugs and other substances are safe for use while hosting them, including normal dietary amounts of most unprocessed foods, spices and herbs. However there are some foods and other substances that may harm a colony, either temporarily stunning them or even killing them.'''

Things that will or may kill, or cause the loss of, human helminths include:

* ❌ Diatomaceous earth. (See [[#Diatomaceous earth|'''full details''']].)
* ❌ Oregano. (See [[#Oregano|'''full details''']].)
* ❌ Sauerkraut. (See [[#Sauerkraut|'''full details''']].)

'''Some foods can cause harm to NA and TT in some people but not others,''' and coconut products are a good example of this. While many hosts of human helminths are able to eat normal dietary amounts of coconut products without affecting their worms, others find that some forms of this food will affect their worms sufficiently to impair their beneficial effects.

The most common food items that may affect helminths in some people but not others are:

* ⚡ Coconut products. (See [[#Coconut|'''full details''']].)
* ⚡ Fatty acids. (See [[#Fatty acids|'''full details''']].)
* ⚡ Ginger. (See [[#Ginger|'''full details''']].)
* ⚡ Honey. (See [[#Honey|'''full details''']].)
* ⚡ Papaya seeds. (See [[#Papaya|'''full details''']].)
* ⚡ Pumpkin seeds and pumpkin seed oil. (See [[#Pumpkin|'''full details''']].)
* ⚡ Digestive enzymes. (See [[#Digestive enzymes|'''full details''']].)
* ⚡ Cayenne. (See [[#Cayenne|'''full details''']].)

If hosting NA, it is best to avoid the food substances listed above until the therapy is delivering benefits, at which point their effect on one’s colony can be tested, initially in small, and then in gradually increasing, quantities to assess the level of risk they are likely to present, and how much of each substance might safely be consumed before the worms are affected.

See the rest of this page for other items marked with a ⚡ or ❌.

'''Medicinal quantities of concentrates, extracts or tinctures, especially of certain herbs, are more likely to have an adverse effect on NA and TT than the plants from which they are derived.''' For example, eating normal dietary amounts of ginger is usually fine, as is occasionally taking a ginger supplement (e.g., to treat a migraine), but taking ginger regularly as a supplement or drinking ginger beer every day may adversely affect NA.

Another example of how the concentrated form of a substance can be harmful to helminths while foods containing the same substances are not are the phytochemical compounds, '''isomyristicin''' and '''bergaptenix'''. While the ''concentrated'' forms of isomyristicin and bergaptenix have shown significant anthelmintic activity against two helminth species, the parent chemicals from which they are derived ('''myristicin''' and '''bergapten''') are both found in several of the fruits, herbs and vegetables consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, and the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

'''People who have a robust immune response to helminths are likely to notice a greater effect on their worms than others.''' These individuals are the ones who need to top up their human helminth colonies more frequently in order to maintain remission from their disease. Typically, they have Crohn's, or one of the other intestinal diseases, but a few in this group have other conditions, such as allergies. [https://www.facebook.com/groups/htsupport/permalink/966004180122204/?comment_id=966023830120239&comment_tracking=%7B%22tn%22:%22R1%22%7D]

'''It is thought to be less likely that anything will harm NA before it attaches to the gut mucosa towards the end of the third week post inoculation''', although, once NA enters the bloodstream, it does begin to feed on proteins in the blood. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.ncbi.nlm.nih.gov/pubmed/29566094]. After it arrives in the small intestine and begins feeding from the gut wall from day 21, NA will always be vulnerable to anything harmful that has entered its host's blood.

'''Substances that are applied to the skin topically in small quantities are unlikely to cause harm to human helminths, even if the substances are known to be a risk when they are ingested.'''

'''Due to the way that TT feeds and attaches to the colonic mucosa, it is not as vulnerable as NA''', as is illustrated by the fact that three times more of the anthelmintic drug, mebendazole, may be required to kill TT than to kill NA.

'''Substances listed on the internet as being "antiparasitic" may have no effect whatsoever on NA and TT.''' Helminths are only one of many different types of parasite. Among the other types, there is a wide range of responses to substances claiming to be antiparasitic, and what kills one type of parasite may not even harm another. Even substances that have shown an anthelmintic effect in test tube studies do not necessarily have an adverse affect on worms being hosted by humans. [https://www.ncbi.nlm.nih.gov/pubmed/27498843]

'''Some foods and substances can reduce the therapeutic/ prophylactic benefits of adult helminths without killing the worms or having any impact on their egg production.''' Therefore, if testing shows the presence of helminth eggs in the host’s feces after ingesting a particular substance, it does not necessarily mean that this food/ substance will not interfere with the health benefits provided by the worms. [https://www.facebook.com/groups/htsupport/posts/9561303440592192?comment_id=9562835637105639] So the details on this page may not be relevant to the practice of helminth incubation, and a tentative examination of the effect of substances on the production of hookworm eggs and larvae can be found in the page section, [[NA incubation: very detailed method by Alana#Promotion of egg viability by dietary manipulation | '''Promotion of egg viability by dietary manipulation''']].

The posts in this [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/ support group sub-thread] contain good general advice on how to manage exposure to substances that can harm human helminths.

=== Worm harm denial ===

A few people have difficulty accepting that any of the substances mentioned on this page might harm helminths, with the exception of anthelmintic drugs. They believe that the adverse effects on human helminths that have been reported by self-treaters have alternative explanations, including delusion on the part of the reporting individual. They argue that, were the claims true, there would no longer be large areas of the planet where these worms remain endemic, and that the substances/foods/spices identified by self-treaters as potentially harmful to human helminths would have become folk remedies for helminth infections. However, this position ignores the science (e.g., [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924796/ Herbal anthelmintic agents: a narrative review]) and the fact that the effect of consuming a food or product with anthelmintic effects will be much less of an issue, if it is even noticed at all, in populations that are continually exposed to helminths and therefore constantly being reinfected.

In the words of one experienced NA self-treater:
{{Quote|indent}}Respect the foods and other items in the care manual that are likely, or potentially, unsafe for helminths. I’ve learned the hard way that coconut oil/milk/flour, raw ginger, curry, etc. are no beuno for my friends on board, and as much as I enjoy those things, they are not worth knocking out my NA for a week or multiple weeks. Everybody’s different here and it’s worth testing in very small amounts. [https://www.facebook.com/groups/htsupport/posts/4395750987147489/]{{Quote|/indent}}

=== Updates & disclaimer ===
This manual is updated regularly. See the page history (via the "View history" link at the top of the page) for a list of amendments.

Although the most harmful substances have been identified, this manual continues to be a work in progress so should not be viewed as definitive. Also see the [[Helminthic Therapy wiki:General disclaimer|'''General disclaimer''']].

Details in this manual are based on first hand reports posted in the [[Helminthic_therapy_support_groups|'''Helminthic therapy support groups''']]. Additional reports and comments on this topic are welcomed, and should be posted to the [https://www.facebook.com/groups/htsupport/ Helminthic Therapy Support group] on Facebook. 
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</div>

<div class="toclimit-3">__TOC__</div>

== Pharmaceuticals ==


=== Anaesthetics (anesthetics), General [https://en.wikipedia.org/wiki/Anesthetic] ===

==== ✅Nitrous oxide (N2O) (E942) [https://en.wikipedia.org/wiki/Nitrous_oxide] ====
<blockquote>
Nitrous oxide (aka laughing gas or sweet air) was, at one time, mistakenly thought to kill hookworms. However, when this gas was used by people who wanted to terminate their hookworm colonies, their attempts met with failure. One subject reported inhaling almost a full can of whipped cream at 3 weeks post inoculation in an attempt to resolve severe side effects, but with no obvious effect on his hookworms. In another case, a balloon full of nitrous oxide failed to have any effect on a hookworm colony, which was later confirmed to be viable by a stool test. [https://www.facebook.com/groups/htsupport/permalink/759492150773409/] Then, in 2017, the notion that nitrous oxide harms NA was finally laid to rest by someone who inhaled a large quantity of the gas over the course of an hour. This individual reported that, although he did get a headache and giggled a lot, his worms were not harmed.

✅ The following forms of nitrogen are also unlikely to be a problem for hookworms.
* Nitric oxide (NO) [https://en.wikipedia.org/wiki/Nitric_oxide]
* Nitrogen dioxide (NO2) [https://en.wikipedia.org/wiki/Nitrogen_dioxide]
* Nitrate (NO3) [https://en.wikipedia.org/wiki/Nitrate]
* Pure nitrogen (N) [https://en.wikipedia.org/wiki/Nitrogen]
* Liquid nitrogen (LN2) [https://en.wikipedia.org/wiki/Liquid_nitrogen]
</blockquote>

==== Other general anaesthetics ====

<blockquote>
It has been suggested that the volatile organic compounds (VOCs) that were used in the early days of anaesthesia might be a risk to hookworms, especially if inhaled in excessive quantity, due to the possibility that they might stun them and cause them to be expelled from the gut before waking up. For example:
* ✅ [https://en.wikipedia.org/wiki/Diethyl_ether diethyl ether]
* ✅ [https://en.wikipedia.org/wiki/Chloroform chloroform]
However, a clinical scientist has reported that, while hosting both NA and TT, he worked around more organic solvents, including dichloromethane (CH2Cl2) and chloroform (CHCl3), than most people are exposed to in a lifetime, and that his hookworms and whipworms continued egg production uninterrupted.

✅ [https://en.wikipedia.org/wiki/Propofol Propofol] While propofol has been shown to adversely affect the mitochondria of roundworms in laboratory conditions, it is clear from the experience of hosts of both hookworms and whipworms that propofol does not harm human helminths in the concentrations used during surgery.

✅ [http://www.sciencedaily.com/releases/2009/08/090804145614.htm Regional nerve blocks] are worm-safe.

</blockquote>



=== Anaesthetics (anesthetics), local [https://en.wikipedia.org/wiki/Anaesthetics] ===

==== ➿ [https://en.wikipedia.org/wiki/Local_anaesthetic Local anaesthetics] ====
<blockquote>
Local anaesthetics interfere with the production of white blood cells as well as the functioning of the cells in circulation, but they appear not to affect ova production by helminths and they certainly don't kill them. While local anaesthetics can cause a temporary return of disease symptoms for up to 8 weeks, helminths generally recover after only a few days, although this varies by person, drug and dosage, making it difficult to predict exactly what will happen in any particular situation.

For dental procedures requiring a local anaesthetic, short-acting drugs are less likely to affect helminths, e.g.
* [https://en.wikipedia.org/wiki/Articaine Articaine] (articadent, astracaine forte, septanest, septocaine, ubistesin forte, ubistesin, ultracaine, zorcaine)
* [https://en.wikipedia.org/wiki/Lidocaine Lidocaine] (xylocaine, lignocaine)
These are a better choice than a longer-acting drug, such as
* [https://en.wikipedia.org/wiki/Carbocaine Mepivacaine] (carbocaine, polocaine)
* [https://en.wikipedia.org/wiki/Bupivacaine Bupivacaine] (Marcaine, Sensorcaine and Vivacaine, etc.)
and one helminth host has reported that the short-acting articaine had no adverse effect on his hookworms.

If a patient explains that they don't want to be numb for several hours, the dentist will usually use one of the short-acting drugs, or one combined with a vasoconstrictor such as epinephrine, which helps to reduce the amount of the drug that reaches the systemic circulation.

If local anaesthetics are used, it can be a good idea to arrange for a small supplementary dose of worms (e.g., 3 or 5 hookworm larvae) to be available for administration the day after exposure to the drug. This small additional inoculation usually helps to reduce the time that established helminths are out of action.
</blockquote>

==== ✅ Alternatives to local anaesthetics ====
<blockquote>
* [https://en.wikipedia.org/wiki/Opioids Opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.)
* [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed versed], etc., routinely used during colonoscopies)
* [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics]
These drugs all appear to be harmless to helminths, so, taken orally at high strength, these may be a suitable substitute for local anaesthetics in many situations. For example, one helminth host has found that 30 mg [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], taken along with 1,000 mg of [https://en.wikipedia.org/wiki/Paracetamol paracetamol (acetaminophen)] an hour or two before a dental appointment can be effective in avoiding all but a few brief moments of mild, dull pain, which he
found to be quite manageable while having a tooth drilled. This subject even found that the combination of dihydrocodeine and paracetamol (acetaminophen) provided adequate pain relief when having a tooth sculpted to take a crown. [https://en.wikipedia.org/wiki/Aspirin Aspirin] and [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] are also harmless to helminths, so, if preferred, these might provide a suitable alternative to paracetamol (acetaminophen).

Another option for completely avoiding any risk to helminths from local anaesthetics was the [https://www.facebook.com/GumEase GumEase] cryoallergenic mouthpiece. This device, which is apparently no longer available to purchase, provided pain relief for up to 20 minutes, and was appropriate for most procedures, including fillings, crowns, extractions and root canals. Previously available from two sources [http://cryodevices.ecrater.com/c/902779/gumease-products], [http://www.dentakit.com/gumease.html] this device unfortunately never caught on with dentists who are firmly wedded to the use of injectable drugs.

Another pain-free alternative is [http://www.youtube.com/watch?v=dcAwKvdqmKI laser dental surgery], which is likely to become increasingly available in the future. If more invasive dental surgery is required - where bone needs to be removed, for example - it may be best to request [https://en.wikipedia.org/wiki/Conscious_sedation conscious sedation]. This renders the patient unaware of what is taking place, but is not the same as a general anaesthetic. Conscious sedation might involve a combination of [https://en.wikipedia.org/wiki/Versed versed] (a short acting IV [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine]) and [https://en.wikipedia.org/wiki/Fentanyl fentanyl] (a short acting IV opiate), both of which are perfectly safe for worms.

</blockquote>

=== Anaesthetics (anesthetics), topical [https://en.wikipedia.org/wiki/Anaesthetics] ===

<blockquote>
✅ Topical anaesthetics (e.g., lidocaine / lignocaine) that are applied to the skin are unlikely to affect helminths within the digestive tract because not enough of the drug will get into the blood stream to affect the worms. Topical lidocaine used before blood draws, punch biopsies and the fitting of a catheter, or applied to the mucous membranes in the mouth or nose, are therefore worm-safe. However, there is a small possibility that fresh L3 NA larvae, which remain within the skin at the inoculation site for the first 40 hours, '''''may''''' be adversely affected by the use of a topical anaesthetic applied directly to this area following inoculation. [https://www.facebook.com/groups/htsupport/posts/6162787843777119/?comment_id=6163364870386083&reply_comment_id=6165161500206420] Further feedback is needed to confirm or dispel this possibility.
</blockquote>

=== Anthelmintics [https://en.wikipedia.org/wiki/Anthelmintics] ===

==== ❌ Anthelmintic drugs ====
<blockquote>
A number of drugs are used to terminate helminth infections, but the effectiveness of different anthelmintics against a single species [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250499/?report=classic varies] greatly. In [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/ one study], a triple dose of [https://en.wikipedia.org/wiki/Albendazole albendazole] (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, whereas a triple dose of [https://en.wikipedia.org/wiki/Mebendazole mebendazole] (3×500 mg over 3 consecutive days) only achieved a cure rate of 58%.

Each anthelmintic drug has varying degrees of effectiveness against different helminths. For example, while a triple dose of '''albendazole''' (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, the same regimen only achieved a 56% cure rate against whipworms [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/] and, in patients with an excessive whipworm infection, '''albendazole''' may need to be taken for 5–7 days. [http://www.ncbi.nlm.nih.gov/pubmed/14754497?dopt=AbstractPlus]

If it becomes necessary to terminate a colony of helminths, a medical doctor should be consulted, and their directions followed. However, under no circumstances should '''mebendazole''' ever be combined with '''metronidazole''' (Flagyl), and this is something about which many doctors and pharmacists may be unaware. There is a risk that this combination may [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ cause Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis].
{{Columns|2}}

==== List of anthelmintics ====

* [https://en.wikipedia.org/wiki/Abamectin Abamectin]

* [https://en.wikipedia.org/wiki/Albendazole Albendazole] (Albenza, Valbazen, Zentel, etc.)

* [https://en.wikipedia.org/wiki/Aminoacetonitrile Aminoacetonitrile] derivatives

* [https://en.wikipedia.org/wiki/Arecoline Arecoline] (Arecaline, Arecholine, Arecolin, Arecoline base, Arekolin, Methylarecaidin.)

* [https://en.wikipedia.org/wiki/Artemisinin Artemisinin] (Artemisinine, qinghaosu)

* [https://en.wikipedia.org/wiki/Bephenium_hydroxynaphthoate Bephenium hydroxynaphthoate] (Alcopar, Alcopara, Befenium, Debefenium, Francin, Nemex). This is an anthelmintic agent once used to treat hookworm and roundworm infections.

* [https://en.wikipedia.org/wiki/Diethylcarbamazine Diethylcarbamazine] (DEC, Hetrazan, Carbilazine, Caricide, Cypip, Ethodryl, Notézine, Spatonin, Filaribits, Banocide Forte and Eofil)

* [https://en.wikipedia.org/wiki/Disulfiram Disulfiram] (Antabuse, Antabus, etc.). While this drug is predominantly used to treat alcoholism, it has also been reported in the scientific literature to possess anthelmintic properties, which were the main reason for its original investigation. Copper‑chelating thiuram compounds such as disulfiram have been noted to produce lethal inhibition of respiration in intestinal worms such as the whipworm Trichuris muris as well as schistosomes, with daily disulfiram treatment of T. muris‑infected animals producing malformed eggs and preventing successful colonisation of mice.

* [https://en.wikipedia.org/wiki/Emodepside Emodepside] (Monepantel) [https://pharmaphorum.com/news/bayer-drug-raises-hope-15bn-people-worm-diseases]

* [https://en.wikipedia.org/wiki/Fenbendazole Fenbendazole]

* [https://en.wikipedia.org/wiki/Flubendazole Flubendazole] (Flutelmium, Flubenol, Biovermin, Flumoxal.)

* '''Isomyristicin''' and '''bergaptenix''' are two phytochemical compounds isolated from the Bhutanese medicinal plants, Corydalis crispa and Pleurospermum amabile, which have shown significant anthelmintic activity against the helminths, Schistosoma mansoni and Trichuris muris. In concentrated form, they may therefore be harmful to other whipworms and possibly also hookworms. [http://www.ncbi.nlm.nih.gov/pubmed/27572696] However, it should be noted that myristicin (the parent chemical from which isomyristicin is derived) and bergapten are both found in very small quantities in the vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/] These chemicals are also found in ⚡ [https://en.wikipedia.org/wiki/Earl_Grey_tea Earl Grey tea], which is flavoured with bergamot oil, and one hookworm host has reported that she experienced a return of symptoms of her disease (POTS) after drinking this brew. However, there are many other NA hosts who drink this tea without any problem, including someone who drinks multiple cups each day of weak Lady Grey tea (citrus bergamot flavour) and has reported still being able to successfully incubate from her small NA colony. [https://www.facebook.com/groups/htsupport/posts/5482091725180071/?comment_id=5483270285062215]

* [https://en.wikipedia.org/wiki/Ivermectin Ivermectin] (Stromectol, Soolantra, Sklice, etc.) Used to treat [https://en.wikipedia.org/wiki/Cutaneous_larva_migrans cutaneous larva migrans] caused by various zoonotic hookworm species. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11125977/]

* [https://en.wikipedia.org/wiki/Levamisole?wprov=sfla1 Levamisole] (Decaris, Ergamisol) is an antihelmintic drug approved for use in veterinary medicine in the United States. It was once used in the treatment of rheumatoid arthritis but proved too dangerous.

* [https://en.wikipedia.org/wiki/Mebendazole Mebendazole] (MBZ, Vermox, Ovex)

* [https://en.wikipedia.org/wiki/Niclosamide Niclosamide] (Niclocide, Fenasal, Phenasal, etc.)

* [https://en.wikipedia.org/wiki/Nitazoxanide Nitazoxanide] (Alinia, Nitaxide) is a broad-spectrum antiparasitic and broad-spectrum antiviral drug used to treat various helminthic, protozoal and viral infections. It has demonstrated activity against tapeworms, [https://www.ncbi.nlm.nih.gov/pubmed/27751770] so may also have an adverse effect on hookworms and whipworms.

* [https://en.wikipedia.org/wiki/Odanacatib Odanacatib] (codenamed MK-0822) is an investigational treatment for osteoporosis and bone metastasis developed by Merck & Co., and possibly available for clinical use from 2016. Unfortunately, this drug has been shown to kill the hookworm, Ancylostoma ceylanicum, in hamsters, decreasing worm burdens by 73%. [https://www.ncbi.nlm.nih.gov/pubmed/27751770] Consequently, it is likely to be trialled as a potential alternative to albendazole and may have an adverse effect on the human hookworm as well as other helminths, so should be avoided by helminth self-treaters.

* [https://en.wikipedia.org/wiki/Oxamniquine Oxamniquine] (e.g., Vansil)

* [https://en.wikipedia.org/wiki/Oxyclozanide Oxyclozanide]

* [https://en.wikipedia.org/wiki/Penicillium_cluniae Penicillium cluniae] (a fungus species of the genus of Penicillium which produces the antinematodal and antiparasitic agents paraherquamide B, paraherquamide C, paraherquamide D, paraherquamide E, paraherquamide F, paraherquamide G, paraherquamide H.)
* [https://en.wikipedia.org/wiki/Phenothiazine Phenothiazine (PTZ)] This is considered to be the first modern anthelmintic, introduced for this purpose in 1940.

* [https://en.wikipedia.org/wiki/Piperazine Piperazine] (piperazine hydrate and piperazine citrate are anthelmintic drugs that kill 60-70% of adult roundworms) and piperazine's many [https://en.wikipedia.org/wiki/Piperazine#Piperazine_derivatives_as_drugs derivatives].

* [https://en.wikipedia.org/wiki/Piperine Piperine] has demonstrated significant anthelmintic properties against various worm species. [https://www.academia.edu/103643829/Anthelmintic_Activity_of_Piperine_from_Black_Pepper] It not only has well documented potent effects against eggs and larvae, but also shows activity against adult worms, with paralysis and death times comparable to the standard anthelmintic drug albendazole. [https://pubmed.ncbi.nlm.nih.gov/31437123/]

* [https://en.wikipedia.org/wiki/Praziquantel Praziquantel] (Biltricide etc.)

* [https://en.wikipedia.org/wiki/Pyrantel Pyrantel pamoate] (Pin-X, Combantrin, etc.)

* [https://en.wikipedia.org/wiki/Pyrvinium Pyrvinium] (Vanquin, viprynium). This anthelmintic was previously used to treat pinworm (Enterobius vermicularis) infections, but has been largely replaced by other anthelmintics, e.g., mebendazole or [https://en.wikipedia.org/wiki/Pyrantel pyrantel pamoate].

* [https://en.wikipedia.org/wiki/Salicylanilide Salicylanilide], Spiroindoles (e.g. derquantel)

* [https://en.wikipedia.org/wiki/Tiabendazole Tiabendazole] (thiabendazole, TBZ, Mintezol, Tresaderm, Arbotect, etc.)

* [https://en.wikipedia.org/wiki/Triclabendazole Triclabendazole] (Fasinex, Egaten, etc.).
{{Columns}}
</blockquote>

==== ❓ Piperazine-derived compounds ====

<blockquote>
There is a whole raft of [https://en.wikipedia.org/wiki/Piperazine%23Piperazine_derivatives_as_drugs piperazine-derived compounds] some of which '''may potentially''' have anthelmintic effects. However, this does not mean that all piperazine derivatives will kill, or even harm, helminths. For example, ✅ [https://en.wikipedia.org/wiki/Viagra Viagra] is a piperazine derivative, but does not kill hookworms.

* These include many antidepressants including
** [https://en.wikipedia.org/wiki/Trazodone trazodone] (Depyrel, Desyrel, Molipaxin, Oleptro, Trazodil, Trazorel, Trialodine, Trittico). One self-treater has been reported to take trazodone almost every night, but continues to get "great results" from her NA. [https://www.facebook.com/groups/htsupport/posts/7313725575350001/?comment_id=7313750828680809&reply_comment_id=7313942228661669]
* antipsychotics such as
** [https://en.wikipedia.org/wiki/Olanzapine olanzapine] (Lanzek, Zypadhera, Zyprexa and [https://www.drugs.com/international/olanzapine.html numerous other names]),
** [https://en.wikipedia.org/wiki/Olanzapine prochlorperazine] (Compazine, Stemzine, Buccastem, Stemetil, Phenotil),
** [https://en.wikipedia.org/wiki/Ziprasidone ziprasidone] (Geodon, Zeldox),
* the migraine treatment
** [https://en.wikipedia.org/wiki/Migraleve Migraleve Pink],
* and antihistamines including
** [https://en.wikipedia.org/wiki/Buclizine buclizine],
** ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine),
** [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan),
** [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5),
** [https://en.wikipedia.org/wiki/Cyclizine cyclizine],
** ⚡ [https://en.wikipedia.org/wiki/Levocetirizine levocetirizine] (Xyzal) (one NA host has reported having no problems with her worms when taking this [https://www.facebook.com/groups/htsupport/permalink/3067416309980970/?comment_id=3067678586621409]),
** [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs,
** ⚡ [https://en.wikipedia.org/wiki/Dimenhydrinate dimenhydrinate] (Dramamine, Draminate, Gravol, etc.) While one NA host has reported that taking this drug had no observable effect on her worms, [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&reply_comment_id=1682358115153470&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] someone with colitis believes that it killed at least some of her NA colony.
** [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
** [https://en.wikipedia.org/wiki/Ebastine ebastine] (Evastin, Kestine, Ebastel, Aleva and Ebatrol) Listed as a [https://en.wikipedia.org/wiki/Piperidine piperidine].
* as well as antianginals, anxiolytics such as
** ⚡ [https://en.wikipedia.org/wiki/Buspirone buspirone] (Buspar), (one self-treater found that the positive effects of NA were lessened in the days following a single dose of buspirone [https://www.facebook.com/groups/htsupport/permalink/1944442368945042/])
* urologicals, e.g.
** [https://en.wikipedia.org/wiki/Sildenafil sildenafil] (Revatio, ✅ Viagra) and
** [https://en.wikipedia.org/wiki/Levitra vardenafil] (Levitra, Staxyn).
</blockquote>

Anthelmintic residues may be encountered in farmed meats, especially the livers of cattle and fowl, but it is not known whether, or to what extent, these might affect therapeutic helminths in hosts who eat this meat.

Canine anthelmintics that have been applied to a dog’s skin should not be a problem for anyone who pets a treated animal so long as they wash their hands immediately after the contact. [https://www.facebook.com/groups/htsupport/permalink/868843983171558/]

=== Antibiotics [https://en.wikipedia.org/wiki/Antibiotics] ===

(Also see [[Human helminth care manual#Natural antibiotics|'''Natural antibiotics''']].)

==== ❌ Antibiotics that may significantly reduce hookworm benefits ====
<blockquote>
* [https://en.wikipedia.org/wiki/Cefazolin Cefazolin] (Also known as cefazoline and cephazolin.) Someone who was given a 1 gram shot of cefazolin post-operatively estimates that she suffered a 60% loss of effect from her hookworms for several weeks. She began to feel better after a 3-day course of prednisone taken one month after the cefazolin exposure, and was mostly back to normal at 6 weeks. However, when [https://en.wikipedia.org/wiki/Cefalexin cefalexin] (aka cephalexin), a drug related to cefazolin within the cephalosporin class, was taken by a different hookworm host for 2 days, this appeared to have no effect on his NA colony.
* [https://en.wikipedia.org/wiki/Levaquin Levofloxacin] has been reported by one NA host as having "completely devastated" her colony. An egg count revealed only 14 ova, and she went from near total remission to a severe flare. "Back to ground zero." [https://www.facebook.com/groups/htsupport/permalink/1626974844025131/?comment_id=1627023594020256&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]
</blockquote>

==== ⚡ Antibiotics that may reduce hookworm benefits in some people ====
<blockquote>

* [https://en.wikipedia.org/wiki/Amoxicillin Amoxicillin] While two hookworm hosts have said that they did not lose their worms following treatment with amoxicillin, three others have reported losing their colonies after taking this drug, for example, [https://www.facebook.com/groups/htsupport/posts/9106626532726554/ here]. Combination drugs that contain amoxicillin e.g., [https://en.wikipedia.org/wiki/Amoxicillin/clavulanic_acid amoxicillin/clavulanic acid] (co-amoxiclav, Augmentin) can also be a threat to human helminths, as was found by a hookworm host whose colony was temporarily "knocked out" after taking amoxicillin and clindamycin together. [https://www.facebook.com/groups/htsupport/permalink/1664279276961354/?comment_id=1664541103601838&reply_comment_id=2421515414571066]

* [https://en.wikipedia.org/wiki/Azithromycin Azithromycin] (brand names include: AZIF-500, Azithral, Azithrocin, Azyth, Azin, Z pack, Zeto and Zithromax) Someone has reported losing her hookworms to a combination of [https://en.wikipedia.org/wiki/Azithromycin azithromycin] (an azalide, a type of macrolide antibiotic) and doxycycline (see below) (a broad spectrum antibiotic of the tetracycline class), whereas a whipworm host [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=892732697449353&offset=0&total_comments=12&comment_tracking=%7B%22tn%22:%22R1%22%7D did not lose her colony] from taking this same combination of drugs. Azithromycin has been used on its own to treat a child with PANDAS and a female adult with an ear infection [https://www.facebook.com/groups/htsupport/permalink/1230554160333870/?comment_id=1230564746999478&comment_tracking=%7B%22tn%22%3A%22R%22%7D] without any worm loss, although its use did result in a temporary suspension of benefits in both cases.

* [https://en.wikipedia.org/wiki/Clindamycin Clindamycin] has been suspected of possibly harming hookworms when taken in combination with amoxicillin or metronidazole, but two NA hosts who took this drug on its own have reported that it had no adverse effect on their colonies. The first took clindamycin for 10 days (starting in the first week of hosting), [https://www.facebook.com/groups/htsupport/permalink/2123829614339649/] and the second took a 7 day course (300mg taken 4 times per day) after which a float test revealed plenty of hookworm eggs. [https://www.facebook.com/groups/htsupport/permalink/2574492762606663/]

* [https://en.wikipedia.org/wiki/Doxycycline Doxycycline] (Vibramycin, Monodox, Microdox, Periostat, Vibra-Tabs, Oracea, Doryx, Vibrox, Adoxa, Doxyhexal, Doxylin, Doxoral, Doxy-1 and Atridox, etc.) is a tetracycline antibiotic that also has antiprotozoal, antibacterial and some anthelmintic effects, although the latter have been claimed to only affect filarial nematodes. In this case, the drug kills a symbiotic bacterium in the worm’s reproductive tract, thus rendering it sterile. Moreover, an eight-week course of doxycycline may be necessary to achieve this effect. One hookworm host has reported that he took doxycycline for a total of 5 weeks without noticeable effect on his worms, and others have also reported having no issues with this drug, [https://www.facebook.com/groups/htsupport/posts/24894037546892199?comment_id=24894176736878280] but another has said that her hookworms “completely stopped working” after taking doxycycline for only three days. She said that this happened “pretty much overnight”, and that, in spite of getting a supplementary dose of worms a month or so after taking the antibiotic, [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786946941361263&offset=0&total_comments=16] she didn’t feel right again for the following 6 months. [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786624918060132&offset=0&total_comments=15] (NB: doxycycline has also been found to have [http://medicalxpress.com/news/2015-03-antibiotics-unexpected-effects-mitochondria.html unexpected effects on mitochondria].)

* [https://en.wikipedia.org/wiki/Flucloxacillin Flucloxacilin], also known as floxacillin. When one hookworm host took this drug with [https://en.wikipedia.org/wiki/Probenecid probenecid] (which is sometimes used to increase the concentration of some antibiotics), she experienced a return of her disease symptoms, although these were not as severe as they had been before she began hosting NA. An incubation yielded only half the usual number of larvae, but, after taking a wake up dose of 12 NA, she was feeling much improved 3 weeks later. [https://www.facebook.com/groups/htsupport/permalink/2286252768097332/] Someone else who had a 10 day course of Flucloxacilin, firstly intravenously, and then orally, found that she lost benefits from her NA for 4-6 weeks. She knew the worms were not dead because she was able to incubate fresh larvae from her colony. On a different occasion, a shorter course of 5 days IV, then oral Flucloxacilin, had minimal impact. [https://www.facebook.com/groups/htsupport/permalink/3702475279808400/?comment_id=3703092116413383]

* ❓ [https://en.wikipedia.org/wiki/Fosfomycin Fosfomycin] (also known as phosphomycin, phosphonomycin, Monurol and Monuril) A single, one-off, 3g dose if this broad-spectrum antibiotic that was taken by a hookworm host to treat a urinary tract infection had no obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&comment_tracking=%7B%22tn%22:%22R%22%7D] However, larger doses or a longer treatment period may produce a different result.

* [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). Two hookworm hosts have reported losing their colonies to [https://en.wikipedia.org/wiki/Metronidazole metronidazole] (Flagyl), [https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1371228706266414/] which may be particularly harmful to hookworms if taken in combination with [https://en.wikipedia.org/wiki/Clindamycin clindamycin] (Dalacin, Lincocin, Daclin). '''Metronidazole''' and '''clindamycin''' are favoured by some dentists due to their proven efficacy against anaerobic bacteria. However, when take on its own, metronidazole does not always kill hookworms, as one host found when she had to take this drug along with amoxicillin for several weeks to treat septic gangrenous appendicitis, [https://www.facebook.com/groups/htsupport/permalink/1899197376802875/?comment_id=1899228090133137&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and another found when he needed to take 750mg daily for 7 days to treat SIBO. [https://www.facebook.com/groups/htsupport/permalink/2060266257362652/] A third NA host was still able to successfully incubate more larvae after taking five doses of 400mg metronidazole daily for three days. [https://www.facebook.com/groups/htsupport/posts/5993193837403188/?comment_id=5993326564056582&reply_comment_id=5993931900662715]

* [https://en.wikipedia.org/wiki/Nitroimidazole Nitroimidazoles] (metronidazole, tinidazole, nimorazole, dimetridazole).

* [https://en.wikipedia.org/wiki/Quinolone_antibiotic Quinolones.] Drugs in the quinolone family have been shown to block a detoxification pathway required by helminths for blood feeding, resulting in arrested development of L3 larvae and adversely affecting the reproductive capacity of adult worms both in vitro and in vivo. [http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006931] (NB. In 2018, the European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds, [https://www.medscape.com/viewarticle/903029] and, in 2019, fluoroquinolones were linked with heart problems. [https://www.sciencedaily.com/releases/2019/09/190910154710.htm])
</blockquote>

==== ✅ Antibiotics that appear ''not'' to affect hookworm benefits ====
<blockquote>

* [https://www.ace-pharm.nl/en/products/broxil/ Broxil] (feneticilline) is a narrow-spectrum antibiotic containing the penicillin derivative pheneticillin potassium. It is used to treat infections caused by Streptococci and certain species of Staphylococci, e.g., pharyngitis, pneumonia and skin and soft tissue infections such as impetigo or abscesses. One NA host has confirmed that a 5 day course of Broxil did not harm her colony. [https://www.facebook.com/groups/htsupport/posts/6533802496675650?comment_id=8769535843102293]

* [https://en.wikipedia.org/wiki/Mycophenolic_acid Mycophenolic acid] Also called mycophenolate mofetil (MMF, trade name CellCept) and mycophenolate sodium (trade name Myfortic), this antibiotic/immunosuppressant drug has broad-spectrum antiviral, antifungal and antibacterial properties, but has not been commercialised as an antibiotic due to its adverse effects. One hookworm host has taken CellCept (500mg x 3 per day), apparently without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1001001649955790/] [https://www.facebook.com/groups/htsupport/permalink/1978467308875881/?comment_id=1978498922206053&reply_comment_id=1979680825421196&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Rifaximin Rifaximin] (Xifaxan, Xifaxanta and Normix, etc.) This drug is poorly absorbed when taken by mouth and stays within the gastrointestinal tract, so is unlikely to affect NA, which feed directly on their host's blood, and will pass by TT while they are grazing on tissue secretions within the intestinal lining. The drug's lack of effect on NA was confirmed by one self-treater who took a 14 day course of the drug to treat SIBO and had no return of symptoms from his sinus condition, and only noticed a minimal effect on egg production by his worms. [https://helminthictherapywiki.org/wiki/Treating_SIBO_and_sinusitis_with_NA_and_TTO]

* [https://en.wikipedia.org/wiki/Roxithromycin Roxithromycin] A ten day course of this drug taken by one NA host appeared not to harm their colony. [https://www.facebook.com/groups/htsupport/posts/23875947818701182?comment_id=24167803662848928]

* [https://en.wikipedia.org/wiki/Trimethoprim Trimethoprim] (Alprim) Two hookworm hosts have reported continuing to enjoy full benefits from their worms after taking this drug to treat urinary tract infections. One took a 5 day course of 100mg Trimethoprim x2 per day, [https://www.facebook.com/groups/htsupport/posts/26349623291333610] whille the second took seven doses of 300mg. Another NA host has reported that, when used to treat UTIs, Alprim not only did not affect her hookworm colony, but did not even arrest the production of ova by her worms. [https://www.facebook.com/groups/htsupport/permalink/1009048252484463/] Also, when the [https://en.wikipedia.org/wiki/Trimethoprim/sulfamethoxazole Trimethoprim/sulfamethoxazole] combination drug, AA-Sulfatrim DS 800, was taken by a hookworm host for 10 days (160mg x2 per day), this had no effect on his NA colony and produced no gastrointestinal changes. (Private communication)
</blockquote>

==== Topical antibiotics ====
<blockquote>
: If applied to the skin, or used as eye drops, [https://en.wikipedia.org/wiki/Antibiotics Topical antibiotics] are unlikely to affect helminths in many cases. For example, four drops of 0.3% [https://www.medicines.org.uk/emc/product/836/smpc Ciloxan] ([https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin]) applied to each eye 3 times each day for 2 weeks had no effect on the colonies of two hookworm hosts, [https://www.facebook.com/groups/htsupport/permalink/874927972563159/?comment_id=875296599192963&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://en.wikipedia.org/wiki/Tobramycin tobramycin] eye drops applied 3 times each day for 2 days, and twice each day for the following 3 days, had no obvious ill effect on another hookworm colony. [https://www.facebook.com/groups/htsupport/posts/4810224872366763/]

:However, someone else has reported that, while 0.3% tobramycin appeared to have no adverse effect when applied to a stye, an ophthalmic suspension of neomycin and polymyxin B sulfates and dexsmethasone did have a mild adverse effect on her NA colony.

:{{Quote|indent}}I ran out of the abx eye drops tobramyacin .3% after 7 days (taking 3-4 times a day). And I had no issues with that. But they refilled it with “neomycin and polymyxin B sulfates and dexsmethasone ophthalmic suspension.” And it has stunned my buddies a bit... I’ve been taking it 3 times a day in one eye for 6 days. I started feeling off around day 4. [https://www.facebook.com/groups/htsupport/posts/10073095316079666?comment_id=10073376886051509&reply_comment_id=23872842805678350]{{Quote|/indent}}
</blockquote>

==== General discussion ====
<blockquote>
Short courses of most other antibiotics will typically only cause a temporary loss of benefit for between 2 and 8 weeks (e.g., ➿ [https://en.wikipedia.org/wiki/Erythromycin erythromycin] [https://www.facebook.com/groups/htsupport/permalink/770548519667772/]), although it is possible for efficacy to be reduced for longer, e.g., [https://www.facebook.com/groups/htsupport/permalink/1131267180262569/?comment_id=1134969589892328&comment_tracking=%7B%22tn%22:%22R%22%7D 4 months], and even [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=951430548246234&comment_tracking=%7B%22tn%22:%22R0%22%7D 6 months], and there is anecdotal evidence suggesting a correlation between the length of a course of antibiotics and the length of time that affected helminths are out of action. This might suggest that a single shot of antibiotic might have little or no effect on human helminths, as has been reported by one hookworm host, [https://www.facebook.com/groups/htsupport/permalink/3419833164739281?comment_id=3422186914503906] but the type of antibiotic used may be critical in this case, and some antibiotic drugs might adversely affect a helminth colony even when only a single injection is administered. This happened when one hookworm host was given a single, 1 gram shot of cefazolin. See [[#Cefazolin|Cefazolin]] for details.

It is possible that even a small dose of antibiotic could cause a return of symptoms in some people. For example, one hookworm host has reported experiencing a recurrence of significant disease symptoms after using 3 drops per day, for only 1½ days, of a solution containing [https://en.wikipedia.org/wiki/Tobramycin tobramycin] 3mg (0.3%).

In cases of dental infection that would routinely be treated by a course of an oral antibiotic, it might be possible to avoid the use of a drug if the dentist is able to use localised ozone injections. [https://www.facebook.com/groups/htsupport/permalink/1252700651452554/] [https://www.facebook.com/groups/htsupport/permalink/1518817608174189/?comment_id=1519018198154130&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

When it is essential to take oral antibiotics, the duration of their negative effect on hookworms can be significantly reduced - perhaps to as little as 2 weeks - by taking a small top-up dose of no more than 5 larvae after finishing the course of drugs. In most cases, this inoculation can be carried out 48 hours after the last dose of the drug, but it's worth asking a pharmacist exactly how long the prescribed drug will take to clear completely from the body. Different antibiotics have different biological half-lives. For example, erythromycin's half-life is only a couple of hours, whereas penicillin's can be up to 56 hours.

An alternative to taking a small top-up dose of NA would be to take 250-500 TSO. One NA host has reported that, without a helminth top-up, it usually takes her 4-6 weeks to come right after an infection. But, if she takes 500 TSO after completing the antibiotics, she recovers within about 10 days. [https://www.facebook.com/groups/htsupport/posts/7062445007144727/?comment_id=7065489936840234] In a later report, this same individual said that even taking just 250 TSO post-antibiotics will enable her to bounce back within a week or so. [https://www.facebook.com/groups/htsupport/posts/7897313170324569/?comment_id=7911601488895737] If ordered at the same time as the antibiotics are started, TSO will arrive in time to be taken after the course of the drug is completed. And, since TSO remain viable for a couple of years in a fridge, a small supply of them can be kept to hand.

It has been suggested that the reduction in the benefits derived from hosting human helminths that is seen after taking antibiotics might result, at least in part, from a loss from the gut microbiome of helpful bacterial species and
the proliferation of less beneficial ones. This suggestion, and the fact that taking probiotics alongside antibiotics has been claimed to help [http://www.sciencedaily.com/releases/2013/05/130530192404.htm offset the gastrointestinal symptoms] typically associated with these drugs, has led to the suggestion that the use of high doses (perhaps 5 or 10 times the normal dose) of good quality probiotics might help to reduce the time that helminths are out of action after using these drugs, especially if the probiotics are taken at a different time of day from the drug. And this effect has been reported by one individual. [https://www.facebook.com/groups/htsupport/permalink/1257052664350686/?comment_id=1257367554319197&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, also see [https://www.ngmedicine.com/taking-probiotics-with-antibiotics-revisited/ this article] which looks at the evidence on the use of probiotics alongside antibiotics, which is not all positive. Additional help in protecting the microbiome might be gained by supplementing with either butyrate [https://www.sciencedirect.com/science/article/pii/S2211124719303845] or charcoal [https://www.ncbi.nlm.nih.gov/pubmed/29186529] alongside an antibiotic. A fecal microbiota transplant (FMT) might also help to restore worm benefits more quickly following treatment with an antibiotic. [https://www.facebook.com/groups/htsupport/permalink/1149149175141036/?comment_id=1242073262515293&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

It is possible that the consumption of prebiotics such as galacto-oligosaccharides (GOS) may also help to restore the gut biome, since GOS has been shown to help [http://www.ncbi.nlm.nih.gov/pubmed/24925303 support the recovery of beneficial bifidobacteria] and increase the production of butyrate, after antibiotic treatment. GOS is available in the form of [https://gutsupp.com GutSupp Prebiotic Powder (formerly "Bimuno")]. Fructooligosaccharides (FOS) and xylooligosaccharides (XOS) may perform a similar function. [https://www.ncbi.nlm.nih.gov/pubmed/30113166] For more detail about the effects of a total loss of worms due to antibitoic use, and how to restore a colony, see [[Hookworm dosing and response#Colony collapse | '''Colony collapse''']].

In the case of someone needing to take antibiotics regularly, or on a long-term basis, there would be little point in them using hookworms until completely off these drugs. Some worm benefits may be maintained in users of the human whipworm, so long as doses of this organism are being taken regularly, every few weeks. Another solution for those who need to take antibiotics frequently, or for prolonged periods, would be to switch to TSO as these are less likely to be adversely affected by antibiotics. While ciprofloxacin is capable of blocking the action of TSO, other antibiotics just slow them down. [https://www.facebook.com/groups/htsupport/permalink/1343118199077465/?comment_id=1343598479029437&comment_tracking=%7B%22tn%22%3A%22R%22%7D] HDC may also be less susceptible to antibiotics than human helminths, although two users of HDC have reported that the antibiotic,
⚡ [https://en.wikipedia.org/wiki/Dapsone Dapsone] (diamino-diphenyl sulfone), causes a return of their disease symptoms.
</blockquote>

==== ➿ Antibiotics best avoided for other reasons ====
<blockquote>
Some antibiotics are best avoided for other reasons.

* [https://en.wikipedia.org/wiki/Fluoroquinolone Fluoroquinolone antibiotics] can be extremely dangerous [https://en.wikipedia.org/wiki/Quinolone_antibiotic#Adverse_effects] and can cause permanent nerve damage. [http://healthimpactnews.com/2013/warning-fluoroquinolone-antibiotics-may-cause-permanent-nerve-damage/] This group of drugs includes [https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin] (cipro), [https://en.wikipedia.org/wiki/Levaquin levofloxacin] (Levaquin, Tavanic, etc.) [https://en.wikipedia.org/wiki/Tequin gatifloxacin] (Gatiflo, Tequin and Zymar), [https://en.wikipedia.org/wiki/Gemifloxacin Gemifloxacin] (Factive), [https://en.wikipedia.org/wiki/Moxifloxacin Moxifloxacin] (Avelox, Vigamox, Moxeza, etc.), [https://en.wikipedia.org/wiki/Norfloxacin Norfloxacin] (Noroxin) and [https://en.wikipedia.org/wiki/Ofloxacin Ofloxacin] (Floxin, Ocuflox, etc.). The European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds in 2018. [https://www.medscape.com/viewarticle/903029]

* [https://en.wikipedia.org/wiki/Clarithromycin Clarithromycin] (Biaxin, etc.) has been shown to increase the risk of a fatal heart attack compared with penicillin V, especially in older people with existing cardiac risk factors, although no increased risk was seen with [https://en.wikipedia.org/wiki/Roxithromycin roxithromycin] [http://www.bmj.com/content/349/bmj.g4930]. Also see this [https://pubmed.ncbi.nlm.nih.gov/29155931/ later study].
</blockquote>

=== Anticoagulants [https://en.wikipedia.org/wiki/Anticoagulant] ===

==== ✅ Safe anticoagulants unless otherwise marked ====
<blockquote>
Anticoagulant medicines and herbs (which reduce the clotting ability of blood) do not harm helminths, but may prolong bleeding from the tiny feeding sites of hookworms, which, themselves, secrete minute amounts of anticoagulants to help their digestive process. Anticoagulant drugs include:
* [https://en.wikipedia.org/wiki/Warfarin warfarin]
* [https://en.wikipedia.org/wiki/Heparin heparin]
Other drugs that have an anticoagulant effect include
* [https://en.wikipedia.org/wiki/Aspirin aspirin] and products containing it, such as
** [https://en.wikipedia.org/wiki/Alka-Seltzer Alka-Seltzer]
** ❓ [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol].

Herbs with an anticoagulant effect include:
* [https://en.wikipedia.org/wiki/Ginkgo_biloba ginkgo biloba]

All of these compounds may prolong bleeding at hookworm feeding sites to some extent, so may potentially contribute to anaemia (anemia) in susceptible individuals, especially if several of these drugs/supplements are taken at the same time.
</blockquote>

=== Antidepressants ===

Some self-treaters use certain SSRIs alongside NA and TTO without any apparent problem, but, according to a 2018 Nature article, [https://www.nature.com/articles/s41598-017-18457-w] some SSRIs (setraline, paroxetine, and chlorpromazine) have such a powerful anthelmintic effect that the authors suggested these drugs could be used clinically as dewormers.

'''NB''' Anyone who wants to start helminthic therapy who is already taking one of the antidepressants that has a known anthelmintic effect should not stop taking the drug without first consulting their medical advisor. This is because, although helminths can eventually help in some cases of depression, the worms are unlikely to start to work immediately and may actually cause a brief initial worsening of this condition before beginning to provide relief. See [[Helminthic therapy and neuropsychiatric disorders#Depression | '''Helminthic therapy and neuropsychiatric disorders: Depression''']].

<blockquote>

* ✅ [https://en.wikipedia.org/wiki/Amitriptyline Amitriptyline] (Elavil, etc.) This tricyclic antidepressant has been taken by at least one hookworm host at 15 mg per day, without issue. [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085576868164924&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Citalopram Citalopram] (Celexa, Cipramil and [https://en.wikipedia.org/wiki/Citalopram#Brand_names numerous other names].) This selective serotonin reuptake inhibitor (SSRI) has been used by at least one hookworm host with no ill effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1994977397224872/?comment_id=1995274433861835&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Doxepin Doxepin] This tricyclic antidepressant and potent antihistamine has been marketed under many names, including Quitaxon, Aponal and Sinequan. One individual has taken Doxepin daily for several years while hosting hookworms, without noticing any adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682894431766505&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Duloxetine Duloxetine] (Cymbalta, etc.) This Serotonin–norepinephrine reuptake inhibitor (SNRI) was taken by one NA host for several years to treat generalised anxiety without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2056263424429602/?comment_id=2058009587588319&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Fluoxetine Fluoxetine] (Prozac, Sarafem, etc.) A study published in Nature reported that this selective serotonin reuptake inhibitor (SSRI) was harmful to the non-theraputic helminth species ''C. elegans'', [https://www.nature.com/articles/s41598-017-18457-w] but fluoxetine is being taken by at least two hookworm hosts without issue [https://www.facebook.com/groups/htsupport/permalink/1686522081403740/?comment_id=1687356354653646&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085350661520878&comment_tracking=%7B%22tn%22%3A%22R%22%7D].

* ❓ [https://en.wikipedia.org/wiki/Venlafaxine Venlafaxine] (Effexor, etc.) There have been no reports about this particular drug yet, but it is a serotonin-norepinephrine reuptake inhibitor (SNRI), and it is already known that duloxetine (Cymbalta, etc.), which is another SNRI, appears to be safe for use by hosts of human helminths.

* ❌ [https://en.wikipedia.org/wiki/Desvenlafaxine Desvenlafaxine] (Pristiq, Desfax, Ellefore, etc.) One hookworm host has reported that this drug wiped out his entire NA colony.

* ⚡ [https://en.wikipedia.org/wiki/Escitalopram Escitalopram] (Cipralex and Lexapro.) After taking "the smallest possible dose" of this selective serotonin reuptake inhibitor (SSRI) in the form of Lexapro for 4 weeks, one user found that she lost all the benefits previously conferred by NA, and even HDC benefits were dampened. [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=2155918287797448&comment_tracking=%7B%22tn%22%3A%22R%22%7D]. However, someone else who took Lexapro for the first 2.5 years that she hosted NA did not lose her colony as a result of this. She was already taking 30 mg per day when she first inoculated, and then lowered the dose to 20 mg 18 months later. This user does have to top up her colony with a dose of 10 NA every three months, but this level of attrition is not excessive and may not be due to the drug. [https://www.facebook.com/groups/htsupport/permalink/2301858276536781/?comment_id=2309854282403847&reply_comment_id=2311232908932651&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Others have reported taking Lexapro without any obvious adverse effect on their NA, e.g, [https://www.facebook.com/groups/htsupport/permalink/3640310742691521?comment_id=3640395312683064 this self-treater] and someone else who had hosted NA for 7 years and been taking Lexapro during this entire time (10mg for 5 years, then 5mg for 2 years, and finally 2.5mg once a week for 3 years [https://www.facebook.com/groups/htsupport/posts/2301858276536781/?comment_id=2309854282403847&reply_comment_id=4866244573431459]) and was never aware of this having any adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Paroxetine Paroxetine] (Aropax, Brisdelle, Deroxat, Paxil, Pexeva, Paxtine, Paxetin, Paroxat, Paraxyl, Sereupin, and Seroxat.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class, has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]

* ❓ [https://en.wikipedia.org/wiki/Sertraline Sertraline] (Sold under a very large number of trade names, [https://www.drugs.com/international/sertraline.html] including Zoloft.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class has shown anthelmintic effects against four widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694] However, someone who has taken doses of either 100 mg or 150 mg of Zoloft daily for 1.5 years has reported continuing benefits from his NA. [https://www.facebook.com/groups/htsupport/permalink/3054501617939106/]
</blockquote>

=== Antifungals [https://en.wikipedia.org/wiki/Antifungals] ===

==== ✅ Safe antifungals unless marked otherwise ====
<blockquote>
The following appear to be safe for use with human helminths
* [https://en.wikipedia.org/wiki/Fluconazole fluconazole] (Diflucan and Trican)
* [https://en.wikipedia.org/wiki/Nystatin nystatin] (Mycostatin, Nilstat, Nystop, etc.) This has been used for many years by one hookworm host without harming his worms. [https://www.facebook.com/groups/htsupport/permalink/1995854040470541/?comment_id=1996211143768164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
* the fatty acid [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid] also appears safe [https://www.facebook.com/groups/htsupport/permalink/935151783207444/?comment_id=935208789868410&comment_tracking=%7B%22tn%22:%22R%22%7D]. However, anyone with a coconut allergy/intolerance should note that ''caprylic acid'' is a coconut/palm kernel derivative.
* the enzyme-based anti-Candida product [https://en.wikipedia.org/wiki/Candex candex] is also worm-safe. One hookworm host took 4 ''Candex'' capsules twice a day for over a month without any obvious harm to his worms. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Chlorophyll Chlorophyll]. A chlorophyll-based solution has been found to be [https://www.researchgate.net/publication/43335937_Antimicrobial_activity_of_chlorophyll-based_solution_on_Candida_albicans_and_Enterococcus_faecalis effective against Candida albicans] and there have been no reports to suggest this might be harmful to helminths. (Also see❓[[#Chlorophyllin|Chlorophyllin]].)

* [http://www.ncbi.nlm.nih.gov/pubmed/23965638 Some probiotics] may help to control candida, especially [https://en.wikipedia.org/wiki/Saccharomyces_boulardii Saccharomyces boulardii], which significantly inhibits [http://www.ncbi.nlm.nih.gov/pubmed/20629753 adhesion by C. albicans], thus [http://www.ncbi.nlm.nih.gov/pubmed/19732158 preventing the formation of biofilms and filamentation], and it is as [http://www.ncbi.nlm.nih.gov/pubmed/23703468 effective as nystatin] in reducing fungal colonization and invasive fungal infection. '''S. boulardii''' has also been taken by at least two helminth hosts without any obvious effect on their worms. At least one strain of Lactobacillus acidophilus can reduce the population of Candida albicans in the gut microbiota. [https://www.ncbi.nlm.nih.gov/pubmed/29997616]

* [https://en.wikipedia.org/wiki/Sodium_butyrate Sodium butyrate] is a powerful antifungal that inhibits pathogenic yeast growth [http://jac.oxfordjournals.org/content/66/11/2573.long]. It is available as a food supplement and is also manufactured in the human intestines by the fermentation of vegetables. The bacteria responsible for butyrate production are vulnerable to antibiotics, but can be reintroduced, or supplemented, by means of [https://en.wikipedia.org/wiki/Fecal_bacteriotherapy fecal microbiota transplants] (FMT), or the addition of the butyrate-producing bacterial species, [https://en.wikipedia.org/wiki/Clostridium_butyricum clostridium butyricum], which generates butyrate directly in the gut. C. butyricum is available in Japan as the probiotic, Miyarisan Tablets, [https://www.facebook.com/photo.php?fbid=10152806891616155&set=p.10152806891616155&type=1&theater] which may sometimes be found online, including on eBay, and in the probiotic formulations, Bifilac and Bifilac HP. [http://www.indiamart.com/abpl/probiotic-dietary-supplements.html] C. butyricum is also available as an animal feed additive. [http://www.alibaba.com/product-detail/probiotic-clostridium-butyricum_1589202110.html] Nutrients that help to increase butyric acid concentrations in the colon include pectin [https://en.wikipedia.org/wiki/Pectin] and larch arabinogalactan [https://en.wikipedia.org/wiki/Arabinogalactan], which is available as a supplement, [https://uk.iherb.com/search?kw=arabinogalactan&cids=1855&rank=1&rawkw=arabinoglactan&refererLocation=suggestion] although arabinogalactan can worsen rheumatic conditions. [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797204570335500&offset=0&total_comments=1], [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797261090329848&offset=0&total_comments=3] When buying any butyrate supplement, it's important to check ''all'' the ingredients in each product. One NA host who took [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] likely because this product contains medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Ascorbic_acid Ascorbic acid] (vitamin C) may interfere with the yeast-to-hypha transition [http://www.ncbi.nlm.nih.gov/pubmed/25084864] of candida.

* [https://en.wikipedia.org/wiki/Apple_cider_vinegar Apple cider vinegar]. Only a single individual has ever reported believing that apple cider vinegar had an adverse effect on their hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616632618392677&reply_comment_id=2617255014997104] Since many other hookworm hosts drink apple cider vinegar without issue, [https://www.facebook.com/groups/htsupport/permalink/1516308765091740/?comment_id=1516658838390066&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] it can be considered to be worm-friendly. It has been revealed as a possible treatment for Candida species involved in denture stomatitis, [http://www.ncbi.nlm.nih.gov/pubmed/25219289] and there have been suggestions that, if ingested, vinegar might induce the body's gut defence system to help combat a Candida albicans infection. [http://www.sciencedaily.com/releases/2015/06/150608151952.htm] Advice on using apple cider vinegar as part of an anti-Candida treatment regimen can be found [http://www.onegreenplanet.org/natural-health/how-to-treat-chronic-yeast-overgrowth-with-apple-cider-vinegar/ here].

* [https://en.wikipedia.org/wiki/Iodine Iodine] appears to have antifungal properties, is worm-friendly, and has proved effective against Candida for one hookworm host.[https://gettinghealthiernow.wordpress.com/2014/11/29/iodine-protocol-destroying-candida/]

* [https://en.wikipedia.org/wiki/Vitamin_D Vitamin D] turns on genes that make antimicrobial peptides, including cathelicidin [https://en.wikipedia.org/wiki/Cathelicidin], which has been shown to kill Candida. However, dosage with this vitamin may be critical, and excessive amounts might be counter-productive [http://www.ncbi.nlm.nih.gov/pubmed/25612733]. Aiming for the optimum blood level [http://www.vitamindcouncil.org/about-vitamin-d/how-do-i-get-the-vitamin-d-my-body-needs/] of vitamin D would therefore appear to be ideal. (Vitamin D3 has been shown to extend the median lifespan of one species of roundworm by 30-40%. [http://www.vitamindcouncil.org/vitamin-d-news/new-research-finds-vitamin-d-extends-the-life-of-roundworms-08-2015/#])

* Some foods [http://www.thecandidadiet.com/candida-fighting-foods.htm], eaten in normal dietary amounts, may help support an anti-Candida programme, but see the separate notes on ⚡[[#Cayenne|cayenne]], ⚡[[#Coconut|coconut]] and ⚡[[#Ginger|ginger]]. Fresh ✅ garlic may be particularly helpful [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538912/], and dietary forms of garlic are known to be worm-safe, but see the details in the separate entry for [[#Garlic|garlic]].

* When Candida is a problem, very low carbohydrate (VLC) diets are best avoided because these cause ketosis, and yeasts love ketones.

* [https://en.wikipedia.org/wiki/Monolaurin Monolaurin] (also known as glycerol monolaurate, glyceryl laurate or 1-lauroyl-glycerol). Monolaurin is a monoglyceride - the mono-ester formed from glycerol and lauric acid. Shown in test tube studies to have antibacterial and antiviral activity, it is commonly used as a surfactant in cosmetics, including deodorants, and as an emulsifier in foods. While it is active against candida [http://www.ncbi.nlm.nih.gov/pubmed/20008774], one subject has reported that taking two teaspoons of monolaurin daily, for a few weeks, produced no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872137176175572&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872142719508351&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R4%22%7D] Another believes that she probably ingested a significant dose of monolaurin by drinking full fat coconut milk daily, but that her hookworms and whipworms both survived this. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] Others have also confirmed that monolaurin is worm-safe. [https://www.facebook.com/groups/htsupport/permalink/974642915924997/?comment_id=975547445834544&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1368090353246916/?comment_id=1369652509757367&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/posts/9279862498736289?comment_id=9280024828720056]

A very worm-friendly way to reduce Candida is to brush one's teeth after every meal instead of just once each day. This has been shown to reduce the abundance of C. albicans in the stool by 10-fold to 100-fold. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874442/] The addition of regular [https://wellnessmama.com/17951/coconut-oil-pulling/ oil pulling using coconut oil] (not to be swallowed) could further reduce the amount of candida. [https://www.facebook.com/groups/htsupport/permalink/1617823828273566/?comment_id=1618578738198075&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>

==== ❓ More antifungals ====

<blockquote>

* ❓ '''Cellular silver''' (see [[#AlternativeTherapies|Alternative therapies]] section). The manufacturers of Advanced Cellular Silver (ACS) 200 Extra Strength [http://www.resultsrna.com/products/acs_200_overview/] claim that this product achieves a 99.9989% kill against C. albicans. Although there have been no reports to date of its possible effect on human helminths, its similarity to ➿'''colloidal silver''' (see [[#AlternativeTherapies|Alternative therapies]] section) suggest that it may not kill the worms but only cause a temporary reduction of benefits.

* ❓ [https://en.wikipedia.org/wiki/Lactoferrin Lactoferrin] (also known as lactotransferrin [LTF]) is found naturally in secretory fluids, such as milk, saliva, tears and nasal secretions. It has antibacterial, antiviral, antifungal and antiparasitic properties, and is effective against candida. It’s antimicrobial properties are enhanced by the peptide, ❓[https://en.wikipedia.org/wiki/Lactoferricin lactoferricin], the anti fungal effects of which exceed those of lactoferrin. However, there have been no reports of any adverse effect on helminths, and one NA host has reported that taking 300mg of lactoferrin per day had no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/2116858295036781/]

* ❓ [https://en.wikipedia.org/wiki/Lavandula Lavender] has antifungal activity and may be of value in treating candida. [http://www.ncbi.nlm.nih.gov/pubmed/26550521]

* ❓ '''Propolis''' (see [[#NutritionalSupplements|Nutritional supplements]] section). Candida has been shown to be susceptible to propolis extract [http://www.ncbi.nlm.nih.gov/pubmed/26149083], and to red propolis alcoholic extract. [http://www.ncbi.nlm.nih.gov/pubmed/26154370]

* ❓ [https://en.wikipedia.org/wiki/Polygodial Polygodial], which has both antifungal and antimicrobial properties and is used as an insecticide, is an active constituent of
** ❓ [https://en.wikipedia.org/wiki/Tasmannia_stipitata Dorrigo pepper],
** ❓ [https://en.wikipedia.org/wiki/Tasmannia mountain pepper],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera horopito],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera_colorata mountain horopito],
** ❌ [https://en.wikipedia.org/wiki/Pseudowintera_colorata Kolorex],
** ❓ [https://en.wikipedia.org/wiki/Drimys_winteri canelo] (Drimys winteri, winter's bark)
** ❓ [https://en.wikipedia.org/wiki/Acmella_oleracea paracress] and
** ❓ [https://en.wikipedia.org/wiki/Persicaria_hydropiper water pepper].
Whilst polygodial has been shown to be effective against single-celled parasites such as protozoa, the only report so far that it might also have an adverse effect on helminths comes from a hookworm host who suspects that she killed her colony by taking '''Kolorex''', which contains a mixture of horopito and ⚡'''aniseed'''.

* ❓ [https://en.wikipedia.org/wiki/Undecylenic_acid Undecylenic Acid]. This is the common name for 10-Undecenoic Acid, which is used in the Thorne Research product, [https://www.thorne.com/products/dp/formula-sf722-reg Formula SF722]. It is a potent antifungal mono-unsaturated fatty acid extracted from coconut and the castor bean. It has been shown to be 11 times stronger than [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid], and is also claimed to have antiparasitic properties, although there have been no reports about this from hosts of therapeutic helminths.

* ⚡ [https://en.wikipedia.org/wiki/Curcumin Curcumin] inhibits candida [http://jac.oxfordjournals.org/content/63/2/337.long], even at low concentrations, but see the main entry below for [[#Turmeric|Turmeric/curcumin]] for further details.

* ❌ [https://en.wikipedia.org/wiki/Nigella_sativa Black cumin] (nigella sativa). Also known as blackseed, black seed, black caraway, fennel-flower, nutmeg flower, Roman coriander, kalonji and 'Love in the Mist'. Extracts of this herb have shown antifungal effects [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642442/] against different strains of Candida albicans, but it has also been used as an anthelmintic since ancient times. While one self-treater has reported that black cumin did not harm NA, HDC or TSO when he took them, [https://www.facebook.com/groups/htsupport/permalink/26499688856327052/] black cumin and its active component, thymoquinone, have nevertheless demonstrated anthelmintic activity against several nematode species, including Trichuris muris - a relative of the human whipworm, Trichuris trichiura - as well as two other human helminths: Ascaris lumbricoides and the blood fluke, Schistosoma mansoni. In India, today, nigella seeds are combined with various purgatives to help kill and expel intestinal parasites, and they have a synergistic effect with pharmaceutical anthelmintics. [https://www.ncbi.nlm.nih.gov/pubmed/30149818]

* ❌ [https://en.wikipedia.org/wiki/Gymnema_sylvestre Gymnema sylvestre] is effective against candida [http://www.k-state.edu/media/newsreleases/jun13/vediyappan91213.html], but hydroalcoholic extracts of this herb have been found to have anthelmintic activity against the Indian earthworm, Pheretima posthuma. [http://www.ijrap.net/admin/php/uploads/525_pdf.pdf] Even though the research worm, C. elegans, appears to be unaffected by gymnema [http://www.ncbi.nlm.nih.gov/pubmed/?term=gymnema+sylvestre+candida] and there are genetic similarities [http://www.ncbi.nlm.nih.gov/pubmed/11812491] between C. elegans and N. americanus, one helminth host suspects that gymnema was responsible for the loss of his hookworm colony.

* ❌ [https://en.wikipedia.org/wiki/Lufenuron Lufenuron] is a benzoylurea pesticide used on crops and in veterinary medicine (in flea control, heartworm treatments and other anthelmintic products). Its powerful anti-fungal effects may be due to its ability to inhibit the synthesis of chitin, which is unfortunately an important constituent of the mouthparts of the hookworm.

Some herbal antifungal products may adversely affect helminths, especially if they are in a concentrated form, so any herbal medicine that claims to have antifungal properties should be approached with caution.

Some foods are coated with edible films containing antifungal compounds such as ❓[https://en.wikipedia.org/wiki/Natamycin natamycin] (pimaricin) and ❌ '''oregano oil''' (see [[#Oregano|Oregano reference]])
but the quantities used in this application are probably insufficient to affect helminths, and there is no evidence [http://www.inchem.org/documents/jecfa/jecmono/v48je06.htm] to date that natamycin harms intestinal flora.

NB. Prolonged treatment with antifungal drugs can disrupt commensal fungal populations and cause an increase in
the severity of disease states, as seen in one study [http://www.ncbi.nlm.nih.gov/pubmed/27237365] in acute and chronic models of colitis and allergic airway
disease.
</blockquote>

=== Antihistamines ===

==== Antihistamines as marked ====

<blockquote>
* ✅ Worm-safe antihistamines are
** [https://en.wikipedia.org/wiki/Diphenhydramine diphenhydramine] -- most likely to cause drowsiness
** [https://en.wikipedia.org/wiki/Loratadine loratadine] (Claritin, Lorafix)
** [https://en.wikipedia.org/wiki/Fexofenadine fexofenadine] (Allegra, Fexidine, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo) -- least likely to cause drowsiness
* ✅ Most '''Benadryl-branded products''' sold in the '''US''' contain only diphenhydramine so are worm-safe, e.g.
** [http://www.benadryl.com/products/allergy/benadryl-ultratab-tablets Benadryl Allergy Ultratab Tablets]
** [http://www.benadryl.com/products/allergy/benadryl-liquid-gels Benadryl Allergy Dye-Free Liqui-gels]
** [http://www.benadryl.com/products/children-allergy/benadryl-allergy-liquid Children’s Benadryl Allergy Liquid]
* ⚡ except
** [https://www.benadryl.com/products/children-allergy/benadryl-allergy-and-sinus-liquid Childrens’ Benadryl Allergy Plus Congestion] which also contains ⚡ phenylephrine. (See [[#Phenylephrine|local reference]].)

'''Benadryl products''' sold in the '''UK''' all contain drugs with anthelmintic potential - either
* ⚡ cetirizine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-liquid-capsules Benadryl Allergy Liquid Release Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-one-day Benadryl One a Day Relief Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-aged-two-plus Benadryl Allergy Children’s (2+ years) 1mg/ml Oral Solution]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-children Benadryl Allergy Children’s 6+ 1mg/ml Oral Solution]
* ⚡ acrivastine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief-plus Benadryl Allergy Relief Plus Decongestant Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief Benadryl Allergy Relief Capsules]
* ❓ [https://en.wikipedia.org/wiki/Chlorphenamine Chlorphenamine] (chlorpheniramine, piriton) While we don’t yet have any confirmation of the effect on helminths of this first-generation antihistamine, it has been suggested by someone who has investigated this that it is unlikely to be harmful to worms.

* ✅ [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium, plus Gastrocrom and Intercron) This is a mast cell stabiliser which prevents the release of histamine from mast cells and is used to treat some allergic conditions. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Doxylamine Doxylamine] (Bendectin, Debendox, Diclectin, Diclegis, Dozile, Lenotan, Merbental, Restavit, Unisom, Valocordin-Doxylamine, Vicks Formula 44 and Vomentin, etc.) One hookworm host believes that an unexpected return of gut symptoms and dry skin may have been caused by taking a quarter of a tablet of this first-generation antihistamine every night for a couple of weeks. [https://www.facebook.com/groups/htsupport/permalink/927991007256855/?comment_id=1007272959328659&comment_tracking=%7B%22tn%22:%22R%22%7D] Another NA host believes that taking diclectin (doxylamine combined with pyridoxine) put her worms out of action until she stoped taking it. [https://www.facebook.com/groups/htsupport/permalink/2706737069382231/]

* ⚡ [https://en.wikipedia.org/wiki/Ketotifen Ketotifen] - This antihistamine and mast cell stabilizer, which has similar effects to cromoglicic acid (see separate listing), is sold under a large variety of trade names [https://www.drugs.com/international/ketotifen.html] that include Allerban, Allergan, Bentifen, Ketasma, Mastifen, Zaditen and Zylofen. In one study using the helminth, Trichinella spiralis, the addition of ketotifen resulted in a greater worm burden and worm size, [https://www.ncbi.nlm.nih.gov/pubmed/16886340] but in a small in vitro test, one hookworm self-treater found that exposing a sample of NA larvae to Naziden left them “a bit lethargic but alive” [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1041766029212685&comment_tracking=%7B%22tn%22:%22R8%22%7D] and they were still alive the next day. [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1042321262490495&comment_tracking=%7B%22tn%22:%22R3%22%7D] However, effects in vivo don’t always correspond with those observed in a petri dish, and ketotifen is a piperazine-related substance so it may have an adverse effect on human helminths in vivo in at least some users.

* ⚡ [https://en.wikipedia.org/wiki/Promethazine Promethazine] (Phenergan, Promethegan, Romergan, Fargan, Farganesse, Prothiazine, Avomine, Atosil, Receptozine, Lergigan, and, in the UK, Sominex). This does not appear to kill helminths, whether taken orally or by intramuscular injection, and one self-treater who needs to take oral Phenergan daily says that her NA are unaffected. [https://www.facebook.com/groups/htsupport/permalink/1597006987021917/?comment_id=1597396203649662&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another hookworm host has reported that this drug did reduce his worm benefits when it was taken orally.
</blockquote>

==== Piperazine related antihistamines ====
<blockquote>
Popular antihistamines derived from, or closely related to, the anthelmintic drug ❌ [https://en.wikipedia.org/wiki/Piperazine piperazine] (See the separate entry for [[#piperazine|piperazine]]).
These include:
* ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine)
* ⚡ [https://en.wikipedia.org/wiki/Levocetrizine_dihydrochloride levocetrizine] (Alcet, Allear, Curin, levcet, Seasonix, T-Day Syrup, Teczine, UVNIL, Vozet, Xaltec, Xozal, Xuzal, Xusal, Xyzal, Zilola, Zyxem)

* ⚡ [https://en.wikipedia.org/wiki/Phenylephrine phenylephrine] Some nasal decongestants and allergy medications contain this drug (e.g., products branded "Sudafed PE", but not those branded "Sudafed") so check the ingredients of the product you are considering using. While one hookworm host has reported using this drug without any adverse effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537715762951030] it does appear to have anthelmintic properties [http://www.ncbi.nlm.nih.gov/pubmed/6127426] and has been reported to have caused a brief return of disease symptoms in one hookworm host after a single dose.
* ⚡ [https://en.wikipedia.org/wiki/Desloratadine desloratadine] (NeoClarityn, Claramax, Clarinex, Larinex, Aerius, Dazit, Azomyr, Deselex and Delot)
* and possibly ⚡ [https://en.wikipedia.org/wiki/Acrivastine acrivastine] (Semprex-D in the US)

While some people have taken cetirizine, levocetirizine or desloratadine concurrently with helminthic therapy -
sometimes for very long periods - and had no loss of benefit from their worms (for example [https://www.facebook.com/groups/htsupport/permalink/892594554129834/?comment_id=892794274109862&offset=0&total_comments=16&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/893959107326712/?qa_ref=qd&comment_id=893959580659998&offset=0&total_comments=9&comment_tracking=%7B%22tn%22:%22R7%22%7D]), there
have been others who have suspected that these drugs have been responsible for adversely affecting or even killing their worms.

Less common antihistamines derived from, or related to ❌piperazine.
At the present time, there is no indication whether or not most of the following drugs could affect human helminths.
* ❓ [https://en.wikipedia.org/wiki/Buclizine buclizine]
* ❓ [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan)
* ❓ [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5)
* ✅/⚡ [https://en.wikipedia.org/wiki/Hydroxyzine Hydroxyzine] (Atarax, Vistaril, etc.) A parent has reported that her son’s NA were not harmed by taking this drug, but dose size and length of use in this case are not known. [https://www.facebook.com/groups/htsupport/2666963426692929/?comment_id=2667238819998723&reply_comment_id=2669051416484130&notif_id=1581006498061422&notif_t=group_comment_mention]
* ❓ [https://en.wikipedia.org/wiki/Cyclizine cyclizine]
* ❓ [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs)
* ⚡ [https://en.wikipedia.org/wiki/Dramamine dimenhydrinate] See [[#dimenhydrinate|dimenhydrinate reference]].
* ❓ [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
* ❓ [https://en.wikipedia.org/wiki/Bilastine bilastine] (Bilaxten) One NA host has reported that she had been taking bilastine on and off for 3 years - the same amount of time that she had been hosting NA - because she has found it to be very effective for her allergies, and, while the NA have sometimes seemed to be working during this time, they have mostly seemed not to be working all that well. However, she had been able to grow more NA consistently for 2 of the 3 years, thus confirming that she still had some worms, but, when she last reported her experience, she had stopped taking the Bilastine to see whether the NA work better in its absence. [https://www.facebook.com/groups/htsupport/posts/4820011088054808/?comment_id=4851343294921587]
</blockquote>

==== ✅ H2 antagonists are safe ====

<blockquote>
H2 antagonists are a separate class of drugs from '''proton-pump Inhibitors''' (see separate section).

The term, “antihistamine” is usually reserved for [https://en.wikipedia.org/wiki/H1_antagonist H1 antagonists] whose main therapeutic effect is mediated by
negative modulation of histamine receptors, but [https://en.wikipedia.org/wiki/H2_antagonist H2 histamine receptor antagonists] can also be considered to be a
type of antihistamine. H2 antagonists include
* [https://en.wikipedia.org/wiki/Ranitidine ranitidine] (Zantac) which works by blocking histamine and thus decreasing the amount of acid released by the cells of the stomach.
Other common H2 antagonists are
* [https://en.wikipedia.org/wiki/Cimetidine cimetidine] (Tagamet)
* [https://en.wikipedia.org/wiki/Famotidine famotidine] (Pepcid) One hookworm host used this drug successfully, without harm to his colony, for at least 2 months, starting with 20mg daily and titrating within a month to 3x20mg per day. [https://www.facebook.com/groups/htsupport/posts/5898386906883882?comment_id=5898568306865742&reply_comment_id=5900280486694524]
* [https://en.wikipedia.org/wiki/Nizatidine nizatidine] (Axid, Tazac).
</blockquote>

=== Antimalarials ===

<blockquote>
*⚡ [https://en.wikipedia.org/wiki/Chloroquine Chloroquine] A cross-epidemiological study of the effect of treatment for malaria in hookworm-endemic areas found that treated patients presented with reduced helminth egg burdens and worm-related pathology, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558454/] and a reduced hookworm egg count has also been reported in another set of subjects taking chloroquine. [https://pubmed.ncbi.nlm.nih.gov/9645872/]
*✅ [https://en.wikipedia.org/wiki/Hydroxychloroquine Hydroxychloroquine] (Plaquenil, etc.) There has been one tentative suggestion from a helminth self-treater that this antimalarial medication, ''might'' have harmed her hookworms, but several others have taken this drug without any adverse effect on their worms. One took Plaquenil for 5 years without harming his NA, [https://www.facebook.com/groups/htsupport/permalink/3000811316641470/?comment_id=3001544019901533] another takes 400 mg daily without any adverse effect on her hookworms, [https://www.facebook.com/groups/htsupport/posts/4823182771070973/?comment_id=4824165244306059] and two further subjects who have taken this drug, one of them in quite large quantities, had no issues with their worms. (Link expired)
No other antimalarial drug has been suspected by self-treaters of harming therapeutic helminths, including [https://en.wikipedia.org/wiki/Quinine Quinine].
</blockquote>

=== Antiprotozoals ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). This is one of three derivatives of ❌[https://en.wikipedia.org/wiki/Nitroimidazole nitroimidazole] that is used against anaerobic bacterial and parasitic, as well as protozoan, infections. One hookworm host has reported[https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] losing her colony to this drug, which should never be combined with [https://en.wikipedia.org/wiki/Mebendazole mebendazole] due a risk that, together, they may cause [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis], something about which many doctors and pharmacists may be unaware, especially in the US.
</blockquote>

=== Antipsychotics ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Chlorpromazine Chlorpromazine] (Thorazine and Largactil, etc.) This antipsychotic medication has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]
</blockquote>

=== Antivirals ===
<blockquote>
(Also see [[Human helminth care manual#Natural antivirals|'''Natural antivirals''']] for effective worm-safe antiviral treatments.)

* ✅ [https://en.wikipedia.org/wiki/Famciclovir Famciclovir] (Famvir) -- One hookworm host took Famciclovir (500mg) 3 times per day for many months without any noticeable effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/884990498223573/?comment_id=885041121551844&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir Nirmatrelvir / ritonavir] This co-packaged medication, which combines two protease inhibitors and is marketed as Paxlovid, is used as a treatment for Covid‑19. There have been no reports of it harming human helminths and one report that it did not harm one self-treater’s NA colony. [https://www.facebook.com/groups/htsupport/posts/6439043419484892/?comment_id=6439498362772731]

* ✅ [https://en.wikipedia.org/wiki/Valtrex Valaciclovir/valacyclovir] (Valtrex, Zelitrex) -- This antiviral drug was taken by one worm host for a week without any adverse effect on his hookworms or whipworms.

* ❌ Nitazoxanide (See separate entry under Anthelmintics)
</blockquote>

=== Immunoglobulin therapy (IVIG) ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Immunoglobulin_therapy Immunoglobulin therapy], also known as normal human immunoglobulin (NHIG) is compatible with helminthic therapy and has been used effectively in combination with TSO. There is no reason to think that it would harm human helminths.
</blockquote>

===Immunomodulatory drugs ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Janus_kinase_inhibitor Janus kinase inhibitors], also known as JAK inhibitor or jakinib (e.g., baricitinib, tofacitinib and upadacitinib [Rinvoq]) are immune modulating medications used in the treatment of some cancers, autoimmune and inflammatory diseases such as rheumatoid arthritis, and various skin conditions. There is no evidence indicating that these drugs might have an anthelmintic effect, [https://www.facebook.com/groups/htsupport/posts/8698182570237621?comment_id=8698286136893931&reply_comment_id=8702949483094263] and there have been no reports from self-treaters of any adverse effects on their worm colonies.
</blockquote>

=== Immunosuppressive drugs ===

<blockquote>
'''✅ Immunosuppressive drugs reported to be safe for use by hosts of human helminths are:'''
* [https://en.wikipedia.org/wiki/Cyclosporin ciclosporin] (cyclosporine, cyclosporin). See also [https://en.wikipedia.org/wiki/Cyclosporins cyclosporins].

* [https://en.wikipedia.org/wiki/Corticosteroid corticosteroids], including:
** [https://en.wikipedia.org/wiki/Prednisone prednisone] and its active metabolite, [https://en.wikipedia.org/wiki/Prednisolone prednisolone]
** [https://en.wikipedia.org/wiki/Fluticasone_propionate fluticasone propionate] Also known as Flixotide (inhalatory), Flixonase and Flonase (nasal). At least three NA hosts have used this drug without any obvious impact on their worms. [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707582379297710&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707720709283877&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707880315934583&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cyclophosphamide cyclophosphamide] (Sold as: Cytoxan, Lyophilized Cytoxan, Endoxan, Neosar, Procytox, Revimmune and Cycloblastin). This has been used repeatedly by one hookworm host who has reported that it had no adverse effect on her colony.

* the [https://en.wikipedia.org/wiki/Thiopurine thiopurines], [https://en.wikipedia.org/wiki/Azathioprine azathioprine] and [https://en.wikipedia.org/wiki/6-MP mercaptopurine]/6-MP (purinethol)

* the [https://en.wikipedia.org/wiki/TNF_inhibitor TNF inhibitors]
** [https://en.wikipedia.org/wiki/Infliximab infliximab] (Remicade)
** [https://en.wikipedia.org/wiki/Adalimumab adalimumab] (Humira)
** [https://en.wikipedia.org/wiki/Certolizumab_pegol certolizumab pegol] (Cimzia)
** [https://en.wikipedia.org/wiki/Golimumab golimumab] (Simponi)

* [https://en.wikipedia.org/wiki/Humanized_antibody humanized antibody drugs], e.g. [https://en.wikipedia.org/wiki/Omalizumab omalizumab] (Xolair)

* [https://en.wikipedia.org/wiki/Monoclonal_antibody%23.22Fully.22_human_monoclonal_antibodies humanized monoclonal antibody drugs] such as [https://en.wikipedia.org/wiki/Natalizumab natalizumab] (Tysabri)

* and [https://en.wikipedia.org/wiki/Fusion_protein recombinant fusion protein] drugs such as [https://en.wikipedia.org/wiki/Etanercept etanercept] (Enbrel)

It can be an advantage to be taking one of these drugs in the early stages of helminthic therapy because they can reduce, or even prevent, the transient side effects triggered by helminths, and their anti-inflammatory action can also help human helminths to become established. So anyone who is already taking one of these drugs should resist the temptation to stop taking it too soon after starting HT.

This applies particularly to subjects with Crohn's and other intestinal diseases, who tend to have a very vigorous immune response to helminths. Suddenly withdrawing a drug that has been keeping this response in check will likely cause a rebound effect that could result in a flare and, potentially, a loss of worms. This is explained in more detail [[Introduction to helminthic therapy#Combining helminthic therapy with drug treatments | '''here''']].
</blockquote>

=== Immunotherapy ===

<blockquote>
✅ [https://en.wikipedia.org/wiki/Allergen_immunotherapy Allergen immunotherapy] -- In the form of sublingual drops/tablets, subcutaneous injections, and [https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-shots-(immunotherapy) allergy “shots”],
this is safe to be used concurrently with helminthic therapy. In fact, many who have used the two therapies together have been very pleased with the combined effects.
</blockquote>

=== Laxatives ===
<blockquote>
Hookworms are usually able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep] using products such as polyethylene glycol (PEG), Macrogol, Colyte, Picosalax, Bisacodyl, phospho soda, sodium picosulfate, or sodium phosphate and/or magnesium citrate. Many hookworm hosts have used the standard colonoscopy bowel prep without any problems (e.g., [https://www.facebook.com/groups/htsupport/permalink/2313948658661076/?comment_id=2316622215060387&comment_tracking=%7B%22tn%22%3A%22R%22%7D]), and there has only been a single report claiming that colonoscopy prep had terminated a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2184696924919584/?comment_id=2184806188241991&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another NA host has reported that, while a colonoscopy prep didn't entirely wipe out his colony, it appeared to have weakened it because he found a much smaller number of larvae than usual when he next incubated. [https://www.facebook.com/groups/htsupport/permalink/6481648121891088/]

It is unlikely that laxatives would dislodge human whipworms once these are mature and embedded in the colonic mucosa, but laxatives could potentially flush them out before this, especially around 21-22 days post inoculation. It may therefore be best to avoid the use of laxatives around this time. After 28 days, human whipworms should not be affected at all.

Also see [[#Diarrhoea/diarrhea|'''Diarrhoea/diarrhea''']].
</blockquote>

=== [https://en.wikipedia.org/wiki/Muscle_relaxant Muscle relaxants] ===
<blockquote>
There is a theoretical risk that anything which relaxes a hookworm host may have a similar effect on their colony, especially NA, and that this might conceivably affect the ability of the worms to maintain their grip on the host’s mucosa, possibly resulting in their expulsion, although this effect would likely be dose-dependent.

Whipworms are much less likely than hookworms to be affected in this way, due to them not feeding directly from the bloodstream and the fact that they anchor themselves deeply into the colonic mucosa, so are not easily dislodged.

There have been two reports of possible adverse effects. In the first of these, a hookworm host suspected ❌ [https://en.wikipedia.org/wiki/Carisoprodol Carisoprodol] (Soma, Sanoma and Carisoma) of causing the loss of his hookworm population. In the second, ❌ [https://en.wikipedia.org/wiki/Cyclobenzaprine Cyclobenzaprine] (Flexeril, Amrix, etc.) was identified as the only likely cause of multiple failed attempts to incubate NA. [https://www.facebook.com/groups/htsupport/posts/24119753220987306/] However, both ✅ [https://en.wikipedia.org/wiki/Guaifenesin '''Guaifenesin'''] and a single night-time dose of 6 mg of [https://en.wikipedia.org/wiki/Tizanidine ✅ '''Tizanidine'''] [https://www.facebook.com/groups/htsupport/posts/4490377691018151/?comment_id=4490387587683828] appear to have been safe.
</blockquote>

=== [https://en.wikipedia.org/wiki/Analgesic Pain relievers (analgesics)] ===
<blockquote>
The following pain relief medications are all harmless to NA and TTO.

* ✅ [https://en.wikipedia.org/wiki/Nonsteroidal_anti-inflammatory_drug '''NSAIDs (nonsteroidal anti-inflammatory drugs''')]
: * [https://en.wikipedia.org/wiki/Aspirin Aspirin]
: * [https://en.wikipedia.org/wiki/Ibuprofen Ibuprofen]
: * [https://en.wikipedia.org/wiki/Diclofenac Diclofenac]
: * [https://en.wikipedia.org/wiki/Naproxen Naproxen]
* ✅ [https://en.wikipedia.org/wiki/Opioids '''Opioids''']
: * [https://en.wikipedia.org/wiki/Codeine Codeine]
: * [https://en.wikipedia.org/wiki/Fentanyl Fentanyl]
: * [https://en.wikipedia.org/wiki/Hydrocodone Hydrocodone]
: * [https://en.wikipedia.org/wiki/Oxycodone Oxycodone]
* ✅ [https://en.wikipedia.org/wiki/Paracetamol '''Paracetamol (acetaminophen)''']
* ✅ [https://en.wikipedia.org/wiki/Benzodiazepine '''Benzodiazepines'''] such as:
: * [https://en.wikipedia.org/wiki/Midazolam Midazolam] ([https://en.wikipedia.org/wiki/Versed Versed])
</blockquote>

=== Recreational drugs ===

==== ❌ Piperazine-based recreational drugs ====
<blockquote>
[http://www.tandfonline.com/doi/pdf/10.1080/13102818.2008.10817529 Piperazine-based recreational drugs] are a group of stimulant drugs with similar effects to ecstasy.
(See separate entry for details on [[#piperazine|piperazine]]) The main piperazine-derivatives that have been used for
recreational purposes include
* [https://en.wikipedia.org/wiki/Benzylpiperazine BZP] (Benzylpiperazine, A2, Frenzy, Nemesis)
* [https://en.wikipedia.org/wiki/Trifluoromethylphenylpiperazine TFMPP] (1-[3-(trifluoro-methyl) phenyl]piperazine)
* [https://en.wikipedia.org/wiki/Meta-Chlorophenylpiperazine mCPP] (meta-chlorophenylpiperazine, 1- [3-Chlorophenyl]-piperazine).
These drugs were frequently mixed with caffeine and a range of vitamins and binders to make party pills that were marketed as
“natural” or “herbal” highs, but were actually purely synthetic. Other piperazine-derived designer drugs include:
* '''AcBZP''' (4-Acetyl-1-benzylpiperazine, AceticBenzylPiperazine)
* [https://en.wikipedia.org/wiki/Methylbenzylpiperazine MBZP] (1-methyl-4-benzylpiperazine)
* [https://en.wikipedia.org/wiki/2C-B-BZP 2C-B-BZP] (4-Bromo-2,5-dimethoxy-1-benzylpiperazine) One user has reported that periodic use of 2C-B did not affect his colony of NA.
* [https://en.wikipedia.org/wiki/Dibenzylpiperazine DBZP] (1,4-Dibenzylpiperazine)
* [https://en.wikipedia.org/wiki/Methylenedioxybenzylpiperazine MDBZP] (3,4 Methylenedioxy-1-benzylpiperazine)
</blockquote>

==== ⚡ Yage (Ayahuasca) ====

<blockquote>
It has been opined that anything that enters the bloodstream and disorients a host has a potential to do the same to hookworms - since they feed on their host’s blood - and that, if the disorientation is excessive, it may cause the worms to lose their grip on the mucosa and possibly be flushed away from their home base in the small intestine, and be lost. Although the assumption that the worms will become inebriated by anything that inebriates their host has been questioned because the 'nervous system' of helminths is quite different from that of mammals, one recreational drug that might produce this effect and cause the loss of hookworms is the South American drug, yage, also known as ayahuasca, as well as by a number of other names. [https://en.wikipedia.org/wiki/Ayahuasca%23Nomenclature]

This psychedelic brew, which is concocted by combining a variety of plant materials, was used as part of S. American native religious rituals and, since being commercialised, has become much more mainstream. Available in Europe and N. America through "churches" set up for its import, this drug causes a deep and immersive hallucinogenic experience during a “trip” lasting 4-8 hours, or 12-18 hours if the subject is re-dosed, which is not uncommon.

"Its purgative properties are important (known as la purga or "the purge"). The intense vomiting and occasional diarrhea it induces can clear the body of worms and other tropical parasites [https://www.ncbi.nlm.nih.gov/pubmed/2656954] and harmala alkaloids themselves have been shown to be anthelmintic. [https://link.springer.com/article/10.1007%2FBF02860378] Thus, this action is twofold; a direct action on the parasites by these harmala alkaloids (particularly harmine in ayahuasca) works to kill the parasites, and parasites are expelled through the increased intestinal motility that is caused by these alkaloids." [https://en.wikipedia.org/wiki/Ayahuasca]

“Tropical plants used by South American natives produce an array of isoquinoline and tryptamine-related alkaloids that are not only hallucinogens, but powerful emetics with a wide range of other biological activities, in particular antimicrobial and anthelmintic properties… We propose that these alkaloid mixtures were initially discovered and developed by indigenous people for treatment of a variety of parasitic diseases and incorporated into religious ceremonies using psychoactivity as an effective dose marker.” [https://www.sciencedirect.com/science/article/pii/0378874182900538]

However, in spite of all this evidence for the antiparastic potential of ayahuasca, one hookworm host has noticed no apparent adverse effect on her worms as a result of taking part in more than 10 ayahuasca ceremonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523441614378445&reply_comment_id=2523573887698551] Another helminth host has confirmed anonymously that he was able to culture more NA from his colony after participating in 3 ceremonies in one year.
</blockquote>

==== ✅ Safe for human helminths unless marked ====

<blockquote>

* [https://en.wikipedia.org/wiki/Betel Betel leaves] -- The leaves of the Piper betle vine (part of the [https://en.wikipedia.org/wiki/Piperaceae Piperaceae] family, which includes pepper and ⚡kava) are used as a mild stimulant and are thought likely to be safe for human helminths, although there have been no reports from helminth hosts to confirm or contradict this.

* ❌ [https://en.wikipedia.org/wiki/Areca_nut betel nut] (or areca nut) seed of the areca palm (and also known as the areca nut palm, betel palm, Pinang palm and Indian nut) is often chewed wrapped in betel leaves - a combination known as [https://en.wikipedia.org/wiki/Paan paan] that is used for its stimulant and psychoactive effects. Betel nuts contain the anthelmintic [https://en.wikipedia.org/wiki/Arecoline arecoline] and have been used as a tapeworm remedy. Fresh betel nuts are also known to be used very effectively by Torres Straight Islanders as a treatment for all types of intestinal worm, and surveys have found that the betel chewers were almost all worm-free, while others weren't. (Prolonged use of the betel nut can create addiction and the World Health Organization classifies the betel nut as a carcinogen.)

* [https://en.wikipedia.org/wiki/Cannabis_(drug) Cannabis], [https://en.wikipedia.org/wiki/Cannabis_(drug)%23Marijuana marijuana] and [https://en.wikipedia.org/wiki/Hashish hashish] appear to be worm-friendly. A paper published in 2015 [https://www.ncbi.nlm.nih.gov/pubmed/26031406] showed that, in the group of hunter-gatherers studied, those who consume cannabis have a significantly lower rate of helminth infection, from which the researchers concluded that the Aka foragers must consume cannabis to kill parasites, even though the scientists admit that, while cannabis kills worms in a petri dish, it has not been shown to kill worms in animals. A different explanation for the correlation seen in this study could be that those individuals with the most worms feel less need to smoke cannabis, and this ties in with the experience of the many helminth hosts who have seen a reduction in anxiety while hosting worms. One host of both hookworms and human whipworms has confirmed the presence of eggs from both species after cannabis use, and another hookworm host who used 10 drops of hemp '''CBD''' ([https://en.wikipedia.org/wiki/Cannabidiol cannabidiol]) oil twice daily, plus a few drops of '''THC''' ([https://en.wikipedia.org/wiki/Tetrahydrocannabinol tetrahydrocannabinol]) oil to help with sleep, has reported that her hookworms were unaffected. [https://www.facebook.com/groups/htsupport/permalink/1037560152966606/?comment_id=1037577039631584&comment_tracking=%7B%22tn%22:%22R%22%7D] Someone else used '''CBD''' oil for several months and noticed no adverse effect on his hookworms, [https://www.facebook.com/groups/htsupport/permalink/1239928846063068/?comment_id=1240221499367136&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and this lack of any adverse effect has been confirmed by numerous other cannabis users. [https://www.facebook.com/groups/htsupport/permalink/1406977876024830/?comment_id=1407227059333245&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1059227607466527/?comment_id=1059279190794702&reply_comment_id=1407016112687673&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has even been shown that CBD extends the lifespan and arrests age-associated physiological decline in the research nematode, C. elegans, so may potentially be beneficial for the health of other helminths. [https://pubmed.ncbi.nlm.nih.gov/35445360/]

* [https://en.wikipedia.org/wiki/Cocaine Cocaine], in its pure, unadulterated state, could be added to this list of worm-safe drugs, but it is commonly adulterated with other substances that might harm helminths, particularly ❌ [https://en.wikipedia.org/wiki/Levamisole levamisole] which, according to one report, is the most popular bulking agent found in 73% of seized coke. [https://www.hotpress.com/sex-drugs/10-things-know-cocaine-specialists-guide-22803299]

* [https://en.wikipedia.org/wiki/Hypnotic Hypnotics] are generally worm-safe, e.g.
** '''propofol''' (see Anaesthetics section) is an ultrashort-acting sedative with amnesiac effects
** anything in the [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] class of drugs (e.g. [https://en.wikipedia.org/wiki/Valium valium])
** the short-acting nonbenzodiazepine hypnotic, [https://en.wikipedia.org/wiki/Zolpidem zolpidem] (e.g. Ambien [https://www.facebook.com/groups/htsupport/permalink/865157116873578/?comment_id=866638886725401&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D], Ambien CR, Intermezzo, Stilnox, Stilnoct, Sublinox, Hypnogen, Lunata, Zonadin, Sanval, Zolsana, Zolfresh)
** the [https://en.wikipedia.org/wiki/Narcotic_analgesic opioids] (e.g. [https://en.wikipedia.org/wiki/Codeine codeine], [https://en.wikipedia.org/wiki/Dextropropoxyphene dextropropoxyphene], [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], [https://en.wikipedia.org/wiki/Hydrocodone hydrocodone], [https://en.wikipedia.org/wiki/Oxycodone oxycodone], [https://en.wikipedia.org/wiki/Tramadol tramadol] and [https://en.wikipedia.org/wiki/Morphine morphine]), along with any of their synthetic or time release variants (e.g. [https://en.wikipedia.org/wiki/Fentanyl fentanyl / fentanil]); [https://www.facebook.com/groups/htsupport/permalink/1080879281968026/?comment_id=1081015631954391&reply_comment_id=1081726205216667&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓ [https://en.wikipedia.org/wiki/Mitragyna_speciosa Kratom] (aka kratum and ketum). [https://www.facebook.com/groups/htsupport/permalink/868935276495762/] [https://www.facebook.com/groups/htsupport/permalink/868935276495762/?comment_id=869019499820673&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D] Extracts and leaves of kratom are reported to have been used as intestinal deworming agents in Thailand, and the FDA has warned consumers not to use any products labeled as containing kratom. [http://www.medicalnewstoday.com/releases/304821.php] However, one human whipworm host has taken small doses without any apparent effect on his worms [https://www.facebook.com/groups/htsupport/permalink/1788272677895346/?comment_id=1796502977072316&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and a hookworm grower has reported no reduction in yield from his cultures after he took kratom.

* [https://en.wikipedia.org/wiki/Opium Opium] and [https://en.wikipedia.org/wiki/Heroin heroin] (aka diacetylmorphine, diamorphine and other names) appear to be worm-friendly.

Most other recreational drugs should be safe for use by helminth hosts, including '''tobacco''', '''nicotine''' and most forms of '''alcohol'''.

* ➿ [https://en.wikipedia.org/wiki/Alcoholic_beverage Alcohol] -- Normal social drinking should not have any adverse effect on helminths, however, alcohol acts as an antimicrobial, and substances produced by the death of gut bacteria can enter the bloodstream to cause inflammation and allergic reactions [https://www.facebook.com/groups/htsupport/permalink/3958483847540874/?comment_id=3958511057538153] which can temporarily make it appear as though therapeutic helminths have stopped working. Overindulgence in alcohol may therefore cause a temporary reduction in worm benefits in a dose-dependent manner. One individual who had successfully put his colitis and celiac disease into remission with NA has reported that, in spite of hosting the worms, drinking beer causes a return of colitis symptoms. Excessive consumption of alcohol that results in the user going into a coma due to alcohol poisoning may incur a greater risk to helminths.
** ❓ [https://en.wikipedia.org/wiki/Absinthe Absinthe] is one alcoholic drink that might present more of a risk, as it was traditionally made using herbs reported to have antiparasitic properties, including ❌'''wormwood'''. (See separate entry). However, the risk from absinthe has been questioned because it only contains the essential oil of wormwood, while the anthelmintic activity of this herb has been linked more to the bitter principles and the alkaloids, which are not included in absinthe.

* ❓ [https://en.wikipedia.org/wiki/MDMA MDMA] (ecstasy) -- As primarily a serotonin and dopamine agonist, this is thought unlikely to have much effect on helminths. However, serotonin agonism increases peristalsis, so using MDMA may not be a good idea until after the worms have attached to the intestinal mucosa. Once they are attached, the increased peristalsis alone would not dislodge them. One hookworm host has reported that he has twice rolled with MDMA and it didn't kill his worms. [https://www.facebook.com/groups/htsupport/permalink/2331685740220701/]

* [https://en.wikipedia.org/wiki/N,N-Dimethyltryptamine DMT] (N,N-Dimethyltryptamine or N,N-DMT) This psychedelic compound with powerful hallucinogenic effects has been reported by one user to be safe for use with NA.

* ❓ [https://en.wikipedia.org/wiki/LSD LSD] (Lysergic acid diethylamide) is unlikely to harm helminths, and there has been one report to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Myristicin Myristicin] -- This psychoactive drug, which is the traditional precursor for the psychedelic and empathogenic drug [https://en.wikipedia.org/wiki/MMDA_(drug) MMDA], is found in very small quantities in vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but this dietary intake is unlikely to be harmful to helminths. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

* ❓ [https://en.wikipedia.org/wiki/Peyote Peyote] (Lophophora williamsii) -- This cactus, which contains psychoactive alkaloids, including mescaline, is thought unlikely to harm helminths, but there have been no reports to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Psilocybin Psilocybin], a [https://en.wikipedia.org/wiki/Substituted_tryptamine substituted tryptamine], is a naturally occurring psychedelic compound produced by more than 200 species of mushroom. Although illegal in most countries/states, psilocybin is used for the self-treatment of cluster headaches and one hookworm host has reported using this compound for two months to treat severe migraines, without noticing any apparent effect on his worms. However, it is possible that higher doses of this hallucinogenic may disorient hookworms for long enough to cause their loss.

* [https://psychedelictimes.com/healing-tobacco-rape-tribal-snuff/ Rapé] (pronounced “ha-peh”) is a powerful snuff originally used by shamans in Brazil and Peru as part of medicinal rituals. This sacred tobacco has increased in popularity outside of the Amazon during the early twenty-first century for its medicinal properties, and two hookworm hosts have reported using rapé without adversely affecting their colonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523128767743063] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410]
</blockquote>

===Statins===
There is evidence that [https://en.wikipedia.org/wiki/Statin statins] can be directly toxic to at least some helminths at sufficiently high concentrations in vitro, with this type of drug being known to inhibit HMG‑CoA reductase, an enzyme essential to many helminths for a number of vital processes including glycosylation, energy metabolism and membrane homeostasis.

In Schistosoma mansoni, for example, multiple statins (including lovastatin and others) have been shown to kill both larval and adult worms in vitro in a concentration‑ and time‑dependent manner. Similarly, in cestodes (tapeworms), simvastatin and fluvastatin have inhibited parasite HMG‑CoA reductase to produce measurable anthelmintic effects in larvae such that statins have been suggested for possible repurposing as anthelmintics for use in controlling cestodes.

While there had been no published evidence by early 2026 that clinically used statin doses have harmed either NA or TTO in human hosts, these species do share extensive metabolic and regulatory machinery with other parasitic nematodes, so it is conceivable that typical human doses of statins might be harmful to these therapeutic worms, and one NA self-treater - a very experienced incubator of this species - reported, in Feb 2026, that taking [https://en.wikipedia.org/wiki/Atorvastatin atorvastatin] (Lipitor, etc.) resulted in the repeated failure of NA larvae to successfully colonise after she had incubated these herself and observed them to be active immediately before their application to her skin. The noticeable lack of the usual entry points indicated that these larvae, although active, were incapable of entering the skin.

===Vaccines===

Three helminth hosts have claimed that they may have lost their hookworms after receiving the ⚡ [https://en.wikipedia.org/wiki/Tetanus_vaccine tetanus vaccine], although others have had tetanus shots without any loss of worms, and several people receiving flu vaccination have reported that this had no effect on their hookworms. [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861706373885309&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861973877191892&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nothing has been reported in respect of other vaccines. Also see [[Helminthic therapy and vaccines | '''Helminthic therapy and vaccines''']].

== Miscellaneous pharmaceuticals and chemicals ==

<blockquote>
''' ✅ Safe for worms unless marked otherwise'''
* ❓ [https://en.wikipedia.org/wiki/Zovirax Aciclovir] (Cyclovir, Herpex, Acivir, Acivirax, Zovirax, Zoral, Xovir and Imavir). There have been no reported problems with this drug so far. See also the related drug, Valaciclovir/valacyclovir.

* ❌ [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) is a soil bacterium that has been engineered into food crops such as corn and rice to render them pest resistant, and residues of Bt-based insecticides have been found on fresh fruits and vegetables. [http://www.ncbi.nlm.nih.gov/pubmed/16672488] Cry5B, a pore-forming protein produced by Bt can kill intestinal worms and is highly effective against all hookworm species tested in all models [https://www.ncbi.nlm.nih.gov/pubmed/29772478]. It is also used as a natural insecticide on crops on some organic farms. However, the risk of therapeutic helminths being killed as a result of their hosts ingesting small amounts of the delta endotoxins produced by Bt is likely to be very low. When used as an insecticide, one of the many Bt strains available is selected for its specific toxicity against the target insect. The strains that produce toxins against nematodes are therefore unlikely to be used as agricultural insecticides. In addition to this, the toxins produced need to be ingested by the target organism to become active and, as proteins, they may be denatured by heat during cooking. [https://www.facebook.com/groups/htsupport/permalink/1270850719637547/?comment_id=1270971972958755&comment_tracking=%7B%22tn%22%3A%22R%22%7D] The probiotic bacterium, Bacillus subtilis, can also be engineered to express the Cry5B protein, a small dose of which has been shown to kill intestinal nematode parasites, achieving a 93 percent elimination of human hookworms in hamsters. [https://web.archive.org/web/20161005204559/https://www.asm.org/index.php/asm-newsroom2/journal-tipsheets/88-news-room/journal-tipsheets/91749-natural-pest-control-protein-effective-against-hookworm-a-billion-could-benefit], [http://www.ncbi.nlm.nih.gov/pubmed/23835175] Although researchers may be pursuing this development as a means of delivering anthelmintics via foods and food supplements, the strain of Bacillus subtilis currently used in probiotics that have been manufactured for human consumption is not known to have been modified in this way, and one hookworm host has reported that his worms were unaffected after eating a lot of natto (made using Bacillus subtilis) and taking the Bacillus subtilis-containing probiotic product, Megasporebiotic. [https://www.facebook.com/groups/htsupport/permalink/1084149894974298/?comment_id=1084177824971505&comment_tracking=%7B%22tn%22:%22R6%22%7D]

* [https://en.wikipedia.org/wiki/Baclofen Baclofen] (Kemstro, Lioresal, Liofen, Gablofen, Beklo and Baclosan) is a derivative of gamma-aminobutyric acid (GABA). One host who took 20-30mgs of baclofen daily reported no loss of worm benefits.

* ❌ [https://en.wikipedia.org/wiki/Barbiturate Barbiturates] have now largely been replaced in routine medical practice by ✅ [https://en.wikipedia.org/wiki/Benzodiazepines benzodiazepines], but they may still be encountered in general anaesthesia, for epilepsy, and in the treatment of acute migraines. These drugs depress the central nervous system, producing effects ranging from mild sedation to total anaesthesia, so, taken in sufficient quantity, they may disorient hookworms sufficiently to cause them to lose their grip on the intestinal mucosa and be flushed away from their feeding site.

* [https://en.wikipedia.org/wiki/Benzodiazepine Benzodiazepines] (BZD, benzos). There have been no reports of this type of drug having any adverse effect on helminths. The short-acting anti-anxiety drug, [https://en.wikipedia.org/wiki/Alprazolam alprazolam] (Xanax), was taken by one hookworm host (0.5 mg 3 or 4 times over the course of a month) without any apparent effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912671848788771&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912703545452268&offset=0&total_comments=4&comment_tracking=%7B%22tn%22:%22R%22%7D] Other self-treaters have found that [https://en.wikipedia.org/wiki/Clonazepam clonazepam] (Klonopin) [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912711478784808&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] and [https://en.wikipedia.org/wiki/Lormetazepam lormetazepam] are both worm-safe, as is [https://en.wikipedia.org/wiki/Lorazepam Lorazepam] (Ativan). [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=1099405830115371&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Bismuth_subsalicylate Bismuth subsalicylate] (pink bismuth, the active ingredient in various stomach-settling medications such as [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol] and Kaopectate) There has been one suggestion that bismuth may have a temporary adverse effect on human helminths, similar to that caused by local anaesthetics/anesthetics, but this has not been confirmed by others. Pepto-Bismol is [http://www.reyessyndrome.org/pdfs/medicationscontainingaspirin.pdf listed] as containing aspirin (acetylsalicylate) or an aspirin-like substance (see ✅ Anticoagulants section regarding this ingredient).

* [https://en.wikipedia.org/wiki/Bisphosphonate Bisphosphonates] This class of drugs appears to be harmless to human helminths. They are used to prevent the loss of bone density, and include [https://en.wikipedia.org/wiki/Zoledronic_acid zoledronic acid] (aka zoledronate, sold under brand names such as Reclast, Zometa, Zometa Concentrate and Aclasta). One NA host has had two infusions of Aclasta without issue. [https://www.facebook.com/groups/htsupport/posts/4932593710129878?comment_id=4934243383298244]

* ❓ [https://en.wikipedia.org/wiki/Calcium_channel_blocker Calcium channel blockers (CCBs)], also known as calcium channel antagonists or calcium antagonists. These medications, which disrupt the movement of calcium through calcium channels, and are commonly used to treat cardiovascular diseases including hypertension, have also shown activity against the non-therapeutic helminth, Schistosoma mansoni. And it has been suggested that the calcium blocking effect of these drugs might be exploited to enhance the effect of existing anthelmintic drugs, or to produce new ones. [https://www.ncbi.nlm.nih.gov/pubmed/30420417] While there have been no reports thus far of therapeutic helminths being affected by calcium channel blockers, this remains a theoretical possibility.

* [https://en.wikipedia.org/wiki/Tegretol Carbamazepine] (Tegretol, Equetro). This appears to be worm-safe. One host who took this for two weeks was still producing ample hookworm ova at the end of this period.

* [https://en.wikipedia.org/wiki/Chlorine Chlorine]. As a constituent of chlorinated water, e.g., municipal water supplies and at swimming baths, this is no threat to helminths.

* ❓[https://en.wikipedia.org/wiki/Chlorine_dioxide Chlorine dioxide] (CD, also known as MMS, CDS, CDH) is an industrial disinfectant and bleach that is used in water purification and detoxification. CD has been taken orally by people who claim that it kills parasites, and that "rope worms" are often released during CD enemas. However, when these rope-like forms have been analysed, they have been found to contain mostly human DNA, so are likely to be merely pieces of gut lining.

* [https://en.wikipedia.org/wiki/Colestyramine Colestyramine/ cholestyramin] (Trade names: Questran, Questran Light, Cholybar, Olestyr, Quantalan and Vasosan.) One self-treater has reported that this bile acid sequestrant did not harm his NA colony or his HDC. [https://www.facebook.com/groups/htsupport/posts/9602012923187910/?comment_id=9603513203037882]

* [http://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=36f623df-2ae3-4858-9783-c058097951f4&type=display Cortifoam], a hydrocortisone rectal aerosol, uses propane and isobutane as propellants, neither of which is known to have any adverse effect on helminths.

* [https://en.wikipedia.org/wiki/COX-2_inhibitors COX-2 inhibitors], e.g., [https://en.wikipedia.org/w/index.php?title=Celecoxib&redirect=no celecoxib] (Celebrex), are safe for use with helminths.

* [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium) is a mast cell stabiliser with anti-allergy effects. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Doxazosin Doxazosin] Sold under brand names such as Cardura and Carduran, this antihypertensive medication has been found to have anthelmintic properties. [https://www.mdpi.com/1424-8247/14/7/686] One hookworm self-treater had indications over a three year period that he had lost his NA colony: reappearance of pre-hookworm symptoms, eosinophil count down to "normal" and inability to incubate more larvae. Repeated re-inoculations with viable larvae failed to restore his colony, and he eventually realised that the loss of the worms had coincided with the change in antihypertensive medication, to the alpha-blocker, doxazocin. [https://www.facebook.com/groups/htsupport/posts/7047958951926666/]

* ❓ [https://en.wikipedia.org/wiki/2,3-Dimercapto-1-propanesulfonic_acid DMPS] (Dimercapto-propane sulfonate/2,3-Dimercapto-1-propanesulfonic acid) and its sodium salt, Unithiol. There have been no reports so far about possible anthelmintic effects following the use of this drug, but there do appear to be some [https://www.ncbi.nlm.nih.gov/pubmed/18568806 serious risks attached to its use].

* [https://en.wikipedia.org/wiki/Dimercaptosuccinic_acid DMSA] (Dimercaptosuccinic acid, also called succimer). The meso isomer form of this organosulfur compound is used as a chelating agent for the treatment of heavy metal toxicity. One hookworm host has taken 25 mg DMSA every 3 hours around the clock for 5 days, and repeated this every 3 weeks for a year without harming her hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=991229547599667&comment_tracking=%7B%22tn%22:%22R0%22%7D] DMSA is apparently such an effective chelator that it may deplete levels of beneficial minerals, so should arguably be used under the guidance of a practitioner. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860226537366636&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* [https://en.wikipedia.org/wiki/Dimethyl_sulfoxide DMSO] (Dimethyl sulfoxide) has been used by two hookworm hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Ethylenediaminetetraacetic_acid EDTA] (Ethylenediaminetetraacetic acid). This heavy metal chelator was taken by one NA host as a single large dose for a provoked urine test. He then took it occasionally after this, but never saw any negative effects whatsoever on his NA. [https://www.facebook.com/groups/htsupport/posts/9163602600362280?comment_id=9165019336887273]

* [https://en.wikipedia.org/wiki/Essential_oil Essential oils]. These are also known as volatile oils, ethereal oils, aetherolea, or simply as the oil of the plant from which they were extracted. Certain essential oils contain some of the most potent antimicrobial compounds available and can be considered to be [http://www.theatlantic.com/health/archive/2015/01/the-new-antibiotics-might-be-essential-oils/384247/ natural antibiotics]. For example ❌'''oregano oil''' (see [[#Oregano|Oregano reference]]) and ⚡'''peppermint oil''' (see [[#Peppermint|Peppermint reference]]) can affect human helminths if ingested. However, small quantities of most essential oils should be safe for helminths when applied topically, since not all of the oil applied will reach the bloodstream. And when essential oils are diffused into the air using a nebuliser, heated over a candle flame or burned, these should not harm helminths, even when using blends containing oregano or peppermint oil. [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=808058079250149&offset=0&total_comments=3] [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=809316062457684&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] However, one hookworm host lost most of her colony when she walked into a room where a diffuser had been left running after a child had emptied an entire bottle of peppermint essential oil into it. She only took one breath in the room before leaving, but her home incubations fell from 25-35 larvae per droplet to just 1 larva per 3 droplets. And, many months and 3 inoculations later, she was still only getting 7-8 larvae per droplet. This inhalation of diffused peppermint oil also caused blistering burns to her face, nostrils and lungs, and did significant damage to her gut microbiome. [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&reply_comment_id=2018765664846045&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Gamma-Aminobutyric_acid GABA] (gamma-aminobutyric acid). It has been reported [http://www.livestrong.com/article/216236-medications-to-treat-human-worms/] that the anthelmintic drug, ivermectin, causes paralysis in worms by increasing GABA, and a hookworm host has mentioned that she “used to do really well with GABA, but worms don't like it.” On the other hand, a child with Type 1 diabetes was given GABA (750mg x4 per day) alongside hookworm therapy without any indication that the worms were affected by this, and another hookworm host who took 20-30mgs per day of ✅'''baclofen''' (a derivative of GABA) reported no loss of worm benefits.

* ⚡ [https://en.wikipedia.org/wiki/Gabapentin Gabapentin] (Neurontin). One hookworm host has taken this without any obvious adverse effect on her colony (link expired), and another has said that she was down from 1200mg to 600mg of gabapentin per day when she first discovered helminths and was never aware of it affecting her worms. [https://www.facebook.com/groups/htsupport/posts/6576693235719909/?comment_id=6576715005717732&reply_comment_id=6576844752371424] However, two other people have reported adverse effects on their colonies. One said that she had little benefit from her NA while she was taking gabapentin (mostly about 300 mg per day, but sometime 600 mg). The other said that single doses as low as 150mg "severely upset" his NA, and that taking 3 doses in a row caused a complete loss of benefits for 4-5 days. [https://www.facebook.com/groups/htsupport/permalink/2926164447439491/]

* ❌ [https://en.wikipedia.org/wiki/Genistein Genistein] is an isoflavone (phytoestrogen) with antioxidant and anthelmintic properties that has been found to be the main substance responsible for the deworming activity of the root-tuber peel extract of Felmingia vestita, the plant traditionally used as an anthelmintic by the Khasi tribes of India. Genistein is a potent cestocide, being highly effective against several species of tapeworm, as well as a pork trematode and a sheep liver fluke. (See also: [https://www.ncbi.nlm.nih.gov/pubmed/29844617]) Given the strength of its effect against these other helminths, it is reasonable to assume that concentrated or synthesised forms of genistein (such as KBU2046 and B43-genistein) may also harm or even kill therapeutic human helminths, although there is no evidence that eating soy products might be harmful to human helminths as a result of the naturally occurring genistein they contain.

* ❓[https://en.wikipedia.org/wiki/Glucagon-like_peptide-1_receptor_agonist Glucagon-like peptide-1 receptor agonists], also known as GLP-1 receptor agonists (GLP-1-RA) or incretin mimetics, e.g., [https://en.wikipedia.org/wiki/Exenatide exenatide] (Byetta, Bydureon), [https://en.wikipedia.org/wiki/Liraglutide liraglutide] (Victoza, Saxenda), [https://en.wikipedia.org/wiki/Lixisenatide lixisenatide] (Lyxumia, Adlyxin), [https://en.wikipedia.org/wiki/Albiglutide albiglutide] (Tanzeum), [https://en.wikipedia.org/wiki/Dulaglutide dulaglutide] (Trulicity), [https://en.wikipedia.org/wiki/Semaglutide semaglutide] (Ozempic, Rybelsus, Wegovy) and [https://en.wikipedia.org/wiki/Tirzepatide tirzepatide] (Mounjaro). This type of drug, which is used to treat diabetes and obesity, has shown anthelmintic effects and has been proposed as a potential anthelmintic agent against Trichuris trichiura. [https://eprints.lancs.ac.uk/id/eprint/171826/1/2022DooleyMRes.pdf] However, no reports of any adverse effects have been posted by helminth hosts.

* [https://en.wikipedia.org/wiki/Guaifenesin Guaifenesin]. This oral expectorant and muscle relaxant is sold under various brand names, including Mucinex, and is added to many other medicines. There have been no reports of this drug having any ill effect on helminths, and one hookworm host has reported that he regularly takes between 2 and 6 x 400 mg guaifenesin tablets to treat congestion, without any apparent effect on his worms. Another NA user reports continuing to use high doses without issue. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Helium Helium] appears to be worm-safe, based on the experience of one hookworm host who deliberately inhaled a small volume of the gas (to enjoy the timbre-changing effect on his voice!) while blowing up balloons, and had no loss of effect from his worm colony.

* Hydrogen therapy. One NA host has reported that inhaling hydrogen gas and drinking hydrogen-infused water has not harmed his colony. (Link expired.)

* [https://en.wikipedia.org/wiki/Hydrogen_peroxide Hydrogen peroxide] (H2O2). This may kill helminths in a petri dish but it is so highly reactive that, if ingested, there is likely to be little left by the time it reaches the stomach. And, when inhaled, H2O2 stays largely within the lungs, with only a small amount reaching the blood. Since the amount that could be transmitted to helminths is therefore negligible, it is thought unlikely that H2O2 would be a problem for any intestinal helminth, although no one has reported on this, one way or the other.

*❓Hyoscyamine [https://en.wikipedia.org/wiki/Hyoscyamine]. (Also known as daturine and levo-atropine. Brand names include Symax, HyoMax, Anaspaz, Egazil, Buwecon, Cystospaz, Levsin, Levbid, Levsinex, Donnamar, NuLev, Spacol T/S and Neoquess.) It has been suggested that hyoscyamine is unlikely to be harmful helminths, [https://www.facebook.com/groups/htsupport/permalink/1459052987483985/?comment_id=1459076817481602&reply_comment_id=1459213767467907&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Iodine Iodine]. This appears not to have any anthelmintic effect in the case of [http://link.springer.com/article/10.1007/BF02356443?no-access=true some species of roundworm and lungworm] and no reports of adverse effects have been posted by helminth hosts who are taking iodine supplements.

* ❓ [https://en.wikipedia.org/wiki/Isotretinoin Isotretinoin] (13-cis retinoic acid, Roaccutane, Accutane, Amnesteem, Claravis, Absorica, Isotroin and Epuris) is used to treat acne and other skin conditions. Although there have been no reports of harm to helminths as a result of taking this drug, anyone considering its use might appreciate knowing that it has been linked to autoimmune disease, which is of course what many readers of this website are already dealing with. The link is controversial, but this paper [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110532/] sets out the facts.

* [https://en.wikipedia.org/wiki/Ketamine Ketamine] There have been no reports to suggest that ketamine might be harmful to human helminths, and one NA host has reported that an incubation following four 200 mg doses of this drug had yielded a bumper crop of larvae, confirming that the drug had had no adverse effect on her colony.

* [https://en.wikipedia.org/wiki/Lactulose Lactulose]. This synthetic, non-digestible sugar used in the treatment of chronic constipation and as a test for small intestine bacterial overgrowth (SIBO) has not been reported to have any untoward effects on human helminths.

* ❌ [https://en.wikipedia.org/wiki/Limonene Limonene] This has been shown to have a comparable anthelmintic effect against adult Schistosoma mansoni as the common anthelmintic drug, praziquantel, [https://pubmed.ncbi.nlm.nih.gov/23408270] (Praziquantel has a 23% cure rate in hookworms. [https://pubmed.ncbi.nlm.nih.gov/29153938]) and one hookworm host has reported experiencing a return of disease symptoms after taking 500 mg of limonene daily for a week. [https://www.facebook.com/groups/htsupport/permalink/2673526096036662/]

* [https://en.wikipedia.org/wiki/Loperamide Loperamide] (Immodium, Lopex, etc.) This drug has been taken by numerous worm hosts and there have been no reports of it harming their worms.

* [[Wikipedia:Low-dose naltrexone|Low dose naltrexone]] (LDN). This is compatible with helminthic therapy and several people have had good results from this combination, although the drug doesn’t suit everyone. More details [https://www.helminthictherapywiki.org/wiki/Helminthic_therapy_and_low-dose_naltrexone_(LDN) here].

* [https://en.wikipedia.org/wiki/Lisdexamfetamine Lisdexamfetamine / L-lysine-dextroamphetamine] (Tyvense, Elvanse, Aduvanz, Venvanse, Vyvanse) is used to treat ADHD and binge eating disorder. One hookworm host took vyvanse for several weeks without noticing any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1462105477178736/?comment_id=1462409000481717&reply_comment_id=1729076717148276&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Mepacrine Mepacrine] (quinacrine [Atabrine]). This is an antiprotozoal drug that has also been used against tapeworms, so it could harm hookworms and whipworms. No one has so far reported any problem with it, but it's likely that few, if any, helminth hosts will have taken it, especially as, "Mepacrine is not the drug of choice because side effects are common, including toxic psychosis, and may cause permanent damage."

* ❓ [https://en.wikipedia.org/wiki/Metformin Metformin] [Glucophage], [https://en.wikipedia.org/wiki/Phenformin phenformin], and [https://en.wikipedia.org/wiki/Rosiglitazone rosiglitazone] [Avandia] are [https://en.wikipedia.org/wiki/Anti-diabetic_medication anti-diabetic medications] (also known as oral hypoglycemic or antihyperglycemic agents) that have been shown to have antibiotic properties [http://www.cysonline.org/article.asp?issn=2229-5186;year=2011;volume=2;issue=4;spage=219;epage=221;aulast=Dash], so might therefore have some degree of anthelmintic effect when used in higher doses. However one NA host has been reported to have taken it with no apparent adverse effects on her worms. [https://www.facebook.com/groups/htsupport/posts/8167008430021707?comment_id=8167027486686468].

* ⚡ [https://en.wikipedia.org/wiki/Methotrexate Methotrexate]. Some people have taken methotrexate alongside HT without any problem, including one NA host who combined these two treatments for 1½ years, taking up to 15 mg methotrexate per day. [https://www.facebook.com/groups/htsupport/permalink/1262248410497778/?comment_id=1262259710496648&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1530311280358155/?comment_id=1530363560352927&reply_comment_id=1531077360281547&comment_tracking=%7B%22tn%22%3A%22R5%22%7D] However, one individual got no benefit from his hookworms for over a year, while he was taking this drug.

* ❓ [https://en.wikipedia.org/wiki/Methylene_blue Methylene blue] Only one self-treater has reported using this substance while hosting NA, apparently taking it every day for about a year without causing any problems for her worms. [https://www.facebook.com/groups/htsupport/permalink/9484774994911704/]

* [https://en.wikipedia.org/wiki/Methylphenidate Methylphenidate] (Ritalin, Concerta, etc.) This doesn’t harm NA (or HDC). [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5659285877460654&reply_comment_id=5659339337455308] [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5660377274018181]

* [https://en.wikipedia.org/wiki/Montelukast Montelukast] (Singulair, Montelo-10, Monteflo, Lukotas, Arokast and Pulmikast). This leukotriene receptor antagonist has been taken intermittently, in 10 mg doses, by one hookworm host with no apparent effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904760852913204&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904793842909905&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R%22%7D] and regularly by another. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1683751361680812&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug Non-steroidal anti-inflammatory drugs] (NSAIDS, NSAIAs or NSAIMs) e.g: [https://en.wikipedia.org/wiki/Aspirin aspirin], [https://en.wikipedia.org/wiki/Diclofenac diclofenac] (sold under many trade names [https://en.wikipedia.org/wiki/Diclofenac%23Trade_names]), [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] and [https://en.wikipedia.org/wiki/Naproxen naproxen], are safe for use with helminths, but see Anticoagulants section regarding aspirin.

* ❓ [https://en.wikipedia.org/wiki/Nintedanib Nintedanib] (Ofev and Vargatef) is a piperazine drug (piperazine is an anthelmintic), so *may* have a harmful effect on NA, and to a lesser extent on TT. Unfortunately, there have been no reports about this drug, although the absence of any previous mention of it is a hopeful indication.

* [https://en.wikipedia.org/wiki/Oxymetazoline Oxymetazoline] (Ocuclear and Drixine) This drug is available over-the-counter as a topical decongestant in the form of oxymetazoline hydrochloride in nasal sprays such as Afrin, Dimetapp, Dristan, Drixoral, Facimin, Mucinex Full Force, Nasivin, Nostrilla, Operil, Otrivin, Otrivine, Oxyspray, SinuFrin, Sudafed OM, Utabon, Vicks Sinex and Zicam. At least one NA host has used these sprays without any harm being caused to his worms.

* ❓ [https://en.wikipedia.org/wiki/Ozone Ozone]. [https://en.wikipedia.org/wiki/Ozone_therapy Ozone therapy] is used as an alternative treatment for various diseases in humans but is still controversial. Ozone is also used to kill microorganisms, in some instances being employed in place of chlorine as a bactericide. It is also used to eradicate water borne parasites such as Giardia lamblia and Cryptosporidium, and to kill insects in stored grain. So there would appear to be a potential for ozone to have an adverse effect on human helminths, although this may depend on dosage and there have been no reports to date of the use of ozone by helminth hosts, so caution would seem to be warranted until more is known.

* [https://en.wikipedia.org/wiki/Acetaminophen Paracetamol] (Called acetaminophen in the US, and also sold under the names tylenol, panadol, etc.) This is safe for use while hosting helminths, but is associated with autism when given to children under 5 years old. [https://pmc.ncbi.nlm.nih.gov/articles/PMC10814214/]

* ❌ [https://en.wikipedia.org/wiki/Pentobarbital Pentobarbital] (US), pentobarbitone (UK), e.g., Nembutal, is a short-acting '''barbiturate''' that has been used as a sleep aid, as well as to euthanise animals and to execute humans. It’s possible that the dosages used to encourage sleep might not have any deleterious effect on human helminths, but, if this drug were to disorientate hookworms, they could lose their grip on the intestinal mucosa and be flushed away. So far, there have been no reports about this drug from any helminth host, although few, if any, will have taken it.

* [https://en.wikipedia.org/wiki/Permethrin Permethrin] Permethrin is an insecticide that causes paralysis and death in insects and arachnids by disrupting sodium channels in the creatures’ nervous systems. However, voltage‑gated sodium channels are much less abundant in hookworms and, for this reason, permethrin is unlikely to pose any risk to NA. [https://www.facebook.com/groups/htsupport/posts/24419855167643775/]

* ⚡ [https://en.wikipedia.org/wiki/Piracetam Piracetam]. This nootropic, cognition- and memory-enhancing drug (Nootropil, Qropi, Myocalm, Dinagen) was suspected as the cause in one case of sudden worm loss.

* ❓ [https://en.wikipedia.org/wiki/Pregabalin Pregabalin] (Lyrica) is a gabapentinoid drug about which the only report so far has been from someone who who had taken 3 doses of 25mg Lyrica daily for several weeks, with no issues for her NA. [https://www.facebook.com/groups/htsupport/posts/4589806321075287/?comment_id=4590199551035964&reply_comment_id=4812188858837031]

* [https://en.wikipedia.org/wiki/Proton-pump_inhibitor Proton-pump inhibitors] (PPIs), including [https://en.wikipedia.org/wiki/Omeprazole omeprazole] (e.g., Losec) and [https://en.wikipedia.org/wiki/Lansoprazole lansoprazole] (e.g., Prevacid). These gastric acid inhibiting drugs appear not to be harmful to helminths, but they may kill 4% of patients who take them. [https://www.ncbi.nlm.nih.gov/pubmed/31147311]

* ❌ [https://en.wikipedia.org/wiki/Prucalopride Prucalopride] (DuphaPro, Prudac, Resolor, Resotran) This drug, which is used in the treatment of constipation has been reported by one hookworm host to have had a “pretty marked negative effect” on his worms, and, by another, to have killed theirs. [https://www.facebook.com/groups/htsupport/posts/5980593935329845?comment_id=7427760963946461&reply_comment_id=8031040043618547]

* [https://en.wikipedia.org/wiki/Pseudoephedrine Pseudoephedrine] is a stimulant nasal decongestant [https://en.wikipedia.org/wiki/Decongestant] that is sometimes added to antihistamine preparations and other products, including some formulations sold under the [https://en.wikipedia.org/wiki/Sudafed Sudafed] brand. Pseudoephedrine has not been reported to have any adverse effect on helminths.

* ➿ [https://en.wikipedia.org/wiki/Iodine-131 Radioactive iodine] (also known as radioiodine), which is used in the treatment of hyperthyroidism, can adversely affect hookworms, at least temporarily. One worm host found that '''isotope I-128''' (used in diagnostics) [https://www.facebook.com/groups/htsupport/permalink/830004963722127/ put her colony out of action for a week or two], and has suggested that '''isotope I-131''' (used to kill thyroid tissue) may have a similar effect.

* [https://www.drugs.com/rhophylac.html Rhophylac] The Rhophylac (anti-D immunoglobulin) injection, which contains human anti-D immunoglobulin, is given to pregnant women with rhesus negative blood type. One hookworm host has reported that her colony was unaffected by this injection. [https://www.facebook.com/groups/htsupport/posts/5063598083696106?comment_id=5068476199874961]

* [https://en.wikipedia.org/wiki/Rizatriptan Rizatriptan] (Maxalt, etc.) does not harm human helminths. [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348347051887903] [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348552771867331]

* [https://en.wikipedia.org/wiki/Viagra Sildenafil] (Viagra). This does not kill hookworms.

* [https://en.wikipedia.org/wiki/Simeticone Simeticone], also known as simethicone (Gas-X, Infacol, Wind-eze, WindSetlers, etc…), is an anti-foaming agent used in different dosages, and in combination with a variety of other drugs, to reduce the bloating, pain and discomfort caused by excessive intestinal gas. Simethicone has been tested directly on pig whipworm ova (TSO) and found to have no effect on them, and one hookworm host has reported taking simethicone periodically with no noticeable adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1969827113073234/?comment_id=1970814692974476&reply_comment_id=1972925246096754&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Sirolimus Sirolimus] (aka rapamycin, sold as Rapamune and Fyarro) This immunosuppressive medication was suspected by one NA host of having negatively impacted his worms for several weeks after he took a single dose of the drug.

* [https://en.wikipedia.org/wiki/Sodium_oxybate Sodium oxybate] (Xyrem, Alcover) is the sodium salt of [https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric_acid γ-hydroxybutyric acid] (GHB), which is unlikely to harm helminths because it’s an endogenous substance found naturally in the human body [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815965665126057&offset=0&total_comments=23&comment_tracking=%7B%22tn%22:%22R%22%7D], and one hookworm/whipworm host has confirmed that it did not affect her worms. [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815975511791739&offset=0&total_comments=24&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Steroid_hormone Steroid hormones]. One host of both hookworms and whipworms takes [https://en.wikipedia.org/wiki/Dehydroepiandrosterone DHEA], [https://en.wikipedia.org/wiki/Progesterone progesterone] and [https://en.wikipedia.org/wiki/Testosterone testosterone] with [https://www.facebook.com/groups/htsupport/permalink/824719590917331/?comment_id=825008124221811&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D no adverse effect on her worms].

* [https://en.wikipedia.org/wiki/Tauroursodeoxycholic_acid Tauroursodeoxycholic acid (TUDCA)] This ambiphilic bile acid has been taken by two NA hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2743109875744950/?comment_id=2744212012301403] [https://www.facebook.com/groups/htsupport/posts/7602581533131069/?comment_id=7614652755257280]

* ❌ [https://en.wikipedia.org/wiki/Turpentine Turpentine]. Also known as spirit of turpentine, oil of turpentine, wood turpentine and, colloquially, turps, this is distilled from pine tree resins. If applied topically to the skin - for example as a treatment for lice - it is unlikely to harm helminths. However, it has been used traditionally as an anthelmintic, so it may be harmful to human helminths if taken internally. It may also be toxic to humans!

* [http://www.netdoctor.co.uk/lung-problems/medicines/vicks-first-defence.html Vicks First Defence]. This cold preventative nasal spray does not contain antiviral chemicals, but forms a microgel that coats the lining of the nose to trap the cold virus and prevent this from reaching, and infecting, the cells within the nose. The microgel also reduces the pH inside the nose, which further helps by making it harder for the cold virus to multiply. It seems unlikely that any of this product’s ingredients [https://www.vicks.co.uk/products/early-cold-treatments/vicks-first-defence-nasal-spray] would harm helminths, although there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Volatile_Organic_Compounds Volatile Organic Compounds] (VOCs), as found in paints, felt tip markers, etc., are unlikely to harm helminths. One helminth host who regularly worked with organic solvents (including CH2Cl2 and CHCl3) has reported that his helminths have not been affected.

* [https://en.wikipedia.org/wiki/Xylometazoline Xylometazoline] Also spelled xylomethazoline, and branded as Otrivin and Otrivine, etc., this decongestant drug is safe for use with human helminths. [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537912206264719]
</blockquote>

== Medical procedures ==

<blockquote>
''' ✅ Safe for human helminths unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Botulinum_toxin Botulinum toxin] Also known as botulinum neurotoxin, and commonly called botox. One NA self-treater has reported receiving cosmetic botox injections with no adverse effect on her worm colony.

* [https://en.wikipedia.org/wiki/Colonoscopy Colonoscopy] As whipworms live in the colon, they may be at some risk of being struck by a colonoscope, but much of their body is embedded in the soft mucosa, and they are well lubricated with mucus, so few, if any, are likely to be damaged. Hookworms should not be affected by colonoscopy at all because they live in the small intestine, which is much higher up the GI tract. Hookworms might possibly be seen during a colonoscopy, but only if the colonoscope is advanced into the terminal ileum, and only then if any hookworms have taken up residence in the ileum, which is not common as they normally concentrate in the upper part of the jejunum, which is above the ileum, and is shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum Anaesthesia for colonoscopy is likely to involve the use of [https://en.wikipedia.org/wiki/Opioids opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.), [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed Versed], etc.) and/or [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics], all of which appear to be harmless to helminths. See also [[Human helminth care manual#Laxatives | Laxatives]] regarding [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep].

* [https://en.wikipedia.org/wiki/Colon_cleansing Colon cleansing] This will not harm hookworms and is unlikely to harm whipworms unless the fluid used contains something to which the whipworms are vulnerable.

* [https://en.wikipedia.org/wiki/Detoxification Detoxification] The use of [https://en.wikipedia.org/wiki/Infrared_sauna infrared saunas] and infrared heating pads is safe for helminths, [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860231720699451&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3617910068264922/] and [https://en.wikipedia.org/wiki/Chelation_therapy chelation therapy] using the [http://www.livingnetwork.co.za/chelationnetwork/chelation-the-andy-cutler-protocol/ Andy Cutler protocol] has been used by one hookworm host with no obvious adverse effect [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860208537368436&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R1%22%7D] on her colony. (Also see ❓'''DMPS''', ✅'''DMSA''' and❓'''EDTA'''.)

* [https://en.wikipedia.org/wiki/Enema Enemas] These will not affect hookworms at all, and the liquid used is unlikely to have any adverse effect on whipworms unless this contains something to which they are susceptible.

* [https://en.wikipedia.org/wiki/Endoscopy Endoscopy] A standard upper endoscopy (via the mouth) will not reach past the duodenum, and probably only as far as the second of the four parts of this section of the small intestine. It would therefore not harm hookworms or even allow a doctor to see the jejunum, which is the predominant location of hookworms by 20 weeks post-inoculation, shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum For information about the anaesthetics used during an endoscopy, see the [[#Anaesthetics|general anaesthetics]] section.

* [https://en.wikipedia.org/wiki/Epidural_opioid_analgesia Epidural opioid analgesia] Opioids such as [https://en.wikipedia.org/wiki/Fentanyl fentanyl] are generally safe for helminths, and one hookworm host has reported that her colony was fine following epidural analgesia administered during labour. [https://www.facebook.com/groups/htsupport/permalink/1960341670688445/?comment_id=1960403224015623&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] If an anaesthetic is added to the epidural, the effects of this may be similar to those of other local anaesthetics. (See the [[#localAnaesthetics|local anaesthetics]] section).
* [https://en.wikipedia.org/wiki/Magnetic_resonance_imaging Magnetic resonance imaging] An MRI is unlikely to harm helminths, but it can cause a temporary adverse reaction in the patient which may overshadow the benefits being provided by their helminths. [https://www.facebook.com/groups/htsupport/permalink/1296754897047129/] The❓gadolinium-based contrast agents used for MRI may also have adverse effects on the patient, [https://www.ncbi.nlm.nih.gov/pubmed/28368880] and there has been one report by a hookworm host who had two MRIs using gadolinium within the same week and experienced a subsequent return of her disease symptoms. [https://www.facebook.com/groups/htsupport/permalink/3934276469961612/]

* ❌ [https://en.wikipedia.org/wiki/Radiation_therapy Radiation therapy] (also known as radiotherapy, and abbreviated as RT, RTx, or XRT) is a treatment for cancer that used ionizing radiation. It had been thought unlikely that this would harm helminths [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1074160752639879&comment_tracking=%7B%22tn%22:%22R%22%7D] but one hookworm host appears to have lost her colony after radiotherapy for breast cancer. [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1240655962657023&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Radiology Radiology] Radiological procedures (e.g., [https://en.wikipedia.org/wiki/Radiography radiography] using [https://en.wikipedia.org/wiki/X-ray X-rays]) and the contrast materials used in these (e.g., [https://en.wikipedia.org/wiki/Barium barium] and [https://en.wikipedia.org/wiki/MRI_contrast_agent%23Gadolinium_.28Gd.29:_Paramagnetic gadolinium]) have been found to be worm-safe by several hookworm users, [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014377761951512&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014821705240451&comment_tracking=%7B%22tn%22:%22R%22%7D] but also see the comments about gadolinium in the previous entry, above, for magnetic resonance imaging.

* [https://en.wikipedia.org/wiki/Ultrasound Ultrasound] At least two hookworm hosts have had ultrasound examinations without their colonies being affected. [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334208813301727&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334224499966825&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



== Alternative therapies ==

=== Natural antibiotics ===
<blockquote>

* ➿ [https://en.wikipedia.org/wiki/Colloidal_silver Colloidal silver]. Some sources have claimed that, if taken orally, this may kill parasite eggs and possibly harm adult worms, but many helminth hosts have taken colloidal silver and there have been no reports of worms being lost as a result. Colloidal silver appears to be the most worm-friendly of the more effective natural antimicrobials, and it has also been shown to have no significant effect on the biodiversity of species in the gut microbiome. [https://www.ncbi.nlm.nih.gov/pubmed/26525505]. Although it can reduce helminthic benefits in a dose-dependent manner while it is being taken, the benefits soon return after its use is discontinued - usually in a matter of days. (Use of this [https://web.archive.org/web/20161227234345/http://www.silversafety.org/autocalculator.php Silver Safety Auto-calculator] will ensure that total silver intake remains at a safe level.)

* ❓ '''Cellular silver'''. The manufacturers of [http://www.resultsrna.com/products/acs_200_overview/ Advanced Cellular Silver (ACS) 200 Extra Strength] claim that it is “...effective against an enormous array of disease causing organisms; literally oxidizing the cell wall of gram positive and gram negative bacteria, spirochetes, virus, fungus, parasites and more without harming healthy flora or damaging human tissue”. Research[http://www.townsendletter.com/Jan2015/silver0115.html] shows that this form of silver may be more effective than ➿'''colloidal silver''' (see Colloidal silver, immediately above), but, so far, there have been no reports from helminth hosts to suggest what effect, if any, it might have on human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Grapefruit_seed_extract Grapefruit seed extract] (GSE). Also known as citrus seed extract and grapefruit seed oil, and often labelled as citrus seed oil. It is used in herbalism and natural therapies as an antibiotic and preservative, and is claimed to be a powerful broad spectrum bactericide, fungicide and antiviral that is effective against a large number of single-celled and multi-celled parasites. However, research has shown that [http://cms.herbalgram.org/press/2012/Many_GFSE_Adulterated_Says_Nonprofit_Research_Consortium.html many “natural” GSE products are adulterated] with undeclared synthetic chemicals, commercially available preservatives and disinfectants, such as [https://en.wikipedia.org/wiki/Triclosan triclosan] and [https://en.wikipedia.org/wiki/Benzethonium_chloride benzethonium chloride]. Some versions of GSE [http://www.ncbi.nlm.nih.gov/pubmed/17468864 may not contain any authentic grapefruit seed extracts] whatsoever, such that its sale may well be one of the most insidious herbal product scams ever. Even if genuinely pure, natural GSE could be found - which, given the evidence, seems doubtful - there may be little point in taking it as an antimicrobial because pure GSE has been shown to have no intrinsic antimicrobial action. And, as the makeup of proprietary GSE products varies so widely, these can not be recommended for worm hosts due to the possibility that one or more of the undeclared ingredients may harm human helminths. (NB. The flesh of grapefruit will not harm helminths.) Also see [[#Grape seed extract|Grape seed extract]], which is safe for use by hosts of human helminths.
</blockquote>

=== Natural antivirals ===
<blockquote>
✅ ''' Antiviral nutraceuticals that are safe for human helminths unless marked otherwise'''

:'''Vitamin C'''

::Taken in large quantities, vitamin C (ascorbic acid) has proved to be very effective against the common cold virus. When volunteers in one study were given 8 grams (8,000 mg) on the first day of a cold, 46% were cold free the next day. [http://www.ncbi.nlm.nih.gov/pubmed/4601508]

::In a study involving 700 students, those taking doses of I gram (1,000 mg) of vitamin C each hour for the first 6 hours and then 1 gram three times daily thereafter reported an 85% decrease in cold symptoms compared to those receiving conventional cold and flu treatment. [http://www.ncbi.nlm.nih.gov/pubmed/10543583]

::The ideal amount of vitamin C for colds or flu varies between individuals, but can be established in each case by taking ascorbic acid to ‘bowel tolerance’. Physicians have suggested starting with 3 grams immediately, then taking 1 gram each hour. Once this causes diarrhoea, the dose is reduced.

::In respect of the coronavirus, SARS-CoV-2, and the disease it manifests (COVID-19), see the following articles.

::* [https://www.mdpi.com/2075-1729/11/11/1166/htm Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence]

::* [https://pubmed.ncbi.nlm.nih.gov/32636851/ Quercetin and Vitamin C: An Experimental, Synergistic Therapy for the Prevention and Treatment of SARS-CoV-2 Related Disease (COVID-19)] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/pdf/fimmu-11-01451.pdf PDF]

::One UK doctor recommends treating coronavirus with 10 grams of vitamin C in 500 ml of water every hour until the patient gets diarrhoea. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::In March 2020, the government in Shanghai, China, officially began recommending high-dose intravenous vitamin C for the treatment of COVID-19. Dosage recommendations varied with the severity of illness, ranging from 50 to 200 mg per kg of body weight per day. [http://orthomolecular.org/resources/omns/v16n16.shtml] In the same month, hospitals in New York also began treating coronavirus patients with vitamin C. [https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/]

::'''Vitamin C dosing for children'''. Authorities on the use of vitamin C recommend dosing children by body weight, giving a proportion of the adult dose commensurate with the child’s weight as a proportion of the weight of the average adult. In one placebo-controlled study, the majority of subjects were infants and children under five years of age with severe pneumonia. They were given 200 mg vitamin C per day, which is equivalent to a modest adult dose of 2,000-3,000 mg per day. The authors of this study concluded that, even at this dose, "Vitamin C is effective in reducing duration of severe pneumonia in children less than five years of age. Oxygen saturation was improved in less than one day." [http://www.journalrmc.com/volumes/1405749894.pdf] Also see, [http://orthomolecular.org/resources/omns/v18n05.shtml Vitamin C and Infants: Determining dose].

::'''Liposomal vitamin C'''. This form of vitamin C is absorbed by a different mechanism, in the gut. The liposomes containing vitamin C can bind directly to the gut cells to release their content of vitamin C which therefore does not require active transport. Thus the maximum level achievable with oral doses of liposomal vitamin C is higher than for regular vitamin C. However, since the absorption mechanism for liposomal vitamin C differs from the active transport of regular vitamin C, both forms can be taken together to increase the level in the bloodstream (up to 400-600 μM), greater than either oral form alone. (Levy TE (2011) Primal Panacea. Medfox Pub. ISBN-13: 978-0983772804)

:'''Vitamin D'''

::This vitamin acts as a natural antibiotic, working against every type of microbe, including viruses, bacteria, fungi and parasites, but it does not harm therapeutic helminths.

::The flu can be treated effectively with a 1-time dose of 50,000 IU vitamin D3, or with 10,000 IU 3 times daily for 2 to 3 days. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/]

:: Some functional medicine practitioners advise that it is relatively safe to increase vitamin D intake to as much as 50,000 IU per day during times of virus exposure. John Cannell, MD, of the Vitamin D Council, suggests that 50,000 IU should be taken once each day for three days at the first sign of a cold or the flu. [https://web.archive.org/web/20211221125912/https://preventdisease.com/news/13/102213_Vitamin-D-Proven-More-Effective-Anti-Viral-Drugs-Vaccines-Preventing-Flu.shtml] David Brownstein, MD, recommends taking 50,000 IU per day for 4 days (link expired) and Dr Stephen Gundry suggests taking as much as 150,000 IU daily for 3 days to treat a respiratory infection. [https://mnchiropractors.com/uncategorized/dr-gundry-on-boosting-immunity-for-coronavirus/]

::* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9653496/ Association between vitamin D supplementation and COVID-19 infection and mortality]

::::Vitamin D supplementation produced a statistically significant reduction in the risk of COVID-19 infection and of the infection ending in death within 30-days. Patients receiving higher cumulative dosages and higher average daily dosages showed a greater reduction in COVID-19 infection rates than patients receiving lower dosages. "As a widely available, inexpensive, and safe treatment, vitamin D3 could be a helpful tool for reducing the spread of COVID-19 infection."

::* [https://www.ncbi.nlm.nih.gov/pubmed/32377965 The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality]

::* [https://www.psychologytoday.com/us/blog/the-fallible-mind/202202/striking-link-between-vitamin-d-levels-and-omicron A “Striking” Link Between Vitamin D Levels and Omicron]

:'''Hydrogen peroxide (H2O2)'''

::Daily use, for 1 minute, of a 1% hydrogen peroxide solution as a mouthwash and throat gargle, and the daily use, for 1 minute, of a 0.5% solution as a nasal rinse, have been found to provide effective protection against SARS-CoV-2 infection. The fact that hydrogen peroxide is safe, inexpensive and readily available led this study’s authors to recommend it for the protection against COVID-19 of healthcare workers, inpatients and all vulnerable groups. And, since H2O2 used in this way will not be swallowed or inhaled, it should not harm helminths.

::* [https://pubmed.ncbi.nlm.nih.gov/35594985/ Further observations on hydrogen peroxide antisepsis and COVID-19 cases among healthcare workers and inpatients] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/pdf/main.pdf PDF]

: '''Lysine'''

:: Lysine appears to be highly suppressive of viral replication. Approximately 80% of acute stage Covid-19 patients given lysine displayed a minimum 70% reduction in symptoms in the first 48 hours. Treatment times varied from 2 days to 3.5 weeks (excluding long term symptomatic subjects), and patients who started lysine in the hospital were discharged an average of 3 days after starting treatment.

::* [https://www.researchgate.net/publication/344210822_Lysine_Therapy_for_SARS-CoV-2 Lysine Therapy for SARS-CoV-2]

:'''Elderberry'''

::Eating elderberries and taking their extracts can help minimise influenza symptoms. [https://www.sciencedirect.com/science/article/abs/pii/S1756464619300313] But note the following.

::* "Patients with autoimmune diseases like rheumatoid arthritis, celiac, hashimoto’s, and lupus need to consult a physician before taking elderberry because it will stimulate their immune system. Elderberry interferes with medications that suppress the immune system and medications used to treat autoimmune diseases.” [https://web.archive.org/web/20190918211012/http://www.mensahmedical.com/elderberry-benefits-dangers-patients/]

::* While elderberry extract is considered to be effective against flu, it works, as many other immune boosters do, by increasing the cytokine response. [https://www.ncbi.nlm.nih.gov/pubmed/11399518] Since COVID-19 (aka SARS-CoV-2) kills primarily by initiating a cytokine storm, elderberry is probably best not relied upon as a stand-alone option against the new coronavirus, and, if used at all, would be best combined with one or more of the other effective anti-pathogenic treatments mentioned in this section.

'''Other worm-safe nutraceuticals with antiviral effects'''

:* [https://www.sciencedirect.com/science/article/pii/S0033062020300372 Nutraceuticals have potential for boosting the type 1 interferon response to RNA viruses including influenza and coronavirus] (ferulic acid, lipoic acid, spirulina, N-Acetylcysteine, selenium, glucosamine, zinc, yeast beta-glucan and elderberry)

:* [http://orthomolecular.org/resources/omns/v16n04.shtml Nutrients recommended by the International Society for Orthomolecular Medicine to prevent and minimise symptoms of viral infection]

:* Virus-Specific nutraceutical and botanical agents listed by the Institute for Functional Medicine. [https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/] [https://www.ifm.org/news-insights/functional-medicine-approach-covid-19-additional-research-nutraceuticals-botanicals/]

:* [https://blog.nutrigold.co.uk/2020/03/09/nutritional-support-for-immunity-against-viruses-including-the-coronavirus/ Nutritional Support for Immunity Against Viruses Including the Coronavirus]

:* [https://cf5e727d-d02d-4d71-89ff-9fe2d3ad957f.filesusr.com/ugd/adf864_cc5004cfa84a46d3b1a0338d4308c42c.pdf A Novel Approach to Treating COVID-19 Using Nutritional and Oxidative Therapies] (Vitamin A, vitamin C [Ascorbate], vitamin D3, Iodine, Nebulized ❓Hydrogen Peroxide and Intramuscular ❓Ozone.)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428453/ Be well: A potential role for vitamin B in COVID-19]

:* [http://www.ncbi.nlm.nih.gov/pubmed/25400245 Bifidobacterium longum MM-2 improves defence against flu virus]

:* [https://www.ncbi.nlm.nih.gov/pubmed/32179788 Ginkgolic acid inhibits fusion of enveloped viruses]

::"Thus, in light of the antiviral effect of ginkgolic acids (GA) on established viral infections of permissive cells, GA potentially could be used to treat acute viral infections (e.g. Coronavirus (COVID-19), EBOV, ZIKV, IAV and measles)."

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929665/ Uncaria tomentosa (Cat’s claw) has an antiviral effect against SARS-CoV-2]

:* [http://orthomolecular.org/resources/omns/v16n22.shtml Sulforaphane as a Treatment for COVID-19]

:* [https://onlinelibrary.wiley.com/doi/10.1002/fsn3.3034 Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies] (Full text) | [https://onlinelibrary.wiley.com/doi/epdf/10.1002/fsn3.3034 PDF]. Also see [https://www.news-medical.net/news/20220908/The-role-of-some-important-antioxidants-in-major-clinical-outcomes-of-subjects-with-COVID-19.aspx this article about the study].

::"It seems that antioxidants, especially vitamins C and D, selenium, and zinc, can improve multiple COVID-19 clinical outcomes."

:* [https://www.sciencedaily.com/releases/2020/04/200429105907.htm Link identified between dietary selenium and outcome of COVID-19 disease]

:* [https://pubmed.ncbi.nlm.nih.gov/32754164/ The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/pdf/fimmu-11-01712.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32388476/ Is copper beneficial for COVID-19 patients?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/pdf/main.pdf PDF]

:* [https://www.europeanreview.org/wp/wp-content/uploads/4062-4063.pdf?fbclid=IwAR0AxUqV9FaHNcaHwlUuzOW9MOYe_1Z3OiHIzVvDJD6J8h3DubgTZGESOGY Are probiotics effective adjuvant therapeutic choice in patients with COVID-19?]

:* [https://pubmed.ncbi.nlm.nih.gov/32733907/ Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/pdf/fmed-07-00389.pdf PDF] (Probiotics)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649937/ N-Acetylcysteine to Combat COVID-19: An Evidence Review]

:* [https://pubmed.ncbi.nlm.nih.gov/34653660/ The Effect of Melatonin on Thrombosis, Sepsis and Mortality Rate in COVID-19 Patients] -- [https://www.sciencedirect.com/science/article/pii/S1201971221007980 Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506572/pdf/main.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32574327/ Therapeutic Algorithm for Use of Melatonin in Patients With COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/pdf/fmed-07-00226.pdf PDF]

:* [https://wrightacademia.org/articles/jscc/jscc-1-002.php?jid=jscc Free Fatty Acids from Fish Oil Inactivate SARS-CoV-2]

::"… free fatty acids in fish oil may have potential as mouth/throat wash to reduce concentration of SARS-CoV-2 viruses in saliva and upper respiratory mucosa and reduce transmission."

'''Plant medicines recommended for the treatment of coronavirus'''

:* [https://www.stephenharrodbuhner.com/wp-content/uploads/2020/08/covid-19-2.update.txt.pdf?fbclid=IwAR3sm7OYMH8_RBH0xjrQM984_SFoSZupSOw5IqSes_n6s4JemMjvyLCCEug SARS-CoV-2 (COVID-19): Herbal protocols for the treatment of infection and post-coronavirus syndrome] (PDF) This is a very detailed treatise on the use of herbs in this context. Individual herbs suggested should be checked for possible anthelmintic effects by searching for them in the rest of this Care Manual.

'''Inhaled treatments - safe for human helminths unless marked otherwise'''

:'''Iodine'''

::Iodine kills all single-celled microbes on contact and can be introduced into the airways by inhalation from a salt pipe or face mask, or via home-made iodine oil. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::* Salt pipe. Two drops of Lugol’s iodine 12% or 15% dripped into the mouthpiece of a salt pipe (or simply applied to a piece of cotton wool) can be sniffed up into the nose and inhaled 2-3 times a day, or even every 2 hours. 15 - 20 sniffs provides an adequate dose.
::* Face mask. 2-4 drops of Lugol’s iodine 15% can be applied to a face mask, and reapplied 3 times a day.
::* Iodine oil. This can be made with 10 parts coconut oil to 1 part Lugol’s Iodine 15%, and applied around the nose and upper lip three times each day. The iodine does stain the skin yellow temporarily, but it is a good way to treat children who may not be able to manage a salt pipe or tolerate a mask.

:: “After the 1918 Influenza Pandemic which killed an estimated 30 million people, governments financed research on the Pandemic’s causes. Over 25 years, influenza viruses were isolated and methods for killing them with various agents discovered. Iodine was the most effective agent for killing viruses, especially influenza viruses. Aerosol iodine was found to kill viruses in sprayed mists, and solutions of iodine were equally effective. In 1945, Burnet and Stone found that putting iodine on mice snouts prevented the mice from being infected with live influenza virus in mists. They suggested that impregnating masks with iodine would help stop viral spread. They also recommended that medical personnel have iodine-aerosol-treated rooms for examination and treatment of highly infected patients. Current methods of dealing with influenza infection are isolation, hand washing, antiviral drugs, and vaccinations. All of these methods can be improved by incorporating iodine into them. When impregnated with iodine, masks become much more effective, and hand washing is more effect when done with mild iodine solutions. Isolation techniques coupled with aerosol iodine would make them safer for patients, medical personnel, and all persons working with the public. Public health authorities could organize the distribution of iodine and at the same time educate the public in the effective use of iodine. Oral iodine might also boost body defense mechanisms in the upper oral and respiratory mucus. Conclusion: Iodine incorporated into masks, solutions, aerosols, and oral preparations could help to kill influenza viruses and fight off an H1N1 Pandemic.” [https://www.drlowe.com/thyroidscience/reviews/derry/Derry.flu.iodine.9.19.09.pdf]

:'''Ascorbic acid (vitamin C)'''

::Nebulisation (atomisation) delivers vitamin C directly to where it is needed in the case of a respiratory infection such as COVID-19, and it is known to be at least as, and possibly more, effective as a method of delivery than intravenous infusion.
::'''Materials''': a nebuliser (or atomiser), ascorbic acid and sodium bicarbonate (which is needed because ascorbic acid on its own is too acidic for the airways).
::'''Method''': Mix 100 grams of ascorbic acid powder with 50 grams of bicarbonate of soda in one litre of filtered/spring water. Once the mixture has stopped bubbling, a very slightly cloudy 10% solution of sodium ascorbate will be left. This contains 500 mg of vitamin C per 10 ml of liquid.
::Nebulising 10 ml of this solution (one dose) will deliver 500 mg, or 0.5 gram, of vitamin C. Start with one dose every 2 hours.
::If the nebulised vitamin C does not provide benefits, the airways can be opened up by nebulising magnesium sulphate (Epsom salts), which is also anti-inflammatory. [https://www.cochrane.org/CD003898/AIRWAYS_inhaled-magnesium-sulfate-safe-and-effective-treatment-people-asthma-attacks] Dissolve 50 grams of Epsom salts in 500 ml of filtered/spring water and nebulise 10 ml of this 1% magnesium solution at a time. This will deliver 1 gram of magnesium, and can be done immediately before nebulising the vitamin C.

:'''Hypertonic saline'''

::A simple solution of salt in water could arguably be the simplest and most readily accessible, side-effect free, worm-friendly antiviral prophylaxis and treatment available. It is suitable for use via a nasal spray to reduce viral load in the airways and thereby minimize the severity of COVID-19 in the early stages of infection. It can also be used in a nebuliser to help treat already established or more severe cases affecting the lungs, and as a gargle to reduce viral load in the mouth. The extra salt from the hypertonic solution accumulates in the viral cells, forcing them to expend ATP in order to re-balance the electrolyte gradient, and this activity limits the amount of ATP available for viral replication. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442612/] And there is a simplified report of this research [https://medicalxpress.com/news/2021-09-reveals-saline-solution-inhibit-replication.html here].

:❓'''Hydrogen peroxide (H2O2)''' (See [[#Hydrogen peroxide|Hydrogen peroxide]].)

:: "Viral syndromes start or are strongly supported by ongoing viral replication in the naso- and oropharynx. When appropriate agents are nebulized (into a fine spray) and this viral presence is quickly eliminated, the rest of the body "mops up" quite nicely the rest of the viral presence. The worst viral infections are continually fed and sustained by the viral growth in the pharynx. Probably the best and most accessible agent to nebulise would be 3% hydrogen peroxide (1 to 5 cc of 3% peroxide with volume brought up to 10 to 12 cc with filtered water) for 15 to 30 minutes several times daily." [http://orthomolecular.org/resources/omns/v15n16.shtml] Also see [http://orthomolecular.org/resources/omns/v16n43.shtml Curing Viruses with Hydrogen Peroxide].

: '''DMSO'''

:: "DMSO can be readily combined with other anti-pathogen agents, such as sodium ascorbate (vitamin C) and magnesium chloride. Anecdotally, this DMSO-vitamin C-magnesium chloride combination has proven to be very effective in clearing biofilms and their underlying pathogen colonies. This can be done with 1 to 5 cc of 99.9% DMSO brought up to 10 to 12 cc (for nebulisation) with a combination solution of vitamin C and magnesium chloride. Precise concentrations are not critical, and the combination solution can be quickly and easily made by adding about 2 teaspoons of sodium ascorbate powder and 2 teaspoons of magnesium chloride powder to about a half cup of water. Since the sodium ascorbate will oxidize over several hours as it turns yellow, it can be made separately from the magnesium chloride solution, which remains very stable and does not significantly deteriorate over time." [http://orthomolecular.org/resources/omns/v15n16.shtml]

: '''Hyperbaric oxygen'''

:: "...hyperbaric oxygen therapy (HBOT) would be an excellent treatment adjunct against severe COVID-19 and a superior alternative to ventilators, which have been shown to cause harm in many patients and increase the risk of death. (Link expired)

: '''Grapefruit seed extract (GSE) and xylitol'''

::Nasal sprays containing GSE and xylitol (e.g., [https://xlear.com/xlear-sinus-care/ Xlear Sinus Care]) may prevent the spread of viral respiratory infections including SAR-CoV-2 and H1N1. GSE significantly reduces the viral load while xylitol prevents attachment of the virus to cell walls. [https://www.biorxiv.org/content/10.1101/2020.12.02.408575v3.full]

'''Other considerations when fighting viral infections'''

:* [https://www.sciencedaily.com/releases/2019/02/190212094839.htm How '''sleep''' can fight infection]

:* [https://www.ncbi.nlm.nih.gov/pubmed/31732517 '''Ketogenic diet''' activates protective γδ T cell responses against influenza virus infection]

:* [https://nutrition.bmj.com/content/early/2022/06/30/bmjnph-2022-000462 Association of '''periodic fasting''' with lower severity of COVID-19 outcomes in the SARS-CoV-2 prevaccine era]

:* [https://www.medicalnewstoday.com/articles/two-cases-suggest-fecal-transplants-may-treat-sars-cov-2-infection Two cases suggest '''fecal transplants''' may treat SARS-CoV-2 infection]

:* [https://journals.lww.com/anesthesia-analgesia/Fulltext/2021/04000/Aspirin_in_Coronavirus_Disease_2019_Related_Acute.1.aspx '''Aspirin''' in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome: An Old, Low-Cost Therapy With a Strong Rationale]

:* [https://www.sciencedaily.com/releases/2019/07/190702112834.htm Pharmaceutical antibiotics weaken flu defences in the lung]

:* [https://www.bmj.com/content/368/bmj.m1182/rr-10?fbclid=IwAR1wHVgtmbbjQ4zcno5d4zjlnmC97fyrrLv7jUuXBtZGpGawQwf6OJat5YU Cholesterol-lowering treatment may worsen the outcome of a COVID-19 infection]
</blockquote>

=== Ayurvedic remedies [https://en.wikipedia.org/wiki/Ayurvedic] ===

:❓ [https://en.wikipedia.org/wiki/Aegle_marmelos Aegle marmelos] (also known as Bael, Bengal quince, golden apple, Japanese bitter orange, Sirphal, stone apple and wood apple) has culinary uses and is employed as an ayurvedic remedy in Indian traditional medicine to treat various illnesses, including irritable bowel syndrome and ulcerative colitis. Sandu bilagyl, a herbal tea combining Aegle marmelos and sugar, is claimed on several commercial websites to have anthelmintic effects, [https://herbalukstore.co.uk/sandu-bilagyl.html] but this characteristic is not mentioned in more detailed articles found online, [https://hort.purdue.edu/newcrop/CropFactSheets/bael.html] where Aegle marmelos is only reported to have pesticidal properties. This may have have been extrapolated by vendors to suggest a possible anthelmintic effect, but there is so far no evidence that it harms intestinal worms, and no self-treaters have reported their experience with it.

<blockquote>
The following ayurvedic remedies are used, in combination, to treat pinworms, so may also have an adverse effect
on other helminths:
* ⚡[https://en.wikipedia.org/wiki/Vidanga vidanga] (Embelia ribes)
* ⚡[https://en.wikipedia.org/wiki/Gurmar Gymnema sylvestre] (cowplant, cowplant, gurmari, gurmarbooti, gurmar, periploca of the woods, meshasringa, Bedki cha pala and miracle fruit)
* ⚡[http://ayurveda-foryou.com/ayurveda_herb/trikatu.html trikatu] - a combination of (see Spices section)
** ⚡[https://en.wikipedia.org/wiki/Black_pepper black pepper] (Piper nigrum - (see[[#Black pepper| Black pepper]])
** ⚡[https://en.wikipedia.org/wiki/Indian_Long_Pepper long pepper] (Piper longum)
** ⚡'''ginger''' (Zingiber officinale - see [[#Ginger|local reference]])

* ⚡[https://en.wikipedia.org/wiki/Triphala Triphala]. This is an Ayurvedic herbal formula combining three myrobalans: Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica/Terminalia bellerica), and Haritaki (Terminalia chebula). The latter two of these are reported to be anthelmintic, but they also have laxative properties, and it may be this characteristic, rather than actual worm killing ability, that is the source of any ‘anthelmintic’ effects.
</blockquote>

=== Chinese herbal medicines [https://en.wikipedia.org/wiki/Chinese_Herbal_Medicine] ===

==== ❌ Anthelmintic Chinese herbs ====

<blockquote>
* Bing Lang (Semen arecae). Used against roundworms and flukes.
* Chuan Lian Gen Pi (Cortex meliae radicis). Used against roundworms.
* Da Huang (Radix et rhizoma rhei). Used in combination remedies to treat flukes.
* Guan Zhong (Rhizoma dryopteris crassirhizomae). Used in combination remedies to treat hookworms.
* Ku Lian Gen Pi (Cortex meliae radicis). Used to treat pinworms, and in combination remedies to treat hookworms.
* Lei Wan (Sclerotium omphaliae). Used specifically to treat hookworms.
* Qian Niu Zi (Semen pharbitidis). Used in combination remedies to treat flukes.
* Qu Hui Wan (Dispel Roundworms Pill). Used against roundworms.
* Shi Jun Zi (Fructus quisqualis). Used against pinworms.
* Tu Jing Jie (Herba chenopodii ambrosioidis). Used in combination remedies to treat hookworms.
* Wu Mei Wan / Wu-Mei Wan (Mume Pill). A 10-herb classical formula used to treat intestinal parasite infections, including roundworms.
* Zi Su Ye (Folium perillae). Used in combination remedies to treat hookworms.
</blockquote>

=== Homeopathic remedies ===

✅ Most homeopathic remedies are unlikely to have any adverse effect on human helminths. For example, the influenza remedy, [https://en.wikipedia.org/wiki/Oscillococcinum Oscillococcinum], has been taken occasionally by one hookworm host without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1590515217671094/?comment_id=1590860620969887&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

==== ❌ Antiparasitic homeopathic remedies [https://en.wikipedia.org/wiki/Homeopathy] ====

<blockquote>
* Cina (a homeopathically potentised form of Eurasian wormwood - [https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina])
* Cuprum oxidatum nigrum
* Indigoz
* Podophyllum
* Sabadilla
* Santoninum
* Spigelia
* Stanum
* Teucrium marum
</blockquote>

=== Light therapy===

No reports have been received about adverse effects on human helminths of any form of [https://en.wikipedia.org/wiki/Light_therapy light therapy] ([https://en.wikipedia.org/wiki/Low-level_laser_therapy#Red_light_therapy red light therapy], near-infrared, far-infrared, etc.), and one NA host has reported regularly using a red light full body bed without issue. [https://www.facebook.com/groups/htsupport/posts/7155942991128261/?comment_id=7156873597701867]

=== Phage therapy [https://en.wikipedia.org/wiki/Phage_therapy] ===

</blockquote>
❓ While it is unlikely that bacteriophages will harm helminths, one hookworm host who took a short course of doses of a cocktail of several phages has reported experiencing a slight temporary reduction in worm benefits following this treatment. The product he took included preservatives (8-hydroxyquinoline sulfate-0,0001 g / ml [calculated content]; or 8-hydroxyquinoline sulfate monohydrate in terms of 8-hydroxyquinoline sulfate-0.0001 g / ml [calculated content]) which may have been responsible for this effect. [https://www.facebook.com/groups/htsupport/permalink/2619124714810134/?comment_id=2619284978127441]
</blockquote>

=== Electromagnetic therapy ===

✅ Several forms of electromagnetic stimulation have been used by hosts of human helminths, including [https://en.wikipedia.org/wiki/Magnet_therapy Magnet Therapy], [https://en.wikipedia.org/wiki/Pulsed_electromagnetic_field_therapy Pulsed Electromagnetic Field (PEMF) therapy] and [https://en.wikipedia.org/wiki/Transcutaneous_electrical_nerve_stimulation Transcutaneous Electrical Nerve Stimulation (TENS)], none of which appear to have had any obvious effect on the worms. [https://www.facebook.com/groups/htsupport/permalink/3123210597734874/] [https://www.facebook.com/groups/htsupport/posts/7903061716416381/?comment_id=7903306649725221&reply_comment_id=7903872713001948]

== Foods, supplements, spices, herbs and fungi ==

There are lists on the internet claiming that common foods and spices such as pumpkin seeds, turmeric, and even carrots, will kill helminths, but '''normal dietary amounts of most ''unprocessed'' foods, spices and herbs, will not harm helminths.'''

For example, carrots and sweet potatoes are both claimed to be 'antiparasitic' in some online lists, but one individual who eats 400 g (14 oz) of one or other of these vegetables every day, is still able to maintain a thriving hookworm colony, and there are others who have eaten far more than this without harming their worms.

The only problem that is likely to arise with foods, spices or herbs is when these, and particularly herbs, are artificially concentrated or processed to create extracts or tinctures. Any herbal medicine that claims to have antiparasitic, or even antibacterial or antifungal properties may present a potential risk to human helminths and should therefore be approached with caution. The ultimate potency of these substances will depend on a number of factors, including, in the case of plants, the part used, the season it was picked, [https://pubmed.ncbi.nlm.nih.gov/37596334/] the method of extraction, [http://www.ncbi.nlm.nih.gov/pubmed?term=21110041] and the extent of concentration and/or processing, as well as dosage.

The effect of such substances also appears to vary between individuals, probably due to differences in the strength of their immune response to helminths, and some people, particularly those who have more difficulty holding on to a viable helminth colony and therefore need more frequent top-ups (especially a subset of patients with IBD or coeliac disease, and some with allergies) may find that ingesting certain substances that have no effect on the worms of other hosts may tip the balance in their case and cause a temporary dip in worm benefits, or even a loss of worms. For example, one helminth host has reported taking peppermint oil continuously without any apparent adverse effect on his worms, yet another individual could not keep a worm colony at all while taking peppermint oil.

In the case of some foods and herbs, a single part of the plant, usually a part that is not normally eaten - perhaps the bark or root - may have antiparasitic properties, while other parts of the same plant may be perfectly safe to eat. For example, the seeds of pomegranates are safe to eat, while the bark of the stems of this plant contains an anthelmintic compound, and the bark of the root contains an even more potent form of this alkaloid, which is used to treat roundworms, pinworms and tapeworms.

'''So, while bearing in mind the general principles set out in the Introduction and the last few paragraphs above, and using the details in the list below, helminth hosts need to observe their own responses and learn what they, as individuals, can and cannot safely consume while hosting helminths.'''

There will often be a warning indication whenever one's worms are not happy. This may be a general loss of wellbeing, or a return of specific symptoms. For example, one person always gets a marked increase in nasal congestion if something compromises the health of his worms.

=== Foods ===
<blockquote>
'''✅ Food items considered safe unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Atemoya Atemoya] The fruit, atemoya, is a hybrid of two other fruits – the sugar-apple (Annona squamosa) and the cherimoya (Annona cherimola). Atemoya is also known as "pineapple sugar apple", anón, chirimorinon, achta and stafeli dogo ("mini soursop"). An NA host has reported that eating the flesh of this fruit appeared not to harm his colony, [https://www.facebook.com/groups/htsupport/posts/7681355011920387/?comment_id=7681459525243269] but that there are neurotoxic compounds, called annonacins, in the seeds, bark, leaves and skin of this plant that may be anthelmintic. While there are also annonacins in the fruit, they are present in much smaller quantities than in the plant’s other parts.

* [https://en.wikipedia.org/wiki/Momordica_charantia Bitter melon] (Momordica charantia) Also known as Momordica chinensis, goya, karela, ampalaya, bitter apple, bitter gourd, bitter squash and balsam-pear. This cucumber-shaped vegetable is found in Asian markets, and aqueous extracts of its leaves and seeds have both been shown to have a dose-dependent adverse effect on one type of adult non-therapeutic helminth (Strongyloides) in test tube studies [https://www.researchgate.net/publication/242567254_In_vitro_anthelmintic_efficacy_of_some_indegeneous_medicinal_plants_against_gastrointestinal_nematodes] and both fruit and seeds have been, and still are, used in a number of countries to treat pinworm infections, and for expelling parasites generally. However, the quantities of fruit and seeds that are quoted as being necessary in order to eradicate worms are rather large, for example two whole melons each day for seven to ten days, repeated after two months. It is therefore unlikely that normal dietary amounts of bitter melon fruit will adversely affect therapeutic helminths, and one hookworm self-treater has reported that bitter melon is a regular part of her diet, but has never adversely affected her worms. [https://www.facebook.com/groups/htsupport/posts/4373320642723857/?comment_id=4376043225784932]

* ⚡ [https://en.wikipedia.org/wiki/Breast_milk Breast milk] (human). There has been one report of a child with severe eczema who was inoculated with hookworms while still being breastfed, and who received only moderate benefits from the worms until breast feeding was suspended. Thereafter, the benefits increased markedly, suggesting that something in the breast milk was inhibiting the worms, possibly the lauric acid which is also found in [[#Coconut|coconut]] products. [https://www.facebook.com/groups/htsupport/permalink/2241418522580757/]

* [https://en.wikipedia.org/wiki/Carrot Carrot] (Daucus carota, subsp. sativus). The taproot of the carrot is rich in beta carotene, a precursor for vitamin A, which has been claimed to increase resistance to penetration by larvae. Carrots have also been claimed to be offensive to all parasites and valuable in the elimination of threadworms, but normal dietary amounts are not harmful to therapeutic helminths, and many helminth hosts have regularly eaten significant quantities of this vegetable (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without adversely affecting their worms.

* ❌ [https://en.wikipedia.org/wiki/Chicory Chicory] (Cichorium intybus). This is well known for its toxicity to intestinal parasites, and studies have indicated that ingestion of chicory by farm animals results in reduced worm burdens. This plant contains volatile oils similar to those found in plants in the related genus Tanacetum, which includes ❌'''Tansy''', and is said to be similarly effective in eliminating intestinal worms. One hookworm host has reported that eating 2 tsp of chicory powder (pesumably ground chicory root) terminated her colony. [https://www.facebook.com/groups/htsupport/posts/8036790633043488?comment_id=8058118634244021] However another NA self-treater has reported that drinking "loads of chickory coffee for a while" had no negative effects on his colony. [https://www.facebook.com/groups/htsupport/posts/9496946530361217?comment_id=9497703880285482] This difference in results was likely due to the high heat used to roast the raw plant material to produce chicory "coffee". This processing destroys or transforms many of the original plant oils present in raw chicory root, with the result that roasted chicory contains little to none of the volatile oils found in the fresh plant. [https://orleanscoffee.com/what-is-chicory/]

* [https://en.wikipedia.org/wiki/Citron Citron] (Citrus medica). Alcoholic extracts of the rind of citron have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. These extracts may therefore also have an adverse effect on other helminths, though there is no evidence that eating normal dietary amounts of the flesh of this fruit might harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Coconut Coconut]. Coconut products contain [[#Medium-chain triglycerides|medium-chain-triglycerides]] (MCT), some of which have been shown to be effective against many parasites including giardia, other protozoa, and also tapeworms. (Also see, [[#Fatty acids|Fatty acids]].) The fats in '''coconut oil''' are 40% lauric acid (lipid number: C12), the MCT most well-known for its antibacterial, antimicrobial and antiviral properties, and the one most likely to be responsible for any adverse effect on helminths. '''Fractionated coconut oil''' contains primarily caprylic acid (C8) and capric acid (C10) [https://web.archive.org/web/20190122225059/https://www.healthline.com/nutrition/fractionated-coconut-oil] which appear not to harm helminths. One hookworm host who routinely consumes 3 to 10 tablespoons daily of MCT oil containing 55% caprylic acid and 35% capric acid has reported that this has no adverse effect on his colony, and that he is able to incubate more NA using eggs from this colony. [https://www.facebook.com/groups/678894952216125/permalink/2965258846913046/?comment_id=2966781426760788] '''Coconut fiber''', especially in the form of dried or ground coconut flesh (desiccated coconut, coconut flour) has long been used to expel intestinal worms, both in humans [https://www.facebook.com/groups/htsupport/permalink/1412001672189117/] and animals, [https://www.ncbi.nlm.nih.gov/pubmed/21120531] [https://www.ncbi.nlm.nih.gov/pubmed/24271156] and becomes more effective as the quantity increases. Eating an entire cake baked with coconut flour brought a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/946802485375707/] Most helminth hosts find that they can eat normal dietary amounts of coconut products without adversely affecting their worms, as can be seen in these examples. [https://www.facebook.com/groups/htsupport/permalink/877714092284547/?comment_id=880956541960302&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026771657378789&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026788797377075&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&reply_comment_id=2214230838632859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nevertheless, coconut products do have a potential to affect human hookworms in some individuals, especially '''coconut oil''' and '''coconut milk''', and the effect is often dose-dependent. For example, one hookworm host who checks the egg output of his worms has reported that they twice produced zero eggs for a period of time after he drank coconut milk. Another hookworm host gets increased pain a few hours after ingesting coconut milk or powder. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] Someone else found that, while consuming 200 mg of coconut milk caused a temporary return of mild symptoms of his disease, he regularly eats coconut oil without any obvious problem, but other hookworm hosts have reported a return of disease symptoms after consuming coconut oil. [https://www.facebook.com/groups/htsupport/permalink/1446457812076836/] [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409474272441857&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3536097503112846/] A hookworm grower has reported that he can consume coconut products "somewhat regularly" and still be able to incubate plenty of larvae, [https://www.facebook.com/groups/678894952216125/permalink/1407193439386269/?comment_id=1407718306000449&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but another grower has found that, while his colony continues to thrive and produce eggs when he takes 3 tablespoons of coconut oil each day, [https://www.facebook.com/groups/htsupport/permalink/1084278171628137/?comment_id=1088696887852932&comment_tracking=%7B%22tn%22:%22R%22%7D] about ⅓ of any larvae produced will be dead, and the rest “less energetic”, so he normally restricts himself to 2 tablespoons per day. '''Coconut water''' may also adversely affect a hookworm colony, as one host found after drinking 1 litre of coconut water, [https://www.facebook.com/groups/htsupport/permalink/1051741958215092/] and another found after drinking coconut water kefir, [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but one NA host has found that the [https://www.lacroixwater.com coconut essence-flavoured sparkling water produced by La Croix] had no ill effect on his worms. [https://www.facebook.com/groups/htsupport/posts/4820278211361429/] One hookworm host finds that '''all coconut products''' have an adverse effect, [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409105045812113&comment_tracking=%7B%22tn%22%3A%22R%22%7D] while two others have said that even small amounts of coconut quickly result in a loss of benefits. [https://www.facebook.com/groups/htsupport/permalink/1331489750240310/?comment_id=1339469669442318&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1526713510717932/?comment_id=1529128360476447&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Some '''CBD oils''' for vaping are suspended in coconut oil. However, most of these are only a 3% suspension, so *may* be safe for use while hosting human helminths. '''Coconut sugar''' should not carry the same degree of risk because, whereas coconut milk, oil and flour are all obtained from the flesh of mature coconuts, and coconut water is also from inside the fleshy part of the coconut, coconut sugar comes from the sap of coconut palm flower buds and consists largely of sugars. The seasoning sauce, '''Coconut Aminos''', is also made from coconut tree sap, and at least one hookworm host has used this regularly without issue. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1697083593680922&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cranberry Cranberry] (Vaccinium macrocarpon). This is claimed by some sources to contain antiparasitic enzymes, and cranberry powder is sometimes included in proprietary antiparasitic formulations, although evidence for its effectiveness in this context is lacking, and there have never been any reports of any form of cranberry having an adverse effect on therapeutic helminths. Cranberry juice was used traditionally to treat urinary tract infections (UTIs), but it works by changing the bacteria in ways that [http://www.medicalnewstoday.com/articles/198711.php prevent bacterial adhesion] rather than killing them. While drinking 15 fl oz of cranberry juice per day is claimed to help arrest a mild urinary infection, [http://www.medicalnewstoday.com/articles/306498.php cranberry powder capsules are more effective] and '''D-mannose''', a cranberry derivative, is even more effective than the powder.

* ❓ [https://en.wikipedia.org/wiki/Rub_(syrup) Date syrup], also known as “rub”. Laboratory tests have revealed that [http://www.sciencedaily.com/releases/2015/03/150330213949.htm some forms of date syrup may have antibacterial activity], possibly due to the presence of phenolic compounds that form naturally in the dates as they mature. Significantly, the syrup was able to inhibit the growth of bacteria faster than ⚡'''Manuka honey''', which several people have suspected of having adversely affected their worms. However, [https://www.facebook.com/groups/htsupport/permalink/811693292219961/?comment_id=811695265553097&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D eating dates is unlikely to be harmful to helminths].

* [https://en.wikipedia.org/wiki/Dietary_fiber Dietary fibre] (fiber). Some sources claim that eating a lot of fibre may reduce the number of intestinal worms, but fibre consumed as an integral part of a normal diet has not been reported to be a problem for human helminths.

* ❓ [https://en.wikipedia.org/wiki/Durian Durian] There are several species of fruit-producing durian trees, the most common of which is [https://en.wikipedia.org/wiki/Durio_zibethinus Durio zibethinus] So far, there have been no reports about durian from self-treaters, but [https://en.wikipedia.org/wiki/Bombax_ceiba Bombax malabaricum] - another member of the Bombacaceae plant family within which durian is classified - has shown significant anthelmintic activity against one flatworm species. [https://pubmed.ncbi.nlm.nih.gov/21853226/]

* ⚡[https://en.wikipedia.org/wiki/Fatty_acid Fatty acids]. Research on the direct effect of fatty acids on helminths is limited. However, the poly-unsaturated fatty acid (PUFA), linoleic acid, has shown in vitro nematocidal activity against both C. elegans [https://pubmed.ncbi.nlm.nih.gov/8202563/] [https://pubmed.ncbi.nlm.nih.gov/32674325/] and H. contortus, [https://pubmed.ncbi.nlm.nih.gov/20075977/] and it has been proposed that unsaturated fatty acids are likely to play a role in the natural attrition of S. mansoni and S. haematobium lung-stage larvae. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It has been hypothesised elsewhere that exposure to some fatty acids could cause lethal damage to helminths by interacting with, and compromising, the integrity of the organisms's cuticle, [https://pubmed.ncbi.nlm.nih.gov/34149425/] and in vitro exposure to arachidonic acid has been shown to cause disintegration of the surface membranes of the trematode, Schistosoma spp., eventually leading to parasite death. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It is likely that the undoubted adverse effect of some coconut products on NA - and possibly also TTO - in ''some'' hosts is due to the fatty acids these products contain, especially lauric acid (C12), and the evidence from the studies presented here suggests that other fatty acids may have an adverse effect on therapeutic helminths in a similar dose-dependent manner, influenced also by the strength of the host's immune response to helminths. People who are hosting NA, in particular, who are not experiencing the benefits they expected should therefore consider the possible effect of any fatty acids they consume, and experiment accordingly. (Also see [[#Medium-chain triglycerides|medium-chain triglycerides]] and [[#Coconut|⚡coconut]].)

* '''Guayusa tea''' ([https://en.wikipedia.org/wiki/Ilex_guayusa ilex guayusa]). The leaves of this Amazonian holly tree are brewed to make a caffeinated drink. One hookworm host who regularly drinks this tea has not noticed any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2248121518577124/?comment_id=2248562038533072&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Genetically_modified_foods Genetically modified foods] (GMOs). Some food crops, such as corn and rice, have been genetically modified to produce ❌'''Cry5B''', a protein that can kill intestinal worms, including the human hookworm. [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt), the bacterium that produces Cry5B, is also applied as a [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php natural insecticide] on crops on some organic farms, but there is no indication yet that GM foods are a potential threat to human helminths.

* [https://en.wikipedia.org/wiki/Grapefruit Grapefruit] (citrus paradisi). The flesh of the common grapefruit is perfectly safe to eat while hosting helminths, although ⚡'''grapefruit seed extract''' does have a potential to harm helminths due to the typical addition of synthetic adulterants. Also potentially harmful are some extracts of the rind of ❌'''Citrus decumana''', a close relative of the grapefruit.

* [https://en.wikipedia.org/wiki/Hibiscus Hibiscus]. One hookworm host has drunk many litres of strong, homemade hibiscus tea over the years without ever harming her colony. [https://www.facebook.com/groups/htsupport/permalink/2647270255328913/?comment_id=2647328495323089]

* ⚡ [https://en.wikipedia.org/wiki/Honey Honey]. Honey can contain antivirals [http://www.ncbi.nlm.nih.gov/pubmed/25333699] and powerful antimicrobials [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074369/], some of which can have effects comparable with those of antibiotics such as clarithromycin, and certain types of honey have particularly potent antimicrobial activity. Several people have suspected that [https://en.wikipedia.org/wiki/M%C4%81nuka_honey '''Manuka''' honey] (which inhibits dental plaque as effectively as chlorhexidine mouthwash [http://www.ncbi.nlm.nih.gov/pubmed/22114423]) has adversely affected their worms, while a few others have reported that '''raw''' honey reduces the benefits from their worms, [https://www.facebook.com/groups/htsupport/permalink/2517832904939316/?comment_id=2524053750983898] in one case causing increased pain several hours after ingestion, [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] and someone else, who had a few teaspoons of '''raw''' honey on two occasions, 4 days apart, has reported that some of his symptoms made a limited return for a day after each ingestion. [https://www.facebook.com/groups/htsupport/posts/5132147986841115/] Research reported in 2014 may explain why '''raw''' honey might have this effect. [http://www.sciencedaily.com/releases/2014/09/140908093741.htm] However, one hookworm host, who regularly takes a '''manuka''' honey/apple cider vinegar combination, has not noticed any loss of benefits, and another two have reported no apparent adverse effect on their worms after consuming '''raw''' honey. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] One of these individuals reports having eaten quite large amounts of '''raw''' honey continuously during his first 3 years with NA and never noticed anything untoward. [https://www.facebook.com/groups/htsupport/permalink/1802586329797314/?comment_id=1807740622615218&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Regular honey appears to be generally worm-safe, [https://www.facebook.com/groups/htsupport/permalink/1223658601023426/?comment_id=1224392167616736&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and, demonstrating the experience of many others, one hookworm host has said that she can consume 2-4 teaspoons of regular honey daily without any issues, but that manuka and any honey labeled as "raw" causes problems. (Identification of the different types of honey: '''Manuka''' honey, which is very viscous with a dark cream to dark brown colour, is produced by bees foraging specifically on the mānuka tree; '''Wild''' honey is often sourced from free-range hives, rather than box hives, by native gatherers who only remove larger honeycomb impurities; '''Raw''' honey is typically only strained to remove physical impurities such as beeswax and dead bees. '''Regular honey''' usually goes through additional processing including finer filtration to remove all debris and air bubbles, and pasteurisation to destroy yeasts. Regular honey may also be subject to utrafiltration, which further refines the product to make it more transparent and smooth, but also removes beneficial nutrients like pollen, enzymes and antioxidants.)

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_emblica Indian gooseberry]. (Phyllanthus emblica, also known as Emblica officinalis, emblic, emblic myrobalan, myrobalan, Malacca tree and amla.) While there are websites online that claim anti-parasitic effects for P. emblica, and one study found that P. emblica exerted toxic effects on a parasitic flat worm, [https://pubmed.ncbi.nlm.nih.gov/19819626/] there is no compelling evidence in the scientific literature for a possible adverse effect on hookworms. Neither have any reports of an adverse effect on their worms been posted by any NA self-treaters, and one study found that a traditional Thai preparation containing P. emblica actually extended the life of the research worm, C. elegans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693129/]

* [https://en.wikipedia.org/wiki/Kefir Kefir]. Although kefir has been claimed online to kill “parasites”, it will not harm hookworms unless it is made with coconut milk. (See [[#Coconut milk |details for coconut milk]].) There has also been a single report of an NA colony possibly being killed after drinking kefir made from coconut water. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (See [[#Coconut water |details for coconut water]].)

* [https://en.wikipedia.org/wiki/Kombucha Kombucha] (Medusomyces gisevii, also called tea mushroom, tea fungus or Manchurian mushroom.) This fermented drink does not harm helminths. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616509485071657]

* [https://en.wikipedia.org/wiki/Lime_(fruit) Lime] (Citrus acida). While alcoholic extracts of the rind of limes have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], and extracts of the rind may have an adverse effect on other helminths, there is no reason to believe that eating the flesh of limes will harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Medium-chain_triglyceride Medium-chain triglycerides] (MCTs) are extracted from ⚡'''coconut oil''', amongst other things, and can be divided into four groups: 1. caproic acid (C6), 2. caprylic acid (C8), 3. capric acid (C10) and 4. lauric acid (C12). [https://blog.bulletproof.com/the-definitive-guide-to-mcts/] Of these, lauric acid is the most well-known for its antibacterial, antimicrobial and antiviral properties, which may explain why coconut oil (which is 40-50% lauric acid) appears more likely to affect human helminths than products containing a mixture of all four types of MCT, such as the milk of cows, sheep and goats, the fatty acids in which contain 10-20% mixed MCTs. (Also see [[#Fatty acids|⚡fatty acids]] and [[#Coconut|⚡coconut]].) One NA host who took the "postbiotic" product, [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] has reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] and the only ingredient in this product that is known to be a potential problem is medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Onion Onion] (Allium cepa). This is used as an ingredient in some proprietary deworming formulations and has been claimed to create an 'uninhabitable environment' for intestinal worms and to help eradicate tapeworms in particular. However, if eaten in normal dietary quantities, onion should not harm therapeutic human helminths.

* [https://en.wikipedia.org/wiki/Organic_foods Organic foods]. While these are less likely to be contaminated with chemicals, some organic farmers apply [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) to their crops as a natural insecticide. This bacterium produces ❌'''Cry5B''', a protein that can kill intestinal worms, [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php including human hookworms]. However many hosts of human helminths have eaten organic foods without them affecting their worms.


* [https://en.wikipedia.org/wiki/Papaya Papaya] (Carica papaya, also known as or papaw, pawpaw or paw paw). The fruit and leaves contain both antiseptic and antiparasitic compounds, including one called [https://en.wikipedia.org/wiki/Carpaine carpaine], which is claimed to kill and expel intestinal worms. Papaya latex has been shown to be an [http://www.ncbi.nlm.nih.gov/pubmed/26343287 effective anthelmintic] against a variety of nematode parasites. However, it is unlikely that eating normal dietary amounts of the flesh of the fruit will adversely affect human helminths and, when someone who grows his own hookworms added a large amount of papaya - comparable to a human eating 2 or 3 pawpaws - to a petri dish full of larvae, these were unaffected. However, ⚡'''Papaya seeds''' are also rich in caricin which is reportedly effective in expelling roundworms. A randomized, placebo-controlled study found that a 20 ml dose of a mixture of air-dried papaya seeds and "natural" honey was effective against various types of human intestinal parasite, although the honey may have contributed to this effect. The mixture demonstrated 100% efficacy in clearing TT, and 80% efficacy against NA. [http://www.ncbi.nlm.nih.gov/pubmed/17472487] Also see [https://www.ncbi.nlm.nih.gov/pubmed/30526582 this paper].

* [https://en.wikipedia.org/wiki/Pomegranate Pomegranate] (Punica granatum). ✅The '''flesh and seeds''' of the pomegranate fruit have not been reported to harm human helminths. However, ❌'''pomegranate extracts''' should be avoided because the bark and stems of this plant contain an anthelmintic compound, punicine, and the bark of the root contains an even more potent form of this alkaloid. [https://www.ncbi.nlm.nih.gov/pubmed/32411422] Extracts of the bark of both the root and stems, and extracts of the rind/peel of the fruit, have a strong anthelmintic effect and are used as traditional remedies to treat roundworms, pinworms and tapeworms, to which they are said to be highly toxic. Alcoholic extracts of the rind/peel have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [https://www.ncbi.nlm.nih.gov/pubmed/1158424] These extracts may therefore have an adverse effect on other helminths, and one hookworm host has reported losing benefits from her colony after accidentally consuming a small amount of pomegranate extract. [https://www.facebook.com/groups/htsupport/permalink/1166864270036193/] Pomegranate peel is used in small quantities in dietary supplements and food preservatives and may not be a significant threat to human helminths in this form. However, ❌'''pomegranate peel powder''', which is available for purchase as a remedy for certain health conditions, might be harmful to helminths if it is used in quantity, for example as an ingredient in smoothies. One hookworm host found that while one company’s pomegranate '''''fruit''''' powder is produced from only the dried pomegranate arils (the seeds and their red fleshy coatings), and not including any peel, the same company’s pomegranate '''''juice''''' powder is produced from the whole fruit - both the seeds/arils and the peel. Neither product carries details on their packaging of which part of the pomegranate they contain, and this self-treater had only realised there was a difference when taking the latter product caused a return of his disease symptoms.

* ✅ [https://en.wikipedia.org/wiki/Pumpkin Pumpkin] and ⚡ [https://en.wikipedia.org/wiki/Pumpkin_seed Pumpkin seeds] (Cucurbita species). This is also referred to as squash or gourd, depending on species, variety and local parlance. Eating the flesh of the pumpkin/squash/gourd is unlikely to have any adverse effect on any human helminth. ⚡'''Pumpkin ''seeds''''' contain an antiparasitic compound called [https://en.wikipedia.org/wiki/Cucurbitacin curcurbitacin] and they were used traditionally as a remedy for tapeworms and roundworms. However, their effect is likely to be dose-dependent, and large amounts are recommend by herbalists for deworming, e,g., up to 25 ounces for adults. Some hookworm hosts have reported no adverse effect on their colony after eating pumpkin seeds, [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2889359654453304] [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2890447241011212&reply_comment_id=2895457573843512] while others have experienced either a temporary return of disease symptoms or even a loss of their colony. For example one found that eating a daily salad for a week with a mixed seed/nut topping containing pumpkin seeds killed her entire colony. [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2888764874512782] Another NA host has reported that taking 1000 mg of ⚡'''pumpkin seed oil''' daily for 2 months significantly reduced the fecundity of his NA, resulting in incubations producing only a handful of L3 larvae after having previously always yielded hundreds of larvae per incubation over a 7 year period. [https://www.facebook.com/groups/htsupport/permalink/1635384559850826/?comment_id=1635389889850293&reply_comment_id=1635944229794859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Since this individual is not treating a disease, but only acting as a reservoir donor, it is not known whether this amount of pumpkin seed oil might affect disease remission.

* [https://en.wikipedia.org/wiki/Radish Radish] (Raphanus sativus). This has been used as an alternative treatment for intestinal parasites, and is included as an ingredient in some proprietary deworming formulations, but it is unlikely to have any adverse effect on human helminths if eaten as part of a normal diet.

* ❌ [https://en.wikipedia.org/wiki/Sauerkraut Sauerkraut] Sauerkraut will not kill human helminths, but it can trigger significant digestive upset in some people, sufficient to cause a setback in the course of their treatment, and including diarrhoea severe enough to flush hookworms from the gut. Two hookworm hosts have reported experiencing significant upset stomach, “gut issues” and diarrhoea after eating only 2 and 3 forkfuls of sauerkraut respectively [https://www.facebook.com/groups/htsupport/permalink/1440317759357508/?comment_id=1440394666016484&reply_comment_id=1443382035717747][https://www.facebook.com/groups/htsupport/permalink/2726061500783121/?comment_id=3607483215974274] and another NA host lost his entire colony due to extreme diarrhoea following his first encounter with sauerkraut. [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓[https://en.wikipedia.org/wiki/Seaweed Seaweed] (macroalgae). Five poly-unsaturated fatty acids (PUFAs) identified in two Nordic seaweeds (S. latissima and L. digitata) were found to have in vitro effects against helminths in swine (Ascaris suum) and sheep (Teladorsagia circumcincta), with a clear synergistic effect being apparent when selected compounds were tested in combination. “Collectively, our data reveal that fatty acids may have a previously unappreciated role as natural anti-parasitic compounds, which suggests that seaweed products may represent a viable option for control of intestinal helminth infections.” [https://pubmed.ncbi.nlm.nih.gov/34149425/] However, there have been no reports so far of NA or TTO being adversely affected by the consumption of seaweed products. (Also see, [[#Fatty acids|⚡fatty acids]].)

* [https://en.wikipedia.org/wiki/Soy_sauce Soy sauce / soya sauce] This liquid condiment made with fermented soybeans is safe for use with human helminths.

* [https://en.wikipedia.org/wiki/Squash_(plant) Squash]. See '''Pumpkin''' above.

* [https://en.wikipedia.org/wiki/Sweet_potatoes Sweet potato] (Ipomoea batatas). Like the carrot, this root vegetable is rich in beta carotene, a precursor for vitamin A, which it has been claimed can increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat significant amounts of sweet potato (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without any adverse effect on their worms.

* [https://en.wikipedia.org/wiki/Tea Tea]. The aromatic beverage prepared by pouring hot or boiling water over cured or fresh leaves of the [https://en.wikipedia.org/wiki/Camellia_sinensis Camellia sinensis] plant, e.g., [https://en.wikipedia.org/wiki/Green_tea green tea], [https://en.wikipedia.org/wiki/Black_tea black tea], [https://en.wikipedia.org/wiki/White_tea white tea] and [https://en.wikipedia.org/wiki/Oolong oolong tea], is generally harmless to therapeutic helminths. However, there ''may'' be a risk of harm to human helminths if ❓medicinal quantities of concentrates, extracts or tinctures made from green tea are consumed. [https://www.researchgate.net/publication/5449030_Potential_anthelmintics_Polyphenols_from_the_tea_plant_Camellia_sinensis_L_are_lethally_toxic_to_Caenorhabditis_elegans]

* ⚡ [https://en.wikipedia.org/wiki/Thai_curry Thai curry]. One hookworm host found that a strong green Thai curry upset his colony to the extent that he needed to add a top-up dose to recover the benefits he had enjoyed previously. [https://www.facebook.com/groups/htsupport/permalink/2259967414059201/?comment_id=2260424784013464&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Juglans_regia Walnut], English (Juglans regia). Also known as the Persian, common, California, or Carpathian walnut. This does not appear to have gained a reputation as an anthelmintic, unlike the ⚡'''black walnut'''.

* [https://en.wikipedia.org/wiki/Watermelon Watermelon] flesh is not a problem for either NA or TTO, but there has been one report from an NA host that eating a "bunch" of ⚡watermelon seeds at a barbecue caused a loss of all worm benefits after about three days. [https://www.facebook.com/groups/htsupport/posts/6765576206831610?comment_id=6765885696800661]

* [https://en.wikipedia.org/wiki/Xylitol Xylitol]. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/833127066743250/?comment_id=833225923400031&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] that he takes xylitol daily in place of sugar and has not noticed any effect on his colony.

* [https://en.wikipedia.org/wiki/Yam_(vegetable) Yam] ([https://en.wikipedia.org/wiki/Dioscorea Dioscorea]). Like carrot and sweet potato, the yam is rich in beta carotene, a precursor for vitamin A which is thought to increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat this vegetable without adversely affecting their worms.
</blockquote>



=== Nutritional supplements ===

<blockquote>
'''✅ Supplements safe for human helminths, unless marked otherwise'''

* [https://en.wikipedia.org/wiki/5-Hydroxytryptophan 5-HTP] (5-Hydroxytryptophan, also known as oxitriptan and marketed under trade names such as Cincofarm, Levothym, Levotonine, Oxyfan, Telesol, Tript-OH and Triptum) This is used as an antidepressant, appetite suppressant and sleep aid. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/811459492243341/?comment_id=811659322223358&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] taking 5-HTP without any adverse effect on her worms.

* [https://en.wikipedia.org/wiki/Acetylcarnitine Acetylcarnitine] (Acetyl-L-carnitine, ALCAR or ALC) is produced naturally by the body, and has been taken by at least two hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1701750936547521&reply_comment_id=1702741433115138&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1702716603117621&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Acetylcysteine Acetylcysteine] (also known as N-acetylcysteine, N-acetyl-L-cysteine and NAC). Three hookworm hosts have reported taking this without causing any problems for their colonies. [https://www.facebook.com/groups/htsupport/permalink/832123420176948/?comment_id=832517453470878&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3049676998421568/?comment_id=3049740311748570] [https://www.facebook.com/groups/htsupport/posts/4840382556017661/?comment_id=4841276152594968]

* [https://en.wikipedia.org/wiki/Activated_charcoal_(medication) Activated charcoal] (also known as activated carbon). There have been no reports of this harming human helminths and three reports confirming that it does not harm NA. [https://www.facebook.com/groups/htsupport/posts/7846458328743387?comment_id=7847087392013814][https://www.facebook.com/groups/htsupport/permalink/513613715361255/?comment_id=514186115304015&comment_tracking=%7B%22tn%22:%22R0%22%7D][https://www.facebook.com/groups/htsupport/permalink/792437597478864/?comment_id=792881060767851&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R3%22%7D]

* [https://en.wikipedia.org/wiki/Lipoic_acid Alpha lipoic acid] (ALA), also known as Lipoic acid (LA), α-lipoic acid and thioctic acid. This organosulphur compound is made naturally in animals, where it is essential for aerobic metabolism. Because of its antioxidant properties, it is also sold as a dietary supplement and is available in some countries as a pharmaceutical drug. One host of both hookworms and human whipworms has taken between 300 and 600 mg of alpha lipoic acid per day without any harm befalling their worms.

* [https://en.wikipedia.org/wiki/Amine_oxidase Amine oxidase] (also known as diamine oxidase, DAO and histaminase). This enzyme, which is involved in the metabolism of histamine, is produced by the body and found in high concentrations in the digestive tract and placenta. It has therefore been suggested [https://www.facebook.com/groups/htsupport/permalink/883903308332292/?comment_id=883916171664339&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] that it is unlikely to be harmful to helminths, although there are not yet any reports to confirm this.

* [https://aseaglobal.com ASEA] Redox Supplement. This “catalytically processed” saline solution should not harm helminths, a fact confirmed by one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/2127858607270083/?comment_id=2129186490470628&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://atrantil.com/ Atrantil] contains three active botanicals: M. balsamea Willd (peppermint) leaf extract, quebracho extract and conker tree extract. While ⚡'''peppermint oil''' has proved to be a problem for some hosts of human helminths (see [[#Peppermint|peppermint reference]]), it is possible that the leaf extract may be worm-safe. However, quebracho extract has been shown to effectively reduce worm burdens in sheep. [http://www.fao.org/docs/eims/upload/agrotech/1905/R7424%20(04)%20Embu%20proceedings.pdf]

* ❓ Avocado seed extract. Extracts of the seeds of the avocado - also known as alligator pear or avocado pear ([https://en.wikipedia.org/wiki/Avocado Persea americana]) - may have an adverse effect on NA. While there have been no reports so far of this effect from self treaters who host either NA or TTO, caution is recommended when trying these extracts because there is scientific evidence suggesting that they possess broad spectrum anthelmintic activity against several other nematode species.

* [https://en.wikipedia.org/wiki/Bee_pollen Bee pollen]. One hookworm host has reported that eating small amounts of this has had no obvious adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Beta-Sitosterol beta-Sitosterol] has demonstrated anthelmintic effects [https://www.ncbi.nlm.nih.gov/pubmed/12587699] and three hookworm hosts have reported a return of their disease symptoms after taking beta-Sitosterol. (expired link), [https://www.facebook.com/groups/htsupport/permalink/1143218725734081/?comment_id=1146128268776460&comment_tracking=%7B%22tn%22:%22R0%22%7D], [https://www.facebook.com/groups/htsupport/posts/7569548336434389/]

* [http://www.webmd.com/vitamins-supplements/ingredientmono-312-BETAINE%20HYDROCHLORIDE.aspx?activeIngredientId=312&activeIngredientName=BETAINE%20HYDROCHLORIDE Betaine hydrochloride]. Two hookworm hosts have reported using betaine HCL without noticing any loss of benefits from their worms. [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106534052735882&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106538649402089&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://www.facebook.com/groups/htsupport/permalink/2070288819693729/?comment_id=2070391136350164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Boron Boron] and [https://en.wikipedia.org/wiki/Borax Borax]. Boron is a chemical element and a trace element in human and plant nutrition. Only small amounts of boron are required for health and an excess can be toxic. It is unlikely to have an adverse effect on helminths when consumed in dietary quantities. Borax is a mineral containing boron which has antifungal properties and also certain [https://en.wikipedia.org/wiki/Borax#Toxicity health risks]. One hookworm host has reported taking 1/2 teaspoon borax per day for 6-7 weeks without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/1232677046788248/?comment_id=1404263146296303&reply_comment_id=1404577376264880&comment_tracking=%7B%22tn%22%3A%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1404253479630603/?comment_id=1404658099590141&reply_comment_id=1405046696217948&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/BPC-157 Bpc 157] This pentadecapeptide, also known as PL 14736, was taken intranasally over 4 days by one NA host who has reported no negative effect on his colony in that time. [https://www.facebook.com/groups/htsupport/posts/6283059368416632/?comment_id=6283148771741025]

* [https://en.wikipedia.org/wiki/Chlorella Chlorella]. One hookworm host took ½ teaspoon of this single-cell green algae daily for a year without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1037512569638031/?comment_id=1037568506299104&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Chlorophyllin Chlorophyllin]. This semi-synthetic derivative of chlorophyll is used as a food colouring agent (e.g., E number E141) and as a treatment aimed at reducing various bodily odours, but its suitability for use by helminth hosts has been questioned because of its apparent [https://www.ncbi.nlm.nih.gov/pubmed/19009310 ability to kill mosquito larvae and other small animals] at low concentrations, although this effect appears to be dependent on the presence of sunlight. (Also see ✅[[#Chlorophyll|Chlorophyll]].)

* [https://en.wikipedia.org/wiki/Chondroitin_sulfate Chondroitin Sulfate]. In an animal study, chondroitin sulfate was shown to prevent threadworms from establishing in the digestive system, but one NA host has taken 900 mg daily for several years without any adverse effect on his worms.

* [https://en.wikipedia.org/wiki/Colostrum Colostrum]. A hookworm host has taken this without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1145589722163648/?comment_id=1145807582141862&comment_tracking=%7B%22tn%22:%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/Mannose D-mannose]. This naturally occurring simple sugar is the ingredient in cranberries that makes their juice effective against urinary tract infections. Pure D-mannose is 10-50 times stronger than cranberry juice, making it more suitable for stubborn cases of UTI, and it reportedly resolves more than 90% of all UTIs within 1-2 days. [https://web.archive.org/web/20210211080155/http://www.tahomaclinicblog.com/d-mannose-for-bladder-and-kidney-infections/], [http://www.townsendletter.com/May2014/gaby0514.html] Taking steps to make the urine less acidic (e.g., by taking Tums[https://www.tums.com/]) might [http://www.sciencedaily.com/releases/2015/06/150625161623.htm make cranberry-based treatments even more effective]. D-mannose is non-toxic, produces no adverse effects and, while there have been no reports to confirm it’s lack of adverse effects on human helminths, it is unlikely to do them any harm.

* ⚡ [https://en.wikipedia.org/wiki/Digestive_enzymes Digestive enzymes], such as papain and bromelain, are said to make the intestinal tract inhospitable to parasites by dissolving their outer layers. In particular, papain - the milky juice of the unripe papaya - is claimed to be a powerful agent for destroying roundworms. One subject has reported a return of symptoms after taking a product containing papain, bromelain, protease, lipase and amylase for several weeks, and another individual has reported losing their entire hookworm colony after taking ''Healthy Origins Broad Spectrum Digestive Enzymes'' [https://healthyoriginseurope.com/products/digestive-enzymes-nec-broad-spectrum?variant=31997110714427] (amylase, protease, peptidase, alpha-galactosidase, glucoamylase, acid maltase, cellulase, pectinase, protease, lipase, lactase, beta-glucanase, invertase and hemicellulase). However, several other hookworm hosts have taken digestive enzymes, including ''Terranova's Quercetin Nettle Complex'' which contains bromelain, without any obvious effect on their worms, [https://www.facebook.com/groups/htsupport/permalink/888731831182773/?comment_id=888738757848747&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] and one of these has regularly taken pancreatin-based products from different manufacturers, mostly from ''Pure Encapsulations'', but also a lipase product by ''Integrative Therapeutics''. Another hookworm host who regularly takes digestive enzymes but has never noticed any adverse effect on his colony, generally avoids papain and bromelain, but regularly takes pancreatin, lipase, ''Acid Ease'', and occasionally ''Udo's Choice'' enzymes. Udo's Choice brand does contain some bromelain, but only a small amount. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] One NA host has reported that 500 mg bromelain twice daily appeared to be well tolerated by his hookworms, and someone else noticed no adverse effect on his NA colony after taking ''Enzymedica Digest Spectrum Multiple Food Intolerance Formula'' (amylase, xylanase, protease, alpha galactosidase, glucoamylase, lactase, lipase, maltase, cellulase, invertase, pectinase and hemicellulase). [https://www.facebook.com/groups/htsupport/posts/4876772765711973?comment_id=4879285832127333] And two other NA hosts have taken a product containing lipase (40,000 USP units), protease (126,000 USP units) and amylase (168,000 USP units) without issue. [https://www.facebook.com/groups/htsupport/posts/6285531644836071/?comment_id=6285909298131639]See also ✅[[#Papaya|Papaya]], and, for a brief explanation of how to stimulate one’s own natural enzyme production using a simple form of micro-massage, see [https://www.foodsmatter.com/nutrition_micronutrition/miscellaneous/articles/free_digestive_enzymes.html this article].

* [https://en.wikipedia.org/wiki/3,3%27-Diindolylmethane Diindolylmethane (DIM)]. 3,3′-Diindolylmethane has never been mentioned by hosts of human helminths as being harmful to their worm colonies, which is unsurprising because it’s a natural compound that is created in the body from the digestion of cruciferous vegetables such as cauliflower, broccoli and Brussels sprouts. Supplements containing DIM are simply a concentrated form of this natural substance.

* [https://en.wikipedia.org/wiki/Folic_acid Folic Acid] has been claimed to help prevent the proliferation of intestinal parasites at a dosage of 400 - 800 mcg (0.4 - 0.8 mg) per day. However, this is not a problem for human helminths because they do not proliferate within their hosts, and there have been no reports of adverse effects from hosts of human worms. One subject has taken a daily vitamin B-complex supplement containing 400 mcg of folic acid without any apparent effect on his hookworms, and another has taken 800 mcg of folate (as calcium L-5 methyltetrahydrofolate) every day for over 4 years with no adverse effect on his hookworms.

* [https://en.wikipedia.org/wiki/Fructooligosaccharide FOS] (fructooligosaccharide) is said to inhibit parasites from attaching to the intestines but no helminth host has reported any problem with this so far.

* [https://en.wikipedia.org/wiki/Fulvic_acid Fulvic acid]. This is a form of [https://en.wikipedia.org/wiki/Humic_acid humic acid] which two hookworm hosts have taken without any apparent adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/] [https://www.facebook.com/groups/htsupport/permalink/1132472786808675/?comment_id=1132930603429560&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Ginseng Ginseng]. Members of the genus, [https://en.wikipedia.org/wiki/Panax Panax], appear not to be harmful to human helminths, and one hookworm host has reported taking ginseng without noticing any untoward effect. [https://www.facebook.com/groups/htsupport/permalink/1453317641390853/?comment_id=1453345564721394&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Glucosamine Glucosamine] may be beneficial for roundworms. Applying this amino sugar experimentally to one roundworm species caused the treated worms to live around 5% longer than their untreated counterparts. [http://www.medicalnewstoday.com/releases/275263.php]

* [https://en.wikipedia.org/wiki/Glutathione Glutathione]. One hookworm host who has taken [https://en.wikipedia.org/wiki/Liposome liposomal glutathione] says he’s confident that this did not harm his worms, [https://www.facebook.com/groups/htsupport/permalink/803451913044099/?comment_id=803468529709104&offset=0&total_comments=6] and several people who have taken other oral glutathione supplements have reported no adverse effects. A hookworm host who received intravenous injections containing glutathione experienced no adverse effect on her NA colony. [https://www.facebook.com/groups/htsupport/permalink/1668651476524134/?comment_id=1668819739840641&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Grape_seed_extract Grape seed extract]. After taking 4 capsules of a product containing 200mg grape extract, 200mg grape seed extract and 200mg Muscadine grape every day for 2 weeks, one hookworm host carried out a successful incubation, indicating that the product had not adversely affected her colony. [https://www.facebook.com/groups/htsupport/permalink/2233069223415687/?comment_id=2282502821805660&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (Also see [[#Grapefruit seed extract (GSE)|Grapefruit seed extract (GSE)]], which can adversely affect human helminths in some people.)

* [https://en.wikipedia.org/wiki/Inulin Inulin] Knowing that chicory can have an adverse effect on human hookworms, a few hookworm hosts have been concerned when finding "inulin from chicory" listed among the ingredients in some supplements. However, while chicory root is a common source of inulin, its commercial processing removes everything but the fructose-based polysaccharide - the dietary fibre which is used in food supplements and to sweeten, or otherwise improve the nutritional value of, manufactured food products. Inulin is therefore not considered to be a threat to human helminths.

* [https://en.wikipedia.org/wiki/Iron Iron]. Supplementary iron taken orally does not harm helminths, but one hookworm host has reported having apparently lost her worms on two occasions after receiving ❓intravenous iron infusions. [https://www.facebook.com/groups/htsupport/permalink/2033546613367950/?comment_id=2033644093358202&reply_comment_id=2033832696672675&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓Lumbricus Tonic. This discontinued [https://www.nutricology.com Nutricology] product contained a powdered earthworm extract as well as ⚡'''sweet flag''' root extract. The herb was last on the list of ingredients however, and there had been no reports by hosts of therapeutic helminths to suggest that the product might be a problem for worms.

* [https://en.wikipedia.org/wiki/Melatonin Melatonin]. This hormone, which is commonly used as a sleep aid, has been taken by many helminth hosts, none of whom have reported any adverse effects on their worm colonies.

* [https://en.wikipedia.org/wiki/Modified_citrus_pectin Modified citrus pectin] (also known as citrus pectin, Pecta-Sol, PectaSol and MCP) is a complex carbohydrate extracted from citrus fruits using a chemical extraction process that makes it soluble, absorbable and more digestible. This is unlikely to have any effect on helminths.

* [https://en.wikipedia.org/wiki/Moringa_oleifera Moringa] (Moringa oleifera, also known as drumstick tree, horseradish tree, ben oil tree and benzoil tree) Although described as a “natural anthelmintic”, moringa has been taken by two helminth self-treaters with no apparent adverse effect on their hookworms. The first takes a 500 mg capsule of 10 to 1 extract (from 5000 mg of Moringa olifeira) twice a week, [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1039406139448674&reply_comment_id=1039533526102602&comment_tracking=%7B%22tn%22:%22R4%22%7D] while the second grows and harvests her own moringa. [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1040747242647897&comment_tracking=%7B%22tn%22:%22R%22%7D] Whatever anthelmintic properties moringa might have may depend on the part of the plant used.

*❓[https://en.wikipedia.org/wiki/Methylsulfonylmethane MSM] (Methylsulfonylmethane) is claimed by one source to be effective against many types of intestinal worm including Enterobius (pinworm [US], threadworm [UK]) and the roundworm, Ascaris. It is suggested that MSM blocks the interface between the parasite and the host by competing with the parasite for binding sites at the surface of the mucous membrane, and that the parasites may find the resulting MSM 'film' impenetrable. However, it may be necessary to take 10,000 mg of MSM per day for three or four weeks to achieve this effect, and one helminth host has reported that he has occasionally taken up to 1 heaped tablespoon of MSM while hosting helminths to treat eczema flare-ups, and has not noticed any loss of worm benefits. Someone else who takes a heaped teaspoonful of equine MSM every other day has also reported observing no adverse effects on her NA. [https://www.facebook.com/groups/htsupport/posts/4170339756355281?comment_id=4174905152565408]

* [https://en.wikipedia.org/wiki/Nattokinase Nattokinase] This serine protease (or serine endopeptidase), which is taken as a nutritional supplement, is an enzyme that cleaves peptide bonds in proteins. Two NA hosts have reported taking 200 mg and 500 mg respectively twice daily with no adverse effect on their hookworm colonies.

* [https://en.wikipedia.org/wiki/Omega-3_fatty_acid Omega-3 fatty acid] supplements are taken regularly by a large number of people, and have not been reported to be harmful to any helminth species. Indeed, omega-3 fatty acids have been found to extend the lifespan of some worms. [https://pubmed.ncbi.nlm.nih.gov/28772063/]

*❓[https://en.wikipedia.org/wiki/Seaprose_S Oryzin] (Aspergillus alkaline proteinase, aspergillopeptidase B, API 21, aspergillopepsin B, aspergillopepsin F, Aspergillus candidus alkaline proteinase, Aspergillus flavus alkaline proteinase, Aspergillus melleus semi-alkaline proteinase, Aspergillus oryzae alkaline proteinase, Aspergillus parasiticus alkaline proteinase, Aspergillus serine proteinase, Aspergillus sydowi alkaline proteinase, Aspergillus soya alkaline proteinase, Aspergillus melleus alkaline proteinase, Aspergillus sulphureus alkaline proteinase, prozyme, P 5380, kyorinase, seaprose S, semialkaline protease, sumizyme MP, prozyme 10, onoprose, onoprose SA, protease P, promelase.) There have been no reports as yet about the possible effects on human helminths of taking this mould/mold-derived proteinase.

* [https://en.wikipedia.org/wiki/Palmitoylethanolamide Palmitoylethanolamide] (PEA) This is unlikely to harm NA, and one NA host who took it for a number of weeks has confirmed that it didn’t harm his worms. [https://www.facebook.com/groups/htsupport/posts/6318336784888890/?comment_id=6318488838207018]

* [https://en.wikipedia.org/wiki/Probiotic Probiotics]. There are many hosts of the human helminths, NA and TTO, who take probiotics regularly, in some cases several different ones each day, [https://www.facebook.com/groups/htsupport/permalink/2644164455639493/?comment_id=2645824198806852] yet there have been no reports by any of them that their worms have been adversely affected. [https://en.wikipedia.org/wiki/Akkermansia_muciniphila Akkermansia muciniphila] was initially suspected in two cases of having caused a loss of hookworms, but these events were more likely to have been the result of the extended adverse reaction that can often be experienced to this particular probiotic when it is first taken, can last for several weeks [https://www.facebook.com/groups/htsupport/posts/8333525306703351/?comment_id=8456943157694898&reply_comment_id=8459002264155654] and, in one case, may have lasted for a couple of months. [https://www.facebook.com/groups/htsupport/posts/8333525306703351?comment_id=8456943157694898&reply_comment_id=8459072834148597] It is known that a number of probiotics - predominantly Lactobacillus species - can have strain-specific effects on certain “parasites”, and, while most of these are not helminths, [https://www.hindawi.com/journals/jpr/2011/610769/] there is some evidence that the milk-based probiotics, lactobacilli and bifidobacteria, may reduce the benefits of HDC. [https://helminthictherapywiki.org/wiki/Self-treating_with_HDC#Probiotics] It is known that some bacteria are capable of mobilizing nematode-trapping fungi, [http://www.nature.com/articles/ncomms6776] and that Saccharomyces boulardii can have an adverse effect on the dog roundworm, Toxocara canis, [http://www.ncbi.nlm.nih.gov/pubmed/26971490] but S. boulardii and soil-based organisms are likely to be OK for HDC, and S. boulardii has been taken by at least two hookworm hosts without any obvious effect on their worms.

*❓[https://en.wikipedia.org/wiki/Propolis Propolis]. An apitherapist speaking at the 2010 International [http://www.bterfoundation.org BTeR Foundation] Conference on Biotherapy had spoken about the antiparasitic properties of this bee product, and suggested that it might harm helminths. Then, a paper published in 2020 revealed that Brazilian red propolis exhibits antiparasitic properties both in vitro and in vivo, and reduces worm burdens and egg production in a mouse model of infection by the helminth, Schistosoma mansoni. [https://pubmed.ncbi.nlm.nih.gov/32918996/] While this new research does not prove that propolis will be harmful to therapeutic helminths, it does make this possibility look more likely. However, one NA host has reported consuming propolis in the form of a dark brown chewing gum, without any obvious effect on his colony. He also reports that the content of propolis varies widely depending on the plants growing around the hive. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3465063380216259] This variation in constituents also results in propolis from different locations having different colours, and it's possible that the different colours might have differing effects on helminths, with green propolis ''possibly'' being the safest. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3703669629688965]

* [https://en.wikipedia.org/wiki/Psyllium Psyllium] appears not to harm hookworms, and one NA host has reported taking 4 rounded tsp of Metamucil (containing powdered psyllium seed husks) every day without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/3363462447043020?comment_id=3364793813576550]. However, psyllium is said to be effective in helping to remove parasite eggs from, and preventing parasites "taking root" in, the gut [https://gutbliss.com/psyllium-husk-a-complete-guide/] and there are indications from one TT host that his regular use of psyllium may be reducing his TT colony and preventing him from culturing this species.

* [https://en.wikipedia.org/wiki/Pyrroloquinoline_quinone Pyrroloquinoline quinone (PQQ)] This enzyme cofactor has been taken by several hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248812458508040&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248893555166597&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Quercetin Quercetin]. Although identified as a promising lead candidate for development as an anthelmintic product, [https://www.nature.com/articles/s41598-025-34049-5] self-treaters have reported that, if taken on its own, quercetin does not harm therapeutic helminths. [https://www.facebook.com/groups/htsupport/permalink/2403427306379877/?comment_id=2404196192969655] [https://www.facebook.com/groups/htsupport/posts/5173747102681203?comment_id=5173760879346492] However, if it is combined with a digestive enzyme - as it often is, to improve absorption - helminths may be adversely affected. See entry for ⚡[[#Digestive enzymes|Digestive enzymes]].

* [https://intelligenceofnature.com/pages/restore Restore]. This supplement, the active ingredient in which is Terrahydrite, was used by someone reporting that her colony is normally particularly sensitive, but was unaffected when she took Restore for long periods. [https://www.facebook.com/groups/htsupport/permalink/1967905053265440/?comment_id=1967995116589767&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Resveratrol Resveratrol]. This may have an adverse effect on some helminths, [http://www.ncbi.nlm.nih.gov/pubmed/19562377] but this is likely to depend on dose size, and three hosts of human helminths who regularly take this compound report no adverse effect on their worms. One has taken “Perfect Resgrape Max” (400 mg trans-resveratrol) daily for many months with no apparent ill effects on her NA. [https://www.facebook.com/groups/htsupport/permalink/1803160683073212/?comment_id=1803255516397062&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (People with MS might want to avoid resveratrol anyway. [http://medicalxpress.com/news/2013-09-resveratrol-red-wine-worsens-ms-like.html])

* [https://en.wikipedia.org/wiki/S-Adenosyl_methionine S-Adenosyl methionine] (SAM, also known as SAMe, SAM-e or AdoMet) has only been reported on by one hookworm host, who observed no adverse effect on his worms after taking 200-400mg SamE per day for several months.

* [https://en.wikipedia.org/wiki/Serratiopeptidase Serrapeptase] (also known as serratiopeptidase, Serratia E-15 protease, serralysin, serratiapeptase, serratia peptidase, serratio peptidase, or serrapeptidase). This proteolytic enzyme (protease) has been taken occasionally by one TTO host two or three times per day over a 4 year period to treat intestinal spasm, without affecting her worms. [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357766200945998&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357787397610545&reply_comment_id=1385081271547824&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has also been taken (at 160k SPU [80mg] per day) for prolonged periods by a hookworm host with no apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&reply_comment_id=2244261005629842&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Spirulina_(dietary_supplement) Spirulina]. This cyanobacterium is [http://www.ncbi.nlm.nih.gov/pubmed/25599112 an effective anti-inflammatory] that is being used by a number of hosts of human helminths without causing any harm to their worms. One hookworm host takes 10 grams of spirulina every day without noticing any deleterious effects on his colony. [https://www.facebook.com/groups/htsupport/permalink/2041940819195196/?comment_id=2043585499030728&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, it is worth noting that a significant proportion of algae-derived products tested in one study were found to contain an unhealthy amount of cyanotoxins caused by overgrowth of cyanobacteria due to the dumping of agricultural fertilisers into waterways. These bacterial products might not harm helminths, but they can contribute to neurological disorders like ALS in humans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371831/]

* [https://en.wikipedia.org/wiki/Sulforaphane Sulforaphane / sulphoraphane] This organosulfur compound, which is obtained from cruciferous vegetables such as broccoli, Brussels sprouts and cabbages, has been taken in large amounts by one hookworm host without it affecting his colony. [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&reply_comment_id=1724935230895758&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Taurine Taurine] is an organic acid that occurs naturally in food, especially seafood and meat (in which form it is no threat to helminths) but it is also produced synthetically and included in a number of products such as health drinks. In this form, it has been linked to a number of [https://web.archive.org/web/20201030111526/https://healthiertalk.com/dangers-taurine-commonly-found-energy-drinks-0996/ health problems], and has consequently been banned in some countries. It has also been shown to have anthelmintic effects, but only against a non-therapeutic helminth [http://www.ncbi.nlm.nih.gov/pubmed/23832642 in mice]. One helminth self-treater has taken 3 grams of taurine per day without any adverse effect on her hookworms. [https://www.facebook.com/groups/htsupport/permalink/2178145842241359/]

* [https://en.wikipedia.org/wiki/Theanine Theanine] This amino acid analogue is commonly known as L-theanine and sometimes L-gamma-glutamylethylamide or N5-ethyl-L-glutamine. It is not to be confused with threonine (a distinct amino acid), theine (an ancient name for caffeine) or thiamine (a B vitamin). Theanine is safe for use by helminth hosts. [https://www.facebook.com/groups/htsupport/posts/8722883501100861/?comment_id=8723517234370821]

* [https://en.wikipedia.org/wiki/Zinc Zinc] is said to inhibit the proliferation of intestinal parasites by stimulating various aspects of the immune system in the digestive tract that counteract parasites. In one animal study [http://jn.nutrition.org/content/130/5/1412S.full] the rodent nematode worm, H. polygyrus, was found to be better able to survive in mice which had been deliberately made deficient in zinc. Those who claim that zinc is an effective antiparasitic in humans suggest a dosage of 15-50 mg per day, but several helminth hosts have taken supplements containing this amount of zinc, in some cases continuously, without issue. One hookworm host takes 10 mg on alternate days, [https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930318850357404&comment_tracking=%7B%22tn%22:%22R0%22%7D],[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930807120308577&comment_tracking=%7B%22tn%22:%22R%22%7D] another has taken 15 mg zinc gluconate or zinc picolinate daily for several years, while yet another has taken 23 mg zinc gluconate/citrate plus 18.75 mg zinc acetate daily, and previously took 30mg zinc picolinate daily[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=943449092377713&comment_tracking=%7B%22tn%22%3A%22R%22%7D], all without any apparent adverse effect on their worms. However, someone who was trying to grow his own hookworms had no success with incubation while he was taking a zinc supplement, the dose of which he had increased slowly to a maximum of 130 mg/day. Three weeks after he stopped all zinc intake, he found NA larvae in his incubations for the first time. [https://www.facebook.com/groups/678894952216125/posts/4716370328468547] ❌[https://en.wikipedia.org/wiki/Zinc_oxide%23ZnO_nanostructures Zinc oxide nanoparticles (ZnO NPs)] have shown strong anthelmintic effects, in vitro, against several gastrointestinal nematodes encountered in veterinary medicine. [http://www.ncbi.nlm.nih.gov/pubmed/26177503] [https://www.ncbi.nlm.nih.gov/pubmed/29975659] [https://www.ncbi.nlm.nih.gov/pubmed/31931890] As well as their topical use in sunscreens and cosmetics, zinc oxide nanoparticles are also used in some food products (in spite of the fact that they can cause DNA damage), but the amounts used in this application may be too small to harm human helminths.

* [https://en.wikipedia.org/wiki/Vitamin_A Vitamin A]. Supplementation with this vitamin has no adverse effect on helminths [https://www.ncbi.nlm.nih.gov/pubmed/25127885] but a vitamin A deficiency may reduce colonisation by worms. [https://www.ncbi.nlm.nih.gov/pubmed/24458645]

* [https://en.wikipedia.org/wiki/Vitamin_C Vitamin C]. This does not harm helminths, even in high doses.

* Xuezikhang, a [https://en.wikipedia.org/wiki/Red_yeast_rice red yeast rice] product, appears to be harmless to hookworms. [https://www.facebook.com/groups/htsupport/permalink/1347982335257718/?comment_id=1348392021883416&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



=== Spices and culinary herbs ===
<blockquote>

* ❓ [https://en.wikipedia.org/wiki/Annatto Annatto / roucou] (Bixa orellana). One in vitro study found that higher concentrations of extracts of B. orellana seeds were effective against the earthworm species, Eisenia fetida, [https://www.researchgate.net/publication/356635196_Evaluation_of_Antihelminthic_Activity_of_Bixa_orellana] but it was not tested in intestinal helminths. There has been a single claim [https://www.reddit.com/r/HelminthicTherapy/comments/wmm6im/caution_annatto_can_harm_na] by an NA host of a return of disease symptoms shortly after starting to take an annatto and rice dietary supplement containing a high concentration of delta-tocotrienol, a form of vitamin E: [https://tricutis-shop.de/DeltaTop-delta-Tocotrienol DeltaTop delta-Tocotrienol].

* ❓ [https://en.wikipedia.org/wiki/Asafoetida Asafoetida] has been used as an anthelmintic in traditional medicine in several parts of the world [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459456/] but there has only been one report to date of its use by someone hosting therapeutic helminths, and this user says that he hasn’t noticed any ill effect on his hookworms after occasionally consuming foods that list asafoetida as an ingredient.

* ✅ [https://en.wikipedia.org/wiki/Basil Basil] Ocimum basilicum, also called great basil, is a culinary herb in the family Lamiaceae (mints) used in cuisines worldwide. In Western cuisine, the generic term "basil" refers to the variety also known as Genovese basil or sweet basil, of which there are many cultivars, including Napolitano basil, also known as Napoletano basil, Neapolitan basil, Mammoth basil, Bolloso Napoletano basil, Napolitano Mammoth-Leafed basil and Italian Large-Leaf basil. Several hookworm hosts have eaten basil and drunk tea made from it without any harm befalling their worms [https://www.facebook.com/groups/htsupport/permalink/872768092779147/?comment_id=872772372778719&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7987286861327199?comment_id=7987574677965084] [https://www.facebook.com/groups/htsupport/posts/7987286861327199/?comment_id=7992929767429575] ❓[https://en.wikipedia.org/wiki/Ocimum_tenuiflorum '''Holy basil'''] (Ocimum tenuiflorum, also known as Ocimum sanctum, tulsi and tulasi/thulasi) is claimed online to be antiparasitic. There is also evidence showing that its essential oil has potent anthelmintic activity, including against the research worm, C. elegans, [http://www.ncbi.nlm.nih.gov/pubmed/11543966] and it has shown some activity against the malaria parasite, [http://www.ncbi.nlm.nih.gov/pubmed/21643655] but there is no indication yet as to how Holy Basil might affect human helminths. Holy Basil is used for religious purposes, in traditional medicine and Ayurveda. It is also used for its essential oil and is widely used as an herbal tea.

* ⚡ [https://en.wikipedia.org/wiki/Black_pepper Black pepper] (Piper nigrum). This is often used as an ingredient in proprietary parasite cleanses due to its established antiparasitic effects. It could therefore have an adverse effect on human helminths, though this is likely to be dependent on the dosage and on the form taken. So, while use of the whole spice in small quantities as a condiment is unlikely to present a problem, taking medicinal quantities of black pepper may harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Bunium_bulbocastanum Bunium bulbocastanum] This vegetable/spice, which is commonly called black cumin, great pignut, black zira or earthnut, is thought to be harmless to helminths when consumed in dietary quantities.

* ⚡ [https://en.wikipedia.org/wiki/Cayenne_pepper Cayenne] (Cayenne pepper is a type of [https://en.wikipedia.org/wiki/Capsicum_annuum Capsicum annuum], and cayenne powder is generally made from [https://en.wikipedia.org/wiki/Bird%27s_eye_chili bird's eye chili peppers], which are classified as [https://archive.org/details/spiceshenry00ridlrich/page/360/mode/2up?view=theater Capsicum minimum] and often mistaken for the similar-looking [https://en.wikipedia.org/wiki/Capsicum_frutescens Capsicum frutescens], cultivar [https://en.wikipedia.org/wiki/Siling_labuyo siling labuyo], the fruits of which are generally smaller and grow in an upwards direction.) Cayenne is claimed to irritate parasites, and often appears as an ingredient in proprietary parasite cleansing products for pets and humans. There have been a couple of reports of an adverse effect on hookworms, including from someone who says that even a smidgen of cayenne causes her to temporarily lose the benefits from her worms. [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1063030367086251&reply_comment_id=1063315093724445&comment_tracking=%7B%22tn%22:%22R1%22%7D] Someone else who has reported a loss of benefits after taking a "lot" of cayenne, has said that their benefits also returned after they stopping taking the cayenne. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1951836918205587&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1956996454356300&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another cayenne user who reported that, in her early days with NA, she topped some meals with about ⅛ tsp of cayenne, has said that, in her case, the worms seemed to be unaffected. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1952375724818373&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Chili_pepper Chili pepper] (chile, chile pepper, chilli pepper, or chilli). While this is used worldwide as a treatment of certain parasites, and has been demonstrated effective against fascioliasis in animals, evidence that chili might be a problem for therapeutic helminths is lacking. One hookworm host has reported that, while cayenne has had negative responses for him, chilli peppers have not been a problem in his experience, [https://www.facebook.com/groups/htsupport/posts/892904287432194?comment_id=6868887949833768] and nor have jalapenos, whether fresh or pickled. [https://www.facebook.com/groups/htsupport/posts/6863122353743661/?comment_id=6868980269824536] Another hookworm host has been reported [https://www.facebook.com/groups/htsupport/permalink/892904287432194/?comment_id=892912737431349&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] to have eaten a HUGE amount of chili during 4 years as a worm host, without any obvious adverse effect on his colony.

* ⚡ [https://en.wikipedia.org/wiki/Cinnamon Cinnamon] is antimicrobial, as well as being claimed to be effective against parasites, including some parasitic worms, and it appears in lists of ingredients in proprietary parasite cleansing products. The main antimicrobial component of cinnamon is ⚡[https://en.wikipedia.org/wiki/Cinnamaldehyde cinnamaldehyde], and this is most concentrated in cinnamon essential oil and cinnamon oleoresins (solid resin extracts produced using solvents) which can be very high in cinnamaldehyde. Forms containing somewhat less cinnamaldehyde are raw cinnamon and cinnamon tinctures which are dissolved in alcohol and about half the strength of raw cinnamon. As cinnamaldehyde is steam-volatile and not water soluble, aqueous extracts of cinnamon should contain less of this substance, and dehydrated/powdered extracts (the form most likely to be encountered in dietary supplements) may contain little, if any at all, so should be less of a threat to helminths. [https://www.facebook.com/groups/htsupport/permalink/2225192197536723/?comment_id=2226458237410119&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Generally, the stronger the taste, the more cinnamaldehyde is likely to be present. While the raw spice is generally safe for use in cooking, there has been one report of someone with helminths relapsing after taking an unspecified supplement containing cinnamon, (link expired) and another report of a return of symptoms after eating a rice pudding made with cinnamon. (Link expired)

* ⚡ [https://en.wikipedia.org/wiki/Clove Clove] (Syzygium aromaticum/Eugenia caryophyllus). Clove oil, which was used traditionally to kill intestinal worms and is claimed to anesthetize fish, contains several powerful antimicrobial agents. While one of these, [https://en.wikipedia.org/wiki/Eugenol eugenol], is claimed to be anthelmintic, its use didn't produce any loss of benefit in one helminth host who applied it liberally to a dry socket following a difficult tooth extraction, and this was in spite of swallowing and breathing eugenol and a related compound called guaiacol.

* ✅ [https://en.wikipedia.org/wiki/Cumin Cumin] (Cuminum cyminum) also known as Roman caraway. While the essential oil derived from this spice has shown efficacy against [https://en.wikipedia.org/wiki/Anisakis Anisakis], a nematode that parasitises fish and marine mammals, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130707/] dietary use of the spice is thought to be harmless to human helminths. But see also, ❌ [[#Bitter cumin|Bitter cumin]], ❌ [[#Black cumin|Black cumin]] and Bunium bulbocastanum (sometimes also called black cumin).

* ❓[https://en.wikipedia.org/wiki/Elwendia_persica Elwendia persica] (aka Bunium persicum, a close relative of Bunium bulbocastanum). The possible effect of this plant on helminths is as yet unknown.

* ✅ [https://en.wikipedia.org/wiki/Fennel Fennel] (Foeniculum vulgare). Fennel seed has a long history of use against pinworms and other parasites, with some authorities suggesting that the herb digests parasite eggs and intoxicates parasites. The leaves and oil are both used as dewormers, but one subject has reported no adverse effect from repeated consumption of dietary amounts of fennel seeds (link expired) and another has reported [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ no loss of worm benefits] after consuming significant quantities of fennel.

* ⚡ [https://en.wikipedia.org/wiki/Fenugreek Fenugreek] (Trigonella foenum-graecum). Both the leaves and seeds of fenugreek have been reported to have anthelmintic properties. Alcoholic extracts of the seeds have shown a dose-dependent inhibition of motility (paralysis) in earthworms, [https://www.researchgate.net/publication/49600762_In_vitro_anthelmintic_activity_of_Fenugreek_seeds_extract_against_Pheritima_posthuma] and an aqueous extract of fenugreek leaves has also shown noteworthy anthelmintic activity against earthworms. [https://www.researchgate.net/publication/303787324_In-vitro_anthelmintic_activity_of_fenugreek_leaves_aqueous_extract_in_Indian_earthworms] After taking half a teaspoon of powdered fenugreek seeds every day for a week, one hookworm host found that his allergies returned with a vengeance. [https://www.facebook.com/groups/htsupport/permalink/1426906954031922/] However, another hookworm host ate about 150 grams of fenugreek leaves in a 2 week period without affecting his worms. [https://www.facebook.com/groups/htsupport/permalink/1406562676066350/?comment_id=1406580359397915&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Garam_masala Garam Masala] The constituents of this blend of ground spices vary between geographical regions, but the majority of the commonly used ingredients do not have anthelmintic properties, thus minimising the anthelmintic potential of any blend that might include one or two items that could be harmful to worms when used on their own. So garam masala is very unlikely to harm helminths.

* ✅ Garlic (Allium sativum). Garlic compounds have demonstrated anthelmintic activity against flatworms in mice, [https://www.ncbi.nlm.nih.gov/pubmed/28536879] garlic oil extract has shown anthelmintic effects against Schistosoma mansoni in mice [http://www.sciencedirect.com/science/article/pii/S1995764515002011] and allicin, the active principle of garlic extract, has also been shown to have anthelmintic properties, although one hookworm host has reported that taking a stabilized allicin extract for several weeks did not kill her worms. [https://www.facebook.com/groups/htsupport/permalink/859756094080347/?comment_id=1146360268753260&comment_tracking=%7B%22tn%22:%22R3%22%7D] Alcoholic extracts of garlic have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424]. However, the exact amount of garlic needed to kill intestinal parasites in humans has not been established. Some sources suggest 1,000 - 4,000 mg per day, using concentrated garlic capsules or tablets, and fresh garlic is said to be more effective than capsules. While chewing three cloves of garlic each day is recommended by some online sources as a treatment for ‘parasites’ in humans, the ingestion of 9 to 14 g of raw garlic daily (54 g total) or 15 to 21 g daily (89 g total) had no evident effect on the egg output of NA in one host, [http://www.ajtmh.org/content/journals/10.4269/ajtmh.1969.18.920] so hookworms may in fact be able to withstand up to 21 grams (approximately 10 cloves) of garlic per day. This means that garlic is unlikely to be an effective killer of mature worms, and its main anthelmintic effect may be to reduce the viability of ova. Cooking may reduce its effect against parasite eggs and larvae, but neither cooked or raw garlic appears to have any adverse effect on the efficacy of a therapeutic hookworm colony.


* ⚡ [https://en.wikipedia.org/wiki/Ginger Ginger] (Zingiber officinale) contains a chemical called zingibain (aka. zingipain, or ginger protease) that has been claimed to dissolve some parasites and their eggs, and numerous hookworm hosts have reported adverse effects after consuming ginger. One subject reported that fresh ginger drinks depress the egg production of his worms and increase his disease symptoms, and another has reported that eating a LOT of ginger 6 weeks post-inoculation caused her hookworm side effects to disappear for a few days, but that these eventually returned. A similar response was noted by someone who was in the habit of adding ginger to sushi platters. She found that this seemed to knock the worms out for a while but that they eventually recovered. [https://www.facebook.com/groups/htsupport/permalink/2249000525155890/?comment_id=2266705326718743&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another hookworm host has found that, while consuming powdered or cooked ginger isn’t a problem for him, drinking ginger tea, or any form of kombucha made with raw ginger will stun his worms badly and result in a return of disease symptoms the next day. [https://www.facebook.com/groups/htsupport/posts/4390196884369566/?comment_id=4395716387150949] Someone else, who said that his favorite brand of ginger beer was “pretty spicy”, so was probably made from raw, or only very briefly pasteurized, ginger juice, reported that, after going on a fairly significant binge of the stuff, his worms stopped producing eggs and their benefits diminished. Yet another worm host, who was putting at least a thumb-sized piece of fresh ginger in a smoothie every day, believes this was responsible for actually killing her hookworms. Others have also had issues with ginger, e.g., [https://www.facebook.com/groups/htsupport/permalink/2337067596349182/] [https://www.facebook.com/groups/htsupport/posts/9292445040811368?comment_id=9295039130551959]. However, one subject has reported eating lots of fresh ginger (mostly cooked) without any problems, and several others have reported a similar lack of issues with ginger. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/1568726056516677/?comment_id=1568873536501929&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1763989756990305/?comment_id=1764057080316906&comment_tracking=%7B%22tn%22%3A%22R%22%7D] One hookworm host says that she regularly takes dried ginger in 1g doses to help with migraines and has not noticed any problems with her worms, [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1062777610444860&reply_comment_id=1062782733777681&comment_tracking=%7B%22tn%22:%22R%22%7D] and another routinely takes 550 mg of ginger root powder every morning without any obvious effect on either his hookworms or his human whipworms.

* ❓ [https://en.wikipedia.org/wiki/Horseradish Horseradish] (Amoracia rusticana) has been claimed to be antiparasitic, and it does contain volatile oils, notably [https://en.wikipedia.org/wiki/Mustard_oil mustard oil], which has antibacterial properties and is used as an antiparasitic by some farmers, but evidence about the effects of its use by helminth hosts is lacking.

* ❓ [https://en.wikipedia.org/wiki/Mustard_(condiment) Mustard]. This condiment is claimed to be effective against intestinal worms, including roundworms and threadworms and, in India, [https://en.wikipedia.org/wiki/Mustard_oil mustard oil] is used as an antiparasitic by some farmers. However, its action is probably more as a laxative that helps to flush out worms rather than to kill them, and hookworms spend much of their time firmly attached to the gut mucosa. One hookworm host has reported taking about 2 grams of ground mustard seeds most days, with no adverse effect on his worms or their egg production. [https://www.facebook.com/groups/htsupport/permalink/1958129950909617/?comment_id=1958255070897105&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nutmeg Nutmeg] (Myristica fragrans, or fragrant nutmeg). This spice, which is obtained by grinding the seed of this tree, (mace is produced from the seed covering) is not harmful to helminths when used as a culinary flavour.


* ❌ [https://en.wikipedia.org/wiki/Oregano Oregano] (Origanum vulgare). Oregano oil, which contains isomeric phenols (primarily carvacrol but also including thymol and limonene), can destroy a number of bacteria, fungi and viruses in dilutions as low as 1/50,000, and is also antiparasitic. It is reported to be effective against protozoan parasites in particular as well as roundworm larvae, and somewhat effective against tapeworms. In one study [http://www.chirochat.org/article_files/Article-2953.pdf], 57 per cent of adults with intestinal parasites who were treated with 600 mg of oregano oil daily for six weeks experienced total eradication of their parasites. Several hosts of therapeutic helminths have reported adverse effects on their worms after ingesting oregano oil and, in at least two cases, it has resulted in a total loss of worms. However, one subject, who took oil of ''wild'' oregano sublingually twice each day for 2 weeks had a stool test sometime after this that was positive for hookworms, so perhaps either the wild form of the herb, or the sublingual route, helped reduce the effect on the worms in this case. Some foods, particularly soft cheeses, may be coated with an [http://www.sciencedaily.com/releases/2014/11/141127082311.htm antimicrobial film incorporating oregano oil] to increase their lifespan, but the amount of oregano involved in this application is unlikely to be a serious threat to helminths. A few '''oregano ''leaves''''' eaten with food are less likely to be harmful to human helminths [https://www.facebook.com/groups/htsupport/permalink/2545907775465162/?comment_id=2545955292127077], but one host of both hookworms and whipworms has reported that, while there was no immediate effect on his worms when he applied a ''heavy'' sprinkling of oregano leaf powder to his food a couple of times in a day, he was later plunged into such a self-critical and depressed mood that, before eventually regaining his usual mental balance, he struggled to do any work for several days.

* ✅ [https://en.wikipedia.org/wiki/Saffron Saffron] This spice is derived from the flower of crocus sativus, commonly known as the "saffron crocus". (See separate entry for this herb.) One hookworm host took a supplement containing turmeric and saffron for 6 weeks without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/]

* ✅ [https://en.wikipedia.org/wiki/Thyme Thyme] (Thymus vulgaris). This is also known as Common Thyme, Garden Thyme. Extracts of the leaves, flowering tops and stems are used to kill hookworms, roundworms, threadworms and skin parasites. However, these are unlikely to harm helminths when eaten in reasonable amounts as part of a normal diet. One helminth host has [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ eaten significant quantities of thyme] without noticing any adverse effect on her hookworm or whipworm populations.


* ✅ [https://en.wikipedia.org/wiki/Turmeric Turmeric] (Curcuma longa), also known as tumeric, generally does not harm human helminths when eaten in food in its natural, whole form, which only contains 3% of the active ingredient, curcumin, [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] or when it is taken in capsules, e.g., as a daily dose of 25 g turmeric (delivering 700 mg curcumin), [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/] or as a dose of 580 mg turmeric extract delivering 551 mg curcuminoids daily. [https://www.facebook.com/groups/htsupport/permalink/3303438489712083/?comment_id=3304307169625215] There have only been two reports of food quantities of turmeric affecting hookworms. The first of these is [https://www.facebook.com/groups/htsupport/permalink/1084044901651464/?comment_id=1084640204925267&comment_tracking=%7B%22tn%22:%22R%22%7D here], and the second was by an individual who boiled and ground turmeric powder into a paste and twice drank a large quantity of this (2 tbsp) in her tea. She subsequently experienced a return of her old symptoms, all of which persisted. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] There is much more chance of helminths being harmed when ⚡[https://en.wikipedia.org/wiki/Curcumin curcumin] is extracted from the turmeric and taken in medicinal quantities. It has been reported that 300 mg of curcumin extract has killed some types of parasites in test tube and animal studies, and that it may temporarily reduce the number of helminth eggs produced. One hookworm host believes that she may have lost her colony as a result of taking a curcumin supplement. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=794226897299934&offset=0&total_comments=11] However, another hookworm host has reported experiencing a very enjoyable “bounce” (indicating a healthy NA colony) after inoculating, in spite of taking 250 mg of curcumin daily. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/] As with other substances that can affect hookworms, the effect of curcumin may depend to some extent on the strength of the individual host’s immune response, as well as on the form of curcumin used. Nano-emulsified curcumin appears to be more effective, therapeutically, [https://www.sciencedaily.com/releases/2014/11/141106113204.htm] so may also have an increased detrimental impact on helminths. Another high-potency form of curcumin is BCM-95, which has been shown to be 6.93 times more bioavailable than normal curcumin, [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792534/] and this product may have been responsible for a sudden return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=808508489205108&offset=0&total_comments=21&comment_tracking=%7B%22tn%22:%22R1%22%7D] The beneficial effect of curcumin can be increased 5- to 10-fold by adding ascorbic acid (vitamin C) [http://www.sciencedirect.com/science/article/pii/S0308814612001744] so taking this vitamin along with curcumin might make it possible to use curcumin therapeutically in much smaller doses (ascorbic acid does not harm helminths), although this vitamin may increase curcumin's adverse effect on helminths if the quantity of the spice is not reduced proportionately.

* ❓ [https://en.wikipedia.org/wiki/Wild_Turmeric Turmeric, Wild] (Curcuma aromatica). While alcoholic extracts of the rhizomes of wild turmeric have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in [http://www.ncbi.nlm.nih.gov/pubmed/1158424 test tube studies] and extracts of the rhizomes may therefore also have an adverse effect on other helminths, it is likely that consuming dietary amounts of this spice will do no harm to human helminths, though this has not yet been confirmed.
</blockquote>

=== Herbs and medicinal plants===

The majority of the herbs listed below have been reported, or claimed, to be antiparasitic, although clinical evidence for this effect is lacking in many cases. Furthermore, where they are indeed antiparasitic, herbs may be more effective against types of parasite other than helminths, although this is not to say that they may not also have some detrimental effect on helminths.

Where a herb is effective against helminths, quite large quantities may be required to dislodge or kill the worms, but consuming some of these herbs on a regular basis, or in the form of concentrates, extracts, tinctures and oils that are directed at the gastrointestinal tract may weaken therapeutic helminths, making them less effective.

It should not be assumed, from a cursory glance at the following list, that most herbs are potential threats to human helminths. This list only contains those herbs that have been mentioned specifically by self-treaters, and there are less than 100 herbs in the entire list. Many thousands of compounds are used in herbal medicine, so it will usually be possible to find a more hookworm-friendly alternative for whatever purpose one has in mind.

Many of the herbs listed below are used to treat a number of conditions in addition to parasite infections, so might be encountered in a range of herbal remedies. It may therefore be advisable for any helminth host who contemplates taking any herbal remedy to check its ingredients against the list below and, where an ingredient appears to have antiparasitic properties, to seek an alternative, if possible.

When taking herbs, an additional risk arises from the fact that the majority of herbal products [http://www.medicalnewstoday.com/releases/267363.php contain unlisted ingredients], in view of which it would seem wise to employ a cautious approach with all herbal products.

==== List of herbs and medicinal plants ====

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* ⚡ [https://en.wikipedia.org/wiki/Acacia Acacia]. Also known as thorntree, [https://en.wikipedia.org/wiki/Whistling_thorn whistling thorn], or wattle. One example of this genus of shrubs and trees, ([https://en.wikipedia.org/wiki/Acacia_mollissima Acacia mearnsii], previously known as Acacia molissima) contains tannin extracts that have been found to have an [http://www.sciencedirect.com/science/article/pii/S0377840107003641 anthelmintic effect] on Haemonchus contortus and Trichostrongylus colubriformis in lambs. For a more detailed consideration of the possible effects of tannins on nematodes, see these papers: [https://www.ncbi.nlm.nih.gov/pubmed/28426037] [https://pubmed.ncbi.nlm.nih.gov/36344622/].

* ❌ [https://en.wikipedia.org/wiki/Ajwain Ajwain] contains thymol (see separate reference), which appears to be the primary constituent of the essential oil extracted from ajwain "seeds" (actually a seed-like fruit). Ajwain may therefore be harmful to human helminths if consumed in the form of ajwain "seeds" or the oil extracted from them, but it ''may'' be less harmful if only the leaves are eaten.

* ⚡ [https://en.wikipedia.org/wiki/Albizia_lebbeck Albizia lebbeck]. Alcoholic extracts of the bark of Albizia lebbeck have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the bark may also have an adverse effect on other helminths.

* ✅ [https://en.wikipedia.org/wiki/Aloe_vera Aloe vera]. This contains an antimicrobial agent, [https://en.wikipedia.org/wiki/Saponin saponin], and the laxative chemical, [https://en.wikipedia.org/wiki/Aloin aloin]. Aloe is perhaps the best known laxative in history, and it may be this, rather than any actual anthelmintic property, that is the source of its reputation for expelling parasites. While extracts have been reported as showing inhibitory effects on two roundworm species, these only affected the hatching of eggs and the development of larval stages. One aloedrinking helminth host has reported that his habit has had no obvious detrimental effect on his worms, and another hookworm host failed to notice any adverse effects after drinking pure aloe juice or gel daily for a week or two, or after drinking one of the 16oz sweetened/flavored drinks. [https://www.facebook.com/groups/htsupport/permalink/803451913044099/]

* ⚡ [https://en.wikipedia.org/wiki/Alpinia Alpinia calcaratta]. Alcoholic extracts of the rhizomes of Alpinia calcaratta have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Alpinia_galanga Alpinia galanga]. Alcoholic extracts of the rhizomes of Alpinia galanga have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of these rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Andrographis_paniculata Andrographis paniculata] (also known as creat, green chiretta; active component: andrographolide). Alcoholic extracts of Andrographis paniculata have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [http://www.ncbi.nlm.nih.gov/pubmed/1158424] Andrographolide has also shown significant ovicidal and larvicidal activity against the human hookworm, [[Ancylostoma duodenale | '''Ancylostoma duodenale''']]. [https://pubmed.ncbi.nlm.nih.gov/30763693/]

* ⚡ [https://en.wikipedia.org/wiki/Anise Anise] (Pimpinella anisum). Also known as aniseed. Anise oil may have modest antiparasitic effects and has been recommended by some practitioners as a treatment for mild intestinal parasite infections, but there have not been any reports about this from helminth hosts.

* ❌ [https://en.wikipedia.org/wiki/Arecoline Arecoline]. This odourless oily liquid derived from the areca nut, fruit of the areca palm ([https://en.wikipedia.org/wiki/Areca_catechu Areca catechu]), has long been used medicinally as an anthelmintic.

* ✅ [https://en.wikipedia.org/wiki/Ashwagandha Ashwagandha] (Withania somnifera). Also known as Indian ginseng, poison gooseberry, and winter cherry. Several hookworm self-treaters have reported using ashwagandha without issue. One NA host has reported that taking 380mg ashwagandha root and 95mg ashwagandha root extract twice each day for a month appeared not to affect her worms. [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832855323437081&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Someone else takes 450 mg ashwagandha x2 per day and reports that his NA are fine, [https://www.facebook.com/groups/htsupport/permalink/2416283988427542/?comment_id=2431728343549773&reply_comment_id=2432787723443835] and a third hookworm host has taken 500mg ashwagandha twice a day without any adverse effect on their worms. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] A naturopathic doctor has also reported that ashwagandha is OK to take while hosting hookworms, [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832031526852794&reply_comment_id=1833267093395904&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and someone who is self-treating with human whipworms (TT) has reported that taking a teaspoon of ashwagandha every day did not have any apparent effect on this species. (Also see the list of concerns and contraindications regarding Ashwagandha in [https://www.facebook.com/groups/htsupport/posts/6319449901444245/ this Facebook post].)

*❓ [https://en.wikipedia.org/wiki/Astragalus Astragalus]. A chloroform extract of the Astragalus species, [https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:477246-1 Astragalus ecbatanus], has been shown to have anthelmintic effects against the protoscoleces (the scoleces of the larval form of tapeworms) of the helminth, [https://en.wikipedia.org/wiki/Echinococcus_granulosus Echinococcus granulosus]. [https://pubmed.ncbi.nlm.nih.gov/36457771/]. However, there have been no reports that either of the forms of astragalus that are sold as food supplements ([https://en.wikipedia.org/wiki/Astragalus_propinquus Astragalus membranaceus/Astragalus propinquus] and Astragalus mongholicus) has had an adverse effect on any of the therapeutic helminths.

* ✅ Bacognize. One hookworm host has taken 300 mg daily of this [https://en.wikipedia.org/wiki/Bacopa_monnieri Bacopa monnieri] whole herb extract, standardized to 12% bacopa glycosides, without any adverse effect on his colony.

* ⚡ [http://www.botanical.com/botanical/mgmh/b/balmon04.html Balmony] (Chelone glabra) A decoction or tincture prepared with all parts of the plant is said to be a highly effective remedy for parasites, including intestinal worms. It was used traditionally by Native Americans to expel worms and is used today in proprietary parasite cleansing preparations.

* ⚡ [https://en.wikipedia.org/wiki/Barberry Barberry] (Berberis vulgaris) contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_bellirica Beleric] (Terminalia bellirica/Terminalia bellerica). Also known as bastard myrobalan or Bahera. This herb is said to be anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ⚡ [https://en.wikipedia.org/wiki/Berberine Berberine] is an amebicide which, in concentrated form, has been shown to kill various parasites such as tapeworms and giardia and to have anti adhesive effects which prevent pathogens from adhering to intestinal mucosal cells. One hookworm host who took one gram of berberine three times a day has reported being pretty sure that this killed his worms. [https://www.facebook.com/groups/htsupport/permalink/1803353316387282/?comment_id=1807383979317549&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Bidens_alba Bidens alba] has been reported as not being a problem for helminths.

* ✅ [https://species.wikimedia.org/wiki/Nymphaea_nouchali Blue Lotus]. Nymphaea nouchali - an aquatic flower also known as red and blue water lily, blue star water lily and star lotus - and its varieties, Nymphaea caerulea (blue Egyptian water lily) and Nelumbo nucifera (Indian lotus, sacred lotus, bean of India, lotus) are not thought to be harmful to helminths. These plants do contain various bioactive compounds such as alkaloids, flavonoids and glycosides, some of which may have antimicrobial or antiparasitic properties against bacteria, fungi, or protozoa, but there is no direct evidence to suggest that any of these compounds might be specifically harmful to helminths.

* ❌ [https://biocidin.com/products/biocidin-liquid-formula Biocidin] is a proprietary herbal blend that includes oregano oil and black walnut, both of which are known to have anthelmintic effects. See the separate entries for these two herbs.

* ❌ [http://scialert.net/fulltext/?doi=ijp.2013.211.226 Bitter cumin] (Centratherum anthelminticum). As its Latin name suggests, the seeds of this member of the daisy family are considered anthelmintic.

* ⚡ [https://en.wikipedia.org/wiki/Bitter_melon Bitter melon] (Momordica charantia) is used as a folk medicine to treat gastrointestinal diseases, and extracts have shown activity against the nematode worm C. elegans in test tube studies[http://www.sciencedirect.com/science/article/pii/S0378874104003770].

* ⚡ [https://en.wikipedia.org/wiki/Juglans_nigra Black walnut] (Juglans nigra). Also known as eastern black walnut. This nut has been claimed to be one of the best overall dewormers for humans, killing both the adult and developmental stages of at least 100 parasites. However, according to the American Cancer Society, available scientific evidence does not support claims that the hulls of the black walnut remove intestinal parasites. Although this nut has a strong flavour, it is actually quite rare, as its shell is hard and difficult to remove. It is therefore only likely to be encountered in expensive baked goods. Most commercially available walnuts are hybrids of the ✅'''English walnut'''. "Commerically-sold walnuts will be English unless specified. The taste and appearance of black walnuts is different too." [https://www.facebook.com/groups/htsupport/posts/7955684137820805/?comment_id=7955710474484838] "Black walnuts are very, VERY rare to find in stores, and 100% this will be specified. 'Walnuts' are ALWAYS English walnuts unless otherwise stated." [https://www.facebook.com/groups/htsupport/posts/7955684137820805?comment_id=7955725021150050]

* ✅ [https://en.wikipedia.org/wiki/Boswellia Boswellia] is a fragrant resin, extracts of which are used in pharmacology, particularly as anti-inflammatories. There have been no suggestions that boswellia might be a problem for helminths, and its anti-inflammatory action could be supportive of the beneficial effects that helminths produce, as demonstrated in Crohn’s disease in this study. [http://www.ncbi.nlm.nih.gov/pubmed/11215357]

*❓[https://en.wikipedia.org/wiki/Bougainvillea_spectabilis Bougainvillea spectabilis.] Also known as great bougainvillea, this plant, which is used to make a tea, has shown dose-dependent anthelmintic effects against the earthworm, Pheretima posthuma. [https://ijppr.humanjournals.com/wp-content/uploads/2020/04/2-IN-VITRO-ANTHELMINTIC-ACTIVITY-OF-CRUDE-EXTRACT-OF-FLOWERS-OF-BOUGAINVILLEA-SPECTABILIS-WILD-AGAINST-PHERETIMA-POSTHUMA.pdf] This effect is thought to result from the plant’s phytochemical constituents, which are believed to damage the mucopolysaccharide layer of worms, leading to paralysis and death. However, while this effect has been demonstrated in a laboratory, bougainvillea does not appear to have been used traditionally as an anthelmintic, and there have been no reports from helminthic therapy self-treaters of any adverse effect on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Breadfruit Breadfruit] (Artocarpus altilis)) A methanol-water fraction of this plant has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 9.5 hours, compared with 35 hours taken by albendazole. Aqueous methanol extracts took 49 hours. [https://www.researchgate.net/publication/21072595]

* ❌ [https://en.wikipedia.org/wiki/Acorus_calamus Calamus/Sweet Flag] (Acorus calamus) The bitter element in sweetflag, acorin, is claimed to have anthelmintic properties, and the standardised rhizome extract of A. calamus has been shown to have significant dose-dependent effects against the rat tapeworm, Hymenolepis diminuta, so may also harm other helminths. [https://www.ncbi.nlm.nih.gov/pubmed/27757269]

* ✅ [https://en.wikipedia.org/wiki/Castor_oil Castor oil]. This will not kill helminths, though it may help to expel worms after eradication, and this is probably the reason for its antiparasitic reputation and it's use in para-cleanse products.

* ✅ [https://en.wikipedia.org/wiki/Cat's_claw Cat’s Claw] is a common name for several plants, but it appears to be applied particularly to two species - [https://en.wikipedia.org/wiki/Uncaria_tomentosa Uncaria tomentosa] (samento), most commonly used in the US, and [https://en.wikipedia.org/wiki/Uncaria_guianensis Uncaria guianensis], typically used in Europe. Medicines made from the root and bark of these species have been claimed online to facilitate the elimination of intestinal parasites, but WebMD states that there is insufficient evidence for its effectiveness against parasites, [http://www.webmd.com/vitamins-supplements/ingredientmono-395-CAT'S%20CLAW.aspx?activeIngredientId=395&activeIngredientName=CAT%27S%20CLAW] and one hookworm host has taken up to 2000-2500 mg of Uncaria tomentosa daily in raw form for months with no adverse effects on his NA. He was even able to incubate fresh larvae from his colony during this period. [https://www.facebook.com/groups/htsupport/posts/4013894361999822?comment_id=4014662455256346]

* ⚡ [https://en.wikipedia.org/wiki/Larrea_tridentata Chaparral] (Larrea tridentata). Some cultures customarily bathe with chaparral annually to eliminate skin parasites, but use of the leaves of Larrea species is not advised, due to the possibility of damage to the liver and kidneys.

* ❌ Chicken weed ([https://en.wikipedia.org/wiki/Salvia_serotina Salvia serotina]), also known as Littlewoman, has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 20 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ✅ [https://en.wikipedia.org/wiki/Fallopia_multiflora Chinese knotweed] (Fallopia multiflora, also known as Reynoutria multiflora (Thunb.) Moldenke, Polygonum multiflorum Thunb., tuber fleeceflower) has been shown to make one nematode live longer. [https://www.sciencedaily.com/releases/2018/10/181009102529.htm]

* ❌ [https://en.wikipedia.org/wiki/Cinnamomum_verum Cinnamomum verum]. This was previously known as ⚡''C. zeylanicum'' and also referred to as ⚡"true cinnamon", ⚡''Ceylon cinnamon'' or ⚡''Sri Lanka cinnamon''. Alcoholic extracts of the bark of ⚡''C. verum'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the bark may also have an adverse effect on other helminths. The spice, ⚡'''cinnamon''' is typically derived from related species within the genus, '''Cinnamomum'''.

* ❌ [https://en.wikipedia.org/wiki/Citrus_decumana Citrus decumana]. Alcoholic extracts of the rind of Citrus decumana have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rind may also have an adverse effect on other helminths. Citrus decumana is a relative of the common ✅[https://en.wikipedia.org/wiki/Grapefruit grapefruit] (citrus paradisi) and, while commercially available forms of ⚡'''grapefruit seed extract''' have a potential to harm human helminths (due to the typical addition of synthetic adulterants), there is no evidence that the flesh of the grapefruit has any adverse effect on helminths.

* ✅ Coffee fruit extract. ([https://en.wikipedia.org/wiki/Coffea_arabica Coffea arabica]) This is harmless to helminths.

* ❓ [https://en.wikipedia.org/wiki/Crocus_sativus Crocus sativus]. Also known as autumn crocus and saffron crocus, this plant is best known for the spice saffron, which is produced from parts of the plant's flowers. (See separate entry for the spice.) Two important bioactive compounds of Crocus sativus (crocin and safranal), and some semi-synthetic derivatives of safranal, have been found to be [http://www.ncbi.nlm.nih.gov/pubmed/25766747 effective against some types of parasite] (Helicobacter pylori, the malaria parasite, plasmodium, and Leishmania). However, there have been no reports of adverse effects on therapeutic helminths.

* ⚡ '''Curled/Curly Mint''' (Mentha spicata variety crispii/Mentha crispa/Mentha crispata). This cultivar of [https://en.wikipedia.org/wiki/Spearmint Spearmint] (Mentha spicata), and close relative of Peppermint (Mentha piperita) (see [[#Peppermint|Peppermint reference]]), may be effective against giardia and amoeba infections, and may have anthelmintic properties. It was once listed on a website under, “herbs that your health care provider might consider using to treat intestinal parasites.” [https://web.archive.org/web/20070918071439/http://health.kernan.org/altmed/articles/intestinal-parasites-000097.htm]

* ❌ [https://en.wikipedia.org/wiki/Desmodium_triflorum Desmodium triflorum]. Alcoholic extracts of Desmodium triflorum have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so it’s extracts may also have an adverse effect on other helminths, possibly due to it containing a significant amount of a powerful psychedelic substance which might cause hookworms to lose their grip and be expelled.

* ✅ [https://en.wikipedia.org/wiki/Echinacea Echinacea]. This is not a single plant but a genus containing several different species. In the case of medicinal products labelled as echinacea, these are likely to have been obtained from one or more of the following sources: E. purpurea, E. angustifolia or E. pallida. Such products may also be either extracts, or the expressed juice of, different plant organs (e.g., roots and leaves) resulting in different products having very different chemical compositions. However, there have been no reports of human helminths being harmed by taking any echinacea products. As the polysaccharides found in Echinacea purpurea roots have been [http://www.ncbi.nlm.nih.gov/pubmed/26190752 shown to have anti-inflammatory effects], water extracts of these roots may be of benefit to helminth hosts who require a supplementary anti-inflammatory.

* ❌ [https://en.wikipedia.org/wiki/Elecampane Elecampane.] (Inula helenium, also known as alant, aster helenium, aster officinalis, aunée, aunée Officinale, elfdock, elfwort, enule campagne, grande aunée, helenio, helenium grandiflorum, horse-elder, horseheal, horse-heal, Indian elecampane, inule aulnée, inule aunée, inule hélénie, &OElig;il-de-cheval, scabwort, velvet dock, wild sunflower and yellow starwort.) According to WebMD, this herb can be used to kill intestinal worms, including hookworms and whipworms. [https://www.webmd.com/vitamins/ai/ingredientmono-2/elecampane] One hookworm host who took some drops containing several herbs that included elecampane suffered “vicious” diarrhoea for 16 hours, after which she reportedly lost the benefits from her worms.

* ❌ [https://en.wikipedia.org/wiki/Epazote Epazote]. See [[#Wormseed|Wormseed]].

* ❌ [http://it.wikipedia.org/wiki/Ceterach_officinarum Erba ruggine] (Ceterach officinarum) is listed on one website under, “Herbals that may kill and expel worms.” [https://web.archive.org/web/20160215131104/http://www.altmd.com/Articles/Worms--Encyclopedia-of-Alternative-Medicine]

* ❓ [https://en.wikipedia.org/wiki/Eurycoma_longifolia Eurycoma longifolia] (commonly called tongkat ali, pasak bumi or malaysian ginseng). The root of the plant is used in Indonesia and Malaysia as a health tonic, the benefits of which are claimed to include the treatment of intestinal worm infections. However, one hookworm host has reported using 100mg tongkat ali extract, containing 10% eurycomanone, for 60 days without any adverse effect on his worm colony. [https://www.facebook.com/groups/htsupport/posts/6839629756092921/?comment_id=6839701856085711]

* ❓ [https://en.wikipedia.org/wiki/Frankincense Frankincense] (olibanum). This aromatic resin is used in incense and perfumes, and is obtained from trees in the Boswellia genus. There have been no reports about it having any effect on helminths.

* ❌ [https://en.wikipedia.org/wiki/Gentian_root Gentian root]. The root and underground stem of [https://en.wikipedia.org/wiki/Gentiana_lutea Gentiana lutea] (yellow gentian) are said to assist in expelling 'harmful organisms'. One subject has reported that taking a form of gentian in large quantity on a daily basis for sinus inflammation was responsible for the loss of his whipworms, although possibly not his hookworms.

* ✅ [https://en.wikipedia.org/wiki/Ginkgo_biloba Ginkgo biloba]. There has been a single hint that ginkgo may have caused a mild reduction in hookworm benefits, but this was by no means certain, and three other helminth hosts have reported taking ginkgo regularly with no apparent adverse effect on their worms. (Also see Anticoagulants.)

* ⚡ [https://en.wikipedia.org/wiki/Goldenseal Goldenseal] (Hydrastis canadensis). This contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Coptis_chinensis Goldenthread/Chinese goldthread] (Coptis chinensis) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Goosefoot Goosefoot] (Chenopodium ambrosioides) is widely used to deworm animals, and the Japanese make a dewormer tea with the leaves. Goosefoot oil is a highly efficient anthelmintic, and extremely toxic. Human consumption of this herb has often produced strong side effects such as nausea and headaches, and even death in some cases.

* ⚡ [https://en.wikipedia.org/wiki/Hagenia Hagenia] (Hagenia abyssinica). Also known as African redwood, brayera, cusso, hagenia, and kousso, hagenia has been used as a treatment for the pork tapeworm (Taenia solium), but is often only partially effective in this case.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_chebula Haritaki] (Terminalia chebula). Also known as Yellow Myrobalan, Chebulic Myrobalan, Kadukkai, Silikha, Himmej, Karakkaya and A-ru-ra. The fruits are reportedly anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ❌ [https://en.wikipedia.org/wiki/Houttuynia_cordata Houttuynia cordata Thunb] (HCT), also known as fish mint, fish leaf, rainbow plant, chameleon plant, heart leaf, fish wort, Chinese lizard tail, and bishop's weed. The leaf extract of this Thai herb, which is used as an anti-inflammatory medication in the treatment of rheumatoid arthritis [https://www.ncbi.nlm.nih.gov/pubmed/26170903] has shown anthelmintic activity against Hymenolepis diminuta, especially the adult worms. [https://www.ncbi.nlm.nih.gov/pubmed/23024502/] The entire Saururaceae plant family is considered to have anthelmintic properties and is used by the Naga tribes in Northeast India to treat intestinal worm infections in general. It may therefore also have a potentially harmful effect on other therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Hydnocarpus_wightiana Hydnocarpus wightiana]. Alcoholic extracts of the seeds have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the seeds may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Hyssopus_officinalis Hyssop] (Hyssopus officinalis). The leaf contains an essential oil with antiseptic properties that has been claimed to have anthelmintic effects, but, if eaten as a herb, hyssop is unlikely to harm helminths.

* ❌ [https://en.wikipedia.org/wiki/Ipecac Ipecac], syrup of. Alkaloids in ipecac, including [https://en.wikipedia.org/wiki/Emetine emetine], are reported to kill several types of parasite, particularly amoebae, but also pinworms and tapeworms, although the amounts needed to produce these effects in humans are generally high and can lead to severe side effects. Emetine and the somewhat safer form, [https://en.wikipedia.org/wiki/Dihydroemetine Dehydroemetine], are usually reserved for rare cases of people infected with amoebae who are not cured by using anti-amoeba drugs.

* ⚡ [https://en.wikipedia.org/wiki/Juniper Juniper] (Juniperus communis) is a very effective natural antibiotic which is also said to have deworming properties, notably against liver fluke, and is used to treat worm infestations in animals. Juniper is also used as the primary flavouring in gin, but there have been no reports of any harm coming to helminths as a result of drinking gin.

* ❌ [https://en.wikipedia.org/wiki/Kaempferia_galanga Kaempferia galanga]. Alcoholic extracts of the rhizomes have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rhizomes may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Kava Kava/ kava-kava] (Piper methysticum). Studies have shown that kava can have potentially harmful effects on helminths by disrupting their neuromuscular function. Kavalactones, the active compounds in kava, produce psychoactive, analgesic, euphoric and sedative effects and, in the case of the roundworm, C. elegans, kavalactones have been found to cause muscle hypercontraction, epileptic-like convulsions and paralysis. One constituent of kava, Kavain, specifically induced worm paralysis without convulsions. [https://pmc.ncbi.nlm.nih.gov/articles/PMC5462554/] While this evidence does not relate directly to therapeutic helminths, and there have not been any reports to date of any adverse effects of kava on therapeutic worms, it is sufficient reason to treat kava with a degree of caution, especially in hookworm self-treaters who are known to have a more aggressive immune response, thus putting their worms under increased duress.

* ❓[https://en.wikipedia.org/wiki/Lactuca_virosa Lactuca virosa] Also known as wild lettuce, bitter lettuce, laitue vireuse, opium lettuce, poisonous lettuce, tall lettuce, great lettuce and rakutu-karyumu-so. While this herb is claimed by a few sources online to have an anthelmintic effect (e.g., [https://herbu.org/wp-content/uploads/2018/09/8-Wild-Lettuce-5pgs.pdf] (PDF)), there have been no reports of it having an adverse effect on either NA or TT. However, it is worth noting that Lactuca virosa can cause toxic effects in those who consume it. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031874/]

* ❓[https://en.wikipedia.org/wiki/Lemon_balm Lemon balm] (Melissa officinalis), a member of the mint family also known as balm, common balm or balm mint. This has been found to exhibit high nematicidal activity against the roundworm, Meloidogyne incognita [https://www.ncbi.nlm.nih.gov/pubmed/20527965] and, when included with other herbs, to help reduce the number of pigs infected with the roundworm, Ascaris suum. [https://www.ncbi.nlm.nih.gov/pubmed/19954891]. It is also listed as a vermifuge on some herbal websites, but there have been no reports thus far of lemon balm having adversely affected either NA to TT, and one NA host has reported using it almost daily for over a year, both as a tea and a tincture, without it causing any issues for her worms. [https://www.facebook.com/groups/htsupport/posts/7626177840771438/]

* ⚡ [https://en.wikipedia.org/wiki/Lemongrass Lemongrass] (Cymbopogon citratus) essential oil has shown [http://www.academia.edu/3999135/Evaluation_of_in_vitro_anthelmintic_activity_of_Cymbopogon_citratus_lemon_grass_extract anthelmintic activity against earthworms]. However, one individual has consumed lemongrass tea [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ without adverse effect] on her hookworm or whipworm colonies.

* ✅ [https://en.wikipedia.org/wiki/Liquorice Liquorice/licorice], the root of Glycyrrhiza glabra. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/798992926823331/?comment_id=799022316820392&offset=0&total_comments=2] taking “lots” of [https://en.wikipedia.org/wiki/Deglycyrrhizinated_licorice deglycyrrhizinated licorice] (DGL) with no ill effect on his worms. And another NA host has reported taking liquorice extract without any problems. [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Liquorice extracts may be useful as an adjunctive therapy [http://www.ncbi.nlm.nih.gov/pubmed/26383911 for psoriasis, for colitis] and possibly other autoimmune diseases, but excessive consumption of liquorice containing glycyrrhizin/glycyrrhizic acid [http://www.sciencedaily.com/releases/2015/03/150302081147.htm may not be wise]. The World Health Organization's recommended daily maximum for liquorice is 2 mg/kg.

* ❌ [https://en.wikipedia.org/wiki/Lippia_nodiflora Lippia nodiflora]. Alcoholic extracts of this have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other worms.

* ❌ Love weed ([https://plants.jstor.org/compilation/cuscuta.americana Cuscuta americana]) extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 2 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ⚡ [https://en.wikipedia.org/wiki/Male_fern Male fern] (Dryopteris filix mas). Also once known as worm fern! The rhizomes and young shoots (fiddleheads) of the male fern have antiparasitic properties and the root has been used to treat tapeworms. However, this herb is seldom used today due to its side effects (e.g. headaches and nausea) and because large doses are extremely poisonous and may induce liver damage. The North American equivalent of the male fern is the evergreen [https://en.wikipedia.org/wiki/Dryopteris_marginalis marginal shield-fern] (Dryopteris marginalis).

* ✅ [https://en.wikipedia.org/wiki/Mastic_(plant_resin) Mastic gum] Mastic (plant resin), also known as tears of Chios, is excreted by the resin glands of certain trees. One NA host has reported chewing mastic gum every day for a couple of months, and said that even chewing it until it dissolved had no harmful effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/6291172814271954/]

* ✅ [https://en.wikipedia.org/wiki/Milk_thistle Milk Thistle] (Silybum marianum). Also known as cardus marianus, blessed milk thistle, Marian Thistle, Mary Thistle, Saint Mary's Thistle, Mediterranean milk thistle, variegated thistle and Scotch thistle. There have been no adverse reports about this herb from worm hosts, and there are no reasons to believe that it might harm human helminths.

* ❌ [https://en.wikipedia.org/wiki/Mimosa_pudica Mimosa pudica] Also known as shy plant, sensitive plant, sleepy plant, action plant, touch-me-not, and shameplant, this popular houseplant is a tropical fern, whose leaves close rapidly when touched. Aqueous methanol extracts of the leaves of this plant showed a similar ability as the anthelmintic drug, levamisole, to inactivate larvae of the helminth, Strongyloides stercoralis. [https://www.researchgate.net/publication/21072595] While there have been no reports to date of this plant having a harmful effect on any of the therapeutic helminths, it has been used extensively as an anti-parasitic agent in traditional and Ayurvedic medicine, so clearly has significant potential as an anthelmintic.

* ✅ [https://en.wikipedia.org/wiki/Miswak Miswak] The miswak is a tooth-cleaning twig obtained from the [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] tree. In addition to this oral hygiene use being documented within traditional medicine systems, parts of the S. persica tree have also been reported to show evidence of anthelmintic activity. [https://pmc.ncbi.nlm.nih.gov/articles/PMC8347844/] However, this evidence comes from test-tube or animal studies, not trials on humans, and the concentrations tested would not necessarily correlate with those encountered during typical miswak stick chewing. So far, there have been no reports of any adverse effects on the helminth colonies of miswak-chewing self-treaters, and at least one hookworm host uses a miswak exclusively for oral hygiene. [https://www.facebook.com/groups/htsupport/permalink/1259998900722729/]

* ❌ [https://en.wikipedia.org/wiki/Morinda_citrifolia Morinda citrifolia], also known as great morinda, Indian mulberry, beach mulberry and cheese fruit). Alcoholic extracts of the tender leaves of ''M. citrifolia'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], so the same extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Mugwort Mugwort] (Artemisia vulgaris). Also known as Moxa, Common Wormwood, Traveler's Herb and Felon Herb, and a relative of wormwood (Artemisia Absinthium). While less effective than anthelmintic drugs, mugwort extracts, and especially the essential oils, are at least moderately effective natural anthelmintics against a range of nematodes and some cestodes. The herb can disrupt helminth neuromuscular function and interfere with energy metabolism, potentially leading to helminth paralysis and death, and it is said to make short work of roundworms, pinworms and tapeworms.

*❓ [https://en.wikipedia.org/wiki/Myrciaria_dubia Myrciaria dubia] (Commonly known as camu-camu, camu camu, camocamo, caçari and araçá-d'água.) This plant’s seed extracts have shown antischistosomicidal activity, [https://www.sciencedirect.com/science/article/pii/S0963996920303598?via%3Dihub] but nothing has been reported about possible adverse effects on any of the therapeutic worms.

* ⚡ [https://en.wikipedia.org/wiki/Myrrh Myrrh]. This has antiparasitic effects against various schistosome species and the liver fluke, Fasciola hepatica.

* ❌ [https://en.wikipedia.org/wiki/Neem Neem] (Azadirachta indica). Also known as margosa, nimtree and Indian lilac. Ayurvedic medicine holds that Neem is the best herb for treating worms and other parasites and that a simple decoction of Neem leaves can kill all parasites present in the intestines. Neem extract has also been shown to be [http://www.banglajol.info/index.php/DUJBS/article/view/8836 more effective against rodent helminths] than standard chemotherapy with albendazole or mebendazole.

* ✅ [https://en.wikipedia.org/wiki/Urtica_dioica Nettle, stinging] (Urtica dioica) Stinging nettle was found to have anthelmintic effects in one study [https://benthamopen.com/contents/pdf/TOPHARMCJ/TOPHARMCJ-3-38.pdf] but this was carried out ''in vitro'', using a nettle ''extract'', and in a non-therapeutic worm (the Indian earthworm) so these findings are not directly applicable to humans using human-adapted helminths. There have been no reports of any adverse effect on human helminths after their hosts have drunk nettle tea, and one hookworm host has reported regularly eating nettles without issue. [https://www.facebook.com/groups/htsupport/permalink/1265558373500115/?comment_id=1265700353485917&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Noni Noni] (Morinda citrifolia). See the separate entry for Morinda citrifolia, above. A test tube study [https://pubmed.ncbi.nlm.nih.gov/1158424/] found that noni helps to eliminate the roundworm, Ascaris lumbricoides, but, so far, no one hosting therapeutic helminths has reported using this.

* ❌ [https://en.wikipedia.org/wiki/Olive_leaf Olive leaf extract] (Olea europaea). Known as 'nature's antibiotic', this extract contains a component called oleuropein that is able to degrade pathological microorganisms of all kinds, and inhibit or kill many types of intestinal parasites including flatworms, hookworms, roundworms and tapeworms. Two subjects have reported losing their helminths after taking this.

* ⚡ [https://en.wikipedia.org/wiki/Oregon_grape Oregon grape] (Berberis aquifolium/mahonia aquifolium) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Oroxylum_indicum Oroxylum indicum] (also known as broken bones plant, Indian calosanthes, Indian trumpet flower, kampong, midnight horror and tree of Damocles). The bark extract of O. indicum [http://www.ncbi.nlm.nih.gov/pubmed/26660694 produces concentration-dependent effects against both larval and adult H. diminuta worms] so may also affect other helminths.

* ❌ [https://en.wikipedia.org/wiki/Palmarosa Palmarosa] (Cymbopogon martinii). Also known as Indian geranium, gingergrass and rosha or rosha grass. This may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Passionflower Passion flower] (Passiflora). This will not harm helminths.

* ❓ [https://en.wikipedia.org/wiki/Handroanthus Pau d’arco]. Also known as lapacho, red lapacho or taheebo, pau d'arco is a tea made from the inner bark of Handroanthus impetiginosus (Pink Ipê), which is claimed to have antiparasitic effects. Its main active ingredients are lapachol, quercetin and other flavonoids. Having expectorant properties, it is used as a herbal remedy for colds, flu and smoker's cough. However, lapachol is rather toxic and is more often used topically, for example as as antibacterial or pesticide. There have been no reports from helminthic therapy self-treaters to suggest what effect, if any, drinking pau d'arco might have on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Mentha_pulegium Pennyroyal] (Mentha pulegium). A member of the mint family, also known as European pennyroyal, pennyrile, squaw mint, mosquito plant and pudding grass. This plant has anthelmintic properties. [https://www.ncbi.nlm.nih.gov/pubmed/32002775]


* ⚡ [https://en.wikipedia.org/wiki/Peppermint Peppermint] (Mentha piperita, aka M. balsamea Willd) is used as an ingredient in some antiparasitic preparations. Several helminth hosts have strongly suspected that peppermint oil killed their worms, and one found he could not establish a worm colony at all while taking peppermint oil. Even eating a lot of peppermints caused a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/948433751879247/?comment_id=948595591863063&comment_tracking=%7B%22tn%22:%22R%22%7D] However, a number of others, who have used peppermint oil as a treatment for IBS, have noticed nothing untoward, and one subject has reported taking peppermint oil continuously without issue. Only the oil has been implicated. Eating ✅''peppermint leaves'', or drinking tea made from them, should not be a problem, as was found by two hookworm hosts who have reported drinking lots of peppermint tea without hurting their worms. [https://www.facebook.com/groups/htsupport/permalink/1986080694781209/?comment_id=1986669308055681&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7433421123380445/?comment_id=7434211146634776] ''Peppermint extract'' has also been reported not to be a problem for another hookworm host. [https://www.facebook.com/groups/htsupport/permalink/3042115625844372/?comment_id=3048690678520200]

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_niruri Phyllanthus niruri], also known as gale of the wind, stonebreaker, shatter stone, seed-under-leaf, carry-me-seed, quebra pedra, chanca piedra and chance pierre. This has been used traditionally to treat intestinal worms, and an extract of the plant has shown anthelmintic potential against a type of parasitic flatworm. [https://jffk.unram.ac.id/index.php/sjp/article/view/245] However, there have been no reports so far of any effects on therapeutic helminths.

* ❌ '''Pollia serzogonian'''. Alcoholic extracts of the rhizomes of ⚡''P. serzogonian'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [http://www.starchild.co.uk/products/6564_3590_quassia-root-chips.aspx Quassia] (Picrasma excelsa) has, anecdotally, been used successfully to treat threadworms and roundworms, as well as giardiasis, especially when used as an enema. It is a favoured botanical anthelmintic because of its low toxicity.

* ✅ [https://en.wikipedia.org/wiki/Rhodiola_rosea Rhodiola rosea]. Two hookworm hosts have reported taking rhodiola without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/995774170478538/?comment_id=996296763759612&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Rosemary Rosemary] has been reported not to be a problem for helminths.

* ❌ [https://en.wikipedia.org/wiki/Salvia_officinalis Sage] (Salvia officinalis) was used traditionally as a treatment for intestinal worms and some forms of sage are still often included as an ingredient in modern proprietary antiparasitic remedies. Also one NA host has reported that drinking sage-containing teas stunned his colony for nearly a month. [https://www.facebook.com/groups/htsupport/posts/3505446409511289/?comment_id=5274927742563138&reply_comment_id=5275387002517212] However, the use of sage leaves as a culinary herb may not pose a problem for helminths, but there has not yet been sufficient feedback to be certain about this. [https://en.wikipedia.org/wiki/Sage_oil Sage oil] is likely to be much more of a problem for helminths, and one helminth provider cautions against the use of any concentrated form of sage.

* ❌ [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] (also known as arak, jhak, pīlu, Salvadora indica, toothbrush tree and mustard tree). Extracts of the root of this plant have been found to have powerful anthelmintic activity in a model worm. [https://www.ncbi.nlm.nih.gov/pubmed/31516352]

* ✅ [https://en.wikipedia.org/wiki/Sambucus_nigra Sambucus nigra], also known as European elderberry, European black elderberry, elder, European elder, elderberry, black elder, and the branded product, Sambucol. Several NA hosts have taken different forms of black elderberry liquid with no harm to their NA. [https://www.facebook.com/groups/htsupport/posts/2546894892033117/] Elderberry is known to stimulate the immune system, so might increase the symptoms of autoimmune diseases [https://www.webmd.com/vitamins-supplements/ingredientmono-434-elderberry.aspx?activeingredientid=434&activeingredientname=elderberry] [https://www.mskcc.org/cancer-care/integrative-medicine/herbs/elderberry-01#references-7] which may give the impression that it has affected a worm colony when it hasn't. Also see the comments [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570536949668921&comment_tracking=%7B%22tn%22%3A%22R0%22%7D here] and [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570537809668835&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

* ❌ [https://en.wikipedia.org/wiki/Santonin Santonin] is extracted from the dry buds of the desert plant ''Eurasian wormwood'' ([https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina]). It acts against most parasites except Echinococcus, and is used to treat roundworms.

* ⚡ [https://en.wikipedia.org/wiki/Saw_palmetto Saw palmetto] (Serenoa repens). Also known simply as Serenoa, or Sabal serrulatum. One individual has reported an inability to maintain a hookworm colony while taking this herb, but had success once the herb was discontinued.

* ✅ [https://en.wikipedia.org/wiki/Shilajit Shilajit] (mumijo). One hookworm host has taken this without any apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/]

* ❓ [https://en.wikipedia.org/wiki/Ulmus_rubra Slippery elm] (ulmus rubra, also known as ulmus fulva). This is listed on at least one website [http://www.livestrong.com/article/395900-herbal-home-remedy-for-hookworms-in-a-human/] as a herb that may be helpful in treating various types of parasitic worms, including hookworms, but the only report [https://www.facebook.com/groups/htsupport/permalink/796860063703284/?comment_id=796869800368977&offset=0&total_comments=2] so far was from a hookworm host who said that she used a small amount of slippery elm powder on a few occasions without noticeably affecting her worms.

* ❓ [https://en.wikipedia.org/wiki/Soursop Soursop]. This is also called graviola, guyabano and guanábana, and is the fruit of the Annona muricata tree. A. muricata has demonstrated nematicidal activity against several roundworms, including Meloidogyne incognita [https://pubmed.ncbi.nlm.nih.gov/37552644/], Trichinella spiralis [https://pubmed.ncbi.nlm.nih.gov/34515021/] and Haemonchus contortus. [https://pubmed.ncbi.nlm.nih.gov/31455460/] [https://pubmed.ncbi.nlm.nih.gov/23583362/] Since NA are nematodes, there is a possibility of A. muricata also producing an adverse effect on this species, but there have been no reports yet by helminth self-treaters.

* ⚡ [https://en.wikipedia.org/wiki/Southernwood Southernwood] (Artemisia abrotanum) This European flowering plant has demonstrated effects against some helminths. It is also known as old man, boy's love, oldman wormwood, lover's plant, appleringie, garderobe, Our Lord's wood, maid's ruin, garden sagebrush, European sage, sitherwood and lemon plant. Spondias (Spondias mombin or Spondias purpurea var. lutea) This tropical fruit, which is also known as hog plums, Spanish plums, libas in Bikol, golden apples and mombins, may have anthelmintic effects.

* ✅ [https://en.wikipedia.org/wiki/Hypericum_perforatum St. John’s Wort] (Hypericum perforatum). It had been considered conceivable that some of the constituents of hypericum might have an adverse effect on helminths if taken in isolation and in large quantities (e.g., hyperforin, which has demonstrated some antibacterial properties, and hypericin, which has shown both antibacterial and antiviral activity), but there have been no reports of adverse effects on human helminths from any hypericum product in more than a decade.

* ⚡ [https://en.wikipedia.org/wiki/Artemisia_annua Sweet Annie] (Artemisia annua). Also known as sweet wormwood, sweet sagewort and annual wormwood. Both the herb and the pure form of its active ingredient, the sesquiterpene lactone, [https://en.wikipedia.org/wiki/Artemisinin artemisinin], have been used traditionally to treat malaria and intestinal parasites. Artemisinin is a potent anthelmintic and has been shown to be effective against [https://en.wikipedia.org/wiki/Schistosoma schistosomes]. [https://www.ncbi.nlm.nih.gov/pubmed/29727708]

* ❌ [https://en.wikipedia.org/wiki/Tansy Tansy] (Tanacetum vulgare), also known as common tansy, cow bitter, bitter buttons and golden buttons, is highly toxic to intestinal parasites and, for centuries, tansy tea has been prescribed by herbalists to expel worms. One study found that both the crude hydroalcoholic extract of T. Vulgare, and its essential oils, possess significant activity against adult S. mansoni worms, and the activity of the essential oils may be related, at least in part, to monoterpene thujones, which were detected as major constituents of the essential oils. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929489/]

* ⚡ [https://en.wikipedia.org/wiki/Tea_tree_oil Tea tree oil] (Melaleuca alternifolia) has been claimed to kill intestinal worms, including roundworms, tapeworms and hookworms, and its anthelmintic activity has been investigated. [https://pubmed.ncbi.nlm.nih.gov/33503761/] The use of tea tree products may therefore have adverse effects on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Tephrosia_purpurea Tephrosia purpurea]. Alcoholic extracts of ⚡''T. purpurea'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Thymol Thymol]. This is a monoterpene phenol found in [https://en.wikipedia.org/wiki/Thyme%23Medicinal_use oil of thyme] and ''oregano oil'' (see separate reference), as well as ''[https://en.wikipedia.org/wiki/Ajwain ajwain] oil'' and ajwain "seeds" (actually the seed-like fruit from which the oil is extracted). Thymol has antimicrobial and antifungal properties and is said to be highly effective against hookworms. It can also be toxic and has caused fatalities in children.

* ⚡ [https://en.wikipedia.org/wiki/Usnea Usnea] are lichen species with powerful antibiotic and antifungal properties. [http://species.wikimedia.org/wiki/Usnea_florida Usnea florida] extract has been found to have a dose-dependent anthelmintic effect against the nematode worm, [https://en.wikipedia.org/wiki/Trichinella_spiralis Trichinella spiralis].

* ❓ [https://en.wikipedia.org/wiki/Arctostaphylos_uva-ursi Uva-ursi]. (Arctostaphylos uva-ursi). One of several related species referred to as bearberry, uva-ursi contains the glycoside [https://en.wikipedia.org/wiki/Arbutin arbutin], which has antimicrobial properties. There are claims online that uva-ursi is also anthelmintic, but, so far, there have been no reports of its effect on therapeutic helminths.

* ✅ [https://en.wikipedia.org/wiki/Valerian_(herb) Valerian] (Valeriana officinalis). One hookworm host has reported taking valerian tincture without noticing any interaction with her worms. [https://www.facebook.com/groups/htsupport/permalink/1300794123309873/?comment_id=1301681973221088&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Vasaka Vasaka] (Justicia adhatoda). Also known as Malabar Nut, Adulsa, Adhatoda and Vasa. From the same family as Adhatoda zeylanica. The leaves (which contain [https://en.wikipedia.org/wiki/Vasicine vasicine], an alkaloid with significant antimicrobial activity), root, bark, fruit, and flowers are all said to help in removing intestinal parasites.

* ❌ [https://en.wikipedia.org/wiki/Vernonia_amygdalina Vernonia amygdalina] Wild Mahale chimpanzees control parasite-related diseases by ingesting the pith of this plant, [https://pubmed.ncbi.nlm.nih.gov/7878093/] and some human tribal communities use concoctions of the plant for the same purpose. [https://en.wikipedia.org/wiki/Vernonia_amygdalina#Medicinal]

* ❌ Vervine ([https://en.wikipedia.org/wiki/Stachytarpheta_jamaicensis Stachytarpheta jamaicensis]) (Also known as, blue porterweed, blue snake weed, bastard vervain, Brazilian tea, Jamaica vervain and light-blue snakeweed. Vervine extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 81.5 hours - not much more than the anthelmintic drug, thiabendazole, which took 74 hours. [https://www.researchgate.net/publication/21072595]

* ✅ Vitaxyn. Alcoholic herbal concoctions with this name, or referred to as "Tancosan", are thought unlikely to be a problem if taken at the recommended dosage and unless they contain some other ingredient that is known to be harmful to helminths. A product called "Tancosan" was taken by one hookworm host for over 2 years without any obvious adverse effect on her worms.

* ✅ [https://en.wikipedia.org/wiki/Vitex_agnus-castus Vitex agnus-castus]. Also known as vitex, chaste tree, chasteberry, Abraham's balm, lilac chastetree and monk's pepper. One hookworm host has taken 1000 mg of dried vitex agnus castus each day for many months without any noticeable ill effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/986939411362014/?comment_id=986984301357525&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Juglans_cinerea White walnut] (Juglans cinerea). Also known as Butternut. This nut has been used to expel rather than kill worms, although both root bark and leaves have been used in combination with an equal amount of ❌''Mugwort'' to treat worms in children.

* ❌ [https://en.wikipedia.org/wiki/Wild_rue Wild rue] (Peganum harmala). Also known as Esfand, Syrian rue, African rue and harmal. Its powdered seeds were used traditionally to expel tapeworms.

* ❌ [https://en.wikipedia.org/wiki/Stachys_officinalis Wood betony] (Stachys officinalis). Also known as betony, purple betony, bishopwort, or bishop's wort. A tea made from this may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Woodsorrel Woodsorrel] (Oxalis) has been reported[https://www.facebook.com/groups/htsupport/permalink/544122108977082/] as not being a problem for worm hosts when eaten as a food.

* ❌ [https://en.wikipedia.org/wiki/Dysphania_ambrosioides Wormseed] (Dysphania ambrosioides, formerly Chenopodium ambrosioides). Also known as epazote, goosefoot, Jesuit's Tea, Mexican Tea, Herba Sancti Mariae and paico. Wormseed is a traditional herbal remedy used in the tropics for expelling roundworms, hookworms and tapeworms. The oil, leaves or whole plants can be used, but one study[http://www.ncbi.nlm.nih.gov/pubmed/?term=Studies+on+the+traditional+herbal+anthelmintic+Chenopodium+ambrosioides+L.:+Ethnopharmacological+evaluation+and+clinical+field+trials] found that the powdered herb did not effectively eradicate hookworms, roundworms, or whipworms.

* ❌ [https://en.wikipedia.org/wiki/Artemisia_absinthium Wormwood] (Artemisia Absinthium). Also known as common wormwood, green ginger or grand wormwood, this herb was used traditionally as an anthelmintic. Other members of the genus, artemisia, that were traditionally used as anthelmintics include white wormwood ([https://en.wikipedia.org/wiki/Artemisia_herba-alba Artemisia herba-alba]), Eurasian wormwood (Artemisia cina) commonly known as santonica, Levant wormseed and wormseed, and Russian wormwood (Artemisia vestita) also known as Buer, Chamariya, Drubsha, Ganga Tulsi, Kubsha, Kundiyaa, Kundja and Seski. [https://pubmed.ncbi.nlm.nih.gov/36985759/]

* ✅ [https://en.wikipedia.org/wiki/Yerba_mate Yerba mate] (also known as erva-mate). No adverse reports have appeared so far about the effect of this herb on human helminths, or of the beverage made from it, known as mate, maté, Chimarrão, cimarrón, Tererê or Tereré.

* ❌ [https://en.wikipedia.org/wiki/Zingiber_zerumbet Zingiber zerumbet]. Alcoholic extracts of the rhizomes of Z. zerumbet have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

{{Columns}}

=== Fungi ===
<blockquote>
* ❓ [https://en.wikipedia.org/wiki/Amanita_muscaria Amanita muscaria] is a psychoactive and poisonous fungus with several known variations, or subspecies. One hookworm host has reported eating "a couple of hats (5-6 max)" on a few occasions without any effect on his NA that he can remember. [https://www.facebook.com/groups/htsupport/posts/2485762264813047/?comment_id=5343576092364969&reply_comment_id=5374046685984576]

* ❌ [https://en.wikipedia.org/wiki/Inonotus_obliquus Chaga mushroom] (Inonotus obliquus). This fungus, which grows singly on birch and other trees, is claimed, in several places online, to be effective against intestinal parasites, and it has been used for this purpose in the traditional folk medicine of Russia and Eastern Europe. One hookworm host thinks that drinking tea made from chaga mushrooms may have caused the failure of several hookworm incubations, [https://www.facebook.com/groups/htsupport/permalink/810579668997990/?comment_id=810664495656174&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R4%22%7D] however, another NA host has taken 200 mg+ daily of the chaga-containing Sacred 7 Mushroom Extract Powder blend (chaga, cordyceps, lion's mane, maitake, reishi, shiitake, & turkey tail) with no apparent ill effect on his NA. [https://www.facebook.com/groups/htsupport/permalink/4610641158991803/?comment_id=4611955338860385&reply_comment_id=4887932381262678]

* ✅ [https://en.wikipedia.org/wiki/Cordyceps Cordyceps] One NA host took 1/4-1/2 teaspoon cordyceps 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ❌ [https://en.wikipedia.org/wiki/Fomitopsis_betulina Fomitopsis betulina]. This edible fungus, which is usually found on birch trees, was previously known as Piptoporus betulinus, and is commonly known as the birch polypore, birch bracket, or razor strop. Wikipedia reports that F. betulina has been widely used in traditional medicines, and a paper referenced in the Wikipedia article suggests that polyporenic acid, found in the fruit body of the fungus, may be poisonous to the human whipworm, Trichuris trichiura (TT). [https://en.wikipedia.org/wiki/Fomitopsis_betulina#Research_on_chemical_constituents] F. betulina also contains toxic resins and an active compound, agaric acid, which are powerful purgatives that can result in strong though short-lived bouts of diarrhoea. [https://sci-hub.hk/10.1016/S0140-6736(05)79939-6]

* ✅ [https://en.wikipedia.org/wiki/Lingzhi_mushroom Lingzhi mushroom] (also known as Reishi). Several self-treaters have taken Reishi mushrooms or their extracts, e.g, [https://www.facebook.com/groups/htsupport/permalink/1301004239955528/?comment_id=1973652139357398], and there have been no reports of any adverse effects on NA or TT. One user says he consumes moderate doses of reishi [https://www.facebook.com/groups/htsupport/permalink/316642988391663/?comment_id=936181859771103] and another has even successfully used Reishi (Reishi Mushroom extract powder, 1000 mg 2x daily) to treat “worm flu”. [https://www.facebook.com/groups/htsupport/permalink/1461731890549428/?comment_id=1461830860539531]

* ✅ [https://en.wikipedia.org/wiki/Hericium_erinaceus Lion’s mane mushroom] (Hericium erinaceus) Also known as yamabushitake (= ‘mountain priest mushroom’), bearded tooth fungus and bearded hedgehog. One NA host took 1/4-1/2 teaspoon lion's mane 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ✅ [https://en.wikipedia.org/wiki/Wolfiporia_extensa Wolfiporia extensa] (also known as hoelen, poria, tuckahoe, China root, fu ling and matsuhodo) is a species of fungus in the family Polyporaceae. One hookworm host has reported drinking Fu Ling herb daily (E-Fong brand extract powder) with no issues for his colony. [https://www.facebook.com/groups/htsupport/posts/10041354979253700/?comment_id=10050698938319304]
</blockquote>

== Miscellaneous ==
{{Columns|2}}
* ✅ [https://en.wikipedia.org/wiki/Apitherapy Bee venom therapy] appears to be safe for worms. [https://www.facebook.com/groups/htsupport/permalink/876826799039943/?comment_id=876902382365718&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R2%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Diatomaceous_earth Diatomaceous earth (DE)]. This is made from the fossilized remains of tiny, aquatic organisms called diatoms which are mined from ancient sea beds and ground into a fine powder to produce food grade or medical grade diatomite. The finer grade diatomites are used as an insecticide and are also employed to deworm pets and humans. They are believed to work by dehydrating the organism, although the sharp edges of the particles may also be damaging to tiny creatures. A daily dose of one heaped teaspoon of DE has been claimed to be effective for human worm control, and one hookworm host has reported that three doses, of approximately one teaspoon each, quickly wiped out her colony and caused the return of all the symptoms of her disease. Someone who actually wanted to terminate a hookworm colony has said that small amounts of DE did not do this for her, but that taking 1 tablespoon each day for three days did completely eradicate a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/3759836894072238/]

* ❓ [https://en.wikipedia.org/wiki/Clay Clay] (bentonite, kaolin, etc.) Some clays have antibacterial properties [https://www.ncbi.nlm.nih.gov/pubmed/26743034] [https://www.sciencedaily.com/releases/2018/08/180821112029.htm] that vary by type, and some have been claimed to be natural parasite preventives that inhibit the reproduction of organisms. One helminth provider at one time advised against the use of clay while hosting worms, but clay is now thought much less likely to harm human hookworms and whipworms than it is tapeworms, and it may in fact not have any adverse effect at all on any type of ''therapeutic'' helminth. Someone has reported taking a "scant soup spoonful" of [https://en.wikipedia.org/wiki/Montmorillonite montmorillonite clay] slurry daily for quite long periods up to 3 or 4 months with no obvious adverse effect on her NA. [https://www.facebook.com/groups/htsupport/posts/5297777343611511/?comment_id=5298086576913921]

* ✅/❌ [https://en.wikipedia.org/wiki/Diarrhea Diarrhoea/diarrhea] While it is possible to lose hookworms to diarrhoea, this is only likely if the diarrhoea is very severe, or if it is severe and prolonged, i.e., lasting for several weeks. There is a description of one individual’s experience of losing a hookworm colon to very severe diarrhoea [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

:People who get diarrhoea/diarrhea as a side effect following their first inoculation with hookworms do not lose all their worms as a result of this, and hookworms are able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep]. See [[Human helminth care manual#Laxatives | '''Laxatives''']].

:It would seem logical to assume that hookworms might be better able to resist being flushed out after the point at which they attach to the gut wall, which is towards the end of the third week post inoculation.

:While adult hookworms do move around to feed, and are therefore theoretically more likely to be lost if diarrhoea strikes while they are on the move, this is unlikely to lead to any significant loss.

:Human whipworms are unlikely to be dislodged by diarrhoea once these are mature and embedded in the colonic mucosa, but they could could potentially be flushed out before this, especially around 21-22 days post inoculation. After 28 days, human whipworms should not be affected at all by diarrhoea.

* ✅ [https://en.wikipedia.org/wiki/Fasting Fasting]. This [https://www.facebook.com/groups/htsupport/permalink/812582472131043/?comment_id=813100818745875&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D will not harm human helminths] because they feed from their host’s blood (hookworms), or from their intestinal tissue (whipworms). Fasting is also unlikely to have any detrimental effect on the rat tapeworm, Hymenolepis diminuta (HDC), even though this species normally lives on carbohydrates consumed by their host. HDC can apparently also live off glycoproteins secreted in the gut.

* ✅ [https://en.wikipedia.org/wiki/Fever Fever]. Running a fever for several days will not harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Hyperbaric_oxygen Hyperbaric oxygen]. This is safe for use alongside helminthic therapy. [https://www.facebook.com/groups/htsupport/permalink/1281704005218885/?comment_id=1284905411565411&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/678894952216125/permalink/2543377009101234/?comment_id=2543517345753867] [https://www.facebook.com/groups/htsupport/posts/4319514804771108?comment_id=4320113668044555]

* ✅ [https://en.wikipedia.org/wiki/Infrared_sauna Infrared sauna]. Two hookworm hosts used an infrared sauna regularly for over 15 years without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2106930399362904/?comment_id=2107487372640540&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Ketosis Ketosis] is a metabolic state in which most of the body's energy supply comes from ketone bodies in the blood. This state is often induced deliberately by fasting or the adoption of a low-carbohydrate diet as a intervention in various medical conditions. One commenter has suggested that ketosis should not be harmful to helminths because, like fungi, they have mitochondria so can metabolise fat and therefore utilise ketones as a food source, unlike bacteria and viruses which require carbohydrates to survive. [https://www.facebook.com/groups/htsupport/permalink/1077988932257061/?comment_id=1078025565586731&comment_tracking=%7B%22tn%22:%22R0%22%7D] For more on keptogenic diets, see [http://perfecthealthdiet.com/2011/02/ketogenic-diets-i-ways-to-make-a-diet-ketogenic/ here].

* ❓ [http://rifevideos.com/index.html Rife machines]. These devices are claimed to be capable of killing or "devitalizing" worms when set to 2,400 Hz. Therefore, assuming that they are able to do what is claimed (and this is a [https://en.wikipedia.org/wiki/Royal_Rife contentious issue]) it would seem sensible to avoid this particular frequency if using these machines.

* ✅ [https://en.wikipedia.org/wiki/Spermidine Spermidine]. When fed to worms, this simple polyamine (found in large quantities in human sperm and grapefruit) significantly prolonged their lifespan. [http://www.rsc.org/chemistryworld/News/2009/October/04100901.asp]

* ✅ Steam. Saunas, hot tubs and hot baths do not harm helminths because the body's core temperature remains relatively constant while the skin sweats.

* ✅ [https://en.wikipedia.org/wiki/Wim_Hof Wim Hof] breathing techniques. Someone who hosts hookworms and has done these exercises on and off for about a year has reported having no issues as a result of combining the two treatments. [https://www.facebook.com/groups/htsupport/permalink/1417893248266626/?comment_id=1417961461593138&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Zeolite Zeolite] Zeolites are microporous, aluminosilicate minerals that are used widely in water purification systems. One hookworm host has reported taking 1 zeolite tablet daily for a week with no adverse affect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/?comment_id=2168119789910631]

{{Columns}}

== Additional scientific studies ==

* 2011 Mar 1 [https://hdl.handle.net/1843/BUOS-8G3LVD Avaliação dos efeitos de fármacos imunomoduladores na infecção de Hamsters, Mesocricetus auratus, POR Ancylostoma ceylanicum (Evaluation of the effects of immunomodulatory drugs on the infection of hamsters, Mesocricetus auratus, by Ancylostoma ceylanicum) (Loss, 1911)] (Thesis, Minas Gerais, Portuguese)

Human helminth care manual

2026-05-09T02:02:56Z

John: /* List of herbs and medicinal plants */

{{Breadcrumb|[[Using_helminths|Using helminths]]|[[Helminth_care|Helminth care]]}}
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|title=
|description=How to care for the two species of human helminth used in helminthic therapy: Necator americanus (NA) and Trichuris trichiura (TT/TTO).
|keywords=worm care, helminth care, Necator americanus, Trichuris trichiura, NA, TT, TTO, caring for my worms
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'''PLEASE READ THIS FIRST''' 
This manual is only concerned with the two '''''human''''' helminths:
* '''Human hookworm - Necator americanus''' (NA) [https://en.wikipedia.org/wiki/Necator_americanus]
* '''Human whipworm - Trichuris trichiura''' (TT) and its ova (TTO) [https://en.wikipedia.org/wiki/Trichuris_trichiura]
For the care of the non-human helminths, TSO and HDC, see the [[Helminth_care |'''Helminth care''']] page. 
=== Key ===
The following classification codes are intended as a general guide only, because the effects of a substance can vary considerably depending on factors such as quantity, concentration, and, in the case of herbal extracts, the part of the plant used. Even the method of extraction can make a difference, and, in the case of foods, perhaps the method, temperature and duration of any cooking, [https://www.facebook.com/groups/htsupport/posts/6863122353743661?comment_id=6863149840407579&reply_comment_id=6863721660350397] so it's important to read the details for each item.

:❌ Will or may kill, or cause the loss of, human helminths.
:⚡ May cause harm to human helminths in some people.
:➿ May cause a temporary reduction in benefits from human helminths.
:❓Insufficient evidence exists to support a judgement on possible effects.
: ✅ Safe, or likely to be safe, for human helminths.

Note that where an entire section is marked with a ✅, this indicates that all the substances listed within that section are safe unless marked otherwise.

=== Using this manual ===
'''* Bookmark this page to facilitate rapid access whenever it is needed.'''

'''* To find information about a specific substance, don't scan the page visually. Instead, use the search function on your device:''' 

* '''PC''' - Control+F 
* '''Mac''' - Command+F 
* '''Mobile''' - "Find in page" in the drop-down menu from the three dots icon

'''* Anything NOT MENTIONED in this manual has never been reported to be a problem, so, unless it is a new or very unusual product/substance, it is far more likely to be safe than unsafe for therapeutic human helminths.''' 

=== General advice ===
'''NA and TT are relatively robust organisms, and most foods, drugs and other substances are safe for use while hosting them, including normal dietary amounts of most unprocessed foods, spices and herbs. However there are some foods and other substances that may harm a colony, either temporarily stunning them or even killing them.'''

Things that will or may kill, or cause the loss of, human helminths include:

* ❌ Diatomaceous earth. (See [[#Diatomaceous earth|'''full details''']].)
* ❌ Oregano. (See [[#Oregano|'''full details''']].)
* ❌ Sauerkraut. (See [[#Sauerkraut|'''full details''']].)

'''Some foods can cause harm to NA and TT in some people but not others,''' and coconut products are a good example of this. While many hosts of human helminths are able to eat normal dietary amounts of coconut products without affecting their worms, others find that some forms of this food will affect their worms sufficiently to impair their beneficial effects.

The most common food items that may affect helminths in some people but not others are:

* ⚡ Coconut products. (See [[#Coconut|'''full details''']].)
* ⚡ Fatty acids. (See [[#Fatty acids|'''full details''']].)
* ⚡ Ginger. (See [[#Ginger|'''full details''']].)
* ⚡ Honey. (See [[#Honey|'''full details''']].)
* ⚡ Papaya seeds. (See [[#Papaya|'''full details''']].)
* ⚡ Pumpkin seeds and pumpkin seed oil. (See [[#Pumpkin|'''full details''']].)
* ⚡ Digestive enzymes. (See [[#Digestive enzymes|'''full details''']].)
* ⚡ Cayenne. (See [[#Cayenne|'''full details''']].)

If hosting NA, it is best to avoid the food substances listed above until the therapy is delivering benefits, at which point their effect on one’s colony can be tested, initially in small, and then in gradually increasing, quantities to assess the level of risk they are likely to present, and how much of each substance might safely be consumed before the worms are affected.

See the rest of this page for other items marked with a ⚡ or ❌.

'''Medicinal quantities of concentrates, extracts or tinctures, especially of certain herbs, are more likely to have an adverse effect on NA and TT than the plants from which they are derived.''' For example, eating normal dietary amounts of ginger is usually fine, as is occasionally taking a ginger supplement (e.g., to treat a migraine), but taking ginger regularly as a supplement or drinking ginger beer every day may adversely affect NA.

Another example of how the concentrated form of a substance can be harmful to helminths while foods containing the same substances are not are the phytochemical compounds, '''isomyristicin''' and '''bergaptenix'''. While the ''concentrated'' forms of isomyristicin and bergaptenix have shown significant anthelmintic activity against two helminth species, the parent chemicals from which they are derived ('''myristicin''' and '''bergapten''') are both found in several of the fruits, herbs and vegetables consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, and the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

'''People who have a robust immune response to helminths are likely to notice a greater effect on their worms than others.''' These individuals are the ones who need to top up their human helminth colonies more frequently in order to maintain remission from their disease. Typically, they have Crohn's, or one of the other intestinal diseases, but a few in this group have other conditions, such as allergies. [https://www.facebook.com/groups/htsupport/permalink/966004180122204/?comment_id=966023830120239&comment_tracking=%7B%22tn%22:%22R1%22%7D]

'''It is thought to be less likely that anything will harm NA before it attaches to the gut mucosa towards the end of the third week post inoculation''', although, once NA enters the bloodstream, it does begin to feed on proteins in the blood. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.ncbi.nlm.nih.gov/pubmed/29566094]. After it arrives in the small intestine and begins feeding from the gut wall from day 21, NA will always be vulnerable to anything harmful that has entered its host's blood.

'''Substances that are applied to the skin topically in small quantities are unlikely to cause harm to human helminths, even if the substances are known to be a risk when they are ingested.'''

'''Due to the way that TT feeds and attaches to the colonic mucosa, it is not as vulnerable as NA''', as is illustrated by the fact that three times more of the anthelmintic drug, mebendazole, may be required to kill TT than to kill NA.

'''Substances listed on the internet as being "antiparasitic" may have no effect whatsoever on NA and TT.''' Helminths are only one of many different types of parasite. Among the other types, there is a wide range of responses to substances claiming to be antiparasitic, and what kills one type of parasite may not even harm another. Even substances that have shown an anthelmintic effect in test tube studies do not necessarily have an adverse affect on worms being hosted by humans. [https://www.ncbi.nlm.nih.gov/pubmed/27498843]

'''Some foods and substances can reduce the therapeutic/ prophylactic benefits of adult helminths without killing the worms or having any impact on their egg production.''' Therefore, if testing shows the presence of helminth eggs in the host’s feces after ingesting a particular substance, it does not necessarily mean that this food/ substance will not interfere with the health benefits provided by the worms. [https://www.facebook.com/groups/htsupport/posts/9561303440592192?comment_id=9562835637105639] So the details on this page may not be relevant to the practice of helminth incubation, and a tentative examination of the effect of substances on the production of hookworm eggs and larvae can be found in the page section, [[NA incubation: very detailed method by Alana#Promotion of egg viability by dietary manipulation | '''Promotion of egg viability by dietary manipulation''']].

The posts in this [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/ support group sub-thread] contain good general advice on how to manage exposure to substances that can harm human helminths.

=== Worm harm denial ===

A few people have difficulty accepting that any of the substances mentioned on this page might harm helminths, with the exception of anthelmintic drugs. They believe that the adverse effects on human helminths that have been reported by self-treaters have alternative explanations, including delusion on the part of the reporting individual. They argue that, were the claims true, there would no longer be large areas of the planet where these worms remain endemic, and that the substances/foods/spices identified by self-treaters as potentially harmful to human helminths would have become folk remedies for helminth infections. However, this position ignores the science (e.g., [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924796/ Herbal anthelmintic agents: a narrative review]) and the fact that the effect of consuming a food or product with anthelmintic effects will be much less of an issue, if it is even noticed at all, in populations that are continually exposed to helminths and therefore constantly being reinfected.

In the words of one experienced NA self-treater:
{{Quote|indent}}Respect the foods and other items in the care manual that are likely, or potentially, unsafe for helminths. I’ve learned the hard way that coconut oil/milk/flour, raw ginger, curry, etc. are no beuno for my friends on board, and as much as I enjoy those things, they are not worth knocking out my NA for a week or multiple weeks. Everybody’s different here and it’s worth testing in very small amounts. [https://www.facebook.com/groups/htsupport/posts/4395750987147489/]{{Quote|/indent}}

=== Updates & disclaimer ===
This manual is updated regularly. See the page history (via the "View history" link at the top of the page) for a list of amendments.

Although the most harmful substances have been identified, this manual continues to be a work in progress so should not be viewed as definitive. Also see the [[Helminthic Therapy wiki:General disclaimer|'''General disclaimer''']].

Details in this manual are based on first hand reports posted in the [[Helminthic_therapy_support_groups|'''Helminthic therapy support groups''']]. Additional reports and comments on this topic are welcomed, and should be posted to the [https://www.facebook.com/groups/htsupport/ Helminthic Therapy Support group] on Facebook. 
{{Columns}}

</div>

<div class="toclimit-3">__TOC__</div>

== Pharmaceuticals ==


=== Anaesthetics (anesthetics), General [https://en.wikipedia.org/wiki/Anesthetic] ===

==== ✅Nitrous oxide (N2O) (E942) [https://en.wikipedia.org/wiki/Nitrous_oxide] ====
<blockquote>
Nitrous oxide (aka laughing gas or sweet air) was, at one time, mistakenly thought to kill hookworms. However, when this gas was used by people who wanted to terminate their hookworm colonies, their attempts met with failure. One subject reported inhaling almost a full can of whipped cream at 3 weeks post inoculation in an attempt to resolve severe side effects, but with no obvious effect on his hookworms. In another case, a balloon full of nitrous oxide failed to have any effect on a hookworm colony, which was later confirmed to be viable by a stool test. [https://www.facebook.com/groups/htsupport/permalink/759492150773409/] Then, in 2017, the notion that nitrous oxide harms NA was finally laid to rest by someone who inhaled a large quantity of the gas over the course of an hour. This individual reported that, although he did get a headache and giggled a lot, his worms were not harmed.

✅ The following forms of nitrogen are also unlikely to be a problem for hookworms.
* Nitric oxide (NO) [https://en.wikipedia.org/wiki/Nitric_oxide]
* Nitrogen dioxide (NO2) [https://en.wikipedia.org/wiki/Nitrogen_dioxide]
* Nitrate (NO3) [https://en.wikipedia.org/wiki/Nitrate]
* Pure nitrogen (N) [https://en.wikipedia.org/wiki/Nitrogen]
* Liquid nitrogen (LN2) [https://en.wikipedia.org/wiki/Liquid_nitrogen]
</blockquote>

==== Other general anaesthetics ====

<blockquote>
It has been suggested that the volatile organic compounds (VOCs) that were used in the early days of anaesthesia might be a risk to hookworms, especially if inhaled in excessive quantity, due to the possibility that they might stun them and cause them to be expelled from the gut before waking up. For example:
* ✅ [https://en.wikipedia.org/wiki/Diethyl_ether diethyl ether]
* ✅ [https://en.wikipedia.org/wiki/Chloroform chloroform]
However, a clinical scientist has reported that, while hosting both NA and TT, he worked around more organic solvents, including dichloromethane (CH2Cl2) and chloroform (CHCl3), than most people are exposed to in a lifetime, and that his hookworms and whipworms continued egg production uninterrupted.

✅ [https://en.wikipedia.org/wiki/Propofol Propofol] While propofol has been shown to adversely affect the mitochondria of roundworms in laboratory conditions, it is clear from the experience of hosts of both hookworms and whipworms that propofol does not harm human helminths in the concentrations used during surgery.

✅ [http://www.sciencedaily.com/releases/2009/08/090804145614.htm Regional nerve blocks] are worm-safe.

</blockquote>



=== Anaesthetics (anesthetics), local [https://en.wikipedia.org/wiki/Anaesthetics] ===

==== ➿ [https://en.wikipedia.org/wiki/Local_anaesthetic Local anaesthetics] ====
<blockquote>
Local anaesthetics interfere with the production of white blood cells as well as the functioning of the cells in circulation, but they appear not to affect ova production by helminths and they certainly don't kill them. While local anaesthetics can cause a temporary return of disease symptoms for up to 8 weeks, helminths generally recover after only a few days, although this varies by person, drug and dosage, making it difficult to predict exactly what will happen in any particular situation.

For dental procedures requiring a local anaesthetic, short-acting drugs are less likely to affect helminths, e.g.
* [https://en.wikipedia.org/wiki/Articaine Articaine] (articadent, astracaine forte, septanest, septocaine, ubistesin forte, ubistesin, ultracaine, zorcaine)
* [https://en.wikipedia.org/wiki/Lidocaine Lidocaine] (xylocaine, lignocaine)
These are a better choice than a longer-acting drug, such as
* [https://en.wikipedia.org/wiki/Carbocaine Mepivacaine] (carbocaine, polocaine)
* [https://en.wikipedia.org/wiki/Bupivacaine Bupivacaine] (Marcaine, Sensorcaine and Vivacaine, etc.)
and one helminth host has reported that the short-acting articaine had no adverse effect on his hookworms.

If a patient explains that they don't want to be numb for several hours, the dentist will usually use one of the short-acting drugs, or one combined with a vasoconstrictor such as epinephrine, which helps to reduce the amount of the drug that reaches the systemic circulation.

If local anaesthetics are used, it can be a good idea to arrange for a small supplementary dose of worms (e.g., 3 or 5 hookworm larvae) to be available for administration the day after exposure to the drug. This small additional inoculation usually helps to reduce the time that established helminths are out of action.
</blockquote>

==== ✅ Alternatives to local anaesthetics ====
<blockquote>
* [https://en.wikipedia.org/wiki/Opioids Opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.)
* [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed versed], etc., routinely used during colonoscopies)
* [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics]
These drugs all appear to be harmless to helminths, so, taken orally at high strength, these may be a suitable substitute for local anaesthetics in many situations. For example, one helminth host has found that 30 mg [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], taken along with 1,000 mg of [https://en.wikipedia.org/wiki/Paracetamol paracetamol (acetaminophen)] an hour or two before a dental appointment can be effective in avoiding all but a few brief moments of mild, dull pain, which he
found to be quite manageable while having a tooth drilled. This subject even found that the combination of dihydrocodeine and paracetamol (acetaminophen) provided adequate pain relief when having a tooth sculpted to take a crown. [https://en.wikipedia.org/wiki/Aspirin Aspirin] and [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] are also harmless to helminths, so, if preferred, these might provide a suitable alternative to paracetamol (acetaminophen).

Another option for completely avoiding any risk to helminths from local anaesthetics was the [https://www.facebook.com/GumEase GumEase] cryoallergenic mouthpiece. This device, which is apparently no longer available to purchase, provided pain relief for up to 20 minutes, and was appropriate for most procedures, including fillings, crowns, extractions and root canals. Previously available from two sources [http://cryodevices.ecrater.com/c/902779/gumease-products], [http://www.dentakit.com/gumease.html] this device unfortunately never caught on with dentists who are firmly wedded to the use of injectable drugs.

Another pain-free alternative is [http://www.youtube.com/watch?v=dcAwKvdqmKI laser dental surgery], which is likely to become increasingly available in the future. If more invasive dental surgery is required - where bone needs to be removed, for example - it may be best to request [https://en.wikipedia.org/wiki/Conscious_sedation conscious sedation]. This renders the patient unaware of what is taking place, but is not the same as a general anaesthetic. Conscious sedation might involve a combination of [https://en.wikipedia.org/wiki/Versed versed] (a short acting IV [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine]) and [https://en.wikipedia.org/wiki/Fentanyl fentanyl] (a short acting IV opiate), both of which are perfectly safe for worms.

</blockquote>

=== Anaesthetics (anesthetics), topical [https://en.wikipedia.org/wiki/Anaesthetics] ===

<blockquote>
✅ Topical anaesthetics (e.g., lidocaine / lignocaine) that are applied to the skin are unlikely to affect helminths within the digestive tract because not enough of the drug will get into the blood stream to affect the worms. Topical lidocaine used before blood draws, punch biopsies and the fitting of a catheter, or applied to the mucous membranes in the mouth or nose, are therefore worm-safe. However, there is a small possibility that fresh L3 NA larvae, which remain within the skin at the inoculation site for the first 40 hours, '''''may''''' be adversely affected by the use of a topical anaesthetic applied directly to this area following inoculation. [https://www.facebook.com/groups/htsupport/posts/6162787843777119/?comment_id=6163364870386083&reply_comment_id=6165161500206420] Further feedback is needed to confirm or dispel this possibility.
</blockquote>

=== Anthelmintics [https://en.wikipedia.org/wiki/Anthelmintics] ===

==== ❌ Anthelmintic drugs ====
<blockquote>
A number of drugs are used to terminate helminth infections, but the effectiveness of different anthelmintics against a single species [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250499/?report=classic varies] greatly. In [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/ one study], a triple dose of [https://en.wikipedia.org/wiki/Albendazole albendazole] (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, whereas a triple dose of [https://en.wikipedia.org/wiki/Mebendazole mebendazole] (3×500 mg over 3 consecutive days) only achieved a cure rate of 58%.

Each anthelmintic drug has varying degrees of effectiveness against different helminths. For example, while a triple dose of '''albendazole''' (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, the same regimen only achieved a 56% cure rate against whipworms [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/] and, in patients with an excessive whipworm infection, '''albendazole''' may need to be taken for 5–7 days. [http://www.ncbi.nlm.nih.gov/pubmed/14754497?dopt=AbstractPlus]

If it becomes necessary to terminate a colony of helminths, a medical doctor should be consulted, and their directions followed. However, under no circumstances should '''mebendazole''' ever be combined with '''metronidazole''' (Flagyl), and this is something about which many doctors and pharmacists may be unaware. There is a risk that this combination may [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ cause Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis].
{{Columns|2}}

==== List of anthelmintics ====

* [https://en.wikipedia.org/wiki/Abamectin Abamectin]

* [https://en.wikipedia.org/wiki/Albendazole Albendazole] (Albenza, Valbazen, Zentel, etc.)

* [https://en.wikipedia.org/wiki/Aminoacetonitrile Aminoacetonitrile] derivatives

* [https://en.wikipedia.org/wiki/Arecoline Arecoline] (Arecaline, Arecholine, Arecolin, Arecoline base, Arekolin, Methylarecaidin.)

* [https://en.wikipedia.org/wiki/Artemisinin Artemisinin] (Artemisinine, qinghaosu)

* [https://en.wikipedia.org/wiki/Bephenium_hydroxynaphthoate Bephenium hydroxynaphthoate] (Alcopar, Alcopara, Befenium, Debefenium, Francin, Nemex). This is an anthelmintic agent once used to treat hookworm and roundworm infections.

* [https://en.wikipedia.org/wiki/Diethylcarbamazine Diethylcarbamazine] (DEC, Hetrazan, Carbilazine, Caricide, Cypip, Ethodryl, Notézine, Spatonin, Filaribits, Banocide Forte and Eofil)

* [https://en.wikipedia.org/wiki/Disulfiram Disulfiram] (Antabuse, Antabus, etc.). While this drug is predominantly used to treat alcoholism, it has also been reported in the scientific literature to possess anthelmintic properties, which were the main reason for its original investigation. Copper‑chelating thiuram compounds such as disulfiram have been noted to produce lethal inhibition of respiration in intestinal worms such as the whipworm Trichuris muris as well as schistosomes, with daily disulfiram treatment of T. muris‑infected animals producing malformed eggs and preventing successful colonisation of mice.

* [https://en.wikipedia.org/wiki/Emodepside Emodepside] (Monepantel) [https://pharmaphorum.com/news/bayer-drug-raises-hope-15bn-people-worm-diseases]

* [https://en.wikipedia.org/wiki/Fenbendazole Fenbendazole]

* [https://en.wikipedia.org/wiki/Flubendazole Flubendazole] (Flutelmium, Flubenol, Biovermin, Flumoxal.)

* '''Isomyristicin''' and '''bergaptenix''' are two phytochemical compounds isolated from the Bhutanese medicinal plants, Corydalis crispa and Pleurospermum amabile, which have shown significant anthelmintic activity against the helminths, Schistosoma mansoni and Trichuris muris. In concentrated form, they may therefore be harmful to other whipworms and possibly also hookworms. [http://www.ncbi.nlm.nih.gov/pubmed/27572696] However, it should be noted that myristicin (the parent chemical from which isomyristicin is derived) and bergapten are both found in very small quantities in the vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/] These chemicals are also found in ⚡ [https://en.wikipedia.org/wiki/Earl_Grey_tea Earl Grey tea], which is flavoured with bergamot oil, and one hookworm host has reported that she experienced a return of symptoms of her disease (POTS) after drinking this brew. However, there are many other NA hosts who drink this tea without any problem, including someone who drinks multiple cups each day of weak Lady Grey tea (citrus bergamot flavour) and has reported still being able to successfully incubate from her small NA colony. [https://www.facebook.com/groups/htsupport/posts/5482091725180071/?comment_id=5483270285062215]

* [https://en.wikipedia.org/wiki/Ivermectin Ivermectin] (Stromectol, Soolantra, Sklice, etc.) Used to treat [https://en.wikipedia.org/wiki/Cutaneous_larva_migrans cutaneous larva migrans] caused by various zoonotic hookworm species. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11125977/]

* [https://en.wikipedia.org/wiki/Levamisole?wprov=sfla1 Levamisole] (Decaris, Ergamisol) is an antihelmintic drug approved for use in veterinary medicine in the United States. It was once used in the treatment of rheumatoid arthritis but proved too dangerous.

* [https://en.wikipedia.org/wiki/Mebendazole Mebendazole] (MBZ, Vermox, Ovex)

* [https://en.wikipedia.org/wiki/Niclosamide Niclosamide] (Niclocide, Fenasal, Phenasal, etc.)

* [https://en.wikipedia.org/wiki/Nitazoxanide Nitazoxanide] (Alinia, Nitaxide) is a broad-spectrum antiparasitic and broad-spectrum antiviral drug used to treat various helminthic, protozoal and viral infections. It has demonstrated activity against tapeworms, [https://www.ncbi.nlm.nih.gov/pubmed/27751770] so may also have an adverse effect on hookworms and whipworms.

* [https://en.wikipedia.org/wiki/Odanacatib Odanacatib] (codenamed MK-0822) is an investigational treatment for osteoporosis and bone metastasis developed by Merck & Co., and possibly available for clinical use from 2016. Unfortunately, this drug has been shown to kill the hookworm, Ancylostoma ceylanicum, in hamsters, decreasing worm burdens by 73%. [https://www.ncbi.nlm.nih.gov/pubmed/27751770] Consequently, it is likely to be trialled as a potential alternative to albendazole and may have an adverse effect on the human hookworm as well as other helminths, so should be avoided by helminth self-treaters.

* [https://en.wikipedia.org/wiki/Oxamniquine Oxamniquine] (e.g., Vansil)

* [https://en.wikipedia.org/wiki/Oxyclozanide Oxyclozanide]

* [https://en.wikipedia.org/wiki/Penicillium_cluniae Penicillium cluniae] (a fungus species of the genus of Penicillium which produces the antinematodal and antiparasitic agents paraherquamide B, paraherquamide C, paraherquamide D, paraherquamide E, paraherquamide F, paraherquamide G, paraherquamide H.)
* [https://en.wikipedia.org/wiki/Phenothiazine Phenothiazine (PTZ)] This is considered to be the first modern anthelmintic, introduced for this purpose in 1940.

* [https://en.wikipedia.org/wiki/Piperazine Piperazine] (piperazine hydrate and piperazine citrate are anthelmintic drugs that kill 60-70% of adult roundworms) and piperazine's many [https://en.wikipedia.org/wiki/Piperazine#Piperazine_derivatives_as_drugs derivatives].

* [https://en.wikipedia.org/wiki/Piperine Piperine] has demonstrated significant anthelmintic properties against various worm species. [https://www.academia.edu/103643829/Anthelmintic_Activity_of_Piperine_from_Black_Pepper] It not only has well documented potent effects against eggs and larvae, but also shows activity against adult worms, with paralysis and death times comparable to the standard anthelmintic drug albendazole. [https://pubmed.ncbi.nlm.nih.gov/31437123/]

* [https://en.wikipedia.org/wiki/Praziquantel Praziquantel] (Biltricide etc.)

* [https://en.wikipedia.org/wiki/Pyrantel Pyrantel pamoate] (Pin-X, Combantrin, etc.)

* [https://en.wikipedia.org/wiki/Pyrvinium Pyrvinium] (Vanquin, viprynium). This anthelmintic was previously used to treat pinworm (Enterobius vermicularis) infections, but has been largely replaced by other anthelmintics, e.g., mebendazole or [https://en.wikipedia.org/wiki/Pyrantel pyrantel pamoate].

* [https://en.wikipedia.org/wiki/Salicylanilide Salicylanilide], Spiroindoles (e.g. derquantel)

* [https://en.wikipedia.org/wiki/Tiabendazole Tiabendazole] (thiabendazole, TBZ, Mintezol, Tresaderm, Arbotect, etc.)

* [https://en.wikipedia.org/wiki/Triclabendazole Triclabendazole] (Fasinex, Egaten, etc.).
{{Columns}}
</blockquote>

==== ❓ Piperazine-derived compounds ====

<blockquote>
There is a whole raft of [https://en.wikipedia.org/wiki/Piperazine%23Piperazine_derivatives_as_drugs piperazine-derived compounds] some of which '''may potentially''' have anthelmintic effects. However, this does not mean that all piperazine derivatives will kill, or even harm, helminths. For example, ✅ [https://en.wikipedia.org/wiki/Viagra Viagra] is a piperazine derivative, but does not kill hookworms.

* These include many antidepressants including
** [https://en.wikipedia.org/wiki/Trazodone trazodone] (Depyrel, Desyrel, Molipaxin, Oleptro, Trazodil, Trazorel, Trialodine, Trittico). One self-treater has been reported to take trazodone almost every night, but continues to get "great results" from her NA. [https://www.facebook.com/groups/htsupport/posts/7313725575350001/?comment_id=7313750828680809&reply_comment_id=7313942228661669]
* antipsychotics such as
** [https://en.wikipedia.org/wiki/Olanzapine olanzapine] (Lanzek, Zypadhera, Zyprexa and [https://www.drugs.com/international/olanzapine.html numerous other names]),
** [https://en.wikipedia.org/wiki/Olanzapine prochlorperazine] (Compazine, Stemzine, Buccastem, Stemetil, Phenotil),
** [https://en.wikipedia.org/wiki/Ziprasidone ziprasidone] (Geodon, Zeldox),
* the migraine treatment
** [https://en.wikipedia.org/wiki/Migraleve Migraleve Pink],
* and antihistamines including
** [https://en.wikipedia.org/wiki/Buclizine buclizine],
** ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine),
** [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan),
** [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5),
** [https://en.wikipedia.org/wiki/Cyclizine cyclizine],
** ⚡ [https://en.wikipedia.org/wiki/Levocetirizine levocetirizine] (Xyzal) (one NA host has reported having no problems with her worms when taking this [https://www.facebook.com/groups/htsupport/permalink/3067416309980970/?comment_id=3067678586621409]),
** [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs,
** ⚡ [https://en.wikipedia.org/wiki/Dimenhydrinate dimenhydrinate] (Dramamine, Draminate, Gravol, etc.) While one NA host has reported that taking this drug had no observable effect on her worms, [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&reply_comment_id=1682358115153470&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] someone with colitis believes that it killed at least some of her NA colony.
** [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
** [https://en.wikipedia.org/wiki/Ebastine ebastine] (Evastin, Kestine, Ebastel, Aleva and Ebatrol) Listed as a [https://en.wikipedia.org/wiki/Piperidine piperidine].
* as well as antianginals, anxiolytics such as
** ⚡ [https://en.wikipedia.org/wiki/Buspirone buspirone] (Buspar), (one self-treater found that the positive effects of NA were lessened in the days following a single dose of buspirone [https://www.facebook.com/groups/htsupport/permalink/1944442368945042/])
* urologicals, e.g.
** [https://en.wikipedia.org/wiki/Sildenafil sildenafil] (Revatio, ✅ Viagra) and
** [https://en.wikipedia.org/wiki/Levitra vardenafil] (Levitra, Staxyn).
</blockquote>

Anthelmintic residues may be encountered in farmed meats, especially the livers of cattle and fowl, but it is not known whether, or to what extent, these might affect therapeutic helminths in hosts who eat this meat.

Canine anthelmintics that have been applied to a dog’s skin should not be a problem for anyone who pets a treated animal so long as they wash their hands immediately after the contact. [https://www.facebook.com/groups/htsupport/permalink/868843983171558/]

=== Antibiotics [https://en.wikipedia.org/wiki/Antibiotics] ===

(Also see [[Human helminth care manual#Natural antibiotics|'''Natural antibiotics''']].)

==== ❌ Antibiotics that may significantly reduce hookworm benefits ====
<blockquote>
* [https://en.wikipedia.org/wiki/Cefazolin Cefazolin] (Also known as cefazoline and cephazolin.) Someone who was given a 1 gram shot of cefazolin post-operatively estimates that she suffered a 60% loss of effect from her hookworms for several weeks. She began to feel better after a 3-day course of prednisone taken one month after the cefazolin exposure, and was mostly back to normal at 6 weeks. However, when [https://en.wikipedia.org/wiki/Cefalexin cefalexin] (aka cephalexin), a drug related to cefazolin within the cephalosporin class, was taken by a different hookworm host for 2 days, this appeared to have no effect on his NA colony.
* [https://en.wikipedia.org/wiki/Levaquin Levofloxacin] has been reported by one NA host as having "completely devastated" her colony. An egg count revealed only 14 ova, and she went from near total remission to a severe flare. "Back to ground zero." [https://www.facebook.com/groups/htsupport/permalink/1626974844025131/?comment_id=1627023594020256&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]
</blockquote>

==== ⚡ Antibiotics that may reduce hookworm benefits in some people ====
<blockquote>

* [https://en.wikipedia.org/wiki/Amoxicillin Amoxicillin] While two hookworm hosts have said that they did not lose their worms following treatment with amoxicillin, three others have reported losing their colonies after taking this drug, for example, [https://www.facebook.com/groups/htsupport/posts/9106626532726554/ here]. Combination drugs that contain amoxicillin e.g., [https://en.wikipedia.org/wiki/Amoxicillin/clavulanic_acid amoxicillin/clavulanic acid] (co-amoxiclav, Augmentin) can also be a threat to human helminths, as was found by a hookworm host whose colony was temporarily "knocked out" after taking amoxicillin and clindamycin together. [https://www.facebook.com/groups/htsupport/permalink/1664279276961354/?comment_id=1664541103601838&reply_comment_id=2421515414571066]

* [https://en.wikipedia.org/wiki/Azithromycin Azithromycin] (brand names include: AZIF-500, Azithral, Azithrocin, Azyth, Azin, Z pack, Zeto and Zithromax) Someone has reported losing her hookworms to a combination of [https://en.wikipedia.org/wiki/Azithromycin azithromycin] (an azalide, a type of macrolide antibiotic) and doxycycline (see below) (a broad spectrum antibiotic of the tetracycline class), whereas a whipworm host [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=892732697449353&offset=0&total_comments=12&comment_tracking=%7B%22tn%22:%22R1%22%7D did not lose her colony] from taking this same combination of drugs. Azithromycin has been used on its own to treat a child with PANDAS and a female adult with an ear infection [https://www.facebook.com/groups/htsupport/permalink/1230554160333870/?comment_id=1230564746999478&comment_tracking=%7B%22tn%22%3A%22R%22%7D] without any worm loss, although its use did result in a temporary suspension of benefits in both cases.

* [https://en.wikipedia.org/wiki/Clindamycin Clindamycin] has been suspected of possibly harming hookworms when taken in combination with amoxicillin or metronidazole, but two NA hosts who took this drug on its own have reported that it had no adverse effect on their colonies. The first took clindamycin for 10 days (starting in the first week of hosting), [https://www.facebook.com/groups/htsupport/permalink/2123829614339649/] and the second took a 7 day course (300mg taken 4 times per day) after which a float test revealed plenty of hookworm eggs. [https://www.facebook.com/groups/htsupport/permalink/2574492762606663/]

* [https://en.wikipedia.org/wiki/Doxycycline Doxycycline] (Vibramycin, Monodox, Microdox, Periostat, Vibra-Tabs, Oracea, Doryx, Vibrox, Adoxa, Doxyhexal, Doxylin, Doxoral, Doxy-1 and Atridox, etc.) is a tetracycline antibiotic that also has antiprotozoal, antibacterial and some anthelmintic effects, although the latter have been claimed to only affect filarial nematodes. In this case, the drug kills a symbiotic bacterium in the worm’s reproductive tract, thus rendering it sterile. Moreover, an eight-week course of doxycycline may be necessary to achieve this effect. One hookworm host has reported that he took doxycycline for a total of 5 weeks without noticeable effect on his worms, and others have also reported having no issues with this drug, [https://www.facebook.com/groups/htsupport/posts/24894037546892199?comment_id=24894176736878280] but another has said that her hookworms “completely stopped working” after taking doxycycline for only three days. She said that this happened “pretty much overnight”, and that, in spite of getting a supplementary dose of worms a month or so after taking the antibiotic, [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786946941361263&offset=0&total_comments=16] she didn’t feel right again for the following 6 months. [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786624918060132&offset=0&total_comments=15] (NB: doxycycline has also been found to have [http://medicalxpress.com/news/2015-03-antibiotics-unexpected-effects-mitochondria.html unexpected effects on mitochondria].)

* [https://en.wikipedia.org/wiki/Flucloxacillin Flucloxacilin], also known as floxacillin. When one hookworm host took this drug with [https://en.wikipedia.org/wiki/Probenecid probenecid] (which is sometimes used to increase the concentration of some antibiotics), she experienced a return of her disease symptoms, although these were not as severe as they had been before she began hosting NA. An incubation yielded only half the usual number of larvae, but, after taking a wake up dose of 12 NA, she was feeling much improved 3 weeks later. [https://www.facebook.com/groups/htsupport/permalink/2286252768097332/] Someone else who had a 10 day course of Flucloxacilin, firstly intravenously, and then orally, found that she lost benefits from her NA for 4-6 weeks. She knew the worms were not dead because she was able to incubate fresh larvae from her colony. On a different occasion, a shorter course of 5 days IV, then oral Flucloxacilin, had minimal impact. [https://www.facebook.com/groups/htsupport/permalink/3702475279808400/?comment_id=3703092116413383]

* ❓ [https://en.wikipedia.org/wiki/Fosfomycin Fosfomycin] (also known as phosphomycin, phosphonomycin, Monurol and Monuril) A single, one-off, 3g dose if this broad-spectrum antibiotic that was taken by a hookworm host to treat a urinary tract infection had no obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&comment_tracking=%7B%22tn%22:%22R%22%7D] However, larger doses or a longer treatment period may produce a different result.

* [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). Two hookworm hosts have reported losing their colonies to [https://en.wikipedia.org/wiki/Metronidazole metronidazole] (Flagyl), [https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1371228706266414/] which may be particularly harmful to hookworms if taken in combination with [https://en.wikipedia.org/wiki/Clindamycin clindamycin] (Dalacin, Lincocin, Daclin). '''Metronidazole''' and '''clindamycin''' are favoured by some dentists due to their proven efficacy against anaerobic bacteria. However, when take on its own, metronidazole does not always kill hookworms, as one host found when she had to take this drug along with amoxicillin for several weeks to treat septic gangrenous appendicitis, [https://www.facebook.com/groups/htsupport/permalink/1899197376802875/?comment_id=1899228090133137&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and another found when he needed to take 750mg daily for 7 days to treat SIBO. [https://www.facebook.com/groups/htsupport/permalink/2060266257362652/] A third NA host was still able to successfully incubate more larvae after taking five doses of 400mg metronidazole daily for three days. [https://www.facebook.com/groups/htsupport/posts/5993193837403188/?comment_id=5993326564056582&reply_comment_id=5993931900662715]

* [https://en.wikipedia.org/wiki/Nitroimidazole Nitroimidazoles] (metronidazole, tinidazole, nimorazole, dimetridazole).

* [https://en.wikipedia.org/wiki/Quinolone_antibiotic Quinolones.] Drugs in the quinolone family have been shown to block a detoxification pathway required by helminths for blood feeding, resulting in arrested development of L3 larvae and adversely affecting the reproductive capacity of adult worms both in vitro and in vivo. [http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006931] (NB. In 2018, the European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds, [https://www.medscape.com/viewarticle/903029] and, in 2019, fluoroquinolones were linked with heart problems. [https://www.sciencedaily.com/releases/2019/09/190910154710.htm])
</blockquote>

==== ✅ Antibiotics that appear ''not'' to affect hookworm benefits ====
<blockquote>

* [https://www.ace-pharm.nl/en/products/broxil/ Broxil] (feneticilline) is a narrow-spectrum antibiotic containing the penicillin derivative pheneticillin potassium. It is used to treat infections caused by Streptococci and certain species of Staphylococci, e.g., pharyngitis, pneumonia and skin and soft tissue infections such as impetigo or abscesses. One NA host has confirmed that a 5 day course of Broxil did not harm her colony. [https://www.facebook.com/groups/htsupport/posts/6533802496675650?comment_id=8769535843102293]

* [https://en.wikipedia.org/wiki/Mycophenolic_acid Mycophenolic acid] Also called mycophenolate mofetil (MMF, trade name CellCept) and mycophenolate sodium (trade name Myfortic), this antibiotic/immunosuppressant drug has broad-spectrum antiviral, antifungal and antibacterial properties, but has not been commercialised as an antibiotic due to its adverse effects. One hookworm host has taken CellCept (500mg x 3 per day), apparently without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1001001649955790/] [https://www.facebook.com/groups/htsupport/permalink/1978467308875881/?comment_id=1978498922206053&reply_comment_id=1979680825421196&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Rifaximin Rifaximin] (Xifaxan, Xifaxanta and Normix, etc.) This drug is poorly absorbed when taken by mouth and stays within the gastrointestinal tract, so is unlikely to affect NA, which feed directly on their host's blood, and will pass by TT while they are grazing on tissue secretions within the intestinal lining. The drug's lack of effect on NA was confirmed by one self-treater who took a 14 day course of the drug to treat SIBO and had no return of symptoms from his sinus condition, and only noticed a minimal effect on egg production by his worms. [https://helminthictherapywiki.org/wiki/Treating_SIBO_and_sinusitis_with_NA_and_TTO]

* [https://en.wikipedia.org/wiki/Roxithromycin Roxithromycin] A ten day course of this drug taken by one NA host appeared not to harm their colony. [https://www.facebook.com/groups/htsupport/posts/23875947818701182?comment_id=24167803662848928]

* [https://en.wikipedia.org/wiki/Trimethoprim Trimethoprim] (Alprim) Two hookworm hosts have reported continuing to enjoy full benefits from their worms after taking this drug to treat urinary tract infections. One took a 5 day course of 100mg Trimethoprim x2 per day, [https://www.facebook.com/groups/htsupport/posts/26349623291333610] whille the second took seven doses of 300mg. Another NA host has reported that, when used to treat UTIs, Alprim not only did not affect her hookworm colony, but did not even arrest the production of ova by her worms. [https://www.facebook.com/groups/htsupport/permalink/1009048252484463/] Also, when the [https://en.wikipedia.org/wiki/Trimethoprim/sulfamethoxazole Trimethoprim/sulfamethoxazole] combination drug, AA-Sulfatrim DS 800, was taken by a hookworm host for 10 days (160mg x2 per day), this had no effect on his NA colony and produced no gastrointestinal changes. (Private communication)
</blockquote>

==== Topical antibiotics ====
<blockquote>
: If applied to the skin, or used as eye drops, [https://en.wikipedia.org/wiki/Antibiotics Topical antibiotics] are unlikely to affect helminths in many cases. For example, four drops of 0.3% [https://www.medicines.org.uk/emc/product/836/smpc Ciloxan] ([https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin]) applied to each eye 3 times each day for 2 weeks had no effect on the colonies of two hookworm hosts, [https://www.facebook.com/groups/htsupport/permalink/874927972563159/?comment_id=875296599192963&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://en.wikipedia.org/wiki/Tobramycin tobramycin] eye drops applied 3 times each day for 2 days, and twice each day for the following 3 days, had no obvious ill effect on another hookworm colony. [https://www.facebook.com/groups/htsupport/posts/4810224872366763/]

:However, someone else has reported that, while 0.3% tobramycin appeared to have no adverse effect when applied to a stye, an ophthalmic suspension of neomycin and polymyxin B sulfates and dexsmethasone did have a mild adverse effect on her NA colony.

:{{Quote|indent}}I ran out of the abx eye drops tobramyacin .3% after 7 days (taking 3-4 times a day). And I had no issues with that. But they refilled it with “neomycin and polymyxin B sulfates and dexsmethasone ophthalmic suspension.” And it has stunned my buddies a bit... I’ve been taking it 3 times a day in one eye for 6 days. I started feeling off around day 4. [https://www.facebook.com/groups/htsupport/posts/10073095316079666?comment_id=10073376886051509&reply_comment_id=23872842805678350]{{Quote|/indent}}
</blockquote>

==== General discussion ====
<blockquote>
Short courses of most other antibiotics will typically only cause a temporary loss of benefit for between 2 and 8 weeks (e.g., ➿ [https://en.wikipedia.org/wiki/Erythromycin erythromycin] [https://www.facebook.com/groups/htsupport/permalink/770548519667772/]), although it is possible for efficacy to be reduced for longer, e.g., [https://www.facebook.com/groups/htsupport/permalink/1131267180262569/?comment_id=1134969589892328&comment_tracking=%7B%22tn%22:%22R%22%7D 4 months], and even [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=951430548246234&comment_tracking=%7B%22tn%22:%22R0%22%7D 6 months], and there is anecdotal evidence suggesting a correlation between the length of a course of antibiotics and the length of time that affected helminths are out of action. This might suggest that a single shot of antibiotic might have little or no effect on human helminths, as has been reported by one hookworm host, [https://www.facebook.com/groups/htsupport/permalink/3419833164739281?comment_id=3422186914503906] but the type of antibiotic used may be critical in this case, and some antibiotic drugs might adversely affect a helminth colony even when only a single injection is administered. This happened when one hookworm host was given a single, 1 gram shot of cefazolin. See [[#Cefazolin|Cefazolin]] for details.

It is possible that even a small dose of antibiotic could cause a return of symptoms in some people. For example, one hookworm host has reported experiencing a recurrence of significant disease symptoms after using 3 drops per day, for only 1½ days, of a solution containing [https://en.wikipedia.org/wiki/Tobramycin tobramycin] 3mg (0.3%).

In cases of dental infection that would routinely be treated by a course of an oral antibiotic, it might be possible to avoid the use of a drug if the dentist is able to use localised ozone injections. [https://www.facebook.com/groups/htsupport/permalink/1252700651452554/] [https://www.facebook.com/groups/htsupport/permalink/1518817608174189/?comment_id=1519018198154130&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

When it is essential to take oral antibiotics, the duration of their negative effect on hookworms can be significantly reduced - perhaps to as little as 2 weeks - by taking a small top-up dose of no more than 5 larvae after finishing the course of drugs. In most cases, this inoculation can be carried out 48 hours after the last dose of the drug, but it's worth asking a pharmacist exactly how long the prescribed drug will take to clear completely from the body. Different antibiotics have different biological half-lives. For example, erythromycin's half-life is only a couple of hours, whereas penicillin's can be up to 56 hours.

An alternative to taking a small top-up dose of NA would be to take 250-500 TSO. One NA host has reported that, without a helminth top-up, it usually takes her 4-6 weeks to come right after an infection. But, if she takes 500 TSO after completing the antibiotics, she recovers within about 10 days. [https://www.facebook.com/groups/htsupport/posts/7062445007144727/?comment_id=7065489936840234] In a later report, this same individual said that even taking just 250 TSO post-antibiotics will enable her to bounce back within a week or so. [https://www.facebook.com/groups/htsupport/posts/7897313170324569/?comment_id=7911601488895737] If ordered at the same time as the antibiotics are started, TSO will arrive in time to be taken after the course of the drug is completed. And, since TSO remain viable for a couple of years in a fridge, a small supply of them can be kept to hand.

It has been suggested that the reduction in the benefits derived from hosting human helminths that is seen after taking antibiotics might result, at least in part, from a loss from the gut microbiome of helpful bacterial species and
the proliferation of less beneficial ones. This suggestion, and the fact that taking probiotics alongside antibiotics has been claimed to help [http://www.sciencedaily.com/releases/2013/05/130530192404.htm offset the gastrointestinal symptoms] typically associated with these drugs, has led to the suggestion that the use of high doses (perhaps 5 or 10 times the normal dose) of good quality probiotics might help to reduce the time that helminths are out of action after using these drugs, especially if the probiotics are taken at a different time of day from the drug. And this effect has been reported by one individual. [https://www.facebook.com/groups/htsupport/permalink/1257052664350686/?comment_id=1257367554319197&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, also see [https://www.ngmedicine.com/taking-probiotics-with-antibiotics-revisited/ this article] which looks at the evidence on the use of probiotics alongside antibiotics, which is not all positive. Additional help in protecting the microbiome might be gained by supplementing with either butyrate [https://www.sciencedirect.com/science/article/pii/S2211124719303845] or charcoal [https://www.ncbi.nlm.nih.gov/pubmed/29186529] alongside an antibiotic. A fecal microbiota transplant (FMT) might also help to restore worm benefits more quickly following treatment with an antibiotic. [https://www.facebook.com/groups/htsupport/permalink/1149149175141036/?comment_id=1242073262515293&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

It is possible that the consumption of prebiotics such as galacto-oligosaccharides (GOS) may also help to restore the gut biome, since GOS has been shown to help [http://www.ncbi.nlm.nih.gov/pubmed/24925303 support the recovery of beneficial bifidobacteria] and increase the production of butyrate, after antibiotic treatment. GOS is available in the form of [https://gutsupp.com GutSupp Prebiotic Powder (formerly "Bimuno")]. Fructooligosaccharides (FOS) and xylooligosaccharides (XOS) may perform a similar function. [https://www.ncbi.nlm.nih.gov/pubmed/30113166] For more detail about the effects of a total loss of worms due to antibitoic use, and how to restore a colony, see [[Hookworm dosing and response#Colony collapse | '''Colony collapse''']].

In the case of someone needing to take antibiotics regularly, or on a long-term basis, there would be little point in them using hookworms until completely off these drugs. Some worm benefits may be maintained in users of the human whipworm, so long as doses of this organism are being taken regularly, every few weeks. Another solution for those who need to take antibiotics frequently, or for prolonged periods, would be to switch to TSO as these are less likely to be adversely affected by antibiotics. While ciprofloxacin is capable of blocking the action of TSO, other antibiotics just slow them down. [https://www.facebook.com/groups/htsupport/permalink/1343118199077465/?comment_id=1343598479029437&comment_tracking=%7B%22tn%22%3A%22R%22%7D] HDC may also be less susceptible to antibiotics than human helminths, although two users of HDC have reported that the antibiotic,
⚡ [https://en.wikipedia.org/wiki/Dapsone Dapsone] (diamino-diphenyl sulfone), causes a return of their disease symptoms.
</blockquote>

==== ➿ Antibiotics best avoided for other reasons ====
<blockquote>
Some antibiotics are best avoided for other reasons.

* [https://en.wikipedia.org/wiki/Fluoroquinolone Fluoroquinolone antibiotics] can be extremely dangerous [https://en.wikipedia.org/wiki/Quinolone_antibiotic#Adverse_effects] and can cause permanent nerve damage. [http://healthimpactnews.com/2013/warning-fluoroquinolone-antibiotics-may-cause-permanent-nerve-damage/] This group of drugs includes [https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin] (cipro), [https://en.wikipedia.org/wiki/Levaquin levofloxacin] (Levaquin, Tavanic, etc.) [https://en.wikipedia.org/wiki/Tequin gatifloxacin] (Gatiflo, Tequin and Zymar), [https://en.wikipedia.org/wiki/Gemifloxacin Gemifloxacin] (Factive), [https://en.wikipedia.org/wiki/Moxifloxacin Moxifloxacin] (Avelox, Vigamox, Moxeza, etc.), [https://en.wikipedia.org/wiki/Norfloxacin Norfloxacin] (Noroxin) and [https://en.wikipedia.org/wiki/Ofloxacin Ofloxacin] (Floxin, Ocuflox, etc.). The European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds in 2018. [https://www.medscape.com/viewarticle/903029]

* [https://en.wikipedia.org/wiki/Clarithromycin Clarithromycin] (Biaxin, etc.) has been shown to increase the risk of a fatal heart attack compared with penicillin V, especially in older people with existing cardiac risk factors, although no increased risk was seen with [https://en.wikipedia.org/wiki/Roxithromycin roxithromycin] [http://www.bmj.com/content/349/bmj.g4930]. Also see this [https://pubmed.ncbi.nlm.nih.gov/29155931/ later study].
</blockquote>

=== Anticoagulants [https://en.wikipedia.org/wiki/Anticoagulant] ===

==== ✅ Safe anticoagulants unless otherwise marked ====
<blockquote>
Anticoagulant medicines and herbs (which reduce the clotting ability of blood) do not harm helminths, but may prolong bleeding from the tiny feeding sites of hookworms, which, themselves, secrete minute amounts of anticoagulants to help their digestive process. Anticoagulant drugs include:
* [https://en.wikipedia.org/wiki/Warfarin warfarin]
* [https://en.wikipedia.org/wiki/Heparin heparin]
Other drugs that have an anticoagulant effect include
* [https://en.wikipedia.org/wiki/Aspirin aspirin] and products containing it, such as
** [https://en.wikipedia.org/wiki/Alka-Seltzer Alka-Seltzer]
** ❓ [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol].

Herbs with an anticoagulant effect include:
* [https://en.wikipedia.org/wiki/Ginkgo_biloba ginkgo biloba]

All of these compounds may prolong bleeding at hookworm feeding sites to some extent, so may potentially contribute to anaemia (anemia) in susceptible individuals, especially if several of these drugs/supplements are taken at the same time.
</blockquote>

=== Antidepressants ===

Some self-treaters use certain SSRIs alongside NA and TTO without any apparent problem, but, according to a 2018 Nature article, [https://www.nature.com/articles/s41598-017-18457-w] some SSRIs (setraline, paroxetine, and chlorpromazine) have such a powerful anthelmintic effect that the authors suggested these drugs could be used clinically as dewormers.

'''NB''' Anyone who wants to start helminthic therapy who is already taking one of the antidepressants that has a known anthelmintic effect should not stop taking the drug without first consulting their medical advisor. This is because, although helminths can eventually help in some cases of depression, the worms are unlikely to start to work immediately and may actually cause a brief initial worsening of this condition before beginning to provide relief. See [[Helminthic therapy and neuropsychiatric disorders#Depression | '''Helminthic therapy and neuropsychiatric disorders: Depression''']].

<blockquote>

* ✅ [https://en.wikipedia.org/wiki/Amitriptyline Amitriptyline] (Elavil, etc.) This tricyclic antidepressant has been taken by at least one hookworm host at 15 mg per day, without issue. [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085576868164924&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Citalopram Citalopram] (Celexa, Cipramil and [https://en.wikipedia.org/wiki/Citalopram#Brand_names numerous other names].) This selective serotonin reuptake inhibitor (SSRI) has been used by at least one hookworm host with no ill effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1994977397224872/?comment_id=1995274433861835&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Doxepin Doxepin] This tricyclic antidepressant and potent antihistamine has been marketed under many names, including Quitaxon, Aponal and Sinequan. One individual has taken Doxepin daily for several years while hosting hookworms, without noticing any adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682894431766505&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Duloxetine Duloxetine] (Cymbalta, etc.) This Serotonin–norepinephrine reuptake inhibitor (SNRI) was taken by one NA host for several years to treat generalised anxiety without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2056263424429602/?comment_id=2058009587588319&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Fluoxetine Fluoxetine] (Prozac, Sarafem, etc.) A study published in Nature reported that this selective serotonin reuptake inhibitor (SSRI) was harmful to the non-theraputic helminth species ''C. elegans'', [https://www.nature.com/articles/s41598-017-18457-w] but fluoxetine is being taken by at least two hookworm hosts without issue [https://www.facebook.com/groups/htsupport/permalink/1686522081403740/?comment_id=1687356354653646&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085350661520878&comment_tracking=%7B%22tn%22%3A%22R%22%7D].

* ❓ [https://en.wikipedia.org/wiki/Venlafaxine Venlafaxine] (Effexor, etc.) There have been no reports about this particular drug yet, but it is a serotonin-norepinephrine reuptake inhibitor (SNRI), and it is already known that duloxetine (Cymbalta, etc.), which is another SNRI, appears to be safe for use by hosts of human helminths.

* ❌ [https://en.wikipedia.org/wiki/Desvenlafaxine Desvenlafaxine] (Pristiq, Desfax, Ellefore, etc.) One hookworm host has reported that this drug wiped out his entire NA colony.

* ⚡ [https://en.wikipedia.org/wiki/Escitalopram Escitalopram] (Cipralex and Lexapro.) After taking "the smallest possible dose" of this selective serotonin reuptake inhibitor (SSRI) in the form of Lexapro for 4 weeks, one user found that she lost all the benefits previously conferred by NA, and even HDC benefits were dampened. [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=2155918287797448&comment_tracking=%7B%22tn%22%3A%22R%22%7D]. However, someone else who took Lexapro for the first 2.5 years that she hosted NA did not lose her colony as a result of this. She was already taking 30 mg per day when she first inoculated, and then lowered the dose to 20 mg 18 months later. This user does have to top up her colony with a dose of 10 NA every three months, but this level of attrition is not excessive and may not be due to the drug. [https://www.facebook.com/groups/htsupport/permalink/2301858276536781/?comment_id=2309854282403847&reply_comment_id=2311232908932651&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Others have reported taking Lexapro without any obvious adverse effect on their NA, e.g, [https://www.facebook.com/groups/htsupport/permalink/3640310742691521?comment_id=3640395312683064 this self-treater] and someone else who had hosted NA for 7 years and been taking Lexapro during this entire time (10mg for 5 years, then 5mg for 2 years, and finally 2.5mg once a week for 3 years [https://www.facebook.com/groups/htsupport/posts/2301858276536781/?comment_id=2309854282403847&reply_comment_id=4866244573431459]) and was never aware of this having any adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Paroxetine Paroxetine] (Aropax, Brisdelle, Deroxat, Paxil, Pexeva, Paxtine, Paxetin, Paroxat, Paraxyl, Sereupin, and Seroxat.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class, has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]

* ❓ [https://en.wikipedia.org/wiki/Sertraline Sertraline] (Sold under a very large number of trade names, [https://www.drugs.com/international/sertraline.html] including Zoloft.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class has shown anthelmintic effects against four widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694] However, someone who has taken doses of either 100 mg or 150 mg of Zoloft daily for 1.5 years has reported continuing benefits from his NA. [https://www.facebook.com/groups/htsupport/permalink/3054501617939106/]
</blockquote>

=== Antifungals [https://en.wikipedia.org/wiki/Antifungals] ===

==== ✅ Safe antifungals unless marked otherwise ====
<blockquote>
The following appear to be safe for use with human helminths
* [https://en.wikipedia.org/wiki/Fluconazole fluconazole] (Diflucan and Trican)
* [https://en.wikipedia.org/wiki/Nystatin nystatin] (Mycostatin, Nilstat, Nystop, etc.) This has been used for many years by one hookworm host without harming his worms. [https://www.facebook.com/groups/htsupport/permalink/1995854040470541/?comment_id=1996211143768164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
* the fatty acid [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid] also appears safe [https://www.facebook.com/groups/htsupport/permalink/935151783207444/?comment_id=935208789868410&comment_tracking=%7B%22tn%22:%22R%22%7D]. However, anyone with a coconut allergy/intolerance should note that ''caprylic acid'' is a coconut/palm kernel derivative.
* the enzyme-based anti-Candida product [https://en.wikipedia.org/wiki/Candex candex] is also worm-safe. One hookworm host took 4 ''Candex'' capsules twice a day for over a month without any obvious harm to his worms. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Chlorophyll Chlorophyll]. A chlorophyll-based solution has been found to be [https://www.researchgate.net/publication/43335937_Antimicrobial_activity_of_chlorophyll-based_solution_on_Candida_albicans_and_Enterococcus_faecalis effective against Candida albicans] and there have been no reports to suggest this might be harmful to helminths. (Also see❓[[#Chlorophyllin|Chlorophyllin]].)

* [http://www.ncbi.nlm.nih.gov/pubmed/23965638 Some probiotics] may help to control candida, especially [https://en.wikipedia.org/wiki/Saccharomyces_boulardii Saccharomyces boulardii], which significantly inhibits [http://www.ncbi.nlm.nih.gov/pubmed/20629753 adhesion by C. albicans], thus [http://www.ncbi.nlm.nih.gov/pubmed/19732158 preventing the formation of biofilms and filamentation], and it is as [http://www.ncbi.nlm.nih.gov/pubmed/23703468 effective as nystatin] in reducing fungal colonization and invasive fungal infection. '''S. boulardii''' has also been taken by at least two helminth hosts without any obvious effect on their worms. At least one strain of Lactobacillus acidophilus can reduce the population of Candida albicans in the gut microbiota. [https://www.ncbi.nlm.nih.gov/pubmed/29997616]

* [https://en.wikipedia.org/wiki/Sodium_butyrate Sodium butyrate] is a powerful antifungal that inhibits pathogenic yeast growth [http://jac.oxfordjournals.org/content/66/11/2573.long]. It is available as a food supplement and is also manufactured in the human intestines by the fermentation of vegetables. The bacteria responsible for butyrate production are vulnerable to antibiotics, but can be reintroduced, or supplemented, by means of [https://en.wikipedia.org/wiki/Fecal_bacteriotherapy fecal microbiota transplants] (FMT), or the addition of the butyrate-producing bacterial species, [https://en.wikipedia.org/wiki/Clostridium_butyricum clostridium butyricum], which generates butyrate directly in the gut. C. butyricum is available in Japan as the probiotic, Miyarisan Tablets, [https://www.facebook.com/photo.php?fbid=10152806891616155&set=p.10152806891616155&type=1&theater] which may sometimes be found online, including on eBay, and in the probiotic formulations, Bifilac and Bifilac HP. [http://www.indiamart.com/abpl/probiotic-dietary-supplements.html] C. butyricum is also available as an animal feed additive. [http://www.alibaba.com/product-detail/probiotic-clostridium-butyricum_1589202110.html] Nutrients that help to increase butyric acid concentrations in the colon include pectin [https://en.wikipedia.org/wiki/Pectin] and larch arabinogalactan [https://en.wikipedia.org/wiki/Arabinogalactan], which is available as a supplement, [https://uk.iherb.com/search?kw=arabinogalactan&cids=1855&rank=1&rawkw=arabinoglactan&refererLocation=suggestion] although arabinogalactan can worsen rheumatic conditions. [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797204570335500&offset=0&total_comments=1], [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797261090329848&offset=0&total_comments=3] When buying any butyrate supplement, it's important to check ''all'' the ingredients in each product. One NA host who took [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] likely because this product contains medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Ascorbic_acid Ascorbic acid] (vitamin C) may interfere with the yeast-to-hypha transition [http://www.ncbi.nlm.nih.gov/pubmed/25084864] of candida.

* [https://en.wikipedia.org/wiki/Apple_cider_vinegar Apple cider vinegar]. Only a single individual has ever reported believing that apple cider vinegar had an adverse effect on their hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616632618392677&reply_comment_id=2617255014997104] Since many other hookworm hosts drink apple cider vinegar without issue, [https://www.facebook.com/groups/htsupport/permalink/1516308765091740/?comment_id=1516658838390066&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] it can be considered to be worm-friendly. It has been revealed as a possible treatment for Candida species involved in denture stomatitis, [http://www.ncbi.nlm.nih.gov/pubmed/25219289] and there have been suggestions that, if ingested, vinegar might induce the body's gut defence system to help combat a Candida albicans infection. [http://www.sciencedaily.com/releases/2015/06/150608151952.htm] Advice on using apple cider vinegar as part of an anti-Candida treatment regimen can be found [http://www.onegreenplanet.org/natural-health/how-to-treat-chronic-yeast-overgrowth-with-apple-cider-vinegar/ here].

* [https://en.wikipedia.org/wiki/Iodine Iodine] appears to have antifungal properties, is worm-friendly, and has proved effective against Candida for one hookworm host.[https://gettinghealthiernow.wordpress.com/2014/11/29/iodine-protocol-destroying-candida/]

* [https://en.wikipedia.org/wiki/Vitamin_D Vitamin D] turns on genes that make antimicrobial peptides, including cathelicidin [https://en.wikipedia.org/wiki/Cathelicidin], which has been shown to kill Candida. However, dosage with this vitamin may be critical, and excessive amounts might be counter-productive [http://www.ncbi.nlm.nih.gov/pubmed/25612733]. Aiming for the optimum blood level [http://www.vitamindcouncil.org/about-vitamin-d/how-do-i-get-the-vitamin-d-my-body-needs/] of vitamin D would therefore appear to be ideal. (Vitamin D3 has been shown to extend the median lifespan of one species of roundworm by 30-40%. [http://www.vitamindcouncil.org/vitamin-d-news/new-research-finds-vitamin-d-extends-the-life-of-roundworms-08-2015/#])

* Some foods [http://www.thecandidadiet.com/candida-fighting-foods.htm], eaten in normal dietary amounts, may help support an anti-Candida programme, but see the separate notes on ⚡[[#Cayenne|cayenne]], ⚡[[#Coconut|coconut]] and ⚡[[#Ginger|ginger]]. Fresh ✅ garlic may be particularly helpful [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538912/], and dietary forms of garlic are known to be worm-safe, but see the details in the separate entry for [[#Garlic|garlic]].

* When Candida is a problem, very low carbohydrate (VLC) diets are best avoided because these cause ketosis, and yeasts love ketones.

* [https://en.wikipedia.org/wiki/Monolaurin Monolaurin] (also known as glycerol monolaurate, glyceryl laurate or 1-lauroyl-glycerol). Monolaurin is a monoglyceride - the mono-ester formed from glycerol and lauric acid. Shown in test tube studies to have antibacterial and antiviral activity, it is commonly used as a surfactant in cosmetics, including deodorants, and as an emulsifier in foods. While it is active against candida [http://www.ncbi.nlm.nih.gov/pubmed/20008774], one subject has reported that taking two teaspoons of monolaurin daily, for a few weeks, produced no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872137176175572&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872142719508351&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R4%22%7D] Another believes that she probably ingested a significant dose of monolaurin by drinking full fat coconut milk daily, but that her hookworms and whipworms both survived this. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] Others have also confirmed that monolaurin is worm-safe. [https://www.facebook.com/groups/htsupport/permalink/974642915924997/?comment_id=975547445834544&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1368090353246916/?comment_id=1369652509757367&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/posts/9279862498736289?comment_id=9280024828720056]

A very worm-friendly way to reduce Candida is to brush one's teeth after every meal instead of just once each day. This has been shown to reduce the abundance of C. albicans in the stool by 10-fold to 100-fold. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874442/] The addition of regular [https://wellnessmama.com/17951/coconut-oil-pulling/ oil pulling using coconut oil] (not to be swallowed) could further reduce the amount of candida. [https://www.facebook.com/groups/htsupport/permalink/1617823828273566/?comment_id=1618578738198075&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>

==== ❓ More antifungals ====

<blockquote>

* ❓ '''Cellular silver''' (see [[#AlternativeTherapies|Alternative therapies]] section). The manufacturers of Advanced Cellular Silver (ACS) 200 Extra Strength [http://www.resultsrna.com/products/acs_200_overview/] claim that this product achieves a 99.9989% kill against C. albicans. Although there have been no reports to date of its possible effect on human helminths, its similarity to ➿'''colloidal silver''' (see [[#AlternativeTherapies|Alternative therapies]] section) suggest that it may not kill the worms but only cause a temporary reduction of benefits.

* ❓ [https://en.wikipedia.org/wiki/Lactoferrin Lactoferrin] (also known as lactotransferrin [LTF]) is found naturally in secretory fluids, such as milk, saliva, tears and nasal secretions. It has antibacterial, antiviral, antifungal and antiparasitic properties, and is effective against candida. It’s antimicrobial properties are enhanced by the peptide, ❓[https://en.wikipedia.org/wiki/Lactoferricin lactoferricin], the anti fungal effects of which exceed those of lactoferrin. However, there have been no reports of any adverse effect on helminths, and one NA host has reported that taking 300mg of lactoferrin per day had no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/2116858295036781/]

* ❓ [https://en.wikipedia.org/wiki/Lavandula Lavender] has antifungal activity and may be of value in treating candida. [http://www.ncbi.nlm.nih.gov/pubmed/26550521]

* ❓ '''Propolis''' (see [[#NutritionalSupplements|Nutritional supplements]] section). Candida has been shown to be susceptible to propolis extract [http://www.ncbi.nlm.nih.gov/pubmed/26149083], and to red propolis alcoholic extract. [http://www.ncbi.nlm.nih.gov/pubmed/26154370]

* ❓ [https://en.wikipedia.org/wiki/Polygodial Polygodial], which has both antifungal and antimicrobial properties and is used as an insecticide, is an active constituent of
** ❓ [https://en.wikipedia.org/wiki/Tasmannia_stipitata Dorrigo pepper],
** ❓ [https://en.wikipedia.org/wiki/Tasmannia mountain pepper],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera horopito],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera_colorata mountain horopito],
** ❌ [https://en.wikipedia.org/wiki/Pseudowintera_colorata Kolorex],
** ❓ [https://en.wikipedia.org/wiki/Drimys_winteri canelo] (Drimys winteri, winter's bark)
** ❓ [https://en.wikipedia.org/wiki/Acmella_oleracea paracress] and
** ❓ [https://en.wikipedia.org/wiki/Persicaria_hydropiper water pepper].
Whilst polygodial has been shown to be effective against single-celled parasites such as protozoa, the only report so far that it might also have an adverse effect on helminths comes from a hookworm host who suspects that she killed her colony by taking '''Kolorex''', which contains a mixture of horopito and ⚡'''aniseed'''.

* ❓ [https://en.wikipedia.org/wiki/Undecylenic_acid Undecylenic Acid]. This is the common name for 10-Undecenoic Acid, which is used in the Thorne Research product, [https://www.thorne.com/products/dp/formula-sf722-reg Formula SF722]. It is a potent antifungal mono-unsaturated fatty acid extracted from coconut and the castor bean. It has been shown to be 11 times stronger than [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid], and is also claimed to have antiparasitic properties, although there have been no reports about this from hosts of therapeutic helminths.

* ⚡ [https://en.wikipedia.org/wiki/Curcumin Curcumin] inhibits candida [http://jac.oxfordjournals.org/content/63/2/337.long], even at low concentrations, but see the main entry below for [[#Turmeric|Turmeric/curcumin]] for further details.

* ❌ [https://en.wikipedia.org/wiki/Nigella_sativa Black cumin] (nigella sativa). Also known as blackseed, black seed, black caraway, fennel-flower, nutmeg flower, Roman coriander, kalonji and 'Love in the Mist'. Extracts of this herb have shown antifungal effects [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642442/] against different strains of Candida albicans, but it has also been used as an anthelmintic since ancient times. While one self-treater has reported that black cumin did not harm NA, HDC or TSO when he took them, [https://www.facebook.com/groups/htsupport/permalink/26499688856327052/] black cumin and its active component, thymoquinone, have nevertheless demonstrated anthelmintic activity against several nematode species, including Trichuris muris - a relative of the human whipworm, Trichuris trichiura - as well as two other human helminths: Ascaris lumbricoides and the blood fluke, Schistosoma mansoni. In India, today, nigella seeds are combined with various purgatives to help kill and expel intestinal parasites, and they have a synergistic effect with pharmaceutical anthelmintics. [https://www.ncbi.nlm.nih.gov/pubmed/30149818]

* ❌ [https://en.wikipedia.org/wiki/Gymnema_sylvestre Gymnema sylvestre] is effective against candida [http://www.k-state.edu/media/newsreleases/jun13/vediyappan91213.html], but hydroalcoholic extracts of this herb have been found to have anthelmintic activity against the Indian earthworm, Pheretima posthuma. [http://www.ijrap.net/admin/php/uploads/525_pdf.pdf] Even though the research worm, C. elegans, appears to be unaffected by gymnema [http://www.ncbi.nlm.nih.gov/pubmed/?term=gymnema+sylvestre+candida] and there are genetic similarities [http://www.ncbi.nlm.nih.gov/pubmed/11812491] between C. elegans and N. americanus, one helminth host suspects that gymnema was responsible for the loss of his hookworm colony.

* ❌ [https://en.wikipedia.org/wiki/Lufenuron Lufenuron] is a benzoylurea pesticide used on crops and in veterinary medicine (in flea control, heartworm treatments and other anthelmintic products). Its powerful anti-fungal effects may be due to its ability to inhibit the synthesis of chitin, which is unfortunately an important constituent of the mouthparts of the hookworm.

Some herbal antifungal products may adversely affect helminths, especially if they are in a concentrated form, so any herbal medicine that claims to have antifungal properties should be approached with caution.

Some foods are coated with edible films containing antifungal compounds such as ❓[https://en.wikipedia.org/wiki/Natamycin natamycin] (pimaricin) and ❌ '''oregano oil''' (see [[#Oregano|Oregano reference]])
but the quantities used in this application are probably insufficient to affect helminths, and there is no evidence [http://www.inchem.org/documents/jecfa/jecmono/v48je06.htm] to date that natamycin harms intestinal flora.

NB. Prolonged treatment with antifungal drugs can disrupt commensal fungal populations and cause an increase in
the severity of disease states, as seen in one study [http://www.ncbi.nlm.nih.gov/pubmed/27237365] in acute and chronic models of colitis and allergic airway
disease.
</blockquote>

=== Antihistamines ===

==== Antihistamines as marked ====

<blockquote>
* ✅ Worm-safe antihistamines are
** [https://en.wikipedia.org/wiki/Diphenhydramine diphenhydramine] -- most likely to cause drowsiness
** [https://en.wikipedia.org/wiki/Loratadine loratadine] (Claritin, Lorafix)
** [https://en.wikipedia.org/wiki/Fexofenadine fexofenadine] (Allegra, Fexidine, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo) -- least likely to cause drowsiness
* ✅ Most '''Benadryl-branded products''' sold in the '''US''' contain only diphenhydramine so are worm-safe, e.g.
** [http://www.benadryl.com/products/allergy/benadryl-ultratab-tablets Benadryl Allergy Ultratab Tablets]
** [http://www.benadryl.com/products/allergy/benadryl-liquid-gels Benadryl Allergy Dye-Free Liqui-gels]
** [http://www.benadryl.com/products/children-allergy/benadryl-allergy-liquid Children’s Benadryl Allergy Liquid]
* ⚡ except
** [https://www.benadryl.com/products/children-allergy/benadryl-allergy-and-sinus-liquid Childrens’ Benadryl Allergy Plus Congestion] which also contains ⚡ phenylephrine. (See [[#Phenylephrine|local reference]].)

'''Benadryl products''' sold in the '''UK''' all contain drugs with anthelmintic potential - either
* ⚡ cetirizine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-liquid-capsules Benadryl Allergy Liquid Release Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-one-day Benadryl One a Day Relief Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-aged-two-plus Benadryl Allergy Children’s (2+ years) 1mg/ml Oral Solution]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-children Benadryl Allergy Children’s 6+ 1mg/ml Oral Solution]
* ⚡ acrivastine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief-plus Benadryl Allergy Relief Plus Decongestant Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief Benadryl Allergy Relief Capsules]
* ❓ [https://en.wikipedia.org/wiki/Chlorphenamine Chlorphenamine] (chlorpheniramine, piriton) While we don’t yet have any confirmation of the effect on helminths of this first-generation antihistamine, it has been suggested by someone who has investigated this that it is unlikely to be harmful to worms.

* ✅ [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium, plus Gastrocrom and Intercron) This is a mast cell stabiliser which prevents the release of histamine from mast cells and is used to treat some allergic conditions. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Doxylamine Doxylamine] (Bendectin, Debendox, Diclectin, Diclegis, Dozile, Lenotan, Merbental, Restavit, Unisom, Valocordin-Doxylamine, Vicks Formula 44 and Vomentin, etc.) One hookworm host believes that an unexpected return of gut symptoms and dry skin may have been caused by taking a quarter of a tablet of this first-generation antihistamine every night for a couple of weeks. [https://www.facebook.com/groups/htsupport/permalink/927991007256855/?comment_id=1007272959328659&comment_tracking=%7B%22tn%22:%22R%22%7D] Another NA host believes that taking diclectin (doxylamine combined with pyridoxine) put her worms out of action until she stoped taking it. [https://www.facebook.com/groups/htsupport/permalink/2706737069382231/]

* ⚡ [https://en.wikipedia.org/wiki/Ketotifen Ketotifen] - This antihistamine and mast cell stabilizer, which has similar effects to cromoglicic acid (see separate listing), is sold under a large variety of trade names [https://www.drugs.com/international/ketotifen.html] that include Allerban, Allergan, Bentifen, Ketasma, Mastifen, Zaditen and Zylofen. In one study using the helminth, Trichinella spiralis, the addition of ketotifen resulted in a greater worm burden and worm size, [https://www.ncbi.nlm.nih.gov/pubmed/16886340] but in a small in vitro test, one hookworm self-treater found that exposing a sample of NA larvae to Naziden left them “a bit lethargic but alive” [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1041766029212685&comment_tracking=%7B%22tn%22:%22R8%22%7D] and they were still alive the next day. [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1042321262490495&comment_tracking=%7B%22tn%22:%22R3%22%7D] However, effects in vivo don’t always correspond with those observed in a petri dish, and ketotifen is a piperazine-related substance so it may have an adverse effect on human helminths in vivo in at least some users.

* ⚡ [https://en.wikipedia.org/wiki/Promethazine Promethazine] (Phenergan, Promethegan, Romergan, Fargan, Farganesse, Prothiazine, Avomine, Atosil, Receptozine, Lergigan, and, in the UK, Sominex). This does not appear to kill helminths, whether taken orally or by intramuscular injection, and one self-treater who needs to take oral Phenergan daily says that her NA are unaffected. [https://www.facebook.com/groups/htsupport/permalink/1597006987021917/?comment_id=1597396203649662&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another hookworm host has reported that this drug did reduce his worm benefits when it was taken orally.
</blockquote>

==== Piperazine related antihistamines ====
<blockquote>
Popular antihistamines derived from, or closely related to, the anthelmintic drug ❌ [https://en.wikipedia.org/wiki/Piperazine piperazine] (See the separate entry for [[#piperazine|piperazine]]).
These include:
* ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine)
* ⚡ [https://en.wikipedia.org/wiki/Levocetrizine_dihydrochloride levocetrizine] (Alcet, Allear, Curin, levcet, Seasonix, T-Day Syrup, Teczine, UVNIL, Vozet, Xaltec, Xozal, Xuzal, Xusal, Xyzal, Zilola, Zyxem)

* ⚡ [https://en.wikipedia.org/wiki/Phenylephrine phenylephrine] Some nasal decongestants and allergy medications contain this drug (e.g., products branded "Sudafed PE", but not those branded "Sudafed") so check the ingredients of the product you are considering using. While one hookworm host has reported using this drug without any adverse effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537715762951030] it does appear to have anthelmintic properties [http://www.ncbi.nlm.nih.gov/pubmed/6127426] and has been reported to have caused a brief return of disease symptoms in one hookworm host after a single dose.
* ⚡ [https://en.wikipedia.org/wiki/Desloratadine desloratadine] (NeoClarityn, Claramax, Clarinex, Larinex, Aerius, Dazit, Azomyr, Deselex and Delot)
* and possibly ⚡ [https://en.wikipedia.org/wiki/Acrivastine acrivastine] (Semprex-D in the US)

While some people have taken cetirizine, levocetirizine or desloratadine concurrently with helminthic therapy -
sometimes for very long periods - and had no loss of benefit from their worms (for example [https://www.facebook.com/groups/htsupport/permalink/892594554129834/?comment_id=892794274109862&offset=0&total_comments=16&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/893959107326712/?qa_ref=qd&comment_id=893959580659998&offset=0&total_comments=9&comment_tracking=%7B%22tn%22:%22R7%22%7D]), there
have been others who have suspected that these drugs have been responsible for adversely affecting or even killing their worms.

Less common antihistamines derived from, or related to ❌piperazine.
At the present time, there is no indication whether or not most of the following drugs could affect human helminths.
* ❓ [https://en.wikipedia.org/wiki/Buclizine buclizine]
* ❓ [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan)
* ❓ [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5)
* ✅/⚡ [https://en.wikipedia.org/wiki/Hydroxyzine Hydroxyzine] (Atarax, Vistaril, etc.) A parent has reported that her son’s NA were not harmed by taking this drug, but dose size and length of use in this case are not known. [https://www.facebook.com/groups/htsupport/2666963426692929/?comment_id=2667238819998723&reply_comment_id=2669051416484130&notif_id=1581006498061422&notif_t=group_comment_mention]
* ❓ [https://en.wikipedia.org/wiki/Cyclizine cyclizine]
* ❓ [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs)
* ⚡ [https://en.wikipedia.org/wiki/Dramamine dimenhydrinate] See [[#dimenhydrinate|dimenhydrinate reference]].
* ❓ [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
* ❓ [https://en.wikipedia.org/wiki/Bilastine bilastine] (Bilaxten) One NA host has reported that she had been taking bilastine on and off for 3 years - the same amount of time that she had been hosting NA - because she has found it to be very effective for her allergies, and, while the NA have sometimes seemed to be working during this time, they have mostly seemed not to be working all that well. However, she had been able to grow more NA consistently for 2 of the 3 years, thus confirming that she still had some worms, but, when she last reported her experience, she had stopped taking the Bilastine to see whether the NA work better in its absence. [https://www.facebook.com/groups/htsupport/posts/4820011088054808/?comment_id=4851343294921587]
</blockquote>

==== ✅ H2 antagonists are safe ====

<blockquote>
H2 antagonists are a separate class of drugs from '''proton-pump Inhibitors''' (see separate section).

The term, “antihistamine” is usually reserved for [https://en.wikipedia.org/wiki/H1_antagonist H1 antagonists] whose main therapeutic effect is mediated by
negative modulation of histamine receptors, but [https://en.wikipedia.org/wiki/H2_antagonist H2 histamine receptor antagonists] can also be considered to be a
type of antihistamine. H2 antagonists include
* [https://en.wikipedia.org/wiki/Ranitidine ranitidine] (Zantac) which works by blocking histamine and thus decreasing the amount of acid released by the cells of the stomach.
Other common H2 antagonists are
* [https://en.wikipedia.org/wiki/Cimetidine cimetidine] (Tagamet)
* [https://en.wikipedia.org/wiki/Famotidine famotidine] (Pepcid) One hookworm host used this drug successfully, without harm to his colony, for at least 2 months, starting with 20mg daily and titrating within a month to 3x20mg per day. [https://www.facebook.com/groups/htsupport/posts/5898386906883882?comment_id=5898568306865742&reply_comment_id=5900280486694524]
* [https://en.wikipedia.org/wiki/Nizatidine nizatidine] (Axid, Tazac).
</blockquote>

=== Antimalarials ===

<blockquote>
*⚡ [https://en.wikipedia.org/wiki/Chloroquine Chloroquine] A cross-epidemiological study of the effect of treatment for malaria in hookworm-endemic areas found that treated patients presented with reduced helminth egg burdens and worm-related pathology, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558454/] and a reduced hookworm egg count has also been reported in another set of subjects taking chloroquine. [https://pubmed.ncbi.nlm.nih.gov/9645872/]
*✅ [https://en.wikipedia.org/wiki/Hydroxychloroquine Hydroxychloroquine] (Plaquenil, etc.) There has been one tentative suggestion from a helminth self-treater that this antimalarial medication, ''might'' have harmed her hookworms, but several others have taken this drug without any adverse effect on their worms. One took Plaquenil for 5 years without harming his NA, [https://www.facebook.com/groups/htsupport/permalink/3000811316641470/?comment_id=3001544019901533] another takes 400 mg daily without any adverse effect on her hookworms, [https://www.facebook.com/groups/htsupport/posts/4823182771070973/?comment_id=4824165244306059] and two further subjects who have taken this drug, one of them in quite large quantities, had no issues with their worms. (Link expired)
No other antimalarial drug has been suspected by self-treaters of harming therapeutic helminths, including [https://en.wikipedia.org/wiki/Quinine Quinine].
</blockquote>

=== Antiprotozoals ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). This is one of three derivatives of ❌[https://en.wikipedia.org/wiki/Nitroimidazole nitroimidazole] that is used against anaerobic bacterial and parasitic, as well as protozoan, infections. One hookworm host has reported[https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] losing her colony to this drug, which should never be combined with [https://en.wikipedia.org/wiki/Mebendazole mebendazole] due a risk that, together, they may cause [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis], something about which many doctors and pharmacists may be unaware, especially in the US.
</blockquote>

=== Antipsychotics ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Chlorpromazine Chlorpromazine] (Thorazine and Largactil, etc.) This antipsychotic medication has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]
</blockquote>

=== Antivirals ===
<blockquote>
(Also see [[Human helminth care manual#Natural antivirals|'''Natural antivirals''']] for effective worm-safe antiviral treatments.)

* ✅ [https://en.wikipedia.org/wiki/Famciclovir Famciclovir] (Famvir) -- One hookworm host took Famciclovir (500mg) 3 times per day for many months without any noticeable effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/884990498223573/?comment_id=885041121551844&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir Nirmatrelvir / ritonavir] This co-packaged medication, which combines two protease inhibitors and is marketed as Paxlovid, is used as a treatment for Covid‑19. There have been no reports of it harming human helminths and one report that it did not harm one self-treater’s NA colony. [https://www.facebook.com/groups/htsupport/posts/6439043419484892/?comment_id=6439498362772731]

* ✅ [https://en.wikipedia.org/wiki/Valtrex Valaciclovir/valacyclovir] (Valtrex, Zelitrex) -- This antiviral drug was taken by one worm host for a week without any adverse effect on his hookworms or whipworms.

* ❌ Nitazoxanide (See separate entry under Anthelmintics)
</blockquote>

=== Immunoglobulin therapy (IVIG) ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Immunoglobulin_therapy Immunoglobulin therapy], also known as normal human immunoglobulin (NHIG) is compatible with helminthic therapy and has been used effectively in combination with TSO. There is no reason to think that it would harm human helminths.
</blockquote>

===Immunomodulatory drugs ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Janus_kinase_inhibitor Janus kinase inhibitors], also known as JAK inhibitor or jakinib (e.g., baricitinib, tofacitinib and upadacitinib [Rinvoq]) are immune modulating medications used in the treatment of some cancers, autoimmune and inflammatory diseases such as rheumatoid arthritis, and various skin conditions. There is no evidence indicating that these drugs might have an anthelmintic effect, [https://www.facebook.com/groups/htsupport/posts/8698182570237621?comment_id=8698286136893931&reply_comment_id=8702949483094263] and there have been no reports from self-treaters of any adverse effects on their worm colonies.
</blockquote>

=== Immunosuppressive drugs ===

<blockquote>
'''✅ Immunosuppressive drugs reported to be safe for use by hosts of human helminths are:'''
* [https://en.wikipedia.org/wiki/Cyclosporin ciclosporin] (cyclosporine, cyclosporin). See also [https://en.wikipedia.org/wiki/Cyclosporins cyclosporins].

* [https://en.wikipedia.org/wiki/Corticosteroid corticosteroids], including:
** [https://en.wikipedia.org/wiki/Prednisone prednisone] and its active metabolite, [https://en.wikipedia.org/wiki/Prednisolone prednisolone]
** [https://en.wikipedia.org/wiki/Fluticasone_propionate fluticasone propionate] Also known as Flixotide (inhalatory), Flixonase and Flonase (nasal). At least three NA hosts have used this drug without any obvious impact on their worms. [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707582379297710&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707720709283877&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707880315934583&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cyclophosphamide cyclophosphamide] (Sold as: Cytoxan, Lyophilized Cytoxan, Endoxan, Neosar, Procytox, Revimmune and Cycloblastin). This has been used repeatedly by one hookworm host who has reported that it had no adverse effect on her colony.

* the [https://en.wikipedia.org/wiki/Thiopurine thiopurines], [https://en.wikipedia.org/wiki/Azathioprine azathioprine] and [https://en.wikipedia.org/wiki/6-MP mercaptopurine]/6-MP (purinethol)

* the [https://en.wikipedia.org/wiki/TNF_inhibitor TNF inhibitors]
** [https://en.wikipedia.org/wiki/Infliximab infliximab] (Remicade)
** [https://en.wikipedia.org/wiki/Adalimumab adalimumab] (Humira)
** [https://en.wikipedia.org/wiki/Certolizumab_pegol certolizumab pegol] (Cimzia)
** [https://en.wikipedia.org/wiki/Golimumab golimumab] (Simponi)

* [https://en.wikipedia.org/wiki/Humanized_antibody humanized antibody drugs], e.g. [https://en.wikipedia.org/wiki/Omalizumab omalizumab] (Xolair)

* [https://en.wikipedia.org/wiki/Monoclonal_antibody%23.22Fully.22_human_monoclonal_antibodies humanized monoclonal antibody drugs] such as [https://en.wikipedia.org/wiki/Natalizumab natalizumab] (Tysabri)

* and [https://en.wikipedia.org/wiki/Fusion_protein recombinant fusion protein] drugs such as [https://en.wikipedia.org/wiki/Etanercept etanercept] (Enbrel)

It can be an advantage to be taking one of these drugs in the early stages of helminthic therapy because they can reduce, or even prevent, the transient side effects triggered by helminths, and their anti-inflammatory action can also help human helminths to become established. So anyone who is already taking one of these drugs should resist the temptation to stop taking it too soon after starting HT.

This applies particularly to subjects with Crohn's and other intestinal diseases, who tend to have a very vigorous immune response to helminths. Suddenly withdrawing a drug that has been keeping this response in check will likely cause a rebound effect that could result in a flare and, potentially, a loss of worms. This is explained in more detail [[Introduction to helminthic therapy#Combining helminthic therapy with drug treatments | '''here''']].
</blockquote>

=== Immunotherapy ===

<blockquote>
✅ [https://en.wikipedia.org/wiki/Allergen_immunotherapy Allergen immunotherapy] -- In the form of sublingual drops/tablets, subcutaneous injections, and [https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-shots-(immunotherapy) allergy “shots”],
this is safe to be used concurrently with helminthic therapy. In fact, many who have used the two therapies together have been very pleased with the combined effects.
</blockquote>

=== Laxatives ===
<blockquote>
Hookworms are usually able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep] using products such as polyethylene glycol (PEG), Macrogol, Colyte, Picosalax, Bisacodyl, phospho soda, sodium picosulfate, or sodium phosphate and/or magnesium citrate. Many hookworm hosts have used the standard colonoscopy bowel prep without any problems (e.g., [https://www.facebook.com/groups/htsupport/permalink/2313948658661076/?comment_id=2316622215060387&comment_tracking=%7B%22tn%22%3A%22R%22%7D]), and there has only been a single report claiming that colonoscopy prep had terminated a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2184696924919584/?comment_id=2184806188241991&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another NA host has reported that, while a colonoscopy prep didn't entirely wipe out his colony, it appeared to have weakened it because he found a much smaller number of larvae than usual when he next incubated. [https://www.facebook.com/groups/htsupport/permalink/6481648121891088/]

It is unlikely that laxatives would dislodge human whipworms once these are mature and embedded in the colonic mucosa, but laxatives could potentially flush them out before this, especially around 21-22 days post inoculation. It may therefore be best to avoid the use of laxatives around this time. After 28 days, human whipworms should not be affected at all.

Also see [[#Diarrhoea/diarrhea|'''Diarrhoea/diarrhea''']].
</blockquote>

=== [https://en.wikipedia.org/wiki/Muscle_relaxant Muscle relaxants] ===
<blockquote>
There is a theoretical risk that anything which relaxes a hookworm host may have a similar effect on their colony, especially NA, and that this might conceivably affect the ability of the worms to maintain their grip on the host’s mucosa, possibly resulting in their expulsion, although this effect would likely be dose-dependent.

Whipworms are much less likely than hookworms to be affected in this way, due to them not feeding directly from the bloodstream and the fact that they anchor themselves deeply into the colonic mucosa, so are not easily dislodged.

There have been two reports of possible adverse effects. In the first of these, a hookworm host suspected ❌ [https://en.wikipedia.org/wiki/Carisoprodol Carisoprodol] (Soma, Sanoma and Carisoma) of causing the loss of his hookworm population. In the second, ❌ [https://en.wikipedia.org/wiki/Cyclobenzaprine Cyclobenzaprine] (Flexeril, Amrix, etc.) was identified as the only likely cause of multiple failed attempts to incubate NA. [https://www.facebook.com/groups/htsupport/posts/24119753220987306/] However, both ✅ [https://en.wikipedia.org/wiki/Guaifenesin '''Guaifenesin'''] and a single night-time dose of 6 mg of [https://en.wikipedia.org/wiki/Tizanidine ✅ '''Tizanidine'''] [https://www.facebook.com/groups/htsupport/posts/4490377691018151/?comment_id=4490387587683828] appear to have been safe.
</blockquote>

=== [https://en.wikipedia.org/wiki/Analgesic Pain relievers (analgesics)] ===
<blockquote>
The following pain relief medications are all harmless to NA and TTO.

* ✅ [https://en.wikipedia.org/wiki/Nonsteroidal_anti-inflammatory_drug '''NSAIDs (nonsteroidal anti-inflammatory drugs''')]
: * [https://en.wikipedia.org/wiki/Aspirin Aspirin]
: * [https://en.wikipedia.org/wiki/Ibuprofen Ibuprofen]
: * [https://en.wikipedia.org/wiki/Diclofenac Diclofenac]
: * [https://en.wikipedia.org/wiki/Naproxen Naproxen]
* ✅ [https://en.wikipedia.org/wiki/Opioids '''Opioids''']
: * [https://en.wikipedia.org/wiki/Codeine Codeine]
: * [https://en.wikipedia.org/wiki/Fentanyl Fentanyl]
: * [https://en.wikipedia.org/wiki/Hydrocodone Hydrocodone]
: * [https://en.wikipedia.org/wiki/Oxycodone Oxycodone]
* ✅ [https://en.wikipedia.org/wiki/Paracetamol '''Paracetamol (acetaminophen)''']
* ✅ [https://en.wikipedia.org/wiki/Benzodiazepine '''Benzodiazepines'''] such as:
: * [https://en.wikipedia.org/wiki/Midazolam Midazolam] ([https://en.wikipedia.org/wiki/Versed Versed])
</blockquote>

=== Recreational drugs ===

==== ❌ Piperazine-based recreational drugs ====
<blockquote>
[http://www.tandfonline.com/doi/pdf/10.1080/13102818.2008.10817529 Piperazine-based recreational drugs] are a group of stimulant drugs with similar effects to ecstasy.
(See separate entry for details on [[#piperazine|piperazine]]) The main piperazine-derivatives that have been used for
recreational purposes include
* [https://en.wikipedia.org/wiki/Benzylpiperazine BZP] (Benzylpiperazine, A2, Frenzy, Nemesis)
* [https://en.wikipedia.org/wiki/Trifluoromethylphenylpiperazine TFMPP] (1-[3-(trifluoro-methyl) phenyl]piperazine)
* [https://en.wikipedia.org/wiki/Meta-Chlorophenylpiperazine mCPP] (meta-chlorophenylpiperazine, 1- [3-Chlorophenyl]-piperazine).
These drugs were frequently mixed with caffeine and a range of vitamins and binders to make party pills that were marketed as
“natural” or “herbal” highs, but were actually purely synthetic. Other piperazine-derived designer drugs include:
* '''AcBZP''' (4-Acetyl-1-benzylpiperazine, AceticBenzylPiperazine)
* [https://en.wikipedia.org/wiki/Methylbenzylpiperazine MBZP] (1-methyl-4-benzylpiperazine)
* [https://en.wikipedia.org/wiki/2C-B-BZP 2C-B-BZP] (4-Bromo-2,5-dimethoxy-1-benzylpiperazine) One user has reported that periodic use of 2C-B did not affect his colony of NA.
* [https://en.wikipedia.org/wiki/Dibenzylpiperazine DBZP] (1,4-Dibenzylpiperazine)
* [https://en.wikipedia.org/wiki/Methylenedioxybenzylpiperazine MDBZP] (3,4 Methylenedioxy-1-benzylpiperazine)
</blockquote>

==== ⚡ Yage (Ayahuasca) ====

<blockquote>
It has been opined that anything that enters the bloodstream and disorients a host has a potential to do the same to hookworms - since they feed on their host’s blood - and that, if the disorientation is excessive, it may cause the worms to lose their grip on the mucosa and possibly be flushed away from their home base in the small intestine, and be lost. Although the assumption that the worms will become inebriated by anything that inebriates their host has been questioned because the 'nervous system' of helminths is quite different from that of mammals, one recreational drug that might produce this effect and cause the loss of hookworms is the South American drug, yage, also known as ayahuasca, as well as by a number of other names. [https://en.wikipedia.org/wiki/Ayahuasca%23Nomenclature]

This psychedelic brew, which is concocted by combining a variety of plant materials, was used as part of S. American native religious rituals and, since being commercialised, has become much more mainstream. Available in Europe and N. America through "churches" set up for its import, this drug causes a deep and immersive hallucinogenic experience during a “trip” lasting 4-8 hours, or 12-18 hours if the subject is re-dosed, which is not uncommon.

"Its purgative properties are important (known as la purga or "the purge"). The intense vomiting and occasional diarrhea it induces can clear the body of worms and other tropical parasites [https://www.ncbi.nlm.nih.gov/pubmed/2656954] and harmala alkaloids themselves have been shown to be anthelmintic. [https://link.springer.com/article/10.1007%2FBF02860378] Thus, this action is twofold; a direct action on the parasites by these harmala alkaloids (particularly harmine in ayahuasca) works to kill the parasites, and parasites are expelled through the increased intestinal motility that is caused by these alkaloids." [https://en.wikipedia.org/wiki/Ayahuasca]

“Tropical plants used by South American natives produce an array of isoquinoline and tryptamine-related alkaloids that are not only hallucinogens, but powerful emetics with a wide range of other biological activities, in particular antimicrobial and anthelmintic properties… We propose that these alkaloid mixtures were initially discovered and developed by indigenous people for treatment of a variety of parasitic diseases and incorporated into religious ceremonies using psychoactivity as an effective dose marker.” [https://www.sciencedirect.com/science/article/pii/0378874182900538]

However, in spite of all this evidence for the antiparastic potential of ayahuasca, one hookworm host has noticed no apparent adverse effect on her worms as a result of taking part in more than 10 ayahuasca ceremonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523441614378445&reply_comment_id=2523573887698551] Another helminth host has confirmed anonymously that he was able to culture more NA from his colony after participating in 3 ceremonies in one year.
</blockquote>

==== ✅ Safe for human helminths unless marked ====

<blockquote>

* [https://en.wikipedia.org/wiki/Betel Betel leaves] -- The leaves of the Piper betle vine (part of the [https://en.wikipedia.org/wiki/Piperaceae Piperaceae] family, which includes pepper and ⚡kava) are used as a mild stimulant and are thought likely to be safe for human helminths, although there have been no reports from helminth hosts to confirm or contradict this.

* ❌ [https://en.wikipedia.org/wiki/Areca_nut betel nut] (or areca nut) seed of the areca palm (and also known as the areca nut palm, betel palm, Pinang palm and Indian nut) is often chewed wrapped in betel leaves - a combination known as [https://en.wikipedia.org/wiki/Paan paan] that is used for its stimulant and psychoactive effects. Betel nuts contain the anthelmintic [https://en.wikipedia.org/wiki/Arecoline arecoline] and have been used as a tapeworm remedy. Fresh betel nuts are also known to be used very effectively by Torres Straight Islanders as a treatment for all types of intestinal worm, and surveys have found that the betel chewers were almost all worm-free, while others weren't. (Prolonged use of the betel nut can create addiction and the World Health Organization classifies the betel nut as a carcinogen.)

* [https://en.wikipedia.org/wiki/Cannabis_(drug) Cannabis], [https://en.wikipedia.org/wiki/Cannabis_(drug)%23Marijuana marijuana] and [https://en.wikipedia.org/wiki/Hashish hashish] appear to be worm-friendly. A paper published in 2015 [https://www.ncbi.nlm.nih.gov/pubmed/26031406] showed that, in the group of hunter-gatherers studied, those who consume cannabis have a significantly lower rate of helminth infection, from which the researchers concluded that the Aka foragers must consume cannabis to kill parasites, even though the scientists admit that, while cannabis kills worms in a petri dish, it has not been shown to kill worms in animals. A different explanation for the correlation seen in this study could be that those individuals with the most worms feel less need to smoke cannabis, and this ties in with the experience of the many helminth hosts who have seen a reduction in anxiety while hosting worms. One host of both hookworms and human whipworms has confirmed the presence of eggs from both species after cannabis use, and another hookworm host who used 10 drops of hemp '''CBD''' ([https://en.wikipedia.org/wiki/Cannabidiol cannabidiol]) oil twice daily, plus a few drops of '''THC''' ([https://en.wikipedia.org/wiki/Tetrahydrocannabinol tetrahydrocannabinol]) oil to help with sleep, has reported that her hookworms were unaffected. [https://www.facebook.com/groups/htsupport/permalink/1037560152966606/?comment_id=1037577039631584&comment_tracking=%7B%22tn%22:%22R%22%7D] Someone else used '''CBD''' oil for several months and noticed no adverse effect on his hookworms, [https://www.facebook.com/groups/htsupport/permalink/1239928846063068/?comment_id=1240221499367136&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and this lack of any adverse effect has been confirmed by numerous other cannabis users. [https://www.facebook.com/groups/htsupport/permalink/1406977876024830/?comment_id=1407227059333245&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1059227607466527/?comment_id=1059279190794702&reply_comment_id=1407016112687673&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has even been shown that CBD extends the lifespan and arrests age-associated physiological decline in the research nematode, C. elegans, so may potentially be beneficial for the health of other helminths. [https://pubmed.ncbi.nlm.nih.gov/35445360/]

* [https://en.wikipedia.org/wiki/Cocaine Cocaine], in its pure, unadulterated state, could be added to this list of worm-safe drugs, but it is commonly adulterated with other substances that might harm helminths, particularly ❌ [https://en.wikipedia.org/wiki/Levamisole levamisole] which, according to one report, is the most popular bulking agent found in 73% of seized coke. [https://www.hotpress.com/sex-drugs/10-things-know-cocaine-specialists-guide-22803299]

* [https://en.wikipedia.org/wiki/Hypnotic Hypnotics] are generally worm-safe, e.g.
** '''propofol''' (see Anaesthetics section) is an ultrashort-acting sedative with amnesiac effects
** anything in the [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] class of drugs (e.g. [https://en.wikipedia.org/wiki/Valium valium])
** the short-acting nonbenzodiazepine hypnotic, [https://en.wikipedia.org/wiki/Zolpidem zolpidem] (e.g. Ambien [https://www.facebook.com/groups/htsupport/permalink/865157116873578/?comment_id=866638886725401&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D], Ambien CR, Intermezzo, Stilnox, Stilnoct, Sublinox, Hypnogen, Lunata, Zonadin, Sanval, Zolsana, Zolfresh)
** the [https://en.wikipedia.org/wiki/Narcotic_analgesic opioids] (e.g. [https://en.wikipedia.org/wiki/Codeine codeine], [https://en.wikipedia.org/wiki/Dextropropoxyphene dextropropoxyphene], [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], [https://en.wikipedia.org/wiki/Hydrocodone hydrocodone], [https://en.wikipedia.org/wiki/Oxycodone oxycodone], [https://en.wikipedia.org/wiki/Tramadol tramadol] and [https://en.wikipedia.org/wiki/Morphine morphine]), along with any of their synthetic or time release variants (e.g. [https://en.wikipedia.org/wiki/Fentanyl fentanyl / fentanil]); [https://www.facebook.com/groups/htsupport/permalink/1080879281968026/?comment_id=1081015631954391&reply_comment_id=1081726205216667&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓ [https://en.wikipedia.org/wiki/Mitragyna_speciosa Kratom] (aka kratum and ketum). [https://www.facebook.com/groups/htsupport/permalink/868935276495762/] [https://www.facebook.com/groups/htsupport/permalink/868935276495762/?comment_id=869019499820673&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D] Extracts and leaves of kratom are reported to have been used as intestinal deworming agents in Thailand, and the FDA has warned consumers not to use any products labeled as containing kratom. [http://www.medicalnewstoday.com/releases/304821.php] However, one human whipworm host has taken small doses without any apparent effect on his worms [https://www.facebook.com/groups/htsupport/permalink/1788272677895346/?comment_id=1796502977072316&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and a hookworm grower has reported no reduction in yield from his cultures after he took kratom.

* [https://en.wikipedia.org/wiki/Opium Opium] and [https://en.wikipedia.org/wiki/Heroin heroin] (aka diacetylmorphine, diamorphine and other names) appear to be worm-friendly.

Most other recreational drugs should be safe for use by helminth hosts, including '''tobacco''', '''nicotine''' and most forms of '''alcohol'''.

* ➿ [https://en.wikipedia.org/wiki/Alcoholic_beverage Alcohol] -- Normal social drinking should not have any adverse effect on helminths, however, alcohol acts as an antimicrobial, and substances produced by the death of gut bacteria can enter the bloodstream to cause inflammation and allergic reactions [https://www.facebook.com/groups/htsupport/permalink/3958483847540874/?comment_id=3958511057538153] which can temporarily make it appear as though therapeutic helminths have stopped working. Overindulgence in alcohol may therefore cause a temporary reduction in worm benefits in a dose-dependent manner. One individual who had successfully put his colitis and celiac disease into remission with NA has reported that, in spite of hosting the worms, drinking beer causes a return of colitis symptoms. Excessive consumption of alcohol that results in the user going into a coma due to alcohol poisoning may incur a greater risk to helminths.
** ❓ [https://en.wikipedia.org/wiki/Absinthe Absinthe] is one alcoholic drink that might present more of a risk, as it was traditionally made using herbs reported to have antiparasitic properties, including ❌'''wormwood'''. (See separate entry). However, the risk from absinthe has been questioned because it only contains the essential oil of wormwood, while the anthelmintic activity of this herb has been linked more to the bitter principles and the alkaloids, which are not included in absinthe.

* ❓ [https://en.wikipedia.org/wiki/MDMA MDMA] (ecstasy) -- As primarily a serotonin and dopamine agonist, this is thought unlikely to have much effect on helminths. However, serotonin agonism increases peristalsis, so using MDMA may not be a good idea until after the worms have attached to the intestinal mucosa. Once they are attached, the increased peristalsis alone would not dislodge them. One hookworm host has reported that he has twice rolled with MDMA and it didn't kill his worms. [https://www.facebook.com/groups/htsupport/permalink/2331685740220701/]

* [https://en.wikipedia.org/wiki/N,N-Dimethyltryptamine DMT] (N,N-Dimethyltryptamine or N,N-DMT) This psychedelic compound with powerful hallucinogenic effects has been reported by one user to be safe for use with NA.

* ❓ [https://en.wikipedia.org/wiki/LSD LSD] (Lysergic acid diethylamide) is unlikely to harm helminths, and there has been one report to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Myristicin Myristicin] -- This psychoactive drug, which is the traditional precursor for the psychedelic and empathogenic drug [https://en.wikipedia.org/wiki/MMDA_(drug) MMDA], is found in very small quantities in vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but this dietary intake is unlikely to be harmful to helminths. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

* ❓ [https://en.wikipedia.org/wiki/Peyote Peyote] (Lophophora williamsii) -- This cactus, which contains psychoactive alkaloids, including mescaline, is thought unlikely to harm helminths, but there have been no reports to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Psilocybin Psilocybin], a [https://en.wikipedia.org/wiki/Substituted_tryptamine substituted tryptamine], is a naturally occurring psychedelic compound produced by more than 200 species of mushroom. Although illegal in most countries/states, psilocybin is used for the self-treatment of cluster headaches and one hookworm host has reported using this compound for two months to treat severe migraines, without noticing any apparent effect on his worms. However, it is possible that higher doses of this hallucinogenic may disorient hookworms for long enough to cause their loss.

* [https://psychedelictimes.com/healing-tobacco-rape-tribal-snuff/ Rapé] (pronounced “ha-peh”) is a powerful snuff originally used by shamans in Brazil and Peru as part of medicinal rituals. This sacred tobacco has increased in popularity outside of the Amazon during the early twenty-first century for its medicinal properties, and two hookworm hosts have reported using rapé without adversely affecting their colonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523128767743063] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410]
</blockquote>

===Statins===
There is evidence that [https://en.wikipedia.org/wiki/Statin statins] can be directly toxic to at least some helminths at sufficiently high concentrations in vitro, with this type of drug being known to inhibit HMG‑CoA reductase, an enzyme essential to many helminths for a number of vital processes including glycosylation, energy metabolism and membrane homeostasis.

In Schistosoma mansoni, for example, multiple statins (including lovastatin and others) have been shown to kill both larval and adult worms in vitro in a concentration‑ and time‑dependent manner. Similarly, in cestodes (tapeworms), simvastatin and fluvastatin have inhibited parasite HMG‑CoA reductase to produce measurable anthelmintic effects in larvae such that statins have been suggested for possible repurposing as anthelmintics for use in controlling cestodes.

While there had been no published evidence by early 2026 that clinically used statin doses have harmed either NA or TTO in human hosts, these species do share extensive metabolic and regulatory machinery with other parasitic nematodes, so it is conceivable that typical human doses of statins might be harmful to these therapeutic worms, and one NA self-treater - a very experienced incubator of this species - reported, in Feb 2026, that taking [https://en.wikipedia.org/wiki/Atorvastatin atorvastatin] (Lipitor, etc.) resulted in the repeated failure of NA larvae to successfully colonise after she had incubated these herself and observed them to be active immediately before their application to her skin. The noticeable lack of the usual entry points indicated that these larvae, although active, were incapable of entering the skin.

===Vaccines===

Three helminth hosts have claimed that they may have lost their hookworms after receiving the ⚡ [https://en.wikipedia.org/wiki/Tetanus_vaccine tetanus vaccine], although others have had tetanus shots without any loss of worms, and several people receiving flu vaccination have reported that this had no effect on their hookworms. [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861706373885309&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861973877191892&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nothing has been reported in respect of other vaccines. Also see [[Helminthic therapy and vaccines | '''Helminthic therapy and vaccines''']].

== Miscellaneous pharmaceuticals and chemicals ==

<blockquote>
''' ✅ Safe for worms unless marked otherwise'''
* ❓ [https://en.wikipedia.org/wiki/Zovirax Aciclovir] (Cyclovir, Herpex, Acivir, Acivirax, Zovirax, Zoral, Xovir and Imavir). There have been no reported problems with this drug so far. See also the related drug, Valaciclovir/valacyclovir.

* ❌ [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) is a soil bacterium that has been engineered into food crops such as corn and rice to render them pest resistant, and residues of Bt-based insecticides have been found on fresh fruits and vegetables. [http://www.ncbi.nlm.nih.gov/pubmed/16672488] Cry5B, a pore-forming protein produced by Bt can kill intestinal worms and is highly effective against all hookworm species tested in all models [https://www.ncbi.nlm.nih.gov/pubmed/29772478]. It is also used as a natural insecticide on crops on some organic farms. However, the risk of therapeutic helminths being killed as a result of their hosts ingesting small amounts of the delta endotoxins produced by Bt is likely to be very low. When used as an insecticide, one of the many Bt strains available is selected for its specific toxicity against the target insect. The strains that produce toxins against nematodes are therefore unlikely to be used as agricultural insecticides. In addition to this, the toxins produced need to be ingested by the target organism to become active and, as proteins, they may be denatured by heat during cooking. [https://www.facebook.com/groups/htsupport/permalink/1270850719637547/?comment_id=1270971972958755&comment_tracking=%7B%22tn%22%3A%22R%22%7D] The probiotic bacterium, Bacillus subtilis, can also be engineered to express the Cry5B protein, a small dose of which has been shown to kill intestinal nematode parasites, achieving a 93 percent elimination of human hookworms in hamsters. [https://web.archive.org/web/20161005204559/https://www.asm.org/index.php/asm-newsroom2/journal-tipsheets/88-news-room/journal-tipsheets/91749-natural-pest-control-protein-effective-against-hookworm-a-billion-could-benefit], [http://www.ncbi.nlm.nih.gov/pubmed/23835175] Although researchers may be pursuing this development as a means of delivering anthelmintics via foods and food supplements, the strain of Bacillus subtilis currently used in probiotics that have been manufactured for human consumption is not known to have been modified in this way, and one hookworm host has reported that his worms were unaffected after eating a lot of natto (made using Bacillus subtilis) and taking the Bacillus subtilis-containing probiotic product, Megasporebiotic. [https://www.facebook.com/groups/htsupport/permalink/1084149894974298/?comment_id=1084177824971505&comment_tracking=%7B%22tn%22:%22R6%22%7D]

* [https://en.wikipedia.org/wiki/Baclofen Baclofen] (Kemstro, Lioresal, Liofen, Gablofen, Beklo and Baclosan) is a derivative of gamma-aminobutyric acid (GABA). One host who took 20-30mgs of baclofen daily reported no loss of worm benefits.

* ❌ [https://en.wikipedia.org/wiki/Barbiturate Barbiturates] have now largely been replaced in routine medical practice by ✅ [https://en.wikipedia.org/wiki/Benzodiazepines benzodiazepines], but they may still be encountered in general anaesthesia, for epilepsy, and in the treatment of acute migraines. These drugs depress the central nervous system, producing effects ranging from mild sedation to total anaesthesia, so, taken in sufficient quantity, they may disorient hookworms sufficiently to cause them to lose their grip on the intestinal mucosa and be flushed away from their feeding site.

* [https://en.wikipedia.org/wiki/Benzodiazepine Benzodiazepines] (BZD, benzos). There have been no reports of this type of drug having any adverse effect on helminths. The short-acting anti-anxiety drug, [https://en.wikipedia.org/wiki/Alprazolam alprazolam] (Xanax), was taken by one hookworm host (0.5 mg 3 or 4 times over the course of a month) without any apparent effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912671848788771&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912703545452268&offset=0&total_comments=4&comment_tracking=%7B%22tn%22:%22R%22%7D] Other self-treaters have found that [https://en.wikipedia.org/wiki/Clonazepam clonazepam] (Klonopin) [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912711478784808&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] and [https://en.wikipedia.org/wiki/Lormetazepam lormetazepam] are both worm-safe, as is [https://en.wikipedia.org/wiki/Lorazepam Lorazepam] (Ativan). [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=1099405830115371&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Bismuth_subsalicylate Bismuth subsalicylate] (pink bismuth, the active ingredient in various stomach-settling medications such as [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol] and Kaopectate) There has been one suggestion that bismuth may have a temporary adverse effect on human helminths, similar to that caused by local anaesthetics/anesthetics, but this has not been confirmed by others. Pepto-Bismol is [http://www.reyessyndrome.org/pdfs/medicationscontainingaspirin.pdf listed] as containing aspirin (acetylsalicylate) or an aspirin-like substance (see ✅ Anticoagulants section regarding this ingredient).

* [https://en.wikipedia.org/wiki/Bisphosphonate Bisphosphonates] This class of drugs appears to be harmless to human helminths. They are used to prevent the loss of bone density, and include [https://en.wikipedia.org/wiki/Zoledronic_acid zoledronic acid] (aka zoledronate, sold under brand names such as Reclast, Zometa, Zometa Concentrate and Aclasta). One NA host has had two infusions of Aclasta without issue. [https://www.facebook.com/groups/htsupport/posts/4932593710129878?comment_id=4934243383298244]

* ❓ [https://en.wikipedia.org/wiki/Calcium_channel_blocker Calcium channel blockers (CCBs)], also known as calcium channel antagonists or calcium antagonists. These medications, which disrupt the movement of calcium through calcium channels, and are commonly used to treat cardiovascular diseases including hypertension, have also shown activity against the non-therapeutic helminth, Schistosoma mansoni. And it has been suggested that the calcium blocking effect of these drugs might be exploited to enhance the effect of existing anthelmintic drugs, or to produce new ones. [https://www.ncbi.nlm.nih.gov/pubmed/30420417] While there have been no reports thus far of therapeutic helminths being affected by calcium channel blockers, this remains a theoretical possibility.

* [https://en.wikipedia.org/wiki/Tegretol Carbamazepine] (Tegretol, Equetro). This appears to be worm-safe. One host who took this for two weeks was still producing ample hookworm ova at the end of this period.

* [https://en.wikipedia.org/wiki/Chlorine Chlorine]. As a constituent of chlorinated water, e.g., municipal water supplies and at swimming baths, this is no threat to helminths.

* ❓[https://en.wikipedia.org/wiki/Chlorine_dioxide Chlorine dioxide] (CD, also known as MMS, CDS, CDH) is an industrial disinfectant and bleach that is used in water purification and detoxification. CD has been taken orally by people who claim that it kills parasites, and that "rope worms" are often released during CD enemas. However, when these rope-like forms have been analysed, they have been found to contain mostly human DNA, so are likely to be merely pieces of gut lining.

* [https://en.wikipedia.org/wiki/Colestyramine Colestyramine/ cholestyramin] (Trade names: Questran, Questran Light, Cholybar, Olestyr, Quantalan and Vasosan.) One self-treater has reported that this bile acid sequestrant did not harm his NA colony or his HDC. [https://www.facebook.com/groups/htsupport/posts/9602012923187910/?comment_id=9603513203037882]

* [http://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=36f623df-2ae3-4858-9783-c058097951f4&type=display Cortifoam], a hydrocortisone rectal aerosol, uses propane and isobutane as propellants, neither of which is known to have any adverse effect on helminths.

* [https://en.wikipedia.org/wiki/COX-2_inhibitors COX-2 inhibitors], e.g., [https://en.wikipedia.org/w/index.php?title=Celecoxib&redirect=no celecoxib] (Celebrex), are safe for use with helminths.

* [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium) is a mast cell stabiliser with anti-allergy effects. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Doxazosin Doxazosin] Sold under brand names such as Cardura and Carduran, this antihypertensive medication has been found to have anthelmintic properties. [https://www.mdpi.com/1424-8247/14/7/686] One hookworm self-treater had indications over a three year period that he had lost his NA colony: reappearance of pre-hookworm symptoms, eosinophil count down to "normal" and inability to incubate more larvae. Repeated re-inoculations with viable larvae failed to restore his colony, and he eventually realised that the loss of the worms had coincided with the change in antihypertensive medication, to the alpha-blocker, doxazocin. [https://www.facebook.com/groups/htsupport/posts/7047958951926666/]

* ❓ [https://en.wikipedia.org/wiki/2,3-Dimercapto-1-propanesulfonic_acid DMPS] (Dimercapto-propane sulfonate/2,3-Dimercapto-1-propanesulfonic acid) and its sodium salt, Unithiol. There have been no reports so far about possible anthelmintic effects following the use of this drug, but there do appear to be some [https://www.ncbi.nlm.nih.gov/pubmed/18568806 serious risks attached to its use].

* [https://en.wikipedia.org/wiki/Dimercaptosuccinic_acid DMSA] (Dimercaptosuccinic acid, also called succimer). The meso isomer form of this organosulfur compound is used as a chelating agent for the treatment of heavy metal toxicity. One hookworm host has taken 25 mg DMSA every 3 hours around the clock for 5 days, and repeated this every 3 weeks for a year without harming her hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=991229547599667&comment_tracking=%7B%22tn%22:%22R0%22%7D] DMSA is apparently such an effective chelator that it may deplete levels of beneficial minerals, so should arguably be used under the guidance of a practitioner. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860226537366636&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* [https://en.wikipedia.org/wiki/Dimethyl_sulfoxide DMSO] (Dimethyl sulfoxide) has been used by two hookworm hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Ethylenediaminetetraacetic_acid EDTA] (Ethylenediaminetetraacetic acid). This heavy metal chelator was taken by one NA host as a single large dose for a provoked urine test. He then took it occasionally after this, but never saw any negative effects whatsoever on his NA. [https://www.facebook.com/groups/htsupport/posts/9163602600362280?comment_id=9165019336887273]

* [https://en.wikipedia.org/wiki/Essential_oil Essential oils]. These are also known as volatile oils, ethereal oils, aetherolea, or simply as the oil of the plant from which they were extracted. Certain essential oils contain some of the most potent antimicrobial compounds available and can be considered to be [http://www.theatlantic.com/health/archive/2015/01/the-new-antibiotics-might-be-essential-oils/384247/ natural antibiotics]. For example ❌'''oregano oil''' (see [[#Oregano|Oregano reference]]) and ⚡'''peppermint oil''' (see [[#Peppermint|Peppermint reference]]) can affect human helminths if ingested. However, small quantities of most essential oils should be safe for helminths when applied topically, since not all of the oil applied will reach the bloodstream. And when essential oils are diffused into the air using a nebuliser, heated over a candle flame or burned, these should not harm helminths, even when using blends containing oregano or peppermint oil. [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=808058079250149&offset=0&total_comments=3] [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=809316062457684&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] However, one hookworm host lost most of her colony when she walked into a room where a diffuser had been left running after a child had emptied an entire bottle of peppermint essential oil into it. She only took one breath in the room before leaving, but her home incubations fell from 25-35 larvae per droplet to just 1 larva per 3 droplets. And, many months and 3 inoculations later, she was still only getting 7-8 larvae per droplet. This inhalation of diffused peppermint oil also caused blistering burns to her face, nostrils and lungs, and did significant damage to her gut microbiome. [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&reply_comment_id=2018765664846045&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Gamma-Aminobutyric_acid GABA] (gamma-aminobutyric acid). It has been reported [http://www.livestrong.com/article/216236-medications-to-treat-human-worms/] that the anthelmintic drug, ivermectin, causes paralysis in worms by increasing GABA, and a hookworm host has mentioned that she “used to do really well with GABA, but worms don't like it.” On the other hand, a child with Type 1 diabetes was given GABA (750mg x4 per day) alongside hookworm therapy without any indication that the worms were affected by this, and another hookworm host who took 20-30mgs per day of ✅'''baclofen''' (a derivative of GABA) reported no loss of worm benefits.

* ⚡ [https://en.wikipedia.org/wiki/Gabapentin Gabapentin] (Neurontin). One hookworm host has taken this without any obvious adverse effect on her colony (link expired), and another has said that she was down from 1200mg to 600mg of gabapentin per day when she first discovered helminths and was never aware of it affecting her worms. [https://www.facebook.com/groups/htsupport/posts/6576693235719909/?comment_id=6576715005717732&reply_comment_id=6576844752371424] However, two other people have reported adverse effects on their colonies. One said that she had little benefit from her NA while she was taking gabapentin (mostly about 300 mg per day, but sometime 600 mg). The other said that single doses as low as 150mg "severely upset" his NA, and that taking 3 doses in a row caused a complete loss of benefits for 4-5 days. [https://www.facebook.com/groups/htsupport/permalink/2926164447439491/]

* ❌ [https://en.wikipedia.org/wiki/Genistein Genistein] is an isoflavone (phytoestrogen) with antioxidant and anthelmintic properties that has been found to be the main substance responsible for the deworming activity of the root-tuber peel extract of Felmingia vestita, the plant traditionally used as an anthelmintic by the Khasi tribes of India. Genistein is a potent cestocide, being highly effective against several species of tapeworm, as well as a pork trematode and a sheep liver fluke. (See also: [https://www.ncbi.nlm.nih.gov/pubmed/29844617]) Given the strength of its effect against these other helminths, it is reasonable to assume that concentrated or synthesised forms of genistein (such as KBU2046 and B43-genistein) may also harm or even kill therapeutic human helminths, although there is no evidence that eating soy products might be harmful to human helminths as a result of the naturally occurring genistein they contain.

* ❓[https://en.wikipedia.org/wiki/Glucagon-like_peptide-1_receptor_agonist Glucagon-like peptide-1 receptor agonists], also known as GLP-1 receptor agonists (GLP-1-RA) or incretin mimetics, e.g., [https://en.wikipedia.org/wiki/Exenatide exenatide] (Byetta, Bydureon), [https://en.wikipedia.org/wiki/Liraglutide liraglutide] (Victoza, Saxenda), [https://en.wikipedia.org/wiki/Lixisenatide lixisenatide] (Lyxumia, Adlyxin), [https://en.wikipedia.org/wiki/Albiglutide albiglutide] (Tanzeum), [https://en.wikipedia.org/wiki/Dulaglutide dulaglutide] (Trulicity), [https://en.wikipedia.org/wiki/Semaglutide semaglutide] (Ozempic, Rybelsus, Wegovy) and [https://en.wikipedia.org/wiki/Tirzepatide tirzepatide] (Mounjaro). This type of drug, which is used to treat diabetes and obesity, has shown anthelmintic effects and has been proposed as a potential anthelmintic agent against Trichuris trichiura. [https://eprints.lancs.ac.uk/id/eprint/171826/1/2022DooleyMRes.pdf] However, no reports of any adverse effects have been posted by helminth hosts.

* [https://en.wikipedia.org/wiki/Guaifenesin Guaifenesin]. This oral expectorant and muscle relaxant is sold under various brand names, including Mucinex, and is added to many other medicines. There have been no reports of this drug having any ill effect on helminths, and one hookworm host has reported that he regularly takes between 2 and 6 x 400 mg guaifenesin tablets to treat congestion, without any apparent effect on his worms. Another NA user reports continuing to use high doses without issue. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Helium Helium] appears to be worm-safe, based on the experience of one hookworm host who deliberately inhaled a small volume of the gas (to enjoy the timbre-changing effect on his voice!) while blowing up balloons, and had no loss of effect from his worm colony.

* Hydrogen therapy. One NA host has reported that inhaling hydrogen gas and drinking hydrogen-infused water has not harmed his colony. (Link expired.)

* [https://en.wikipedia.org/wiki/Hydrogen_peroxide Hydrogen peroxide] (H2O2). This may kill helminths in a petri dish but it is so highly reactive that, if ingested, there is likely to be little left by the time it reaches the stomach. And, when inhaled, H2O2 stays largely within the lungs, with only a small amount reaching the blood. Since the amount that could be transmitted to helminths is therefore negligible, it is thought unlikely that H2O2 would be a problem for any intestinal helminth, although no one has reported on this, one way or the other.

*❓Hyoscyamine [https://en.wikipedia.org/wiki/Hyoscyamine]. (Also known as daturine and levo-atropine. Brand names include Symax, HyoMax, Anaspaz, Egazil, Buwecon, Cystospaz, Levsin, Levbid, Levsinex, Donnamar, NuLev, Spacol T/S and Neoquess.) It has been suggested that hyoscyamine is unlikely to be harmful helminths, [https://www.facebook.com/groups/htsupport/permalink/1459052987483985/?comment_id=1459076817481602&reply_comment_id=1459213767467907&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Iodine Iodine]. This appears not to have any anthelmintic effect in the case of [http://link.springer.com/article/10.1007/BF02356443?no-access=true some species of roundworm and lungworm] and no reports of adverse effects have been posted by helminth hosts who are taking iodine supplements.

* ❓ [https://en.wikipedia.org/wiki/Isotretinoin Isotretinoin] (13-cis retinoic acid, Roaccutane, Accutane, Amnesteem, Claravis, Absorica, Isotroin and Epuris) is used to treat acne and other skin conditions. Although there have been no reports of harm to helminths as a result of taking this drug, anyone considering its use might appreciate knowing that it has been linked to autoimmune disease, which is of course what many readers of this website are already dealing with. The link is controversial, but this paper [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110532/] sets out the facts.

* [https://en.wikipedia.org/wiki/Ketamine Ketamine] There have been no reports to suggest that ketamine might be harmful to human helminths, and one NA host has reported that an incubation following four 200 mg doses of this drug had yielded a bumper crop of larvae, confirming that the drug had had no adverse effect on her colony.

* [https://en.wikipedia.org/wiki/Lactulose Lactulose]. This synthetic, non-digestible sugar used in the treatment of chronic constipation and as a test for small intestine bacterial overgrowth (SIBO) has not been reported to have any untoward effects on human helminths.

* ❌ [https://en.wikipedia.org/wiki/Limonene Limonene] This has been shown to have a comparable anthelmintic effect against adult Schistosoma mansoni as the common anthelmintic drug, praziquantel, [https://pubmed.ncbi.nlm.nih.gov/23408270] (Praziquantel has a 23% cure rate in hookworms. [https://pubmed.ncbi.nlm.nih.gov/29153938]) and one hookworm host has reported experiencing a return of disease symptoms after taking 500 mg of limonene daily for a week. [https://www.facebook.com/groups/htsupport/permalink/2673526096036662/]

* [https://en.wikipedia.org/wiki/Loperamide Loperamide] (Immodium, Lopex, etc.) This drug has been taken by numerous worm hosts and there have been no reports of it harming their worms.

* [[Wikipedia:Low-dose naltrexone|Low dose naltrexone]] (LDN). This is compatible with helminthic therapy and several people have had good results from this combination, although the drug doesn’t suit everyone. More details [https://www.helminthictherapywiki.org/wiki/Helminthic_therapy_and_low-dose_naltrexone_(LDN) here].

* [https://en.wikipedia.org/wiki/Lisdexamfetamine Lisdexamfetamine / L-lysine-dextroamphetamine] (Tyvense, Elvanse, Aduvanz, Venvanse, Vyvanse) is used to treat ADHD and binge eating disorder. One hookworm host took vyvanse for several weeks without noticing any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1462105477178736/?comment_id=1462409000481717&reply_comment_id=1729076717148276&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Mepacrine Mepacrine] (quinacrine [Atabrine]). This is an antiprotozoal drug that has also been used against tapeworms, so it could harm hookworms and whipworms. No one has so far reported any problem with it, but it's likely that few, if any, helminth hosts will have taken it, especially as, "Mepacrine is not the drug of choice because side effects are common, including toxic psychosis, and may cause permanent damage."

* ❓ [https://en.wikipedia.org/wiki/Metformin Metformin] [Glucophage], [https://en.wikipedia.org/wiki/Phenformin phenformin], and [https://en.wikipedia.org/wiki/Rosiglitazone rosiglitazone] [Avandia] are [https://en.wikipedia.org/wiki/Anti-diabetic_medication anti-diabetic medications] (also known as oral hypoglycemic or antihyperglycemic agents) that have been shown to have antibiotic properties [http://www.cysonline.org/article.asp?issn=2229-5186;year=2011;volume=2;issue=4;spage=219;epage=221;aulast=Dash], so might therefore have some degree of anthelmintic effect when used in higher doses. However one NA host has been reported to have taken it with no apparent adverse effects on her worms. [https://www.facebook.com/groups/htsupport/posts/8167008430021707?comment_id=8167027486686468].

* ⚡ [https://en.wikipedia.org/wiki/Methotrexate Methotrexate]. Some people have taken methotrexate alongside HT without any problem, including one NA host who combined these two treatments for 1½ years, taking up to 15 mg methotrexate per day. [https://www.facebook.com/groups/htsupport/permalink/1262248410497778/?comment_id=1262259710496648&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1530311280358155/?comment_id=1530363560352927&reply_comment_id=1531077360281547&comment_tracking=%7B%22tn%22%3A%22R5%22%7D] However, one individual got no benefit from his hookworms for over a year, while he was taking this drug.

* ❓ [https://en.wikipedia.org/wiki/Methylene_blue Methylene blue] Only one self-treater has reported using this substance while hosting NA, apparently taking it every day for about a year without causing any problems for her worms. [https://www.facebook.com/groups/htsupport/permalink/9484774994911704/]

* [https://en.wikipedia.org/wiki/Methylphenidate Methylphenidate] (Ritalin, Concerta, etc.) This doesn’t harm NA (or HDC). [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5659285877460654&reply_comment_id=5659339337455308] [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5660377274018181]

* [https://en.wikipedia.org/wiki/Montelukast Montelukast] (Singulair, Montelo-10, Monteflo, Lukotas, Arokast and Pulmikast). This leukotriene receptor antagonist has been taken intermittently, in 10 mg doses, by one hookworm host with no apparent effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904760852913204&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904793842909905&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R%22%7D] and regularly by another. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1683751361680812&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug Non-steroidal anti-inflammatory drugs] (NSAIDS, NSAIAs or NSAIMs) e.g: [https://en.wikipedia.org/wiki/Aspirin aspirin], [https://en.wikipedia.org/wiki/Diclofenac diclofenac] (sold under many trade names [https://en.wikipedia.org/wiki/Diclofenac%23Trade_names]), [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] and [https://en.wikipedia.org/wiki/Naproxen naproxen], are safe for use with helminths, but see Anticoagulants section regarding aspirin.

* ❓ [https://en.wikipedia.org/wiki/Nintedanib Nintedanib] (Ofev and Vargatef) is a piperazine drug (piperazine is an anthelmintic), so *may* have a harmful effect on NA, and to a lesser extent on TT. Unfortunately, there have been no reports about this drug, although the absence of any previous mention of it is a hopeful indication.

* [https://en.wikipedia.org/wiki/Oxymetazoline Oxymetazoline] (Ocuclear and Drixine) This drug is available over-the-counter as a topical decongestant in the form of oxymetazoline hydrochloride in nasal sprays such as Afrin, Dimetapp, Dristan, Drixoral, Facimin, Mucinex Full Force, Nasivin, Nostrilla, Operil, Otrivin, Otrivine, Oxyspray, SinuFrin, Sudafed OM, Utabon, Vicks Sinex and Zicam. At least one NA host has used these sprays without any harm being caused to his worms.

* ❓ [https://en.wikipedia.org/wiki/Ozone Ozone]. [https://en.wikipedia.org/wiki/Ozone_therapy Ozone therapy] is used as an alternative treatment for various diseases in humans but is still controversial. Ozone is also used to kill microorganisms, in some instances being employed in place of chlorine as a bactericide. It is also used to eradicate water borne parasites such as Giardia lamblia and Cryptosporidium, and to kill insects in stored grain. So there would appear to be a potential for ozone to have an adverse effect on human helminths, although this may depend on dosage and there have been no reports to date of the use of ozone by helminth hosts, so caution would seem to be warranted until more is known.

* [https://en.wikipedia.org/wiki/Acetaminophen Paracetamol] (Called acetaminophen in the US, and also sold under the names tylenol, panadol, etc.) This is safe for use while hosting helminths, but is associated with autism when given to children under 5 years old. [https://pmc.ncbi.nlm.nih.gov/articles/PMC10814214/]

* ❌ [https://en.wikipedia.org/wiki/Pentobarbital Pentobarbital] (US), pentobarbitone (UK), e.g., Nembutal, is a short-acting '''barbiturate''' that has been used as a sleep aid, as well as to euthanise animals and to execute humans. It’s possible that the dosages used to encourage sleep might not have any deleterious effect on human helminths, but, if this drug were to disorientate hookworms, they could lose their grip on the intestinal mucosa and be flushed away. So far, there have been no reports about this drug from any helminth host, although few, if any, will have taken it.

* [https://en.wikipedia.org/wiki/Permethrin Permethrin] Permethrin is an insecticide that causes paralysis and death in insects and arachnids by disrupting sodium channels in the creatures’ nervous systems. However, voltage‑gated sodium channels are much less abundant in hookworms and, for this reason, permethrin is unlikely to pose any risk to NA. [https://www.facebook.com/groups/htsupport/posts/24419855167643775/]

* ⚡ [https://en.wikipedia.org/wiki/Piracetam Piracetam]. This nootropic, cognition- and memory-enhancing drug (Nootropil, Qropi, Myocalm, Dinagen) was suspected as the cause in one case of sudden worm loss.

* ❓ [https://en.wikipedia.org/wiki/Pregabalin Pregabalin] (Lyrica) is a gabapentinoid drug about which the only report so far has been from someone who who had taken 3 doses of 25mg Lyrica daily for several weeks, with no issues for her NA. [https://www.facebook.com/groups/htsupport/posts/4589806321075287/?comment_id=4590199551035964&reply_comment_id=4812188858837031]

* [https://en.wikipedia.org/wiki/Proton-pump_inhibitor Proton-pump inhibitors] (PPIs), including [https://en.wikipedia.org/wiki/Omeprazole omeprazole] (e.g., Losec) and [https://en.wikipedia.org/wiki/Lansoprazole lansoprazole] (e.g., Prevacid). These gastric acid inhibiting drugs appear not to be harmful to helminths, but they may kill 4% of patients who take them. [https://www.ncbi.nlm.nih.gov/pubmed/31147311]

* ❌ [https://en.wikipedia.org/wiki/Prucalopride Prucalopride] (DuphaPro, Prudac, Resolor, Resotran) This drug, which is used in the treatment of constipation has been reported by one hookworm host to have had a “pretty marked negative effect” on his worms, and, by another, to have killed theirs. [https://www.facebook.com/groups/htsupport/posts/5980593935329845?comment_id=7427760963946461&reply_comment_id=8031040043618547]

* [https://en.wikipedia.org/wiki/Pseudoephedrine Pseudoephedrine] is a stimulant nasal decongestant [https://en.wikipedia.org/wiki/Decongestant] that is sometimes added to antihistamine preparations and other products, including some formulations sold under the [https://en.wikipedia.org/wiki/Sudafed Sudafed] brand. Pseudoephedrine has not been reported to have any adverse effect on helminths.

* ➿ [https://en.wikipedia.org/wiki/Iodine-131 Radioactive iodine] (also known as radioiodine), which is used in the treatment of hyperthyroidism, can adversely affect hookworms, at least temporarily. One worm host found that '''isotope I-128''' (used in diagnostics) [https://www.facebook.com/groups/htsupport/permalink/830004963722127/ put her colony out of action for a week or two], and has suggested that '''isotope I-131''' (used to kill thyroid tissue) may have a similar effect.

* [https://www.drugs.com/rhophylac.html Rhophylac] The Rhophylac (anti-D immunoglobulin) injection, which contains human anti-D immunoglobulin, is given to pregnant women with rhesus negative blood type. One hookworm host has reported that her colony was unaffected by this injection. [https://www.facebook.com/groups/htsupport/posts/5063598083696106?comment_id=5068476199874961]

* [https://en.wikipedia.org/wiki/Rizatriptan Rizatriptan] (Maxalt, etc.) does not harm human helminths. [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348347051887903] [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348552771867331]

* [https://en.wikipedia.org/wiki/Viagra Sildenafil] (Viagra). This does not kill hookworms.

* [https://en.wikipedia.org/wiki/Simeticone Simeticone], also known as simethicone (Gas-X, Infacol, Wind-eze, WindSetlers, etc…), is an anti-foaming agent used in different dosages, and in combination with a variety of other drugs, to reduce the bloating, pain and discomfort caused by excessive intestinal gas. Simethicone has been tested directly on pig whipworm ova (TSO) and found to have no effect on them, and one hookworm host has reported taking simethicone periodically with no noticeable adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1969827113073234/?comment_id=1970814692974476&reply_comment_id=1972925246096754&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Sirolimus Sirolimus] (aka rapamycin, sold as Rapamune and Fyarro) This immunosuppressive medication was suspected by one NA host of having negatively impacted his worms for several weeks after he took a single dose of the drug.

* [https://en.wikipedia.org/wiki/Sodium_oxybate Sodium oxybate] (Xyrem, Alcover) is the sodium salt of [https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric_acid γ-hydroxybutyric acid] (GHB), which is unlikely to harm helminths because it’s an endogenous substance found naturally in the human body [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815965665126057&offset=0&total_comments=23&comment_tracking=%7B%22tn%22:%22R%22%7D], and one hookworm/whipworm host has confirmed that it did not affect her worms. [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815975511791739&offset=0&total_comments=24&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Steroid_hormone Steroid hormones]. One host of both hookworms and whipworms takes [https://en.wikipedia.org/wiki/Dehydroepiandrosterone DHEA], [https://en.wikipedia.org/wiki/Progesterone progesterone] and [https://en.wikipedia.org/wiki/Testosterone testosterone] with [https://www.facebook.com/groups/htsupport/permalink/824719590917331/?comment_id=825008124221811&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D no adverse effect on her worms].

* [https://en.wikipedia.org/wiki/Tauroursodeoxycholic_acid Tauroursodeoxycholic acid (TUDCA)] This ambiphilic bile acid has been taken by two NA hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2743109875744950/?comment_id=2744212012301403] [https://www.facebook.com/groups/htsupport/posts/7602581533131069/?comment_id=7614652755257280]

* ❌ [https://en.wikipedia.org/wiki/Turpentine Turpentine]. Also known as spirit of turpentine, oil of turpentine, wood turpentine and, colloquially, turps, this is distilled from pine tree resins. If applied topically to the skin - for example as a treatment for lice - it is unlikely to harm helminths. However, it has been used traditionally as an anthelmintic, so it may be harmful to human helminths if taken internally. It may also be toxic to humans!

* [http://www.netdoctor.co.uk/lung-problems/medicines/vicks-first-defence.html Vicks First Defence]. This cold preventative nasal spray does not contain antiviral chemicals, but forms a microgel that coats the lining of the nose to trap the cold virus and prevent this from reaching, and infecting, the cells within the nose. The microgel also reduces the pH inside the nose, which further helps by making it harder for the cold virus to multiply. It seems unlikely that any of this product’s ingredients [https://www.vicks.co.uk/products/early-cold-treatments/vicks-first-defence-nasal-spray] would harm helminths, although there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Volatile_Organic_Compounds Volatile Organic Compounds] (VOCs), as found in paints, felt tip markers, etc., are unlikely to harm helminths. One helminth host who regularly worked with organic solvents (including CH2Cl2 and CHCl3) has reported that his helminths have not been affected.

* [https://en.wikipedia.org/wiki/Xylometazoline Xylometazoline] Also spelled xylomethazoline, and branded as Otrivin and Otrivine, etc., this decongestant drug is safe for use with human helminths. [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537912206264719]
</blockquote>

== Medical procedures ==

<blockquote>
''' ✅ Safe for human helminths unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Botulinum_toxin Botulinum toxin] Also known as botulinum neurotoxin, and commonly called botox. One NA self-treater has reported receiving cosmetic botox injections with no adverse effect on her worm colony.

* [https://en.wikipedia.org/wiki/Colonoscopy Colonoscopy] As whipworms live in the colon, they may be at some risk of being struck by a colonoscope, but much of their body is embedded in the soft mucosa, and they are well lubricated with mucus, so few, if any, are likely to be damaged. Hookworms should not be affected by colonoscopy at all because they live in the small intestine, which is much higher up the GI tract. Hookworms might possibly be seen during a colonoscopy, but only if the colonoscope is advanced into the terminal ileum, and only then if any hookworms have taken up residence in the ileum, which is not common as they normally concentrate in the upper part of the jejunum, which is above the ileum, and is shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum Anaesthesia for colonoscopy is likely to involve the use of [https://en.wikipedia.org/wiki/Opioids opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.), [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed Versed], etc.) and/or [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics], all of which appear to be harmless to helminths. See also [[Human helminth care manual#Laxatives | Laxatives]] regarding [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep].

* [https://en.wikipedia.org/wiki/Colon_cleansing Colon cleansing] This will not harm hookworms and is unlikely to harm whipworms unless the fluid used contains something to which the whipworms are vulnerable.

* [https://en.wikipedia.org/wiki/Detoxification Detoxification] The use of [https://en.wikipedia.org/wiki/Infrared_sauna infrared saunas] and infrared heating pads is safe for helminths, [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860231720699451&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3617910068264922/] and [https://en.wikipedia.org/wiki/Chelation_therapy chelation therapy] using the [http://www.livingnetwork.co.za/chelationnetwork/chelation-the-andy-cutler-protocol/ Andy Cutler protocol] has been used by one hookworm host with no obvious adverse effect [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860208537368436&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R1%22%7D] on her colony. (Also see ❓'''DMPS''', ✅'''DMSA''' and❓'''EDTA'''.)

* [https://en.wikipedia.org/wiki/Enema Enemas] These will not affect hookworms at all, and the liquid used is unlikely to have any adverse effect on whipworms unless this contains something to which they are susceptible.

* [https://en.wikipedia.org/wiki/Endoscopy Endoscopy] A standard upper endoscopy (via the mouth) will not reach past the duodenum, and probably only as far as the second of the four parts of this section of the small intestine. It would therefore not harm hookworms or even allow a doctor to see the jejunum, which is the predominant location of hookworms by 20 weeks post-inoculation, shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum For information about the anaesthetics used during an endoscopy, see the [[#Anaesthetics|general anaesthetics]] section.

* [https://en.wikipedia.org/wiki/Epidural_opioid_analgesia Epidural opioid analgesia] Opioids such as [https://en.wikipedia.org/wiki/Fentanyl fentanyl] are generally safe for helminths, and one hookworm host has reported that her colony was fine following epidural analgesia administered during labour. [https://www.facebook.com/groups/htsupport/permalink/1960341670688445/?comment_id=1960403224015623&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] If an anaesthetic is added to the epidural, the effects of this may be similar to those of other local anaesthetics. (See the [[#localAnaesthetics|local anaesthetics]] section).
* [https://en.wikipedia.org/wiki/Magnetic_resonance_imaging Magnetic resonance imaging] An MRI is unlikely to harm helminths, but it can cause a temporary adverse reaction in the patient which may overshadow the benefits being provided by their helminths. [https://www.facebook.com/groups/htsupport/permalink/1296754897047129/] The❓gadolinium-based contrast agents used for MRI may also have adverse effects on the patient, [https://www.ncbi.nlm.nih.gov/pubmed/28368880] and there has been one report by a hookworm host who had two MRIs using gadolinium within the same week and experienced a subsequent return of her disease symptoms. [https://www.facebook.com/groups/htsupport/permalink/3934276469961612/]

* ❌ [https://en.wikipedia.org/wiki/Radiation_therapy Radiation therapy] (also known as radiotherapy, and abbreviated as RT, RTx, or XRT) is a treatment for cancer that used ionizing radiation. It had been thought unlikely that this would harm helminths [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1074160752639879&comment_tracking=%7B%22tn%22:%22R%22%7D] but one hookworm host appears to have lost her colony after radiotherapy for breast cancer. [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1240655962657023&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Radiology Radiology] Radiological procedures (e.g., [https://en.wikipedia.org/wiki/Radiography radiography] using [https://en.wikipedia.org/wiki/X-ray X-rays]) and the contrast materials used in these (e.g., [https://en.wikipedia.org/wiki/Barium barium] and [https://en.wikipedia.org/wiki/MRI_contrast_agent%23Gadolinium_.28Gd.29:_Paramagnetic gadolinium]) have been found to be worm-safe by several hookworm users, [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014377761951512&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014821705240451&comment_tracking=%7B%22tn%22:%22R%22%7D] but also see the comments about gadolinium in the previous entry, above, for magnetic resonance imaging.

* [https://en.wikipedia.org/wiki/Ultrasound Ultrasound] At least two hookworm hosts have had ultrasound examinations without their colonies being affected. [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334208813301727&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334224499966825&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



== Alternative therapies ==

=== Natural antibiotics ===
<blockquote>

* ➿ [https://en.wikipedia.org/wiki/Colloidal_silver Colloidal silver]. Some sources have claimed that, if taken orally, this may kill parasite eggs and possibly harm adult worms, but many helminth hosts have taken colloidal silver and there have been no reports of worms being lost as a result. Colloidal silver appears to be the most worm-friendly of the more effective natural antimicrobials, and it has also been shown to have no significant effect on the biodiversity of species in the gut microbiome. [https://www.ncbi.nlm.nih.gov/pubmed/26525505]. Although it can reduce helminthic benefits in a dose-dependent manner while it is being taken, the benefits soon return after its use is discontinued - usually in a matter of days. (Use of this [https://web.archive.org/web/20161227234345/http://www.silversafety.org/autocalculator.php Silver Safety Auto-calculator] will ensure that total silver intake remains at a safe level.)

* ❓ '''Cellular silver'''. The manufacturers of [http://www.resultsrna.com/products/acs_200_overview/ Advanced Cellular Silver (ACS) 200 Extra Strength] claim that it is “...effective against an enormous array of disease causing organisms; literally oxidizing the cell wall of gram positive and gram negative bacteria, spirochetes, virus, fungus, parasites and more without harming healthy flora or damaging human tissue”. Research[http://www.townsendletter.com/Jan2015/silver0115.html] shows that this form of silver may be more effective than ➿'''colloidal silver''' (see Colloidal silver, immediately above), but, so far, there have been no reports from helminth hosts to suggest what effect, if any, it might have on human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Grapefruit_seed_extract Grapefruit seed extract] (GSE). Also known as citrus seed extract and grapefruit seed oil, and often labelled as citrus seed oil. It is used in herbalism and natural therapies as an antibiotic and preservative, and is claimed to be a powerful broad spectrum bactericide, fungicide and antiviral that is effective against a large number of single-celled and multi-celled parasites. However, research has shown that [http://cms.herbalgram.org/press/2012/Many_GFSE_Adulterated_Says_Nonprofit_Research_Consortium.html many “natural” GSE products are adulterated] with undeclared synthetic chemicals, commercially available preservatives and disinfectants, such as [https://en.wikipedia.org/wiki/Triclosan triclosan] and [https://en.wikipedia.org/wiki/Benzethonium_chloride benzethonium chloride]. Some versions of GSE [http://www.ncbi.nlm.nih.gov/pubmed/17468864 may not contain any authentic grapefruit seed extracts] whatsoever, such that its sale may well be one of the most insidious herbal product scams ever. Even if genuinely pure, natural GSE could be found - which, given the evidence, seems doubtful - there may be little point in taking it as an antimicrobial because pure GSE has been shown to have no intrinsic antimicrobial action. And, as the makeup of proprietary GSE products varies so widely, these can not be recommended for worm hosts due to the possibility that one or more of the undeclared ingredients may harm human helminths. (NB. The flesh of grapefruit will not harm helminths.) Also see [[#Grape seed extract|Grape seed extract]], which is safe for use by hosts of human helminths.
</blockquote>

=== Natural antivirals ===
<blockquote>
✅ ''' Antiviral nutraceuticals that are safe for human helminths unless marked otherwise'''

:'''Vitamin C'''

::Taken in large quantities, vitamin C (ascorbic acid) has proved to be very effective against the common cold virus. When volunteers in one study were given 8 grams (8,000 mg) on the first day of a cold, 46% were cold free the next day. [http://www.ncbi.nlm.nih.gov/pubmed/4601508]

::In a study involving 700 students, those taking doses of I gram (1,000 mg) of vitamin C each hour for the first 6 hours and then 1 gram three times daily thereafter reported an 85% decrease in cold symptoms compared to those receiving conventional cold and flu treatment. [http://www.ncbi.nlm.nih.gov/pubmed/10543583]

::The ideal amount of vitamin C for colds or flu varies between individuals, but can be established in each case by taking ascorbic acid to ‘bowel tolerance’. Physicians have suggested starting with 3 grams immediately, then taking 1 gram each hour. Once this causes diarrhoea, the dose is reduced.

::In respect of the coronavirus, SARS-CoV-2, and the disease it manifests (COVID-19), see the following articles.

::* [https://www.mdpi.com/2075-1729/11/11/1166/htm Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence]

::* [https://pubmed.ncbi.nlm.nih.gov/32636851/ Quercetin and Vitamin C: An Experimental, Synergistic Therapy for the Prevention and Treatment of SARS-CoV-2 Related Disease (COVID-19)] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/pdf/fimmu-11-01451.pdf PDF]

::One UK doctor recommends treating coronavirus with 10 grams of vitamin C in 500 ml of water every hour until the patient gets diarrhoea. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::In March 2020, the government in Shanghai, China, officially began recommending high-dose intravenous vitamin C for the treatment of COVID-19. Dosage recommendations varied with the severity of illness, ranging from 50 to 200 mg per kg of body weight per day. [http://orthomolecular.org/resources/omns/v16n16.shtml] In the same month, hospitals in New York also began treating coronavirus patients with vitamin C. [https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/]

::'''Vitamin C dosing for children'''. Authorities on the use of vitamin C recommend dosing children by body weight, giving a proportion of the adult dose commensurate with the child’s weight as a proportion of the weight of the average adult. In one placebo-controlled study, the majority of subjects were infants and children under five years of age with severe pneumonia. They were given 200 mg vitamin C per day, which is equivalent to a modest adult dose of 2,000-3,000 mg per day. The authors of this study concluded that, even at this dose, "Vitamin C is effective in reducing duration of severe pneumonia in children less than five years of age. Oxygen saturation was improved in less than one day." [http://www.journalrmc.com/volumes/1405749894.pdf] Also see, [http://orthomolecular.org/resources/omns/v18n05.shtml Vitamin C and Infants: Determining dose].

::'''Liposomal vitamin C'''. This form of vitamin C is absorbed by a different mechanism, in the gut. The liposomes containing vitamin C can bind directly to the gut cells to release their content of vitamin C which therefore does not require active transport. Thus the maximum level achievable with oral doses of liposomal vitamin C is higher than for regular vitamin C. However, since the absorption mechanism for liposomal vitamin C differs from the active transport of regular vitamin C, both forms can be taken together to increase the level in the bloodstream (up to 400-600 μM), greater than either oral form alone. (Levy TE (2011) Primal Panacea. Medfox Pub. ISBN-13: 978-0983772804)

:'''Vitamin D'''

::This vitamin acts as a natural antibiotic, working against every type of microbe, including viruses, bacteria, fungi and parasites, but it does not harm therapeutic helminths.

::The flu can be treated effectively with a 1-time dose of 50,000 IU vitamin D3, or with 10,000 IU 3 times daily for 2 to 3 days. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/]

:: Some functional medicine practitioners advise that it is relatively safe to increase vitamin D intake to as much as 50,000 IU per day during times of virus exposure. John Cannell, MD, of the Vitamin D Council, suggests that 50,000 IU should be taken once each day for three days at the first sign of a cold or the flu. [https://web.archive.org/web/20211221125912/https://preventdisease.com/news/13/102213_Vitamin-D-Proven-More-Effective-Anti-Viral-Drugs-Vaccines-Preventing-Flu.shtml] David Brownstein, MD, recommends taking 50,000 IU per day for 4 days (link expired) and Dr Stephen Gundry suggests taking as much as 150,000 IU daily for 3 days to treat a respiratory infection. [https://mnchiropractors.com/uncategorized/dr-gundry-on-boosting-immunity-for-coronavirus/]

::* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9653496/ Association between vitamin D supplementation and COVID-19 infection and mortality]

::::Vitamin D supplementation produced a statistically significant reduction in the risk of COVID-19 infection and of the infection ending in death within 30-days. Patients receiving higher cumulative dosages and higher average daily dosages showed a greater reduction in COVID-19 infection rates than patients receiving lower dosages. "As a widely available, inexpensive, and safe treatment, vitamin D3 could be a helpful tool for reducing the spread of COVID-19 infection."

::* [https://www.ncbi.nlm.nih.gov/pubmed/32377965 The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality]

::* [https://www.psychologytoday.com/us/blog/the-fallible-mind/202202/striking-link-between-vitamin-d-levels-and-omicron A “Striking” Link Between Vitamin D Levels and Omicron]

:'''Hydrogen peroxide (H2O2)'''

::Daily use, for 1 minute, of a 1% hydrogen peroxide solution as a mouthwash and throat gargle, and the daily use, for 1 minute, of a 0.5% solution as a nasal rinse, have been found to provide effective protection against SARS-CoV-2 infection. The fact that hydrogen peroxide is safe, inexpensive and readily available led this study’s authors to recommend it for the protection against COVID-19 of healthcare workers, inpatients and all vulnerable groups. And, since H2O2 used in this way will not be swallowed or inhaled, it should not harm helminths.

::* [https://pubmed.ncbi.nlm.nih.gov/35594985/ Further observations on hydrogen peroxide antisepsis and COVID-19 cases among healthcare workers and inpatients] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/pdf/main.pdf PDF]

: '''Lysine'''

:: Lysine appears to be highly suppressive of viral replication. Approximately 80% of acute stage Covid-19 patients given lysine displayed a minimum 70% reduction in symptoms in the first 48 hours. Treatment times varied from 2 days to 3.5 weeks (excluding long term symptomatic subjects), and patients who started lysine in the hospital were discharged an average of 3 days after starting treatment.

::* [https://www.researchgate.net/publication/344210822_Lysine_Therapy_for_SARS-CoV-2 Lysine Therapy for SARS-CoV-2]

:'''Elderberry'''

::Eating elderberries and taking their extracts can help minimise influenza symptoms. [https://www.sciencedirect.com/science/article/abs/pii/S1756464619300313] But note the following.

::* "Patients with autoimmune diseases like rheumatoid arthritis, celiac, hashimoto’s, and lupus need to consult a physician before taking elderberry because it will stimulate their immune system. Elderberry interferes with medications that suppress the immune system and medications used to treat autoimmune diseases.” [https://web.archive.org/web/20190918211012/http://www.mensahmedical.com/elderberry-benefits-dangers-patients/]

::* While elderberry extract is considered to be effective against flu, it works, as many other immune boosters do, by increasing the cytokine response. [https://www.ncbi.nlm.nih.gov/pubmed/11399518] Since COVID-19 (aka SARS-CoV-2) kills primarily by initiating a cytokine storm, elderberry is probably best not relied upon as a stand-alone option against the new coronavirus, and, if used at all, would be best combined with one or more of the other effective anti-pathogenic treatments mentioned in this section.

'''Other worm-safe nutraceuticals with antiviral effects'''

:* [https://www.sciencedirect.com/science/article/pii/S0033062020300372 Nutraceuticals have potential for boosting the type 1 interferon response to RNA viruses including influenza and coronavirus] (ferulic acid, lipoic acid, spirulina, N-Acetylcysteine, selenium, glucosamine, zinc, yeast beta-glucan and elderberry)

:* [http://orthomolecular.org/resources/omns/v16n04.shtml Nutrients recommended by the International Society for Orthomolecular Medicine to prevent and minimise symptoms of viral infection]

:* Virus-Specific nutraceutical and botanical agents listed by the Institute for Functional Medicine. [https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/] [https://www.ifm.org/news-insights/functional-medicine-approach-covid-19-additional-research-nutraceuticals-botanicals/]

:* [https://blog.nutrigold.co.uk/2020/03/09/nutritional-support-for-immunity-against-viruses-including-the-coronavirus/ Nutritional Support for Immunity Against Viruses Including the Coronavirus]

:* [https://cf5e727d-d02d-4d71-89ff-9fe2d3ad957f.filesusr.com/ugd/adf864_cc5004cfa84a46d3b1a0338d4308c42c.pdf A Novel Approach to Treating COVID-19 Using Nutritional and Oxidative Therapies] (Vitamin A, vitamin C [Ascorbate], vitamin D3, Iodine, Nebulized ❓Hydrogen Peroxide and Intramuscular ❓Ozone.)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428453/ Be well: A potential role for vitamin B in COVID-19]

:* [http://www.ncbi.nlm.nih.gov/pubmed/25400245 Bifidobacterium longum MM-2 improves defence against flu virus]

:* [https://www.ncbi.nlm.nih.gov/pubmed/32179788 Ginkgolic acid inhibits fusion of enveloped viruses]

::"Thus, in light of the antiviral effect of ginkgolic acids (GA) on established viral infections of permissive cells, GA potentially could be used to treat acute viral infections (e.g. Coronavirus (COVID-19), EBOV, ZIKV, IAV and measles)."

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929665/ Uncaria tomentosa (Cat’s claw) has an antiviral effect against SARS-CoV-2]

:* [http://orthomolecular.org/resources/omns/v16n22.shtml Sulforaphane as a Treatment for COVID-19]

:* [https://onlinelibrary.wiley.com/doi/10.1002/fsn3.3034 Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies] (Full text) | [https://onlinelibrary.wiley.com/doi/epdf/10.1002/fsn3.3034 PDF]. Also see [https://www.news-medical.net/news/20220908/The-role-of-some-important-antioxidants-in-major-clinical-outcomes-of-subjects-with-COVID-19.aspx this article about the study].

::"It seems that antioxidants, especially vitamins C and D, selenium, and zinc, can improve multiple COVID-19 clinical outcomes."

:* [https://www.sciencedaily.com/releases/2020/04/200429105907.htm Link identified between dietary selenium and outcome of COVID-19 disease]

:* [https://pubmed.ncbi.nlm.nih.gov/32754164/ The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/pdf/fimmu-11-01712.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32388476/ Is copper beneficial for COVID-19 patients?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/pdf/main.pdf PDF]

:* [https://www.europeanreview.org/wp/wp-content/uploads/4062-4063.pdf?fbclid=IwAR0AxUqV9FaHNcaHwlUuzOW9MOYe_1Z3OiHIzVvDJD6J8h3DubgTZGESOGY Are probiotics effective adjuvant therapeutic choice in patients with COVID-19?]

:* [https://pubmed.ncbi.nlm.nih.gov/32733907/ Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/pdf/fmed-07-00389.pdf PDF] (Probiotics)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649937/ N-Acetylcysteine to Combat COVID-19: An Evidence Review]

:* [https://pubmed.ncbi.nlm.nih.gov/34653660/ The Effect of Melatonin on Thrombosis, Sepsis and Mortality Rate in COVID-19 Patients] -- [https://www.sciencedirect.com/science/article/pii/S1201971221007980 Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506572/pdf/main.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32574327/ Therapeutic Algorithm for Use of Melatonin in Patients With COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/pdf/fmed-07-00226.pdf PDF]

:* [https://wrightacademia.org/articles/jscc/jscc-1-002.php?jid=jscc Free Fatty Acids from Fish Oil Inactivate SARS-CoV-2]

::"… free fatty acids in fish oil may have potential as mouth/throat wash to reduce concentration of SARS-CoV-2 viruses in saliva and upper respiratory mucosa and reduce transmission."

'''Plant medicines recommended for the treatment of coronavirus'''

:* [https://www.stephenharrodbuhner.com/wp-content/uploads/2020/08/covid-19-2.update.txt.pdf?fbclid=IwAR3sm7OYMH8_RBH0xjrQM984_SFoSZupSOw5IqSes_n6s4JemMjvyLCCEug SARS-CoV-2 (COVID-19): Herbal protocols for the treatment of infection and post-coronavirus syndrome] (PDF) This is a very detailed treatise on the use of herbs in this context. Individual herbs suggested should be checked for possible anthelmintic effects by searching for them in the rest of this Care Manual.

'''Inhaled treatments - safe for human helminths unless marked otherwise'''

:'''Iodine'''

::Iodine kills all single-celled microbes on contact and can be introduced into the airways by inhalation from a salt pipe or face mask, or via home-made iodine oil. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::* Salt pipe. Two drops of Lugol’s iodine 12% or 15% dripped into the mouthpiece of a salt pipe (or simply applied to a piece of cotton wool) can be sniffed up into the nose and inhaled 2-3 times a day, or even every 2 hours. 15 - 20 sniffs provides an adequate dose.
::* Face mask. 2-4 drops of Lugol’s iodine 15% can be applied to a face mask, and reapplied 3 times a day.
::* Iodine oil. This can be made with 10 parts coconut oil to 1 part Lugol’s Iodine 15%, and applied around the nose and upper lip three times each day. The iodine does stain the skin yellow temporarily, but it is a good way to treat children who may not be able to manage a salt pipe or tolerate a mask.

:: “After the 1918 Influenza Pandemic which killed an estimated 30 million people, governments financed research on the Pandemic’s causes. Over 25 years, influenza viruses were isolated and methods for killing them with various agents discovered. Iodine was the most effective agent for killing viruses, especially influenza viruses. Aerosol iodine was found to kill viruses in sprayed mists, and solutions of iodine were equally effective. In 1945, Burnet and Stone found that putting iodine on mice snouts prevented the mice from being infected with live influenza virus in mists. They suggested that impregnating masks with iodine would help stop viral spread. They also recommended that medical personnel have iodine-aerosol-treated rooms for examination and treatment of highly infected patients. Current methods of dealing with influenza infection are isolation, hand washing, antiviral drugs, and vaccinations. All of these methods can be improved by incorporating iodine into them. When impregnated with iodine, masks become much more effective, and hand washing is more effect when done with mild iodine solutions. Isolation techniques coupled with aerosol iodine would make them safer for patients, medical personnel, and all persons working with the public. Public health authorities could organize the distribution of iodine and at the same time educate the public in the effective use of iodine. Oral iodine might also boost body defense mechanisms in the upper oral and respiratory mucus. Conclusion: Iodine incorporated into masks, solutions, aerosols, and oral preparations could help to kill influenza viruses and fight off an H1N1 Pandemic.” [https://www.drlowe.com/thyroidscience/reviews/derry/Derry.flu.iodine.9.19.09.pdf]

:'''Ascorbic acid (vitamin C)'''

::Nebulisation (atomisation) delivers vitamin C directly to where it is needed in the case of a respiratory infection such as COVID-19, and it is known to be at least as, and possibly more, effective as a method of delivery than intravenous infusion.
::'''Materials''': a nebuliser (or atomiser), ascorbic acid and sodium bicarbonate (which is needed because ascorbic acid on its own is too acidic for the airways).
::'''Method''': Mix 100 grams of ascorbic acid powder with 50 grams of bicarbonate of soda in one litre of filtered/spring water. Once the mixture has stopped bubbling, a very slightly cloudy 10% solution of sodium ascorbate will be left. This contains 500 mg of vitamin C per 10 ml of liquid.
::Nebulising 10 ml of this solution (one dose) will deliver 500 mg, or 0.5 gram, of vitamin C. Start with one dose every 2 hours.
::If the nebulised vitamin C does not provide benefits, the airways can be opened up by nebulising magnesium sulphate (Epsom salts), which is also anti-inflammatory. [https://www.cochrane.org/CD003898/AIRWAYS_inhaled-magnesium-sulfate-safe-and-effective-treatment-people-asthma-attacks] Dissolve 50 grams of Epsom salts in 500 ml of filtered/spring water and nebulise 10 ml of this 1% magnesium solution at a time. This will deliver 1 gram of magnesium, and can be done immediately before nebulising the vitamin C.

:'''Hypertonic saline'''

::A simple solution of salt in water could arguably be the simplest and most readily accessible, side-effect free, worm-friendly antiviral prophylaxis and treatment available. It is suitable for use via a nasal spray to reduce viral load in the airways and thereby minimize the severity of COVID-19 in the early stages of infection. It can also be used in a nebuliser to help treat already established or more severe cases affecting the lungs, and as a gargle to reduce viral load in the mouth. The extra salt from the hypertonic solution accumulates in the viral cells, forcing them to expend ATP in order to re-balance the electrolyte gradient, and this activity limits the amount of ATP available for viral replication. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442612/] And there is a simplified report of this research [https://medicalxpress.com/news/2021-09-reveals-saline-solution-inhibit-replication.html here].

:❓'''Hydrogen peroxide (H2O2)''' (See [[#Hydrogen peroxide|Hydrogen peroxide]].)

:: "Viral syndromes start or are strongly supported by ongoing viral replication in the naso- and oropharynx. When appropriate agents are nebulized (into a fine spray) and this viral presence is quickly eliminated, the rest of the body "mops up" quite nicely the rest of the viral presence. The worst viral infections are continually fed and sustained by the viral growth in the pharynx. Probably the best and most accessible agent to nebulise would be 3% hydrogen peroxide (1 to 5 cc of 3% peroxide with volume brought up to 10 to 12 cc with filtered water) for 15 to 30 minutes several times daily." [http://orthomolecular.org/resources/omns/v15n16.shtml] Also see [http://orthomolecular.org/resources/omns/v16n43.shtml Curing Viruses with Hydrogen Peroxide].

: '''DMSO'''

:: "DMSO can be readily combined with other anti-pathogen agents, such as sodium ascorbate (vitamin C) and magnesium chloride. Anecdotally, this DMSO-vitamin C-magnesium chloride combination has proven to be very effective in clearing biofilms and their underlying pathogen colonies. This can be done with 1 to 5 cc of 99.9% DMSO brought up to 10 to 12 cc (for nebulisation) with a combination solution of vitamin C and magnesium chloride. Precise concentrations are not critical, and the combination solution can be quickly and easily made by adding about 2 teaspoons of sodium ascorbate powder and 2 teaspoons of magnesium chloride powder to about a half cup of water. Since the sodium ascorbate will oxidize over several hours as it turns yellow, it can be made separately from the magnesium chloride solution, which remains very stable and does not significantly deteriorate over time." [http://orthomolecular.org/resources/omns/v15n16.shtml]

: '''Hyperbaric oxygen'''

:: "...hyperbaric oxygen therapy (HBOT) would be an excellent treatment adjunct against severe COVID-19 and a superior alternative to ventilators, which have been shown to cause harm in many patients and increase the risk of death. (Link expired)

: '''Grapefruit seed extract (GSE) and xylitol'''

::Nasal sprays containing GSE and xylitol (e.g., [https://xlear.com/xlear-sinus-care/ Xlear Sinus Care]) may prevent the spread of viral respiratory infections including SAR-CoV-2 and H1N1. GSE significantly reduces the viral load while xylitol prevents attachment of the virus to cell walls. [https://www.biorxiv.org/content/10.1101/2020.12.02.408575v3.full]

'''Other considerations when fighting viral infections'''

:* [https://www.sciencedaily.com/releases/2019/02/190212094839.htm How '''sleep''' can fight infection]

:* [https://www.ncbi.nlm.nih.gov/pubmed/31732517 '''Ketogenic diet''' activates protective γδ T cell responses against influenza virus infection]

:* [https://nutrition.bmj.com/content/early/2022/06/30/bmjnph-2022-000462 Association of '''periodic fasting''' with lower severity of COVID-19 outcomes in the SARS-CoV-2 prevaccine era]

:* [https://www.medicalnewstoday.com/articles/two-cases-suggest-fecal-transplants-may-treat-sars-cov-2-infection Two cases suggest '''fecal transplants''' may treat SARS-CoV-2 infection]

:* [https://journals.lww.com/anesthesia-analgesia/Fulltext/2021/04000/Aspirin_in_Coronavirus_Disease_2019_Related_Acute.1.aspx '''Aspirin''' in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome: An Old, Low-Cost Therapy With a Strong Rationale]

:* [https://www.sciencedaily.com/releases/2019/07/190702112834.htm Pharmaceutical antibiotics weaken flu defences in the lung]

:* [https://www.bmj.com/content/368/bmj.m1182/rr-10?fbclid=IwAR1wHVgtmbbjQ4zcno5d4zjlnmC97fyrrLv7jUuXBtZGpGawQwf6OJat5YU Cholesterol-lowering treatment may worsen the outcome of a COVID-19 infection]
</blockquote>

=== Ayurvedic remedies [https://en.wikipedia.org/wiki/Ayurvedic] ===

:❓ [https://en.wikipedia.org/wiki/Aegle_marmelos Aegle marmelos] (also known as Bael, Bengal quince, golden apple, Japanese bitter orange, Sirphal, stone apple and wood apple) has culinary uses and is employed as an ayurvedic remedy in Indian traditional medicine to treat various illnesses, including irritable bowel syndrome and ulcerative colitis. Sandu bilagyl, a herbal tea combining Aegle marmelos and sugar, is claimed on several commercial websites to have anthelmintic effects, [https://herbalukstore.co.uk/sandu-bilagyl.html] but this characteristic is not mentioned in more detailed articles found online, [https://hort.purdue.edu/newcrop/CropFactSheets/bael.html] where Aegle marmelos is only reported to have pesticidal properties. This may have have been extrapolated by vendors to suggest a possible anthelmintic effect, but there is so far no evidence that it harms intestinal worms, and no self-treaters have reported their experience with it.

<blockquote>
The following ayurvedic remedies are used, in combination, to treat pinworms, so may also have an adverse effect
on other helminths:
* ⚡[https://en.wikipedia.org/wiki/Vidanga vidanga] (Embelia ribes)
* ⚡[https://en.wikipedia.org/wiki/Gurmar Gymnema sylvestre] (cowplant, cowplant, gurmari, gurmarbooti, gurmar, periploca of the woods, meshasringa, Bedki cha pala and miracle fruit)
* ⚡[http://ayurveda-foryou.com/ayurveda_herb/trikatu.html trikatu] - a combination of (see Spices section)
** ⚡[https://en.wikipedia.org/wiki/Black_pepper black pepper] (Piper nigrum - (see[[#Black pepper| Black pepper]])
** ⚡[https://en.wikipedia.org/wiki/Indian_Long_Pepper long pepper] (Piper longum)
** ⚡'''ginger''' (Zingiber officinale - see [[#Ginger|local reference]])

* ⚡[https://en.wikipedia.org/wiki/Triphala Triphala]. This is an Ayurvedic herbal formula combining three myrobalans: Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica/Terminalia bellerica), and Haritaki (Terminalia chebula). The latter two of these are reported to be anthelmintic, but they also have laxative properties, and it may be this characteristic, rather than actual worm killing ability, that is the source of any ‘anthelmintic’ effects.
</blockquote>

=== Chinese herbal medicines [https://en.wikipedia.org/wiki/Chinese_Herbal_Medicine] ===

==== ❌ Anthelmintic Chinese herbs ====

<blockquote>
* Bing Lang (Semen arecae). Used against roundworms and flukes.
* Chuan Lian Gen Pi (Cortex meliae radicis). Used against roundworms.
* Da Huang (Radix et rhizoma rhei). Used in combination remedies to treat flukes.
* Guan Zhong (Rhizoma dryopteris crassirhizomae). Used in combination remedies to treat hookworms.
* Ku Lian Gen Pi (Cortex meliae radicis). Used to treat pinworms, and in combination remedies to treat hookworms.
* Lei Wan (Sclerotium omphaliae). Used specifically to treat hookworms.
* Qian Niu Zi (Semen pharbitidis). Used in combination remedies to treat flukes.
* Qu Hui Wan (Dispel Roundworms Pill). Used against roundworms.
* Shi Jun Zi (Fructus quisqualis). Used against pinworms.
* Tu Jing Jie (Herba chenopodii ambrosioidis). Used in combination remedies to treat hookworms.
* Wu Mei Wan / Wu-Mei Wan (Mume Pill). A 10-herb classical formula used to treat intestinal parasite infections, including roundworms.
* Zi Su Ye (Folium perillae). Used in combination remedies to treat hookworms.
</blockquote>

=== Homeopathic remedies ===

✅ Most homeopathic remedies are unlikely to have any adverse effect on human helminths. For example, the influenza remedy, [https://en.wikipedia.org/wiki/Oscillococcinum Oscillococcinum], has been taken occasionally by one hookworm host without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1590515217671094/?comment_id=1590860620969887&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

==== ❌ Antiparasitic homeopathic remedies [https://en.wikipedia.org/wiki/Homeopathy] ====

<blockquote>
* Cina (a homeopathically potentised form of Eurasian wormwood - [https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina])
* Cuprum oxidatum nigrum
* Indigoz
* Podophyllum
* Sabadilla
* Santoninum
* Spigelia
* Stanum
* Teucrium marum
</blockquote>

=== Light therapy===

No reports have been received about adverse effects on human helminths of any form of [https://en.wikipedia.org/wiki/Light_therapy light therapy] ([https://en.wikipedia.org/wiki/Low-level_laser_therapy#Red_light_therapy red light therapy], near-infrared, far-infrared, etc.), and one NA host has reported regularly using a red light full body bed without issue. [https://www.facebook.com/groups/htsupport/posts/7155942991128261/?comment_id=7156873597701867]

=== Phage therapy [https://en.wikipedia.org/wiki/Phage_therapy] ===

</blockquote>
❓ While it is unlikely that bacteriophages will harm helminths, one hookworm host who took a short course of doses of a cocktail of several phages has reported experiencing a slight temporary reduction in worm benefits following this treatment. The product he took included preservatives (8-hydroxyquinoline sulfate-0,0001 g / ml [calculated content]; or 8-hydroxyquinoline sulfate monohydrate in terms of 8-hydroxyquinoline sulfate-0.0001 g / ml [calculated content]) which may have been responsible for this effect. [https://www.facebook.com/groups/htsupport/permalink/2619124714810134/?comment_id=2619284978127441]
</blockquote>

=== Electromagnetic therapy ===

✅ Several forms of electromagnetic stimulation have been used by hosts of human helminths, including [https://en.wikipedia.org/wiki/Magnet_therapy Magnet Therapy], [https://en.wikipedia.org/wiki/Pulsed_electromagnetic_field_therapy Pulsed Electromagnetic Field (PEMF) therapy] and [https://en.wikipedia.org/wiki/Transcutaneous_electrical_nerve_stimulation Transcutaneous Electrical Nerve Stimulation (TENS)], none of which appear to have had any obvious effect on the worms. [https://www.facebook.com/groups/htsupport/permalink/3123210597734874/] [https://www.facebook.com/groups/htsupport/posts/7903061716416381/?comment_id=7903306649725221&reply_comment_id=7903872713001948]

== Foods, supplements, spices, herbs and fungi ==

There are lists on the internet claiming that common foods and spices such as pumpkin seeds, turmeric, and even carrots, will kill helminths, but '''normal dietary amounts of most ''unprocessed'' foods, spices and herbs, will not harm helminths.'''

For example, carrots and sweet potatoes are both claimed to be 'antiparasitic' in some online lists, but one individual who eats 400 g (14 oz) of one or other of these vegetables every day, is still able to maintain a thriving hookworm colony, and there are others who have eaten far more than this without harming their worms.

The only problem that is likely to arise with foods, spices or herbs is when these, and particularly herbs, are artificially concentrated or processed to create extracts or tinctures. Any herbal medicine that claims to have antiparasitic, or even antibacterial or antifungal properties may present a potential risk to human helminths and should therefore be approached with caution. The ultimate potency of these substances will depend on a number of factors, including, in the case of plants, the part used, the season it was picked, [https://pubmed.ncbi.nlm.nih.gov/37596334/] the method of extraction, [http://www.ncbi.nlm.nih.gov/pubmed?term=21110041] and the extent of concentration and/or processing, as well as dosage.

The effect of such substances also appears to vary between individuals, probably due to differences in the strength of their immune response to helminths, and some people, particularly those who have more difficulty holding on to a viable helminth colony and therefore need more frequent top-ups (especially a subset of patients with IBD or coeliac disease, and some with allergies) may find that ingesting certain substances that have no effect on the worms of other hosts may tip the balance in their case and cause a temporary dip in worm benefits, or even a loss of worms. For example, one helminth host has reported taking peppermint oil continuously without any apparent adverse effect on his worms, yet another individual could not keep a worm colony at all while taking peppermint oil.

In the case of some foods and herbs, a single part of the plant, usually a part that is not normally eaten - perhaps the bark or root - may have antiparasitic properties, while other parts of the same plant may be perfectly safe to eat. For example, the seeds of pomegranates are safe to eat, while the bark of the stems of this plant contains an anthelmintic compound, and the bark of the root contains an even more potent form of this alkaloid, which is used to treat roundworms, pinworms and tapeworms.

'''So, while bearing in mind the general principles set out in the Introduction and the last few paragraphs above, and using the details in the list below, helminth hosts need to observe their own responses and learn what they, as individuals, can and cannot safely consume while hosting helminths.'''

There will often be a warning indication whenever one's worms are not happy. This may be a general loss of wellbeing, or a return of specific symptoms. For example, one person always gets a marked increase in nasal congestion if something compromises the health of his worms.

=== Foods ===
<blockquote>
'''✅ Food items considered safe unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Atemoya Atemoya] The fruit, atemoya, is a hybrid of two other fruits – the sugar-apple (Annona squamosa) and the cherimoya (Annona cherimola). Atemoya is also known as "pineapple sugar apple", anón, chirimorinon, achta and stafeli dogo ("mini soursop"). An NA host has reported that eating the flesh of this fruit appeared not to harm his colony, [https://www.facebook.com/groups/htsupport/posts/7681355011920387/?comment_id=7681459525243269] but that there are neurotoxic compounds, called annonacins, in the seeds, bark, leaves and skin of this plant that may be anthelmintic. While there are also annonacins in the fruit, they are present in much smaller quantities than in the plant’s other parts.

* [https://en.wikipedia.org/wiki/Momordica_charantia Bitter melon] (Momordica charantia) Also known as Momordica chinensis, goya, karela, ampalaya, bitter apple, bitter gourd, bitter squash and balsam-pear. This cucumber-shaped vegetable is found in Asian markets, and aqueous extracts of its leaves and seeds have both been shown to have a dose-dependent adverse effect on one type of adult non-therapeutic helminth (Strongyloides) in test tube studies [https://www.researchgate.net/publication/242567254_In_vitro_anthelmintic_efficacy_of_some_indegeneous_medicinal_plants_against_gastrointestinal_nematodes] and both fruit and seeds have been, and still are, used in a number of countries to treat pinworm infections, and for expelling parasites generally. However, the quantities of fruit and seeds that are quoted as being necessary in order to eradicate worms are rather large, for example two whole melons each day for seven to ten days, repeated after two months. It is therefore unlikely that normal dietary amounts of bitter melon fruit will adversely affect therapeutic helminths, and one hookworm self-treater has reported that bitter melon is a regular part of her diet, but has never adversely affected her worms. [https://www.facebook.com/groups/htsupport/posts/4373320642723857/?comment_id=4376043225784932]

* ⚡ [https://en.wikipedia.org/wiki/Breast_milk Breast milk] (human). There has been one report of a child with severe eczema who was inoculated with hookworms while still being breastfed, and who received only moderate benefits from the worms until breast feeding was suspended. Thereafter, the benefits increased markedly, suggesting that something in the breast milk was inhibiting the worms, possibly the lauric acid which is also found in [[#Coconut|coconut]] products. [https://www.facebook.com/groups/htsupport/permalink/2241418522580757/]

* [https://en.wikipedia.org/wiki/Carrot Carrot] (Daucus carota, subsp. sativus). The taproot of the carrot is rich in beta carotene, a precursor for vitamin A, which has been claimed to increase resistance to penetration by larvae. Carrots have also been claimed to be offensive to all parasites and valuable in the elimination of threadworms, but normal dietary amounts are not harmful to therapeutic helminths, and many helminth hosts have regularly eaten significant quantities of this vegetable (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without adversely affecting their worms.

* ❌ [https://en.wikipedia.org/wiki/Chicory Chicory] (Cichorium intybus). This is well known for its toxicity to intestinal parasites, and studies have indicated that ingestion of chicory by farm animals results in reduced worm burdens. This plant contains volatile oils similar to those found in plants in the related genus Tanacetum, which includes ❌'''Tansy''', and is said to be similarly effective in eliminating intestinal worms. One hookworm host has reported that eating 2 tsp of chicory powder (pesumably ground chicory root) terminated her colony. [https://www.facebook.com/groups/htsupport/posts/8036790633043488?comment_id=8058118634244021] However another NA self-treater has reported that drinking "loads of chickory coffee for a while" had no negative effects on his colony. [https://www.facebook.com/groups/htsupport/posts/9496946530361217?comment_id=9497703880285482] This difference in results was likely due to the high heat used to roast the raw plant material to produce chicory "coffee". This processing destroys or transforms many of the original plant oils present in raw chicory root, with the result that roasted chicory contains little to none of the volatile oils found in the fresh plant. [https://orleanscoffee.com/what-is-chicory/]

* [https://en.wikipedia.org/wiki/Citron Citron] (Citrus medica). Alcoholic extracts of the rind of citron have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. These extracts may therefore also have an adverse effect on other helminths, though there is no evidence that eating normal dietary amounts of the flesh of this fruit might harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Coconut Coconut]. Coconut products contain [[#Medium-chain triglycerides|medium-chain-triglycerides]] (MCT), some of which have been shown to be effective against many parasites including giardia, other protozoa, and also tapeworms. (Also see, [[#Fatty acids|Fatty acids]].) The fats in '''coconut oil''' are 40% lauric acid (lipid number: C12), the MCT most well-known for its antibacterial, antimicrobial and antiviral properties, and the one most likely to be responsible for any adverse effect on helminths. '''Fractionated coconut oil''' contains primarily caprylic acid (C8) and capric acid (C10) [https://web.archive.org/web/20190122225059/https://www.healthline.com/nutrition/fractionated-coconut-oil] which appear not to harm helminths. One hookworm host who routinely consumes 3 to 10 tablespoons daily of MCT oil containing 55% caprylic acid and 35% capric acid has reported that this has no adverse effect on his colony, and that he is able to incubate more NA using eggs from this colony. [https://www.facebook.com/groups/678894952216125/permalink/2965258846913046/?comment_id=2966781426760788] '''Coconut fiber''', especially in the form of dried or ground coconut flesh (desiccated coconut, coconut flour) has long been used to expel intestinal worms, both in humans [https://www.facebook.com/groups/htsupport/permalink/1412001672189117/] and animals, [https://www.ncbi.nlm.nih.gov/pubmed/21120531] [https://www.ncbi.nlm.nih.gov/pubmed/24271156] and becomes more effective as the quantity increases. Eating an entire cake baked with coconut flour brought a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/946802485375707/] Most helminth hosts find that they can eat normal dietary amounts of coconut products without adversely affecting their worms, as can be seen in these examples. [https://www.facebook.com/groups/htsupport/permalink/877714092284547/?comment_id=880956541960302&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026771657378789&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026788797377075&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&reply_comment_id=2214230838632859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nevertheless, coconut products do have a potential to affect human hookworms in some individuals, especially '''coconut oil''' and '''coconut milk''', and the effect is often dose-dependent. For example, one hookworm host who checks the egg output of his worms has reported that they twice produced zero eggs for a period of time after he drank coconut milk. Another hookworm host gets increased pain a few hours after ingesting coconut milk or powder. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] Someone else found that, while consuming 200 mg of coconut milk caused a temporary return of mild symptoms of his disease, he regularly eats coconut oil without any obvious problem, but other hookworm hosts have reported a return of disease symptoms after consuming coconut oil. [https://www.facebook.com/groups/htsupport/permalink/1446457812076836/] [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409474272441857&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3536097503112846/] A hookworm grower has reported that he can consume coconut products "somewhat regularly" and still be able to incubate plenty of larvae, [https://www.facebook.com/groups/678894952216125/permalink/1407193439386269/?comment_id=1407718306000449&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but another grower has found that, while his colony continues to thrive and produce eggs when he takes 3 tablespoons of coconut oil each day, [https://www.facebook.com/groups/htsupport/permalink/1084278171628137/?comment_id=1088696887852932&comment_tracking=%7B%22tn%22:%22R%22%7D] about ⅓ of any larvae produced will be dead, and the rest “less energetic”, so he normally restricts himself to 2 tablespoons per day. '''Coconut water''' may also adversely affect a hookworm colony, as one host found after drinking 1 litre of coconut water, [https://www.facebook.com/groups/htsupport/permalink/1051741958215092/] and another found after drinking coconut water kefir, [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but one NA host has found that the [https://www.lacroixwater.com coconut essence-flavoured sparkling water produced by La Croix] had no ill effect on his worms. [https://www.facebook.com/groups/htsupport/posts/4820278211361429/] One hookworm host finds that '''all coconut products''' have an adverse effect, [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409105045812113&comment_tracking=%7B%22tn%22%3A%22R%22%7D] while two others have said that even small amounts of coconut quickly result in a loss of benefits. [https://www.facebook.com/groups/htsupport/permalink/1331489750240310/?comment_id=1339469669442318&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1526713510717932/?comment_id=1529128360476447&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Some '''CBD oils''' for vaping are suspended in coconut oil. However, most of these are only a 3% suspension, so *may* be safe for use while hosting human helminths. '''Coconut sugar''' should not carry the same degree of risk because, whereas coconut milk, oil and flour are all obtained from the flesh of mature coconuts, and coconut water is also from inside the fleshy part of the coconut, coconut sugar comes from the sap of coconut palm flower buds and consists largely of sugars. The seasoning sauce, '''Coconut Aminos''', is also made from coconut tree sap, and at least one hookworm host has used this regularly without issue. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1697083593680922&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cranberry Cranberry] (Vaccinium macrocarpon). This is claimed by some sources to contain antiparasitic enzymes, and cranberry powder is sometimes included in proprietary antiparasitic formulations, although evidence for its effectiveness in this context is lacking, and there have never been any reports of any form of cranberry having an adverse effect on therapeutic helminths. Cranberry juice was used traditionally to treat urinary tract infections (UTIs), but it works by changing the bacteria in ways that [http://www.medicalnewstoday.com/articles/198711.php prevent bacterial adhesion] rather than killing them. While drinking 15 fl oz of cranberry juice per day is claimed to help arrest a mild urinary infection, [http://www.medicalnewstoday.com/articles/306498.php cranberry powder capsules are more effective] and '''D-mannose''', a cranberry derivative, is even more effective than the powder.

* ❓ [https://en.wikipedia.org/wiki/Rub_(syrup) Date syrup], also known as “rub”. Laboratory tests have revealed that [http://www.sciencedaily.com/releases/2015/03/150330213949.htm some forms of date syrup may have antibacterial activity], possibly due to the presence of phenolic compounds that form naturally in the dates as they mature. Significantly, the syrup was able to inhibit the growth of bacteria faster than ⚡'''Manuka honey''', which several people have suspected of having adversely affected their worms. However, [https://www.facebook.com/groups/htsupport/permalink/811693292219961/?comment_id=811695265553097&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D eating dates is unlikely to be harmful to helminths].

* [https://en.wikipedia.org/wiki/Dietary_fiber Dietary fibre] (fiber). Some sources claim that eating a lot of fibre may reduce the number of intestinal worms, but fibre consumed as an integral part of a normal diet has not been reported to be a problem for human helminths.

* ❓ [https://en.wikipedia.org/wiki/Durian Durian] There are several species of fruit-producing durian trees, the most common of which is [https://en.wikipedia.org/wiki/Durio_zibethinus Durio zibethinus] So far, there have been no reports about durian from self-treaters, but [https://en.wikipedia.org/wiki/Bombax_ceiba Bombax malabaricum] - another member of the Bombacaceae plant family within which durian is classified - has shown significant anthelmintic activity against one flatworm species. [https://pubmed.ncbi.nlm.nih.gov/21853226/]

* ⚡[https://en.wikipedia.org/wiki/Fatty_acid Fatty acids]. Research on the direct effect of fatty acids on helminths is limited. However, the poly-unsaturated fatty acid (PUFA), linoleic acid, has shown in vitro nematocidal activity against both C. elegans [https://pubmed.ncbi.nlm.nih.gov/8202563/] [https://pubmed.ncbi.nlm.nih.gov/32674325/] and H. contortus, [https://pubmed.ncbi.nlm.nih.gov/20075977/] and it has been proposed that unsaturated fatty acids are likely to play a role in the natural attrition of S. mansoni and S. haematobium lung-stage larvae. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It has been hypothesised elsewhere that exposure to some fatty acids could cause lethal damage to helminths by interacting with, and compromising, the integrity of the organisms's cuticle, [https://pubmed.ncbi.nlm.nih.gov/34149425/] and in vitro exposure to arachidonic acid has been shown to cause disintegration of the surface membranes of the trematode, Schistosoma spp., eventually leading to parasite death. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It is likely that the undoubted adverse effect of some coconut products on NA - and possibly also TTO - in ''some'' hosts is due to the fatty acids these products contain, especially lauric acid (C12), and the evidence from the studies presented here suggests that other fatty acids may have an adverse effect on therapeutic helminths in a similar dose-dependent manner, influenced also by the strength of the host's immune response to helminths. People who are hosting NA, in particular, who are not experiencing the benefits they expected should therefore consider the possible effect of any fatty acids they consume, and experiment accordingly. (Also see [[#Medium-chain triglycerides|medium-chain triglycerides]] and [[#Coconut|⚡coconut]].)

* '''Guayusa tea''' ([https://en.wikipedia.org/wiki/Ilex_guayusa ilex guayusa]). The leaves of this Amazonian holly tree are brewed to make a caffeinated drink. One hookworm host who regularly drinks this tea has not noticed any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2248121518577124/?comment_id=2248562038533072&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Genetically_modified_foods Genetically modified foods] (GMOs). Some food crops, such as corn and rice, have been genetically modified to produce ❌'''Cry5B''', a protein that can kill intestinal worms, including the human hookworm. [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt), the bacterium that produces Cry5B, is also applied as a [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php natural insecticide] on crops on some organic farms, but there is no indication yet that GM foods are a potential threat to human helminths.

* [https://en.wikipedia.org/wiki/Grapefruit Grapefruit] (citrus paradisi). The flesh of the common grapefruit is perfectly safe to eat while hosting helminths, although ⚡'''grapefruit seed extract''' does have a potential to harm helminths due to the typical addition of synthetic adulterants. Also potentially harmful are some extracts of the rind of ❌'''Citrus decumana''', a close relative of the grapefruit.

* [https://en.wikipedia.org/wiki/Hibiscus Hibiscus]. One hookworm host has drunk many litres of strong, homemade hibiscus tea over the years without ever harming her colony. [https://www.facebook.com/groups/htsupport/permalink/2647270255328913/?comment_id=2647328495323089]

* ⚡ [https://en.wikipedia.org/wiki/Honey Honey]. Honey can contain antivirals [http://www.ncbi.nlm.nih.gov/pubmed/25333699] and powerful antimicrobials [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074369/], some of which can have effects comparable with those of antibiotics such as clarithromycin, and certain types of honey have particularly potent antimicrobial activity. Several people have suspected that [https://en.wikipedia.org/wiki/M%C4%81nuka_honey '''Manuka''' honey] (which inhibits dental plaque as effectively as chlorhexidine mouthwash [http://www.ncbi.nlm.nih.gov/pubmed/22114423]) has adversely affected their worms, while a few others have reported that '''raw''' honey reduces the benefits from their worms, [https://www.facebook.com/groups/htsupport/permalink/2517832904939316/?comment_id=2524053750983898] in one case causing increased pain several hours after ingestion, [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] and someone else, who had a few teaspoons of '''raw''' honey on two occasions, 4 days apart, has reported that some of his symptoms made a limited return for a day after each ingestion. [https://www.facebook.com/groups/htsupport/posts/5132147986841115/] Research reported in 2014 may explain why '''raw''' honey might have this effect. [http://www.sciencedaily.com/releases/2014/09/140908093741.htm] However, one hookworm host, who regularly takes a '''manuka''' honey/apple cider vinegar combination, has not noticed any loss of benefits, and another two have reported no apparent adverse effect on their worms after consuming '''raw''' honey. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] One of these individuals reports having eaten quite large amounts of '''raw''' honey continuously during his first 3 years with NA and never noticed anything untoward. [https://www.facebook.com/groups/htsupport/permalink/1802586329797314/?comment_id=1807740622615218&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Regular honey appears to be generally worm-safe, [https://www.facebook.com/groups/htsupport/permalink/1223658601023426/?comment_id=1224392167616736&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and, demonstrating the experience of many others, one hookworm host has said that she can consume 2-4 teaspoons of regular honey daily without any issues, but that manuka and any honey labeled as "raw" causes problems. (Identification of the different types of honey: '''Manuka''' honey, which is very viscous with a dark cream to dark brown colour, is produced by bees foraging specifically on the mānuka tree; '''Wild''' honey is often sourced from free-range hives, rather than box hives, by native gatherers who only remove larger honeycomb impurities; '''Raw''' honey is typically only strained to remove physical impurities such as beeswax and dead bees. '''Regular honey''' usually goes through additional processing including finer filtration to remove all debris and air bubbles, and pasteurisation to destroy yeasts. Regular honey may also be subject to utrafiltration, which further refines the product to make it more transparent and smooth, but also removes beneficial nutrients like pollen, enzymes and antioxidants.)

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_emblica Indian gooseberry]. (Phyllanthus emblica, also known as Emblica officinalis, emblic, emblic myrobalan, myrobalan, Malacca tree and amla.) While there are websites online that claim anti-parasitic effects for P. emblica, and one study found that P. emblica exerted toxic effects on a parasitic flat worm, [https://pubmed.ncbi.nlm.nih.gov/19819626/] there is no compelling evidence in the scientific literature for a possible adverse effect on hookworms. Neither have any reports of an adverse effect on their worms been posted by any NA self-treaters, and one study found that a traditional Thai preparation containing P. emblica actually extended the life of the research worm, C. elegans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693129/]

* [https://en.wikipedia.org/wiki/Kefir Kefir]. Although kefir has been claimed online to kill “parasites”, it will not harm hookworms unless it is made with coconut milk. (See [[#Coconut milk |details for coconut milk]].) There has also been a single report of an NA colony possibly being killed after drinking kefir made from coconut water. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (See [[#Coconut water |details for coconut water]].)

* [https://en.wikipedia.org/wiki/Kombucha Kombucha] (Medusomyces gisevii, also called tea mushroom, tea fungus or Manchurian mushroom.) This fermented drink does not harm helminths. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616509485071657]

* [https://en.wikipedia.org/wiki/Lime_(fruit) Lime] (Citrus acida). While alcoholic extracts of the rind of limes have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], and extracts of the rind may have an adverse effect on other helminths, there is no reason to believe that eating the flesh of limes will harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Medium-chain_triglyceride Medium-chain triglycerides] (MCTs) are extracted from ⚡'''coconut oil''', amongst other things, and can be divided into four groups: 1. caproic acid (C6), 2. caprylic acid (C8), 3. capric acid (C10) and 4. lauric acid (C12). [https://blog.bulletproof.com/the-definitive-guide-to-mcts/] Of these, lauric acid is the most well-known for its antibacterial, antimicrobial and antiviral properties, which may explain why coconut oil (which is 40-50% lauric acid) appears more likely to affect human helminths than products containing a mixture of all four types of MCT, such as the milk of cows, sheep and goats, the fatty acids in which contain 10-20% mixed MCTs. (Also see [[#Fatty acids|⚡fatty acids]] and [[#Coconut|⚡coconut]].) One NA host who took the "postbiotic" product, [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] has reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] and the only ingredient in this product that is known to be a potential problem is medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Onion Onion] (Allium cepa). This is used as an ingredient in some proprietary deworming formulations and has been claimed to create an 'uninhabitable environment' for intestinal worms and to help eradicate tapeworms in particular. However, if eaten in normal dietary quantities, onion should not harm therapeutic human helminths.

* [https://en.wikipedia.org/wiki/Organic_foods Organic foods]. While these are less likely to be contaminated with chemicals, some organic farmers apply [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) to their crops as a natural insecticide. This bacterium produces ❌'''Cry5B''', a protein that can kill intestinal worms, [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php including human hookworms]. However many hosts of human helminths have eaten organic foods without them affecting their worms.


* [https://en.wikipedia.org/wiki/Papaya Papaya] (Carica papaya, also known as or papaw, pawpaw or paw paw). The fruit and leaves contain both antiseptic and antiparasitic compounds, including one called [https://en.wikipedia.org/wiki/Carpaine carpaine], which is claimed to kill and expel intestinal worms. Papaya latex has been shown to be an [http://www.ncbi.nlm.nih.gov/pubmed/26343287 effective anthelmintic] against a variety of nematode parasites. However, it is unlikely that eating normal dietary amounts of the flesh of the fruit will adversely affect human helminths and, when someone who grows his own hookworms added a large amount of papaya - comparable to a human eating 2 or 3 pawpaws - to a petri dish full of larvae, these were unaffected. However, ⚡'''Papaya seeds''' are also rich in caricin which is reportedly effective in expelling roundworms. A randomized, placebo-controlled study found that a 20 ml dose of a mixture of air-dried papaya seeds and "natural" honey was effective against various types of human intestinal parasite, although the honey may have contributed to this effect. The mixture demonstrated 100% efficacy in clearing TT, and 80% efficacy against NA. [http://www.ncbi.nlm.nih.gov/pubmed/17472487] Also see [https://www.ncbi.nlm.nih.gov/pubmed/30526582 this paper].

* [https://en.wikipedia.org/wiki/Pomegranate Pomegranate] (Punica granatum). ✅The '''flesh and seeds''' of the pomegranate fruit have not been reported to harm human helminths. However, ❌'''pomegranate extracts''' should be avoided because the bark and stems of this plant contain an anthelmintic compound, punicine, and the bark of the root contains an even more potent form of this alkaloid. [https://www.ncbi.nlm.nih.gov/pubmed/32411422] Extracts of the bark of both the root and stems, and extracts of the rind/peel of the fruit, have a strong anthelmintic effect and are used as traditional remedies to treat roundworms, pinworms and tapeworms, to which they are said to be highly toxic. Alcoholic extracts of the rind/peel have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [https://www.ncbi.nlm.nih.gov/pubmed/1158424] These extracts may therefore have an adverse effect on other helminths, and one hookworm host has reported losing benefits from her colony after accidentally consuming a small amount of pomegranate extract. [https://www.facebook.com/groups/htsupport/permalink/1166864270036193/] Pomegranate peel is used in small quantities in dietary supplements and food preservatives and may not be a significant threat to human helminths in this form. However, ❌'''pomegranate peel powder''', which is available for purchase as a remedy for certain health conditions, might be harmful to helminths if it is used in quantity, for example as an ingredient in smoothies. One hookworm host found that while one company’s pomegranate '''''fruit''''' powder is produced from only the dried pomegranate arils (the seeds and their red fleshy coatings), and not including any peel, the same company’s pomegranate '''''juice''''' powder is produced from the whole fruit - both the seeds/arils and the peel. Neither product carries details on their packaging of which part of the pomegranate they contain, and this self-treater had only realised there was a difference when taking the latter product caused a return of his disease symptoms.

* ✅ [https://en.wikipedia.org/wiki/Pumpkin Pumpkin] and ⚡ [https://en.wikipedia.org/wiki/Pumpkin_seed Pumpkin seeds] (Cucurbita species). This is also referred to as squash or gourd, depending on species, variety and local parlance. Eating the flesh of the pumpkin/squash/gourd is unlikely to have any adverse effect on any human helminth. ⚡'''Pumpkin ''seeds''''' contain an antiparasitic compound called [https://en.wikipedia.org/wiki/Cucurbitacin curcurbitacin] and they were used traditionally as a remedy for tapeworms and roundworms. However, their effect is likely to be dose-dependent, and large amounts are recommend by herbalists for deworming, e,g., up to 25 ounces for adults. Some hookworm hosts have reported no adverse effect on their colony after eating pumpkin seeds, [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2889359654453304] [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2890447241011212&reply_comment_id=2895457573843512] while others have experienced either a temporary return of disease symptoms or even a loss of their colony. For example one found that eating a daily salad for a week with a mixed seed/nut topping containing pumpkin seeds killed her entire colony. [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2888764874512782] Another NA host has reported that taking 1000 mg of ⚡'''pumpkin seed oil''' daily for 2 months significantly reduced the fecundity of his NA, resulting in incubations producing only a handful of L3 larvae after having previously always yielded hundreds of larvae per incubation over a 7 year period. [https://www.facebook.com/groups/htsupport/permalink/1635384559850826/?comment_id=1635389889850293&reply_comment_id=1635944229794859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Since this individual is not treating a disease, but only acting as a reservoir donor, it is not known whether this amount of pumpkin seed oil might affect disease remission.

* [https://en.wikipedia.org/wiki/Radish Radish] (Raphanus sativus). This has been used as an alternative treatment for intestinal parasites, and is included as an ingredient in some proprietary deworming formulations, but it is unlikely to have any adverse effect on human helminths if eaten as part of a normal diet.

* ❌ [https://en.wikipedia.org/wiki/Sauerkraut Sauerkraut] Sauerkraut will not kill human helminths, but it can trigger significant digestive upset in some people, sufficient to cause a setback in the course of their treatment, and including diarrhoea severe enough to flush hookworms from the gut. Two hookworm hosts have reported experiencing significant upset stomach, “gut issues” and diarrhoea after eating only 2 and 3 forkfuls of sauerkraut respectively [https://www.facebook.com/groups/htsupport/permalink/1440317759357508/?comment_id=1440394666016484&reply_comment_id=1443382035717747][https://www.facebook.com/groups/htsupport/permalink/2726061500783121/?comment_id=3607483215974274] and another NA host lost his entire colony due to extreme diarrhoea following his first encounter with sauerkraut. [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓[https://en.wikipedia.org/wiki/Seaweed Seaweed] (macroalgae). Five poly-unsaturated fatty acids (PUFAs) identified in two Nordic seaweeds (S. latissima and L. digitata) were found to have in vitro effects against helminths in swine (Ascaris suum) and sheep (Teladorsagia circumcincta), with a clear synergistic effect being apparent when selected compounds were tested in combination. “Collectively, our data reveal that fatty acids may have a previously unappreciated role as natural anti-parasitic compounds, which suggests that seaweed products may represent a viable option for control of intestinal helminth infections.” [https://pubmed.ncbi.nlm.nih.gov/34149425/] However, there have been no reports so far of NA or TTO being adversely affected by the consumption of seaweed products. (Also see, [[#Fatty acids|⚡fatty acids]].)

* [https://en.wikipedia.org/wiki/Soy_sauce Soy sauce / soya sauce] This liquid condiment made with fermented soybeans is safe for use with human helminths.

* [https://en.wikipedia.org/wiki/Squash_(plant) Squash]. See '''Pumpkin''' above.

* [https://en.wikipedia.org/wiki/Sweet_potatoes Sweet potato] (Ipomoea batatas). Like the carrot, this root vegetable is rich in beta carotene, a precursor for vitamin A, which it has been claimed can increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat significant amounts of sweet potato (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without any adverse effect on their worms.

* [https://en.wikipedia.org/wiki/Tea Tea]. The aromatic beverage prepared by pouring hot or boiling water over cured or fresh leaves of the [https://en.wikipedia.org/wiki/Camellia_sinensis Camellia sinensis] plant, e.g., [https://en.wikipedia.org/wiki/Green_tea green tea], [https://en.wikipedia.org/wiki/Black_tea black tea], [https://en.wikipedia.org/wiki/White_tea white tea] and [https://en.wikipedia.org/wiki/Oolong oolong tea], is generally harmless to therapeutic helminths. However, there ''may'' be a risk of harm to human helminths if ❓medicinal quantities of concentrates, extracts or tinctures made from green tea are consumed. [https://www.researchgate.net/publication/5449030_Potential_anthelmintics_Polyphenols_from_the_tea_plant_Camellia_sinensis_L_are_lethally_toxic_to_Caenorhabditis_elegans]

* ⚡ [https://en.wikipedia.org/wiki/Thai_curry Thai curry]. One hookworm host found that a strong green Thai curry upset his colony to the extent that he needed to add a top-up dose to recover the benefits he had enjoyed previously. [https://www.facebook.com/groups/htsupport/permalink/2259967414059201/?comment_id=2260424784013464&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Juglans_regia Walnut], English (Juglans regia). Also known as the Persian, common, California, or Carpathian walnut. This does not appear to have gained a reputation as an anthelmintic, unlike the ⚡'''black walnut'''.

* [https://en.wikipedia.org/wiki/Watermelon Watermelon] flesh is not a problem for either NA or TTO, but there has been one report from an NA host that eating a "bunch" of ⚡watermelon seeds at a barbecue caused a loss of all worm benefits after about three days. [https://www.facebook.com/groups/htsupport/posts/6765576206831610?comment_id=6765885696800661]

* [https://en.wikipedia.org/wiki/Xylitol Xylitol]. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/833127066743250/?comment_id=833225923400031&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] that he takes xylitol daily in place of sugar and has not noticed any effect on his colony.

* [https://en.wikipedia.org/wiki/Yam_(vegetable) Yam] ([https://en.wikipedia.org/wiki/Dioscorea Dioscorea]). Like carrot and sweet potato, the yam is rich in beta carotene, a precursor for vitamin A which is thought to increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat this vegetable without adversely affecting their worms.
</blockquote>



=== Nutritional supplements ===

<blockquote>
'''✅ Supplements safe for human helminths, unless marked otherwise'''

* [https://en.wikipedia.org/wiki/5-Hydroxytryptophan 5-HTP] (5-Hydroxytryptophan, also known as oxitriptan and marketed under trade names such as Cincofarm, Levothym, Levotonine, Oxyfan, Telesol, Tript-OH and Triptum) This is used as an antidepressant, appetite suppressant and sleep aid. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/811459492243341/?comment_id=811659322223358&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] taking 5-HTP without any adverse effect on her worms.

* [https://en.wikipedia.org/wiki/Acetylcarnitine Acetylcarnitine] (Acetyl-L-carnitine, ALCAR or ALC) is produced naturally by the body, and has been taken by at least two hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1701750936547521&reply_comment_id=1702741433115138&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1702716603117621&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Acetylcysteine Acetylcysteine] (also known as N-acetylcysteine, N-acetyl-L-cysteine and NAC). Three hookworm hosts have reported taking this without causing any problems for their colonies. [https://www.facebook.com/groups/htsupport/permalink/832123420176948/?comment_id=832517453470878&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3049676998421568/?comment_id=3049740311748570] [https://www.facebook.com/groups/htsupport/posts/4840382556017661/?comment_id=4841276152594968]

* [https://en.wikipedia.org/wiki/Activated_charcoal_(medication) Activated charcoal] (also known as activated carbon). There have been no reports of this harming human helminths and three reports confirming that it does not harm NA. [https://www.facebook.com/groups/htsupport/posts/7846458328743387?comment_id=7847087392013814][https://www.facebook.com/groups/htsupport/permalink/513613715361255/?comment_id=514186115304015&comment_tracking=%7B%22tn%22:%22R0%22%7D][https://www.facebook.com/groups/htsupport/permalink/792437597478864/?comment_id=792881060767851&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R3%22%7D]

* [https://en.wikipedia.org/wiki/Lipoic_acid Alpha lipoic acid] (ALA), also known as Lipoic acid (LA), α-lipoic acid and thioctic acid. This organosulphur compound is made naturally in animals, where it is essential for aerobic metabolism. Because of its antioxidant properties, it is also sold as a dietary supplement and is available in some countries as a pharmaceutical drug. One host of both hookworms and human whipworms has taken between 300 and 600 mg of alpha lipoic acid per day without any harm befalling their worms.

* [https://en.wikipedia.org/wiki/Amine_oxidase Amine oxidase] (also known as diamine oxidase, DAO and histaminase). This enzyme, which is involved in the metabolism of histamine, is produced by the body and found in high concentrations in the digestive tract and placenta. It has therefore been suggested [https://www.facebook.com/groups/htsupport/permalink/883903308332292/?comment_id=883916171664339&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] that it is unlikely to be harmful to helminths, although there are not yet any reports to confirm this.

* [https://aseaglobal.com ASEA] Redox Supplement. This “catalytically processed” saline solution should not harm helminths, a fact confirmed by one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/2127858607270083/?comment_id=2129186490470628&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://atrantil.com/ Atrantil] contains three active botanicals: M. balsamea Willd (peppermint) leaf extract, quebracho extract and conker tree extract. While ⚡'''peppermint oil''' has proved to be a problem for some hosts of human helminths (see [[#Peppermint|peppermint reference]]), it is possible that the leaf extract may be worm-safe. However, quebracho extract has been shown to effectively reduce worm burdens in sheep. [http://www.fao.org/docs/eims/upload/agrotech/1905/R7424%20(04)%20Embu%20proceedings.pdf]

* ❓ Avocado seed extract. Extracts of the seeds of the avocado - also known as alligator pear or avocado pear ([https://en.wikipedia.org/wiki/Avocado Persea americana]) - may have an adverse effect on NA. While there have been no reports so far of this effect from self treaters who host either NA or TTO, caution is recommended when trying these extracts because there is scientific evidence suggesting that they possess broad spectrum anthelmintic activity against several other nematode species.

* [https://en.wikipedia.org/wiki/Bee_pollen Bee pollen]. One hookworm host has reported that eating small amounts of this has had no obvious adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Beta-Sitosterol beta-Sitosterol] has demonstrated anthelmintic effects [https://www.ncbi.nlm.nih.gov/pubmed/12587699] and three hookworm hosts have reported a return of their disease symptoms after taking beta-Sitosterol. (expired link), [https://www.facebook.com/groups/htsupport/permalink/1143218725734081/?comment_id=1146128268776460&comment_tracking=%7B%22tn%22:%22R0%22%7D], [https://www.facebook.com/groups/htsupport/posts/7569548336434389/]

* [http://www.webmd.com/vitamins-supplements/ingredientmono-312-BETAINE%20HYDROCHLORIDE.aspx?activeIngredientId=312&activeIngredientName=BETAINE%20HYDROCHLORIDE Betaine hydrochloride]. Two hookworm hosts have reported using betaine HCL without noticing any loss of benefits from their worms. [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106534052735882&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106538649402089&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://www.facebook.com/groups/htsupport/permalink/2070288819693729/?comment_id=2070391136350164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Boron Boron] and [https://en.wikipedia.org/wiki/Borax Borax]. Boron is a chemical element and a trace element in human and plant nutrition. Only small amounts of boron are required for health and an excess can be toxic. It is unlikely to have an adverse effect on helminths when consumed in dietary quantities. Borax is a mineral containing boron which has antifungal properties and also certain [https://en.wikipedia.org/wiki/Borax#Toxicity health risks]. One hookworm host has reported taking 1/2 teaspoon borax per day for 6-7 weeks without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/1232677046788248/?comment_id=1404263146296303&reply_comment_id=1404577376264880&comment_tracking=%7B%22tn%22%3A%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1404253479630603/?comment_id=1404658099590141&reply_comment_id=1405046696217948&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/BPC-157 Bpc 157] This pentadecapeptide, also known as PL 14736, was taken intranasally over 4 days by one NA host who has reported no negative effect on his colony in that time. [https://www.facebook.com/groups/htsupport/posts/6283059368416632/?comment_id=6283148771741025]

* [https://en.wikipedia.org/wiki/Chlorella Chlorella]. One hookworm host took ½ teaspoon of this single-cell green algae daily for a year without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1037512569638031/?comment_id=1037568506299104&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Chlorophyllin Chlorophyllin]. This semi-synthetic derivative of chlorophyll is used as a food colouring agent (e.g., E number E141) and as a treatment aimed at reducing various bodily odours, but its suitability for use by helminth hosts has been questioned because of its apparent [https://www.ncbi.nlm.nih.gov/pubmed/19009310 ability to kill mosquito larvae and other small animals] at low concentrations, although this effect appears to be dependent on the presence of sunlight. (Also see ✅[[#Chlorophyll|Chlorophyll]].)

* [https://en.wikipedia.org/wiki/Chondroitin_sulfate Chondroitin Sulfate]. In an animal study, chondroitin sulfate was shown to prevent threadworms from establishing in the digestive system, but one NA host has taken 900 mg daily for several years without any adverse effect on his worms.

* [https://en.wikipedia.org/wiki/Colostrum Colostrum]. A hookworm host has taken this without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1145589722163648/?comment_id=1145807582141862&comment_tracking=%7B%22tn%22:%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/Mannose D-mannose]. This naturally occurring simple sugar is the ingredient in cranberries that makes their juice effective against urinary tract infections. Pure D-mannose is 10-50 times stronger than cranberry juice, making it more suitable for stubborn cases of UTI, and it reportedly resolves more than 90% of all UTIs within 1-2 days. [https://web.archive.org/web/20210211080155/http://www.tahomaclinicblog.com/d-mannose-for-bladder-and-kidney-infections/], [http://www.townsendletter.com/May2014/gaby0514.html] Taking steps to make the urine less acidic (e.g., by taking Tums[https://www.tums.com/]) might [http://www.sciencedaily.com/releases/2015/06/150625161623.htm make cranberry-based treatments even more effective]. D-mannose is non-toxic, produces no adverse effects and, while there have been no reports to confirm it’s lack of adverse effects on human helminths, it is unlikely to do them any harm.

* ⚡ [https://en.wikipedia.org/wiki/Digestive_enzymes Digestive enzymes], such as papain and bromelain, are said to make the intestinal tract inhospitable to parasites by dissolving their outer layers. In particular, papain - the milky juice of the unripe papaya - is claimed to be a powerful agent for destroying roundworms. One subject has reported a return of symptoms after taking a product containing papain, bromelain, protease, lipase and amylase for several weeks, and another individual has reported losing their entire hookworm colony after taking ''Healthy Origins Broad Spectrum Digestive Enzymes'' [https://healthyoriginseurope.com/products/digestive-enzymes-nec-broad-spectrum?variant=31997110714427] (amylase, protease, peptidase, alpha-galactosidase, glucoamylase, acid maltase, cellulase, pectinase, protease, lipase, lactase, beta-glucanase, invertase and hemicellulase). However, several other hookworm hosts have taken digestive enzymes, including ''Terranova's Quercetin Nettle Complex'' which contains bromelain, without any obvious effect on their worms, [https://www.facebook.com/groups/htsupport/permalink/888731831182773/?comment_id=888738757848747&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] and one of these has regularly taken pancreatin-based products from different manufacturers, mostly from ''Pure Encapsulations'', but also a lipase product by ''Integrative Therapeutics''. Another hookworm host who regularly takes digestive enzymes but has never noticed any adverse effect on his colony, generally avoids papain and bromelain, but regularly takes pancreatin, lipase, ''Acid Ease'', and occasionally ''Udo's Choice'' enzymes. Udo's Choice brand does contain some bromelain, but only a small amount. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] One NA host has reported that 500 mg bromelain twice daily appeared to be well tolerated by his hookworms, and someone else noticed no adverse effect on his NA colony after taking ''Enzymedica Digest Spectrum Multiple Food Intolerance Formula'' (amylase, xylanase, protease, alpha galactosidase, glucoamylase, lactase, lipase, maltase, cellulase, invertase, pectinase and hemicellulase). [https://www.facebook.com/groups/htsupport/posts/4876772765711973?comment_id=4879285832127333] And two other NA hosts have taken a product containing lipase (40,000 USP units), protease (126,000 USP units) and amylase (168,000 USP units) without issue. [https://www.facebook.com/groups/htsupport/posts/6285531644836071/?comment_id=6285909298131639]See also ✅[[#Papaya|Papaya]], and, for a brief explanation of how to stimulate one’s own natural enzyme production using a simple form of micro-massage, see [https://www.foodsmatter.com/nutrition_micronutrition/miscellaneous/articles/free_digestive_enzymes.html this article].

* [https://en.wikipedia.org/wiki/3,3%27-Diindolylmethane Diindolylmethane (DIM)]. 3,3′-Diindolylmethane has never been mentioned by hosts of human helminths as being harmful to their worm colonies, which is unsurprising because it’s a natural compound that is created in the body from the digestion of cruciferous vegetables such as cauliflower, broccoli and Brussels sprouts. Supplements containing DIM are simply a concentrated form of this natural substance.

* [https://en.wikipedia.org/wiki/Folic_acid Folic Acid] has been claimed to help prevent the proliferation of intestinal parasites at a dosage of 400 - 800 mcg (0.4 - 0.8 mg) per day. However, this is not a problem for human helminths because they do not proliferate within their hosts, and there have been no reports of adverse effects from hosts of human worms. One subject has taken a daily vitamin B-complex supplement containing 400 mcg of folic acid without any apparent effect on his hookworms, and another has taken 800 mcg of folate (as calcium L-5 methyltetrahydrofolate) every day for over 4 years with no adverse effect on his hookworms.

* [https://en.wikipedia.org/wiki/Fructooligosaccharide FOS] (fructooligosaccharide) is said to inhibit parasites from attaching to the intestines but no helminth host has reported any problem with this so far.

* [https://en.wikipedia.org/wiki/Fulvic_acid Fulvic acid]. This is a form of [https://en.wikipedia.org/wiki/Humic_acid humic acid] which two hookworm hosts have taken without any apparent adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/] [https://www.facebook.com/groups/htsupport/permalink/1132472786808675/?comment_id=1132930603429560&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Ginseng Ginseng]. Members of the genus, [https://en.wikipedia.org/wiki/Panax Panax], appear not to be harmful to human helminths, and one hookworm host has reported taking ginseng without noticing any untoward effect. [https://www.facebook.com/groups/htsupport/permalink/1453317641390853/?comment_id=1453345564721394&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Glucosamine Glucosamine] may be beneficial for roundworms. Applying this amino sugar experimentally to one roundworm species caused the treated worms to live around 5% longer than their untreated counterparts. [http://www.medicalnewstoday.com/releases/275263.php]

* [https://en.wikipedia.org/wiki/Glutathione Glutathione]. One hookworm host who has taken [https://en.wikipedia.org/wiki/Liposome liposomal glutathione] says he’s confident that this did not harm his worms, [https://www.facebook.com/groups/htsupport/permalink/803451913044099/?comment_id=803468529709104&offset=0&total_comments=6] and several people who have taken other oral glutathione supplements have reported no adverse effects. A hookworm host who received intravenous injections containing glutathione experienced no adverse effect on her NA colony. [https://www.facebook.com/groups/htsupport/permalink/1668651476524134/?comment_id=1668819739840641&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Grape_seed_extract Grape seed extract]. After taking 4 capsules of a product containing 200mg grape extract, 200mg grape seed extract and 200mg Muscadine grape every day for 2 weeks, one hookworm host carried out a successful incubation, indicating that the product had not adversely affected her colony. [https://www.facebook.com/groups/htsupport/permalink/2233069223415687/?comment_id=2282502821805660&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (Also see [[#Grapefruit seed extract (GSE)|Grapefruit seed extract (GSE)]], which can adversely affect human helminths in some people.)

* [https://en.wikipedia.org/wiki/Inulin Inulin] Knowing that chicory can have an adverse effect on human hookworms, a few hookworm hosts have been concerned when finding "inulin from chicory" listed among the ingredients in some supplements. However, while chicory root is a common source of inulin, its commercial processing removes everything but the fructose-based polysaccharide - the dietary fibre which is used in food supplements and to sweeten, or otherwise improve the nutritional value of, manufactured food products. Inulin is therefore not considered to be a threat to human helminths.

* [https://en.wikipedia.org/wiki/Iron Iron]. Supplementary iron taken orally does not harm helminths, but one hookworm host has reported having apparently lost her worms on two occasions after receiving ❓intravenous iron infusions. [https://www.facebook.com/groups/htsupport/permalink/2033546613367950/?comment_id=2033644093358202&reply_comment_id=2033832696672675&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓Lumbricus Tonic. This discontinued [https://www.nutricology.com Nutricology] product contained a powdered earthworm extract as well as ⚡'''sweet flag''' root extract. The herb was last on the list of ingredients however, and there had been no reports by hosts of therapeutic helminths to suggest that the product might be a problem for worms.

* [https://en.wikipedia.org/wiki/Melatonin Melatonin]. This hormone, which is commonly used as a sleep aid, has been taken by many helminth hosts, none of whom have reported any adverse effects on their worm colonies.

* [https://en.wikipedia.org/wiki/Modified_citrus_pectin Modified citrus pectin] (also known as citrus pectin, Pecta-Sol, PectaSol and MCP) is a complex carbohydrate extracted from citrus fruits using a chemical extraction process that makes it soluble, absorbable and more digestible. This is unlikely to have any effect on helminths.

* [https://en.wikipedia.org/wiki/Moringa_oleifera Moringa] (Moringa oleifera, also known as drumstick tree, horseradish tree, ben oil tree and benzoil tree) Although described as a “natural anthelmintic”, moringa has been taken by two helminth self-treaters with no apparent adverse effect on their hookworms. The first takes a 500 mg capsule of 10 to 1 extract (from 5000 mg of Moringa olifeira) twice a week, [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1039406139448674&reply_comment_id=1039533526102602&comment_tracking=%7B%22tn%22:%22R4%22%7D] while the second grows and harvests her own moringa. [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1040747242647897&comment_tracking=%7B%22tn%22:%22R%22%7D] Whatever anthelmintic properties moringa might have may depend on the part of the plant used.

*❓[https://en.wikipedia.org/wiki/Methylsulfonylmethane MSM] (Methylsulfonylmethane) is claimed by one source to be effective against many types of intestinal worm including Enterobius (pinworm [US], threadworm [UK]) and the roundworm, Ascaris. It is suggested that MSM blocks the interface between the parasite and the host by competing with the parasite for binding sites at the surface of the mucous membrane, and that the parasites may find the resulting MSM 'film' impenetrable. However, it may be necessary to take 10,000 mg of MSM per day for three or four weeks to achieve this effect, and one helminth host has reported that he has occasionally taken up to 1 heaped tablespoon of MSM while hosting helminths to treat eczema flare-ups, and has not noticed any loss of worm benefits. Someone else who takes a heaped teaspoonful of equine MSM every other day has also reported observing no adverse effects on her NA. [https://www.facebook.com/groups/htsupport/posts/4170339756355281?comment_id=4174905152565408]

* [https://en.wikipedia.org/wiki/Nattokinase Nattokinase] This serine protease (or serine endopeptidase), which is taken as a nutritional supplement, is an enzyme that cleaves peptide bonds in proteins. Two NA hosts have reported taking 200 mg and 500 mg respectively twice daily with no adverse effect on their hookworm colonies.

* [https://en.wikipedia.org/wiki/Omega-3_fatty_acid Omega-3 fatty acid] supplements are taken regularly by a large number of people, and have not been reported to be harmful to any helminth species. Indeed, omega-3 fatty acids have been found to extend the lifespan of some worms. [https://pubmed.ncbi.nlm.nih.gov/28772063/]

*❓[https://en.wikipedia.org/wiki/Seaprose_S Oryzin] (Aspergillus alkaline proteinase, aspergillopeptidase B, API 21, aspergillopepsin B, aspergillopepsin F, Aspergillus candidus alkaline proteinase, Aspergillus flavus alkaline proteinase, Aspergillus melleus semi-alkaline proteinase, Aspergillus oryzae alkaline proteinase, Aspergillus parasiticus alkaline proteinase, Aspergillus serine proteinase, Aspergillus sydowi alkaline proteinase, Aspergillus soya alkaline proteinase, Aspergillus melleus alkaline proteinase, Aspergillus sulphureus alkaline proteinase, prozyme, P 5380, kyorinase, seaprose S, semialkaline protease, sumizyme MP, prozyme 10, onoprose, onoprose SA, protease P, promelase.) There have been no reports as yet about the possible effects on human helminths of taking this mould/mold-derived proteinase.

* [https://en.wikipedia.org/wiki/Palmitoylethanolamide Palmitoylethanolamide] (PEA) This is unlikely to harm NA, and one NA host who took it for a number of weeks has confirmed that it didn’t harm his worms. [https://www.facebook.com/groups/htsupport/posts/6318336784888890/?comment_id=6318488838207018]

* [https://en.wikipedia.org/wiki/Probiotic Probiotics]. There are many hosts of the human helminths, NA and TTO, who take probiotics regularly, in some cases several different ones each day, [https://www.facebook.com/groups/htsupport/permalink/2644164455639493/?comment_id=2645824198806852] yet there have been no reports by any of them that their worms have been adversely affected. [https://en.wikipedia.org/wiki/Akkermansia_muciniphila Akkermansia muciniphila] was initially suspected in two cases of having caused a loss of hookworms, but these events were more likely to have been the result of the extended adverse reaction that can often be experienced to this particular probiotic when it is first taken, can last for several weeks [https://www.facebook.com/groups/htsupport/posts/8333525306703351/?comment_id=8456943157694898&reply_comment_id=8459002264155654] and, in one case, may have lasted for a couple of months. [https://www.facebook.com/groups/htsupport/posts/8333525306703351?comment_id=8456943157694898&reply_comment_id=8459072834148597] It is known that a number of probiotics - predominantly Lactobacillus species - can have strain-specific effects on certain “parasites”, and, while most of these are not helminths, [https://www.hindawi.com/journals/jpr/2011/610769/] there is some evidence that the milk-based probiotics, lactobacilli and bifidobacteria, may reduce the benefits of HDC. [https://helminthictherapywiki.org/wiki/Self-treating_with_HDC#Probiotics] It is known that some bacteria are capable of mobilizing nematode-trapping fungi, [http://www.nature.com/articles/ncomms6776] and that Saccharomyces boulardii can have an adverse effect on the dog roundworm, Toxocara canis, [http://www.ncbi.nlm.nih.gov/pubmed/26971490] but S. boulardii and soil-based organisms are likely to be OK for HDC, and S. boulardii has been taken by at least two hookworm hosts without any obvious effect on their worms.

*❓[https://en.wikipedia.org/wiki/Propolis Propolis]. An apitherapist speaking at the 2010 International [http://www.bterfoundation.org BTeR Foundation] Conference on Biotherapy had spoken about the antiparasitic properties of this bee product, and suggested that it might harm helminths. Then, a paper published in 2020 revealed that Brazilian red propolis exhibits antiparasitic properties both in vitro and in vivo, and reduces worm burdens and egg production in a mouse model of infection by the helminth, Schistosoma mansoni. [https://pubmed.ncbi.nlm.nih.gov/32918996/] While this new research does not prove that propolis will be harmful to therapeutic helminths, it does make this possibility look more likely. However, one NA host has reported consuming propolis in the form of a dark brown chewing gum, without any obvious effect on his colony. He also reports that the content of propolis varies widely depending on the plants growing around the hive. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3465063380216259] This variation in constituents also results in propolis from different locations having different colours, and it's possible that the different colours might have differing effects on helminths, with green propolis ''possibly'' being the safest. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3703669629688965]

* [https://en.wikipedia.org/wiki/Psyllium Psyllium] appears not to harm hookworms, and one NA host has reported taking 4 rounded tsp of Metamucil (containing powdered psyllium seed husks) every day without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/3363462447043020?comment_id=3364793813576550]. However, psyllium is said to be effective in helping to remove parasite eggs from, and preventing parasites "taking root" in, the gut [https://gutbliss.com/psyllium-husk-a-complete-guide/] and there are indications from one TT host that his regular use of psyllium may be reducing his TT colony and preventing him from culturing this species.

* [https://en.wikipedia.org/wiki/Pyrroloquinoline_quinone Pyrroloquinoline quinone (PQQ)] This enzyme cofactor has been taken by several hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248812458508040&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248893555166597&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Quercetin Quercetin]. Although identified as a promising lead candidate for development as an anthelmintic product, [https://www.nature.com/articles/s41598-025-34049-5] self-treaters have reported that, if taken on its own, quercetin does not harm therapeutic helminths. [https://www.facebook.com/groups/htsupport/permalink/2403427306379877/?comment_id=2404196192969655] [https://www.facebook.com/groups/htsupport/posts/5173747102681203?comment_id=5173760879346492] However, if it is combined with a digestive enzyme - as it often is, to improve absorption - helminths may be adversely affected. See entry for ⚡[[#Digestive enzymes|Digestive enzymes]].

* [https://intelligenceofnature.com/pages/restore Restore]. This supplement, the active ingredient in which is Terrahydrite, was used by someone reporting that her colony is normally particularly sensitive, but was unaffected when she took Restore for long periods. [https://www.facebook.com/groups/htsupport/permalink/1967905053265440/?comment_id=1967995116589767&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Resveratrol Resveratrol]. This may have an adverse effect on some helminths, [http://www.ncbi.nlm.nih.gov/pubmed/19562377] but this is likely to depend on dose size, and three hosts of human helminths who regularly take this compound report no adverse effect on their worms. One has taken “Perfect Resgrape Max” (400 mg trans-resveratrol) daily for many months with no apparent ill effects on her NA. [https://www.facebook.com/groups/htsupport/permalink/1803160683073212/?comment_id=1803255516397062&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (People with MS might want to avoid resveratrol anyway. [http://medicalxpress.com/news/2013-09-resveratrol-red-wine-worsens-ms-like.html])

* [https://en.wikipedia.org/wiki/S-Adenosyl_methionine S-Adenosyl methionine] (SAM, also known as SAMe, SAM-e or AdoMet) has only been reported on by one hookworm host, who observed no adverse effect on his worms after taking 200-400mg SamE per day for several months.

* [https://en.wikipedia.org/wiki/Serratiopeptidase Serrapeptase] (also known as serratiopeptidase, Serratia E-15 protease, serralysin, serratiapeptase, serratia peptidase, serratio peptidase, or serrapeptidase). This proteolytic enzyme (protease) has been taken occasionally by one TTO host two or three times per day over a 4 year period to treat intestinal spasm, without affecting her worms. [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357766200945998&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357787397610545&reply_comment_id=1385081271547824&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has also been taken (at 160k SPU [80mg] per day) for prolonged periods by a hookworm host with no apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&reply_comment_id=2244261005629842&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Spirulina_(dietary_supplement) Spirulina]. This cyanobacterium is [http://www.ncbi.nlm.nih.gov/pubmed/25599112 an effective anti-inflammatory] that is being used by a number of hosts of human helminths without causing any harm to their worms. One hookworm host takes 10 grams of spirulina every day without noticing any deleterious effects on his colony. [https://www.facebook.com/groups/htsupport/permalink/2041940819195196/?comment_id=2043585499030728&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, it is worth noting that a significant proportion of algae-derived products tested in one study were found to contain an unhealthy amount of cyanotoxins caused by overgrowth of cyanobacteria due to the dumping of agricultural fertilisers into waterways. These bacterial products might not harm helminths, but they can contribute to neurological disorders like ALS in humans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371831/]

* [https://en.wikipedia.org/wiki/Sulforaphane Sulforaphane / sulphoraphane] This organosulfur compound, which is obtained from cruciferous vegetables such as broccoli, Brussels sprouts and cabbages, has been taken in large amounts by one hookworm host without it affecting his colony. [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&reply_comment_id=1724935230895758&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Taurine Taurine] is an organic acid that occurs naturally in food, especially seafood and meat (in which form it is no threat to helminths) but it is also produced synthetically and included in a number of products such as health drinks. In this form, it has been linked to a number of [https://web.archive.org/web/20201030111526/https://healthiertalk.com/dangers-taurine-commonly-found-energy-drinks-0996/ health problems], and has consequently been banned in some countries. It has also been shown to have anthelmintic effects, but only against a non-therapeutic helminth [http://www.ncbi.nlm.nih.gov/pubmed/23832642 in mice]. One helminth self-treater has taken 3 grams of taurine per day without any adverse effect on her hookworms. [https://www.facebook.com/groups/htsupport/permalink/2178145842241359/]

* [https://en.wikipedia.org/wiki/Theanine Theanine] This amino acid analogue is commonly known as L-theanine and sometimes L-gamma-glutamylethylamide or N5-ethyl-L-glutamine. It is not to be confused with threonine (a distinct amino acid), theine (an ancient name for caffeine) or thiamine (a B vitamin). Theanine is safe for use by helminth hosts. [https://www.facebook.com/groups/htsupport/posts/8722883501100861/?comment_id=8723517234370821]

* [https://en.wikipedia.org/wiki/Zinc Zinc] is said to inhibit the proliferation of intestinal parasites by stimulating various aspects of the immune system in the digestive tract that counteract parasites. In one animal study [http://jn.nutrition.org/content/130/5/1412S.full] the rodent nematode worm, H. polygyrus, was found to be better able to survive in mice which had been deliberately made deficient in zinc. Those who claim that zinc is an effective antiparasitic in humans suggest a dosage of 15-50 mg per day, but several helminth hosts have taken supplements containing this amount of zinc, in some cases continuously, without issue. One hookworm host takes 10 mg on alternate days, [https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930318850357404&comment_tracking=%7B%22tn%22:%22R0%22%7D],[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930807120308577&comment_tracking=%7B%22tn%22:%22R%22%7D] another has taken 15 mg zinc gluconate or zinc picolinate daily for several years, while yet another has taken 23 mg zinc gluconate/citrate plus 18.75 mg zinc acetate daily, and previously took 30mg zinc picolinate daily[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=943449092377713&comment_tracking=%7B%22tn%22%3A%22R%22%7D], all without any apparent adverse effect on their worms. However, someone who was trying to grow his own hookworms had no success with incubation while he was taking a zinc supplement, the dose of which he had increased slowly to a maximum of 130 mg/day. Three weeks after he stopped all zinc intake, he found NA larvae in his incubations for the first time. [https://www.facebook.com/groups/678894952216125/posts/4716370328468547] ❌[https://en.wikipedia.org/wiki/Zinc_oxide%23ZnO_nanostructures Zinc oxide nanoparticles (ZnO NPs)] have shown strong anthelmintic effects, in vitro, against several gastrointestinal nematodes encountered in veterinary medicine. [http://www.ncbi.nlm.nih.gov/pubmed/26177503] [https://www.ncbi.nlm.nih.gov/pubmed/29975659] [https://www.ncbi.nlm.nih.gov/pubmed/31931890] As well as their topical use in sunscreens and cosmetics, zinc oxide nanoparticles are also used in some food products (in spite of the fact that they can cause DNA damage), but the amounts used in this application may be too small to harm human helminths.

* [https://en.wikipedia.org/wiki/Vitamin_A Vitamin A]. Supplementation with this vitamin has no adverse effect on helminths [https://www.ncbi.nlm.nih.gov/pubmed/25127885] but a vitamin A deficiency may reduce colonisation by worms. [https://www.ncbi.nlm.nih.gov/pubmed/24458645]

* [https://en.wikipedia.org/wiki/Vitamin_C Vitamin C]. This does not harm helminths, even in high doses.

* Xuezikhang, a [https://en.wikipedia.org/wiki/Red_yeast_rice red yeast rice] product, appears to be harmless to hookworms. [https://www.facebook.com/groups/htsupport/permalink/1347982335257718/?comment_id=1348392021883416&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



=== Spices and culinary herbs ===
<blockquote>

* ❓ [https://en.wikipedia.org/wiki/Annatto Annatto / roucou] (Bixa orellana). One in vitro study found that higher concentrations of extracts of B. orellana seeds were effective against the earthworm species, Eisenia fetida, [https://www.researchgate.net/publication/356635196_Evaluation_of_Antihelminthic_Activity_of_Bixa_orellana] but it was not tested in intestinal helminths. There has been a single claim [https://www.reddit.com/r/HelminthicTherapy/comments/wmm6im/caution_annatto_can_harm_na] by an NA host of a return of disease symptoms shortly after starting to take an annatto and rice dietary supplement containing a high concentration of delta-tocotrienol, a form of vitamin E: [https://tricutis-shop.de/DeltaTop-delta-Tocotrienol DeltaTop delta-Tocotrienol].

* ❓ [https://en.wikipedia.org/wiki/Asafoetida Asafoetida] has been used as an anthelmintic in traditional medicine in several parts of the world [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459456/] but there has only been one report to date of its use by someone hosting therapeutic helminths, and this user says that he hasn’t noticed any ill effect on his hookworms after occasionally consuming foods that list asafoetida as an ingredient.

* ✅ [https://en.wikipedia.org/wiki/Basil Basil] Ocimum basilicum, also called great basil, is a culinary herb in the family Lamiaceae (mints) used in cuisines worldwide. In Western cuisine, the generic term "basil" refers to the variety also known as Genovese basil or sweet basil, of which there are many cultivars, including Napolitano basil, also known as Napoletano basil, Neapolitan basil, Mammoth basil, Bolloso Napoletano basil, Napolitano Mammoth-Leafed basil and Italian Large-Leaf basil. Several hookworm hosts have eaten basil and drunk tea made from it without any harm befalling their worms [https://www.facebook.com/groups/htsupport/permalink/872768092779147/?comment_id=872772372778719&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7987286861327199?comment_id=7987574677965084] [https://www.facebook.com/groups/htsupport/posts/7987286861327199/?comment_id=7992929767429575] ❓[https://en.wikipedia.org/wiki/Ocimum_tenuiflorum '''Holy basil'''] (Ocimum tenuiflorum, also known as Ocimum sanctum, tulsi and tulasi/thulasi) is claimed online to be antiparasitic. There is also evidence showing that its essential oil has potent anthelmintic activity, including against the research worm, C. elegans, [http://www.ncbi.nlm.nih.gov/pubmed/11543966] and it has shown some activity against the malaria parasite, [http://www.ncbi.nlm.nih.gov/pubmed/21643655] but there is no indication yet as to how Holy Basil might affect human helminths. Holy Basil is used for religious purposes, in traditional medicine and Ayurveda. It is also used for its essential oil and is widely used as an herbal tea.

* ⚡ [https://en.wikipedia.org/wiki/Black_pepper Black pepper] (Piper nigrum). This is often used as an ingredient in proprietary parasite cleanses due to its established antiparasitic effects. It could therefore have an adverse effect on human helminths, though this is likely to be dependent on the dosage and on the form taken. So, while use of the whole spice in small quantities as a condiment is unlikely to present a problem, taking medicinal quantities of black pepper may harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Bunium_bulbocastanum Bunium bulbocastanum] This vegetable/spice, which is commonly called black cumin, great pignut, black zira or earthnut, is thought to be harmless to helminths when consumed in dietary quantities.

* ⚡ [https://en.wikipedia.org/wiki/Cayenne_pepper Cayenne] (Cayenne pepper is a type of [https://en.wikipedia.org/wiki/Capsicum_annuum Capsicum annuum], and cayenne powder is generally made from [https://en.wikipedia.org/wiki/Bird%27s_eye_chili bird's eye chili peppers], which are classified as [https://archive.org/details/spiceshenry00ridlrich/page/360/mode/2up?view=theater Capsicum minimum] and often mistaken for the similar-looking [https://en.wikipedia.org/wiki/Capsicum_frutescens Capsicum frutescens], cultivar [https://en.wikipedia.org/wiki/Siling_labuyo siling labuyo], the fruits of which are generally smaller and grow in an upwards direction.) Cayenne is claimed to irritate parasites, and often appears as an ingredient in proprietary parasite cleansing products for pets and humans. There have been a couple of reports of an adverse effect on hookworms, including from someone who says that even a smidgen of cayenne causes her to temporarily lose the benefits from her worms. [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1063030367086251&reply_comment_id=1063315093724445&comment_tracking=%7B%22tn%22:%22R1%22%7D] Someone else who has reported a loss of benefits after taking a "lot" of cayenne, has said that their benefits also returned after they stopping taking the cayenne. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1951836918205587&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1956996454356300&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another cayenne user who reported that, in her early days with NA, she topped some meals with about ⅛ tsp of cayenne, has said that, in her case, the worms seemed to be unaffected. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1952375724818373&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Chili_pepper Chili pepper] (chile, chile pepper, chilli pepper, or chilli). While this is used worldwide as a treatment of certain parasites, and has been demonstrated effective against fascioliasis in animals, evidence that chili might be a problem for therapeutic helminths is lacking. One hookworm host has reported that, while cayenne has had negative responses for him, chilli peppers have not been a problem in his experience, [https://www.facebook.com/groups/htsupport/posts/892904287432194?comment_id=6868887949833768] and nor have jalapenos, whether fresh or pickled. [https://www.facebook.com/groups/htsupport/posts/6863122353743661/?comment_id=6868980269824536] Another hookworm host has been reported [https://www.facebook.com/groups/htsupport/permalink/892904287432194/?comment_id=892912737431349&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] to have eaten a HUGE amount of chili during 4 years as a worm host, without any obvious adverse effect on his colony.

* ⚡ [https://en.wikipedia.org/wiki/Cinnamon Cinnamon] is antimicrobial, as well as being claimed to be effective against parasites, including some parasitic worms, and it appears in lists of ingredients in proprietary parasite cleansing products. The main antimicrobial component of cinnamon is ⚡[https://en.wikipedia.org/wiki/Cinnamaldehyde cinnamaldehyde], and this is most concentrated in cinnamon essential oil and cinnamon oleoresins (solid resin extracts produced using solvents) which can be very high in cinnamaldehyde. Forms containing somewhat less cinnamaldehyde are raw cinnamon and cinnamon tinctures which are dissolved in alcohol and about half the strength of raw cinnamon. As cinnamaldehyde is steam-volatile and not water soluble, aqueous extracts of cinnamon should contain less of this substance, and dehydrated/powdered extracts (the form most likely to be encountered in dietary supplements) may contain little, if any at all, so should be less of a threat to helminths. [https://www.facebook.com/groups/htsupport/permalink/2225192197536723/?comment_id=2226458237410119&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Generally, the stronger the taste, the more cinnamaldehyde is likely to be present. While the raw spice is generally safe for use in cooking, there has been one report of someone with helminths relapsing after taking an unspecified supplement containing cinnamon, (link expired) and another report of a return of symptoms after eating a rice pudding made with cinnamon. (Link expired)

* ⚡ [https://en.wikipedia.org/wiki/Clove Clove] (Syzygium aromaticum/Eugenia caryophyllus). Clove oil, which was used traditionally to kill intestinal worms and is claimed to anesthetize fish, contains several powerful antimicrobial agents. While one of these, [https://en.wikipedia.org/wiki/Eugenol eugenol], is claimed to be anthelmintic, its use didn't produce any loss of benefit in one helminth host who applied it liberally to a dry socket following a difficult tooth extraction, and this was in spite of swallowing and breathing eugenol and a related compound called guaiacol.

* ✅ [https://en.wikipedia.org/wiki/Cumin Cumin] (Cuminum cyminum) also known as Roman caraway. While the essential oil derived from this spice has shown efficacy against [https://en.wikipedia.org/wiki/Anisakis Anisakis], a nematode that parasitises fish and marine mammals, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130707/] dietary use of the spice is thought to be harmless to human helminths. But see also, ❌ [[#Bitter cumin|Bitter cumin]], ❌ [[#Black cumin|Black cumin]] and Bunium bulbocastanum (sometimes also called black cumin).

* ❓[https://en.wikipedia.org/wiki/Elwendia_persica Elwendia persica] (aka Bunium persicum, a close relative of Bunium bulbocastanum). The possible effect of this plant on helminths is as yet unknown.

* ✅ [https://en.wikipedia.org/wiki/Fennel Fennel] (Foeniculum vulgare). Fennel seed has a long history of use against pinworms and other parasites, with some authorities suggesting that the herb digests parasite eggs and intoxicates parasites. The leaves and oil are both used as dewormers, but one subject has reported no adverse effect from repeated consumption of dietary amounts of fennel seeds (link expired) and another has reported [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ no loss of worm benefits] after consuming significant quantities of fennel.

* ⚡ [https://en.wikipedia.org/wiki/Fenugreek Fenugreek] (Trigonella foenum-graecum). Both the leaves and seeds of fenugreek have been reported to have anthelmintic properties. Alcoholic extracts of the seeds have shown a dose-dependent inhibition of motility (paralysis) in earthworms, [https://www.researchgate.net/publication/49600762_In_vitro_anthelmintic_activity_of_Fenugreek_seeds_extract_against_Pheritima_posthuma] and an aqueous extract of fenugreek leaves has also shown noteworthy anthelmintic activity against earthworms. [https://www.researchgate.net/publication/303787324_In-vitro_anthelmintic_activity_of_fenugreek_leaves_aqueous_extract_in_Indian_earthworms] After taking half a teaspoon of powdered fenugreek seeds every day for a week, one hookworm host found that his allergies returned with a vengeance. [https://www.facebook.com/groups/htsupport/permalink/1426906954031922/] However, another hookworm host ate about 150 grams of fenugreek leaves in a 2 week period without affecting his worms. [https://www.facebook.com/groups/htsupport/permalink/1406562676066350/?comment_id=1406580359397915&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Garam_masala Garam Masala] The constituents of this blend of ground spices vary between geographical regions, but the majority of the commonly used ingredients do not have anthelmintic properties, thus minimising the anthelmintic potential of any blend that might include one or two items that could be harmful to worms when used on their own. So garam masala is very unlikely to harm helminths.

* ✅ Garlic (Allium sativum). Garlic compounds have demonstrated anthelmintic activity against flatworms in mice, [https://www.ncbi.nlm.nih.gov/pubmed/28536879] garlic oil extract has shown anthelmintic effects against Schistosoma mansoni in mice [http://www.sciencedirect.com/science/article/pii/S1995764515002011] and allicin, the active principle of garlic extract, has also been shown to have anthelmintic properties, although one hookworm host has reported that taking a stabilized allicin extract for several weeks did not kill her worms. [https://www.facebook.com/groups/htsupport/permalink/859756094080347/?comment_id=1146360268753260&comment_tracking=%7B%22tn%22:%22R3%22%7D] Alcoholic extracts of garlic have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424]. However, the exact amount of garlic needed to kill intestinal parasites in humans has not been established. Some sources suggest 1,000 - 4,000 mg per day, using concentrated garlic capsules or tablets, and fresh garlic is said to be more effective than capsules. While chewing three cloves of garlic each day is recommended by some online sources as a treatment for ‘parasites’ in humans, the ingestion of 9 to 14 g of raw garlic daily (54 g total) or 15 to 21 g daily (89 g total) had no evident effect on the egg output of NA in one host, [http://www.ajtmh.org/content/journals/10.4269/ajtmh.1969.18.920] so hookworms may in fact be able to withstand up to 21 grams (approximately 10 cloves) of garlic per day. This means that garlic is unlikely to be an effective killer of mature worms, and its main anthelmintic effect may be to reduce the viability of ova. Cooking may reduce its effect against parasite eggs and larvae, but neither cooked or raw garlic appears to have any adverse effect on the efficacy of a therapeutic hookworm colony.


* ⚡ [https://en.wikipedia.org/wiki/Ginger Ginger] (Zingiber officinale) contains a chemical called zingibain (aka. zingipain, or ginger protease) that has been claimed to dissolve some parasites and their eggs, and numerous hookworm hosts have reported adverse effects after consuming ginger. One subject reported that fresh ginger drinks depress the egg production of his worms and increase his disease symptoms, and another has reported that eating a LOT of ginger 6 weeks post-inoculation caused her hookworm side effects to disappear for a few days, but that these eventually returned. A similar response was noted by someone who was in the habit of adding ginger to sushi platters. She found that this seemed to knock the worms out for a while but that they eventually recovered. [https://www.facebook.com/groups/htsupport/permalink/2249000525155890/?comment_id=2266705326718743&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another hookworm host has found that, while consuming powdered or cooked ginger isn’t a problem for him, drinking ginger tea, or any form of kombucha made with raw ginger will stun his worms badly and result in a return of disease symptoms the next day. [https://www.facebook.com/groups/htsupport/posts/4390196884369566/?comment_id=4395716387150949] Someone else, who said that his favorite brand of ginger beer was “pretty spicy”, so was probably made from raw, or only very briefly pasteurized, ginger juice, reported that, after going on a fairly significant binge of the stuff, his worms stopped producing eggs and their benefits diminished. Yet another worm host, who was putting at least a thumb-sized piece of fresh ginger in a smoothie every day, believes this was responsible for actually killing her hookworms. Others have also had issues with ginger, e.g., [https://www.facebook.com/groups/htsupport/permalink/2337067596349182/] [https://www.facebook.com/groups/htsupport/posts/9292445040811368?comment_id=9295039130551959]. However, one subject has reported eating lots of fresh ginger (mostly cooked) without any problems, and several others have reported a similar lack of issues with ginger. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/1568726056516677/?comment_id=1568873536501929&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1763989756990305/?comment_id=1764057080316906&comment_tracking=%7B%22tn%22%3A%22R%22%7D] One hookworm host says that she regularly takes dried ginger in 1g doses to help with migraines and has not noticed any problems with her worms, [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1062777610444860&reply_comment_id=1062782733777681&comment_tracking=%7B%22tn%22:%22R%22%7D] and another routinely takes 550 mg of ginger root powder every morning without any obvious effect on either his hookworms or his human whipworms.

* ❓ [https://en.wikipedia.org/wiki/Horseradish Horseradish] (Amoracia rusticana) has been claimed to be antiparasitic, and it does contain volatile oils, notably [https://en.wikipedia.org/wiki/Mustard_oil mustard oil], which has antibacterial properties and is used as an antiparasitic by some farmers, but evidence about the effects of its use by helminth hosts is lacking.

* ❓ [https://en.wikipedia.org/wiki/Mustard_(condiment) Mustard]. This condiment is claimed to be effective against intestinal worms, including roundworms and threadworms and, in India, [https://en.wikipedia.org/wiki/Mustard_oil mustard oil] is used as an antiparasitic by some farmers. However, its action is probably more as a laxative that helps to flush out worms rather than to kill them, and hookworms spend much of their time firmly attached to the gut mucosa. One hookworm host has reported taking about 2 grams of ground mustard seeds most days, with no adverse effect on his worms or their egg production. [https://www.facebook.com/groups/htsupport/permalink/1958129950909617/?comment_id=1958255070897105&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nutmeg Nutmeg] (Myristica fragrans, or fragrant nutmeg). This spice, which is obtained by grinding the seed of this tree, (mace is produced from the seed covering) is not harmful to helminths when used as a culinary flavour.


* ❌ [https://en.wikipedia.org/wiki/Oregano Oregano] (Origanum vulgare). Oregano oil, which contains isomeric phenols (primarily carvacrol but also including thymol and limonene), can destroy a number of bacteria, fungi and viruses in dilutions as low as 1/50,000, and is also antiparasitic. It is reported to be effective against protozoan parasites in particular as well as roundworm larvae, and somewhat effective against tapeworms. In one study [http://www.chirochat.org/article_files/Article-2953.pdf], 57 per cent of adults with intestinal parasites who were treated with 600 mg of oregano oil daily for six weeks experienced total eradication of their parasites. Several hosts of therapeutic helminths have reported adverse effects on their worms after ingesting oregano oil and, in at least two cases, it has resulted in a total loss of worms. However, one subject, who took oil of ''wild'' oregano sublingually twice each day for 2 weeks had a stool test sometime after this that was positive for hookworms, so perhaps either the wild form of the herb, or the sublingual route, helped reduce the effect on the worms in this case. Some foods, particularly soft cheeses, may be coated with an [http://www.sciencedaily.com/releases/2014/11/141127082311.htm antimicrobial film incorporating oregano oil] to increase their lifespan, but the amount of oregano involved in this application is unlikely to be a serious threat to helminths. A few '''oregano ''leaves''''' eaten with food are less likely to be harmful to human helminths [https://www.facebook.com/groups/htsupport/permalink/2545907775465162/?comment_id=2545955292127077], but one host of both hookworms and whipworms has reported that, while there was no immediate effect on his worms when he applied a ''heavy'' sprinkling of oregano leaf powder to his food a couple of times in a day, he was later plunged into such a self-critical and depressed mood that, before eventually regaining his usual mental balance, he struggled to do any work for several days.

* ✅ [https://en.wikipedia.org/wiki/Saffron Saffron] This spice is derived from the flower of crocus sativus, commonly known as the "saffron crocus". (See separate entry for this herb.) One hookworm host took a supplement containing turmeric and saffron for 6 weeks without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/]

* ✅ [https://en.wikipedia.org/wiki/Thyme Thyme] (Thymus vulgaris). This is also known as Common Thyme, Garden Thyme. Extracts of the leaves, flowering tops and stems are used to kill hookworms, roundworms, threadworms and skin parasites. However, these are unlikely to harm helminths when eaten in reasonable amounts as part of a normal diet. One helminth host has [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ eaten significant quantities of thyme] without noticing any adverse effect on her hookworm or whipworm populations.


* ✅ [https://en.wikipedia.org/wiki/Turmeric Turmeric] (Curcuma longa), also known as tumeric, generally does not harm human helminths when eaten in food in its natural, whole form, which only contains 3% of the active ingredient, curcumin, [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] or when it is taken in capsules, e.g., as a daily dose of 25 g turmeric (delivering 700 mg curcumin), [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/] or as a dose of 580 mg turmeric extract delivering 551 mg curcuminoids daily. [https://www.facebook.com/groups/htsupport/permalink/3303438489712083/?comment_id=3304307169625215] There have only been two reports of food quantities of turmeric affecting hookworms. The first of these is [https://www.facebook.com/groups/htsupport/permalink/1084044901651464/?comment_id=1084640204925267&comment_tracking=%7B%22tn%22:%22R%22%7D here], and the second was by an individual who boiled and ground turmeric powder into a paste and twice drank a large quantity of this (2 tbsp) in her tea. She subsequently experienced a return of her old symptoms, all of which persisted. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] There is much more chance of helminths being harmed when ⚡[https://en.wikipedia.org/wiki/Curcumin curcumin] is extracted from the turmeric and taken in medicinal quantities. It has been reported that 300 mg of curcumin extract has killed some types of parasites in test tube and animal studies, and that it may temporarily reduce the number of helminth eggs produced. One hookworm host believes that she may have lost her colony as a result of taking a curcumin supplement. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=794226897299934&offset=0&total_comments=11] However, another hookworm host has reported experiencing a very enjoyable “bounce” (indicating a healthy NA colony) after inoculating, in spite of taking 250 mg of curcumin daily. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/] As with other substances that can affect hookworms, the effect of curcumin may depend to some extent on the strength of the individual host’s immune response, as well as on the form of curcumin used. Nano-emulsified curcumin appears to be more effective, therapeutically, [https://www.sciencedaily.com/releases/2014/11/141106113204.htm] so may also have an increased detrimental impact on helminths. Another high-potency form of curcumin is BCM-95, which has been shown to be 6.93 times more bioavailable than normal curcumin, [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792534/] and this product may have been responsible for a sudden return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=808508489205108&offset=0&total_comments=21&comment_tracking=%7B%22tn%22:%22R1%22%7D] The beneficial effect of curcumin can be increased 5- to 10-fold by adding ascorbic acid (vitamin C) [http://www.sciencedirect.com/science/article/pii/S0308814612001744] so taking this vitamin along with curcumin might make it possible to use curcumin therapeutically in much smaller doses (ascorbic acid does not harm helminths), although this vitamin may increase curcumin's adverse effect on helminths if the quantity of the spice is not reduced proportionately.

* ❓ [https://en.wikipedia.org/wiki/Wild_Turmeric Turmeric, Wild] (Curcuma aromatica). While alcoholic extracts of the rhizomes of wild turmeric have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in [http://www.ncbi.nlm.nih.gov/pubmed/1158424 test tube studies] and extracts of the rhizomes may therefore also have an adverse effect on other helminths, it is likely that consuming dietary amounts of this spice will do no harm to human helminths, though this has not yet been confirmed.
</blockquote>

=== Herbs and medicinal plants===

The majority of the herbs listed below have been reported, or claimed, to be antiparasitic, although clinical evidence for this effect is lacking in many cases. Furthermore, where they are indeed antiparasitic, herbs may be more effective against types of parasite other than helminths, although this is not to say that they may not also have some detrimental effect on helminths.

Where a herb is effective against helminths, quite large quantities may be required to dislodge or kill the worms, but consuming some of these herbs on a regular basis, or in the form of concentrates, extracts, tinctures and oils that are directed at the gastrointestinal tract may weaken therapeutic helminths, making them less effective.

It should not be assumed, from a cursory glance at the following list, that most herbs are potential threats to human helminths. This list only contains those herbs that have been mentioned specifically by self-treaters, and there are less than 100 herbs in the entire list. Many thousands of compounds are used in herbal medicine, so it will usually be possible to find a more hookworm-friendly alternative for whatever purpose one has in mind.

Many of the herbs listed below are used to treat a number of conditions in addition to parasite infections, so might be encountered in a range of herbal remedies. It may therefore be advisable for any helminth host who contemplates taking any herbal remedy to check its ingredients against the list below and, where an ingredient appears to have antiparasitic properties, to seek an alternative, if possible.

When taking herbs, an additional risk arises from the fact that the majority of herbal products [http://www.medicalnewstoday.com/releases/267363.php contain unlisted ingredients], in view of which it would seem wise to employ a cautious approach with all herbal products.

==== List of herbs and medicinal plants ====

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* ⚡ [https://en.wikipedia.org/wiki/Acacia Acacia]. Also known as thorntree, [https://en.wikipedia.org/wiki/Whistling_thorn whistling thorn], or wattle. One example of this genus of shrubs and trees, ([https://en.wikipedia.org/wiki/Acacia_mollissima Acacia mearnsii], previously known as Acacia molissima) contains tannin extracts that have been found to have an [http://www.sciencedirect.com/science/article/pii/S0377840107003641 anthelmintic effect] on Haemonchus contortus and Trichostrongylus colubriformis in lambs. For a more detailed consideration of the possible effects of tannins on nematodes, see these papers: [https://www.ncbi.nlm.nih.gov/pubmed/28426037] [https://pubmed.ncbi.nlm.nih.gov/36344622/].

* ❌ [https://en.wikipedia.org/wiki/Ajwain Ajwain] contains thymol (see separate reference), which appears to be the primary constituent of the essential oil extracted from ajwain "seeds" (actually a seed-like fruit). Ajwain may therefore be harmful to human helminths if consumed in the form of ajwain "seeds" or the oil extracted from them, but it ''may'' be less harmful if only the leaves are eaten.

* ⚡ [https://en.wikipedia.org/wiki/Albizia_lebbeck Albizia lebbeck]. Alcoholic extracts of the bark of Albizia lebbeck have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the bark may also have an adverse effect on other helminths.

* ✅ [https://en.wikipedia.org/wiki/Aloe_vera Aloe vera]. This contains an antimicrobial agent, [https://en.wikipedia.org/wiki/Saponin saponin], and the laxative chemical, [https://en.wikipedia.org/wiki/Aloin aloin]. Aloe is perhaps the best known laxative in history, and it may be this, rather than any actual anthelmintic property, that is the source of its reputation for expelling parasites. While extracts have been reported as showing inhibitory effects on two roundworm species, these only affected the hatching of eggs and the development of larval stages. One aloedrinking helminth host has reported that his habit has had no obvious detrimental effect on his worms, and another hookworm host failed to notice any adverse effects after drinking pure aloe juice or gel daily for a week or two, or after drinking one of the 16oz sweetened/flavored drinks. [https://www.facebook.com/groups/htsupport/permalink/803451913044099/]

* ⚡ [https://en.wikipedia.org/wiki/Alpinia Alpinia calcaratta]. Alcoholic extracts of the rhizomes of Alpinia calcaratta have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Alpinia_galanga Alpinia galanga]. Alcoholic extracts of the rhizomes of Alpinia galanga have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of these rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Andrographis_paniculata Andrographis paniculata] (also known as creat, green chiretta; active component: andrographolide). Alcoholic extracts of Andrographis paniculata have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [http://www.ncbi.nlm.nih.gov/pubmed/1158424] Andrographolide has also shown significant ovicidal and larvicidal activity against the human hookworm, [[Ancylostoma duodenale | '''Ancylostoma duodenale''']]. [https://pubmed.ncbi.nlm.nih.gov/30763693/]

* ⚡ [https://en.wikipedia.org/wiki/Anise Anise] (Pimpinella anisum). Also known as aniseed. Anise oil may have modest antiparasitic effects and has been recommended by some practitioners as a treatment for mild intestinal parasite infections, but there have not been any reports about this from helminth hosts.

* ❌ [https://en.wikipedia.org/wiki/Arecoline Arecoline]. This odourless oily liquid derived from the areca nut, fruit of the areca palm ([https://en.wikipedia.org/wiki/Areca_catechu Areca catechu]), has long been used medicinally as an anthelmintic.

* ✅ [https://en.wikipedia.org/wiki/Ashwagandha Ashwagandha] (Withania somnifera). Also known as Indian ginseng, poison gooseberry, and winter cherry. Several hookworm self-treaters have reported using ashwagandha without issue. One NA host has reported that taking 380mg ashwagandha root and 95mg ashwagandha root extract twice each day for a month appeared not to affect her worms. [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832855323437081&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Someone else takes 450 mg ashwagandha x2 per day and reports that his NA are fine, [https://www.facebook.com/groups/htsupport/permalink/2416283988427542/?comment_id=2431728343549773&reply_comment_id=2432787723443835] and a third hookworm host has taken 500mg ashwagandha twice a day without any adverse effect on their worms. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] A naturopathic doctor has also reported that ashwagandha is OK to take while hosting hookworms, [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832031526852794&reply_comment_id=1833267093395904&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and someone who is self-treating with human whipworms (TT) has reported that taking a teaspoon of ashwagandha every day did not have any apparent effect on this species. (Also see the list of concerns and contraindications regarding Ashwagandha in [https://www.facebook.com/groups/htsupport/posts/6319449901444245/ this Facebook post].)

*❓ [https://en.wikipedia.org/wiki/Astragalus Astragalus]. A chloroform extract of the Astragalus species, [https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:477246-1 Astragalus ecbatanus], has been shown to have anthelmintic effects against the protoscoleces (the scoleces of the larval form of tapeworms) of the helminth, [https://en.wikipedia.org/wiki/Echinococcus_granulosus Echinococcus granulosus]. [https://pubmed.ncbi.nlm.nih.gov/36457771/]. However, there have been no reports that either of the forms of astragalus that are sold as food supplements ([https://en.wikipedia.org/wiki/Astragalus_propinquus Astragalus membranaceus/Astragalus propinquus] and Astragalus mongholicus) has had an adverse effect on any of the therapeutic helminths.

* ✅ Bacognize. One hookworm host has taken 300 mg daily of this [https://en.wikipedia.org/wiki/Bacopa_monnieri Bacopa monnieri] whole herb extract, standardized to 12% bacopa glycosides, without any adverse effect on his colony.

* ⚡ [http://www.botanical.com/botanical/mgmh/b/balmon04.html Balmony] (Chelone glabra) A decoction or tincture prepared with all parts of the plant is said to be a highly effective remedy for parasites, including intestinal worms. It was used traditionally by Native Americans to expel worms and is used today in proprietary parasite cleansing preparations.

* ⚡ [https://en.wikipedia.org/wiki/Barberry Barberry] (Berberis vulgaris) contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_bellirica Beleric] (Terminalia bellirica/Terminalia bellerica). Also known as bastard myrobalan or Bahera. This herb is said to be anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ⚡ [https://en.wikipedia.org/wiki/Berberine Berberine] is an amebicide which, in concentrated form, has been shown to kill various parasites such as tapeworms and giardia and to have anti adhesive effects which prevent pathogens from adhering to intestinal mucosal cells. One hookworm host who took one gram of berberine three times a day has reported being pretty sure that this killed his worms. [https://www.facebook.com/groups/htsupport/permalink/1803353316387282/?comment_id=1807383979317549&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Bidens_alba Bidens alba] has been reported as not being a problem for helminths.

* ✅ [https://species.wikimedia.org/wiki/Nymphaea_nouchali Blue Lotus]. Nymphaea nouchali - an aquatic flower also known as red and blue water lily, blue star water lily and star lotus - and its varieties, Nymphaea caerulea (blue Egyptian water lily) and Nelumbo nucifera (Indian lotus, sacred lotus, bean of India, lotus) are not thought to be harmful to helminths. These plants do contain various bioactive compounds such as alkaloids, flavonoids and glycosides, some of which may have antimicrobial or antiparasitic properties against bacteria, fungi, or protozoa, but there is no direct evidence to suggest that any of these compounds might be specifically harmful to helminths.

* ❌ [https://biocidin.com/products/biocidin-liquid-formula Biocidin] is a proprietary herbal blend that includes oregano oil and black walnut, both of which are known to have anthelmintic effects. See the separate entries for these two herbs.

* ❌ [http://scialert.net/fulltext/?doi=ijp.2013.211.226 Bitter cumin] (Centratherum anthelminticum). As its Latin name suggests, the seeds of this member of the daisy family are considered anthelmintic.

* ⚡ [https://en.wikipedia.org/wiki/Bitter_melon Bitter melon] (Momordica charantia) is used as a folk medicine to treat gastrointestinal diseases, and extracts have shown activity against the nematode worm C. elegans in test tube studies[http://www.sciencedirect.com/science/article/pii/S0378874104003770].

* ⚡ [https://en.wikipedia.org/wiki/Juglans_nigra Black walnut] (Juglans nigra). Also known as eastern black walnut. This nut has been claimed to be one of the best overall dewormers for humans, killing both the adult and developmental stages of at least 100 parasites. However, according to the American Cancer Society, available scientific evidence does not support claims that the hulls of the black walnut remove intestinal parasites. Although this nut has a strong flavour, it is actually quite rare, as its shell is hard and difficult to remove. It is therefore only likely to be encountered in expensive baked goods. Most commercially available walnuts are hybrids of the ✅'''English walnut'''. "Commerically-sold walnuts will be English unless specified. The taste and appearance of black walnuts is different too." [https://www.facebook.com/groups/htsupport/posts/7955684137820805/?comment_id=7955710474484838] "Black walnuts are very, VERY rare to find in stores, and 100% this will be specified. 'Walnuts' are ALWAYS English walnuts unless otherwise stated." [https://www.facebook.com/groups/htsupport/posts/7955684137820805?comment_id=7955725021150050]

* ✅ [https://en.wikipedia.org/wiki/Boswellia Boswellia] is a fragrant resin, extracts of which are used in pharmacology, particularly as anti-inflammatories. There have been no suggestions that boswellia might be a problem for helminths, and its anti-inflammatory action could be supportive of the beneficial effects that helminths produce, as demonstrated in Crohn’s disease in this study. [http://www.ncbi.nlm.nih.gov/pubmed/11215357]

*❓[https://en.wikipedia.org/wiki/Bougainvillea_spectabilis Bougainvillea spectabilis.] Also known as great bougainvillea, this plant, which is used to make a tea, has shown dose-dependent anthelmintic effects against the earthworm, Pheretima posthuma. [https://ijppr.humanjournals.com/wp-content/uploads/2020/04/2-IN-VITRO-ANTHELMINTIC-ACTIVITY-OF-CRUDE-EXTRACT-OF-FLOWERS-OF-BOUGAINVILLEA-SPECTABILIS-WILD-AGAINST-PHERETIMA-POSTHUMA.pdf] This effect is thought to result from the plant’s phytochemical constituents, which are believed to damage the mucopolysaccharide layer of worms, leading to paralysis and death. However, while this effect has been demonstrated in a laboratory, bougainvillea does not appear to have been used traditionally as an anthelmintic, and there have been no reports from helminthic therapy self-treaters of any adverse effect on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Breadfruit Breadfruit] (Artocarpus altilis)) A methanol-water fraction of this plant has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 9.5 hours, compared with 35 hours taken by albendazole. Aqueous methanol extracts took 49 hours. [https://www.researchgate.net/publication/21072595]

* ❌ [https://en.wikipedia.org/wiki/Acorus_calamus Calamus/Sweet Flag] (Acorus calamus) The bitter element in sweetflag, acorin, is claimed to have anthelmintic properties, and the standardised rhizome extract of A. calamus has been shown to have significant dose-dependent effects against the rat tapeworm, Hymenolepis diminuta, so may also harm other helminths. [https://www.ncbi.nlm.nih.gov/pubmed/27757269]

* ✅ [https://en.wikipedia.org/wiki/Castor_oil Castor oil]. This will not kill helminths, though it may help to expel worms after eradication, and this is probably the reason for its antiparasitic reputation and it's use in para-cleanse products.

* ✅ [https://en.wikipedia.org/wiki/Cat's_claw Cat’s Claw] is a common name for several plants, but it appears to be applied particularly to two species - [https://en.wikipedia.org/wiki/Uncaria_tomentosa Uncaria tomentosa] (samento), most commonly used in the US, and [https://en.wikipedia.org/wiki/Uncaria_guianensis Uncaria guianensis], typically used in Europe. Medicines made from the root and bark of these species have been claimed online to facilitate the elimination of intestinal parasites, but WebMD states that there is insufficient evidence for its effectiveness against parasites, [http://www.webmd.com/vitamins-supplements/ingredientmono-395-CAT'S%20CLAW.aspx?activeIngredientId=395&activeIngredientName=CAT%27S%20CLAW] and one hookworm host has taken up to 2000-2500 mg of Uncaria tomentosa daily in raw form for months with no adverse effects on his NA. He was even able to incubate fresh larvae from his colony during this period. [https://www.facebook.com/groups/htsupport/posts/4013894361999822?comment_id=4014662455256346]

* ⚡ [https://en.wikipedia.org/wiki/Larrea_tridentata Chaparral] (Larrea tridentata). Some cultures customarily bathe with chaparral annually to eliminate skin parasites, but use of the leaves of Larrea species is not advised, due to the possibility of damage to the liver and kidneys.

* ❌ Chicken weed ([https://en.wikipedia.org/wiki/Salvia_serotina Salvia serotina]), also known as Littlewoman, has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 20 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ✅ [https://en.wikipedia.org/wiki/Fallopia_multiflora Chinese knotweed] (Fallopia multiflora, also known as Reynoutria multiflora (Thunb.) Moldenke, Polygonum multiflorum Thunb., tuber fleeceflower) has been shown to make one nematode live longer. [https://www.sciencedaily.com/releases/2018/10/181009102529.htm]

* ❌ [https://en.wikipedia.org/wiki/Cinnamomum_verum Cinnamomum verum]. This was previously known as ⚡''C. zeylanicum'' and also referred to as ⚡"true cinnamon", ⚡''Ceylon cinnamon'' or ⚡''Sri Lanka cinnamon''. Alcoholic extracts of the bark of ⚡''C. verum'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the bark may also have an adverse effect on other helminths. The spice, ⚡'''cinnamon''' is typically derived from related species within the genus, '''Cinnamomum'''.

* ❌ [https://en.wikipedia.org/wiki/Citrus_decumana Citrus decumana]. Alcoholic extracts of the rind of Citrus decumana have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rind may also have an adverse effect on other helminths. Citrus decumana is a relative of the common ✅[https://en.wikipedia.org/wiki/Grapefruit grapefruit] (citrus paradisi) and, while commercially available forms of ⚡'''grapefruit seed extract''' have a potential to harm human helminths (due to the typical addition of synthetic adulterants), there is no evidence that the flesh of the grapefruit has any adverse effect on helminths.

* ✅ Coffee fruit extract. ([https://en.wikipedia.org/wiki/Coffea_arabica Coffea arabica]) This is harmless to helminths.

* ❓ [https://en.wikipedia.org/wiki/Crocus_sativus Crocus sativus]. Also known as autumn crocus and saffron crocus, this plant is best known for the spice saffron, which is produced from parts of the plant's flowers. (See separate entry for the spice.) Two important bioactive compounds of Crocus sativus (crocin and safranal), and some semi-synthetic derivatives of safranal, have been found to be [http://www.ncbi.nlm.nih.gov/pubmed/25766747 effective against some types of parasite] (Helicobacter pylori, the malaria parasite, plasmodium, and Leishmania). However, there have been no reports of adverse effects on therapeutic helminths.

* ⚡ '''Curled/Curly Mint''' (Mentha spicata variety crispii/Mentha crispa/Mentha crispata). This cultivar of [https://en.wikipedia.org/wiki/Spearmint Spearmint] (Mentha spicata), and close relative of Peppermint (Mentha piperita) (see [[#Peppermint|Peppermint reference]]), may be effective against giardia and amoeba infections, and may have anthelmintic properties. It was once listed on a website under, “herbs that your health care provider might consider using to treat intestinal parasites.” [https://web.archive.org/web/20070918071439/http://health.kernan.org/altmed/articles/intestinal-parasites-000097.htm]

* ❌ [https://en.wikipedia.org/wiki/Desmodium_triflorum Desmodium triflorum]. Alcoholic extracts of Desmodium triflorum have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so it’s extracts may also have an adverse effect on other helminths, possibly due to it containing a significant amount of a powerful psychedelic substance which might cause hookworms to lose their grip and be expelled.

* ✅ [https://en.wikipedia.org/wiki/Echinacea Echinacea]. This is not a single plant but a genus containing several different species. In the case of medicinal products labelled as echinacea, these are likely to have been obtained from one or more of the following sources: E. purpurea, E. angustifolia or E. pallida. Such products may also be either extracts, or the expressed juice of, different plant organs (e.g., roots and leaves) resulting in different products having very different chemical compositions. However, there have been no reports of human helminths being harmed by taking any echinacea products. As the polysaccharides found in Echinacea purpurea roots have been [http://www.ncbi.nlm.nih.gov/pubmed/26190752 shown to have anti-inflammatory effects], water extracts of these roots may be of benefit to helminth hosts who require a supplementary anti-inflammatory.

* ❌ [https://en.wikipedia.org/wiki/Elecampane Elecampane.] (Inula helenium, also known as alant, aster helenium, aster officinalis, aunée, aunée Officinale, elfdock, elfwort, enule campagne, grande aunée, helenio, helenium grandiflorum, horse-elder, horseheal, horse-heal, Indian elecampane, inule aulnée, inule aunée, inule hélénie, &OElig;il-de-cheval, scabwort, velvet dock, wild sunflower and yellow starwort.) According to WebMD, this herb can be used to kill intestinal worms, including hookworms and whipworms. [https://www.webmd.com/vitamins/ai/ingredientmono-2/elecampane] One hookworm host who took some drops containing several herbs that included elecampane suffered “vicious” diarrhoea for 16 hours, after which she reportedly lost the benefits from her worms.

* ❌ [https://en.wikipedia.org/wiki/Epazote Epazote]. See [[#Wormseed|Wormseed]].

* ❌ [http://it.wikipedia.org/wiki/Ceterach_officinarum Erba ruggine] (Ceterach officinarum) is listed on one website under, “Herbals that may kill and expel worms.” [https://web.archive.org/web/20160215131104/http://www.altmd.com/Articles/Worms--Encyclopedia-of-Alternative-Medicine]

* ❓ [https://en.wikipedia.org/wiki/Eurycoma_longifolia Eurycoma longifolia] (commonly called tongkat ali, pasak bumi or malaysian ginseng). The root of the plant is used in Indonesia and Malaysia as a health tonic, the benefits of which are claimed to include the treatment of intestinal worm infections. However, one hookworm host has reported using 100mg tongkat ali extract, containing 10% eurycomanone, for 60 days without any adverse effect on his worm colony. [https://www.facebook.com/groups/htsupport/posts/6839629756092921/?comment_id=6839701856085711]

* ❓ [https://en.wikipedia.org/wiki/Frankincense Frankincense] (olibanum). This aromatic resin is used in incense and perfumes, and is obtained from trees in the Boswellia genus. There have been no reports about it having any effect on helminths.

* ❌ [https://en.wikipedia.org/wiki/Gentian_root Gentian root]. The root and underground stem of [https://en.wikipedia.org/wiki/Gentiana_lutea Gentiana lutea] (yellow gentian) are said to assist in expelling 'harmful organisms'. One subject has reported that taking a form of gentian in large quantity on a daily basis for sinus inflammation was responsible for the loss of his whipworms, although possibly not his hookworms.

* ✅ [https://en.wikipedia.org/wiki/Ginkgo_biloba Ginkgo biloba]. There has been a single hint that ginkgo may have caused a mild reduction in hookworm benefits, but this was by no means certain, and three other helminth hosts have reported taking ginkgo regularly with no apparent adverse effect on their worms. (Also see Anticoagulants.)

* ⚡ [https://en.wikipedia.org/wiki/Goldenseal Goldenseal] (Hydrastis canadensis). This contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Coptis_chinensis Goldenthread/Chinese goldthread] (Coptis chinensis) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Goosefoot Goosefoot] (Chenopodium ambrosioides) is widely used to deworm animals, and the Japanese make a dewormer tea with the leaves. Goosefoot oil is a highly efficient anthelmintic, and extremely toxic. Human consumption of this herb has often produced strong side effects such as nausea and headaches, and even death in some cases.

* ⚡ [https://en.wikipedia.org/wiki/Hagenia Hagenia] (Hagenia abyssinica). Also known as African redwood, brayera, cusso, hagenia, and kousso, hagenia has been used as a treatment for the pork tapeworm (Taenia solium), but is often only partially effective in this case.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_chebula Haritaki] (Terminalia chebula). Also known as Yellow Myrobalan, Chebulic Myrobalan, Kadukkai, Silikha, Himmej, Karakkaya and A-ru-ra. The fruits are reportedly anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ❌ [https://en.wikipedia.org/wiki/Houttuynia_cordata Houttuynia cordata Thunb] (HCT), also known as fish mint, fish leaf, rainbow plant, chameleon plant, heart leaf, fish wort, Chinese lizard tail, and bishop's weed. The leaf extract of this Thai herb, which is used as an anti-inflammatory medication in the treatment of rheumatoid arthritis [https://www.ncbi.nlm.nih.gov/pubmed/26170903] has shown anthelmintic activity against Hymenolepis diminuta, especially the adult worms. [https://www.ncbi.nlm.nih.gov/pubmed/23024502/] The entire Saururaceae plant family is considered to have anthelmintic properties and is used by the Naga tribes in Northeast India to treat intestinal worm infections in general. It may therefore also have a potentially harmful effect on other therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Hydnocarpus_wightiana Hydnocarpus wightiana]. Alcoholic extracts of the seeds have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the seeds may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Hyssopus_officinalis Hyssop] (Hyssopus officinalis). The leaf contains an essential oil with antiseptic properties that has been claimed to have anthelmintic effects, but, if eaten as a herb, hyssop is unlikely to harm helminths.

* ❌ [https://en.wikipedia.org/wiki/Ipecac Ipecac], syrup of. Alkaloids in ipecac, including [https://en.wikipedia.org/wiki/Emetine emetine], are reported to kill several types of parasite, particularly amoebae, but also pinworms and tapeworms, although the amounts needed to produce these effects in humans are generally high and can lead to severe side effects. Emetine and the somewhat safer form, [https://en.wikipedia.org/wiki/Dihydroemetine Dehydroemetine], are usually reserved for rare cases of people infected with amoebae who are not cured by using anti-amoeba drugs.

* ⚡ [https://en.wikipedia.org/wiki/Juniper Juniper] (Juniperus communis) is a very effective natural antibiotic which is also said to have deworming properties, notably against liver fluke, and is used to treat worm infestations in animals. Juniper is also used as the primary flavouring in gin, but there have been no reports of any harm coming to helminths as a result of drinking gin.

* ❌ [https://en.wikipedia.org/wiki/Kaempferia_galanga Kaempferia galanga]. Alcoholic extracts of the rhizomes have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rhizomes may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Kava Kava/ kava-kava] (Piper methysticum). Studies have shown that kava can have potentially harmful effects on helminths by disrupting their neuromuscular function. Kavalactones, the active compounds in kava, produce psychoactive, analgesic, euphoric and sedative effects and, in the case of the roundworm, C. elegans, kavalactones have been found to cause muscle hypercontraction, epileptic-like convulsions and paralysis. One constituent of kava, Kavain, specifically induced worm paralysis without convulsions. [https://pmc.ncbi.nlm.nih.gov/articles/PMC5462554/] While this evidence does not relate directly to therapeutic helminths, and there have not been any reports to date of any adverse effects of kava on therapeutic worms, it is sufficient reason to treat kava with a degree of caution, especially in hookworm self-treaters who are known to have a more aggressive immune response, thus putting their worms under increased duress.

* ❓[https://en.wikipedia.org/wiki/Lactuca_virosa Lactuca virosa] Also known as wild lettuce, bitter lettuce, laitue vireuse, opium lettuce, poisonous lettuce, tall lettuce, great lettuce and rakutu-karyumu-so. While this herb is claimed by a few sources online to have an anthelmintic effect (e.g., [https://herbu.org/wp-content/uploads/2018/09/8-Wild-Lettuce-5pgs.pdf] (PDF)), there have been no reports of it having an adverse effect on either NA or TT. However, it is worth noting that Lactuca virosa can cause toxic effects in those who consume it. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031874/]

* ❓[https://en.wikipedia.org/wiki/Lemon_balm Lemon balm] (Melissa officinalis), a member of the mint family also known as balm, common balm or balm mint. This has been found to exhibit high nematicidal activity against the roundworm, Meloidogyne incognita [https://www.ncbi.nlm.nih.gov/pubmed/20527965] and, when included with other herbs, to help reduce the number of pigs infected with the roundworm, Ascaris suum. [https://www.ncbi.nlm.nih.gov/pubmed/19954891]. It is also listed as a vermifuge on some herbal websites, but there have been no reports thus far of lemon balm having adversely affected either NA to TT, and one NA host has reported using it almost daily for over a year, both as a tea and a tincture, without it causing any issues for her worms. [https://www.facebook.com/groups/htsupport/posts/7626177840771438/]

* ⚡ [https://en.wikipedia.org/wiki/Lemongrass Lemongrass] (Cymbopogon citratus) essential oil has shown [http://www.academia.edu/3999135/Evaluation_of_in_vitro_anthelmintic_activity_of_Cymbopogon_citratus_lemon_grass_extract anthelmintic activity against earthworms]. However, one individual has consumed lemongrass tea [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ without adverse effect] on her hookworm or whipworm colonies.

* ✅ [https://en.wikipedia.org/wiki/Liquorice Liquorice/licorice], the root of Glycyrrhiza glabra. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/798992926823331/?comment_id=799022316820392&offset=0&total_comments=2] taking “lots” of [https://en.wikipedia.org/wiki/Deglycyrrhizinated_licorice deglycyrrhizinated licorice] (DGL) with no ill effect on his worms. And another NA host has reported taking liquorice extract without any problems. [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Liquorice extracts may be useful as an adjunctive therapy [http://www.ncbi.nlm.nih.gov/pubmed/26383911 for psoriasis, for colitis] and possibly other autoimmune diseases, but excessive consumption of liquorice containing glycyrrhizin/glycyrrhizic acid [http://www.sciencedaily.com/releases/2015/03/150302081147.htm may not be wise]. The World Health Organization's recommended daily maximum for liquorice is 2 mg/kg.

* ❌ [https://en.wikipedia.org/wiki/Lippia_nodiflora Lippia nodiflora]. Alcoholic extracts of this have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other worms.

* ❌ Love weed ([https://plants.jstor.org/compilation/cuscuta.americana Cuscuta americana]) extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 2 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ⚡ [https://en.wikipedia.org/wiki/Male_fern Male fern] (Dryopteris filix mas). Also once known as worm fern! The rhizomes and young shoots (fiddleheads) of the male fern have antiparasitic properties and the root has been used to treat tapeworms. However, this herb is seldom used today due to its side effects (e.g. headaches and nausea) and because large doses are extremely poisonous and may induce liver damage. The North American equivalent of the male fern is the evergreen [https://en.wikipedia.org/wiki/Dryopteris_marginalis marginal shield-fern] (Dryopteris marginalis).

* ✅ [https://en.wikipedia.org/wiki/Mastic_(plant_resin) Mastic gum] Mastic (plant resin), also known as tears of Chios, is excreted by the resin glands of certain trees. One NA host has reported chewing mastic gum every day for a couple of months, and said that even chewing it until it dissolved had no harmful effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/6291172814271954/]

* ✅ [https://en.wikipedia.org/wiki/Milk_thistle Milk Thistle] (Silybum marianum). Also known as cardus marianus, blessed milk thistle, Marian Thistle, Mary Thistle, Saint Mary's Thistle, Mediterranean milk thistle, variegated thistle and Scotch thistle. There have been no adverse reports about this herb from worm hosts, and there are no reasons to believe that it might harm human helminths.

* ❌ [https://en.wikipedia.org/wiki/Mimosa_pudica Mimosa pudica] Also known as shy plant, sensitive plant, sleepy plant, action plant, touch-me-not, and shameplant, this popular houseplant is a tropical fern, whose leaves close rapidly when touched. Aqueous methanol extracts of the leaves of this plant showed a similar ability as the anthelmintic drug, levamisole, to inactivate larvae of the helminth, Strongyloides stercoralis. [https://www.researchgate.net/publication/21072595] While there have been no reports to date of this plant having a harmful effect on any of the therapeutic helminths, it has been used extensively as an anti-parasitic agent in traditional and Ayurvedic medicine, so clearly has significant potential as an anthelmintic.

* ❓[https://en.wikipedia.org/wiki/Miswak Miswak] The miswak is a tooth-cleaning twig obtained from the [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] tree. In addition to this oral hygiene use being documented within traditional medicine systems, parts of the S. persica tree have also been reported to show evidence of anthelmintic activity. [https://pmc.ncbi.nlm.nih.gov/articles/PMC8347844/] However, this evidence comes from test-tube or animal studies, not trials on humans, and the concentrations tested would not necessarily correlate with those encountered during typical miswak stick chewing. So far, there have been no reports of any adverse effects on the helminth colonies of miswak-chewing self-treaters, and at least one hookworm host uses a miswak exclusively for oral hygiene. [https://www.facebook.com/groups/htsupport/permalink/1259998900722729/]

* ❌ [https://en.wikipedia.org/wiki/Morinda_citrifolia Morinda citrifolia], also known as great morinda, Indian mulberry, beach mulberry and cheese fruit). Alcoholic extracts of the tender leaves of ''M. citrifolia'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], so the same extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Mugwort Mugwort] (Artemisia vulgaris). Also known as Moxa, Common Wormwood, Traveler's Herb and Felon Herb, and a relative of wormwood (Artemisia Absinthium). While less effective than anthelmintic drugs, mugwort extracts, and especially the essential oils, are at least moderately effective natural anthelmintics against a range of nematodes and some cestodes. The herb can disrupt helminth neuromuscular function and interfere with energy metabolism, potentially leading to helminth paralysis and death, and it is said to make short work of roundworms, pinworms and tapeworms.

*❓ [https://en.wikipedia.org/wiki/Myrciaria_dubia Myrciaria dubia] (Commonly known as camu-camu, camu camu, camocamo, caçari and araçá-d'água.) This plant’s seed extracts have shown antischistosomicidal activity, [https://www.sciencedirect.com/science/article/pii/S0963996920303598?via%3Dihub] but nothing has been reported about possible adverse effects on any of the therapeutic worms.

* ⚡ [https://en.wikipedia.org/wiki/Myrrh Myrrh]. This has antiparasitic effects against various schistosome species and the liver fluke, Fasciola hepatica.

* ❌ [https://en.wikipedia.org/wiki/Neem Neem] (Azadirachta indica). Also known as margosa, nimtree and Indian lilac. Ayurvedic medicine holds that Neem is the best herb for treating worms and other parasites and that a simple decoction of Neem leaves can kill all parasites present in the intestines. Neem extract has also been shown to be [http://www.banglajol.info/index.php/DUJBS/article/view/8836 more effective against rodent helminths] than standard chemotherapy with albendazole or mebendazole.

* ✅ [https://en.wikipedia.org/wiki/Urtica_dioica Nettle, stinging] (Urtica dioica) Stinging nettle was found to have anthelmintic effects in one study [https://benthamopen.com/contents/pdf/TOPHARMCJ/TOPHARMCJ-3-38.pdf] but this was carried out ''in vitro'', using a nettle ''extract'', and in a non-therapeutic worm (the Indian earthworm) so these findings are not directly applicable to humans using human-adapted helminths. There have been no reports of any adverse effect on human helminths after their hosts have drunk nettle tea, and one hookworm host has reported regularly eating nettles without issue. [https://www.facebook.com/groups/htsupport/permalink/1265558373500115/?comment_id=1265700353485917&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Noni Noni] (Morinda citrifolia). See the separate entry for Morinda citrifolia, above. A test tube study [https://pubmed.ncbi.nlm.nih.gov/1158424/] found that noni helps to eliminate the roundworm, Ascaris lumbricoides, but, so far, no one hosting therapeutic helminths has reported using this.

* ❌ [https://en.wikipedia.org/wiki/Olive_leaf Olive leaf extract] (Olea europaea). Known as 'nature's antibiotic', this extract contains a component called oleuropein that is able to degrade pathological microorganisms of all kinds, and inhibit or kill many types of intestinal parasites including flatworms, hookworms, roundworms and tapeworms. Two subjects have reported losing their helminths after taking this.

* ⚡ [https://en.wikipedia.org/wiki/Oregon_grape Oregon grape] (Berberis aquifolium/mahonia aquifolium) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Oroxylum_indicum Oroxylum indicum] (also known as broken bones plant, Indian calosanthes, Indian trumpet flower, kampong, midnight horror and tree of Damocles). The bark extract of O. indicum [http://www.ncbi.nlm.nih.gov/pubmed/26660694 produces concentration-dependent effects against both larval and adult H. diminuta worms] so may also affect other helminths.

* ❌ [https://en.wikipedia.org/wiki/Palmarosa Palmarosa] (Cymbopogon martinii). Also known as Indian geranium, gingergrass and rosha or rosha grass. This may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Passionflower Passion flower] (Passiflora). This will not harm helminths.

* ❓ [https://en.wikipedia.org/wiki/Handroanthus Pau d’arco]. Also known as lapacho, red lapacho or taheebo, pau d'arco is a tea made from the inner bark of Handroanthus impetiginosus (Pink Ipê), which is claimed to have antiparasitic effects. Its main active ingredients are lapachol, quercetin and other flavonoids. Having expectorant properties, it is used as a herbal remedy for colds, flu and smoker's cough. However, lapachol is rather toxic and is more often used topically, for example as as antibacterial or pesticide. There have been no reports from helminthic therapy self-treaters to suggest what effect, if any, drinking pau d'arco might have on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Mentha_pulegium Pennyroyal] (Mentha pulegium). A member of the mint family, also known as European pennyroyal, pennyrile, squaw mint, mosquito plant and pudding grass. This plant has anthelmintic properties. [https://www.ncbi.nlm.nih.gov/pubmed/32002775]


* ⚡ [https://en.wikipedia.org/wiki/Peppermint Peppermint] (Mentha piperita, aka M. balsamea Willd) is used as an ingredient in some antiparasitic preparations. Several helminth hosts have strongly suspected that peppermint oil killed their worms, and one found he could not establish a worm colony at all while taking peppermint oil. Even eating a lot of peppermints caused a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/948433751879247/?comment_id=948595591863063&comment_tracking=%7B%22tn%22:%22R%22%7D] However, a number of others, who have used peppermint oil as a treatment for IBS, have noticed nothing untoward, and one subject has reported taking peppermint oil continuously without issue. Only the oil has been implicated. Eating ✅''peppermint leaves'', or drinking tea made from them, should not be a problem, as was found by two hookworm hosts who have reported drinking lots of peppermint tea without hurting their worms. [https://www.facebook.com/groups/htsupport/permalink/1986080694781209/?comment_id=1986669308055681&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7433421123380445/?comment_id=7434211146634776] ''Peppermint extract'' has also been reported not to be a problem for another hookworm host. [https://www.facebook.com/groups/htsupport/permalink/3042115625844372/?comment_id=3048690678520200]

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_niruri Phyllanthus niruri], also known as gale of the wind, stonebreaker, shatter stone, seed-under-leaf, carry-me-seed, quebra pedra, chanca piedra and chance pierre. This has been used traditionally to treat intestinal worms, and an extract of the plant has shown anthelmintic potential against a type of parasitic flatworm. [https://jffk.unram.ac.id/index.php/sjp/article/view/245] However, there have been no reports so far of any effects on therapeutic helminths.

* ❌ '''Pollia serzogonian'''. Alcoholic extracts of the rhizomes of ⚡''P. serzogonian'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [http://www.starchild.co.uk/products/6564_3590_quassia-root-chips.aspx Quassia] (Picrasma excelsa) has, anecdotally, been used successfully to treat threadworms and roundworms, as well as giardiasis, especially when used as an enema. It is a favoured botanical anthelmintic because of its low toxicity.

* ✅ [https://en.wikipedia.org/wiki/Rhodiola_rosea Rhodiola rosea]. Two hookworm hosts have reported taking rhodiola without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/995774170478538/?comment_id=996296763759612&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Rosemary Rosemary] has been reported not to be a problem for helminths.

* ❌ [https://en.wikipedia.org/wiki/Salvia_officinalis Sage] (Salvia officinalis) was used traditionally as a treatment for intestinal worms and some forms of sage are still often included as an ingredient in modern proprietary antiparasitic remedies. Also one NA host has reported that drinking sage-containing teas stunned his colony for nearly a month. [https://www.facebook.com/groups/htsupport/posts/3505446409511289/?comment_id=5274927742563138&reply_comment_id=5275387002517212] However, the use of sage leaves as a culinary herb may not pose a problem for helminths, but there has not yet been sufficient feedback to be certain about this. [https://en.wikipedia.org/wiki/Sage_oil Sage oil] is likely to be much more of a problem for helminths, and one helminth provider cautions against the use of any concentrated form of sage.

* ❌ [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] (also known as arak, jhak, pīlu, Salvadora indica, toothbrush tree and mustard tree). Extracts of the root of this plant have been found to have powerful anthelmintic activity in a model worm. [https://www.ncbi.nlm.nih.gov/pubmed/31516352]

* ✅ [https://en.wikipedia.org/wiki/Sambucus_nigra Sambucus nigra], also known as European elderberry, European black elderberry, elder, European elder, elderberry, black elder, and the branded product, Sambucol. Several NA hosts have taken different forms of black elderberry liquid with no harm to their NA. [https://www.facebook.com/groups/htsupport/posts/2546894892033117/] Elderberry is known to stimulate the immune system, so might increase the symptoms of autoimmune diseases [https://www.webmd.com/vitamins-supplements/ingredientmono-434-elderberry.aspx?activeingredientid=434&activeingredientname=elderberry] [https://www.mskcc.org/cancer-care/integrative-medicine/herbs/elderberry-01#references-7] which may give the impression that it has affected a worm colony when it hasn't. Also see the comments [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570536949668921&comment_tracking=%7B%22tn%22%3A%22R0%22%7D here] and [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570537809668835&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

* ❌ [https://en.wikipedia.org/wiki/Santonin Santonin] is extracted from the dry buds of the desert plant ''Eurasian wormwood'' ([https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina]). It acts against most parasites except Echinococcus, and is used to treat roundworms.

* ⚡ [https://en.wikipedia.org/wiki/Saw_palmetto Saw palmetto] (Serenoa repens). Also known simply as Serenoa, or Sabal serrulatum. One individual has reported an inability to maintain a hookworm colony while taking this herb, but had success once the herb was discontinued.

* ✅ [https://en.wikipedia.org/wiki/Shilajit Shilajit] (mumijo). One hookworm host has taken this without any apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/]

* ❓ [https://en.wikipedia.org/wiki/Ulmus_rubra Slippery elm] (ulmus rubra, also known as ulmus fulva). This is listed on at least one website [http://www.livestrong.com/article/395900-herbal-home-remedy-for-hookworms-in-a-human/] as a herb that may be helpful in treating various types of parasitic worms, including hookworms, but the only report [https://www.facebook.com/groups/htsupport/permalink/796860063703284/?comment_id=796869800368977&offset=0&total_comments=2] so far was from a hookworm host who said that she used a small amount of slippery elm powder on a few occasions without noticeably affecting her worms.

* ❓ [https://en.wikipedia.org/wiki/Soursop Soursop]. This is also called graviola, guyabano and guanábana, and is the fruit of the Annona muricata tree. A. muricata has demonstrated nematicidal activity against several roundworms, including Meloidogyne incognita [https://pubmed.ncbi.nlm.nih.gov/37552644/], Trichinella spiralis [https://pubmed.ncbi.nlm.nih.gov/34515021/] and Haemonchus contortus. [https://pubmed.ncbi.nlm.nih.gov/31455460/] [https://pubmed.ncbi.nlm.nih.gov/23583362/] Since NA are nematodes, there is a possibility of A. muricata also producing an adverse effect on this species, but there have been no reports yet by helminth self-treaters.

* ⚡ [https://en.wikipedia.org/wiki/Southernwood Southernwood] (Artemisia abrotanum) This European flowering plant has demonstrated effects against some helminths. It is also known as old man, boy's love, oldman wormwood, lover's plant, appleringie, garderobe, Our Lord's wood, maid's ruin, garden sagebrush, European sage, sitherwood and lemon plant. Spondias (Spondias mombin or Spondias purpurea var. lutea) This tropical fruit, which is also known as hog plums, Spanish plums, libas in Bikol, golden apples and mombins, may have anthelmintic effects.

* ✅ [https://en.wikipedia.org/wiki/Hypericum_perforatum St. John’s Wort] (Hypericum perforatum). It had been considered conceivable that some of the constituents of hypericum might have an adverse effect on helminths if taken in isolation and in large quantities (e.g., hyperforin, which has demonstrated some antibacterial properties, and hypericin, which has shown both antibacterial and antiviral activity), but there have been no reports of adverse effects on human helminths from any hypericum product in more than a decade.

* ⚡ [https://en.wikipedia.org/wiki/Artemisia_annua Sweet Annie] (Artemisia annua). Also known as sweet wormwood, sweet sagewort and annual wormwood. Both the herb and the pure form of its active ingredient, the sesquiterpene lactone, [https://en.wikipedia.org/wiki/Artemisinin artemisinin], have been used traditionally to treat malaria and intestinal parasites. Artemisinin is a potent anthelmintic and has been shown to be effective against [https://en.wikipedia.org/wiki/Schistosoma schistosomes]. [https://www.ncbi.nlm.nih.gov/pubmed/29727708]

* ❌ [https://en.wikipedia.org/wiki/Tansy Tansy] (Tanacetum vulgare), also known as common tansy, cow bitter, bitter buttons and golden buttons, is highly toxic to intestinal parasites and, for centuries, tansy tea has been prescribed by herbalists to expel worms. One study found that both the crude hydroalcoholic extract of T. Vulgare, and its essential oils, possess significant activity against adult S. mansoni worms, and the activity of the essential oils may be related, at least in part, to monoterpene thujones, which were detected as major constituents of the essential oils. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929489/]

* ⚡ [https://en.wikipedia.org/wiki/Tea_tree_oil Tea tree oil] (Melaleuca alternifolia) has been claimed to kill intestinal worms, including roundworms, tapeworms and hookworms, and its anthelmintic activity has been investigated. [https://pubmed.ncbi.nlm.nih.gov/33503761/] The use of tea tree products may therefore have adverse effects on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Tephrosia_purpurea Tephrosia purpurea]. Alcoholic extracts of ⚡''T. purpurea'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Thymol Thymol]. This is a monoterpene phenol found in [https://en.wikipedia.org/wiki/Thyme%23Medicinal_use oil of thyme] and ''oregano oil'' (see separate reference), as well as ''[https://en.wikipedia.org/wiki/Ajwain ajwain] oil'' and ajwain "seeds" (actually the seed-like fruit from which the oil is extracted). Thymol has antimicrobial and antifungal properties and is said to be highly effective against hookworms. It can also be toxic and has caused fatalities in children.

* ⚡ [https://en.wikipedia.org/wiki/Usnea Usnea] are lichen species with powerful antibiotic and antifungal properties. [http://species.wikimedia.org/wiki/Usnea_florida Usnea florida] extract has been found to have a dose-dependent anthelmintic effect against the nematode worm, [https://en.wikipedia.org/wiki/Trichinella_spiralis Trichinella spiralis].

* ❓ [https://en.wikipedia.org/wiki/Arctostaphylos_uva-ursi Uva-ursi]. (Arctostaphylos uva-ursi). One of several related species referred to as bearberry, uva-ursi contains the glycoside [https://en.wikipedia.org/wiki/Arbutin arbutin], which has antimicrobial properties. There are claims online that uva-ursi is also anthelmintic, but, so far, there have been no reports of its effect on therapeutic helminths.

* ✅ [https://en.wikipedia.org/wiki/Valerian_(herb) Valerian] (Valeriana officinalis). One hookworm host has reported taking valerian tincture without noticing any interaction with her worms. [https://www.facebook.com/groups/htsupport/permalink/1300794123309873/?comment_id=1301681973221088&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Vasaka Vasaka] (Justicia adhatoda). Also known as Malabar Nut, Adulsa, Adhatoda and Vasa. From the same family as Adhatoda zeylanica. The leaves (which contain [https://en.wikipedia.org/wiki/Vasicine vasicine], an alkaloid with significant antimicrobial activity), root, bark, fruit, and flowers are all said to help in removing intestinal parasites.

* ❌ [https://en.wikipedia.org/wiki/Vernonia_amygdalina Vernonia amygdalina] Wild Mahale chimpanzees control parasite-related diseases by ingesting the pith of this plant, [https://pubmed.ncbi.nlm.nih.gov/7878093/] and some human tribal communities use concoctions of the plant for the same purpose. [https://en.wikipedia.org/wiki/Vernonia_amygdalina#Medicinal]

* ❌ Vervine ([https://en.wikipedia.org/wiki/Stachytarpheta_jamaicensis Stachytarpheta jamaicensis]) (Also known as, blue porterweed, blue snake weed, bastard vervain, Brazilian tea, Jamaica vervain and light-blue snakeweed. Vervine extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 81.5 hours - not much more than the anthelmintic drug, thiabendazole, which took 74 hours. [https://www.researchgate.net/publication/21072595]

* ✅ Vitaxyn. Alcoholic herbal concoctions with this name, or referred to as "Tancosan", are thought unlikely to be a problem if taken at the recommended dosage and unless they contain some other ingredient that is known to be harmful to helminths. A product called "Tancosan" was taken by one hookworm host for over 2 years without any obvious adverse effect on her worms.

* ✅ [https://en.wikipedia.org/wiki/Vitex_agnus-castus Vitex agnus-castus]. Also known as vitex, chaste tree, chasteberry, Abraham's balm, lilac chastetree and monk's pepper. One hookworm host has taken 1000 mg of dried vitex agnus castus each day for many months without any noticeable ill effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/986939411362014/?comment_id=986984301357525&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Juglans_cinerea White walnut] (Juglans cinerea). Also known as Butternut. This nut has been used to expel rather than kill worms, although both root bark and leaves have been used in combination with an equal amount of ❌''Mugwort'' to treat worms in children.

* ❌ [https://en.wikipedia.org/wiki/Wild_rue Wild rue] (Peganum harmala). Also known as Esfand, Syrian rue, African rue and harmal. Its powdered seeds were used traditionally to expel tapeworms.

* ❌ [https://en.wikipedia.org/wiki/Stachys_officinalis Wood betony] (Stachys officinalis). Also known as betony, purple betony, bishopwort, or bishop's wort. A tea made from this may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Woodsorrel Woodsorrel] (Oxalis) has been reported[https://www.facebook.com/groups/htsupport/permalink/544122108977082/] as not being a problem for worm hosts when eaten as a food.

* ❌ [https://en.wikipedia.org/wiki/Dysphania_ambrosioides Wormseed] (Dysphania ambrosioides, formerly Chenopodium ambrosioides). Also known as epazote, goosefoot, Jesuit's Tea, Mexican Tea, Herba Sancti Mariae and paico. Wormseed is a traditional herbal remedy used in the tropics for expelling roundworms, hookworms and tapeworms. The oil, leaves or whole plants can be used, but one study[http://www.ncbi.nlm.nih.gov/pubmed/?term=Studies+on+the+traditional+herbal+anthelmintic+Chenopodium+ambrosioides+L.:+Ethnopharmacological+evaluation+and+clinical+field+trials] found that the powdered herb did not effectively eradicate hookworms, roundworms, or whipworms.

* ❌ [https://en.wikipedia.org/wiki/Artemisia_absinthium Wormwood] (Artemisia Absinthium). Also known as common wormwood, green ginger or grand wormwood, this herb was used traditionally as an anthelmintic. Other members of the genus, artemisia, that were traditionally used as anthelmintics include white wormwood ([https://en.wikipedia.org/wiki/Artemisia_herba-alba Artemisia herba-alba]), Eurasian wormwood (Artemisia cina) commonly known as santonica, Levant wormseed and wormseed, and Russian wormwood (Artemisia vestita) also known as Buer, Chamariya, Drubsha, Ganga Tulsi, Kubsha, Kundiyaa, Kundja and Seski. [https://pubmed.ncbi.nlm.nih.gov/36985759/]

* ✅ [https://en.wikipedia.org/wiki/Yerba_mate Yerba mate] (also known as erva-mate). No adverse reports have appeared so far about the effect of this herb on human helminths, or of the beverage made from it, known as mate, maté, Chimarrão, cimarrón, Tererê or Tereré.

* ❌ [https://en.wikipedia.org/wiki/Zingiber_zerumbet Zingiber zerumbet]. Alcoholic extracts of the rhizomes of Z. zerumbet have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

{{Columns}}

=== Fungi ===
<blockquote>
* ❓ [https://en.wikipedia.org/wiki/Amanita_muscaria Amanita muscaria] is a psychoactive and poisonous fungus with several known variations, or subspecies. One hookworm host has reported eating "a couple of hats (5-6 max)" on a few occasions without any effect on his NA that he can remember. [https://www.facebook.com/groups/htsupport/posts/2485762264813047/?comment_id=5343576092364969&reply_comment_id=5374046685984576]

* ❌ [https://en.wikipedia.org/wiki/Inonotus_obliquus Chaga mushroom] (Inonotus obliquus). This fungus, which grows singly on birch and other trees, is claimed, in several places online, to be effective against intestinal parasites, and it has been used for this purpose in the traditional folk medicine of Russia and Eastern Europe. One hookworm host thinks that drinking tea made from chaga mushrooms may have caused the failure of several hookworm incubations, [https://www.facebook.com/groups/htsupport/permalink/810579668997990/?comment_id=810664495656174&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R4%22%7D] however, another NA host has taken 200 mg+ daily of the chaga-containing Sacred 7 Mushroom Extract Powder blend (chaga, cordyceps, lion's mane, maitake, reishi, shiitake, & turkey tail) with no apparent ill effect on his NA. [https://www.facebook.com/groups/htsupport/permalink/4610641158991803/?comment_id=4611955338860385&reply_comment_id=4887932381262678]

* ✅ [https://en.wikipedia.org/wiki/Cordyceps Cordyceps] One NA host took 1/4-1/2 teaspoon cordyceps 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ❌ [https://en.wikipedia.org/wiki/Fomitopsis_betulina Fomitopsis betulina]. This edible fungus, which is usually found on birch trees, was previously known as Piptoporus betulinus, and is commonly known as the birch polypore, birch bracket, or razor strop. Wikipedia reports that F. betulina has been widely used in traditional medicines, and a paper referenced in the Wikipedia article suggests that polyporenic acid, found in the fruit body of the fungus, may be poisonous to the human whipworm, Trichuris trichiura (TT). [https://en.wikipedia.org/wiki/Fomitopsis_betulina#Research_on_chemical_constituents] F. betulina also contains toxic resins and an active compound, agaric acid, which are powerful purgatives that can result in strong though short-lived bouts of diarrhoea. [https://sci-hub.hk/10.1016/S0140-6736(05)79939-6]

* ✅ [https://en.wikipedia.org/wiki/Lingzhi_mushroom Lingzhi mushroom] (also known as Reishi). Several self-treaters have taken Reishi mushrooms or their extracts, e.g, [https://www.facebook.com/groups/htsupport/permalink/1301004239955528/?comment_id=1973652139357398], and there have been no reports of any adverse effects on NA or TT. One user says he consumes moderate doses of reishi [https://www.facebook.com/groups/htsupport/permalink/316642988391663/?comment_id=936181859771103] and another has even successfully used Reishi (Reishi Mushroom extract powder, 1000 mg 2x daily) to treat “worm flu”. [https://www.facebook.com/groups/htsupport/permalink/1461731890549428/?comment_id=1461830860539531]

* ✅ [https://en.wikipedia.org/wiki/Hericium_erinaceus Lion’s mane mushroom] (Hericium erinaceus) Also known as yamabushitake (= ‘mountain priest mushroom’), bearded tooth fungus and bearded hedgehog. One NA host took 1/4-1/2 teaspoon lion's mane 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ✅ [https://en.wikipedia.org/wiki/Wolfiporia_extensa Wolfiporia extensa] (also known as hoelen, poria, tuckahoe, China root, fu ling and matsuhodo) is a species of fungus in the family Polyporaceae. One hookworm host has reported drinking Fu Ling herb daily (E-Fong brand extract powder) with no issues for his colony. [https://www.facebook.com/groups/htsupport/posts/10041354979253700/?comment_id=10050698938319304]
</blockquote>

== Miscellaneous ==
{{Columns|2}}
* ✅ [https://en.wikipedia.org/wiki/Apitherapy Bee venom therapy] appears to be safe for worms. [https://www.facebook.com/groups/htsupport/permalink/876826799039943/?comment_id=876902382365718&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R2%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Diatomaceous_earth Diatomaceous earth (DE)]. This is made from the fossilized remains of tiny, aquatic organisms called diatoms which are mined from ancient sea beds and ground into a fine powder to produce food grade or medical grade diatomite. The finer grade diatomites are used as an insecticide and are also employed to deworm pets and humans. They are believed to work by dehydrating the organism, although the sharp edges of the particles may also be damaging to tiny creatures. A daily dose of one heaped teaspoon of DE has been claimed to be effective for human worm control, and one hookworm host has reported that three doses, of approximately one teaspoon each, quickly wiped out her colony and caused the return of all the symptoms of her disease. Someone who actually wanted to terminate a hookworm colony has said that small amounts of DE did not do this for her, but that taking 1 tablespoon each day for three days did completely eradicate a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/3759836894072238/]

* ❓ [https://en.wikipedia.org/wiki/Clay Clay] (bentonite, kaolin, etc.) Some clays have antibacterial properties [https://www.ncbi.nlm.nih.gov/pubmed/26743034] [https://www.sciencedaily.com/releases/2018/08/180821112029.htm] that vary by type, and some have been claimed to be natural parasite preventives that inhibit the reproduction of organisms. One helminth provider at one time advised against the use of clay while hosting worms, but clay is now thought much less likely to harm human hookworms and whipworms than it is tapeworms, and it may in fact not have any adverse effect at all on any type of ''therapeutic'' helminth. Someone has reported taking a "scant soup spoonful" of [https://en.wikipedia.org/wiki/Montmorillonite montmorillonite clay] slurry daily for quite long periods up to 3 or 4 months with no obvious adverse effect on her NA. [https://www.facebook.com/groups/htsupport/posts/5297777343611511/?comment_id=5298086576913921]

* ✅/❌ [https://en.wikipedia.org/wiki/Diarrhea Diarrhoea/diarrhea] While it is possible to lose hookworms to diarrhoea, this is only likely if the diarrhoea is very severe, or if it is severe and prolonged, i.e., lasting for several weeks. There is a description of one individual’s experience of losing a hookworm colon to very severe diarrhoea [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

:People who get diarrhoea/diarrhea as a side effect following their first inoculation with hookworms do not lose all their worms as a result of this, and hookworms are able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep]. See [[Human helminth care manual#Laxatives | '''Laxatives''']].

:It would seem logical to assume that hookworms might be better able to resist being flushed out after the point at which they attach to the gut wall, which is towards the end of the third week post inoculation.

:While adult hookworms do move around to feed, and are therefore theoretically more likely to be lost if diarrhoea strikes while they are on the move, this is unlikely to lead to any significant loss.

:Human whipworms are unlikely to be dislodged by diarrhoea once these are mature and embedded in the colonic mucosa, but they could could potentially be flushed out before this, especially around 21-22 days post inoculation. After 28 days, human whipworms should not be affected at all by diarrhoea.

* ✅ [https://en.wikipedia.org/wiki/Fasting Fasting]. This [https://www.facebook.com/groups/htsupport/permalink/812582472131043/?comment_id=813100818745875&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D will not harm human helminths] because they feed from their host’s blood (hookworms), or from their intestinal tissue (whipworms). Fasting is also unlikely to have any detrimental effect on the rat tapeworm, Hymenolepis diminuta (HDC), even though this species normally lives on carbohydrates consumed by their host. HDC can apparently also live off glycoproteins secreted in the gut.

* ✅ [https://en.wikipedia.org/wiki/Fever Fever]. Running a fever for several days will not harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Hyperbaric_oxygen Hyperbaric oxygen]. This is safe for use alongside helminthic therapy. [https://www.facebook.com/groups/htsupport/permalink/1281704005218885/?comment_id=1284905411565411&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/678894952216125/permalink/2543377009101234/?comment_id=2543517345753867] [https://www.facebook.com/groups/htsupport/posts/4319514804771108?comment_id=4320113668044555]

* ✅ [https://en.wikipedia.org/wiki/Infrared_sauna Infrared sauna]. Two hookworm hosts used an infrared sauna regularly for over 15 years without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2106930399362904/?comment_id=2107487372640540&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Ketosis Ketosis] is a metabolic state in which most of the body's energy supply comes from ketone bodies in the blood. This state is often induced deliberately by fasting or the adoption of a low-carbohydrate diet as a intervention in various medical conditions. One commenter has suggested that ketosis should not be harmful to helminths because, like fungi, they have mitochondria so can metabolise fat and therefore utilise ketones as a food source, unlike bacteria and viruses which require carbohydrates to survive. [https://www.facebook.com/groups/htsupport/permalink/1077988932257061/?comment_id=1078025565586731&comment_tracking=%7B%22tn%22:%22R0%22%7D] For more on keptogenic diets, see [http://perfecthealthdiet.com/2011/02/ketogenic-diets-i-ways-to-make-a-diet-ketogenic/ here].

* ❓ [http://rifevideos.com/index.html Rife machines]. These devices are claimed to be capable of killing or "devitalizing" worms when set to 2,400 Hz. Therefore, assuming that they are able to do what is claimed (and this is a [https://en.wikipedia.org/wiki/Royal_Rife contentious issue]) it would seem sensible to avoid this particular frequency if using these machines.

* ✅ [https://en.wikipedia.org/wiki/Spermidine Spermidine]. When fed to worms, this simple polyamine (found in large quantities in human sperm and grapefruit) significantly prolonged their lifespan. [http://www.rsc.org/chemistryworld/News/2009/October/04100901.asp]

* ✅ Steam. Saunas, hot tubs and hot baths do not harm helminths because the body's core temperature remains relatively constant while the skin sweats.

* ✅ [https://en.wikipedia.org/wiki/Wim_Hof Wim Hof] breathing techniques. Someone who hosts hookworms and has done these exercises on and off for about a year has reported having no issues as a result of combining the two treatments. [https://www.facebook.com/groups/htsupport/permalink/1417893248266626/?comment_id=1417961461593138&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Zeolite Zeolite] Zeolites are microporous, aluminosilicate minerals that are used widely in water purification systems. One hookworm host has reported taking 1 zeolite tablet daily for a week with no adverse affect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/?comment_id=2168119789910631]

{{Columns}}

== Additional scientific studies ==

* 2011 Mar 1 [https://hdl.handle.net/1843/BUOS-8G3LVD Avaliação dos efeitos de fármacos imunomoduladores na infecção de Hamsters, Mesocricetus auratus, POR Ancylostoma ceylanicum (Evaluation of the effects of immunomodulatory drugs on the infection of hamsters, Mesocricetus auratus, by Ancylostoma ceylanicum) (Loss, 1911)] (Thesis, Minas Gerais, Portuguese)

Human helminth care manual

2026-05-09T01:45:05Z

John: /* List of herbs and medicinal plants */

{{Breadcrumb|[[Using_helminths|Using helminths]]|[[Helminth_care|Helminth care]]}}
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|title=
|description=How to care for the two species of human helminth used in helminthic therapy: Necator americanus (NA) and Trichuris trichiura (TT/TTO).
|keywords=worm care, helminth care, Necator americanus, Trichuris trichiura, NA, TT, TTO, caring for my worms
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'''PLEASE READ THIS FIRST''' 
This manual is only concerned with the two '''''human''''' helminths:
* '''Human hookworm - Necator americanus''' (NA) [https://en.wikipedia.org/wiki/Necator_americanus]
* '''Human whipworm - Trichuris trichiura''' (TT) and its ova (TTO) [https://en.wikipedia.org/wiki/Trichuris_trichiura]
For the care of the non-human helminths, TSO and HDC, see the [[Helminth_care |'''Helminth care''']] page. 
=== Key ===
The following classification codes are intended as a general guide only, because the effects of a substance can vary considerably depending on factors such as quantity, concentration, and, in the case of herbal extracts, the part of the plant used. Even the method of extraction can make a difference, and, in the case of foods, perhaps the method, temperature and duration of any cooking, [https://www.facebook.com/groups/htsupport/posts/6863122353743661?comment_id=6863149840407579&reply_comment_id=6863721660350397] so it's important to read the details for each item.

:❌ Will or may kill, or cause the loss of, human helminths.
:⚡ May cause harm to human helminths in some people.
:➿ May cause a temporary reduction in benefits from human helminths.
:❓Insufficient evidence exists to support a judgement on possible effects.
: ✅ Safe, or likely to be safe, for human helminths.

Note that where an entire section is marked with a ✅, this indicates that all the substances listed within that section are safe unless marked otherwise.

=== Using this manual ===
'''* Bookmark this page to facilitate rapid access whenever it is needed.'''

'''* To find information about a specific substance, don't scan the page visually. Instead, use the search function on your device:''' 

* '''PC''' - Control+F 
* '''Mac''' - Command+F 
* '''Mobile''' - "Find in page" in the drop-down menu from the three dots icon

'''* Anything NOT MENTIONED in this manual has never been reported to be a problem, so, unless it is a new or very unusual product/substance, it is far more likely to be safe than unsafe for therapeutic human helminths.''' 

=== General advice ===
'''NA and TT are relatively robust organisms, and most foods, drugs and other substances are safe for use while hosting them, including normal dietary amounts of most unprocessed foods, spices and herbs. However there are some foods and other substances that may harm a colony, either temporarily stunning them or even killing them.'''

Things that will or may kill, or cause the loss of, human helminths include:

* ❌ Diatomaceous earth. (See [[#Diatomaceous earth|'''full details''']].)
* ❌ Oregano. (See [[#Oregano|'''full details''']].)
* ❌ Sauerkraut. (See [[#Sauerkraut|'''full details''']].)

'''Some foods can cause harm to NA and TT in some people but not others,''' and coconut products are a good example of this. While many hosts of human helminths are able to eat normal dietary amounts of coconut products without affecting their worms, others find that some forms of this food will affect their worms sufficiently to impair their beneficial effects.

The most common food items that may affect helminths in some people but not others are:

* ⚡ Coconut products. (See [[#Coconut|'''full details''']].)
* ⚡ Fatty acids. (See [[#Fatty acids|'''full details''']].)
* ⚡ Ginger. (See [[#Ginger|'''full details''']].)
* ⚡ Honey. (See [[#Honey|'''full details''']].)
* ⚡ Papaya seeds. (See [[#Papaya|'''full details''']].)
* ⚡ Pumpkin seeds and pumpkin seed oil. (See [[#Pumpkin|'''full details''']].)
* ⚡ Digestive enzymes. (See [[#Digestive enzymes|'''full details''']].)
* ⚡ Cayenne. (See [[#Cayenne|'''full details''']].)

If hosting NA, it is best to avoid the food substances listed above until the therapy is delivering benefits, at which point their effect on one’s colony can be tested, initially in small, and then in gradually increasing, quantities to assess the level of risk they are likely to present, and how much of each substance might safely be consumed before the worms are affected.

See the rest of this page for other items marked with a ⚡ or ❌.

'''Medicinal quantities of concentrates, extracts or tinctures, especially of certain herbs, are more likely to have an adverse effect on NA and TT than the plants from which they are derived.''' For example, eating normal dietary amounts of ginger is usually fine, as is occasionally taking a ginger supplement (e.g., to treat a migraine), but taking ginger regularly as a supplement or drinking ginger beer every day may adversely affect NA.

Another example of how the concentrated form of a substance can be harmful to helminths while foods containing the same substances are not are the phytochemical compounds, '''isomyristicin''' and '''bergaptenix'''. While the ''concentrated'' forms of isomyristicin and bergaptenix have shown significant anthelmintic activity against two helminth species, the parent chemicals from which they are derived ('''myristicin''' and '''bergapten''') are both found in several of the fruits, herbs and vegetables consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, and the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

'''People who have a robust immune response to helminths are likely to notice a greater effect on their worms than others.''' These individuals are the ones who need to top up their human helminth colonies more frequently in order to maintain remission from their disease. Typically, they have Crohn's, or one of the other intestinal diseases, but a few in this group have other conditions, such as allergies. [https://www.facebook.com/groups/htsupport/permalink/966004180122204/?comment_id=966023830120239&comment_tracking=%7B%22tn%22:%22R1%22%7D]

'''It is thought to be less likely that anything will harm NA before it attaches to the gut mucosa towards the end of the third week post inoculation''', although, once NA enters the bloodstream, it does begin to feed on proteins in the blood. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.ncbi.nlm.nih.gov/pubmed/29566094]. After it arrives in the small intestine and begins feeding from the gut wall from day 21, NA will always be vulnerable to anything harmful that has entered its host's blood.

'''Substances that are applied to the skin topically in small quantities are unlikely to cause harm to human helminths, even if the substances are known to be a risk when they are ingested.'''

'''Due to the way that TT feeds and attaches to the colonic mucosa, it is not as vulnerable as NA''', as is illustrated by the fact that three times more of the anthelmintic drug, mebendazole, may be required to kill TT than to kill NA.

'''Substances listed on the internet as being "antiparasitic" may have no effect whatsoever on NA and TT.''' Helminths are only one of many different types of parasite. Among the other types, there is a wide range of responses to substances claiming to be antiparasitic, and what kills one type of parasite may not even harm another. Even substances that have shown an anthelmintic effect in test tube studies do not necessarily have an adverse affect on worms being hosted by humans. [https://www.ncbi.nlm.nih.gov/pubmed/27498843]

'''Some foods and substances can reduce the therapeutic/ prophylactic benefits of adult helminths without killing the worms or having any impact on their egg production.''' Therefore, if testing shows the presence of helminth eggs in the host’s feces after ingesting a particular substance, it does not necessarily mean that this food/ substance will not interfere with the health benefits provided by the worms. [https://www.facebook.com/groups/htsupport/posts/9561303440592192?comment_id=9562835637105639] So the details on this page may not be relevant to the practice of helminth incubation, and a tentative examination of the effect of substances on the production of hookworm eggs and larvae can be found in the page section, [[NA incubation: very detailed method by Alana#Promotion of egg viability by dietary manipulation | '''Promotion of egg viability by dietary manipulation''']].

The posts in this [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/ support group sub-thread] contain good general advice on how to manage exposure to substances that can harm human helminths.

=== Worm harm denial ===

A few people have difficulty accepting that any of the substances mentioned on this page might harm helminths, with the exception of anthelmintic drugs. They believe that the adverse effects on human helminths that have been reported by self-treaters have alternative explanations, including delusion on the part of the reporting individual. They argue that, were the claims true, there would no longer be large areas of the planet where these worms remain endemic, and that the substances/foods/spices identified by self-treaters as potentially harmful to human helminths would have become folk remedies for helminth infections. However, this position ignores the science (e.g., [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9924796/ Herbal anthelmintic agents: a narrative review]) and the fact that the effect of consuming a food or product with anthelmintic effects will be much less of an issue, if it is even noticed at all, in populations that are continually exposed to helminths and therefore constantly being reinfected.

In the words of one experienced NA self-treater:
{{Quote|indent}}Respect the foods and other items in the care manual that are likely, or potentially, unsafe for helminths. I’ve learned the hard way that coconut oil/milk/flour, raw ginger, curry, etc. are no beuno for my friends on board, and as much as I enjoy those things, they are not worth knocking out my NA for a week or multiple weeks. Everybody’s different here and it’s worth testing in very small amounts. [https://www.facebook.com/groups/htsupport/posts/4395750987147489/]{{Quote|/indent}}

=== Updates & disclaimer ===
This manual is updated regularly. See the page history (via the "View history" link at the top of the page) for a list of amendments.

Although the most harmful substances have been identified, this manual continues to be a work in progress so should not be viewed as definitive. Also see the [[Helminthic Therapy wiki:General disclaimer|'''General disclaimer''']].

Details in this manual are based on first hand reports posted in the [[Helminthic_therapy_support_groups|'''Helminthic therapy support groups''']]. Additional reports and comments on this topic are welcomed, and should be posted to the [https://www.facebook.com/groups/htsupport/ Helminthic Therapy Support group] on Facebook. 
{{Columns}}

</div>

<div class="toclimit-3">__TOC__</div>

== Pharmaceuticals ==


=== Anaesthetics (anesthetics), General [https://en.wikipedia.org/wiki/Anesthetic] ===

==== ✅Nitrous oxide (N2O) (E942) [https://en.wikipedia.org/wiki/Nitrous_oxide] ====
<blockquote>
Nitrous oxide (aka laughing gas or sweet air) was, at one time, mistakenly thought to kill hookworms. However, when this gas was used by people who wanted to terminate their hookworm colonies, their attempts met with failure. One subject reported inhaling almost a full can of whipped cream at 3 weeks post inoculation in an attempt to resolve severe side effects, but with no obvious effect on his hookworms. In another case, a balloon full of nitrous oxide failed to have any effect on a hookworm colony, which was later confirmed to be viable by a stool test. [https://www.facebook.com/groups/htsupport/permalink/759492150773409/] Then, in 2017, the notion that nitrous oxide harms NA was finally laid to rest by someone who inhaled a large quantity of the gas over the course of an hour. This individual reported that, although he did get a headache and giggled a lot, his worms were not harmed.

✅ The following forms of nitrogen are also unlikely to be a problem for hookworms.
* Nitric oxide (NO) [https://en.wikipedia.org/wiki/Nitric_oxide]
* Nitrogen dioxide (NO2) [https://en.wikipedia.org/wiki/Nitrogen_dioxide]
* Nitrate (NO3) [https://en.wikipedia.org/wiki/Nitrate]
* Pure nitrogen (N) [https://en.wikipedia.org/wiki/Nitrogen]
* Liquid nitrogen (LN2) [https://en.wikipedia.org/wiki/Liquid_nitrogen]
</blockquote>

==== Other general anaesthetics ====

<blockquote>
It has been suggested that the volatile organic compounds (VOCs) that were used in the early days of anaesthesia might be a risk to hookworms, especially if inhaled in excessive quantity, due to the possibility that they might stun them and cause them to be expelled from the gut before waking up. For example:
* ✅ [https://en.wikipedia.org/wiki/Diethyl_ether diethyl ether]
* ✅ [https://en.wikipedia.org/wiki/Chloroform chloroform]
However, a clinical scientist has reported that, while hosting both NA and TT, he worked around more organic solvents, including dichloromethane (CH2Cl2) and chloroform (CHCl3), than most people are exposed to in a lifetime, and that his hookworms and whipworms continued egg production uninterrupted.

✅ [https://en.wikipedia.org/wiki/Propofol Propofol] While propofol has been shown to adversely affect the mitochondria of roundworms in laboratory conditions, it is clear from the experience of hosts of both hookworms and whipworms that propofol does not harm human helminths in the concentrations used during surgery.

✅ [http://www.sciencedaily.com/releases/2009/08/090804145614.htm Regional nerve blocks] are worm-safe.

</blockquote>



=== Anaesthetics (anesthetics), local [https://en.wikipedia.org/wiki/Anaesthetics] ===

==== ➿ [https://en.wikipedia.org/wiki/Local_anaesthetic Local anaesthetics] ====
<blockquote>
Local anaesthetics interfere with the production of white blood cells as well as the functioning of the cells in circulation, but they appear not to affect ova production by helminths and they certainly don't kill them. While local anaesthetics can cause a temporary return of disease symptoms for up to 8 weeks, helminths generally recover after only a few days, although this varies by person, drug and dosage, making it difficult to predict exactly what will happen in any particular situation.

For dental procedures requiring a local anaesthetic, short-acting drugs are less likely to affect helminths, e.g.
* [https://en.wikipedia.org/wiki/Articaine Articaine] (articadent, astracaine forte, septanest, septocaine, ubistesin forte, ubistesin, ultracaine, zorcaine)
* [https://en.wikipedia.org/wiki/Lidocaine Lidocaine] (xylocaine, lignocaine)
These are a better choice than a longer-acting drug, such as
* [https://en.wikipedia.org/wiki/Carbocaine Mepivacaine] (carbocaine, polocaine)
* [https://en.wikipedia.org/wiki/Bupivacaine Bupivacaine] (Marcaine, Sensorcaine and Vivacaine, etc.)
and one helminth host has reported that the short-acting articaine had no adverse effect on his hookworms.

If a patient explains that they don't want to be numb for several hours, the dentist will usually use one of the short-acting drugs, or one combined with a vasoconstrictor such as epinephrine, which helps to reduce the amount of the drug that reaches the systemic circulation.

If local anaesthetics are used, it can be a good idea to arrange for a small supplementary dose of worms (e.g., 3 or 5 hookworm larvae) to be available for administration the day after exposure to the drug. This small additional inoculation usually helps to reduce the time that established helminths are out of action.
</blockquote>

==== ✅ Alternatives to local anaesthetics ====
<blockquote>
* [https://en.wikipedia.org/wiki/Opioids Opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.)
* [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed versed], etc., routinely used during colonoscopies)
* [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics]
These drugs all appear to be harmless to helminths, so, taken orally at high strength, these may be a suitable substitute for local anaesthetics in many situations. For example, one helminth host has found that 30 mg [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], taken along with 1,000 mg of [https://en.wikipedia.org/wiki/Paracetamol paracetamol (acetaminophen)] an hour or two before a dental appointment can be effective in avoiding all but a few brief moments of mild, dull pain, which he
found to be quite manageable while having a tooth drilled. This subject even found that the combination of dihydrocodeine and paracetamol (acetaminophen) provided adequate pain relief when having a tooth sculpted to take a crown. [https://en.wikipedia.org/wiki/Aspirin Aspirin] and [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] are also harmless to helminths, so, if preferred, these might provide a suitable alternative to paracetamol (acetaminophen).

Another option for completely avoiding any risk to helminths from local anaesthetics was the [https://www.facebook.com/GumEase GumEase] cryoallergenic mouthpiece. This device, which is apparently no longer available to purchase, provided pain relief for up to 20 minutes, and was appropriate for most procedures, including fillings, crowns, extractions and root canals. Previously available from two sources [http://cryodevices.ecrater.com/c/902779/gumease-products], [http://www.dentakit.com/gumease.html] this device unfortunately never caught on with dentists who are firmly wedded to the use of injectable drugs.

Another pain-free alternative is [http://www.youtube.com/watch?v=dcAwKvdqmKI laser dental surgery], which is likely to become increasingly available in the future. If more invasive dental surgery is required - where bone needs to be removed, for example - it may be best to request [https://en.wikipedia.org/wiki/Conscious_sedation conscious sedation]. This renders the patient unaware of what is taking place, but is not the same as a general anaesthetic. Conscious sedation might involve a combination of [https://en.wikipedia.org/wiki/Versed versed] (a short acting IV [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine]) and [https://en.wikipedia.org/wiki/Fentanyl fentanyl] (a short acting IV opiate), both of which are perfectly safe for worms.

</blockquote>

=== Anaesthetics (anesthetics), topical [https://en.wikipedia.org/wiki/Anaesthetics] ===

<blockquote>
✅ Topical anaesthetics (e.g., lidocaine / lignocaine) that are applied to the skin are unlikely to affect helminths within the digestive tract because not enough of the drug will get into the blood stream to affect the worms. Topical lidocaine used before blood draws, punch biopsies and the fitting of a catheter, or applied to the mucous membranes in the mouth or nose, are therefore worm-safe. However, there is a small possibility that fresh L3 NA larvae, which remain within the skin at the inoculation site for the first 40 hours, '''''may''''' be adversely affected by the use of a topical anaesthetic applied directly to this area following inoculation. [https://www.facebook.com/groups/htsupport/posts/6162787843777119/?comment_id=6163364870386083&reply_comment_id=6165161500206420] Further feedback is needed to confirm or dispel this possibility.
</blockquote>

=== Anthelmintics [https://en.wikipedia.org/wiki/Anthelmintics] ===

==== ❌ Anthelmintic drugs ====
<blockquote>
A number of drugs are used to terminate helminth infections, but the effectiveness of different anthelmintics against a single species [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250499/?report=classic varies] greatly. In [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/ one study], a triple dose of [https://en.wikipedia.org/wiki/Albendazole albendazole] (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, whereas a triple dose of [https://en.wikipedia.org/wiki/Mebendazole mebendazole] (3×500 mg over 3 consecutive days) only achieved a cure rate of 58%.

Each anthelmintic drug has varying degrees of effectiveness against different helminths. For example, while a triple dose of '''albendazole''' (3×400 mg over 3 consecutive days) showed a cure rate against hookworms of 92%, the same regimen only achieved a 56% cure rate against whipworms [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181256/] and, in patients with an excessive whipworm infection, '''albendazole''' may need to be taken for 5–7 days. [http://www.ncbi.nlm.nih.gov/pubmed/14754497?dopt=AbstractPlus]

If it becomes necessary to terminate a colony of helminths, a medical doctor should be consulted, and their directions followed. However, under no circumstances should '''mebendazole''' ever be combined with '''metronidazole''' (Flagyl), and this is something about which many doctors and pharmacists may be unaware. There is a risk that this combination may [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ cause Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis].
{{Columns|2}}

==== List of anthelmintics ====

* [https://en.wikipedia.org/wiki/Abamectin Abamectin]

* [https://en.wikipedia.org/wiki/Albendazole Albendazole] (Albenza, Valbazen, Zentel, etc.)

* [https://en.wikipedia.org/wiki/Aminoacetonitrile Aminoacetonitrile] derivatives

* [https://en.wikipedia.org/wiki/Arecoline Arecoline] (Arecaline, Arecholine, Arecolin, Arecoline base, Arekolin, Methylarecaidin.)

* [https://en.wikipedia.org/wiki/Artemisinin Artemisinin] (Artemisinine, qinghaosu)

* [https://en.wikipedia.org/wiki/Bephenium_hydroxynaphthoate Bephenium hydroxynaphthoate] (Alcopar, Alcopara, Befenium, Debefenium, Francin, Nemex). This is an anthelmintic agent once used to treat hookworm and roundworm infections.

* [https://en.wikipedia.org/wiki/Diethylcarbamazine Diethylcarbamazine] (DEC, Hetrazan, Carbilazine, Caricide, Cypip, Ethodryl, Notézine, Spatonin, Filaribits, Banocide Forte and Eofil)

* [https://en.wikipedia.org/wiki/Disulfiram Disulfiram] (Antabuse, Antabus, etc.). While this drug is predominantly used to treat alcoholism, it has also been reported in the scientific literature to possess anthelmintic properties, which were the main reason for its original investigation. Copper‑chelating thiuram compounds such as disulfiram have been noted to produce lethal inhibition of respiration in intestinal worms such as the whipworm Trichuris muris as well as schistosomes, with daily disulfiram treatment of T. muris‑infected animals producing malformed eggs and preventing successful colonisation of mice.

* [https://en.wikipedia.org/wiki/Emodepside Emodepside] (Monepantel) [https://pharmaphorum.com/news/bayer-drug-raises-hope-15bn-people-worm-diseases]

* [https://en.wikipedia.org/wiki/Fenbendazole Fenbendazole]

* [https://en.wikipedia.org/wiki/Flubendazole Flubendazole] (Flutelmium, Flubenol, Biovermin, Flumoxal.)

* '''Isomyristicin''' and '''bergaptenix''' are two phytochemical compounds isolated from the Bhutanese medicinal plants, Corydalis crispa and Pleurospermum amabile, which have shown significant anthelmintic activity against the helminths, Schistosoma mansoni and Trichuris muris. In concentrated form, they may therefore be harmful to other whipworms and possibly also hookworms. [http://www.ncbi.nlm.nih.gov/pubmed/27572696] However, it should be noted that myristicin (the parent chemical from which isomyristicin is derived) and bergapten are both found in very small quantities in the vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but the risk of an anthelmintic effect from this very limited dietary intake is negligible. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/] These chemicals are also found in ⚡ [https://en.wikipedia.org/wiki/Earl_Grey_tea Earl Grey tea], which is flavoured with bergamot oil, and one hookworm host has reported that she experienced a return of symptoms of her disease (POTS) after drinking this brew. However, there are many other NA hosts who drink this tea without any problem, including someone who drinks multiple cups each day of weak Lady Grey tea (citrus bergamot flavour) and has reported still being able to successfully incubate from her small NA colony. [https://www.facebook.com/groups/htsupport/posts/5482091725180071/?comment_id=5483270285062215]

* [https://en.wikipedia.org/wiki/Ivermectin Ivermectin] (Stromectol, Soolantra, Sklice, etc.) Used to treat [https://en.wikipedia.org/wiki/Cutaneous_larva_migrans cutaneous larva migrans] caused by various zoonotic hookworm species. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11125977/]

* [https://en.wikipedia.org/wiki/Levamisole?wprov=sfla1 Levamisole] (Decaris, Ergamisol) is an antihelmintic drug approved for use in veterinary medicine in the United States. It was once used in the treatment of rheumatoid arthritis but proved too dangerous.

* [https://en.wikipedia.org/wiki/Mebendazole Mebendazole] (MBZ, Vermox, Ovex)

* [https://en.wikipedia.org/wiki/Niclosamide Niclosamide] (Niclocide, Fenasal, Phenasal, etc.)

* [https://en.wikipedia.org/wiki/Nitazoxanide Nitazoxanide] (Alinia, Nitaxide) is a broad-spectrum antiparasitic and broad-spectrum antiviral drug used to treat various helminthic, protozoal and viral infections. It has demonstrated activity against tapeworms, [https://www.ncbi.nlm.nih.gov/pubmed/27751770] so may also have an adverse effect on hookworms and whipworms.

* [https://en.wikipedia.org/wiki/Odanacatib Odanacatib] (codenamed MK-0822) is an investigational treatment for osteoporosis and bone metastasis developed by Merck & Co., and possibly available for clinical use from 2016. Unfortunately, this drug has been shown to kill the hookworm, Ancylostoma ceylanicum, in hamsters, decreasing worm burdens by 73%. [https://www.ncbi.nlm.nih.gov/pubmed/27751770] Consequently, it is likely to be trialled as a potential alternative to albendazole and may have an adverse effect on the human hookworm as well as other helminths, so should be avoided by helminth self-treaters.

* [https://en.wikipedia.org/wiki/Oxamniquine Oxamniquine] (e.g., Vansil)

* [https://en.wikipedia.org/wiki/Oxyclozanide Oxyclozanide]

* [https://en.wikipedia.org/wiki/Penicillium_cluniae Penicillium cluniae] (a fungus species of the genus of Penicillium which produces the antinematodal and antiparasitic agents paraherquamide B, paraherquamide C, paraherquamide D, paraherquamide E, paraherquamide F, paraherquamide G, paraherquamide H.)
* [https://en.wikipedia.org/wiki/Phenothiazine Phenothiazine (PTZ)] This is considered to be the first modern anthelmintic, introduced for this purpose in 1940.

* [https://en.wikipedia.org/wiki/Piperazine Piperazine] (piperazine hydrate and piperazine citrate are anthelmintic drugs that kill 60-70% of adult roundworms) and piperazine's many [https://en.wikipedia.org/wiki/Piperazine#Piperazine_derivatives_as_drugs derivatives].

* [https://en.wikipedia.org/wiki/Piperine Piperine] has demonstrated significant anthelmintic properties against various worm species. [https://www.academia.edu/103643829/Anthelmintic_Activity_of_Piperine_from_Black_Pepper] It not only has well documented potent effects against eggs and larvae, but also shows activity against adult worms, with paralysis and death times comparable to the standard anthelmintic drug albendazole. [https://pubmed.ncbi.nlm.nih.gov/31437123/]

* [https://en.wikipedia.org/wiki/Praziquantel Praziquantel] (Biltricide etc.)

* [https://en.wikipedia.org/wiki/Pyrantel Pyrantel pamoate] (Pin-X, Combantrin, etc.)

* [https://en.wikipedia.org/wiki/Pyrvinium Pyrvinium] (Vanquin, viprynium). This anthelmintic was previously used to treat pinworm (Enterobius vermicularis) infections, but has been largely replaced by other anthelmintics, e.g., mebendazole or [https://en.wikipedia.org/wiki/Pyrantel pyrantel pamoate].

* [https://en.wikipedia.org/wiki/Salicylanilide Salicylanilide], Spiroindoles (e.g. derquantel)

* [https://en.wikipedia.org/wiki/Tiabendazole Tiabendazole] (thiabendazole, TBZ, Mintezol, Tresaderm, Arbotect, etc.)

* [https://en.wikipedia.org/wiki/Triclabendazole Triclabendazole] (Fasinex, Egaten, etc.).
{{Columns}}
</blockquote>

==== ❓ Piperazine-derived compounds ====

<blockquote>
There is a whole raft of [https://en.wikipedia.org/wiki/Piperazine%23Piperazine_derivatives_as_drugs piperazine-derived compounds] some of which '''may potentially''' have anthelmintic effects. However, this does not mean that all piperazine derivatives will kill, or even harm, helminths. For example, ✅ [https://en.wikipedia.org/wiki/Viagra Viagra] is a piperazine derivative, but does not kill hookworms.

* These include many antidepressants including
** [https://en.wikipedia.org/wiki/Trazodone trazodone] (Depyrel, Desyrel, Molipaxin, Oleptro, Trazodil, Trazorel, Trialodine, Trittico). One self-treater has been reported to take trazodone almost every night, but continues to get "great results" from her NA. [https://www.facebook.com/groups/htsupport/posts/7313725575350001/?comment_id=7313750828680809&reply_comment_id=7313942228661669]
* antipsychotics such as
** [https://en.wikipedia.org/wiki/Olanzapine olanzapine] (Lanzek, Zypadhera, Zyprexa and [https://www.drugs.com/international/olanzapine.html numerous other names]),
** [https://en.wikipedia.org/wiki/Olanzapine prochlorperazine] (Compazine, Stemzine, Buccastem, Stemetil, Phenotil),
** [https://en.wikipedia.org/wiki/Ziprasidone ziprasidone] (Geodon, Zeldox),
* the migraine treatment
** [https://en.wikipedia.org/wiki/Migraleve Migraleve Pink],
* and antihistamines including
** [https://en.wikipedia.org/wiki/Buclizine buclizine],
** ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine),
** [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan),
** [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5),
** [https://en.wikipedia.org/wiki/Cyclizine cyclizine],
** ⚡ [https://en.wikipedia.org/wiki/Levocetirizine levocetirizine] (Xyzal) (one NA host has reported having no problems with her worms when taking this [https://www.facebook.com/groups/htsupport/permalink/3067416309980970/?comment_id=3067678586621409]),
** [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs,
** ⚡ [https://en.wikipedia.org/wiki/Dimenhydrinate dimenhydrinate] (Dramamine, Draminate, Gravol, etc.) While one NA host has reported that taking this drug had no observable effect on her worms, [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682333608489254&reply_comment_id=1682358115153470&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] someone with colitis believes that it killed at least some of her NA colony.
** [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
** [https://en.wikipedia.org/wiki/Ebastine ebastine] (Evastin, Kestine, Ebastel, Aleva and Ebatrol) Listed as a [https://en.wikipedia.org/wiki/Piperidine piperidine].
* as well as antianginals, anxiolytics such as
** ⚡ [https://en.wikipedia.org/wiki/Buspirone buspirone] (Buspar), (one self-treater found that the positive effects of NA were lessened in the days following a single dose of buspirone [https://www.facebook.com/groups/htsupport/permalink/1944442368945042/])
* urologicals, e.g.
** [https://en.wikipedia.org/wiki/Sildenafil sildenafil] (Revatio, ✅ Viagra) and
** [https://en.wikipedia.org/wiki/Levitra vardenafil] (Levitra, Staxyn).
</blockquote>

Anthelmintic residues may be encountered in farmed meats, especially the livers of cattle and fowl, but it is not known whether, or to what extent, these might affect therapeutic helminths in hosts who eat this meat.

Canine anthelmintics that have been applied to a dog’s skin should not be a problem for anyone who pets a treated animal so long as they wash their hands immediately after the contact. [https://www.facebook.com/groups/htsupport/permalink/868843983171558/]

=== Antibiotics [https://en.wikipedia.org/wiki/Antibiotics] ===

(Also see [[Human helminth care manual#Natural antibiotics|'''Natural antibiotics''']].)

==== ❌ Antibiotics that may significantly reduce hookworm benefits ====
<blockquote>
* [https://en.wikipedia.org/wiki/Cefazolin Cefazolin] (Also known as cefazoline and cephazolin.) Someone who was given a 1 gram shot of cefazolin post-operatively estimates that she suffered a 60% loss of effect from her hookworms for several weeks. She began to feel better after a 3-day course of prednisone taken one month after the cefazolin exposure, and was mostly back to normal at 6 weeks. However, when [https://en.wikipedia.org/wiki/Cefalexin cefalexin] (aka cephalexin), a drug related to cefazolin within the cephalosporin class, was taken by a different hookworm host for 2 days, this appeared to have no effect on his NA colony.
* [https://en.wikipedia.org/wiki/Levaquin Levofloxacin] has been reported by one NA host as having "completely devastated" her colony. An egg count revealed only 14 ova, and she went from near total remission to a severe flare. "Back to ground zero." [https://www.facebook.com/groups/htsupport/permalink/1626974844025131/?comment_id=1627023594020256&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]
</blockquote>

==== ⚡ Antibiotics that may reduce hookworm benefits in some people ====
<blockquote>

* [https://en.wikipedia.org/wiki/Amoxicillin Amoxicillin] While two hookworm hosts have said that they did not lose their worms following treatment with amoxicillin, three others have reported losing their colonies after taking this drug, for example, [https://www.facebook.com/groups/htsupport/posts/9106626532726554/ here]. Combination drugs that contain amoxicillin e.g., [https://en.wikipedia.org/wiki/Amoxicillin/clavulanic_acid amoxicillin/clavulanic acid] (co-amoxiclav, Augmentin) can also be a threat to human helminths, as was found by a hookworm host whose colony was temporarily "knocked out" after taking amoxicillin and clindamycin together. [https://www.facebook.com/groups/htsupport/permalink/1664279276961354/?comment_id=1664541103601838&reply_comment_id=2421515414571066]

* [https://en.wikipedia.org/wiki/Azithromycin Azithromycin] (brand names include: AZIF-500, Azithral, Azithrocin, Azyth, Azin, Z pack, Zeto and Zithromax) Someone has reported losing her hookworms to a combination of [https://en.wikipedia.org/wiki/Azithromycin azithromycin] (an azalide, a type of macrolide antibiotic) and doxycycline (see below) (a broad spectrum antibiotic of the tetracycline class), whereas a whipworm host [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=892732697449353&offset=0&total_comments=12&comment_tracking=%7B%22tn%22:%22R1%22%7D did not lose her colony] from taking this same combination of drugs. Azithromycin has been used on its own to treat a child with PANDAS and a female adult with an ear infection [https://www.facebook.com/groups/htsupport/permalink/1230554160333870/?comment_id=1230564746999478&comment_tracking=%7B%22tn%22%3A%22R%22%7D] without any worm loss, although its use did result in a temporary suspension of benefits in both cases.

* [https://en.wikipedia.org/wiki/Clindamycin Clindamycin] has been suspected of possibly harming hookworms when taken in combination with amoxicillin or metronidazole, but two NA hosts who took this drug on its own have reported that it had no adverse effect on their colonies. The first took clindamycin for 10 days (starting in the first week of hosting), [https://www.facebook.com/groups/htsupport/permalink/2123829614339649/] and the second took a 7 day course (300mg taken 4 times per day) after which a float test revealed plenty of hookworm eggs. [https://www.facebook.com/groups/htsupport/permalink/2574492762606663/]

* [https://en.wikipedia.org/wiki/Doxycycline Doxycycline] (Vibramycin, Monodox, Microdox, Periostat, Vibra-Tabs, Oracea, Doryx, Vibrox, Adoxa, Doxyhexal, Doxylin, Doxoral, Doxy-1 and Atridox, etc.) is a tetracycline antibiotic that also has antiprotozoal, antibacterial and some anthelmintic effects, although the latter have been claimed to only affect filarial nematodes. In this case, the drug kills a symbiotic bacterium in the worm’s reproductive tract, thus rendering it sterile. Moreover, an eight-week course of doxycycline may be necessary to achieve this effect. One hookworm host has reported that he took doxycycline for a total of 5 weeks without noticeable effect on his worms, and others have also reported having no issues with this drug, [https://www.facebook.com/groups/htsupport/posts/24894037546892199?comment_id=24894176736878280] but another has said that her hookworms “completely stopped working” after taking doxycycline for only three days. She said that this happened “pretty much overnight”, and that, in spite of getting a supplementary dose of worms a month or so after taking the antibiotic, [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786946941361263&offset=0&total_comments=16] she didn’t feel right again for the following 6 months. [https://www.facebook.com/groups/htsupport/permalink/786180988104525/?comment_id=786624918060132&offset=0&total_comments=15] (NB: doxycycline has also been found to have [http://medicalxpress.com/news/2015-03-antibiotics-unexpected-effects-mitochondria.html unexpected effects on mitochondria].)

* [https://en.wikipedia.org/wiki/Flucloxacillin Flucloxacilin], also known as floxacillin. When one hookworm host took this drug with [https://en.wikipedia.org/wiki/Probenecid probenecid] (which is sometimes used to increase the concentration of some antibiotics), she experienced a return of her disease symptoms, although these were not as severe as they had been before she began hosting NA. An incubation yielded only half the usual number of larvae, but, after taking a wake up dose of 12 NA, she was feeling much improved 3 weeks later. [https://www.facebook.com/groups/htsupport/permalink/2286252768097332/] Someone else who had a 10 day course of Flucloxacilin, firstly intravenously, and then orally, found that she lost benefits from her NA for 4-6 weeks. She knew the worms were not dead because she was able to incubate fresh larvae from her colony. On a different occasion, a shorter course of 5 days IV, then oral Flucloxacilin, had minimal impact. [https://www.facebook.com/groups/htsupport/permalink/3702475279808400/?comment_id=3703092116413383]

* ❓ [https://en.wikipedia.org/wiki/Fosfomycin Fosfomycin] (also known as phosphomycin, phosphonomycin, Monurol and Monuril) A single, one-off, 3g dose if this broad-spectrum antibiotic that was taken by a hookworm host to treat a urinary tract infection had no obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&comment_tracking=%7B%22tn%22:%22R%22%7D] However, larger doses or a longer treatment period may produce a different result.

* [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). Two hookworm hosts have reported losing their colonies to [https://en.wikipedia.org/wiki/Metronidazole metronidazole] (Flagyl), [https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1371228706266414/] which may be particularly harmful to hookworms if taken in combination with [https://en.wikipedia.org/wiki/Clindamycin clindamycin] (Dalacin, Lincocin, Daclin). '''Metronidazole''' and '''clindamycin''' are favoured by some dentists due to their proven efficacy against anaerobic bacteria. However, when take on its own, metronidazole does not always kill hookworms, as one host found when she had to take this drug along with amoxicillin for several weeks to treat septic gangrenous appendicitis, [https://www.facebook.com/groups/htsupport/permalink/1899197376802875/?comment_id=1899228090133137&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and another found when he needed to take 750mg daily for 7 days to treat SIBO. [https://www.facebook.com/groups/htsupport/permalink/2060266257362652/] A third NA host was still able to successfully incubate more larvae after taking five doses of 400mg metronidazole daily for three days. [https://www.facebook.com/groups/htsupport/posts/5993193837403188/?comment_id=5993326564056582&reply_comment_id=5993931900662715]

* [https://en.wikipedia.org/wiki/Nitroimidazole Nitroimidazoles] (metronidazole, tinidazole, nimorazole, dimetridazole).

* [https://en.wikipedia.org/wiki/Quinolone_antibiotic Quinolones.] Drugs in the quinolone family have been shown to block a detoxification pathway required by helminths for blood feeding, resulting in arrested development of L3 larvae and adversely affecting the reproductive capacity of adult worms both in vitro and in vivo. [http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1006931] (NB. In 2018, the European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds, [https://www.medscape.com/viewarticle/903029] and, in 2019, fluoroquinolones were linked with heart problems. [https://www.sciencedaily.com/releases/2019/09/190910154710.htm])
</blockquote>

==== ✅ Antibiotics that appear ''not'' to affect hookworm benefits ====
<blockquote>

* [https://www.ace-pharm.nl/en/products/broxil/ Broxil] (feneticilline) is a narrow-spectrum antibiotic containing the penicillin derivative pheneticillin potassium. It is used to treat infections caused by Streptococci and certain species of Staphylococci, e.g., pharyngitis, pneumonia and skin and soft tissue infections such as impetigo or abscesses. One NA host has confirmed that a 5 day course of Broxil did not harm her colony. [https://www.facebook.com/groups/htsupport/posts/6533802496675650?comment_id=8769535843102293]

* [https://en.wikipedia.org/wiki/Mycophenolic_acid Mycophenolic acid] Also called mycophenolate mofetil (MMF, trade name CellCept) and mycophenolate sodium (trade name Myfortic), this antibiotic/immunosuppressant drug has broad-spectrum antiviral, antifungal and antibacterial properties, but has not been commercialised as an antibiotic due to its adverse effects. One hookworm host has taken CellCept (500mg x 3 per day), apparently without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1001001649955790/] [https://www.facebook.com/groups/htsupport/permalink/1978467308875881/?comment_id=1978498922206053&reply_comment_id=1979680825421196&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Rifaximin Rifaximin] (Xifaxan, Xifaxanta and Normix, etc.) This drug is poorly absorbed when taken by mouth and stays within the gastrointestinal tract, so is unlikely to affect NA, which feed directly on their host's blood, and will pass by TT while they are grazing on tissue secretions within the intestinal lining. The drug's lack of effect on NA was confirmed by one self-treater who took a 14 day course of the drug to treat SIBO and had no return of symptoms from his sinus condition, and only noticed a minimal effect on egg production by his worms. [https://helminthictherapywiki.org/wiki/Treating_SIBO_and_sinusitis_with_NA_and_TTO]

* [https://en.wikipedia.org/wiki/Roxithromycin Roxithromycin] A ten day course of this drug taken by one NA host appeared not to harm their colony. [https://www.facebook.com/groups/htsupport/posts/23875947818701182?comment_id=24167803662848928]

* [https://en.wikipedia.org/wiki/Trimethoprim Trimethoprim] (Alprim) Two hookworm hosts have reported continuing to enjoy full benefits from their worms after taking this drug to treat urinary tract infections. One took a 5 day course of 100mg Trimethoprim x2 per day, [https://www.facebook.com/groups/htsupport/posts/26349623291333610] whille the second took seven doses of 300mg. Another NA host has reported that, when used to treat UTIs, Alprim not only did not affect her hookworm colony, but did not even arrest the production of ova by her worms. [https://www.facebook.com/groups/htsupport/permalink/1009048252484463/] Also, when the [https://en.wikipedia.org/wiki/Trimethoprim/sulfamethoxazole Trimethoprim/sulfamethoxazole] combination drug, AA-Sulfatrim DS 800, was taken by a hookworm host for 10 days (160mg x2 per day), this had no effect on his NA colony and produced no gastrointestinal changes. (Private communication)
</blockquote>

==== Topical antibiotics ====
<blockquote>
: If applied to the skin, or used as eye drops, [https://en.wikipedia.org/wiki/Antibiotics Topical antibiotics] are unlikely to affect helminths in many cases. For example, four drops of 0.3% [https://www.medicines.org.uk/emc/product/836/smpc Ciloxan] ([https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin]) applied to each eye 3 times each day for 2 weeks had no effect on the colonies of two hookworm hosts, [https://www.facebook.com/groups/htsupport/permalink/874927972563159/?comment_id=875296599192963&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://en.wikipedia.org/wiki/Tobramycin tobramycin] eye drops applied 3 times each day for 2 days, and twice each day for the following 3 days, had no obvious ill effect on another hookworm colony. [https://www.facebook.com/groups/htsupport/posts/4810224872366763/]

:However, someone else has reported that, while 0.3% tobramycin appeared to have no adverse effect when applied to a stye, an ophthalmic suspension of neomycin and polymyxin B sulfates and dexsmethasone did have a mild adverse effect on her NA colony.

:{{Quote|indent}}I ran out of the abx eye drops tobramyacin .3% after 7 days (taking 3-4 times a day). And I had no issues with that. But they refilled it with “neomycin and polymyxin B sulfates and dexsmethasone ophthalmic suspension.” And it has stunned my buddies a bit... I’ve been taking it 3 times a day in one eye for 6 days. I started feeling off around day 4. [https://www.facebook.com/groups/htsupport/posts/10073095316079666?comment_id=10073376886051509&reply_comment_id=23872842805678350]{{Quote|/indent}}
</blockquote>

==== General discussion ====
<blockquote>
Short courses of most other antibiotics will typically only cause a temporary loss of benefit for between 2 and 8 weeks (e.g., ➿ [https://en.wikipedia.org/wiki/Erythromycin erythromycin] [https://www.facebook.com/groups/htsupport/permalink/770548519667772/]), although it is possible for efficacy to be reduced for longer, e.g., [https://www.facebook.com/groups/htsupport/permalink/1131267180262569/?comment_id=1134969589892328&comment_tracking=%7B%22tn%22:%22R%22%7D 4 months], and even [https://www.facebook.com/groups/htsupport/permalink/700908506631774/?comment_id=951430548246234&comment_tracking=%7B%22tn%22:%22R0%22%7D 6 months], and there is anecdotal evidence suggesting a correlation between the length of a course of antibiotics and the length of time that affected helminths are out of action. This might suggest that a single shot of antibiotic might have little or no effect on human helminths, as has been reported by one hookworm host, [https://www.facebook.com/groups/htsupport/permalink/3419833164739281?comment_id=3422186914503906] but the type of antibiotic used may be critical in this case, and some antibiotic drugs might adversely affect a helminth colony even when only a single injection is administered. This happened when one hookworm host was given a single, 1 gram shot of cefazolin. See [[#Cefazolin|Cefazolin]] for details.

It is possible that even a small dose of antibiotic could cause a return of symptoms in some people. For example, one hookworm host has reported experiencing a recurrence of significant disease symptoms after using 3 drops per day, for only 1½ days, of a solution containing [https://en.wikipedia.org/wiki/Tobramycin tobramycin] 3mg (0.3%).

In cases of dental infection that would routinely be treated by a course of an oral antibiotic, it might be possible to avoid the use of a drug if the dentist is able to use localised ozone injections. [https://www.facebook.com/groups/htsupport/permalink/1252700651452554/] [https://www.facebook.com/groups/htsupport/permalink/1518817608174189/?comment_id=1519018198154130&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

When it is essential to take oral antibiotics, the duration of their negative effect on hookworms can be significantly reduced - perhaps to as little as 2 weeks - by taking a small top-up dose of no more than 5 larvae after finishing the course of drugs. In most cases, this inoculation can be carried out 48 hours after the last dose of the drug, but it's worth asking a pharmacist exactly how long the prescribed drug will take to clear completely from the body. Different antibiotics have different biological half-lives. For example, erythromycin's half-life is only a couple of hours, whereas penicillin's can be up to 56 hours.

An alternative to taking a small top-up dose of NA would be to take 250-500 TSO. One NA host has reported that, without a helminth top-up, it usually takes her 4-6 weeks to come right after an infection. But, if she takes 500 TSO after completing the antibiotics, she recovers within about 10 days. [https://www.facebook.com/groups/htsupport/posts/7062445007144727/?comment_id=7065489936840234] In a later report, this same individual said that even taking just 250 TSO post-antibiotics will enable her to bounce back within a week or so. [https://www.facebook.com/groups/htsupport/posts/7897313170324569/?comment_id=7911601488895737] If ordered at the same time as the antibiotics are started, TSO will arrive in time to be taken after the course of the drug is completed. And, since TSO remain viable for a couple of years in a fridge, a small supply of them can be kept to hand.

It has been suggested that the reduction in the benefits derived from hosting human helminths that is seen after taking antibiotics might result, at least in part, from a loss from the gut microbiome of helpful bacterial species and
the proliferation of less beneficial ones. This suggestion, and the fact that taking probiotics alongside antibiotics has been claimed to help [http://www.sciencedaily.com/releases/2013/05/130530192404.htm offset the gastrointestinal symptoms] typically associated with these drugs, has led to the suggestion that the use of high doses (perhaps 5 or 10 times the normal dose) of good quality probiotics might help to reduce the time that helminths are out of action after using these drugs, especially if the probiotics are taken at a different time of day from the drug. And this effect has been reported by one individual. [https://www.facebook.com/groups/htsupport/permalink/1257052664350686/?comment_id=1257367554319197&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, also see [https://www.ngmedicine.com/taking-probiotics-with-antibiotics-revisited/ this article] which looks at the evidence on the use of probiotics alongside antibiotics, which is not all positive. Additional help in protecting the microbiome might be gained by supplementing with either butyrate [https://www.sciencedirect.com/science/article/pii/S2211124719303845] or charcoal [https://www.ncbi.nlm.nih.gov/pubmed/29186529] alongside an antibiotic. A fecal microbiota transplant (FMT) might also help to restore worm benefits more quickly following treatment with an antibiotic. [https://www.facebook.com/groups/htsupport/permalink/1149149175141036/?comment_id=1242073262515293&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

It is possible that the consumption of prebiotics such as galacto-oligosaccharides (GOS) may also help to restore the gut biome, since GOS has been shown to help [http://www.ncbi.nlm.nih.gov/pubmed/24925303 support the recovery of beneficial bifidobacteria] and increase the production of butyrate, after antibiotic treatment. GOS is available in the form of [https://gutsupp.com GutSupp Prebiotic Powder (formerly "Bimuno")]. Fructooligosaccharides (FOS) and xylooligosaccharides (XOS) may perform a similar function. [https://www.ncbi.nlm.nih.gov/pubmed/30113166] For more detail about the effects of a total loss of worms due to antibitoic use, and how to restore a colony, see [[Hookworm dosing and response#Colony collapse | '''Colony collapse''']].

In the case of someone needing to take antibiotics regularly, or on a long-term basis, there would be little point in them using hookworms until completely off these drugs. Some worm benefits may be maintained in users of the human whipworm, so long as doses of this organism are being taken regularly, every few weeks. Another solution for those who need to take antibiotics frequently, or for prolonged periods, would be to switch to TSO as these are less likely to be adversely affected by antibiotics. While ciprofloxacin is capable of blocking the action of TSO, other antibiotics just slow them down. [https://www.facebook.com/groups/htsupport/permalink/1343118199077465/?comment_id=1343598479029437&comment_tracking=%7B%22tn%22%3A%22R%22%7D] HDC may also be less susceptible to antibiotics than human helminths, although two users of HDC have reported that the antibiotic,
⚡ [https://en.wikipedia.org/wiki/Dapsone Dapsone] (diamino-diphenyl sulfone), causes a return of their disease symptoms.
</blockquote>

==== ➿ Antibiotics best avoided for other reasons ====
<blockquote>
Some antibiotics are best avoided for other reasons.

* [https://en.wikipedia.org/wiki/Fluoroquinolone Fluoroquinolone antibiotics] can be extremely dangerous [https://en.wikipedia.org/wiki/Quinolone_antibiotic#Adverse_effects] and can cause permanent nerve damage. [http://healthimpactnews.com/2013/warning-fluoroquinolone-antibiotics-may-cause-permanent-nerve-damage/] This group of drugs includes [https://en.wikipedia.org/wiki/Ciprofloxacin ciprofloxacin] (cipro), [https://en.wikipedia.org/wiki/Levaquin levofloxacin] (Levaquin, Tavanic, etc.) [https://en.wikipedia.org/wiki/Tequin gatifloxacin] (Gatiflo, Tequin and Zymar), [https://en.wikipedia.org/wiki/Gemifloxacin Gemifloxacin] (Factive), [https://en.wikipedia.org/wiki/Moxifloxacin Moxifloxacin] (Avelox, Vigamox, Moxeza, etc.), [https://en.wikipedia.org/wiki/Norfloxacin Norfloxacin] (Noroxin) and [https://en.wikipedia.org/wiki/Ofloxacin Ofloxacin] (Floxin, Ocuflox, etc.). The European Medicines Agency began to recommend restrictions on the use of fluoroquinolone and quinolone antibiotics on safety grounds in 2018. [https://www.medscape.com/viewarticle/903029]

* [https://en.wikipedia.org/wiki/Clarithromycin Clarithromycin] (Biaxin, etc.) has been shown to increase the risk of a fatal heart attack compared with penicillin V, especially in older people with existing cardiac risk factors, although no increased risk was seen with [https://en.wikipedia.org/wiki/Roxithromycin roxithromycin] [http://www.bmj.com/content/349/bmj.g4930]. Also see this [https://pubmed.ncbi.nlm.nih.gov/29155931/ later study].
</blockquote>

=== Anticoagulants [https://en.wikipedia.org/wiki/Anticoagulant] ===

==== ✅ Safe anticoagulants unless otherwise marked ====
<blockquote>
Anticoagulant medicines and herbs (which reduce the clotting ability of blood) do not harm helminths, but may prolong bleeding from the tiny feeding sites of hookworms, which, themselves, secrete minute amounts of anticoagulants to help their digestive process. Anticoagulant drugs include:
* [https://en.wikipedia.org/wiki/Warfarin warfarin]
* [https://en.wikipedia.org/wiki/Heparin heparin]
Other drugs that have an anticoagulant effect include
* [https://en.wikipedia.org/wiki/Aspirin aspirin] and products containing it, such as
** [https://en.wikipedia.org/wiki/Alka-Seltzer Alka-Seltzer]
** ❓ [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol].

Herbs with an anticoagulant effect include:
* [https://en.wikipedia.org/wiki/Ginkgo_biloba ginkgo biloba]

All of these compounds may prolong bleeding at hookworm feeding sites to some extent, so may potentially contribute to anaemia (anemia) in susceptible individuals, especially if several of these drugs/supplements are taken at the same time.
</blockquote>

=== Antidepressants ===

Some self-treaters use certain SSRIs alongside NA and TTO without any apparent problem, but, according to a 2018 Nature article, [https://www.nature.com/articles/s41598-017-18457-w] some SSRIs (setraline, paroxetine, and chlorpromazine) have such a powerful anthelmintic effect that the authors suggested these drugs could be used clinically as dewormers.

'''NB''' Anyone who wants to start helminthic therapy who is already taking one of the antidepressants that has a known anthelmintic effect should not stop taking the drug without first consulting their medical advisor. This is because, although helminths can eventually help in some cases of depression, the worms are unlikely to start to work immediately and may actually cause a brief initial worsening of this condition before beginning to provide relief. See [[Helminthic therapy and neuropsychiatric disorders#Depression | '''Helminthic therapy and neuropsychiatric disorders: Depression''']].

<blockquote>

* ✅ [https://en.wikipedia.org/wiki/Amitriptyline Amitriptyline] (Elavil, etc.) This tricyclic antidepressant has been taken by at least one hookworm host at 15 mg per day, without issue. [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085576868164924&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Citalopram Citalopram] (Celexa, Cipramil and [https://en.wikipedia.org/wiki/Citalopram#Brand_names numerous other names].) This selective serotonin reuptake inhibitor (SSRI) has been used by at least one hookworm host with no ill effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1994977397224872/?comment_id=1995274433861835&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Doxepin Doxepin] This tricyclic antidepressant and potent antihistamine has been marketed under many names, including Quitaxon, Aponal and Sinequan. One individual has taken Doxepin daily for several years while hosting hookworms, without noticing any adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1682894431766505&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Duloxetine Duloxetine] (Cymbalta, etc.) This Serotonin–norepinephrine reuptake inhibitor (SNRI) was taken by one NA host for several years to treat generalised anxiety without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2056263424429602/?comment_id=2058009587588319&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Fluoxetine Fluoxetine] (Prozac, Sarafem, etc.) A study published in Nature reported that this selective serotonin reuptake inhibitor (SSRI) was harmful to the non-theraputic helminth species ''C. elegans'', [https://www.nature.com/articles/s41598-017-18457-w] but fluoxetine is being taken by at least two hookworm hosts without issue [https://www.facebook.com/groups/htsupport/permalink/1686522081403740/?comment_id=1687356354653646&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2085317178190893/?comment_id=2085350661520878&comment_tracking=%7B%22tn%22%3A%22R%22%7D].

* ❓ [https://en.wikipedia.org/wiki/Venlafaxine Venlafaxine] (Effexor, etc.) There have been no reports about this particular drug yet, but it is a serotonin-norepinephrine reuptake inhibitor (SNRI), and it is already known that duloxetine (Cymbalta, etc.), which is another SNRI, appears to be safe for use by hosts of human helminths.

* ❌ [https://en.wikipedia.org/wiki/Desvenlafaxine Desvenlafaxine] (Pristiq, Desfax, Ellefore, etc.) One hookworm host has reported that this drug wiped out his entire NA colony.

* ⚡ [https://en.wikipedia.org/wiki/Escitalopram Escitalopram] (Cipralex and Lexapro.) After taking "the smallest possible dose" of this selective serotonin reuptake inhibitor (SSRI) in the form of Lexapro for 4 weeks, one user found that she lost all the benefits previously conferred by NA, and even HDC benefits were dampened. [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=2155918287797448&comment_tracking=%7B%22tn%22%3A%22R%22%7D]. However, someone else who took Lexapro for the first 2.5 years that she hosted NA did not lose her colony as a result of this. She was already taking 30 mg per day when she first inoculated, and then lowered the dose to 20 mg 18 months later. This user does have to top up her colony with a dose of 10 NA every three months, but this level of attrition is not excessive and may not be due to the drug. [https://www.facebook.com/groups/htsupport/permalink/2301858276536781/?comment_id=2309854282403847&reply_comment_id=2311232908932651&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Others have reported taking Lexapro without any obvious adverse effect on their NA, e.g, [https://www.facebook.com/groups/htsupport/permalink/3640310742691521?comment_id=3640395312683064 this self-treater] and someone else who had hosted NA for 7 years and been taking Lexapro during this entire time (10mg for 5 years, then 5mg for 2 years, and finally 2.5mg once a week for 3 years [https://www.facebook.com/groups/htsupport/posts/2301858276536781/?comment_id=2309854282403847&reply_comment_id=4866244573431459]) and was never aware of this having any adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Paroxetine Paroxetine] (Aropax, Brisdelle, Deroxat, Paxil, Pexeva, Paxtine, Paxetin, Paroxat, Paraxyl, Sereupin, and Seroxat.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class, has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]

* ❓ [https://en.wikipedia.org/wiki/Sertraline Sertraline] (Sold under a very large number of trade names, [https://www.drugs.com/international/sertraline.html] including Zoloft.) This antidepressant of the selective serotonin reuptake inhibitor (SSRI) class has shown anthelmintic effects against four widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694] However, someone who has taken doses of either 100 mg or 150 mg of Zoloft daily for 1.5 years has reported continuing benefits from his NA. [https://www.facebook.com/groups/htsupport/permalink/3054501617939106/]
</blockquote>

=== Antifungals [https://en.wikipedia.org/wiki/Antifungals] ===

==== ✅ Safe antifungals unless marked otherwise ====
<blockquote>
The following appear to be safe for use with human helminths
* [https://en.wikipedia.org/wiki/Fluconazole fluconazole] (Diflucan and Trican)
* [https://en.wikipedia.org/wiki/Nystatin nystatin] (Mycostatin, Nilstat, Nystop, etc.) This has been used for many years by one hookworm host without harming his worms. [https://www.facebook.com/groups/htsupport/permalink/1995854040470541/?comment_id=1996211143768164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
* the fatty acid [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid] also appears safe [https://www.facebook.com/groups/htsupport/permalink/935151783207444/?comment_id=935208789868410&comment_tracking=%7B%22tn%22:%22R%22%7D]. However, anyone with a coconut allergy/intolerance should note that ''caprylic acid'' is a coconut/palm kernel derivative.
* the enzyme-based anti-Candida product [https://en.wikipedia.org/wiki/Candex candex] is also worm-safe. One hookworm host took 4 ''Candex'' capsules twice a day for over a month without any obvious harm to his worms. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Chlorophyll Chlorophyll]. A chlorophyll-based solution has been found to be [https://www.researchgate.net/publication/43335937_Antimicrobial_activity_of_chlorophyll-based_solution_on_Candida_albicans_and_Enterococcus_faecalis effective against Candida albicans] and there have been no reports to suggest this might be harmful to helminths. (Also see❓[[#Chlorophyllin|Chlorophyllin]].)

* [http://www.ncbi.nlm.nih.gov/pubmed/23965638 Some probiotics] may help to control candida, especially [https://en.wikipedia.org/wiki/Saccharomyces_boulardii Saccharomyces boulardii], which significantly inhibits [http://www.ncbi.nlm.nih.gov/pubmed/20629753 adhesion by C. albicans], thus [http://www.ncbi.nlm.nih.gov/pubmed/19732158 preventing the formation of biofilms and filamentation], and it is as [http://www.ncbi.nlm.nih.gov/pubmed/23703468 effective as nystatin] in reducing fungal colonization and invasive fungal infection. '''S. boulardii''' has also been taken by at least two helminth hosts without any obvious effect on their worms. At least one strain of Lactobacillus acidophilus can reduce the population of Candida albicans in the gut microbiota. [https://www.ncbi.nlm.nih.gov/pubmed/29997616]

* [https://en.wikipedia.org/wiki/Sodium_butyrate Sodium butyrate] is a powerful antifungal that inhibits pathogenic yeast growth [http://jac.oxfordjournals.org/content/66/11/2573.long]. It is available as a food supplement and is also manufactured in the human intestines by the fermentation of vegetables. The bacteria responsible for butyrate production are vulnerable to antibiotics, but can be reintroduced, or supplemented, by means of [https://en.wikipedia.org/wiki/Fecal_bacteriotherapy fecal microbiota transplants] (FMT), or the addition of the butyrate-producing bacterial species, [https://en.wikipedia.org/wiki/Clostridium_butyricum clostridium butyricum], which generates butyrate directly in the gut. C. butyricum is available in Japan as the probiotic, Miyarisan Tablets, [https://www.facebook.com/photo.php?fbid=10152806891616155&set=p.10152806891616155&type=1&theater] which may sometimes be found online, including on eBay, and in the probiotic formulations, Bifilac and Bifilac HP. [http://www.indiamart.com/abpl/probiotic-dietary-supplements.html] C. butyricum is also available as an animal feed additive. [http://www.alibaba.com/product-detail/probiotic-clostridium-butyricum_1589202110.html] Nutrients that help to increase butyric acid concentrations in the colon include pectin [https://en.wikipedia.org/wiki/Pectin] and larch arabinogalactan [https://en.wikipedia.org/wiki/Arabinogalactan], which is available as a supplement, [https://uk.iherb.com/search?kw=arabinogalactan&cids=1855&rank=1&rawkw=arabinoglactan&refererLocation=suggestion] although arabinogalactan can worsen rheumatic conditions. [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797204570335500&offset=0&total_comments=1], [https://www.facebook.com/groups/htsupport/permalink/797203453668945/?comment_id=797261090329848&offset=0&total_comments=3] When buying any butyrate supplement, it's important to check ''all'' the ingredients in each product. One NA host who took [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] likely because this product contains medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Ascorbic_acid Ascorbic acid] (vitamin C) may interfere with the yeast-to-hypha transition [http://www.ncbi.nlm.nih.gov/pubmed/25084864] of candida.

* [https://en.wikipedia.org/wiki/Apple_cider_vinegar Apple cider vinegar]. Only a single individual has ever reported believing that apple cider vinegar had an adverse effect on their hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616632618392677&reply_comment_id=2617255014997104] Since many other hookworm hosts drink apple cider vinegar without issue, [https://www.facebook.com/groups/htsupport/permalink/1516308765091740/?comment_id=1516658838390066&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] it can be considered to be worm-friendly. It has been revealed as a possible treatment for Candida species involved in denture stomatitis, [http://www.ncbi.nlm.nih.gov/pubmed/25219289] and there have been suggestions that, if ingested, vinegar might induce the body's gut defence system to help combat a Candida albicans infection. [http://www.sciencedaily.com/releases/2015/06/150608151952.htm] Advice on using apple cider vinegar as part of an anti-Candida treatment regimen can be found [http://www.onegreenplanet.org/natural-health/how-to-treat-chronic-yeast-overgrowth-with-apple-cider-vinegar/ here].

* [https://en.wikipedia.org/wiki/Iodine Iodine] appears to have antifungal properties, is worm-friendly, and has proved effective against Candida for one hookworm host.[https://gettinghealthiernow.wordpress.com/2014/11/29/iodine-protocol-destroying-candida/]

* [https://en.wikipedia.org/wiki/Vitamin_D Vitamin D] turns on genes that make antimicrobial peptides, including cathelicidin [https://en.wikipedia.org/wiki/Cathelicidin], which has been shown to kill Candida. However, dosage with this vitamin may be critical, and excessive amounts might be counter-productive [http://www.ncbi.nlm.nih.gov/pubmed/25612733]. Aiming for the optimum blood level [http://www.vitamindcouncil.org/about-vitamin-d/how-do-i-get-the-vitamin-d-my-body-needs/] of vitamin D would therefore appear to be ideal. (Vitamin D3 has been shown to extend the median lifespan of one species of roundworm by 30-40%. [http://www.vitamindcouncil.org/vitamin-d-news/new-research-finds-vitamin-d-extends-the-life-of-roundworms-08-2015/#])

* Some foods [http://www.thecandidadiet.com/candida-fighting-foods.htm], eaten in normal dietary amounts, may help support an anti-Candida programme, but see the separate notes on ⚡[[#Cayenne|cayenne]], ⚡[[#Coconut|coconut]] and ⚡[[#Ginger|ginger]]. Fresh ✅ garlic may be particularly helpful [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC538912/], and dietary forms of garlic are known to be worm-safe, but see the details in the separate entry for [[#Garlic|garlic]].

* When Candida is a problem, very low carbohydrate (VLC) diets are best avoided because these cause ketosis, and yeasts love ketones.

* [https://en.wikipedia.org/wiki/Monolaurin Monolaurin] (also known as glycerol monolaurate, glyceryl laurate or 1-lauroyl-glycerol). Monolaurin is a monoglyceride - the mono-ester formed from glycerol and lauric acid. Shown in test tube studies to have antibacterial and antiviral activity, it is commonly used as a surfactant in cosmetics, including deodorants, and as an emulsifier in foods. While it is active against candida [http://www.ncbi.nlm.nih.gov/pubmed/20008774], one subject has reported that taking two teaspoons of monolaurin daily, for a few weeks, produced no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872137176175572&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872142719508351&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R4%22%7D] Another believes that she probably ingested a significant dose of monolaurin by drinking full fat coconut milk daily, but that her hookworms and whipworms both survived this. [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] Others have also confirmed that monolaurin is worm-safe. [https://www.facebook.com/groups/htsupport/permalink/974642915924997/?comment_id=975547445834544&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1368090353246916/?comment_id=1369652509757367&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/posts/9279862498736289?comment_id=9280024828720056]

A very worm-friendly way to reduce Candida is to brush one's teeth after every meal instead of just once each day. This has been shown to reduce the abundance of C. albicans in the stool by 10-fold to 100-fold. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874442/] The addition of regular [https://wellnessmama.com/17951/coconut-oil-pulling/ oil pulling using coconut oil] (not to be swallowed) could further reduce the amount of candida. [https://www.facebook.com/groups/htsupport/permalink/1617823828273566/?comment_id=1618578738198075&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>

==== ❓ More antifungals ====

<blockquote>

* ❓ '''Cellular silver''' (see [[#AlternativeTherapies|Alternative therapies]] section). The manufacturers of Advanced Cellular Silver (ACS) 200 Extra Strength [http://www.resultsrna.com/products/acs_200_overview/] claim that this product achieves a 99.9989% kill against C. albicans. Although there have been no reports to date of its possible effect on human helminths, its similarity to ➿'''colloidal silver''' (see [[#AlternativeTherapies|Alternative therapies]] section) suggest that it may not kill the worms but only cause a temporary reduction of benefits.

* ❓ [https://en.wikipedia.org/wiki/Lactoferrin Lactoferrin] (also known as lactotransferrin [LTF]) is found naturally in secretory fluids, such as milk, saliva, tears and nasal secretions. It has antibacterial, antiviral, antifungal and antiparasitic properties, and is effective against candida. It’s antimicrobial properties are enhanced by the peptide, ❓[https://en.wikipedia.org/wiki/Lactoferricin lactoferricin], the anti fungal effects of which exceed those of lactoferrin. However, there have been no reports of any adverse effect on helminths, and one NA host has reported that taking 300mg of lactoferrin per day had no obvious effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/2116858295036781/]

* ❓ [https://en.wikipedia.org/wiki/Lavandula Lavender] has antifungal activity and may be of value in treating candida. [http://www.ncbi.nlm.nih.gov/pubmed/26550521]

* ❓ '''Propolis''' (see [[#NutritionalSupplements|Nutritional supplements]] section). Candida has been shown to be susceptible to propolis extract [http://www.ncbi.nlm.nih.gov/pubmed/26149083], and to red propolis alcoholic extract. [http://www.ncbi.nlm.nih.gov/pubmed/26154370]

* ❓ [https://en.wikipedia.org/wiki/Polygodial Polygodial], which has both antifungal and antimicrobial properties and is used as an insecticide, is an active constituent of
** ❓ [https://en.wikipedia.org/wiki/Tasmannia_stipitata Dorrigo pepper],
** ❓ [https://en.wikipedia.org/wiki/Tasmannia mountain pepper],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera horopito],
** ❓ [https://en.wikipedia.org/wiki/Pseudowintera_colorata mountain horopito],
** ❌ [https://en.wikipedia.org/wiki/Pseudowintera_colorata Kolorex],
** ❓ [https://en.wikipedia.org/wiki/Drimys_winteri canelo] (Drimys winteri, winter's bark)
** ❓ [https://en.wikipedia.org/wiki/Acmella_oleracea paracress] and
** ❓ [https://en.wikipedia.org/wiki/Persicaria_hydropiper water pepper].
Whilst polygodial has been shown to be effective against single-celled parasites such as protozoa, the only report so far that it might also have an adverse effect on helminths comes from a hookworm host who suspects that she killed her colony by taking '''Kolorex''', which contains a mixture of horopito and ⚡'''aniseed'''.

* ❓ [https://en.wikipedia.org/wiki/Undecylenic_acid Undecylenic Acid]. This is the common name for 10-Undecenoic Acid, which is used in the Thorne Research product, [https://www.thorne.com/products/dp/formula-sf722-reg Formula SF722]. It is a potent antifungal mono-unsaturated fatty acid extracted from coconut and the castor bean. It has been shown to be 11 times stronger than [https://en.wikipedia.org/wiki/Caprylic_acid caprylic acid], and is also claimed to have antiparasitic properties, although there have been no reports about this from hosts of therapeutic helminths.

* ⚡ [https://en.wikipedia.org/wiki/Curcumin Curcumin] inhibits candida [http://jac.oxfordjournals.org/content/63/2/337.long], even at low concentrations, but see the main entry below for [[#Turmeric|Turmeric/curcumin]] for further details.

* ❌ [https://en.wikipedia.org/wiki/Nigella_sativa Black cumin] (nigella sativa). Also known as blackseed, black seed, black caraway, fennel-flower, nutmeg flower, Roman coriander, kalonji and 'Love in the Mist'. Extracts of this herb have shown antifungal effects [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3642442/] against different strains of Candida albicans, but it has also been used as an anthelmintic since ancient times. While one self-treater has reported that black cumin did not harm NA, HDC or TSO when he took them, [https://www.facebook.com/groups/htsupport/permalink/26499688856327052/] black cumin and its active component, thymoquinone, have nevertheless demonstrated anthelmintic activity against several nematode species, including Trichuris muris - a relative of the human whipworm, Trichuris trichiura - as well as two other human helminths: Ascaris lumbricoides and the blood fluke, Schistosoma mansoni. In India, today, nigella seeds are combined with various purgatives to help kill and expel intestinal parasites, and they have a synergistic effect with pharmaceutical anthelmintics. [https://www.ncbi.nlm.nih.gov/pubmed/30149818]

* ❌ [https://en.wikipedia.org/wiki/Gymnema_sylvestre Gymnema sylvestre] is effective against candida [http://www.k-state.edu/media/newsreleases/jun13/vediyappan91213.html], but hydroalcoholic extracts of this herb have been found to have anthelmintic activity against the Indian earthworm, Pheretima posthuma. [http://www.ijrap.net/admin/php/uploads/525_pdf.pdf] Even though the research worm, C. elegans, appears to be unaffected by gymnema [http://www.ncbi.nlm.nih.gov/pubmed/?term=gymnema+sylvestre+candida] and there are genetic similarities [http://www.ncbi.nlm.nih.gov/pubmed/11812491] between C. elegans and N. americanus, one helminth host suspects that gymnema was responsible for the loss of his hookworm colony.

* ❌ [https://en.wikipedia.org/wiki/Lufenuron Lufenuron] is a benzoylurea pesticide used on crops and in veterinary medicine (in flea control, heartworm treatments and other anthelmintic products). Its powerful anti-fungal effects may be due to its ability to inhibit the synthesis of chitin, which is unfortunately an important constituent of the mouthparts of the hookworm.

Some herbal antifungal products may adversely affect helminths, especially if they are in a concentrated form, so any herbal medicine that claims to have antifungal properties should be approached with caution.

Some foods are coated with edible films containing antifungal compounds such as ❓[https://en.wikipedia.org/wiki/Natamycin natamycin] (pimaricin) and ❌ '''oregano oil''' (see [[#Oregano|Oregano reference]])
but the quantities used in this application are probably insufficient to affect helminths, and there is no evidence [http://www.inchem.org/documents/jecfa/jecmono/v48je06.htm] to date that natamycin harms intestinal flora.

NB. Prolonged treatment with antifungal drugs can disrupt commensal fungal populations and cause an increase in
the severity of disease states, as seen in one study [http://www.ncbi.nlm.nih.gov/pubmed/27237365] in acute and chronic models of colitis and allergic airway
disease.
</blockquote>

=== Antihistamines ===

==== Antihistamines as marked ====

<blockquote>
* ✅ Worm-safe antihistamines are
** [https://en.wikipedia.org/wiki/Diphenhydramine diphenhydramine] -- most likely to cause drowsiness
** [https://en.wikipedia.org/wiki/Loratadine loratadine] (Claritin, Lorafix)
** [https://en.wikipedia.org/wiki/Fexofenadine fexofenadine] (Allegra, Fexidine, Telfast, Fastofen, Tilfur, Vifas, Telfexo, Allerfexo) -- least likely to cause drowsiness
* ✅ Most '''Benadryl-branded products''' sold in the '''US''' contain only diphenhydramine so are worm-safe, e.g.
** [http://www.benadryl.com/products/allergy/benadryl-ultratab-tablets Benadryl Allergy Ultratab Tablets]
** [http://www.benadryl.com/products/allergy/benadryl-liquid-gels Benadryl Allergy Dye-Free Liqui-gels]
** [http://www.benadryl.com/products/children-allergy/benadryl-allergy-liquid Children’s Benadryl Allergy Liquid]
* ⚡ except
** [https://www.benadryl.com/products/children-allergy/benadryl-allergy-and-sinus-liquid Childrens’ Benadryl Allergy Plus Congestion] which also contains ⚡ phenylephrine. (See [[#Phenylephrine|local reference]].)

'''Benadryl products''' sold in the '''UK''' all contain drugs with anthelmintic potential - either
* ⚡ cetirizine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-liquid-capsules Benadryl Allergy Liquid Release Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-one-day Benadryl One a Day Relief Tablets/Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-aged-two-plus Benadryl Allergy Children’s (2+ years) 1mg/ml Oral Solution]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-children Benadryl Allergy Children’s 6+ 1mg/ml Oral Solution]
* ⚡ acrivastine
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief-plus Benadryl Allergy Relief Plus Decongestant Capsules]
** [http://www.benadryl.co.uk/allergy-relief-products/benadryl-allergy-relief Benadryl Allergy Relief Capsules]
* ❓ [https://en.wikipedia.org/wiki/Chlorphenamine Chlorphenamine] (chlorpheniramine, piriton) While we don’t yet have any confirmation of the effect on helminths of this first-generation antihistamine, it has been suggested by someone who has investigated this that it is unlikely to be harmful to worms.

* ✅ [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium, plus Gastrocrom and Intercron) This is a mast cell stabiliser which prevents the release of histamine from mast cells and is used to treat some allergic conditions. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Doxylamine Doxylamine] (Bendectin, Debendox, Diclectin, Diclegis, Dozile, Lenotan, Merbental, Restavit, Unisom, Valocordin-Doxylamine, Vicks Formula 44 and Vomentin, etc.) One hookworm host believes that an unexpected return of gut symptoms and dry skin may have been caused by taking a quarter of a tablet of this first-generation antihistamine every night for a couple of weeks. [https://www.facebook.com/groups/htsupport/permalink/927991007256855/?comment_id=1007272959328659&comment_tracking=%7B%22tn%22:%22R%22%7D] Another NA host believes that taking diclectin (doxylamine combined with pyridoxine) put her worms out of action until she stoped taking it. [https://www.facebook.com/groups/htsupport/permalink/2706737069382231/]

* ⚡ [https://en.wikipedia.org/wiki/Ketotifen Ketotifen] - This antihistamine and mast cell stabilizer, which has similar effects to cromoglicic acid (see separate listing), is sold under a large variety of trade names [https://www.drugs.com/international/ketotifen.html] that include Allerban, Allergan, Bentifen, Ketasma, Mastifen, Zaditen and Zylofen. In one study using the helminth, Trichinella spiralis, the addition of ketotifen resulted in a greater worm burden and worm size, [https://www.ncbi.nlm.nih.gov/pubmed/16886340] but in a small in vitro test, one hookworm self-treater found that exposing a sample of NA larvae to Naziden left them “a bit lethargic but alive” [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1041766029212685&comment_tracking=%7B%22tn%22:%22R8%22%7D] and they were still alive the next day. [https://www.facebook.com/groups/htsupport/permalink/1037890422933579/?comment_id=1039541612768460&reply_comment_id=1042321262490495&comment_tracking=%7B%22tn%22:%22R3%22%7D] However, effects in vivo don’t always correspond with those observed in a petri dish, and ketotifen is a piperazine-related substance so it may have an adverse effect on human helminths in vivo in at least some users.

* ⚡ [https://en.wikipedia.org/wiki/Promethazine Promethazine] (Phenergan, Promethegan, Romergan, Fargan, Farganesse, Prothiazine, Avomine, Atosil, Receptozine, Lergigan, and, in the UK, Sominex). This does not appear to kill helminths, whether taken orally or by intramuscular injection, and one self-treater who needs to take oral Phenergan daily says that her NA are unaffected. [https://www.facebook.com/groups/htsupport/permalink/1597006987021917/?comment_id=1597396203649662&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another hookworm host has reported that this drug did reduce his worm benefits when it was taken orally.
</blockquote>

==== Piperazine related antihistamines ====
<blockquote>
Popular antihistamines derived from, or closely related to, the anthelmintic drug ❌ [https://en.wikipedia.org/wiki/Piperazine piperazine] (See the separate entry for [[#piperazine|piperazine]]).
These include:
* ⚡ [https://en.wikipedia.org/wiki/Cetirizine cetirizine] (Zyrtec, Reactine)
* ⚡ [https://en.wikipedia.org/wiki/Levocetrizine_dihydrochloride levocetrizine] (Alcet, Allear, Curin, levcet, Seasonix, T-Day Syrup, Teczine, UVNIL, Vozet, Xaltec, Xozal, Xuzal, Xusal, Xyzal, Zilola, Zyxem)

* ⚡ [https://en.wikipedia.org/wiki/Phenylephrine phenylephrine] Some nasal decongestants and allergy medications contain this drug (e.g., products branded "Sudafed PE", but not those branded "Sudafed") so check the ingredients of the product you are considering using. While one hookworm host has reported using this drug without any adverse effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537715762951030] it does appear to have anthelmintic properties [http://www.ncbi.nlm.nih.gov/pubmed/6127426] and has been reported to have caused a brief return of disease symptoms in one hookworm host after a single dose.
* ⚡ [https://en.wikipedia.org/wiki/Desloratadine desloratadine] (NeoClarityn, Claramax, Clarinex, Larinex, Aerius, Dazit, Azomyr, Deselex and Delot)
* and possibly ⚡ [https://en.wikipedia.org/wiki/Acrivastine acrivastine] (Semprex-D in the US)

While some people have taken cetirizine, levocetirizine or desloratadine concurrently with helminthic therapy -
sometimes for very long periods - and had no loss of benefit from their worms (for example [https://www.facebook.com/groups/htsupport/permalink/892594554129834/?comment_id=892794274109862&offset=0&total_comments=16&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/893959107326712/?qa_ref=qd&comment_id=893959580659998&offset=0&total_comments=9&comment_tracking=%7B%22tn%22:%22R7%22%7D]), there
have been others who have suspected that these drugs have been responsible for adversely affecting or even killing their worms.

Less common antihistamines derived from, or related to ❌piperazine.
At the present time, there is no indication whether or not most of the following drugs could affect human helminths.
* ❓ [https://en.wikipedia.org/wiki/Buclizine buclizine]
* ❓ [https://en.wikipedia.org/wiki/Chlorcyclizine chlorcyclizine] (Di-paralene, Mantadil, Pruresidine, Trihistan)
* ❓ [https://en.wikipedia.org/wiki/Cinnarizine cinnarizine] (Stugeron, Stunarone, R5)
* ✅/⚡ [https://en.wikipedia.org/wiki/Hydroxyzine Hydroxyzine] (Atarax, Vistaril, etc.) A parent has reported that her son’s NA were not harmed by taking this drug, but dose size and length of use in this case are not known. [https://www.facebook.com/groups/htsupport/2666963426692929/?comment_id=2667238819998723&reply_comment_id=2669051416484130&notif_id=1581006498061422&notif_t=group_comment_mention]
* ❓ [https://en.wikipedia.org/wiki/Cyclizine cyclizine]
* ❓ [https://en.wikipedia.org/wiki/Meclizine meclizine] (Bonine, Bonamine, Antivert, Postafen, Sea Legs)
* ⚡ [https://en.wikipedia.org/wiki/Dramamine dimenhydrinate] See [[#dimenhydrinate|dimenhydrinate reference]].
* ❓ [https://en.wikipedia.org/wiki/Niaprazine niaprazine]
* ❓ [https://en.wikipedia.org/wiki/Bilastine bilastine] (Bilaxten) One NA host has reported that she had been taking bilastine on and off for 3 years - the same amount of time that she had been hosting NA - because she has found it to be very effective for her allergies, and, while the NA have sometimes seemed to be working during this time, they have mostly seemed not to be working all that well. However, she had been able to grow more NA consistently for 2 of the 3 years, thus confirming that she still had some worms, but, when she last reported her experience, she had stopped taking the Bilastine to see whether the NA work better in its absence. [https://www.facebook.com/groups/htsupport/posts/4820011088054808/?comment_id=4851343294921587]
</blockquote>

==== ✅ H2 antagonists are safe ====

<blockquote>
H2 antagonists are a separate class of drugs from '''proton-pump Inhibitors''' (see separate section).

The term, “antihistamine” is usually reserved for [https://en.wikipedia.org/wiki/H1_antagonist H1 antagonists] whose main therapeutic effect is mediated by
negative modulation of histamine receptors, but [https://en.wikipedia.org/wiki/H2_antagonist H2 histamine receptor antagonists] can also be considered to be a
type of antihistamine. H2 antagonists include
* [https://en.wikipedia.org/wiki/Ranitidine ranitidine] (Zantac) which works by blocking histamine and thus decreasing the amount of acid released by the cells of the stomach.
Other common H2 antagonists are
* [https://en.wikipedia.org/wiki/Cimetidine cimetidine] (Tagamet)
* [https://en.wikipedia.org/wiki/Famotidine famotidine] (Pepcid) One hookworm host used this drug successfully, without harm to his colony, for at least 2 months, starting with 20mg daily and titrating within a month to 3x20mg per day. [https://www.facebook.com/groups/htsupport/posts/5898386906883882?comment_id=5898568306865742&reply_comment_id=5900280486694524]
* [https://en.wikipedia.org/wiki/Nizatidine nizatidine] (Axid, Tazac).
</blockquote>

=== Antimalarials ===

<blockquote>
*⚡ [https://en.wikipedia.org/wiki/Chloroquine Chloroquine] A cross-epidemiological study of the effect of treatment for malaria in hookworm-endemic areas found that treated patients presented with reduced helminth egg burdens and worm-related pathology, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4558454/] and a reduced hookworm egg count has also been reported in another set of subjects taking chloroquine. [https://pubmed.ncbi.nlm.nih.gov/9645872/]
*✅ [https://en.wikipedia.org/wiki/Hydroxychloroquine Hydroxychloroquine] (Plaquenil, etc.) There has been one tentative suggestion from a helminth self-treater that this antimalarial medication, ''might'' have harmed her hookworms, but several others have taken this drug without any adverse effect on their worms. One took Plaquenil for 5 years without harming his NA, [https://www.facebook.com/groups/htsupport/permalink/3000811316641470/?comment_id=3001544019901533] another takes 400 mg daily without any adverse effect on her hookworms, [https://www.facebook.com/groups/htsupport/posts/4823182771070973/?comment_id=4824165244306059] and two further subjects who have taken this drug, one of them in quite large quantities, had no issues with their worms. (Link expired)
No other antimalarial drug has been suspected by self-treaters of harming therapeutic helminths, including [https://en.wikipedia.org/wiki/Quinine Quinine].
</blockquote>

=== Antiprotozoals ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Metronidazole Metronidazole] (Flagyl). This is one of three derivatives of ❌[https://en.wikipedia.org/wiki/Nitroimidazole nitroimidazole] that is used against anaerobic bacterial and parasitic, as well as protozoan, infections. One hookworm host has reported[https://www.facebook.com/groups/htsupport/permalink/861694407219849/?comment_id=861879177201372&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] losing her colony to this drug, which should never be combined with [https://en.wikipedia.org/wiki/Mebendazole mebendazole] due a risk that, together, they may cause [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1447769/ Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis], something about which many doctors and pharmacists may be unaware, especially in the US.
</blockquote>

=== Antipsychotics ===

<blockquote>
* ❌ [https://en.wikipedia.org/wiki/Chlorpromazine Chlorpromazine] (Thorazine and Largactil, etc.) This antipsychotic medication has shown anthelmintic effects against three widely divergent helminth species. It kills C. elegans at multiple life stages and acts rapidly to inhibit its feeding within minutes of exposure. It also decreases motility in the adult mouse whipworm, Trichuris muris, prevents hatching and development of the dog hookworm, Ancylostoma caninum, and kills the blood fluke flatworm, Schistosoma mansoni. [https://www.ncbi.nlm.nih.gov/pubmed/29343694]
</blockquote>

=== Antivirals ===
<blockquote>
(Also see [[Human helminth care manual#Natural antivirals|'''Natural antivirals''']] for effective worm-safe antiviral treatments.)

* ✅ [https://en.wikipedia.org/wiki/Famciclovir Famciclovir] (Famvir) -- One hookworm host took Famciclovir (500mg) 3 times per day for many months without any noticeable effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/884990498223573/?comment_id=885041121551844&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nirmatrelvir/ritonavir Nirmatrelvir / ritonavir] This co-packaged medication, which combines two protease inhibitors and is marketed as Paxlovid, is used as a treatment for Covid‑19. There have been no reports of it harming human helminths and one report that it did not harm one self-treater’s NA colony. [https://www.facebook.com/groups/htsupport/posts/6439043419484892/?comment_id=6439498362772731]

* ✅ [https://en.wikipedia.org/wiki/Valtrex Valaciclovir/valacyclovir] (Valtrex, Zelitrex) -- This antiviral drug was taken by one worm host for a week without any adverse effect on his hookworms or whipworms.

* ❌ Nitazoxanide (See separate entry under Anthelmintics)
</blockquote>

=== Immunoglobulin therapy (IVIG) ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Immunoglobulin_therapy Immunoglobulin therapy], also known as normal human immunoglobulin (NHIG) is compatible with helminthic therapy and has been used effectively in combination with TSO. There is no reason to think that it would harm human helminths.
</blockquote>

===Immunomodulatory drugs ===
<blockquote>
* ✅ [https://en.wikipedia.org/wiki/Janus_kinase_inhibitor Janus kinase inhibitors], also known as JAK inhibitor or jakinib (e.g., baricitinib, tofacitinib and upadacitinib [Rinvoq]) are immune modulating medications used in the treatment of some cancers, autoimmune and inflammatory diseases such as rheumatoid arthritis, and various skin conditions. There is no evidence indicating that these drugs might have an anthelmintic effect, [https://www.facebook.com/groups/htsupport/posts/8698182570237621?comment_id=8698286136893931&reply_comment_id=8702949483094263] and there have been no reports from self-treaters of any adverse effects on their worm colonies.
</blockquote>

=== Immunosuppressive drugs ===

<blockquote>
'''✅ Immunosuppressive drugs reported to be safe for use by hosts of human helminths are:'''
* [https://en.wikipedia.org/wiki/Cyclosporin ciclosporin] (cyclosporine, cyclosporin). See also [https://en.wikipedia.org/wiki/Cyclosporins cyclosporins].

* [https://en.wikipedia.org/wiki/Corticosteroid corticosteroids], including:
** [https://en.wikipedia.org/wiki/Prednisone prednisone] and its active metabolite, [https://en.wikipedia.org/wiki/Prednisolone prednisolone]
** [https://en.wikipedia.org/wiki/Fluticasone_propionate fluticasone propionate] Also known as Flixotide (inhalatory), Flixonase and Flonase (nasal). At least three NA hosts have used this drug without any obvious impact on their worms. [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707582379297710&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707720709283877&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1707473322641949/?comment_id=1707880315934583&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cyclophosphamide cyclophosphamide] (Sold as: Cytoxan, Lyophilized Cytoxan, Endoxan, Neosar, Procytox, Revimmune and Cycloblastin). This has been used repeatedly by one hookworm host who has reported that it had no adverse effect on her colony.

* the [https://en.wikipedia.org/wiki/Thiopurine thiopurines], [https://en.wikipedia.org/wiki/Azathioprine azathioprine] and [https://en.wikipedia.org/wiki/6-MP mercaptopurine]/6-MP (purinethol)

* the [https://en.wikipedia.org/wiki/TNF_inhibitor TNF inhibitors]
** [https://en.wikipedia.org/wiki/Infliximab infliximab] (Remicade)
** [https://en.wikipedia.org/wiki/Adalimumab adalimumab] (Humira)
** [https://en.wikipedia.org/wiki/Certolizumab_pegol certolizumab pegol] (Cimzia)
** [https://en.wikipedia.org/wiki/Golimumab golimumab] (Simponi)

* [https://en.wikipedia.org/wiki/Humanized_antibody humanized antibody drugs], e.g. [https://en.wikipedia.org/wiki/Omalizumab omalizumab] (Xolair)

* [https://en.wikipedia.org/wiki/Monoclonal_antibody%23.22Fully.22_human_monoclonal_antibodies humanized monoclonal antibody drugs] such as [https://en.wikipedia.org/wiki/Natalizumab natalizumab] (Tysabri)

* and [https://en.wikipedia.org/wiki/Fusion_protein recombinant fusion protein] drugs such as [https://en.wikipedia.org/wiki/Etanercept etanercept] (Enbrel)

It can be an advantage to be taking one of these drugs in the early stages of helminthic therapy because they can reduce, or even prevent, the transient side effects triggered by helminths, and their anti-inflammatory action can also help human helminths to become established. So anyone who is already taking one of these drugs should resist the temptation to stop taking it too soon after starting HT.

This applies particularly to subjects with Crohn's and other intestinal diseases, who tend to have a very vigorous immune response to helminths. Suddenly withdrawing a drug that has been keeping this response in check will likely cause a rebound effect that could result in a flare and, potentially, a loss of worms. This is explained in more detail [[Introduction to helminthic therapy#Combining helminthic therapy with drug treatments | '''here''']].
</blockquote>

=== Immunotherapy ===

<blockquote>
✅ [https://en.wikipedia.org/wiki/Allergen_immunotherapy Allergen immunotherapy] -- In the form of sublingual drops/tablets, subcutaneous injections, and [https://www.aaaai.org/tools-for-the-public/conditions-library/allergies/allergy-shots-(immunotherapy) allergy “shots”],
this is safe to be used concurrently with helminthic therapy. In fact, many who have used the two therapies together have been very pleased with the combined effects.
</blockquote>

=== Laxatives ===
<blockquote>
Hookworms are usually able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep] using products such as polyethylene glycol (PEG), Macrogol, Colyte, Picosalax, Bisacodyl, phospho soda, sodium picosulfate, or sodium phosphate and/or magnesium citrate. Many hookworm hosts have used the standard colonoscopy bowel prep without any problems (e.g., [https://www.facebook.com/groups/htsupport/permalink/2313948658661076/?comment_id=2316622215060387&comment_tracking=%7B%22tn%22%3A%22R%22%7D]), and there has only been a single report claiming that colonoscopy prep had terminated a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/2184696924919584/?comment_id=2184806188241991&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, another NA host has reported that, while a colonoscopy prep didn't entirely wipe out his colony, it appeared to have weakened it because he found a much smaller number of larvae than usual when he next incubated. [https://www.facebook.com/groups/htsupport/permalink/6481648121891088/]

It is unlikely that laxatives would dislodge human whipworms once these are mature and embedded in the colonic mucosa, but laxatives could potentially flush them out before this, especially around 21-22 days post inoculation. It may therefore be best to avoid the use of laxatives around this time. After 28 days, human whipworms should not be affected at all.

Also see [[#Diarrhoea/diarrhea|'''Diarrhoea/diarrhea''']].
</blockquote>

=== [https://en.wikipedia.org/wiki/Muscle_relaxant Muscle relaxants] ===
<blockquote>
There is a theoretical risk that anything which relaxes a hookworm host may have a similar effect on their colony, especially NA, and that this might conceivably affect the ability of the worms to maintain their grip on the host’s mucosa, possibly resulting in their expulsion, although this effect would likely be dose-dependent.

Whipworms are much less likely than hookworms to be affected in this way, due to them not feeding directly from the bloodstream and the fact that they anchor themselves deeply into the colonic mucosa, so are not easily dislodged.

There have been two reports of possible adverse effects. In the first of these, a hookworm host suspected ❌ [https://en.wikipedia.org/wiki/Carisoprodol Carisoprodol] (Soma, Sanoma and Carisoma) of causing the loss of his hookworm population. In the second, ❌ [https://en.wikipedia.org/wiki/Cyclobenzaprine Cyclobenzaprine] (Flexeril, Amrix, etc.) was identified as the only likely cause of multiple failed attempts to incubate NA. [https://www.facebook.com/groups/htsupport/posts/24119753220987306/] However, both ✅ [https://en.wikipedia.org/wiki/Guaifenesin '''Guaifenesin'''] and a single night-time dose of 6 mg of [https://en.wikipedia.org/wiki/Tizanidine ✅ '''Tizanidine'''] [https://www.facebook.com/groups/htsupport/posts/4490377691018151/?comment_id=4490387587683828] appear to have been safe.
</blockquote>

=== [https://en.wikipedia.org/wiki/Analgesic Pain relievers (analgesics)] ===
<blockquote>
The following pain relief medications are all harmless to NA and TTO.

* ✅ [https://en.wikipedia.org/wiki/Nonsteroidal_anti-inflammatory_drug '''NSAIDs (nonsteroidal anti-inflammatory drugs''')]
: * [https://en.wikipedia.org/wiki/Aspirin Aspirin]
: * [https://en.wikipedia.org/wiki/Ibuprofen Ibuprofen]
: * [https://en.wikipedia.org/wiki/Diclofenac Diclofenac]
: * [https://en.wikipedia.org/wiki/Naproxen Naproxen]
* ✅ [https://en.wikipedia.org/wiki/Opioids '''Opioids''']
: * [https://en.wikipedia.org/wiki/Codeine Codeine]
: * [https://en.wikipedia.org/wiki/Fentanyl Fentanyl]
: * [https://en.wikipedia.org/wiki/Hydrocodone Hydrocodone]
: * [https://en.wikipedia.org/wiki/Oxycodone Oxycodone]
* ✅ [https://en.wikipedia.org/wiki/Paracetamol '''Paracetamol (acetaminophen)''']
* ✅ [https://en.wikipedia.org/wiki/Benzodiazepine '''Benzodiazepines'''] such as:
: * [https://en.wikipedia.org/wiki/Midazolam Midazolam] ([https://en.wikipedia.org/wiki/Versed Versed])
</blockquote>

=== Recreational drugs ===

==== ❌ Piperazine-based recreational drugs ====
<blockquote>
[http://www.tandfonline.com/doi/pdf/10.1080/13102818.2008.10817529 Piperazine-based recreational drugs] are a group of stimulant drugs with similar effects to ecstasy.
(See separate entry for details on [[#piperazine|piperazine]]) The main piperazine-derivatives that have been used for
recreational purposes include
* [https://en.wikipedia.org/wiki/Benzylpiperazine BZP] (Benzylpiperazine, A2, Frenzy, Nemesis)
* [https://en.wikipedia.org/wiki/Trifluoromethylphenylpiperazine TFMPP] (1-[3-(trifluoro-methyl) phenyl]piperazine)
* [https://en.wikipedia.org/wiki/Meta-Chlorophenylpiperazine mCPP] (meta-chlorophenylpiperazine, 1- [3-Chlorophenyl]-piperazine).
These drugs were frequently mixed with caffeine and a range of vitamins and binders to make party pills that were marketed as
“natural” or “herbal” highs, but were actually purely synthetic. Other piperazine-derived designer drugs include:
* '''AcBZP''' (4-Acetyl-1-benzylpiperazine, AceticBenzylPiperazine)
* [https://en.wikipedia.org/wiki/Methylbenzylpiperazine MBZP] (1-methyl-4-benzylpiperazine)
* [https://en.wikipedia.org/wiki/2C-B-BZP 2C-B-BZP] (4-Bromo-2,5-dimethoxy-1-benzylpiperazine) One user has reported that periodic use of 2C-B did not affect his colony of NA.
* [https://en.wikipedia.org/wiki/Dibenzylpiperazine DBZP] (1,4-Dibenzylpiperazine)
* [https://en.wikipedia.org/wiki/Methylenedioxybenzylpiperazine MDBZP] (3,4 Methylenedioxy-1-benzylpiperazine)
</blockquote>

==== ⚡ Yage (Ayahuasca) ====

<blockquote>
It has been opined that anything that enters the bloodstream and disorients a host has a potential to do the same to hookworms - since they feed on their host’s blood - and that, if the disorientation is excessive, it may cause the worms to lose their grip on the mucosa and possibly be flushed away from their home base in the small intestine, and be lost. Although the assumption that the worms will become inebriated by anything that inebriates their host has been questioned because the 'nervous system' of helminths is quite different from that of mammals, one recreational drug that might produce this effect and cause the loss of hookworms is the South American drug, yage, also known as ayahuasca, as well as by a number of other names. [https://en.wikipedia.org/wiki/Ayahuasca%23Nomenclature]

This psychedelic brew, which is concocted by combining a variety of plant materials, was used as part of S. American native religious rituals and, since being commercialised, has become much more mainstream. Available in Europe and N. America through "churches" set up for its import, this drug causes a deep and immersive hallucinogenic experience during a “trip” lasting 4-8 hours, or 12-18 hours if the subject is re-dosed, which is not uncommon.

"Its purgative properties are important (known as la purga or "the purge"). The intense vomiting and occasional diarrhea it induces can clear the body of worms and other tropical parasites [https://www.ncbi.nlm.nih.gov/pubmed/2656954] and harmala alkaloids themselves have been shown to be anthelmintic. [https://link.springer.com/article/10.1007%2FBF02860378] Thus, this action is twofold; a direct action on the parasites by these harmala alkaloids (particularly harmine in ayahuasca) works to kill the parasites, and parasites are expelled through the increased intestinal motility that is caused by these alkaloids." [https://en.wikipedia.org/wiki/Ayahuasca]

“Tropical plants used by South American natives produce an array of isoquinoline and tryptamine-related alkaloids that are not only hallucinogens, but powerful emetics with a wide range of other biological activities, in particular antimicrobial and anthelmintic properties… We propose that these alkaloid mixtures were initially discovered and developed by indigenous people for treatment of a variety of parasitic diseases and incorporated into religious ceremonies using psychoactivity as an effective dose marker.” [https://www.sciencedirect.com/science/article/pii/0378874182900538]

However, in spite of all this evidence for the antiparastic potential of ayahuasca, one hookworm host has noticed no apparent adverse effect on her worms as a result of taking part in more than 10 ayahuasca ceremonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523441614378445&reply_comment_id=2523573887698551] Another helminth host has confirmed anonymously that he was able to culture more NA from his colony after participating in 3 ceremonies in one year.
</blockquote>

==== ✅ Safe for human helminths unless marked ====

<blockquote>

* [https://en.wikipedia.org/wiki/Betel Betel leaves] -- The leaves of the Piper betle vine (part of the [https://en.wikipedia.org/wiki/Piperaceae Piperaceae] family, which includes pepper and ⚡kava) are used as a mild stimulant and are thought likely to be safe for human helminths, although there have been no reports from helminth hosts to confirm or contradict this.

* ❌ [https://en.wikipedia.org/wiki/Areca_nut betel nut] (or areca nut) seed of the areca palm (and also known as the areca nut palm, betel palm, Pinang palm and Indian nut) is often chewed wrapped in betel leaves - a combination known as [https://en.wikipedia.org/wiki/Paan paan] that is used for its stimulant and psychoactive effects. Betel nuts contain the anthelmintic [https://en.wikipedia.org/wiki/Arecoline arecoline] and have been used as a tapeworm remedy. Fresh betel nuts are also known to be used very effectively by Torres Straight Islanders as a treatment for all types of intestinal worm, and surveys have found that the betel chewers were almost all worm-free, while others weren't. (Prolonged use of the betel nut can create addiction and the World Health Organization classifies the betel nut as a carcinogen.)

* [https://en.wikipedia.org/wiki/Cannabis_(drug) Cannabis], [https://en.wikipedia.org/wiki/Cannabis_(drug)%23Marijuana marijuana] and [https://en.wikipedia.org/wiki/Hashish hashish] appear to be worm-friendly. A paper published in 2015 [https://www.ncbi.nlm.nih.gov/pubmed/26031406] showed that, in the group of hunter-gatherers studied, those who consume cannabis have a significantly lower rate of helminth infection, from which the researchers concluded that the Aka foragers must consume cannabis to kill parasites, even though the scientists admit that, while cannabis kills worms in a petri dish, it has not been shown to kill worms in animals. A different explanation for the correlation seen in this study could be that those individuals with the most worms feel less need to smoke cannabis, and this ties in with the experience of the many helminth hosts who have seen a reduction in anxiety while hosting worms. One host of both hookworms and human whipworms has confirmed the presence of eggs from both species after cannabis use, and another hookworm host who used 10 drops of hemp '''CBD''' ([https://en.wikipedia.org/wiki/Cannabidiol cannabidiol]) oil twice daily, plus a few drops of '''THC''' ([https://en.wikipedia.org/wiki/Tetrahydrocannabinol tetrahydrocannabinol]) oil to help with sleep, has reported that her hookworms were unaffected. [https://www.facebook.com/groups/htsupport/permalink/1037560152966606/?comment_id=1037577039631584&comment_tracking=%7B%22tn%22:%22R%22%7D] Someone else used '''CBD''' oil for several months and noticed no adverse effect on his hookworms, [https://www.facebook.com/groups/htsupport/permalink/1239928846063068/?comment_id=1240221499367136&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and this lack of any adverse effect has been confirmed by numerous other cannabis users. [https://www.facebook.com/groups/htsupport/permalink/1406977876024830/?comment_id=1407227059333245&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1059227607466527/?comment_id=1059279190794702&reply_comment_id=1407016112687673&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has even been shown that CBD extends the lifespan and arrests age-associated physiological decline in the research nematode, C. elegans, so may potentially be beneficial for the health of other helminths. [https://pubmed.ncbi.nlm.nih.gov/35445360/]

* [https://en.wikipedia.org/wiki/Cocaine Cocaine], in its pure, unadulterated state, could be added to this list of worm-safe drugs, but it is commonly adulterated with other substances that might harm helminths, particularly ❌ [https://en.wikipedia.org/wiki/Levamisole levamisole] which, according to one report, is the most popular bulking agent found in 73% of seized coke. [https://www.hotpress.com/sex-drugs/10-things-know-cocaine-specialists-guide-22803299]

* [https://en.wikipedia.org/wiki/Hypnotic Hypnotics] are generally worm-safe, e.g.
** '''propofol''' (see Anaesthetics section) is an ultrashort-acting sedative with amnesiac effects
** anything in the [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] class of drugs (e.g. [https://en.wikipedia.org/wiki/Valium valium])
** the short-acting nonbenzodiazepine hypnotic, [https://en.wikipedia.org/wiki/Zolpidem zolpidem] (e.g. Ambien [https://www.facebook.com/groups/htsupport/permalink/865157116873578/?comment_id=866638886725401&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D], Ambien CR, Intermezzo, Stilnox, Stilnoct, Sublinox, Hypnogen, Lunata, Zonadin, Sanval, Zolsana, Zolfresh)
** the [https://en.wikipedia.org/wiki/Narcotic_analgesic opioids] (e.g. [https://en.wikipedia.org/wiki/Codeine codeine], [https://en.wikipedia.org/wiki/Dextropropoxyphene dextropropoxyphene], [https://en.wikipedia.org/wiki/Dihydrocodeine dihydrocodeine], [https://en.wikipedia.org/wiki/Hydrocodone hydrocodone], [https://en.wikipedia.org/wiki/Oxycodone oxycodone], [https://en.wikipedia.org/wiki/Tramadol tramadol] and [https://en.wikipedia.org/wiki/Morphine morphine]), along with any of their synthetic or time release variants (e.g. [https://en.wikipedia.org/wiki/Fentanyl fentanyl / fentanil]); [https://www.facebook.com/groups/htsupport/permalink/1080879281968026/?comment_id=1081015631954391&reply_comment_id=1081726205216667&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓ [https://en.wikipedia.org/wiki/Mitragyna_speciosa Kratom] (aka kratum and ketum). [https://www.facebook.com/groups/htsupport/permalink/868935276495762/] [https://www.facebook.com/groups/htsupport/permalink/868935276495762/?comment_id=869019499820673&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D] Extracts and leaves of kratom are reported to have been used as intestinal deworming agents in Thailand, and the FDA has warned consumers not to use any products labeled as containing kratom. [http://www.medicalnewstoday.com/releases/304821.php] However, one human whipworm host has taken small doses without any apparent effect on his worms [https://www.facebook.com/groups/htsupport/permalink/1788272677895346/?comment_id=1796502977072316&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and a hookworm grower has reported no reduction in yield from his cultures after he took kratom.

* [https://en.wikipedia.org/wiki/Opium Opium] and [https://en.wikipedia.org/wiki/Heroin heroin] (aka diacetylmorphine, diamorphine and other names) appear to be worm-friendly.

Most other recreational drugs should be safe for use by helminth hosts, including '''tobacco''', '''nicotine''' and most forms of '''alcohol'''.

* ➿ [https://en.wikipedia.org/wiki/Alcoholic_beverage Alcohol] -- Normal social drinking should not have any adverse effect on helminths, however, alcohol acts as an antimicrobial, and substances produced by the death of gut bacteria can enter the bloodstream to cause inflammation and allergic reactions [https://www.facebook.com/groups/htsupport/permalink/3958483847540874/?comment_id=3958511057538153] which can temporarily make it appear as though therapeutic helminths have stopped working. Overindulgence in alcohol may therefore cause a temporary reduction in worm benefits in a dose-dependent manner. One individual who had successfully put his colitis and celiac disease into remission with NA has reported that, in spite of hosting the worms, drinking beer causes a return of colitis symptoms. Excessive consumption of alcohol that results in the user going into a coma due to alcohol poisoning may incur a greater risk to helminths.
** ❓ [https://en.wikipedia.org/wiki/Absinthe Absinthe] is one alcoholic drink that might present more of a risk, as it was traditionally made using herbs reported to have antiparasitic properties, including ❌'''wormwood'''. (See separate entry). However, the risk from absinthe has been questioned because it only contains the essential oil of wormwood, while the anthelmintic activity of this herb has been linked more to the bitter principles and the alkaloids, which are not included in absinthe.

* ❓ [https://en.wikipedia.org/wiki/MDMA MDMA] (ecstasy) -- As primarily a serotonin and dopamine agonist, this is thought unlikely to have much effect on helminths. However, serotonin agonism increases peristalsis, so using MDMA may not be a good idea until after the worms have attached to the intestinal mucosa. Once they are attached, the increased peristalsis alone would not dislodge them. One hookworm host has reported that he has twice rolled with MDMA and it didn't kill his worms. [https://www.facebook.com/groups/htsupport/permalink/2331685740220701/]

* [https://en.wikipedia.org/wiki/N,N-Dimethyltryptamine DMT] (N,N-Dimethyltryptamine or N,N-DMT) This psychedelic compound with powerful hallucinogenic effects has been reported by one user to be safe for use with NA.

* ❓ [https://en.wikipedia.org/wiki/LSD LSD] (Lysergic acid diethylamide) is unlikely to harm helminths, and there has been one report to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Myristicin Myristicin] -- This psychoactive drug, which is the traditional precursor for the psychedelic and empathogenic drug [https://en.wikipedia.org/wiki/MMDA_(drug) MMDA], is found in very small quantities in vegetables, herbs and fruits consumed by humans on a daily basis, e.g., parsley, celery, lemons, figs, carrots, grape juice, nutmeg and dill, but this dietary intake is unlikely to be harmful to helminths. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5004179/]

* ❓ [https://en.wikipedia.org/wiki/Peyote Peyote] (Lophophora williamsii) -- This cactus, which contains psychoactive alkaloids, including mescaline, is thought unlikely to harm helminths, but there have been no reports to confirm this.

* ❓ [https://en.wikipedia.org/wiki/Psilocybin Psilocybin], a [https://en.wikipedia.org/wiki/Substituted_tryptamine substituted tryptamine], is a naturally occurring psychedelic compound produced by more than 200 species of mushroom. Although illegal in most countries/states, psilocybin is used for the self-treatment of cluster headaches and one hookworm host has reported using this compound for two months to treat severe migraines, without noticing any apparent effect on his worms. However, it is possible that higher doses of this hallucinogenic may disorient hookworms for long enough to cause their loss.

* [https://psychedelictimes.com/healing-tobacco-rape-tribal-snuff/ Rapé] (pronounced “ha-peh”) is a powerful snuff originally used by shamans in Brazil and Peru as part of medicinal rituals. This sacred tobacco has increased in popularity outside of the Amazon during the early twenty-first century for its medicinal properties, and two hookworm hosts have reported using rapé without adversely affecting their colonies. [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523128767743063] [https://www.facebook.com/groups/htsupport/permalink/2523125094410097/?comment_id=2523255297730410]
</blockquote>

===Statins===
There is evidence that [https://en.wikipedia.org/wiki/Statin statins] can be directly toxic to at least some helminths at sufficiently high concentrations in vitro, with this type of drug being known to inhibit HMG‑CoA reductase, an enzyme essential to many helminths for a number of vital processes including glycosylation, energy metabolism and membrane homeostasis.

In Schistosoma mansoni, for example, multiple statins (including lovastatin and others) have been shown to kill both larval and adult worms in vitro in a concentration‑ and time‑dependent manner. Similarly, in cestodes (tapeworms), simvastatin and fluvastatin have inhibited parasite HMG‑CoA reductase to produce measurable anthelmintic effects in larvae such that statins have been suggested for possible repurposing as anthelmintics for use in controlling cestodes.

While there had been no published evidence by early 2026 that clinically used statin doses have harmed either NA or TTO in human hosts, these species do share extensive metabolic and regulatory machinery with other parasitic nematodes, so it is conceivable that typical human doses of statins might be harmful to these therapeutic worms, and one NA self-treater - a very experienced incubator of this species - reported, in Feb 2026, that taking [https://en.wikipedia.org/wiki/Atorvastatin atorvastatin] (Lipitor, etc.) resulted in the repeated failure of NA larvae to successfully colonise after she had incubated these herself and observed them to be active immediately before their application to her skin. The noticeable lack of the usual entry points indicated that these larvae, although active, were incapable of entering the skin.

===Vaccines===

Three helminth hosts have claimed that they may have lost their hookworms after receiving the ⚡ [https://en.wikipedia.org/wiki/Tetanus_vaccine tetanus vaccine], although others have had tetanus shots without any loss of worms, and several people receiving flu vaccination have reported that this had no effect on their hookworms. [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861706373885309&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1861574483898498/?comment_id=1861973877191892&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nothing has been reported in respect of other vaccines. Also see [[Helminthic therapy and vaccines | '''Helminthic therapy and vaccines''']].

== Miscellaneous pharmaceuticals and chemicals ==

<blockquote>
''' ✅ Safe for worms unless marked otherwise'''
* ❓ [https://en.wikipedia.org/wiki/Zovirax Aciclovir] (Cyclovir, Herpex, Acivir, Acivirax, Zovirax, Zoral, Xovir and Imavir). There have been no reported problems with this drug so far. See also the related drug, Valaciclovir/valacyclovir.

* ❌ [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) is a soil bacterium that has been engineered into food crops such as corn and rice to render them pest resistant, and residues of Bt-based insecticides have been found on fresh fruits and vegetables. [http://www.ncbi.nlm.nih.gov/pubmed/16672488] Cry5B, a pore-forming protein produced by Bt can kill intestinal worms and is highly effective against all hookworm species tested in all models [https://www.ncbi.nlm.nih.gov/pubmed/29772478]. It is also used as a natural insecticide on crops on some organic farms. However, the risk of therapeutic helminths being killed as a result of their hosts ingesting small amounts of the delta endotoxins produced by Bt is likely to be very low. When used as an insecticide, one of the many Bt strains available is selected for its specific toxicity against the target insect. The strains that produce toxins against nematodes are therefore unlikely to be used as agricultural insecticides. In addition to this, the toxins produced need to be ingested by the target organism to become active and, as proteins, they may be denatured by heat during cooking. [https://www.facebook.com/groups/htsupport/permalink/1270850719637547/?comment_id=1270971972958755&comment_tracking=%7B%22tn%22%3A%22R%22%7D] The probiotic bacterium, Bacillus subtilis, can also be engineered to express the Cry5B protein, a small dose of which has been shown to kill intestinal nematode parasites, achieving a 93 percent elimination of human hookworms in hamsters. [https://web.archive.org/web/20161005204559/https://www.asm.org/index.php/asm-newsroom2/journal-tipsheets/88-news-room/journal-tipsheets/91749-natural-pest-control-protein-effective-against-hookworm-a-billion-could-benefit], [http://www.ncbi.nlm.nih.gov/pubmed/23835175] Although researchers may be pursuing this development as a means of delivering anthelmintics via foods and food supplements, the strain of Bacillus subtilis currently used in probiotics that have been manufactured for human consumption is not known to have been modified in this way, and one hookworm host has reported that his worms were unaffected after eating a lot of natto (made using Bacillus subtilis) and taking the Bacillus subtilis-containing probiotic product, Megasporebiotic. [https://www.facebook.com/groups/htsupport/permalink/1084149894974298/?comment_id=1084177824971505&comment_tracking=%7B%22tn%22:%22R6%22%7D]

* [https://en.wikipedia.org/wiki/Baclofen Baclofen] (Kemstro, Lioresal, Liofen, Gablofen, Beklo and Baclosan) is a derivative of gamma-aminobutyric acid (GABA). One host who took 20-30mgs of baclofen daily reported no loss of worm benefits.

* ❌ [https://en.wikipedia.org/wiki/Barbiturate Barbiturates] have now largely been replaced in routine medical practice by ✅ [https://en.wikipedia.org/wiki/Benzodiazepines benzodiazepines], but they may still be encountered in general anaesthesia, for epilepsy, and in the treatment of acute migraines. These drugs depress the central nervous system, producing effects ranging from mild sedation to total anaesthesia, so, taken in sufficient quantity, they may disorient hookworms sufficiently to cause them to lose their grip on the intestinal mucosa and be flushed away from their feeding site.

* [https://en.wikipedia.org/wiki/Benzodiazepine Benzodiazepines] (BZD, benzos). There have been no reports of this type of drug having any adverse effect on helminths. The short-acting anti-anxiety drug, [https://en.wikipedia.org/wiki/Alprazolam alprazolam] (Xanax), was taken by one hookworm host (0.5 mg 3 or 4 times over the course of a month) without any apparent effect on his worms. [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912671848788771&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912703545452268&offset=0&total_comments=4&comment_tracking=%7B%22tn%22:%22R%22%7D] Other self-treaters have found that [https://en.wikipedia.org/wiki/Clonazepam clonazepam] (Klonopin) [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=912711478784808&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] and [https://en.wikipedia.org/wiki/Lormetazepam lormetazepam] are both worm-safe, as is [https://en.wikipedia.org/wiki/Lorazepam Lorazepam] (Ativan). [https://www.facebook.com/groups/htsupport/permalink/912662098789746/?comment_id=1099405830115371&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Bismuth_subsalicylate Bismuth subsalicylate] (pink bismuth, the active ingredient in various stomach-settling medications such as [https://en.wikipedia.org/wiki/Pepto-Bismol Pepto-Bismol] and Kaopectate) There has been one suggestion that bismuth may have a temporary adverse effect on human helminths, similar to that caused by local anaesthetics/anesthetics, but this has not been confirmed by others. Pepto-Bismol is [http://www.reyessyndrome.org/pdfs/medicationscontainingaspirin.pdf listed] as containing aspirin (acetylsalicylate) or an aspirin-like substance (see ✅ Anticoagulants section regarding this ingredient).

* [https://en.wikipedia.org/wiki/Bisphosphonate Bisphosphonates] This class of drugs appears to be harmless to human helminths. They are used to prevent the loss of bone density, and include [https://en.wikipedia.org/wiki/Zoledronic_acid zoledronic acid] (aka zoledronate, sold under brand names such as Reclast, Zometa, Zometa Concentrate and Aclasta). One NA host has had two infusions of Aclasta without issue. [https://www.facebook.com/groups/htsupport/posts/4932593710129878?comment_id=4934243383298244]

* ❓ [https://en.wikipedia.org/wiki/Calcium_channel_blocker Calcium channel blockers (CCBs)], also known as calcium channel antagonists or calcium antagonists. These medications, which disrupt the movement of calcium through calcium channels, and are commonly used to treat cardiovascular diseases including hypertension, have also shown activity against the non-therapeutic helminth, Schistosoma mansoni. And it has been suggested that the calcium blocking effect of these drugs might be exploited to enhance the effect of existing anthelmintic drugs, or to produce new ones. [https://www.ncbi.nlm.nih.gov/pubmed/30420417] While there have been no reports thus far of therapeutic helminths being affected by calcium channel blockers, this remains a theoretical possibility.

* [https://en.wikipedia.org/wiki/Tegretol Carbamazepine] (Tegretol, Equetro). This appears to be worm-safe. One host who took this for two weeks was still producing ample hookworm ova at the end of this period.

* [https://en.wikipedia.org/wiki/Chlorine Chlorine]. As a constituent of chlorinated water, e.g., municipal water supplies and at swimming baths, this is no threat to helminths.

* ❓[https://en.wikipedia.org/wiki/Chlorine_dioxide Chlorine dioxide] (CD, also known as MMS, CDS, CDH) is an industrial disinfectant and bleach that is used in water purification and detoxification. CD has been taken orally by people who claim that it kills parasites, and that "rope worms" are often released during CD enemas. However, when these rope-like forms have been analysed, they have been found to contain mostly human DNA, so are likely to be merely pieces of gut lining.

* [https://en.wikipedia.org/wiki/Colestyramine Colestyramine/ cholestyramin] (Trade names: Questran, Questran Light, Cholybar, Olestyr, Quantalan and Vasosan.) One self-treater has reported that this bile acid sequestrant did not harm his NA colony or his HDC. [https://www.facebook.com/groups/htsupport/posts/9602012923187910/?comment_id=9603513203037882]

* [http://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?setid=36f623df-2ae3-4858-9783-c058097951f4&type=display Cortifoam], a hydrocortisone rectal aerosol, uses propane and isobutane as propellants, neither of which is known to have any adverse effect on helminths.

* [https://en.wikipedia.org/wiki/COX-2_inhibitors COX-2 inhibitors], e.g., [https://en.wikipedia.org/w/index.php?title=Celecoxib&redirect=no celecoxib] (Celebrex), are safe for use with helminths.

* [https://en.wikipedia.org/wiki/Cromoglicic_acid Cromoglicic acid] (cromolyn, cromoglycate or cromoglicate, sodium cromoglicate [Nalcrom] or cromolyn sodium) is a mast cell stabiliser with anti-allergy effects. One hookworm host has taken 8x100mg capsules of Nalcrom daily for periods of up to 10 days without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/952539741468648/?comment_id=953466358042653&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Doxazosin Doxazosin] Sold under brand names such as Cardura and Carduran, this antihypertensive medication has been found to have anthelmintic properties. [https://www.mdpi.com/1424-8247/14/7/686] One hookworm self-treater had indications over a three year period that he had lost his NA colony: reappearance of pre-hookworm symptoms, eosinophil count down to "normal" and inability to incubate more larvae. Repeated re-inoculations with viable larvae failed to restore his colony, and he eventually realised that the loss of the worms had coincided with the change in antihypertensive medication, to the alpha-blocker, doxazocin. [https://www.facebook.com/groups/htsupport/posts/7047958951926666/]

* ❓ [https://en.wikipedia.org/wiki/2,3-Dimercapto-1-propanesulfonic_acid DMPS] (Dimercapto-propane sulfonate/2,3-Dimercapto-1-propanesulfonic acid) and its sodium salt, Unithiol. There have been no reports so far about possible anthelmintic effects following the use of this drug, but there do appear to be some [https://www.ncbi.nlm.nih.gov/pubmed/18568806 serious risks attached to its use].

* [https://en.wikipedia.org/wiki/Dimercaptosuccinic_acid DMSA] (Dimercaptosuccinic acid, also called succimer). The meso isomer form of this organosulfur compound is used as a chelating agent for the treatment of heavy metal toxicity. One hookworm host has taken 25 mg DMSA every 3 hours around the clock for 5 days, and repeated this every 3 weeks for a year without harming her hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=991229547599667&comment_tracking=%7B%22tn%22:%22R0%22%7D] DMSA is apparently such an effective chelator that it may deplete levels of beneficial minerals, so should arguably be used under the guidance of a practitioner. [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860226537366636&comment_tracking=%7B%22tn%22:%22R1%22%7D]

* [https://en.wikipedia.org/wiki/Dimethyl_sulfoxide DMSO] (Dimethyl sulfoxide) has been used by two hookworm hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Ethylenediaminetetraacetic_acid EDTA] (Ethylenediaminetetraacetic acid). This heavy metal chelator was taken by one NA host as a single large dose for a provoked urine test. He then took it occasionally after this, but never saw any negative effects whatsoever on his NA. [https://www.facebook.com/groups/htsupport/posts/9163602600362280?comment_id=9165019336887273]

* [https://en.wikipedia.org/wiki/Essential_oil Essential oils]. These are also known as volatile oils, ethereal oils, aetherolea, or simply as the oil of the plant from which they were extracted. Certain essential oils contain some of the most potent antimicrobial compounds available and can be considered to be [http://www.theatlantic.com/health/archive/2015/01/the-new-antibiotics-might-be-essential-oils/384247/ natural antibiotics]. For example ❌'''oregano oil''' (see [[#Oregano|Oregano reference]]) and ⚡'''peppermint oil''' (see [[#Peppermint|Peppermint reference]]) can affect human helminths if ingested. However, small quantities of most essential oils should be safe for helminths when applied topically, since not all of the oil applied will reach the bloodstream. And when essential oils are diffused into the air using a nebuliser, heated over a candle flame or burned, these should not harm helminths, even when using blends containing oregano or peppermint oil. [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=808058079250149&offset=0&total_comments=3] [https://www.facebook.com/groups/htsupport/permalink/807989739256983/?comment_id=809316062457684&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] However, one hookworm host lost most of her colony when she walked into a room where a diffuser had been left running after a child had emptied an entire bottle of peppermint essential oil into it. She only took one breath in the room before leaving, but her home incubations fell from 25-35 larvae per droplet to just 1 larva per 3 droplets. And, many months and 3 inoculations later, she was still only getting 7-8 larvae per droplet. This inhalation of diffused peppermint oil also caused blistering burns to her face, nostrils and lungs, and did significant damage to her gut microbiome. [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2017826074940004/?comment_id=2018762378179707&reply_comment_id=2018765664846045&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Gamma-Aminobutyric_acid GABA] (gamma-aminobutyric acid). It has been reported [http://www.livestrong.com/article/216236-medications-to-treat-human-worms/] that the anthelmintic drug, ivermectin, causes paralysis in worms by increasing GABA, and a hookworm host has mentioned that she “used to do really well with GABA, but worms don't like it.” On the other hand, a child with Type 1 diabetes was given GABA (750mg x4 per day) alongside hookworm therapy without any indication that the worms were affected by this, and another hookworm host who took 20-30mgs per day of ✅'''baclofen''' (a derivative of GABA) reported no loss of worm benefits.

* ⚡ [https://en.wikipedia.org/wiki/Gabapentin Gabapentin] (Neurontin). One hookworm host has taken this without any obvious adverse effect on her colony (link expired), and another has said that she was down from 1200mg to 600mg of gabapentin per day when she first discovered helminths and was never aware of it affecting her worms. [https://www.facebook.com/groups/htsupport/posts/6576693235719909/?comment_id=6576715005717732&reply_comment_id=6576844752371424] However, two other people have reported adverse effects on their colonies. One said that she had little benefit from her NA while she was taking gabapentin (mostly about 300 mg per day, but sometime 600 mg). The other said that single doses as low as 150mg "severely upset" his NA, and that taking 3 doses in a row caused a complete loss of benefits for 4-5 days. [https://www.facebook.com/groups/htsupport/permalink/2926164447439491/]

* ❌ [https://en.wikipedia.org/wiki/Genistein Genistein] is an isoflavone (phytoestrogen) with antioxidant and anthelmintic properties that has been found to be the main substance responsible for the deworming activity of the root-tuber peel extract of Felmingia vestita, the plant traditionally used as an anthelmintic by the Khasi tribes of India. Genistein is a potent cestocide, being highly effective against several species of tapeworm, as well as a pork trematode and a sheep liver fluke. (See also: [https://www.ncbi.nlm.nih.gov/pubmed/29844617]) Given the strength of its effect against these other helminths, it is reasonable to assume that concentrated or synthesised forms of genistein (such as KBU2046 and B43-genistein) may also harm or even kill therapeutic human helminths, although there is no evidence that eating soy products might be harmful to human helminths as a result of the naturally occurring genistein they contain.

* ❓[https://en.wikipedia.org/wiki/Glucagon-like_peptide-1_receptor_agonist Glucagon-like peptide-1 receptor agonists], also known as GLP-1 receptor agonists (GLP-1-RA) or incretin mimetics, e.g., [https://en.wikipedia.org/wiki/Exenatide exenatide] (Byetta, Bydureon), [https://en.wikipedia.org/wiki/Liraglutide liraglutide] (Victoza, Saxenda), [https://en.wikipedia.org/wiki/Lixisenatide lixisenatide] (Lyxumia, Adlyxin), [https://en.wikipedia.org/wiki/Albiglutide albiglutide] (Tanzeum), [https://en.wikipedia.org/wiki/Dulaglutide dulaglutide] (Trulicity), [https://en.wikipedia.org/wiki/Semaglutide semaglutide] (Ozempic, Rybelsus, Wegovy) and [https://en.wikipedia.org/wiki/Tirzepatide tirzepatide] (Mounjaro). This type of drug, which is used to treat diabetes and obesity, has shown anthelmintic effects and has been proposed as a potential anthelmintic agent against Trichuris trichiura. [https://eprints.lancs.ac.uk/id/eprint/171826/1/2022DooleyMRes.pdf] However, no reports of any adverse effects have been posted by helminth hosts.

* [https://en.wikipedia.org/wiki/Guaifenesin Guaifenesin]. This oral expectorant and muscle relaxant is sold under various brand names, including Mucinex, and is added to many other medicines. There have been no reports of this drug having any ill effect on helminths, and one hookworm host has reported that he regularly takes between 2 and 6 x 400 mg guaifenesin tablets to treat congestion, without any apparent effect on his worms. Another NA user reports continuing to use high doses without issue. [https://www.facebook.com/groups/htsupport/permalink/2437715306284410/?comment_id=2439412252781382]

* [https://en.wikipedia.org/wiki/Helium Helium] appears to be worm-safe, based on the experience of one hookworm host who deliberately inhaled a small volume of the gas (to enjoy the timbre-changing effect on his voice!) while blowing up balloons, and had no loss of effect from his worm colony.

* Hydrogen therapy. One NA host has reported that inhaling hydrogen gas and drinking hydrogen-infused water has not harmed his colony. (Link expired.)

* [https://en.wikipedia.org/wiki/Hydrogen_peroxide Hydrogen peroxide] (H2O2). This may kill helminths in a petri dish but it is so highly reactive that, if ingested, there is likely to be little left by the time it reaches the stomach. And, when inhaled, H2O2 stays largely within the lungs, with only a small amount reaching the blood. Since the amount that could be transmitted to helminths is therefore negligible, it is thought unlikely that H2O2 would be a problem for any intestinal helminth, although no one has reported on this, one way or the other.

*❓Hyoscyamine [https://en.wikipedia.org/wiki/Hyoscyamine]. (Also known as daturine and levo-atropine. Brand names include Symax, HyoMax, Anaspaz, Egazil, Buwecon, Cystospaz, Levsin, Levbid, Levsinex, Donnamar, NuLev, Spacol T/S and Neoquess.) It has been suggested that hyoscyamine is unlikely to be harmful helminths, [https://www.facebook.com/groups/htsupport/permalink/1459052987483985/?comment_id=1459076817481602&reply_comment_id=1459213767467907&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Iodine Iodine]. This appears not to have any anthelmintic effect in the case of [http://link.springer.com/article/10.1007/BF02356443?no-access=true some species of roundworm and lungworm] and no reports of adverse effects have been posted by helminth hosts who are taking iodine supplements.

* ❓ [https://en.wikipedia.org/wiki/Isotretinoin Isotretinoin] (13-cis retinoic acid, Roaccutane, Accutane, Amnesteem, Claravis, Absorica, Isotroin and Epuris) is used to treat acne and other skin conditions. Although there have been no reports of harm to helminths as a result of taking this drug, anyone considering its use might appreciate knowing that it has been linked to autoimmune disease, which is of course what many readers of this website are already dealing with. The link is controversial, but this paper [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110532/] sets out the facts.

* [https://en.wikipedia.org/wiki/Ketamine Ketamine] There have been no reports to suggest that ketamine might be harmful to human helminths, and one NA host has reported that an incubation following four 200 mg doses of this drug had yielded a bumper crop of larvae, confirming that the drug had had no adverse effect on her colony.

* [https://en.wikipedia.org/wiki/Lactulose Lactulose]. This synthetic, non-digestible sugar used in the treatment of chronic constipation and as a test for small intestine bacterial overgrowth (SIBO) has not been reported to have any untoward effects on human helminths.

* ❌ [https://en.wikipedia.org/wiki/Limonene Limonene] This has been shown to have a comparable anthelmintic effect against adult Schistosoma mansoni as the common anthelmintic drug, praziquantel, [https://pubmed.ncbi.nlm.nih.gov/23408270] (Praziquantel has a 23% cure rate in hookworms. [https://pubmed.ncbi.nlm.nih.gov/29153938]) and one hookworm host has reported experiencing a return of disease symptoms after taking 500 mg of limonene daily for a week. [https://www.facebook.com/groups/htsupport/permalink/2673526096036662/]

* [https://en.wikipedia.org/wiki/Loperamide Loperamide] (Immodium, Lopex, etc.) This drug has been taken by numerous worm hosts and there have been no reports of it harming their worms.

* [[Wikipedia:Low-dose naltrexone|Low dose naltrexone]] (LDN). This is compatible with helminthic therapy and several people have had good results from this combination, although the drug doesn’t suit everyone. More details [https://www.helminthictherapywiki.org/wiki/Helminthic_therapy_and_low-dose_naltrexone_(LDN) here].

* [https://en.wikipedia.org/wiki/Lisdexamfetamine Lisdexamfetamine / L-lysine-dextroamphetamine] (Tyvense, Elvanse, Aduvanz, Venvanse, Vyvanse) is used to treat ADHD and binge eating disorder. One hookworm host took vyvanse for several weeks without noticing any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1462105477178736/?comment_id=1462409000481717&reply_comment_id=1729076717148276&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Mepacrine Mepacrine] (quinacrine [Atabrine]). This is an antiprotozoal drug that has also been used against tapeworms, so it could harm hookworms and whipworms. No one has so far reported any problem with it, but it's likely that few, if any, helminth hosts will have taken it, especially as, "Mepacrine is not the drug of choice because side effects are common, including toxic psychosis, and may cause permanent damage."

* ❓ [https://en.wikipedia.org/wiki/Metformin Metformin] [Glucophage], [https://en.wikipedia.org/wiki/Phenformin phenformin], and [https://en.wikipedia.org/wiki/Rosiglitazone rosiglitazone] [Avandia] are [https://en.wikipedia.org/wiki/Anti-diabetic_medication anti-diabetic medications] (also known as oral hypoglycemic or antihyperglycemic agents) that have been shown to have antibiotic properties [http://www.cysonline.org/article.asp?issn=2229-5186;year=2011;volume=2;issue=4;spage=219;epage=221;aulast=Dash], so might therefore have some degree of anthelmintic effect when used in higher doses. However one NA host has been reported to have taken it with no apparent adverse effects on her worms. [https://www.facebook.com/groups/htsupport/posts/8167008430021707?comment_id=8167027486686468].

* ⚡ [https://en.wikipedia.org/wiki/Methotrexate Methotrexate]. Some people have taken methotrexate alongside HT without any problem, including one NA host who combined these two treatments for 1½ years, taking up to 15 mg methotrexate per day. [https://www.facebook.com/groups/htsupport/permalink/1262248410497778/?comment_id=1262259710496648&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1530311280358155/?comment_id=1530363560352927&reply_comment_id=1531077360281547&comment_tracking=%7B%22tn%22%3A%22R5%22%7D] However, one individual got no benefit from his hookworms for over a year, while he was taking this drug.

* ❓ [https://en.wikipedia.org/wiki/Methylene_blue Methylene blue] Only one self-treater has reported using this substance while hosting NA, apparently taking it every day for about a year without causing any problems for her worms. [https://www.facebook.com/groups/htsupport/permalink/9484774994911704/]

* [https://en.wikipedia.org/wiki/Methylphenidate Methylphenidate] (Ritalin, Concerta, etc.) This doesn’t harm NA (or HDC). [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5659285877460654&reply_comment_id=5659339337455308] [https://www.facebook.com/groups/htsupport/posts/5659268434129065/?comment_id=5660377274018181]

* [https://en.wikipedia.org/wiki/Montelukast Montelukast] (Singulair, Montelo-10, Monteflo, Lukotas, Arokast and Pulmikast). This leukotriene receptor antagonist has been taken intermittently, in 10 mg doses, by one hookworm host with no apparent effect on her colony, [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904760852913204&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/904649709590985/?comment_id=904793842909905&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R%22%7D] and regularly by another. [https://www.facebook.com/groups/htsupport/permalink/1682302251825723/?comment_id=1683751361680812&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug Non-steroidal anti-inflammatory drugs] (NSAIDS, NSAIAs or NSAIMs) e.g: [https://en.wikipedia.org/wiki/Aspirin aspirin], [https://en.wikipedia.org/wiki/Diclofenac diclofenac] (sold under many trade names [https://en.wikipedia.org/wiki/Diclofenac%23Trade_names]), [https://en.wikipedia.org/wiki/Ibuprofen ibuprofen] and [https://en.wikipedia.org/wiki/Naproxen naproxen], are safe for use with helminths, but see Anticoagulants section regarding aspirin.

* ❓ [https://en.wikipedia.org/wiki/Nintedanib Nintedanib] (Ofev and Vargatef) is a piperazine drug (piperazine is an anthelmintic), so *may* have a harmful effect on NA, and to a lesser extent on TT. Unfortunately, there have been no reports about this drug, although the absence of any previous mention of it is a hopeful indication.

* [https://en.wikipedia.org/wiki/Oxymetazoline Oxymetazoline] (Ocuclear and Drixine) This drug is available over-the-counter as a topical decongestant in the form of oxymetazoline hydrochloride in nasal sprays such as Afrin, Dimetapp, Dristan, Drixoral, Facimin, Mucinex Full Force, Nasivin, Nostrilla, Operil, Otrivin, Otrivine, Oxyspray, SinuFrin, Sudafed OM, Utabon, Vicks Sinex and Zicam. At least one NA host has used these sprays without any harm being caused to his worms.

* ❓ [https://en.wikipedia.org/wiki/Ozone Ozone]. [https://en.wikipedia.org/wiki/Ozone_therapy Ozone therapy] is used as an alternative treatment for various diseases in humans but is still controversial. Ozone is also used to kill microorganisms, in some instances being employed in place of chlorine as a bactericide. It is also used to eradicate water borne parasites such as Giardia lamblia and Cryptosporidium, and to kill insects in stored grain. So there would appear to be a potential for ozone to have an adverse effect on human helminths, although this may depend on dosage and there have been no reports to date of the use of ozone by helminth hosts, so caution would seem to be warranted until more is known.

* [https://en.wikipedia.org/wiki/Acetaminophen Paracetamol] (Called acetaminophen in the US, and also sold under the names tylenol, panadol, etc.) This is safe for use while hosting helminths, but is associated with autism when given to children under 5 years old. [https://pmc.ncbi.nlm.nih.gov/articles/PMC10814214/]

* ❌ [https://en.wikipedia.org/wiki/Pentobarbital Pentobarbital] (US), pentobarbitone (UK), e.g., Nembutal, is a short-acting '''barbiturate''' that has been used as a sleep aid, as well as to euthanise animals and to execute humans. It’s possible that the dosages used to encourage sleep might not have any deleterious effect on human helminths, but, if this drug were to disorientate hookworms, they could lose their grip on the intestinal mucosa and be flushed away. So far, there have been no reports about this drug from any helminth host, although few, if any, will have taken it.

* [https://en.wikipedia.org/wiki/Permethrin Permethrin] Permethrin is an insecticide that causes paralysis and death in insects and arachnids by disrupting sodium channels in the creatures’ nervous systems. However, voltage‑gated sodium channels are much less abundant in hookworms and, for this reason, permethrin is unlikely to pose any risk to NA. [https://www.facebook.com/groups/htsupport/posts/24419855167643775/]

* ⚡ [https://en.wikipedia.org/wiki/Piracetam Piracetam]. This nootropic, cognition- and memory-enhancing drug (Nootropil, Qropi, Myocalm, Dinagen) was suspected as the cause in one case of sudden worm loss.

* ❓ [https://en.wikipedia.org/wiki/Pregabalin Pregabalin] (Lyrica) is a gabapentinoid drug about which the only report so far has been from someone who who had taken 3 doses of 25mg Lyrica daily for several weeks, with no issues for her NA. [https://www.facebook.com/groups/htsupport/posts/4589806321075287/?comment_id=4590199551035964&reply_comment_id=4812188858837031]

* [https://en.wikipedia.org/wiki/Proton-pump_inhibitor Proton-pump inhibitors] (PPIs), including [https://en.wikipedia.org/wiki/Omeprazole omeprazole] (e.g., Losec) and [https://en.wikipedia.org/wiki/Lansoprazole lansoprazole] (e.g., Prevacid). These gastric acid inhibiting drugs appear not to be harmful to helminths, but they may kill 4% of patients who take them. [https://www.ncbi.nlm.nih.gov/pubmed/31147311]

* ❌ [https://en.wikipedia.org/wiki/Prucalopride Prucalopride] (DuphaPro, Prudac, Resolor, Resotran) This drug, which is used in the treatment of constipation has been reported by one hookworm host to have had a “pretty marked negative effect” on his worms, and, by another, to have killed theirs. [https://www.facebook.com/groups/htsupport/posts/5980593935329845?comment_id=7427760963946461&reply_comment_id=8031040043618547]

* [https://en.wikipedia.org/wiki/Pseudoephedrine Pseudoephedrine] is a stimulant nasal decongestant [https://en.wikipedia.org/wiki/Decongestant] that is sometimes added to antihistamine preparations and other products, including some formulations sold under the [https://en.wikipedia.org/wiki/Sudafed Sudafed] brand. Pseudoephedrine has not been reported to have any adverse effect on helminths.

* ➿ [https://en.wikipedia.org/wiki/Iodine-131 Radioactive iodine] (also known as radioiodine), which is used in the treatment of hyperthyroidism, can adversely affect hookworms, at least temporarily. One worm host found that '''isotope I-128''' (used in diagnostics) [https://www.facebook.com/groups/htsupport/permalink/830004963722127/ put her colony out of action for a week or two], and has suggested that '''isotope I-131''' (used to kill thyroid tissue) may have a similar effect.

* [https://www.drugs.com/rhophylac.html Rhophylac] The Rhophylac (anti-D immunoglobulin) injection, which contains human anti-D immunoglobulin, is given to pregnant women with rhesus negative blood type. One hookworm host has reported that her colony was unaffected by this injection. [https://www.facebook.com/groups/htsupport/posts/5063598083696106?comment_id=5068476199874961]

* [https://en.wikipedia.org/wiki/Rizatriptan Rizatriptan] (Maxalt, etc.) does not harm human helminths. [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348347051887903] [https://www.facebook.com/groups/htsupport/permalink/2348310255224916/?comment_id=2348552771867331]

* [https://en.wikipedia.org/wiki/Viagra Sildenafil] (Viagra). This does not kill hookworms.

* [https://en.wikipedia.org/wiki/Simeticone Simeticone], also known as simethicone (Gas-X, Infacol, Wind-eze, WindSetlers, etc…), is an anti-foaming agent used in different dosages, and in combination with a variety of other drugs, to reduce the bloating, pain and discomfort caused by excessive intestinal gas. Simethicone has been tested directly on pig whipworm ova (TSO) and found to have no effect on them, and one hookworm host has reported taking simethicone periodically with no noticeable adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1969827113073234/?comment_id=1970814692974476&reply_comment_id=1972925246096754&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Sirolimus Sirolimus] (aka rapamycin, sold as Rapamune and Fyarro) This immunosuppressive medication was suspected by one NA host of having negatively impacted his worms for several weeks after he took a single dose of the drug.

* [https://en.wikipedia.org/wiki/Sodium_oxybate Sodium oxybate] (Xyrem, Alcover) is the sodium salt of [https://en.wikipedia.org/wiki/Gamma-Hydroxybutyric_acid γ-hydroxybutyric acid] (GHB), which is unlikely to harm helminths because it’s an endogenous substance found naturally in the human body [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815965665126057&offset=0&total_comments=23&comment_tracking=%7B%22tn%22:%22R%22%7D], and one hookworm/whipworm host has confirmed that it did not affect her worms. [https://www.facebook.com/groups/htsupport/permalink/813700862019204/?comment_id=815975511791739&offset=0&total_comments=24&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Steroid_hormone Steroid hormones]. One host of both hookworms and whipworms takes [https://en.wikipedia.org/wiki/Dehydroepiandrosterone DHEA], [https://en.wikipedia.org/wiki/Progesterone progesterone] and [https://en.wikipedia.org/wiki/Testosterone testosterone] with [https://www.facebook.com/groups/htsupport/permalink/824719590917331/?comment_id=825008124221811&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D no adverse effect on her worms].

* [https://en.wikipedia.org/wiki/Tauroursodeoxycholic_acid Tauroursodeoxycholic acid (TUDCA)] This ambiphilic bile acid has been taken by two NA hosts without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2743109875744950/?comment_id=2744212012301403] [https://www.facebook.com/groups/htsupport/posts/7602581533131069/?comment_id=7614652755257280]

* ❌ [https://en.wikipedia.org/wiki/Turpentine Turpentine]. Also known as spirit of turpentine, oil of turpentine, wood turpentine and, colloquially, turps, this is distilled from pine tree resins. If applied topically to the skin - for example as a treatment for lice - it is unlikely to harm helminths. However, it has been used traditionally as an anthelmintic, so it may be harmful to human helminths if taken internally. It may also be toxic to humans!

* [http://www.netdoctor.co.uk/lung-problems/medicines/vicks-first-defence.html Vicks First Defence]. This cold preventative nasal spray does not contain antiviral chemicals, but forms a microgel that coats the lining of the nose to trap the cold virus and prevent this from reaching, and infecting, the cells within the nose. The microgel also reduces the pH inside the nose, which further helps by making it harder for the cold virus to multiply. It seems unlikely that any of this product’s ingredients [https://www.vicks.co.uk/products/early-cold-treatments/vicks-first-defence-nasal-spray] would harm helminths, although there have been no reports to confirm this.

* [https://en.wikipedia.org/wiki/Volatile_Organic_Compounds Volatile Organic Compounds] (VOCs), as found in paints, felt tip markers, etc., are unlikely to harm helminths. One helminth host who regularly worked with organic solvents (including CH2Cl2 and CHCl3) has reported that his helminths have not been affected.

* [https://en.wikipedia.org/wiki/Xylometazoline Xylometazoline] Also spelled xylomethazoline, and branded as Otrivin and Otrivine, etc., this decongestant drug is safe for use with human helminths. [https://www.facebook.com/groups/htsupport/permalink/2537589059630367/?comment_id=2537912206264719]
</blockquote>

== Medical procedures ==

<blockquote>
''' ✅ Safe for human helminths unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Botulinum_toxin Botulinum toxin] Also known as botulinum neurotoxin, and commonly called botox. One NA self-treater has reported receiving cosmetic botox injections with no adverse effect on her worm colony.

* [https://en.wikipedia.org/wiki/Colonoscopy Colonoscopy] As whipworms live in the colon, they may be at some risk of being struck by a colonoscope, but much of their body is embedded in the soft mucosa, and they are well lubricated with mucus, so few, if any, are likely to be damaged. Hookworms should not be affected by colonoscopy at all because they live in the small intestine, which is much higher up the GI tract. Hookworms might possibly be seen during a colonoscopy, but only if the colonoscope is advanced into the terminal ileum, and only then if any hookworms have taken up residence in the ileum, which is not common as they normally concentrate in the upper part of the jejunum, which is above the ileum, and is shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum Anaesthesia for colonoscopy is likely to involve the use of [https://en.wikipedia.org/wiki/Opioids opioid] pain killers ([https://en.wikipedia.org/wiki/Fentanyl fentanyl], etc.), [https://en.wikipedia.org/wiki/Benzodiazepine benzodiazepine] anaesthetics ([https://en.wikipedia.org/wiki/Versed Versed], etc.) and/or [https://en.wikipedia.org/wiki/Narcotic_analgesic narcotic analgesics], all of which appear to be harmless to helminths. See also [[Human helminth care manual#Laxatives | Laxatives]] regarding [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep].

* [https://en.wikipedia.org/wiki/Colon_cleansing Colon cleansing] This will not harm hookworms and is unlikely to harm whipworms unless the fluid used contains something to which the whipworms are vulnerable.

* [https://en.wikipedia.org/wiki/Detoxification Detoxification] The use of [https://en.wikipedia.org/wiki/Infrared_sauna infrared saunas] and infrared heating pads is safe for helminths, [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860231720699451&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3617910068264922/] and [https://en.wikipedia.org/wiki/Chelation_therapy chelation therapy] using the [http://www.livingnetwork.co.za/chelationnetwork/chelation-the-andy-cutler-protocol/ Andy Cutler protocol] has been used by one hookworm host with no obvious adverse effect [https://www.facebook.com/groups/htsupport/permalink/860154964040460/?comment_id=860208537368436&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R1%22%7D] on her colony. (Also see ❓'''DMPS''', ✅'''DMSA''' and❓'''EDTA'''.)

* [https://en.wikipedia.org/wiki/Enema Enemas] These will not affect hookworms at all, and the liquid used is unlikely to have any adverse effect on whipworms unless this contains something to which they are susceptible.

* [https://en.wikipedia.org/wiki/Endoscopy Endoscopy] A standard upper endoscopy (via the mouth) will not reach past the duodenum, and probably only as far as the second of the four parts of this section of the small intestine. It would therefore not harm hookworms or even allow a doctor to see the jejunum, which is the predominant location of hookworms by 20 weeks post-inoculation, shown in red in this representation. mouth ➤ oesophagus ➤ stomach ➤ [https://en.wikipedia.org/wiki/Duodenum duodenum] ➤ [https://en.wikipedia.org/wiki/Jejunum jejunum] ➤ [https://en.wikipedia.org/wiki/Ileum ileum] ➤ [https://en.wikipedia.org/wiki/Cecum caecum] ➤ colon ➤ rectum For information about the anaesthetics used during an endoscopy, see the [[#Anaesthetics|general anaesthetics]] section.

* [https://en.wikipedia.org/wiki/Epidural_opioid_analgesia Epidural opioid analgesia] Opioids such as [https://en.wikipedia.org/wiki/Fentanyl fentanyl] are generally safe for helminths, and one hookworm host has reported that her colony was fine following epidural analgesia administered during labour. [https://www.facebook.com/groups/htsupport/permalink/1960341670688445/?comment_id=1960403224015623&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] If an anaesthetic is added to the epidural, the effects of this may be similar to those of other local anaesthetics. (See the [[#localAnaesthetics|local anaesthetics]] section).
* [https://en.wikipedia.org/wiki/Magnetic_resonance_imaging Magnetic resonance imaging] An MRI is unlikely to harm helminths, but it can cause a temporary adverse reaction in the patient which may overshadow the benefits being provided by their helminths. [https://www.facebook.com/groups/htsupport/permalink/1296754897047129/] The❓gadolinium-based contrast agents used for MRI may also have adverse effects on the patient, [https://www.ncbi.nlm.nih.gov/pubmed/28368880] and there has been one report by a hookworm host who had two MRIs using gadolinium within the same week and experienced a subsequent return of her disease symptoms. [https://www.facebook.com/groups/htsupport/permalink/3934276469961612/]

* ❌ [https://en.wikipedia.org/wiki/Radiation_therapy Radiation therapy] (also known as radiotherapy, and abbreviated as RT, RTx, or XRT) is a treatment for cancer that used ionizing radiation. It had been thought unlikely that this would harm helminths [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1074160752639879&comment_tracking=%7B%22tn%22:%22R%22%7D] but one hookworm host appears to have lost her colony after radiotherapy for breast cancer. [https://www.facebook.com/groups/htsupport/permalink/1074039122652042/?comment_id=1240655962657023&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Radiology Radiology] Radiological procedures (e.g., [https://en.wikipedia.org/wiki/Radiography radiography] using [https://en.wikipedia.org/wiki/X-ray X-rays]) and the contrast materials used in these (e.g., [https://en.wikipedia.org/wiki/Barium barium] and [https://en.wikipedia.org/wiki/MRI_contrast_agent%23Gadolinium_.28Gd.29:_Paramagnetic gadolinium]) have been found to be worm-safe by several hookworm users, [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014377761951512&comment_tracking=%7B%22tn%22:%22R%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1014349448621010/?comment_id=1014821705240451&comment_tracking=%7B%22tn%22:%22R%22%7D] but also see the comments about gadolinium in the previous entry, above, for magnetic resonance imaging.

* [https://en.wikipedia.org/wiki/Ultrasound Ultrasound] At least two hookworm hosts have had ultrasound examinations without their colonies being affected. [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334208813301727&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2334201623302446/?comment_id=2334224499966825&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



== Alternative therapies ==

=== Natural antibiotics ===
<blockquote>

* ➿ [https://en.wikipedia.org/wiki/Colloidal_silver Colloidal silver]. Some sources have claimed that, if taken orally, this may kill parasite eggs and possibly harm adult worms, but many helminth hosts have taken colloidal silver and there have been no reports of worms being lost as a result. Colloidal silver appears to be the most worm-friendly of the more effective natural antimicrobials, and it has also been shown to have no significant effect on the biodiversity of species in the gut microbiome. [https://www.ncbi.nlm.nih.gov/pubmed/26525505]. Although it can reduce helminthic benefits in a dose-dependent manner while it is being taken, the benefits soon return after its use is discontinued - usually in a matter of days. (Use of this [https://web.archive.org/web/20161227234345/http://www.silversafety.org/autocalculator.php Silver Safety Auto-calculator] will ensure that total silver intake remains at a safe level.)

* ❓ '''Cellular silver'''. The manufacturers of [http://www.resultsrna.com/products/acs_200_overview/ Advanced Cellular Silver (ACS) 200 Extra Strength] claim that it is “...effective against an enormous array of disease causing organisms; literally oxidizing the cell wall of gram positive and gram negative bacteria, spirochetes, virus, fungus, parasites and more without harming healthy flora or damaging human tissue”. Research[http://www.townsendletter.com/Jan2015/silver0115.html] shows that this form of silver may be more effective than ➿'''colloidal silver''' (see Colloidal silver, immediately above), but, so far, there have been no reports from helminth hosts to suggest what effect, if any, it might have on human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Grapefruit_seed_extract Grapefruit seed extract] (GSE). Also known as citrus seed extract and grapefruit seed oil, and often labelled as citrus seed oil. It is used in herbalism and natural therapies as an antibiotic and preservative, and is claimed to be a powerful broad spectrum bactericide, fungicide and antiviral that is effective against a large number of single-celled and multi-celled parasites. However, research has shown that [http://cms.herbalgram.org/press/2012/Many_GFSE_Adulterated_Says_Nonprofit_Research_Consortium.html many “natural” GSE products are adulterated] with undeclared synthetic chemicals, commercially available preservatives and disinfectants, such as [https://en.wikipedia.org/wiki/Triclosan triclosan] and [https://en.wikipedia.org/wiki/Benzethonium_chloride benzethonium chloride]. Some versions of GSE [http://www.ncbi.nlm.nih.gov/pubmed/17468864 may not contain any authentic grapefruit seed extracts] whatsoever, such that its sale may well be one of the most insidious herbal product scams ever. Even if genuinely pure, natural GSE could be found - which, given the evidence, seems doubtful - there may be little point in taking it as an antimicrobial because pure GSE has been shown to have no intrinsic antimicrobial action. And, as the makeup of proprietary GSE products varies so widely, these can not be recommended for worm hosts due to the possibility that one or more of the undeclared ingredients may harm human helminths. (NB. The flesh of grapefruit will not harm helminths.) Also see [[#Grape seed extract|Grape seed extract]], which is safe for use by hosts of human helminths.
</blockquote>

=== Natural antivirals ===
<blockquote>
✅ ''' Antiviral nutraceuticals that are safe for human helminths unless marked otherwise'''

:'''Vitamin C'''

::Taken in large quantities, vitamin C (ascorbic acid) has proved to be very effective against the common cold virus. When volunteers in one study were given 8 grams (8,000 mg) on the first day of a cold, 46% were cold free the next day. [http://www.ncbi.nlm.nih.gov/pubmed/4601508]

::In a study involving 700 students, those taking doses of I gram (1,000 mg) of vitamin C each hour for the first 6 hours and then 1 gram three times daily thereafter reported an 85% decrease in cold symptoms compared to those receiving conventional cold and flu treatment. [http://www.ncbi.nlm.nih.gov/pubmed/10543583]

::The ideal amount of vitamin C for colds or flu varies between individuals, but can be established in each case by taking ascorbic acid to ‘bowel tolerance’. Physicians have suggested starting with 3 grams immediately, then taking 1 gram each hour. Once this causes diarrhoea, the dose is reduced.

::In respect of the coronavirus, SARS-CoV-2, and the disease it manifests (COVID-19), see the following articles.

::* [https://www.mdpi.com/2075-1729/11/11/1166/htm Vitamin C Intervention for Critical COVID-19: A Pragmatic Review of the Current Level of Evidence]

::* [https://pubmed.ncbi.nlm.nih.gov/32636851/ Quercetin and Vitamin C: An Experimental, Synergistic Therapy for the Prevention and Treatment of SARS-CoV-2 Related Disease (COVID-19)] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318306/pdf/fimmu-11-01451.pdf PDF]

::One UK doctor recommends treating coronavirus with 10 grams of vitamin C in 500 ml of water every hour until the patient gets diarrhoea. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::In March 2020, the government in Shanghai, China, officially began recommending high-dose intravenous vitamin C for the treatment of COVID-19. Dosage recommendations varied with the severity of illness, ranging from 50 to 200 mg per kg of body weight per day. [http://orthomolecular.org/resources/omns/v16n16.shtml] In the same month, hospitals in New York also began treating coronavirus patients with vitamin C. [https://nypost.com/2020/03/24/new-york-hospitals-treating-coronavirus-patients-with-vitamin-c/]

::'''Vitamin C dosing for children'''. Authorities on the use of vitamin C recommend dosing children by body weight, giving a proportion of the adult dose commensurate with the child’s weight as a proportion of the weight of the average adult. In one placebo-controlled study, the majority of subjects were infants and children under five years of age with severe pneumonia. They were given 200 mg vitamin C per day, which is equivalent to a modest adult dose of 2,000-3,000 mg per day. The authors of this study concluded that, even at this dose, "Vitamin C is effective in reducing duration of severe pneumonia in children less than five years of age. Oxygen saturation was improved in less than one day." [http://www.journalrmc.com/volumes/1405749894.pdf] Also see, [http://orthomolecular.org/resources/omns/v18n05.shtml Vitamin C and Infants: Determining dose].

::'''Liposomal vitamin C'''. This form of vitamin C is absorbed by a different mechanism, in the gut. The liposomes containing vitamin C can bind directly to the gut cells to release their content of vitamin C which therefore does not require active transport. Thus the maximum level achievable with oral doses of liposomal vitamin C is higher than for regular vitamin C. However, since the absorption mechanism for liposomal vitamin C differs from the active transport of regular vitamin C, both forms can be taken together to increase the level in the bloodstream (up to 400-600 μM), greater than either oral form alone. (Levy TE (2011) Primal Panacea. Medfox Pub. ISBN-13: 978-0983772804)

:'''Vitamin D'''

::This vitamin acts as a natural antibiotic, working against every type of microbe, including viruses, bacteria, fungi and parasites, but it does not harm therapeutic helminths.

::The flu can be treated effectively with a 1-time dose of 50,000 IU vitamin D3, or with 10,000 IU 3 times daily for 2 to 3 days. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/]

:: Some functional medicine practitioners advise that it is relatively safe to increase vitamin D intake to as much as 50,000 IU per day during times of virus exposure. John Cannell, MD, of the Vitamin D Council, suggests that 50,000 IU should be taken once each day for three days at the first sign of a cold or the flu. [https://web.archive.org/web/20211221125912/https://preventdisease.com/news/13/102213_Vitamin-D-Proven-More-Effective-Anti-Viral-Drugs-Vaccines-Preventing-Flu.shtml] David Brownstein, MD, recommends taking 50,000 IU per day for 4 days (link expired) and Dr Stephen Gundry suggests taking as much as 150,000 IU daily for 3 days to treat a respiratory infection. [https://mnchiropractors.com/uncategorized/dr-gundry-on-boosting-immunity-for-coronavirus/]

::* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9653496/ Association between vitamin D supplementation and COVID-19 infection and mortality]

::::Vitamin D supplementation produced a statistically significant reduction in the risk of COVID-19 infection and of the infection ending in death within 30-days. Patients receiving higher cumulative dosages and higher average daily dosages showed a greater reduction in COVID-19 infection rates than patients receiving lower dosages. "As a widely available, inexpensive, and safe treatment, vitamin D3 could be a helpful tool for reducing the spread of COVID-19 infection."

::* [https://www.ncbi.nlm.nih.gov/pubmed/32377965 The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality]

::* [https://www.psychologytoday.com/us/blog/the-fallible-mind/202202/striking-link-between-vitamin-d-levels-and-omicron A “Striking” Link Between Vitamin D Levels and Omicron]

:'''Hydrogen peroxide (H2O2)'''

::Daily use, for 1 minute, of a 1% hydrogen peroxide solution as a mouthwash and throat gargle, and the daily use, for 1 minute, of a 0.5% solution as a nasal rinse, have been found to provide effective protection against SARS-CoV-2 infection. The fact that hydrogen peroxide is safe, inexpensive and readily available led this study’s authors to recommend it for the protection against COVID-19 of healthcare workers, inpatients and all vulnerable groups. And, since H2O2 used in this way will not be swallowed or inhaled, it should not harm helminths.

::* [https://pubmed.ncbi.nlm.nih.gov/35594985/ Further observations on hydrogen peroxide antisepsis and COVID-19 cases among healthcare workers and inpatients] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9113766/pdf/main.pdf PDF]

: '''Lysine'''

:: Lysine appears to be highly suppressive of viral replication. Approximately 80% of acute stage Covid-19 patients given lysine displayed a minimum 70% reduction in symptoms in the first 48 hours. Treatment times varied from 2 days to 3.5 weeks (excluding long term symptomatic subjects), and patients who started lysine in the hospital were discharged an average of 3 days after starting treatment.

::* [https://www.researchgate.net/publication/344210822_Lysine_Therapy_for_SARS-CoV-2 Lysine Therapy for SARS-CoV-2]

:'''Elderberry'''

::Eating elderberries and taking their extracts can help minimise influenza symptoms. [https://www.sciencedirect.com/science/article/abs/pii/S1756464619300313] But note the following.

::* "Patients with autoimmune diseases like rheumatoid arthritis, celiac, hashimoto’s, and lupus need to consult a physician before taking elderberry because it will stimulate their immune system. Elderberry interferes with medications that suppress the immune system and medications used to treat autoimmune diseases.” [https://web.archive.org/web/20190918211012/http://www.mensahmedical.com/elderberry-benefits-dangers-patients/]

::* While elderberry extract is considered to be effective against flu, it works, as many other immune boosters do, by increasing the cytokine response. [https://www.ncbi.nlm.nih.gov/pubmed/11399518] Since COVID-19 (aka SARS-CoV-2) kills primarily by initiating a cytokine storm, elderberry is probably best not relied upon as a stand-alone option against the new coronavirus, and, if used at all, would be best combined with one or more of the other effective anti-pathogenic treatments mentioned in this section.

'''Other worm-safe nutraceuticals with antiviral effects'''

:* [https://www.sciencedirect.com/science/article/pii/S0033062020300372 Nutraceuticals have potential for boosting the type 1 interferon response to RNA viruses including influenza and coronavirus] (ferulic acid, lipoic acid, spirulina, N-Acetylcysteine, selenium, glucosamine, zinc, yeast beta-glucan and elderberry)

:* [http://orthomolecular.org/resources/omns/v16n04.shtml Nutrients recommended by the International Society for Orthomolecular Medicine to prevent and minimise symptoms of viral infection]

:* Virus-Specific nutraceutical and botanical agents listed by the Institute for Functional Medicine. [https://www.ifm.org/news-insights/the-functional-medicine-approach-to-covid-19-virus-specific-nutraceutical-and-botanical-agents/] [https://www.ifm.org/news-insights/functional-medicine-approach-covid-19-additional-research-nutraceuticals-botanicals/]

:* [https://blog.nutrigold.co.uk/2020/03/09/nutritional-support-for-immunity-against-viruses-including-the-coronavirus/ Nutritional Support for Immunity Against Viruses Including the Coronavirus]

:* [https://cf5e727d-d02d-4d71-89ff-9fe2d3ad957f.filesusr.com/ugd/adf864_cc5004cfa84a46d3b1a0338d4308c42c.pdf A Novel Approach to Treating COVID-19 Using Nutritional and Oxidative Therapies] (Vitamin A, vitamin C [Ascorbate], vitamin D3, Iodine, Nebulized ❓Hydrogen Peroxide and Intramuscular ❓Ozone.)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7428453/ Be well: A potential role for vitamin B in COVID-19]

:* [http://www.ncbi.nlm.nih.gov/pubmed/25400245 Bifidobacterium longum MM-2 improves defence against flu virus]

:* [https://www.ncbi.nlm.nih.gov/pubmed/32179788 Ginkgolic acid inhibits fusion of enveloped viruses]

::"Thus, in light of the antiviral effect of ginkgolic acids (GA) on established viral infections of permissive cells, GA potentially could be used to treat acute viral infections (e.g. Coronavirus (COVID-19), EBOV, ZIKV, IAV and measles)."

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7929665/ Uncaria tomentosa (Cat’s claw) has an antiviral effect against SARS-CoV-2]

:* [http://orthomolecular.org/resources/omns/v16n22.shtml Sulforaphane as a Treatment for COVID-19]

:* [https://onlinelibrary.wiley.com/doi/10.1002/fsn3.3034 Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies] (Full text) | [https://onlinelibrary.wiley.com/doi/epdf/10.1002/fsn3.3034 PDF]. Also see [https://www.news-medical.net/news/20220908/The-role-of-some-important-antioxidants-in-major-clinical-outcomes-of-subjects-with-COVID-19.aspx this article about the study].

::"It seems that antioxidants, especially vitamins C and D, selenium, and zinc, can improve multiple COVID-19 clinical outcomes."

:* [https://www.sciencedaily.com/releases/2020/04/200429105907.htm Link identified between dietary selenium and outcome of COVID-19 disease]

:* [https://pubmed.ncbi.nlm.nih.gov/32754164/ The Potential Impact of Zinc Supplementation on COVID-19 Pathogenesis] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/pdf/fimmu-11-01712.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32388476/ Is copper beneficial for COVID-19 patients?] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199671/pdf/main.pdf PDF]

:* [https://www.europeanreview.org/wp/wp-content/uploads/4062-4063.pdf?fbclid=IwAR0AxUqV9FaHNcaHwlUuzOW9MOYe_1Z3OiHIzVvDJD6J8h3DubgTZGESOGY Are probiotics effective adjuvant therapeutic choice in patients with COVID-19?]

:* [https://pubmed.ncbi.nlm.nih.gov/32733907/ Challenges in the Management of SARS-CoV2 Infection: The Role of Oral Bacteriotherapy as Complementary Therapeutic Strategy to Avoid the Progression of COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358304/pdf/fmed-07-00389.pdf PDF] (Probiotics)

:* [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649937/ N-Acetylcysteine to Combat COVID-19: An Evidence Review]

:* [https://pubmed.ncbi.nlm.nih.gov/34653660/ The Effect of Melatonin on Thrombosis, Sepsis and Mortality Rate in COVID-19 Patients] -- [https://www.sciencedirect.com/science/article/pii/S1201971221007980 Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506572/pdf/main.pdf PDF]

:* [https://pubmed.ncbi.nlm.nih.gov/32574327/ Therapeutic Algorithm for Use of Melatonin in Patients With COVID-19] -- [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/ Full text] | [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242729/pdf/fmed-07-00226.pdf PDF]

:* [https://wrightacademia.org/articles/jscc/jscc-1-002.php?jid=jscc Free Fatty Acids from Fish Oil Inactivate SARS-CoV-2]

::"… free fatty acids in fish oil may have potential as mouth/throat wash to reduce concentration of SARS-CoV-2 viruses in saliva and upper respiratory mucosa and reduce transmission."

'''Plant medicines recommended for the treatment of coronavirus'''

:* [https://www.stephenharrodbuhner.com/wp-content/uploads/2020/08/covid-19-2.update.txt.pdf?fbclid=IwAR3sm7OYMH8_RBH0xjrQM984_SFoSZupSOw5IqSes_n6s4JemMjvyLCCEug SARS-CoV-2 (COVID-19): Herbal protocols for the treatment of infection and post-coronavirus syndrome] (PDF) This is a very detailed treatise on the use of herbs in this context. Individual herbs suggested should be checked for possible anthelmintic effects by searching for them in the rest of this Care Manual.

'''Inhaled treatments - safe for human helminths unless marked otherwise'''

:'''Iodine'''

::Iodine kills all single-celled microbes on contact and can be introduced into the airways by inhalation from a salt pipe or face mask, or via home-made iodine oil. [https://www.hammersmithbooks.co.uk/2020/03/13/coronavirus-what-you-need-to-know/?fbclid=IwAR39JZPiB9hCM4gOo4n2TFp2gZf30-hOl9--b1IuXwEDWyDZQzloCbWmX_8]

::* Salt pipe. Two drops of Lugol’s iodine 12% or 15% dripped into the mouthpiece of a salt pipe (or simply applied to a piece of cotton wool) can be sniffed up into the nose and inhaled 2-3 times a day, or even every 2 hours. 15 - 20 sniffs provides an adequate dose.
::* Face mask. 2-4 drops of Lugol’s iodine 15% can be applied to a face mask, and reapplied 3 times a day.
::* Iodine oil. This can be made with 10 parts coconut oil to 1 part Lugol’s Iodine 15%, and applied around the nose and upper lip three times each day. The iodine does stain the skin yellow temporarily, but it is a good way to treat children who may not be able to manage a salt pipe or tolerate a mask.

:: “After the 1918 Influenza Pandemic which killed an estimated 30 million people, governments financed research on the Pandemic’s causes. Over 25 years, influenza viruses were isolated and methods for killing them with various agents discovered. Iodine was the most effective agent for killing viruses, especially influenza viruses. Aerosol iodine was found to kill viruses in sprayed mists, and solutions of iodine were equally effective. In 1945, Burnet and Stone found that putting iodine on mice snouts prevented the mice from being infected with live influenza virus in mists. They suggested that impregnating masks with iodine would help stop viral spread. They also recommended that medical personnel have iodine-aerosol-treated rooms for examination and treatment of highly infected patients. Current methods of dealing with influenza infection are isolation, hand washing, antiviral drugs, and vaccinations. All of these methods can be improved by incorporating iodine into them. When impregnated with iodine, masks become much more effective, and hand washing is more effect when done with mild iodine solutions. Isolation techniques coupled with aerosol iodine would make them safer for patients, medical personnel, and all persons working with the public. Public health authorities could organize the distribution of iodine and at the same time educate the public in the effective use of iodine. Oral iodine might also boost body defense mechanisms in the upper oral and respiratory mucus. Conclusion: Iodine incorporated into masks, solutions, aerosols, and oral preparations could help to kill influenza viruses and fight off an H1N1 Pandemic.” [https://www.drlowe.com/thyroidscience/reviews/derry/Derry.flu.iodine.9.19.09.pdf]

:'''Ascorbic acid (vitamin C)'''

::Nebulisation (atomisation) delivers vitamin C directly to where it is needed in the case of a respiratory infection such as COVID-19, and it is known to be at least as, and possibly more, effective as a method of delivery than intravenous infusion.
::'''Materials''': a nebuliser (or atomiser), ascorbic acid and sodium bicarbonate (which is needed because ascorbic acid on its own is too acidic for the airways).
::'''Method''': Mix 100 grams of ascorbic acid powder with 50 grams of bicarbonate of soda in one litre of filtered/spring water. Once the mixture has stopped bubbling, a very slightly cloudy 10% solution of sodium ascorbate will be left. This contains 500 mg of vitamin C per 10 ml of liquid.
::Nebulising 10 ml of this solution (one dose) will deliver 500 mg, or 0.5 gram, of vitamin C. Start with one dose every 2 hours.
::If the nebulised vitamin C does not provide benefits, the airways can be opened up by nebulising magnesium sulphate (Epsom salts), which is also anti-inflammatory. [https://www.cochrane.org/CD003898/AIRWAYS_inhaled-magnesium-sulfate-safe-and-effective-treatment-people-asthma-attacks] Dissolve 50 grams of Epsom salts in 500 ml of filtered/spring water and nebulise 10 ml of this 1% magnesium solution at a time. This will deliver 1 gram of magnesium, and can be done immediately before nebulising the vitamin C.

:'''Hypertonic saline'''

::A simple solution of salt in water could arguably be the simplest and most readily accessible, side-effect free, worm-friendly antiviral prophylaxis and treatment available. It is suitable for use via a nasal spray to reduce viral load in the airways and thereby minimize the severity of COVID-19 in the early stages of infection. It can also be used in a nebuliser to help treat already established or more severe cases affecting the lungs, and as a gargle to reduce viral load in the mouth. The extra salt from the hypertonic solution accumulates in the viral cells, forcing them to expend ATP in order to re-balance the electrolyte gradient, and this activity limits the amount of ATP available for viral replication. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8442612/] And there is a simplified report of this research [https://medicalxpress.com/news/2021-09-reveals-saline-solution-inhibit-replication.html here].

:❓'''Hydrogen peroxide (H2O2)''' (See [[#Hydrogen peroxide|Hydrogen peroxide]].)

:: "Viral syndromes start or are strongly supported by ongoing viral replication in the naso- and oropharynx. When appropriate agents are nebulized (into a fine spray) and this viral presence is quickly eliminated, the rest of the body "mops up" quite nicely the rest of the viral presence. The worst viral infections are continually fed and sustained by the viral growth in the pharynx. Probably the best and most accessible agent to nebulise would be 3% hydrogen peroxide (1 to 5 cc of 3% peroxide with volume brought up to 10 to 12 cc with filtered water) for 15 to 30 minutes several times daily." [http://orthomolecular.org/resources/omns/v15n16.shtml] Also see [http://orthomolecular.org/resources/omns/v16n43.shtml Curing Viruses with Hydrogen Peroxide].

: '''DMSO'''

:: "DMSO can be readily combined with other anti-pathogen agents, such as sodium ascorbate (vitamin C) and magnesium chloride. Anecdotally, this DMSO-vitamin C-magnesium chloride combination has proven to be very effective in clearing biofilms and their underlying pathogen colonies. This can be done with 1 to 5 cc of 99.9% DMSO brought up to 10 to 12 cc (for nebulisation) with a combination solution of vitamin C and magnesium chloride. Precise concentrations are not critical, and the combination solution can be quickly and easily made by adding about 2 teaspoons of sodium ascorbate powder and 2 teaspoons of magnesium chloride powder to about a half cup of water. Since the sodium ascorbate will oxidize over several hours as it turns yellow, it can be made separately from the magnesium chloride solution, which remains very stable and does not significantly deteriorate over time." [http://orthomolecular.org/resources/omns/v15n16.shtml]

: '''Hyperbaric oxygen'''

:: "...hyperbaric oxygen therapy (HBOT) would be an excellent treatment adjunct against severe COVID-19 and a superior alternative to ventilators, which have been shown to cause harm in many patients and increase the risk of death. (Link expired)

: '''Grapefruit seed extract (GSE) and xylitol'''

::Nasal sprays containing GSE and xylitol (e.g., [https://xlear.com/xlear-sinus-care/ Xlear Sinus Care]) may prevent the spread of viral respiratory infections including SAR-CoV-2 and H1N1. GSE significantly reduces the viral load while xylitol prevents attachment of the virus to cell walls. [https://www.biorxiv.org/content/10.1101/2020.12.02.408575v3.full]

'''Other considerations when fighting viral infections'''

:* [https://www.sciencedaily.com/releases/2019/02/190212094839.htm How '''sleep''' can fight infection]

:* [https://www.ncbi.nlm.nih.gov/pubmed/31732517 '''Ketogenic diet''' activates protective γδ T cell responses against influenza virus infection]

:* [https://nutrition.bmj.com/content/early/2022/06/30/bmjnph-2022-000462 Association of '''periodic fasting''' with lower severity of COVID-19 outcomes in the SARS-CoV-2 prevaccine era]

:* [https://www.medicalnewstoday.com/articles/two-cases-suggest-fecal-transplants-may-treat-sars-cov-2-infection Two cases suggest '''fecal transplants''' may treat SARS-CoV-2 infection]

:* [https://journals.lww.com/anesthesia-analgesia/Fulltext/2021/04000/Aspirin_in_Coronavirus_Disease_2019_Related_Acute.1.aspx '''Aspirin''' in Coronavirus Disease 2019–Related Acute Respiratory Distress Syndrome: An Old, Low-Cost Therapy With a Strong Rationale]

:* [https://www.sciencedaily.com/releases/2019/07/190702112834.htm Pharmaceutical antibiotics weaken flu defences in the lung]

:* [https://www.bmj.com/content/368/bmj.m1182/rr-10?fbclid=IwAR1wHVgtmbbjQ4zcno5d4zjlnmC97fyrrLv7jUuXBtZGpGawQwf6OJat5YU Cholesterol-lowering treatment may worsen the outcome of a COVID-19 infection]
</blockquote>

=== Ayurvedic remedies [https://en.wikipedia.org/wiki/Ayurvedic] ===

:❓ [https://en.wikipedia.org/wiki/Aegle_marmelos Aegle marmelos] (also known as Bael, Bengal quince, golden apple, Japanese bitter orange, Sirphal, stone apple and wood apple) has culinary uses and is employed as an ayurvedic remedy in Indian traditional medicine to treat various illnesses, including irritable bowel syndrome and ulcerative colitis. Sandu bilagyl, a herbal tea combining Aegle marmelos and sugar, is claimed on several commercial websites to have anthelmintic effects, [https://herbalukstore.co.uk/sandu-bilagyl.html] but this characteristic is not mentioned in more detailed articles found online, [https://hort.purdue.edu/newcrop/CropFactSheets/bael.html] where Aegle marmelos is only reported to have pesticidal properties. This may have have been extrapolated by vendors to suggest a possible anthelmintic effect, but there is so far no evidence that it harms intestinal worms, and no self-treaters have reported their experience with it.

<blockquote>
The following ayurvedic remedies are used, in combination, to treat pinworms, so may also have an adverse effect
on other helminths:
* ⚡[https://en.wikipedia.org/wiki/Vidanga vidanga] (Embelia ribes)
* ⚡[https://en.wikipedia.org/wiki/Gurmar Gymnema sylvestre] (cowplant, cowplant, gurmari, gurmarbooti, gurmar, periploca of the woods, meshasringa, Bedki cha pala and miracle fruit)
* ⚡[http://ayurveda-foryou.com/ayurveda_herb/trikatu.html trikatu] - a combination of (see Spices section)
** ⚡[https://en.wikipedia.org/wiki/Black_pepper black pepper] (Piper nigrum - (see[[#Black pepper| Black pepper]])
** ⚡[https://en.wikipedia.org/wiki/Indian_Long_Pepper long pepper] (Piper longum)
** ⚡'''ginger''' (Zingiber officinale - see [[#Ginger|local reference]])

* ⚡[https://en.wikipedia.org/wiki/Triphala Triphala]. This is an Ayurvedic herbal formula combining three myrobalans: Amalaki (Emblica officinalis), Bibhitaki (Terminalia bellirica/Terminalia bellerica), and Haritaki (Terminalia chebula). The latter two of these are reported to be anthelmintic, but they also have laxative properties, and it may be this characteristic, rather than actual worm killing ability, that is the source of any ‘anthelmintic’ effects.
</blockquote>

=== Chinese herbal medicines [https://en.wikipedia.org/wiki/Chinese_Herbal_Medicine] ===

==== ❌ Anthelmintic Chinese herbs ====

<blockquote>
* Bing Lang (Semen arecae). Used against roundworms and flukes.
* Chuan Lian Gen Pi (Cortex meliae radicis). Used against roundworms.
* Da Huang (Radix et rhizoma rhei). Used in combination remedies to treat flukes.
* Guan Zhong (Rhizoma dryopteris crassirhizomae). Used in combination remedies to treat hookworms.
* Ku Lian Gen Pi (Cortex meliae radicis). Used to treat pinworms, and in combination remedies to treat hookworms.
* Lei Wan (Sclerotium omphaliae). Used specifically to treat hookworms.
* Qian Niu Zi (Semen pharbitidis). Used in combination remedies to treat flukes.
* Qu Hui Wan (Dispel Roundworms Pill). Used against roundworms.
* Shi Jun Zi (Fructus quisqualis). Used against pinworms.
* Tu Jing Jie (Herba chenopodii ambrosioidis). Used in combination remedies to treat hookworms.
* Wu Mei Wan / Wu-Mei Wan (Mume Pill). A 10-herb classical formula used to treat intestinal parasite infections, including roundworms.
* Zi Su Ye (Folium perillae). Used in combination remedies to treat hookworms.
</blockquote>

=== Homeopathic remedies ===

✅ Most homeopathic remedies are unlikely to have any adverse effect on human helminths. For example, the influenza remedy, [https://en.wikipedia.org/wiki/Oscillococcinum Oscillococcinum], has been taken occasionally by one hookworm host without harming her colony. [https://www.facebook.com/groups/htsupport/permalink/1590515217671094/?comment_id=1590860620969887&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

==== ❌ Antiparasitic homeopathic remedies [https://en.wikipedia.org/wiki/Homeopathy] ====

<blockquote>
* Cina (a homeopathically potentised form of Eurasian wormwood - [https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina])
* Cuprum oxidatum nigrum
* Indigoz
* Podophyllum
* Sabadilla
* Santoninum
* Spigelia
* Stanum
* Teucrium marum
</blockquote>

=== Light therapy===

No reports have been received about adverse effects on human helminths of any form of [https://en.wikipedia.org/wiki/Light_therapy light therapy] ([https://en.wikipedia.org/wiki/Low-level_laser_therapy#Red_light_therapy red light therapy], near-infrared, far-infrared, etc.), and one NA host has reported regularly using a red light full body bed without issue. [https://www.facebook.com/groups/htsupport/posts/7155942991128261/?comment_id=7156873597701867]

=== Phage therapy [https://en.wikipedia.org/wiki/Phage_therapy] ===

</blockquote>
❓ While it is unlikely that bacteriophages will harm helminths, one hookworm host who took a short course of doses of a cocktail of several phages has reported experiencing a slight temporary reduction in worm benefits following this treatment. The product he took included preservatives (8-hydroxyquinoline sulfate-0,0001 g / ml [calculated content]; or 8-hydroxyquinoline sulfate monohydrate in terms of 8-hydroxyquinoline sulfate-0.0001 g / ml [calculated content]) which may have been responsible for this effect. [https://www.facebook.com/groups/htsupport/permalink/2619124714810134/?comment_id=2619284978127441]
</blockquote>

=== Electromagnetic therapy ===

✅ Several forms of electromagnetic stimulation have been used by hosts of human helminths, including [https://en.wikipedia.org/wiki/Magnet_therapy Magnet Therapy], [https://en.wikipedia.org/wiki/Pulsed_electromagnetic_field_therapy Pulsed Electromagnetic Field (PEMF) therapy] and [https://en.wikipedia.org/wiki/Transcutaneous_electrical_nerve_stimulation Transcutaneous Electrical Nerve Stimulation (TENS)], none of which appear to have had any obvious effect on the worms. [https://www.facebook.com/groups/htsupport/permalink/3123210597734874/] [https://www.facebook.com/groups/htsupport/posts/7903061716416381/?comment_id=7903306649725221&reply_comment_id=7903872713001948]

== Foods, supplements, spices, herbs and fungi ==

There are lists on the internet claiming that common foods and spices such as pumpkin seeds, turmeric, and even carrots, will kill helminths, but '''normal dietary amounts of most ''unprocessed'' foods, spices and herbs, will not harm helminths.'''

For example, carrots and sweet potatoes are both claimed to be 'antiparasitic' in some online lists, but one individual who eats 400 g (14 oz) of one or other of these vegetables every day, is still able to maintain a thriving hookworm colony, and there are others who have eaten far more than this without harming their worms.

The only problem that is likely to arise with foods, spices or herbs is when these, and particularly herbs, are artificially concentrated or processed to create extracts or tinctures. Any herbal medicine that claims to have antiparasitic, or even antibacterial or antifungal properties may present a potential risk to human helminths and should therefore be approached with caution. The ultimate potency of these substances will depend on a number of factors, including, in the case of plants, the part used, the season it was picked, [https://pubmed.ncbi.nlm.nih.gov/37596334/] the method of extraction, [http://www.ncbi.nlm.nih.gov/pubmed?term=21110041] and the extent of concentration and/or processing, as well as dosage.

The effect of such substances also appears to vary between individuals, probably due to differences in the strength of their immune response to helminths, and some people, particularly those who have more difficulty holding on to a viable helminth colony and therefore need more frequent top-ups (especially a subset of patients with IBD or coeliac disease, and some with allergies) may find that ingesting certain substances that have no effect on the worms of other hosts may tip the balance in their case and cause a temporary dip in worm benefits, or even a loss of worms. For example, one helminth host has reported taking peppermint oil continuously without any apparent adverse effect on his worms, yet another individual could not keep a worm colony at all while taking peppermint oil.

In the case of some foods and herbs, a single part of the plant, usually a part that is not normally eaten - perhaps the bark or root - may have antiparasitic properties, while other parts of the same plant may be perfectly safe to eat. For example, the seeds of pomegranates are safe to eat, while the bark of the stems of this plant contains an anthelmintic compound, and the bark of the root contains an even more potent form of this alkaloid, which is used to treat roundworms, pinworms and tapeworms.

'''So, while bearing in mind the general principles set out in the Introduction and the last few paragraphs above, and using the details in the list below, helminth hosts need to observe their own responses and learn what they, as individuals, can and cannot safely consume while hosting helminths.'''

There will often be a warning indication whenever one's worms are not happy. This may be a general loss of wellbeing, or a return of specific symptoms. For example, one person always gets a marked increase in nasal congestion if something compromises the health of his worms.

=== Foods ===
<blockquote>
'''✅ Food items considered safe unless marked otherwise'''

* [https://en.wikipedia.org/wiki/Atemoya Atemoya] The fruit, atemoya, is a hybrid of two other fruits – the sugar-apple (Annona squamosa) and the cherimoya (Annona cherimola). Atemoya is also known as "pineapple sugar apple", anón, chirimorinon, achta and stafeli dogo ("mini soursop"). An NA host has reported that eating the flesh of this fruit appeared not to harm his colony, [https://www.facebook.com/groups/htsupport/posts/7681355011920387/?comment_id=7681459525243269] but that there are neurotoxic compounds, called annonacins, in the seeds, bark, leaves and skin of this plant that may be anthelmintic. While there are also annonacins in the fruit, they are present in much smaller quantities than in the plant’s other parts.

* [https://en.wikipedia.org/wiki/Momordica_charantia Bitter melon] (Momordica charantia) Also known as Momordica chinensis, goya, karela, ampalaya, bitter apple, bitter gourd, bitter squash and balsam-pear. This cucumber-shaped vegetable is found in Asian markets, and aqueous extracts of its leaves and seeds have both been shown to have a dose-dependent adverse effect on one type of adult non-therapeutic helminth (Strongyloides) in test tube studies [https://www.researchgate.net/publication/242567254_In_vitro_anthelmintic_efficacy_of_some_indegeneous_medicinal_plants_against_gastrointestinal_nematodes] and both fruit and seeds have been, and still are, used in a number of countries to treat pinworm infections, and for expelling parasites generally. However, the quantities of fruit and seeds that are quoted as being necessary in order to eradicate worms are rather large, for example two whole melons each day for seven to ten days, repeated after two months. It is therefore unlikely that normal dietary amounts of bitter melon fruit will adversely affect therapeutic helminths, and one hookworm self-treater has reported that bitter melon is a regular part of her diet, but has never adversely affected her worms. [https://www.facebook.com/groups/htsupport/posts/4373320642723857/?comment_id=4376043225784932]

* ⚡ [https://en.wikipedia.org/wiki/Breast_milk Breast milk] (human). There has been one report of a child with severe eczema who was inoculated with hookworms while still being breastfed, and who received only moderate benefits from the worms until breast feeding was suspended. Thereafter, the benefits increased markedly, suggesting that something in the breast milk was inhibiting the worms, possibly the lauric acid which is also found in [[#Coconut|coconut]] products. [https://www.facebook.com/groups/htsupport/permalink/2241418522580757/]

* [https://en.wikipedia.org/wiki/Carrot Carrot] (Daucus carota, subsp. sativus). The taproot of the carrot is rich in beta carotene, a precursor for vitamin A, which has been claimed to increase resistance to penetration by larvae. Carrots have also been claimed to be offensive to all parasites and valuable in the elimination of threadworms, but normal dietary amounts are not harmful to therapeutic helminths, and many helminth hosts have regularly eaten significant quantities of this vegetable (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without adversely affecting their worms.

* ❌ [https://en.wikipedia.org/wiki/Chicory Chicory] (Cichorium intybus). This is well known for its toxicity to intestinal parasites, and studies have indicated that ingestion of chicory by farm animals results in reduced worm burdens. This plant contains volatile oils similar to those found in plants in the related genus Tanacetum, which includes ❌'''Tansy''', and is said to be similarly effective in eliminating intestinal worms. One hookworm host has reported that eating 2 tsp of chicory powder (pesumably ground chicory root) terminated her colony. [https://www.facebook.com/groups/htsupport/posts/8036790633043488?comment_id=8058118634244021] However another NA self-treater has reported that drinking "loads of chickory coffee for a while" had no negative effects on his colony. [https://www.facebook.com/groups/htsupport/posts/9496946530361217?comment_id=9497703880285482] This difference in results was likely due to the high heat used to roast the raw plant material to produce chicory "coffee". This processing destroys or transforms many of the original plant oils present in raw chicory root, with the result that roasted chicory contains little to none of the volatile oils found in the fresh plant. [https://orleanscoffee.com/what-is-chicory/]

* [https://en.wikipedia.org/wiki/Citron Citron] (Citrus medica). Alcoholic extracts of the rind of citron have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. These extracts may therefore also have an adverse effect on other helminths, though there is no evidence that eating normal dietary amounts of the flesh of this fruit might harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Coconut Coconut]. Coconut products contain [[#Medium-chain triglycerides|medium-chain-triglycerides]] (MCT), some of which have been shown to be effective against many parasites including giardia, other protozoa, and also tapeworms. (Also see, [[#Fatty acids|Fatty acids]].) The fats in '''coconut oil''' are 40% lauric acid (lipid number: C12), the MCT most well-known for its antibacterial, antimicrobial and antiviral properties, and the one most likely to be responsible for any adverse effect on helminths. '''Fractionated coconut oil''' contains primarily caprylic acid (C8) and capric acid (C10) [https://web.archive.org/web/20190122225059/https://www.healthline.com/nutrition/fractionated-coconut-oil] which appear not to harm helminths. One hookworm host who routinely consumes 3 to 10 tablespoons daily of MCT oil containing 55% caprylic acid and 35% capric acid has reported that this has no adverse effect on his colony, and that he is able to incubate more NA using eggs from this colony. [https://www.facebook.com/groups/678894952216125/permalink/2965258846913046/?comment_id=2966781426760788] '''Coconut fiber''', especially in the form of dried or ground coconut flesh (desiccated coconut, coconut flour) has long been used to expel intestinal worms, both in humans [https://www.facebook.com/groups/htsupport/permalink/1412001672189117/] and animals, [https://www.ncbi.nlm.nih.gov/pubmed/21120531] [https://www.ncbi.nlm.nih.gov/pubmed/24271156] and becomes more effective as the quantity increases. Eating an entire cake baked with coconut flour brought a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/946802485375707/] Most helminth hosts find that they can eat normal dietary amounts of coconut products without adversely affecting their worms, as can be seen in these examples. [https://www.facebook.com/groups/htsupport/permalink/877714092284547/?comment_id=880956541960302&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/872052362850720/?comment_id=872162672839689&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026771657378789&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1026756790713609/?comment_id=1026788797377075&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2214083125314297/?comment_id=2214217708634172&reply_comment_id=2214230838632859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Nevertheless, coconut products do have a potential to affect human hookworms in some individuals, especially '''coconut oil''' and '''coconut milk''', and the effect is often dose-dependent. For example, one hookworm host who checks the egg output of his worms has reported that they twice produced zero eggs for a period of time after he drank coconut milk. Another hookworm host gets increased pain a few hours after ingesting coconut milk or powder. [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] Someone else found that, while consuming 200 mg of coconut milk caused a temporary return of mild symptoms of his disease, he regularly eats coconut oil without any obvious problem, but other hookworm hosts have reported a return of disease symptoms after consuming coconut oil. [https://www.facebook.com/groups/htsupport/permalink/1446457812076836/] [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409474272441857&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3536097503112846/] A hookworm grower has reported that he can consume coconut products "somewhat regularly" and still be able to incubate plenty of larvae, [https://www.facebook.com/groups/678894952216125/permalink/1407193439386269/?comment_id=1407718306000449&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but another grower has found that, while his colony continues to thrive and produce eggs when he takes 3 tablespoons of coconut oil each day, [https://www.facebook.com/groups/htsupport/permalink/1084278171628137/?comment_id=1088696887852932&comment_tracking=%7B%22tn%22:%22R%22%7D] about ⅓ of any larvae produced will be dead, and the rest “less energetic”, so he normally restricts himself to 2 tablespoons per day. '''Coconut water''' may also adversely affect a hookworm colony, as one host found after drinking 1 litre of coconut water, [https://www.facebook.com/groups/htsupport/permalink/1051741958215092/] and another found after drinking coconut water kefir, [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] but one NA host has found that the [https://www.lacroixwater.com coconut essence-flavoured sparkling water produced by La Croix] had no ill effect on his worms. [https://www.facebook.com/groups/htsupport/posts/4820278211361429/] One hookworm host finds that '''all coconut products''' have an adverse effect, [https://www.facebook.com/groups/htsupport/permalink/1408578419198109/?comment_id=1409105045812113&comment_tracking=%7B%22tn%22%3A%22R%22%7D] while two others have said that even small amounts of coconut quickly result in a loss of benefits. [https://www.facebook.com/groups/htsupport/permalink/1331489750240310/?comment_id=1339469669442318&comment_tracking=%7B%22tn%22%3A%22R2%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1526713510717932/?comment_id=1529128360476447&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Some '''CBD oils''' for vaping are suspended in coconut oil. However, most of these are only a 3% suspension, so *may* be safe for use while hosting human helminths. '''Coconut sugar''' should not carry the same degree of risk because, whereas coconut milk, oil and flour are all obtained from the flesh of mature coconuts, and coconut water is also from inside the fleshy part of the coconut, coconut sugar comes from the sap of coconut palm flower buds and consists largely of sugars. The seasoning sauce, '''Coconut Aminos''', is also made from coconut tree sap, and at least one hookworm host has used this regularly without issue. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1697083593680922&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Cranberry Cranberry] (Vaccinium macrocarpon). This is claimed by some sources to contain antiparasitic enzymes, and cranberry powder is sometimes included in proprietary antiparasitic formulations, although evidence for its effectiveness in this context is lacking, and there have never been any reports of any form of cranberry having an adverse effect on therapeutic helminths. Cranberry juice was used traditionally to treat urinary tract infections (UTIs), but it works by changing the bacteria in ways that [http://www.medicalnewstoday.com/articles/198711.php prevent bacterial adhesion] rather than killing them. While drinking 15 fl oz of cranberry juice per day is claimed to help arrest a mild urinary infection, [http://www.medicalnewstoday.com/articles/306498.php cranberry powder capsules are more effective] and '''D-mannose''', a cranberry derivative, is even more effective than the powder.

* ❓ [https://en.wikipedia.org/wiki/Rub_(syrup) Date syrup], also known as “rub”. Laboratory tests have revealed that [http://www.sciencedaily.com/releases/2015/03/150330213949.htm some forms of date syrup may have antibacterial activity], possibly due to the presence of phenolic compounds that form naturally in the dates as they mature. Significantly, the syrup was able to inhibit the growth of bacteria faster than ⚡'''Manuka honey''', which several people have suspected of having adversely affected their worms. However, [https://www.facebook.com/groups/htsupport/permalink/811693292219961/?comment_id=811695265553097&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D eating dates is unlikely to be harmful to helminths].

* [https://en.wikipedia.org/wiki/Dietary_fiber Dietary fibre] (fiber). Some sources claim that eating a lot of fibre may reduce the number of intestinal worms, but fibre consumed as an integral part of a normal diet has not been reported to be a problem for human helminths.

* ❓ [https://en.wikipedia.org/wiki/Durian Durian] There are several species of fruit-producing durian trees, the most common of which is [https://en.wikipedia.org/wiki/Durio_zibethinus Durio zibethinus] So far, there have been no reports about durian from self-treaters, but [https://en.wikipedia.org/wiki/Bombax_ceiba Bombax malabaricum] - another member of the Bombacaceae plant family within which durian is classified - has shown significant anthelmintic activity against one flatworm species. [https://pubmed.ncbi.nlm.nih.gov/21853226/]

* ⚡[https://en.wikipedia.org/wiki/Fatty_acid Fatty acids]. Research on the direct effect of fatty acids on helminths is limited. However, the poly-unsaturated fatty acid (PUFA), linoleic acid, has shown in vitro nematocidal activity against both C. elegans [https://pubmed.ncbi.nlm.nih.gov/8202563/] [https://pubmed.ncbi.nlm.nih.gov/32674325/] and H. contortus, [https://pubmed.ncbi.nlm.nih.gov/20075977/] and it has been proposed that unsaturated fatty acids are likely to play a role in the natural attrition of S. mansoni and S. haematobium lung-stage larvae. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It has been hypothesised elsewhere that exposure to some fatty acids could cause lethal damage to helminths by interacting with, and compromising, the integrity of the organisms's cuticle, [https://pubmed.ncbi.nlm.nih.gov/34149425/] and in vitro exposure to arachidonic acid has been shown to cause disintegration of the surface membranes of the trematode, Schistosoma spp., eventually leading to parasite death. [https://pubmed.ncbi.nlm.nih.gov/16419753/] It is likely that the undoubted adverse effect of some coconut products on NA - and possibly also TTO - in ''some'' hosts is due to the fatty acids these products contain, especially lauric acid (C12), and the evidence from the studies presented here suggests that other fatty acids may have an adverse effect on therapeutic helminths in a similar dose-dependent manner, influenced also by the strength of the host's immune response to helminths. People who are hosting NA, in particular, who are not experiencing the benefits they expected should therefore consider the possible effect of any fatty acids they consume, and experiment accordingly. (Also see [[#Medium-chain triglycerides|medium-chain triglycerides]] and [[#Coconut|⚡coconut]].)

* '''Guayusa tea''' ([https://en.wikipedia.org/wiki/Ilex_guayusa ilex guayusa]). The leaves of this Amazonian holly tree are brewed to make a caffeinated drink. One hookworm host who regularly drinks this tea has not noticed any adverse effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/2248121518577124/?comment_id=2248562038533072&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Genetically_modified_foods Genetically modified foods] (GMOs). Some food crops, such as corn and rice, have been genetically modified to produce ❌'''Cry5B''', a protein that can kill intestinal worms, including the human hookworm. [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt), the bacterium that produces Cry5B, is also applied as a [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php natural insecticide] on crops on some organic farms, but there is no indication yet that GM foods are a potential threat to human helminths.

* [https://en.wikipedia.org/wiki/Grapefruit Grapefruit] (citrus paradisi). The flesh of the common grapefruit is perfectly safe to eat while hosting helminths, although ⚡'''grapefruit seed extract''' does have a potential to harm helminths due to the typical addition of synthetic adulterants. Also potentially harmful are some extracts of the rind of ❌'''Citrus decumana''', a close relative of the grapefruit.

* [https://en.wikipedia.org/wiki/Hibiscus Hibiscus]. One hookworm host has drunk many litres of strong, homemade hibiscus tea over the years without ever harming her colony. [https://www.facebook.com/groups/htsupport/permalink/2647270255328913/?comment_id=2647328495323089]

* ⚡ [https://en.wikipedia.org/wiki/Honey Honey]. Honey can contain antivirals [http://www.ncbi.nlm.nih.gov/pubmed/25333699] and powerful antimicrobials [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074369/], some of which can have effects comparable with those of antibiotics such as clarithromycin, and certain types of honey have particularly potent antimicrobial activity. Several people have suspected that [https://en.wikipedia.org/wiki/M%C4%81nuka_honey '''Manuka''' honey] (which inhibits dental plaque as effectively as chlorhexidine mouthwash [http://www.ncbi.nlm.nih.gov/pubmed/22114423]) has adversely affected their worms, while a few others have reported that '''raw''' honey reduces the benefits from their worms, [https://www.facebook.com/groups/htsupport/permalink/2517832904939316/?comment_id=2524053750983898] in one case causing increased pain several hours after ingestion, [https://www.facebook.com/groups/htsupport/permalink/966600183395937/?comment_id=967794996609789&reply_comment_id=968778733178082&comment_tracking=%7B%22tn%22:%22R3%22%7D] and someone else, who had a few teaspoons of '''raw''' honey on two occasions, 4 days apart, has reported that some of his symptoms made a limited return for a day after each ingestion. [https://www.facebook.com/groups/htsupport/posts/5132147986841115/] Research reported in 2014 may explain why '''raw''' honey might have this effect. [http://www.sciencedaily.com/releases/2014/09/140908093741.htm] However, one hookworm host, who regularly takes a '''manuka''' honey/apple cider vinegar combination, has not noticed any loss of benefits, and another two have reported no apparent adverse effect on their worms after consuming '''raw''' honey. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] One of these individuals reports having eaten quite large amounts of '''raw''' honey continuously during his first 3 years with NA and never noticed anything untoward. [https://www.facebook.com/groups/htsupport/permalink/1802586329797314/?comment_id=1807740622615218&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Regular honey appears to be generally worm-safe, [https://www.facebook.com/groups/htsupport/permalink/1223658601023426/?comment_id=1224392167616736&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and, demonstrating the experience of many others, one hookworm host has said that she can consume 2-4 teaspoons of regular honey daily without any issues, but that manuka and any honey labeled as "raw" causes problems. (Identification of the different types of honey: '''Manuka''' honey, which is very viscous with a dark cream to dark brown colour, is produced by bees foraging specifically on the mānuka tree; '''Wild''' honey is often sourced from free-range hives, rather than box hives, by native gatherers who only remove larger honeycomb impurities; '''Raw''' honey is typically only strained to remove physical impurities such as beeswax and dead bees. '''Regular honey''' usually goes through additional processing including finer filtration to remove all debris and air bubbles, and pasteurisation to destroy yeasts. Regular honey may also be subject to utrafiltration, which further refines the product to make it more transparent and smooth, but also removes beneficial nutrients like pollen, enzymes and antioxidants.)

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_emblica Indian gooseberry]. (Phyllanthus emblica, also known as Emblica officinalis, emblic, emblic myrobalan, myrobalan, Malacca tree and amla.) While there are websites online that claim anti-parasitic effects for P. emblica, and one study found that P. emblica exerted toxic effects on a parasitic flat worm, [https://pubmed.ncbi.nlm.nih.gov/19819626/] there is no compelling evidence in the scientific literature for a possible adverse effect on hookworms. Neither have any reports of an adverse effect on their worms been posted by any NA self-treaters, and one study found that a traditional Thai preparation containing P. emblica actually extended the life of the research worm, C. elegans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693129/]

* [https://en.wikipedia.org/wiki/Kefir Kefir]. Although kefir has been claimed online to kill “parasites”, it will not harm hookworms unless it is made with coconut milk. (See [[#Coconut milk |details for coconut milk]].) There has also been a single report of an NA colony possibly being killed after drinking kefir made from coconut water. [https://www.facebook.com/groups/htsupport/permalink/1696907597031855/?comment_id=1698709520184996&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (See [[#Coconut water |details for coconut water]].)

* [https://en.wikipedia.org/wiki/Kombucha Kombucha] (Medusomyces gisevii, also called tea mushroom, tea fungus or Manchurian mushroom.) This fermented drink does not harm helminths. [https://www.facebook.com/groups/htsupport/permalink/2616391711750101/?comment_id=2616509485071657]

* [https://en.wikipedia.org/wiki/Lime_(fruit) Lime] (Citrus acida). While alcoholic extracts of the rind of limes have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], and extracts of the rind may have an adverse effect on other helminths, there is no reason to believe that eating the flesh of limes will harm human helminths.

* ⚡ [https://en.wikipedia.org/wiki/Medium-chain_triglyceride Medium-chain triglycerides] (MCTs) are extracted from ⚡'''coconut oil''', amongst other things, and can be divided into four groups: 1. caproic acid (C6), 2. caprylic acid (C8), 3. capric acid (C10) and 4. lauric acid (C12). [https://blog.bulletproof.com/the-definitive-guide-to-mcts/] Of these, lauric acid is the most well-known for its antibacterial, antimicrobial and antiviral properties, which may explain why coconut oil (which is 40-50% lauric acid) appears more likely to affect human helminths than products containing a mixture of all four types of MCT, such as the milk of cows, sheep and goats, the fatty acids in which contain 10-20% mixed MCTs. (Also see [[#Fatty acids|⚡fatty acids]] and [[#Coconut|⚡coconut]].) One NA host who took the "postbiotic" product, [https://bodybio.co.uk/products/butyrate BodyBio Sodium Butyrate] has reported that this killed, or at least stunned, his colony, [https://www.facebook.com/groups/htsupport/posts/26047337781562164/?comment_id=26051335694495706&reply_comment_id=26164657629830178&notif_id=1774758235710203&notif_t=group_comment_mention] and the only ingredient in this product that is known to be a potential problem is medium-chain triglycerides (MCT).

* [https://en.wikipedia.org/wiki/Onion Onion] (Allium cepa). This is used as an ingredient in some proprietary deworming formulations and has been claimed to create an 'uninhabitable environment' for intestinal worms and to help eradicate tapeworms in particular. However, if eaten in normal dietary quantities, onion should not harm therapeutic human helminths.

* [https://en.wikipedia.org/wiki/Organic_foods Organic foods]. While these are less likely to be contaminated with chemicals, some organic farmers apply [https://en.wikipedia.org/wiki/Bacillus_thuringiensis Bacillus thuringiensis] (Bt) to their crops as a natural insecticide. This bacterium produces ❌'''Cry5B''', a protein that can kill intestinal worms, [http://www.eurekalert.org/pub_releases/2013-07/asfm-npc072313.php including human hookworms]. However many hosts of human helminths have eaten organic foods without them affecting their worms.


* [https://en.wikipedia.org/wiki/Papaya Papaya] (Carica papaya, also known as or papaw, pawpaw or paw paw). The fruit and leaves contain both antiseptic and antiparasitic compounds, including one called [https://en.wikipedia.org/wiki/Carpaine carpaine], which is claimed to kill and expel intestinal worms. Papaya latex has been shown to be an [http://www.ncbi.nlm.nih.gov/pubmed/26343287 effective anthelmintic] against a variety of nematode parasites. However, it is unlikely that eating normal dietary amounts of the flesh of the fruit will adversely affect human helminths and, when someone who grows his own hookworms added a large amount of papaya - comparable to a human eating 2 or 3 pawpaws - to a petri dish full of larvae, these were unaffected. However, ⚡'''Papaya seeds''' are also rich in caricin which is reportedly effective in expelling roundworms. A randomized, placebo-controlled study found that a 20 ml dose of a mixture of air-dried papaya seeds and "natural" honey was effective against various types of human intestinal parasite, although the honey may have contributed to this effect. The mixture demonstrated 100% efficacy in clearing TT, and 80% efficacy against NA. [http://www.ncbi.nlm.nih.gov/pubmed/17472487] Also see [https://www.ncbi.nlm.nih.gov/pubmed/30526582 this paper].

* [https://en.wikipedia.org/wiki/Pomegranate Pomegranate] (Punica granatum). ✅The '''flesh and seeds''' of the pomegranate fruit have not been reported to harm human helminths. However, ❌'''pomegranate extracts''' should be avoided because the bark and stems of this plant contain an anthelmintic compound, punicine, and the bark of the root contains an even more potent form of this alkaloid. [https://www.ncbi.nlm.nih.gov/pubmed/32411422] Extracts of the bark of both the root and stems, and extracts of the rind/peel of the fruit, have a strong anthelmintic effect and are used as traditional remedies to treat roundworms, pinworms and tapeworms, to which they are said to be highly toxic. Alcoholic extracts of the rind/peel have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [https://www.ncbi.nlm.nih.gov/pubmed/1158424] These extracts may therefore have an adverse effect on other helminths, and one hookworm host has reported losing benefits from her colony after accidentally consuming a small amount of pomegranate extract. [https://www.facebook.com/groups/htsupport/permalink/1166864270036193/] Pomegranate peel is used in small quantities in dietary supplements and food preservatives and may not be a significant threat to human helminths in this form. However, ❌'''pomegranate peel powder''', which is available for purchase as a remedy for certain health conditions, might be harmful to helminths if it is used in quantity, for example as an ingredient in smoothies. One hookworm host found that while one company’s pomegranate '''''fruit''''' powder is produced from only the dried pomegranate arils (the seeds and their red fleshy coatings), and not including any peel, the same company’s pomegranate '''''juice''''' powder is produced from the whole fruit - both the seeds/arils and the peel. Neither product carries details on their packaging of which part of the pomegranate they contain, and this self-treater had only realised there was a difference when taking the latter product caused a return of his disease symptoms.

* ✅ [https://en.wikipedia.org/wiki/Pumpkin Pumpkin] and ⚡ [https://en.wikipedia.org/wiki/Pumpkin_seed Pumpkin seeds] (Cucurbita species). This is also referred to as squash or gourd, depending on species, variety and local parlance. Eating the flesh of the pumpkin/squash/gourd is unlikely to have any adverse effect on any human helminth. ⚡'''Pumpkin ''seeds''''' contain an antiparasitic compound called [https://en.wikipedia.org/wiki/Cucurbitacin curcurbitacin] and they were used traditionally as a remedy for tapeworms and roundworms. However, their effect is likely to be dose-dependent, and large amounts are recommend by herbalists for deworming, e,g., up to 25 ounces for adults. Some hookworm hosts have reported no adverse effect on their colony after eating pumpkin seeds, [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2889359654453304] [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2890447241011212&reply_comment_id=2895457573843512] while others have experienced either a temporary return of disease symptoms or even a loss of their colony. For example one found that eating a daily salad for a week with a mixed seed/nut topping containing pumpkin seeds killed her entire colony. [https://www.facebook.com/groups/htsupport/permalink/2888440857878517/?comment_id=2888764874512782] Another NA host has reported that taking 1000 mg of ⚡'''pumpkin seed oil''' daily for 2 months significantly reduced the fecundity of his NA, resulting in incubations producing only a handful of L3 larvae after having previously always yielded hundreds of larvae per incubation over a 7 year period. [https://www.facebook.com/groups/htsupport/permalink/1635384559850826/?comment_id=1635389889850293&reply_comment_id=1635944229794859&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Since this individual is not treating a disease, but only acting as a reservoir donor, it is not known whether this amount of pumpkin seed oil might affect disease remission.

* [https://en.wikipedia.org/wiki/Radish Radish] (Raphanus sativus). This has been used as an alternative treatment for intestinal parasites, and is included as an ingredient in some proprietary deworming formulations, but it is unlikely to have any adverse effect on human helminths if eaten as part of a normal diet.

* ❌ [https://en.wikipedia.org/wiki/Sauerkraut Sauerkraut] Sauerkraut will not kill human helminths, but it can trigger significant digestive upset in some people, sufficient to cause a setback in the course of their treatment, and including diarrhoea severe enough to flush hookworms from the gut. Two hookworm hosts have reported experiencing significant upset stomach, “gut issues” and diarrhoea after eating only 2 and 3 forkfuls of sauerkraut respectively [https://www.facebook.com/groups/htsupport/permalink/1440317759357508/?comment_id=1440394666016484&reply_comment_id=1443382035717747][https://www.facebook.com/groups/htsupport/permalink/2726061500783121/?comment_id=3607483215974274] and another NA host lost his entire colony due to extreme diarrhoea following his first encounter with sauerkraut. [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓[https://en.wikipedia.org/wiki/Seaweed Seaweed] (macroalgae). Five poly-unsaturated fatty acids (PUFAs) identified in two Nordic seaweeds (S. latissima and L. digitata) were found to have in vitro effects against helminths in swine (Ascaris suum) and sheep (Teladorsagia circumcincta), with a clear synergistic effect being apparent when selected compounds were tested in combination. “Collectively, our data reveal that fatty acids may have a previously unappreciated role as natural anti-parasitic compounds, which suggests that seaweed products may represent a viable option for control of intestinal helminth infections.” [https://pubmed.ncbi.nlm.nih.gov/34149425/] However, there have been no reports so far of NA or TTO being adversely affected by the consumption of seaweed products. (Also see, [[#Fatty acids|⚡fatty acids]].)

* [https://en.wikipedia.org/wiki/Soy_sauce Soy sauce / soya sauce] This liquid condiment made with fermented soybeans is safe for use with human helminths.

* [https://en.wikipedia.org/wiki/Squash_(plant) Squash]. See '''Pumpkin''' above.

* [https://en.wikipedia.org/wiki/Sweet_potatoes Sweet potato] (Ipomoea batatas). Like the carrot, this root vegetable is rich in beta carotene, a precursor for vitamin A, which it has been claimed can increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat significant amounts of sweet potato (e.g., up to 1kg daily [https://www.facebook.com/groups/htsupport/permalink/1074474759275145/?comment_id=1084028951653059&comment_tracking=%7B%22tn%22:%22R%22%7D]) without any adverse effect on their worms.

* [https://en.wikipedia.org/wiki/Tea Tea]. The aromatic beverage prepared by pouring hot or boiling water over cured or fresh leaves of the [https://en.wikipedia.org/wiki/Camellia_sinensis Camellia sinensis] plant, e.g., [https://en.wikipedia.org/wiki/Green_tea green tea], [https://en.wikipedia.org/wiki/Black_tea black tea], [https://en.wikipedia.org/wiki/White_tea white tea] and [https://en.wikipedia.org/wiki/Oolong oolong tea], is generally harmless to therapeutic helminths. However, there ''may'' be a risk of harm to human helminths if ❓medicinal quantities of concentrates, extracts or tinctures made from green tea are consumed. [https://www.researchgate.net/publication/5449030_Potential_anthelmintics_Polyphenols_from_the_tea_plant_Camellia_sinensis_L_are_lethally_toxic_to_Caenorhabditis_elegans]

* ⚡ [https://en.wikipedia.org/wiki/Thai_curry Thai curry]. One hookworm host found that a strong green Thai curry upset his colony to the extent that he needed to add a top-up dose to recover the benefits he had enjoyed previously. [https://www.facebook.com/groups/htsupport/permalink/2259967414059201/?comment_id=2260424784013464&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Juglans_regia Walnut], English (Juglans regia). Also known as the Persian, common, California, or Carpathian walnut. This does not appear to have gained a reputation as an anthelmintic, unlike the ⚡'''black walnut'''.

* [https://en.wikipedia.org/wiki/Watermelon Watermelon] flesh is not a problem for either NA or TTO, but there has been one report from an NA host that eating a "bunch" of ⚡watermelon seeds at a barbecue caused a loss of all worm benefits after about three days. [https://www.facebook.com/groups/htsupport/posts/6765576206831610?comment_id=6765885696800661]

* [https://en.wikipedia.org/wiki/Xylitol Xylitol]. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/833127066743250/?comment_id=833225923400031&offset=0&total_comments=6&comment_tracking=%7B%22tn%22:%22R%22%7D] that he takes xylitol daily in place of sugar and has not noticed any effect on his colony.

* [https://en.wikipedia.org/wiki/Yam_(vegetable) Yam] ([https://en.wikipedia.org/wiki/Dioscorea Dioscorea]). Like carrot and sweet potato, the yam is rich in beta carotene, a precursor for vitamin A which is thought to increase resistance to penetration by larvae. However, numerous hosts of human helminths regularly eat this vegetable without adversely affecting their worms.
</blockquote>



=== Nutritional supplements ===

<blockquote>
'''✅ Supplements safe for human helminths, unless marked otherwise'''

* [https://en.wikipedia.org/wiki/5-Hydroxytryptophan 5-HTP] (5-Hydroxytryptophan, also known as oxitriptan and marketed under trade names such as Cincofarm, Levothym, Levotonine, Oxyfan, Telesol, Tript-OH and Triptum) This is used as an antidepressant, appetite suppressant and sleep aid. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/811459492243341/?comment_id=811659322223358&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] taking 5-HTP without any adverse effect on her worms.

* [https://en.wikipedia.org/wiki/Acetylcarnitine Acetylcarnitine] (Acetyl-L-carnitine, ALCAR or ALC) is produced naturally by the body, and has been taken by at least two hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1701750936547521&reply_comment_id=1702741433115138&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1701733326549282/?comment_id=1702716603117621&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Acetylcysteine Acetylcysteine] (also known as N-acetylcysteine, N-acetyl-L-cysteine and NAC). Three hookworm hosts have reported taking this without causing any problems for their colonies. [https://www.facebook.com/groups/htsupport/permalink/832123420176948/?comment_id=832517453470878&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/3049676998421568/?comment_id=3049740311748570] [https://www.facebook.com/groups/htsupport/posts/4840382556017661/?comment_id=4841276152594968]

* [https://en.wikipedia.org/wiki/Activated_charcoal_(medication) Activated charcoal] (also known as activated carbon). There have been no reports of this harming human helminths and three reports confirming that it does not harm NA. [https://www.facebook.com/groups/htsupport/posts/7846458328743387?comment_id=7847087392013814][https://www.facebook.com/groups/htsupport/permalink/513613715361255/?comment_id=514186115304015&comment_tracking=%7B%22tn%22:%22R0%22%7D][https://www.facebook.com/groups/htsupport/permalink/792437597478864/?comment_id=792881060767851&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R3%22%7D]

* [https://en.wikipedia.org/wiki/Lipoic_acid Alpha lipoic acid] (ALA), also known as Lipoic acid (LA), α-lipoic acid and thioctic acid. This organosulphur compound is made naturally in animals, where it is essential for aerobic metabolism. Because of its antioxidant properties, it is also sold as a dietary supplement and is available in some countries as a pharmaceutical drug. One host of both hookworms and human whipworms has taken between 300 and 600 mg of alpha lipoic acid per day without any harm befalling their worms.

* [https://en.wikipedia.org/wiki/Amine_oxidase Amine oxidase] (also known as diamine oxidase, DAO and histaminase). This enzyme, which is involved in the metabolism of histamine, is produced by the body and found in high concentrations in the digestive tract and placenta. It has therefore been suggested [https://www.facebook.com/groups/htsupport/permalink/883903308332292/?comment_id=883916171664339&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] that it is unlikely to be harmful to helminths, although there are not yet any reports to confirm this.

* [https://aseaglobal.com ASEA] Redox Supplement. This “catalytically processed” saline solution should not harm helminths, a fact confirmed by one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/2127858607270083/?comment_id=2129186490470628&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❌ [https://atrantil.com/ Atrantil] contains three active botanicals: M. balsamea Willd (peppermint) leaf extract, quebracho extract and conker tree extract. While ⚡'''peppermint oil''' has proved to be a problem for some hosts of human helminths (see [[#Peppermint|peppermint reference]]), it is possible that the leaf extract may be worm-safe. However, quebracho extract has been shown to effectively reduce worm burdens in sheep. [http://www.fao.org/docs/eims/upload/agrotech/1905/R7424%20(04)%20Embu%20proceedings.pdf]

* ❓ Avocado seed extract. Extracts of the seeds of the avocado - also known as alligator pear or avocado pear ([https://en.wikipedia.org/wiki/Avocado Persea americana]) - may have an adverse effect on NA. While there have been no reports so far of this effect from self treaters who host either NA or TTO, caution is recommended when trying these extracts because there is scientific evidence suggesting that they possess broad spectrum anthelmintic activity against several other nematode species.

* [https://en.wikipedia.org/wiki/Bee_pollen Bee pollen]. One hookworm host has reported that eating small amounts of this has had no obvious adverse effect on his worms.

* ❌ [https://en.wikipedia.org/wiki/Beta-Sitosterol beta-Sitosterol] has demonstrated anthelmintic effects [https://www.ncbi.nlm.nih.gov/pubmed/12587699] and three hookworm hosts have reported a return of their disease symptoms after taking beta-Sitosterol. (expired link), [https://www.facebook.com/groups/htsupport/permalink/1143218725734081/?comment_id=1146128268776460&comment_tracking=%7B%22tn%22:%22R0%22%7D], [https://www.facebook.com/groups/htsupport/posts/7569548336434389/]

* [http://www.webmd.com/vitamins-supplements/ingredientmono-312-BETAINE%20HYDROCHLORIDE.aspx?activeIngredientId=312&activeIngredientName=BETAINE%20HYDROCHLORIDE Betaine hydrochloride]. Two hookworm hosts have reported using betaine HCL without noticing any loss of benefits from their worms. [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106534052735882&comment_tracking=%7B%22tn%22:%22R1%22%7D], [https://www.facebook.com/groups/htsupport/permalink/1103458306376790/?comment_id=1106538649402089&comment_tracking=%7B%22tn%22:%22R%22%7D] and [https://www.facebook.com/groups/htsupport/permalink/2070288819693729/?comment_id=2070391136350164&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Boron Boron] and [https://en.wikipedia.org/wiki/Borax Borax]. Boron is a chemical element and a trace element in human and plant nutrition. Only small amounts of boron are required for health and an excess can be toxic. It is unlikely to have an adverse effect on helminths when consumed in dietary quantities. Borax is a mineral containing boron which has antifungal properties and also certain [https://en.wikipedia.org/wiki/Borax#Toxicity health risks]. One hookworm host has reported taking 1/2 teaspoon borax per day for 6-7 weeks without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/1232677046788248/?comment_id=1404263146296303&reply_comment_id=1404577376264880&comment_tracking=%7B%22tn%22%3A%22R7%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1404253479630603/?comment_id=1404658099590141&reply_comment_id=1405046696217948&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/BPC-157 Bpc 157] This pentadecapeptide, also known as PL 14736, was taken intranasally over 4 days by one NA host who has reported no negative effect on his colony in that time. [https://www.facebook.com/groups/htsupport/posts/6283059368416632/?comment_id=6283148771741025]

* [https://en.wikipedia.org/wiki/Chlorella Chlorella]. One hookworm host took ½ teaspoon of this single-cell green algae daily for a year without any obvious effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/1037512569638031/?comment_id=1037568506299104&comment_tracking=%7B%22tn%22:%22R%22%7D]

*❓[https://en.wikipedia.org/wiki/Chlorophyllin Chlorophyllin]. This semi-synthetic derivative of chlorophyll is used as a food colouring agent (e.g., E number E141) and as a treatment aimed at reducing various bodily odours, but its suitability for use by helminth hosts has been questioned because of its apparent [https://www.ncbi.nlm.nih.gov/pubmed/19009310 ability to kill mosquito larvae and other small animals] at low concentrations, although this effect appears to be dependent on the presence of sunlight. (Also see ✅[[#Chlorophyll|Chlorophyll]].)

* [https://en.wikipedia.org/wiki/Chondroitin_sulfate Chondroitin Sulfate]. In an animal study, chondroitin sulfate was shown to prevent threadworms from establishing in the digestive system, but one NA host has taken 900 mg daily for several years without any adverse effect on his worms.

* [https://en.wikipedia.org/wiki/Colostrum Colostrum]. A hookworm host has taken this without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/1145589722163648/?comment_id=1145807582141862&comment_tracking=%7B%22tn%22:%22R1%22%7D]

*❓[https://en.wikipedia.org/wiki/Mannose D-mannose]. This naturally occurring simple sugar is the ingredient in cranberries that makes their juice effective against urinary tract infections. Pure D-mannose is 10-50 times stronger than cranberry juice, making it more suitable for stubborn cases of UTI, and it reportedly resolves more than 90% of all UTIs within 1-2 days. [https://web.archive.org/web/20210211080155/http://www.tahomaclinicblog.com/d-mannose-for-bladder-and-kidney-infections/], [http://www.townsendletter.com/May2014/gaby0514.html] Taking steps to make the urine less acidic (e.g., by taking Tums[https://www.tums.com/]) might [http://www.sciencedaily.com/releases/2015/06/150625161623.htm make cranberry-based treatments even more effective]. D-mannose is non-toxic, produces no adverse effects and, while there have been no reports to confirm it’s lack of adverse effects on human helminths, it is unlikely to do them any harm.

* ⚡ [https://en.wikipedia.org/wiki/Digestive_enzymes Digestive enzymes], such as papain and bromelain, are said to make the intestinal tract inhospitable to parasites by dissolving their outer layers. In particular, papain - the milky juice of the unripe papaya - is claimed to be a powerful agent for destroying roundworms. One subject has reported a return of symptoms after taking a product containing papain, bromelain, protease, lipase and amylase for several weeks, and another individual has reported losing their entire hookworm colony after taking ''Healthy Origins Broad Spectrum Digestive Enzymes'' [https://healthyoriginseurope.com/products/digestive-enzymes-nec-broad-spectrum?variant=31997110714427] (amylase, protease, peptidase, alpha-galactosidase, glucoamylase, acid maltase, cellulase, pectinase, protease, lipase, lactase, beta-glucanase, invertase and hemicellulase). However, several other hookworm hosts have taken digestive enzymes, including ''Terranova's Quercetin Nettle Complex'' which contains bromelain, without any obvious effect on their worms, [https://www.facebook.com/groups/htsupport/permalink/888731831182773/?comment_id=888738757848747&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] and one of these has regularly taken pancreatin-based products from different manufacturers, mostly from ''Pure Encapsulations'', but also a lipase product by ''Integrative Therapeutics''. Another hookworm host who regularly takes digestive enzymes but has never noticed any adverse effect on his colony, generally avoids papain and bromelain, but regularly takes pancreatin, lipase, ''Acid Ease'', and occasionally ''Udo's Choice'' enzymes. Udo's Choice brand does contain some bromelain, but only a small amount. [https://www.facebook.com/groups/htsupport/permalink/821478984574725/?comment_id=821502387905718&offset=0&total_comments=1&comment_tracking=%7B%22tn%22:%22R%22%7D] One NA host has reported that 500 mg bromelain twice daily appeared to be well tolerated by his hookworms, and someone else noticed no adverse effect on his NA colony after taking ''Enzymedica Digest Spectrum Multiple Food Intolerance Formula'' (amylase, xylanase, protease, alpha galactosidase, glucoamylase, lactase, lipase, maltase, cellulase, invertase, pectinase and hemicellulase). [https://www.facebook.com/groups/htsupport/posts/4876772765711973?comment_id=4879285832127333] And two other NA hosts have taken a product containing lipase (40,000 USP units), protease (126,000 USP units) and amylase (168,000 USP units) without issue. [https://www.facebook.com/groups/htsupport/posts/6285531644836071/?comment_id=6285909298131639]See also ✅[[#Papaya|Papaya]], and, for a brief explanation of how to stimulate one’s own natural enzyme production using a simple form of micro-massage, see [https://www.foodsmatter.com/nutrition_micronutrition/miscellaneous/articles/free_digestive_enzymes.html this article].

* [https://en.wikipedia.org/wiki/3,3%27-Diindolylmethane Diindolylmethane (DIM)]. 3,3′-Diindolylmethane has never been mentioned by hosts of human helminths as being harmful to their worm colonies, which is unsurprising because it’s a natural compound that is created in the body from the digestion of cruciferous vegetables such as cauliflower, broccoli and Brussels sprouts. Supplements containing DIM are simply a concentrated form of this natural substance.

* [https://en.wikipedia.org/wiki/Folic_acid Folic Acid] has been claimed to help prevent the proliferation of intestinal parasites at a dosage of 400 - 800 mcg (0.4 - 0.8 mg) per day. However, this is not a problem for human helminths because they do not proliferate within their hosts, and there have been no reports of adverse effects from hosts of human worms. One subject has taken a daily vitamin B-complex supplement containing 400 mcg of folic acid without any apparent effect on his hookworms, and another has taken 800 mcg of folate (as calcium L-5 methyltetrahydrofolate) every day for over 4 years with no adverse effect on his hookworms.

* [https://en.wikipedia.org/wiki/Fructooligosaccharide FOS] (fructooligosaccharide) is said to inhibit parasites from attaching to the intestines but no helminth host has reported any problem with this so far.

* [https://en.wikipedia.org/wiki/Fulvic_acid Fulvic acid]. This is a form of [https://en.wikipedia.org/wiki/Humic_acid humic acid] which two hookworm hosts have taken without any apparent adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/] [https://www.facebook.com/groups/htsupport/permalink/1132472786808675/?comment_id=1132930603429560&comment_tracking=%7B%22tn%22:%22R%22%7D]

* [https://en.wikipedia.org/wiki/Ginseng Ginseng]. Members of the genus, [https://en.wikipedia.org/wiki/Panax Panax], appear not to be harmful to human helminths, and one hookworm host has reported taking ginseng without noticing any untoward effect. [https://www.facebook.com/groups/htsupport/permalink/1453317641390853/?comment_id=1453345564721394&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Glucosamine Glucosamine] may be beneficial for roundworms. Applying this amino sugar experimentally to one roundworm species caused the treated worms to live around 5% longer than their untreated counterparts. [http://www.medicalnewstoday.com/releases/275263.php]

* [https://en.wikipedia.org/wiki/Glutathione Glutathione]. One hookworm host who has taken [https://en.wikipedia.org/wiki/Liposome liposomal glutathione] says he’s confident that this did not harm his worms, [https://www.facebook.com/groups/htsupport/permalink/803451913044099/?comment_id=803468529709104&offset=0&total_comments=6] and several people who have taken other oral glutathione supplements have reported no adverse effects. A hookworm host who received intravenous injections containing glutathione experienced no adverse effect on her NA colony. [https://www.facebook.com/groups/htsupport/permalink/1668651476524134/?comment_id=1668819739840641&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Grape_seed_extract Grape seed extract]. After taking 4 capsules of a product containing 200mg grape extract, 200mg grape seed extract and 200mg Muscadine grape every day for 2 weeks, one hookworm host carried out a successful incubation, indicating that the product had not adversely affected her colony. [https://www.facebook.com/groups/htsupport/permalink/2233069223415687/?comment_id=2282502821805660&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (Also see [[#Grapefruit seed extract (GSE)|Grapefruit seed extract (GSE)]], which can adversely affect human helminths in some people.)

* [https://en.wikipedia.org/wiki/Inulin Inulin] Knowing that chicory can have an adverse effect on human hookworms, a few hookworm hosts have been concerned when finding "inulin from chicory" listed among the ingredients in some supplements. However, while chicory root is a common source of inulin, its commercial processing removes everything but the fructose-based polysaccharide - the dietary fibre which is used in food supplements and to sweeten, or otherwise improve the nutritional value of, manufactured food products. Inulin is therefore not considered to be a threat to human helminths.

* [https://en.wikipedia.org/wiki/Iron Iron]. Supplementary iron taken orally does not harm helminths, but one hookworm host has reported having apparently lost her worms on two occasions after receiving ❓intravenous iron infusions. [https://www.facebook.com/groups/htsupport/permalink/2033546613367950/?comment_id=2033644093358202&reply_comment_id=2033832696672675&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

*❓Lumbricus Tonic. This discontinued [https://www.nutricology.com Nutricology] product contained a powdered earthworm extract as well as ⚡'''sweet flag''' root extract. The herb was last on the list of ingredients however, and there had been no reports by hosts of therapeutic helminths to suggest that the product might be a problem for worms.

* [https://en.wikipedia.org/wiki/Melatonin Melatonin]. This hormone, which is commonly used as a sleep aid, has been taken by many helminth hosts, none of whom have reported any adverse effects on their worm colonies.

* [https://en.wikipedia.org/wiki/Modified_citrus_pectin Modified citrus pectin] (also known as citrus pectin, Pecta-Sol, PectaSol and MCP) is a complex carbohydrate extracted from citrus fruits using a chemical extraction process that makes it soluble, absorbable and more digestible. This is unlikely to have any effect on helminths.

* [https://en.wikipedia.org/wiki/Moringa_oleifera Moringa] (Moringa oleifera, also known as drumstick tree, horseradish tree, ben oil tree and benzoil tree) Although described as a “natural anthelmintic”, moringa has been taken by two helminth self-treaters with no apparent adverse effect on their hookworms. The first takes a 500 mg capsule of 10 to 1 extract (from 5000 mg of Moringa olifeira) twice a week, [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1039406139448674&reply_comment_id=1039533526102602&comment_tracking=%7B%22tn%22:%22R4%22%7D] while the second grows and harvests her own moringa. [https://www.facebook.com/groups/htsupport/permalink/1039296249459663/?comment_id=1040747242647897&comment_tracking=%7B%22tn%22:%22R%22%7D] Whatever anthelmintic properties moringa might have may depend on the part of the plant used.

*❓[https://en.wikipedia.org/wiki/Methylsulfonylmethane MSM] (Methylsulfonylmethane) is claimed by one source to be effective against many types of intestinal worm including Enterobius (pinworm [US], threadworm [UK]) and the roundworm, Ascaris. It is suggested that MSM blocks the interface between the parasite and the host by competing with the parasite for binding sites at the surface of the mucous membrane, and that the parasites may find the resulting MSM 'film' impenetrable. However, it may be necessary to take 10,000 mg of MSM per day for three or four weeks to achieve this effect, and one helminth host has reported that he has occasionally taken up to 1 heaped tablespoon of MSM while hosting helminths to treat eczema flare-ups, and has not noticed any loss of worm benefits. Someone else who takes a heaped teaspoonful of equine MSM every other day has also reported observing no adverse effects on her NA. [https://www.facebook.com/groups/htsupport/posts/4170339756355281?comment_id=4174905152565408]

* [https://en.wikipedia.org/wiki/Nattokinase Nattokinase] This serine protease (or serine endopeptidase), which is taken as a nutritional supplement, is an enzyme that cleaves peptide bonds in proteins. Two NA hosts have reported taking 200 mg and 500 mg respectively twice daily with no adverse effect on their hookworm colonies.

* [https://en.wikipedia.org/wiki/Omega-3_fatty_acid Omega-3 fatty acid] supplements are taken regularly by a large number of people, and have not been reported to be harmful to any helminth species. Indeed, omega-3 fatty acids have been found to extend the lifespan of some worms. [https://pubmed.ncbi.nlm.nih.gov/28772063/]

*❓[https://en.wikipedia.org/wiki/Seaprose_S Oryzin] (Aspergillus alkaline proteinase, aspergillopeptidase B, API 21, aspergillopepsin B, aspergillopepsin F, Aspergillus candidus alkaline proteinase, Aspergillus flavus alkaline proteinase, Aspergillus melleus semi-alkaline proteinase, Aspergillus oryzae alkaline proteinase, Aspergillus parasiticus alkaline proteinase, Aspergillus serine proteinase, Aspergillus sydowi alkaline proteinase, Aspergillus soya alkaline proteinase, Aspergillus melleus alkaline proteinase, Aspergillus sulphureus alkaline proteinase, prozyme, P 5380, kyorinase, seaprose S, semialkaline protease, sumizyme MP, prozyme 10, onoprose, onoprose SA, protease P, promelase.) There have been no reports as yet about the possible effects on human helminths of taking this mould/mold-derived proteinase.

* [https://en.wikipedia.org/wiki/Palmitoylethanolamide Palmitoylethanolamide] (PEA) This is unlikely to harm NA, and one NA host who took it for a number of weeks has confirmed that it didn’t harm his worms. [https://www.facebook.com/groups/htsupport/posts/6318336784888890/?comment_id=6318488838207018]

* [https://en.wikipedia.org/wiki/Probiotic Probiotics]. There are many hosts of the human helminths, NA and TTO, who take probiotics regularly, in some cases several different ones each day, [https://www.facebook.com/groups/htsupport/permalink/2644164455639493/?comment_id=2645824198806852] yet there have been no reports by any of them that their worms have been adversely affected. [https://en.wikipedia.org/wiki/Akkermansia_muciniphila Akkermansia muciniphila] was initially suspected in two cases of having caused a loss of hookworms, but these events were more likely to have been the result of the extended adverse reaction that can often be experienced to this particular probiotic when it is first taken, can last for several weeks [https://www.facebook.com/groups/htsupport/posts/8333525306703351/?comment_id=8456943157694898&reply_comment_id=8459002264155654] and, in one case, may have lasted for a couple of months. [https://www.facebook.com/groups/htsupport/posts/8333525306703351?comment_id=8456943157694898&reply_comment_id=8459072834148597] It is known that a number of probiotics - predominantly Lactobacillus species - can have strain-specific effects on certain “parasites”, and, while most of these are not helminths, [https://www.hindawi.com/journals/jpr/2011/610769/] there is some evidence that the milk-based probiotics, lactobacilli and bifidobacteria, may reduce the benefits of HDC. [https://helminthictherapywiki.org/wiki/Self-treating_with_HDC#Probiotics] It is known that some bacteria are capable of mobilizing nematode-trapping fungi, [http://www.nature.com/articles/ncomms6776] and that Saccharomyces boulardii can have an adverse effect on the dog roundworm, Toxocara canis, [http://www.ncbi.nlm.nih.gov/pubmed/26971490] but S. boulardii and soil-based organisms are likely to be OK for HDC, and S. boulardii has been taken by at least two hookworm hosts without any obvious effect on their worms.

*❓[https://en.wikipedia.org/wiki/Propolis Propolis]. An apitherapist speaking at the 2010 International [http://www.bterfoundation.org BTeR Foundation] Conference on Biotherapy had spoken about the antiparasitic properties of this bee product, and suggested that it might harm helminths. Then, a paper published in 2020 revealed that Brazilian red propolis exhibits antiparasitic properties both in vitro and in vivo, and reduces worm burdens and egg production in a mouse model of infection by the helminth, Schistosoma mansoni. [https://pubmed.ncbi.nlm.nih.gov/32918996/] While this new research does not prove that propolis will be harmful to therapeutic helminths, it does make this possibility look more likely. However, one NA host has reported consuming propolis in the form of a dark brown chewing gum, without any obvious effect on his colony. He also reports that the content of propolis varies widely depending on the plants growing around the hive. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3465063380216259] This variation in constituents also results in propolis from different locations having different colours, and it's possible that the different colours might have differing effects on helminths, with green propolis ''possibly'' being the safest. [https://www.facebook.com/groups/htsupport/permalink/3465002256889038/?comment_id=3703669629688965]

* [https://en.wikipedia.org/wiki/Psyllium Psyllium] appears not to harm hookworms, and one NA host has reported taking 4 rounded tsp of Metamucil (containing powdered psyllium seed husks) every day without harming his colony. [https://www.facebook.com/groups/htsupport/permalink/3363462447043020?comment_id=3364793813576550]. However, psyllium is said to be effective in helping to remove parasite eggs from, and preventing parasites "taking root" in, the gut [https://gutbliss.com/psyllium-husk-a-complete-guide/] and there are indications from one TT host that his regular use of psyllium may be reducing his TT colony and preventing him from culturing this species.

* [https://en.wikipedia.org/wiki/Pyrroloquinoline_quinone Pyrroloquinoline quinone (PQQ)] This enzyme cofactor has been taken by several hookworm hosts without issue. [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248812458508040&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1248482738541012/?comment_id=1248893555166597&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Quercetin Quercetin]. Although identified as a promising lead candidate for development as an anthelmintic product, [https://www.nature.com/articles/s41598-025-34049-5] self-treaters have reported that, if taken on its own, quercetin does not harm therapeutic helminths. [https://www.facebook.com/groups/htsupport/permalink/2403427306379877/?comment_id=2404196192969655] [https://www.facebook.com/groups/htsupport/posts/5173747102681203?comment_id=5173760879346492] However, if it is combined with a digestive enzyme - as it often is, to improve absorption - helminths may be adversely affected. See entry for ⚡[[#Digestive enzymes|Digestive enzymes]].

* [https://intelligenceofnature.com/pages/restore Restore]. This supplement, the active ingredient in which is Terrahydrite, was used by someone reporting that her colony is normally particularly sensitive, but was unaffected when she took Restore for long periods. [https://www.facebook.com/groups/htsupport/permalink/1967905053265440/?comment_id=1967995116589767&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Resveratrol Resveratrol]. This may have an adverse effect on some helminths, [http://www.ncbi.nlm.nih.gov/pubmed/19562377] but this is likely to depend on dose size, and three hosts of human helminths who regularly take this compound report no adverse effect on their worms. One has taken “Perfect Resgrape Max” (400 mg trans-resveratrol) daily for many months with no apparent ill effects on her NA. [https://www.facebook.com/groups/htsupport/permalink/1803160683073212/?comment_id=1803255516397062&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (People with MS might want to avoid resveratrol anyway. [http://medicalxpress.com/news/2013-09-resveratrol-red-wine-worsens-ms-like.html])

* [https://en.wikipedia.org/wiki/S-Adenosyl_methionine S-Adenosyl methionine] (SAM, also known as SAMe, SAM-e or AdoMet) has only been reported on by one hookworm host, who observed no adverse effect on his worms after taking 200-400mg SamE per day for several months.

* [https://en.wikipedia.org/wiki/Serratiopeptidase Serrapeptase] (also known as serratiopeptidase, Serratia E-15 protease, serralysin, serratiapeptase, serratia peptidase, serratio peptidase, or serrapeptidase). This proteolytic enzyme (protease) has been taken occasionally by one TTO host two or three times per day over a 4 year period to treat intestinal spasm, without affecting her worms. [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357766200945998&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1357761264279825/?comment_id=1357787397610545&reply_comment_id=1385081271547824&comment_tracking=%7B%22tn%22%3A%22R%22%7D] It has also been taken (at 160k SPU [80mg] per day) for prolonged periods by a hookworm host with no apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2241120995943843/?comment_id=2242321465823796&reply_comment_id=2244261005629842&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* [https://en.wikipedia.org/wiki/Spirulina_(dietary_supplement) Spirulina]. This cyanobacterium is [http://www.ncbi.nlm.nih.gov/pubmed/25599112 an effective anti-inflammatory] that is being used by a number of hosts of human helminths without causing any harm to their worms. One hookworm host takes 10 grams of spirulina every day without noticing any deleterious effects on his colony. [https://www.facebook.com/groups/htsupport/permalink/2041940819195196/?comment_id=2043585499030728&comment_tracking=%7B%22tn%22%3A%22R%22%7D] However, it is worth noting that a significant proportion of algae-derived products tested in one study were found to contain an unhealthy amount of cyanotoxins caused by overgrowth of cyanobacteria due to the dumping of agricultural fertilisers into waterways. These bacterial products might not harm helminths, but they can contribute to neurological disorders like ALS in humans. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371831/]

* [https://en.wikipedia.org/wiki/Sulforaphane Sulforaphane / sulphoraphane] This organosulfur compound, which is obtained from cruciferous vegetables such as broccoli, Brussels sprouts and cabbages, has been taken in large amounts by one hookworm host without it affecting his colony. [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1724242074298407/?comment_id=1724765027579445&reply_comment_id=1724935230895758&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]

* [https://en.wikipedia.org/wiki/Taurine Taurine] is an organic acid that occurs naturally in food, especially seafood and meat (in which form it is no threat to helminths) but it is also produced synthetically and included in a number of products such as health drinks. In this form, it has been linked to a number of [https://web.archive.org/web/20201030111526/https://healthiertalk.com/dangers-taurine-commonly-found-energy-drinks-0996/ health problems], and has consequently been banned in some countries. It has also been shown to have anthelmintic effects, but only against a non-therapeutic helminth [http://www.ncbi.nlm.nih.gov/pubmed/23832642 in mice]. One helminth self-treater has taken 3 grams of taurine per day without any adverse effect on her hookworms. [https://www.facebook.com/groups/htsupport/permalink/2178145842241359/]

* [https://en.wikipedia.org/wiki/Theanine Theanine] This amino acid analogue is commonly known as L-theanine and sometimes L-gamma-glutamylethylamide or N5-ethyl-L-glutamine. It is not to be confused with threonine (a distinct amino acid), theine (an ancient name for caffeine) or thiamine (a B vitamin). Theanine is safe for use by helminth hosts. [https://www.facebook.com/groups/htsupport/posts/8722883501100861/?comment_id=8723517234370821]

* [https://en.wikipedia.org/wiki/Zinc Zinc] is said to inhibit the proliferation of intestinal parasites by stimulating various aspects of the immune system in the digestive tract that counteract parasites. In one animal study [http://jn.nutrition.org/content/130/5/1412S.full] the rodent nematode worm, H. polygyrus, was found to be better able to survive in mice which had been deliberately made deficient in zinc. Those who claim that zinc is an effective antiparasitic in humans suggest a dosage of 15-50 mg per day, but several helminth hosts have taken supplements containing this amount of zinc, in some cases continuously, without issue. One hookworm host takes 10 mg on alternate days, [https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930318850357404&comment_tracking=%7B%22tn%22:%22R0%22%7D],[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=930807120308577&comment_tracking=%7B%22tn%22:%22R%22%7D] another has taken 15 mg zinc gluconate or zinc picolinate daily for several years, while yet another has taken 23 mg zinc gluconate/citrate plus 18.75 mg zinc acetate daily, and previously took 30mg zinc picolinate daily[https://www.facebook.com/groups/htsupport/permalink/930029970386292/?comment_id=943449092377713&comment_tracking=%7B%22tn%22%3A%22R%22%7D], all without any apparent adverse effect on their worms. However, someone who was trying to grow his own hookworms had no success with incubation while he was taking a zinc supplement, the dose of which he had increased slowly to a maximum of 130 mg/day. Three weeks after he stopped all zinc intake, he found NA larvae in his incubations for the first time. [https://www.facebook.com/groups/678894952216125/posts/4716370328468547] ❌[https://en.wikipedia.org/wiki/Zinc_oxide%23ZnO_nanostructures Zinc oxide nanoparticles (ZnO NPs)] have shown strong anthelmintic effects, in vitro, against several gastrointestinal nematodes encountered in veterinary medicine. [http://www.ncbi.nlm.nih.gov/pubmed/26177503] [https://www.ncbi.nlm.nih.gov/pubmed/29975659] [https://www.ncbi.nlm.nih.gov/pubmed/31931890] As well as their topical use in sunscreens and cosmetics, zinc oxide nanoparticles are also used in some food products (in spite of the fact that they can cause DNA damage), but the amounts used in this application may be too small to harm human helminths.

* [https://en.wikipedia.org/wiki/Vitamin_A Vitamin A]. Supplementation with this vitamin has no adverse effect on helminths [https://www.ncbi.nlm.nih.gov/pubmed/25127885] but a vitamin A deficiency may reduce colonisation by worms. [https://www.ncbi.nlm.nih.gov/pubmed/24458645]

* [https://en.wikipedia.org/wiki/Vitamin_C Vitamin C]. This does not harm helminths, even in high doses.

* Xuezikhang, a [https://en.wikipedia.org/wiki/Red_yeast_rice red yeast rice] product, appears to be harmless to hookworms. [https://www.facebook.com/groups/htsupport/permalink/1347982335257718/?comment_id=1348392021883416&comment_tracking=%7B%22tn%22%3A%22R%22%7D]
</blockquote>



=== Spices and culinary herbs ===
<blockquote>

* ❓ [https://en.wikipedia.org/wiki/Annatto Annatto / roucou] (Bixa orellana). One in vitro study found that higher concentrations of extracts of B. orellana seeds were effective against the earthworm species, Eisenia fetida, [https://www.researchgate.net/publication/356635196_Evaluation_of_Antihelminthic_Activity_of_Bixa_orellana] but it was not tested in intestinal helminths. There has been a single claim [https://www.reddit.com/r/HelminthicTherapy/comments/wmm6im/caution_annatto_can_harm_na] by an NA host of a return of disease symptoms shortly after starting to take an annatto and rice dietary supplement containing a high concentration of delta-tocotrienol, a form of vitamin E: [https://tricutis-shop.de/DeltaTop-delta-Tocotrienol DeltaTop delta-Tocotrienol].

* ❓ [https://en.wikipedia.org/wiki/Asafoetida Asafoetida] has been used as an anthelmintic in traditional medicine in several parts of the world [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459456/] but there has only been one report to date of its use by someone hosting therapeutic helminths, and this user says that he hasn’t noticed any ill effect on his hookworms after occasionally consuming foods that list asafoetida as an ingredient.

* ✅ [https://en.wikipedia.org/wiki/Basil Basil] Ocimum basilicum, also called great basil, is a culinary herb in the family Lamiaceae (mints) used in cuisines worldwide. In Western cuisine, the generic term "basil" refers to the variety also known as Genovese basil or sweet basil, of which there are many cultivars, including Napolitano basil, also known as Napoletano basil, Neapolitan basil, Mammoth basil, Bolloso Napoletano basil, Napolitano Mammoth-Leafed basil and Italian Large-Leaf basil. Several hookworm hosts have eaten basil and drunk tea made from it without any harm befalling their worms [https://www.facebook.com/groups/htsupport/permalink/872768092779147/?comment_id=872772372778719&offset=0&total_comments=2&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7987286861327199?comment_id=7987574677965084] [https://www.facebook.com/groups/htsupport/posts/7987286861327199/?comment_id=7992929767429575] ❓[https://en.wikipedia.org/wiki/Ocimum_tenuiflorum '''Holy basil'''] (Ocimum tenuiflorum, also known as Ocimum sanctum, tulsi and tulasi/thulasi) is claimed online to be antiparasitic. There is also evidence showing that its essential oil has potent anthelmintic activity, including against the research worm, C. elegans, [http://www.ncbi.nlm.nih.gov/pubmed/11543966] and it has shown some activity against the malaria parasite, [http://www.ncbi.nlm.nih.gov/pubmed/21643655] but there is no indication yet as to how Holy Basil might affect human helminths. Holy Basil is used for religious purposes, in traditional medicine and Ayurveda. It is also used for its essential oil and is widely used as an herbal tea.

* ⚡ [https://en.wikipedia.org/wiki/Black_pepper Black pepper] (Piper nigrum). This is often used as an ingredient in proprietary parasite cleanses due to its established antiparasitic effects. It could therefore have an adverse effect on human helminths, though this is likely to be dependent on the dosage and on the form taken. So, while use of the whole spice in small quantities as a condiment is unlikely to present a problem, taking medicinal quantities of black pepper may harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Bunium_bulbocastanum Bunium bulbocastanum] This vegetable/spice, which is commonly called black cumin, great pignut, black zira or earthnut, is thought to be harmless to helminths when consumed in dietary quantities.

* ⚡ [https://en.wikipedia.org/wiki/Cayenne_pepper Cayenne] (Cayenne pepper is a type of [https://en.wikipedia.org/wiki/Capsicum_annuum Capsicum annuum], and cayenne powder is generally made from [https://en.wikipedia.org/wiki/Bird%27s_eye_chili bird's eye chili peppers], which are classified as [https://archive.org/details/spiceshenry00ridlrich/page/360/mode/2up?view=theater Capsicum minimum] and often mistaken for the similar-looking [https://en.wikipedia.org/wiki/Capsicum_frutescens Capsicum frutescens], cultivar [https://en.wikipedia.org/wiki/Siling_labuyo siling labuyo], the fruits of which are generally smaller and grow in an upwards direction.) Cayenne is claimed to irritate parasites, and often appears as an ingredient in proprietary parasite cleansing products for pets and humans. There have been a couple of reports of an adverse effect on hookworms, including from someone who says that even a smidgen of cayenne causes her to temporarily lose the benefits from her worms. [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1063030367086251&reply_comment_id=1063315093724445&comment_tracking=%7B%22tn%22:%22R1%22%7D] Someone else who has reported a loss of benefits after taking a "lot" of cayenne, has said that their benefits also returned after they stopping taking the cayenne. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1951836918205587&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1951098958279383&reply_comment_id=1956996454356300&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another cayenne user who reported that, in her early days with NA, she topped some meals with about ⅛ tsp of cayenne, has said that, in her case, the worms seemed to be unaffected. [https://www.facebook.com/groups/htsupport/permalink/1950621241660488/?comment_id=1952375724818373&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Chili_pepper Chili pepper] (chile, chile pepper, chilli pepper, or chilli). While this is used worldwide as a treatment of certain parasites, and has been demonstrated effective against fascioliasis in animals, evidence that chili might be a problem for therapeutic helminths is lacking. One hookworm host has reported that, while cayenne has had negative responses for him, chilli peppers have not been a problem in his experience, [https://www.facebook.com/groups/htsupport/posts/892904287432194?comment_id=6868887949833768] and nor have jalapenos, whether fresh or pickled. [https://www.facebook.com/groups/htsupport/posts/6863122353743661/?comment_id=6868980269824536] Another hookworm host has been reported [https://www.facebook.com/groups/htsupport/permalink/892904287432194/?comment_id=892912737431349&offset=0&total_comments=7&comment_tracking=%7B%22tn%22:%22R0%22%7D] to have eaten a HUGE amount of chili during 4 years as a worm host, without any obvious adverse effect on his colony.

* ⚡ [https://en.wikipedia.org/wiki/Cinnamon Cinnamon] is antimicrobial, as well as being claimed to be effective against parasites, including some parasitic worms, and it appears in lists of ingredients in proprietary parasite cleansing products. The main antimicrobial component of cinnamon is ⚡[https://en.wikipedia.org/wiki/Cinnamaldehyde cinnamaldehyde], and this is most concentrated in cinnamon essential oil and cinnamon oleoresins (solid resin extracts produced using solvents) which can be very high in cinnamaldehyde. Forms containing somewhat less cinnamaldehyde are raw cinnamon and cinnamon tinctures which are dissolved in alcohol and about half the strength of raw cinnamon. As cinnamaldehyde is steam-volatile and not water soluble, aqueous extracts of cinnamon should contain less of this substance, and dehydrated/powdered extracts (the form most likely to be encountered in dietary supplements) may contain little, if any at all, so should be less of a threat to helminths. [https://www.facebook.com/groups/htsupport/permalink/2225192197536723/?comment_id=2226458237410119&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Generally, the stronger the taste, the more cinnamaldehyde is likely to be present. While the raw spice is generally safe for use in cooking, there has been one report of someone with helminths relapsing after taking an unspecified supplement containing cinnamon, (link expired) and another report of a return of symptoms after eating a rice pudding made with cinnamon. (Link expired)

* ⚡ [https://en.wikipedia.org/wiki/Clove Clove] (Syzygium aromaticum/Eugenia caryophyllus). Clove oil, which was used traditionally to kill intestinal worms and is claimed to anesthetize fish, contains several powerful antimicrobial agents. While one of these, [https://en.wikipedia.org/wiki/Eugenol eugenol], is claimed to be anthelmintic, its use didn't produce any loss of benefit in one helminth host who applied it liberally to a dry socket following a difficult tooth extraction, and this was in spite of swallowing and breathing eugenol and a related compound called guaiacol.

* ✅ [https://en.wikipedia.org/wiki/Cumin Cumin] (Cuminum cyminum) also known as Roman caraway. While the essential oil derived from this spice has shown efficacy against [https://en.wikipedia.org/wiki/Anisakis Anisakis], a nematode that parasitises fish and marine mammals, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6130707/] dietary use of the spice is thought to be harmless to human helminths. But see also, ❌ [[#Bitter cumin|Bitter cumin]], ❌ [[#Black cumin|Black cumin]] and Bunium bulbocastanum (sometimes also called black cumin).

* ❓[https://en.wikipedia.org/wiki/Elwendia_persica Elwendia persica] (aka Bunium persicum, a close relative of Bunium bulbocastanum). The possible effect of this plant on helminths is as yet unknown.

* ✅ [https://en.wikipedia.org/wiki/Fennel Fennel] (Foeniculum vulgare). Fennel seed has a long history of use against pinworms and other parasites, with some authorities suggesting that the herb digests parasite eggs and intoxicates parasites. The leaves and oil are both used as dewormers, but one subject has reported no adverse effect from repeated consumption of dietary amounts of fennel seeds (link expired) and another has reported [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ no loss of worm benefits] after consuming significant quantities of fennel.

* ⚡ [https://en.wikipedia.org/wiki/Fenugreek Fenugreek] (Trigonella foenum-graecum). Both the leaves and seeds of fenugreek have been reported to have anthelmintic properties. Alcoholic extracts of the seeds have shown a dose-dependent inhibition of motility (paralysis) in earthworms, [https://www.researchgate.net/publication/49600762_In_vitro_anthelmintic_activity_of_Fenugreek_seeds_extract_against_Pheritima_posthuma] and an aqueous extract of fenugreek leaves has also shown noteworthy anthelmintic activity against earthworms. [https://www.researchgate.net/publication/303787324_In-vitro_anthelmintic_activity_of_fenugreek_leaves_aqueous_extract_in_Indian_earthworms] After taking half a teaspoon of powdered fenugreek seeds every day for a week, one hookworm host found that his allergies returned with a vengeance. [https://www.facebook.com/groups/htsupport/permalink/1426906954031922/] However, another hookworm host ate about 150 grams of fenugreek leaves in a 2 week period without affecting his worms. [https://www.facebook.com/groups/htsupport/permalink/1406562676066350/?comment_id=1406580359397915&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Garam_masala Garam Masala] The constituents of this blend of ground spices vary between geographical regions, but the majority of the commonly used ingredients do not have anthelmintic properties, thus minimising the anthelmintic potential of any blend that might include one or two items that could be harmful to worms when used on their own. So garam masala is very unlikely to harm helminths.

* ✅ Garlic (Allium sativum). Garlic compounds have demonstrated anthelmintic activity against flatworms in mice, [https://www.ncbi.nlm.nih.gov/pubmed/28536879] garlic oil extract has shown anthelmintic effects against Schistosoma mansoni in mice [http://www.sciencedirect.com/science/article/pii/S1995764515002011] and allicin, the active principle of garlic extract, has also been shown to have anthelmintic properties, although one hookworm host has reported that taking a stabilized allicin extract for several weeks did not kill her worms. [https://www.facebook.com/groups/htsupport/permalink/859756094080347/?comment_id=1146360268753260&comment_tracking=%7B%22tn%22:%22R3%22%7D] Alcoholic extracts of garlic have also shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424]. However, the exact amount of garlic needed to kill intestinal parasites in humans has not been established. Some sources suggest 1,000 - 4,000 mg per day, using concentrated garlic capsules or tablets, and fresh garlic is said to be more effective than capsules. While chewing three cloves of garlic each day is recommended by some online sources as a treatment for ‘parasites’ in humans, the ingestion of 9 to 14 g of raw garlic daily (54 g total) or 15 to 21 g daily (89 g total) had no evident effect on the egg output of NA in one host, [http://www.ajtmh.org/content/journals/10.4269/ajtmh.1969.18.920] so hookworms may in fact be able to withstand up to 21 grams (approximately 10 cloves) of garlic per day. This means that garlic is unlikely to be an effective killer of mature worms, and its main anthelmintic effect may be to reduce the viability of ova. Cooking may reduce its effect against parasite eggs and larvae, but neither cooked or raw garlic appears to have any adverse effect on the efficacy of a therapeutic hookworm colony.


* ⚡ [https://en.wikipedia.org/wiki/Ginger Ginger] (Zingiber officinale) contains a chemical called zingibain (aka. zingipain, or ginger protease) that has been claimed to dissolve some parasites and their eggs, and numerous hookworm hosts have reported adverse effects after consuming ginger. One subject reported that fresh ginger drinks depress the egg production of his worms and increase his disease symptoms, and another has reported that eating a LOT of ginger 6 weeks post-inoculation caused her hookworm side effects to disappear for a few days, but that these eventually returned. A similar response was noted by someone who was in the habit of adding ginger to sushi platters. She found that this seemed to knock the worms out for a while but that they eventually recovered. [https://www.facebook.com/groups/htsupport/permalink/2249000525155890/?comment_id=2266705326718743&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Another hookworm host has found that, while consuming powdered or cooked ginger isn’t a problem for him, drinking ginger tea, or any form of kombucha made with raw ginger will stun his worms badly and result in a return of disease symptoms the next day. [https://www.facebook.com/groups/htsupport/posts/4390196884369566/?comment_id=4395716387150949] Someone else, who said that his favorite brand of ginger beer was “pretty spicy”, so was probably made from raw, or only very briefly pasteurized, ginger juice, reported that, after going on a fairly significant binge of the stuff, his worms stopped producing eggs and their benefits diminished. Yet another worm host, who was putting at least a thumb-sized piece of fresh ginger in a smoothie every day, believes this was responsible for actually killing her hookworms. Others have also had issues with ginger, e.g., [https://www.facebook.com/groups/htsupport/permalink/2337067596349182/] [https://www.facebook.com/groups/htsupport/posts/9292445040811368?comment_id=9295039130551959]. However, one subject has reported eating lots of fresh ginger (mostly cooked) without any problems, and several others have reported a similar lack of issues with ginger. [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] [https://www.facebook.com/groups/htsupport/permalink/1568726056516677/?comment_id=1568873536501929&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1763989756990305/?comment_id=1764057080316906&comment_tracking=%7B%22tn%22%3A%22R%22%7D] One hookworm host says that she regularly takes dried ginger in 1g doses to help with migraines and has not noticed any problems with her worms, [https://www.facebook.com/groups/htsupport/permalink/1062770903778864/?comment_id=1062777610444860&reply_comment_id=1062782733777681&comment_tracking=%7B%22tn%22:%22R%22%7D] and another routinely takes 550 mg of ginger root powder every morning without any obvious effect on either his hookworms or his human whipworms.

* ❓ [https://en.wikipedia.org/wiki/Horseradish Horseradish] (Amoracia rusticana) has been claimed to be antiparasitic, and it does contain volatile oils, notably [https://en.wikipedia.org/wiki/Mustard_oil mustard oil], which has antibacterial properties and is used as an antiparasitic by some farmers, but evidence about the effects of its use by helminth hosts is lacking.

* ❓ [https://en.wikipedia.org/wiki/Mustard_(condiment) Mustard]. This condiment is claimed to be effective against intestinal worms, including roundworms and threadworms and, in India, [https://en.wikipedia.org/wiki/Mustard_oil mustard oil] is used as an antiparasitic by some farmers. However, its action is probably more as a laxative that helps to flush out worms rather than to kill them, and hookworms spend much of their time firmly attached to the gut mucosa. One hookworm host has reported taking about 2 grams of ground mustard seeds most days, with no adverse effect on his worms or their egg production. [https://www.facebook.com/groups/htsupport/permalink/1958129950909617/?comment_id=1958255070897105&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Nutmeg Nutmeg] (Myristica fragrans, or fragrant nutmeg). This spice, which is obtained by grinding the seed of this tree, (mace is produced from the seed covering) is not harmful to helminths when used as a culinary flavour.


* ❌ [https://en.wikipedia.org/wiki/Oregano Oregano] (Origanum vulgare). Oregano oil, which contains isomeric phenols (primarily carvacrol but also including thymol and limonene), can destroy a number of bacteria, fungi and viruses in dilutions as low as 1/50,000, and is also antiparasitic. It is reported to be effective against protozoan parasites in particular as well as roundworm larvae, and somewhat effective against tapeworms. In one study [http://www.chirochat.org/article_files/Article-2953.pdf], 57 per cent of adults with intestinal parasites who were treated with 600 mg of oregano oil daily for six weeks experienced total eradication of their parasites. Several hosts of therapeutic helminths have reported adverse effects on their worms after ingesting oregano oil and, in at least two cases, it has resulted in a total loss of worms. However, one subject, who took oil of ''wild'' oregano sublingually twice each day for 2 weeks had a stool test sometime after this that was positive for hookworms, so perhaps either the wild form of the herb, or the sublingual route, helped reduce the effect on the worms in this case. Some foods, particularly soft cheeses, may be coated with an [http://www.sciencedaily.com/releases/2014/11/141127082311.htm antimicrobial film incorporating oregano oil] to increase their lifespan, but the amount of oregano involved in this application is unlikely to be a serious threat to helminths. A few '''oregano ''leaves''''' eaten with food are less likely to be harmful to human helminths [https://www.facebook.com/groups/htsupport/permalink/2545907775465162/?comment_id=2545955292127077], but one host of both hookworms and whipworms has reported that, while there was no immediate effect on his worms when he applied a ''heavy'' sprinkling of oregano leaf powder to his food a couple of times in a day, he was later plunged into such a self-critical and depressed mood that, before eventually regaining his usual mental balance, he struggled to do any work for several days.

* ✅ [https://en.wikipedia.org/wiki/Saffron Saffron] This spice is derived from the flower of crocus sativus, commonly known as the "saffron crocus". (See separate entry for this herb.) One hookworm host took a supplement containing turmeric and saffron for 6 weeks without any adverse effect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/]

* ✅ [https://en.wikipedia.org/wiki/Thyme Thyme] (Thymus vulgaris). This is also known as Common Thyme, Garden Thyme. Extracts of the leaves, flowering tops and stems are used to kill hookworms, roundworms, threadworms and skin parasites. However, these are unlikely to harm helminths when eaten in reasonable amounts as part of a normal diet. One helminth host has [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ eaten significant quantities of thyme] without noticing any adverse effect on her hookworm or whipworm populations.


* ✅ [https://en.wikipedia.org/wiki/Turmeric Turmeric] (Curcuma longa), also known as tumeric, generally does not harm human helminths when eaten in food in its natural, whole form, which only contains 3% of the active ingredient, curcumin, [https://www.facebook.com/groups/htsupport/permalink/544122108977082/] or when it is taken in capsules, e.g., as a daily dose of 25 g turmeric (delivering 700 mg curcumin), [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/] or as a dose of 580 mg turmeric extract delivering 551 mg curcuminoids daily. [https://www.facebook.com/groups/htsupport/permalink/3303438489712083/?comment_id=3304307169625215] There have only been two reports of food quantities of turmeric affecting hookworms. The first of these is [https://www.facebook.com/groups/htsupport/permalink/1084044901651464/?comment_id=1084640204925267&comment_tracking=%7B%22tn%22:%22R%22%7D here], and the second was by an individual who boiled and ground turmeric powder into a paste and twice drank a large quantity of this (2 tbsp) in her tea. She subsequently experienced a return of her old symptoms, all of which persisted. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] There is much more chance of helminths being harmed when ⚡[https://en.wikipedia.org/wiki/Curcumin curcumin] is extracted from the turmeric and taken in medicinal quantities. It has been reported that 300 mg of curcumin extract has killed some types of parasites in test tube and animal studies, and that it may temporarily reduce the number of helminth eggs produced. One hookworm host believes that she may have lost her colony as a result of taking a curcumin supplement. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=794226897299934&offset=0&total_comments=11] However, another hookworm host has reported experiencing a very enjoyable “bounce” (indicating a healthy NA colony) after inoculating, in spite of taking 250 mg of curcumin daily. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/] As with other substances that can affect hookworms, the effect of curcumin may depend to some extent on the strength of the individual host’s immune response, as well as on the form of curcumin used. Nano-emulsified curcumin appears to be more effective, therapeutically, [https://www.sciencedaily.com/releases/2014/11/141106113204.htm] so may also have an increased detrimental impact on helminths. Another high-potency form of curcumin is BCM-95, which has been shown to be 6.93 times more bioavailable than normal curcumin, [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2792534/] and this product may have been responsible for a sudden return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/792892197433404/?comment_id=808508489205108&offset=0&total_comments=21&comment_tracking=%7B%22tn%22:%22R1%22%7D] The beneficial effect of curcumin can be increased 5- to 10-fold by adding ascorbic acid (vitamin C) [http://www.sciencedirect.com/science/article/pii/S0308814612001744] so taking this vitamin along with curcumin might make it possible to use curcumin therapeutically in much smaller doses (ascorbic acid does not harm helminths), although this vitamin may increase curcumin's adverse effect on helminths if the quantity of the spice is not reduced proportionately.

* ❓ [https://en.wikipedia.org/wiki/Wild_Turmeric Turmeric, Wild] (Curcuma aromatica). While alcoholic extracts of the rhizomes of wild turmeric have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in [http://www.ncbi.nlm.nih.gov/pubmed/1158424 test tube studies] and extracts of the rhizomes may therefore also have an adverse effect on other helminths, it is likely that consuming dietary amounts of this spice will do no harm to human helminths, though this has not yet been confirmed.
</blockquote>

=== Herbs and medicinal plants===

The majority of the herbs listed below have been reported, or claimed, to be antiparasitic, although clinical evidence for this effect is lacking in many cases. Furthermore, where they are indeed antiparasitic, herbs may be more effective against types of parasite other than helminths, although this is not to say that they may not also have some detrimental effect on helminths.

Where a herb is effective against helminths, quite large quantities may be required to dislodge or kill the worms, but consuming some of these herbs on a regular basis, or in the form of concentrates, extracts, tinctures and oils that are directed at the gastrointestinal tract may weaken therapeutic helminths, making them less effective.

It should not be assumed, from a cursory glance at the following list, that most herbs are potential threats to human helminths. This list only contains those herbs that have been mentioned specifically by self-treaters, and there are less than 100 herbs in the entire list. Many thousands of compounds are used in herbal medicine, so it will usually be possible to find a more hookworm-friendly alternative for whatever purpose one has in mind.

Many of the herbs listed below are used to treat a number of conditions in addition to parasite infections, so might be encountered in a range of herbal remedies. It may therefore be advisable for any helminth host who contemplates taking any herbal remedy to check its ingredients against the list below and, where an ingredient appears to have antiparasitic properties, to seek an alternative, if possible.

When taking herbs, an additional risk arises from the fact that the majority of herbal products [http://www.medicalnewstoday.com/releases/267363.php contain unlisted ingredients], in view of which it would seem wise to employ a cautious approach with all herbal products.

==== List of herbs and medicinal plants ====

{{Columns|2}}
* ⚡ [https://en.wikipedia.org/wiki/Acacia Acacia]. Also known as thorntree, [https://en.wikipedia.org/wiki/Whistling_thorn whistling thorn], or wattle. One example of this genus of shrubs and trees, ([https://en.wikipedia.org/wiki/Acacia_mollissima Acacia mearnsii], previously known as Acacia molissima) contains tannin extracts that have been found to have an [http://www.sciencedirect.com/science/article/pii/S0377840107003641 anthelmintic effect] on Haemonchus contortus and Trichostrongylus colubriformis in lambs. For a more detailed consideration of the possible effects of tannins on nematodes, see these papers: [https://www.ncbi.nlm.nih.gov/pubmed/28426037] [https://pubmed.ncbi.nlm.nih.gov/36344622/].

* ❌ [https://en.wikipedia.org/wiki/Ajwain Ajwain] contains thymol (see separate reference), which appears to be the primary constituent of the essential oil extracted from ajwain "seeds" (actually a seed-like fruit). Ajwain may therefore be harmful to human helminths if consumed in the form of ajwain "seeds" or the oil extracted from them, but it ''may'' be less harmful if only the leaves are eaten.

* ⚡ [https://en.wikipedia.org/wiki/Albizia_lebbeck Albizia lebbeck]. Alcoholic extracts of the bark of Albizia lebbeck have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the bark may also have an adverse effect on other helminths.

* ✅ [https://en.wikipedia.org/wiki/Aloe_vera Aloe vera]. This contains an antimicrobial agent, [https://en.wikipedia.org/wiki/Saponin saponin], and the laxative chemical, [https://en.wikipedia.org/wiki/Aloin aloin]. Aloe is perhaps the best known laxative in history, and it may be this, rather than any actual anthelmintic property, that is the source of its reputation for expelling parasites. While extracts have been reported as showing inhibitory effects on two roundworm species, these only affected the hatching of eggs and the development of larval stages. One aloedrinking helminth host has reported that his habit has had no obvious detrimental effect on his worms, and another hookworm host failed to notice any adverse effects after drinking pure aloe juice or gel daily for a week or two, or after drinking one of the 16oz sweetened/flavored drinks. [https://www.facebook.com/groups/htsupport/permalink/803451913044099/]

* ⚡ [https://en.wikipedia.org/wiki/Alpinia Alpinia calcaratta]. Alcoholic extracts of the rhizomes of Alpinia calcaratta have shown ‘moderate’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Alpinia_galanga Alpinia galanga]. Alcoholic extracts of the rhizomes of Alpinia galanga have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of these rhizomes may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Andrographis_paniculata Andrographis paniculata] (also known as creat, green chiretta; active component: andrographolide). Alcoholic extracts of Andrographis paniculata have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies. [http://www.ncbi.nlm.nih.gov/pubmed/1158424] Andrographolide has also shown significant ovicidal and larvicidal activity against the human hookworm, [[Ancylostoma duodenale | '''Ancylostoma duodenale''']]. [https://pubmed.ncbi.nlm.nih.gov/30763693/]

* ⚡ [https://en.wikipedia.org/wiki/Anise Anise] (Pimpinella anisum). Also known as aniseed. Anise oil may have modest antiparasitic effects and has been recommended by some practitioners as a treatment for mild intestinal parasite infections, but there have not been any reports about this from helminth hosts.

* ❌ [https://en.wikipedia.org/wiki/Arecoline Arecoline]. This odourless oily liquid derived from the areca nut, fruit of the areca palm ([https://en.wikipedia.org/wiki/Areca_catechu Areca catechu]), has long been used medicinally as an anthelmintic.

* ✅ [https://en.wikipedia.org/wiki/Ashwagandha Ashwagandha] (Withania somnifera). Also known as Indian ginseng, poison gooseberry, and winter cherry. Several hookworm self-treaters have reported using ashwagandha without issue. One NA host has reported that taking 380mg ashwagandha root and 95mg ashwagandha root extract twice each day for a month appeared not to affect her worms. [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832855323437081&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Someone else takes 450 mg ashwagandha x2 per day and reports that his NA are fine, [https://www.facebook.com/groups/htsupport/permalink/2416283988427542/?comment_id=2431728343549773&reply_comment_id=2432787723443835] and a third hookworm host has taken 500mg ashwagandha twice a day without any adverse effect on their worms. [https://www.facebook.com/groups/htsupport/permalink/1874049555984324/?comment_id=1875375212518425&comment_tracking=%7B%22tn%22%3A%22R%22%7D] A naturopathic doctor has also reported that ashwagandha is OK to take while hosting hookworms, [https://www.facebook.com/groups/htsupport/permalink/1831773386878608/?comment_id=1832031526852794&reply_comment_id=1833267093395904&comment_tracking=%7B%22tn%22%3A%22R%22%7D] and someone who is self-treating with human whipworms (TT) has reported that taking a teaspoon of ashwagandha every day did not have any apparent effect on this species. (Also see the list of concerns and contraindications regarding Ashwagandha in [https://www.facebook.com/groups/htsupport/posts/6319449901444245/ this Facebook post].)

*❓ [https://en.wikipedia.org/wiki/Astragalus Astragalus]. A chloroform extract of the Astragalus species, [https://powo.science.kew.org/taxon/urn:lsid:ipni.org:names:477246-1 Astragalus ecbatanus], has been shown to have anthelmintic effects against the protoscoleces (the scoleces of the larval form of tapeworms) of the helminth, [https://en.wikipedia.org/wiki/Echinococcus_granulosus Echinococcus granulosus]. [https://pubmed.ncbi.nlm.nih.gov/36457771/]. However, there have been no reports that either of the forms of astragalus that are sold as food supplements ([https://en.wikipedia.org/wiki/Astragalus_propinquus Astragalus membranaceus/Astragalus propinquus] and Astragalus mongholicus) has had an adverse effect on any of the therapeutic helminths.

* ✅ Bacognize. One hookworm host has taken 300 mg daily of this [https://en.wikipedia.org/wiki/Bacopa_monnieri Bacopa monnieri] whole herb extract, standardized to 12% bacopa glycosides, without any adverse effect on his colony.

* ⚡ [http://www.botanical.com/botanical/mgmh/b/balmon04.html Balmony] (Chelone glabra) A decoction or tincture prepared with all parts of the plant is said to be a highly effective remedy for parasites, including intestinal worms. It was used traditionally by Native Americans to expel worms and is used today in proprietary parasite cleansing preparations.

* ⚡ [https://en.wikipedia.org/wiki/Barberry Barberry] (Berberis vulgaris) contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_bellirica Beleric] (Terminalia bellirica/Terminalia bellerica). Also known as bastard myrobalan or Bahera. This herb is said to be anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ⚡ [https://en.wikipedia.org/wiki/Berberine Berberine] is an amebicide which, in concentrated form, has been shown to kill various parasites such as tapeworms and giardia and to have anti adhesive effects which prevent pathogens from adhering to intestinal mucosal cells. One hookworm host who took one gram of berberine three times a day has reported being pretty sure that this killed his worms. [https://www.facebook.com/groups/htsupport/permalink/1803353316387282/?comment_id=1807383979317549&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Bidens_alba Bidens alba] has been reported as not being a problem for helminths.

* ✅ [https://species.wikimedia.org/wiki/Nymphaea_nouchali Blue Lotus]. Nymphaea nouchali - an aquatic flower also known as red and blue water lily, blue star water lily and star lotus - and its varieties, Nymphaea caerulea (blue Egyptian water lily) and Nelumbo nucifera (Indian lotus, sacred lotus, bean of India, lotus) are not thought to be harmful to helminths. These plants do contain various bioactive compounds such as alkaloids, flavonoids and glycosides, some of which may have antimicrobial or antiparasitic properties against bacteria, fungi, or protozoa, but there is no direct evidence to suggest that any of these compounds might be specifically harmful to helminths.

* ❌ [https://biocidin.com/products/biocidin-liquid-formula Biocidin] is a proprietary herbal blend that includes oregano oil and black walnut, both of which are known to have anthelmintic effects. See the separate entries for these two herbs.

* ❌ [http://scialert.net/fulltext/?doi=ijp.2013.211.226 Bitter cumin] (Centratherum anthelminticum). As its Latin name suggests, the seeds of this member of the daisy family are considered anthelmintic.

* ⚡ [https://en.wikipedia.org/wiki/Bitter_melon Bitter melon] (Momordica charantia) is used as a folk medicine to treat gastrointestinal diseases, and extracts have shown activity against the nematode worm C. elegans in test tube studies[http://www.sciencedirect.com/science/article/pii/S0378874104003770].

* ⚡ [https://en.wikipedia.org/wiki/Juglans_nigra Black walnut] (Juglans nigra). Also known as eastern black walnut. This nut has been claimed to be one of the best overall dewormers for humans, killing both the adult and developmental stages of at least 100 parasites. However, according to the American Cancer Society, available scientific evidence does not support claims that the hulls of the black walnut remove intestinal parasites. Although this nut has a strong flavour, it is actually quite rare, as its shell is hard and difficult to remove. It is therefore only likely to be encountered in expensive baked goods. Most commercially available walnuts are hybrids of the ✅'''English walnut'''. "Commerically-sold walnuts will be English unless specified. The taste and appearance of black walnuts is different too." [https://www.facebook.com/groups/htsupport/posts/7955684137820805/?comment_id=7955710474484838] "Black walnuts are very, VERY rare to find in stores, and 100% this will be specified. 'Walnuts' are ALWAYS English walnuts unless otherwise stated." [https://www.facebook.com/groups/htsupport/posts/7955684137820805?comment_id=7955725021150050]

* ✅ [https://en.wikipedia.org/wiki/Boswellia Boswellia] is a fragrant resin, extracts of which are used in pharmacology, particularly as anti-inflammatories. There have been no suggestions that boswellia might be a problem for helminths, and its anti-inflammatory action could be supportive of the beneficial effects that helminths produce, as demonstrated in Crohn’s disease in this study. [http://www.ncbi.nlm.nih.gov/pubmed/11215357]

*❓[https://en.wikipedia.org/wiki/Bougainvillea_spectabilis Bougainvillea spectabilis.] Also known as great bougainvillea, this plant, which is used to make a tea, has shown dose-dependent anthelmintic effects against the earthworm, Pheretima posthuma. [https://ijppr.humanjournals.com/wp-content/uploads/2020/04/2-IN-VITRO-ANTHELMINTIC-ACTIVITY-OF-CRUDE-EXTRACT-OF-FLOWERS-OF-BOUGAINVILLEA-SPECTABILIS-WILD-AGAINST-PHERETIMA-POSTHUMA.pdf] This effect is thought to result from the plant’s phytochemical constituents, which are believed to damage the mucopolysaccharide layer of worms, leading to paralysis and death. However, while this effect has been demonstrated in a laboratory, bougainvillea does not appear to have been used traditionally as an anthelmintic, and there have been no reports from helminthic therapy self-treaters of any adverse effect on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Breadfruit Breadfruit] (Artocarpus altilis)) A methanol-water fraction of this plant has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 9.5 hours, compared with 35 hours taken by albendazole. Aqueous methanol extracts took 49 hours. [https://www.researchgate.net/publication/21072595]

* ❌ [https://en.wikipedia.org/wiki/Acorus_calamus Calamus/Sweet Flag] (Acorus calamus) The bitter element in sweetflag, acorin, is claimed to have anthelmintic properties, and the standardised rhizome extract of A. calamus has been shown to have significant dose-dependent effects against the rat tapeworm, Hymenolepis diminuta, so may also harm other helminths. [https://www.ncbi.nlm.nih.gov/pubmed/27757269]

* ✅ [https://en.wikipedia.org/wiki/Castor_oil Castor oil]. This will not kill helminths, though it may help to expel worms after eradication, and this is probably the reason for its antiparasitic reputation and it's use in para-cleanse products.

* ✅ [https://en.wikipedia.org/wiki/Cat's_claw Cat’s Claw] is a common name for several plants, but it appears to be applied particularly to two species - [https://en.wikipedia.org/wiki/Uncaria_tomentosa Uncaria tomentosa] (samento), most commonly used in the US, and [https://en.wikipedia.org/wiki/Uncaria_guianensis Uncaria guianensis], typically used in Europe. Medicines made from the root and bark of these species have been claimed online to facilitate the elimination of intestinal parasites, but WebMD states that there is insufficient evidence for its effectiveness against parasites, [http://www.webmd.com/vitamins-supplements/ingredientmono-395-CAT'S%20CLAW.aspx?activeIngredientId=395&activeIngredientName=CAT%27S%20CLAW] and one hookworm host has taken up to 2000-2500 mg of Uncaria tomentosa daily in raw form for months with no adverse effects on his NA. He was even able to incubate fresh larvae from his colony during this period. [https://www.facebook.com/groups/htsupport/posts/4013894361999822?comment_id=4014662455256346]

* ⚡ [https://en.wikipedia.org/wiki/Larrea_tridentata Chaparral] (Larrea tridentata). Some cultures customarily bathe with chaparral annually to eliminate skin parasites, but use of the leaves of Larrea species is not advised, due to the possibility of damage to the liver and kidneys.

* ❌ Chicken weed ([https://en.wikipedia.org/wiki/Salvia_serotina Salvia serotina]), also known as Littlewoman, has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 20 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ✅ [https://en.wikipedia.org/wiki/Fallopia_multiflora Chinese knotweed] (Fallopia multiflora, also known as Reynoutria multiflora (Thunb.) Moldenke, Polygonum multiflorum Thunb., tuber fleeceflower) has been shown to make one nematode live longer. [https://www.sciencedaily.com/releases/2018/10/181009102529.htm]

* ❌ [https://en.wikipedia.org/wiki/Cinnamomum_verum Cinnamomum verum]. This was previously known as ⚡''C. zeylanicum'' and also referred to as ⚡"true cinnamon", ⚡''Ceylon cinnamon'' or ⚡''Sri Lanka cinnamon''. Alcoholic extracts of the bark of ⚡''C. verum'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the bark may also have an adverse effect on other helminths. The spice, ⚡'''cinnamon''' is typically derived from related species within the genus, '''Cinnamomum'''.

* ❌ [https://en.wikipedia.org/wiki/Citrus_decumana Citrus decumana]. Alcoholic extracts of the rind of Citrus decumana have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rind may also have an adverse effect on other helminths. Citrus decumana is a relative of the common ✅[https://en.wikipedia.org/wiki/Grapefruit grapefruit] (citrus paradisi) and, while commercially available forms of ⚡'''grapefruit seed extract''' have a potential to harm human helminths (due to the typical addition of synthetic adulterants), there is no evidence that the flesh of the grapefruit has any adverse effect on helminths.

* ✅ Coffee fruit extract. ([https://en.wikipedia.org/wiki/Coffea_arabica Coffea arabica]) This is harmless to helminths.

* ❓ [https://en.wikipedia.org/wiki/Crocus_sativus Crocus sativus]. Also known as autumn crocus and saffron crocus, this plant is best known for the spice saffron, which is produced from parts of the plant's flowers. (See separate entry for the spice.) Two important bioactive compounds of Crocus sativus (crocin and safranal), and some semi-synthetic derivatives of safranal, have been found to be [http://www.ncbi.nlm.nih.gov/pubmed/25766747 effective against some types of parasite] (Helicobacter pylori, the malaria parasite, plasmodium, and Leishmania). However, there have been no reports of adverse effects on therapeutic helminths.

* ⚡ '''Curled/Curly Mint''' (Mentha spicata variety crispii/Mentha crispa/Mentha crispata). This cultivar of [https://en.wikipedia.org/wiki/Spearmint Spearmint] (Mentha spicata), and close relative of Peppermint (Mentha piperita) (see [[#Peppermint|Peppermint reference]]), may be effective against giardia and amoeba infections, and may have anthelmintic properties. It was once listed on a website under, “herbs that your health care provider might consider using to treat intestinal parasites.” [https://web.archive.org/web/20070918071439/http://health.kernan.org/altmed/articles/intestinal-parasites-000097.htm]

* ❌ [https://en.wikipedia.org/wiki/Desmodium_triflorum Desmodium triflorum]. Alcoholic extracts of Desmodium triflorum have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so it’s extracts may also have an adverse effect on other helminths, possibly due to it containing a significant amount of a powerful psychedelic substance which might cause hookworms to lose their grip and be expelled.

* ✅ [https://en.wikipedia.org/wiki/Echinacea Echinacea]. This is not a single plant but a genus containing several different species. In the case of medicinal products labelled as echinacea, these are likely to have been obtained from one or more of the following sources: E. purpurea, E. angustifolia or E. pallida. Such products may also be either extracts, or the expressed juice of, different plant organs (e.g., roots and leaves) resulting in different products having very different chemical compositions. However, there have been no reports of human helminths being harmed by taking any echinacea products. As the polysaccharides found in Echinacea purpurea roots have been [http://www.ncbi.nlm.nih.gov/pubmed/26190752 shown to have anti-inflammatory effects], water extracts of these roots may be of benefit to helminth hosts who require a supplementary anti-inflammatory.

* ❌ [https://en.wikipedia.org/wiki/Elecampane Elecampane.] (Inula helenium, also known as alant, aster helenium, aster officinalis, aunée, aunée Officinale, elfdock, elfwort, enule campagne, grande aunée, helenio, helenium grandiflorum, horse-elder, horseheal, horse-heal, Indian elecampane, inule aulnée, inule aunée, inule hélénie, &OElig;il-de-cheval, scabwort, velvet dock, wild sunflower and yellow starwort.) According to WebMD, this herb can be used to kill intestinal worms, including hookworms and whipworms. [https://www.webmd.com/vitamins/ai/ingredientmono-2/elecampane] One hookworm host who took some drops containing several herbs that included elecampane suffered “vicious” diarrhoea for 16 hours, after which she reportedly lost the benefits from her worms.

* ❌ [https://en.wikipedia.org/wiki/Epazote Epazote]. See [[#Wormseed|Wormseed]].

* ❌ [http://it.wikipedia.org/wiki/Ceterach_officinarum Erba ruggine] (Ceterach officinarum) is listed on one website under, “Herbals that may kill and expel worms.” [https://web.archive.org/web/20160215131104/http://www.altmd.com/Articles/Worms--Encyclopedia-of-Alternative-Medicine]

* ❓ [https://en.wikipedia.org/wiki/Eurycoma_longifolia Eurycoma longifolia] (commonly called tongkat ali, pasak bumi or malaysian ginseng). The root of the plant is used in Indonesia and Malaysia as a health tonic, the benefits of which are claimed to include the treatment of intestinal worm infections. However, one hookworm host has reported using 100mg tongkat ali extract, containing 10% eurycomanone, for 60 days without any adverse effect on his worm colony. [https://www.facebook.com/groups/htsupport/posts/6839629756092921/?comment_id=6839701856085711]

* ❓ [https://en.wikipedia.org/wiki/Frankincense Frankincense] (olibanum). This aromatic resin is used in incense and perfumes, and is obtained from trees in the Boswellia genus. There have been no reports about it having any effect on helminths.

* ❌ [https://en.wikipedia.org/wiki/Gentian_root Gentian root]. The root and underground stem of [https://en.wikipedia.org/wiki/Gentiana_lutea Gentiana lutea] (yellow gentian) are said to assist in expelling 'harmful organisms'. One subject has reported that taking a form of gentian in large quantity on a daily basis for sinus inflammation was responsible for the loss of his whipworms, although possibly not his hookworms.

* ✅ [https://en.wikipedia.org/wiki/Ginkgo_biloba Ginkgo biloba]. There has been a single hint that ginkgo may have caused a mild reduction in hookworm benefits, but this was by no means certain, and three other helminth hosts have reported taking ginkgo regularly with no apparent adverse effect on their worms. (Also see Anticoagulants.)

* ⚡ [https://en.wikipedia.org/wiki/Goldenseal Goldenseal] (Hydrastis canadensis). This contains ⚡'''berberine'''.

* ⚡ [https://en.wikipedia.org/wiki/Coptis_chinensis Goldenthread/Chinese goldthread] (Coptis chinensis) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Goosefoot Goosefoot] (Chenopodium ambrosioides) is widely used to deworm animals, and the Japanese make a dewormer tea with the leaves. Goosefoot oil is a highly efficient anthelmintic, and extremely toxic. Human consumption of this herb has often produced strong side effects such as nausea and headaches, and even death in some cases.

* ⚡ [https://en.wikipedia.org/wiki/Hagenia Hagenia] (Hagenia abyssinica). Also known as African redwood, brayera, cusso, hagenia, and kousso, hagenia has been used as a treatment for the pork tapeworm (Taenia solium), but is often only partially effective in this case.

* ⚡ [https://en.wikipedia.org/wiki/Terminalia_chebula Haritaki] (Terminalia chebula). Also known as Yellow Myrobalan, Chebulic Myrobalan, Kadukkai, Silikha, Himmej, Karakkaya and A-ru-ra. The fruits are reportedly anthelmintic, but this reputation may be due more to its laxative properties than any actual worm-killing potential.

* ❌ [https://en.wikipedia.org/wiki/Houttuynia_cordata Houttuynia cordata Thunb] (HCT), also known as fish mint, fish leaf, rainbow plant, chameleon plant, heart leaf, fish wort, Chinese lizard tail, and bishop's weed. The leaf extract of this Thai herb, which is used as an anti-inflammatory medication in the treatment of rheumatoid arthritis [https://www.ncbi.nlm.nih.gov/pubmed/26170903] has shown anthelmintic activity against Hymenolepis diminuta, especially the adult worms. [https://www.ncbi.nlm.nih.gov/pubmed/23024502/] The entire Saururaceae plant family is considered to have anthelmintic properties and is used by the Naga tribes in Northeast India to treat intestinal worm infections in general. It may therefore also have a potentially harmful effect on other therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Hydnocarpus_wightiana Hydnocarpus wightiana]. Alcoholic extracts of the seeds have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the seeds may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Hyssopus_officinalis Hyssop] (Hyssopus officinalis). The leaf contains an essential oil with antiseptic properties that has been claimed to have anthelmintic effects, but, if eaten as a herb, hyssop is unlikely to harm helminths.

* ❌ [https://en.wikipedia.org/wiki/Ipecac Ipecac], syrup of. Alkaloids in ipecac, including [https://en.wikipedia.org/wiki/Emetine emetine], are reported to kill several types of parasite, particularly amoebae, but also pinworms and tapeworms, although the amounts needed to produce these effects in humans are generally high and can lead to severe side effects. Emetine and the somewhat safer form, [https://en.wikipedia.org/wiki/Dihydroemetine Dehydroemetine], are usually reserved for rare cases of people infected with amoebae who are not cured by using anti-amoeba drugs.

* ⚡ [https://en.wikipedia.org/wiki/Juniper Juniper] (Juniperus communis) is a very effective natural antibiotic which is also said to have deworming properties, notably against liver fluke, and is used to treat worm infestations in animals. Juniper is also used as the primary flavouring in gin, but there have been no reports of any harm coming to helminths as a result of drinking gin.

* ❌ [https://en.wikipedia.org/wiki/Kaempferia_galanga Kaempferia galanga]. Alcoholic extracts of the rhizomes have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so extracts of the rhizomes may also have an adverse effect on other helminths.

* ⚡ [https://en.wikipedia.org/wiki/Kava Kava/ kava-kava] (Piper methysticum). Studies have shown that kava can have potentially harmful effects on helminths by disrupting their neuromuscular function. Kavalactones, the active compounds in kava, produce psychoactive, analgesic, euphoric and sedative effects and, in the case of the roundworm, C. elegans, kavalactones have been found to cause muscle hypercontraction, epileptic-like convulsions and paralysis. One constituent of kava, Kavain, specifically induced worm paralysis without convulsions. [https://pmc.ncbi.nlm.nih.gov/articles/PMC5462554/] While this evidence does not relate directly to therapeutic helminths, and there have not been any reports to date of any adverse effects of kava on therapeutic worms, it is sufficient reason to treat kava with a degree of caution, especially in hookworm self-treaters who are known to have a more aggressive immune response, thus putting their worms under increased duress.

* ❓[https://en.wikipedia.org/wiki/Lactuca_virosa Lactuca virosa] Also known as wild lettuce, bitter lettuce, laitue vireuse, opium lettuce, poisonous lettuce, tall lettuce, great lettuce and rakutu-karyumu-so. While this herb is claimed by a few sources online to have an anthelmintic effect (e.g., [https://herbu.org/wp-content/uploads/2018/09/8-Wild-Lettuce-5pgs.pdf] (PDF)), there have been no reports of it having an adverse effect on either NA or TT. However, it is worth noting that Lactuca virosa can cause toxic effects in those who consume it. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3031874/]

* ❓[https://en.wikipedia.org/wiki/Lemon_balm Lemon balm] (Melissa officinalis), a member of the mint family also known as balm, common balm or balm mint. This has been found to exhibit high nematicidal activity against the roundworm, Meloidogyne incognita [https://www.ncbi.nlm.nih.gov/pubmed/20527965] and, when included with other herbs, to help reduce the number of pigs infected with the roundworm, Ascaris suum. [https://www.ncbi.nlm.nih.gov/pubmed/19954891]. It is also listed as a vermifuge on some herbal websites, but there have been no reports thus far of lemon balm having adversely affected either NA to TT, and one NA host has reported using it almost daily for over a year, both as a tea and a tincture, without it causing any issues for her worms. [https://www.facebook.com/groups/htsupport/posts/7626177840771438/]

* ⚡ [https://en.wikipedia.org/wiki/Lemongrass Lemongrass] (Cymbopogon citratus) essential oil has shown [http://www.academia.edu/3999135/Evaluation_of_in_vitro_anthelmintic_activity_of_Cymbopogon_citratus_lemon_grass_extract anthelmintic activity against earthworms]. However, one individual has consumed lemongrass tea [https://www.facebook.com/groups/htsupport/permalink/544122108977082/ without adverse effect] on her hookworm or whipworm colonies.

* ✅ [https://en.wikipedia.org/wiki/Liquorice Liquorice/licorice], the root of Glycyrrhiza glabra. One hookworm host has reported [https://www.facebook.com/groups/htsupport/permalink/798992926823331/?comment_id=799022316820392&offset=0&total_comments=2] taking “lots” of [https://en.wikipedia.org/wiki/Deglycyrrhizinated_licorice deglycyrrhizinated licorice] (DGL) with no ill effect on his worms. And another NA host has reported taking liquorice extract without any problems. [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D] Liquorice extracts may be useful as an adjunctive therapy [http://www.ncbi.nlm.nih.gov/pubmed/26383911 for psoriasis, for colitis] and possibly other autoimmune diseases, but excessive consumption of liquorice containing glycyrrhizin/glycyrrhizic acid [http://www.sciencedaily.com/releases/2015/03/150302081147.htm may not be wise]. The World Health Organization's recommended daily maximum for liquorice is 2 mg/kg.

* ❌ [https://en.wikipedia.org/wiki/Lippia_nodiflora Lippia nodiflora]. Alcoholic extracts of this have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other worms.

* ❌ Love weed ([https://plants.jstor.org/compilation/cuscuta.americana Cuscuta americana]) extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 2 hours, compared with 35 hours taken by albendazole. [https://www.researchgate.net/publication/21072595]

* ⚡ [https://en.wikipedia.org/wiki/Male_fern Male fern] (Dryopteris filix mas). Also once known as worm fern! The rhizomes and young shoots (fiddleheads) of the male fern have antiparasitic properties and the root has been used to treat tapeworms. However, this herb is seldom used today due to its side effects (e.g. headaches and nausea) and because large doses are extremely poisonous and may induce liver damage. The North American equivalent of the male fern is the evergreen [https://en.wikipedia.org/wiki/Dryopteris_marginalis marginal shield-fern] (Dryopteris marginalis).

* ✅ [https://en.wikipedia.org/wiki/Mastic_(plant_resin) Mastic gum] Mastic (plant resin), also known as tears of Chios, is excreted by the resin glands of certain trees. One NA host has reported chewing mastic gum every day for a couple of months, and said that even chewing it until it dissolved had no harmful effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/6291172814271954/]

* ✅ [https://en.wikipedia.org/wiki/Milk_thistle Milk Thistle] (Silybum marianum). Also known as cardus marianus, blessed milk thistle, Marian Thistle, Mary Thistle, Saint Mary's Thistle, Mediterranean milk thistle, variegated thistle and Scotch thistle. There have been no adverse reports about this herb from worm hosts, and there are no reasons to believe that it might harm human helminths.

* ❌ [https://en.wikipedia.org/wiki/Mimosa_pudica Mimosa pudica] Also known as shy plant, sensitive plant, sleepy plant, action plant, touch-me-not, and shameplant, this popular houseplant is a tropical fern, whose leaves close rapidly when touched. Aqueous methanol extracts of the leaves of this plant showed a similar ability as the anthelmintic drug, levamisole, to inactivate larvae of the helminth, Strongyloides stercoralis. [https://www.researchgate.net/publication/21072595] While there have been no reports to date of this plant having a harmful effect on any of the therapeutic helminths, it has been used extensively as an anti-parasitic agent in traditional and Ayurvedic medicine, so clearly has significant potential as an anthelmintic.

* ❓[https://en.wikipedia.org/wiki/Miswak Miswak] The miswak is a tooth-cleaning twig obtained from the [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] tree. In addition to this oral hygiene use being documented within traditional medicine systems, parts of the S. persica tree have also been reported to show evidence of anthelmintic activity. [https://pmc.ncbi.nlm.nih.gov/articles/PMC8347844/] However, this evidence comes from test-tube or animal studies, not trials on humans, and the concentrations tested would not necessarily correlate with those encountered during typical miswak stick chewing. So far, there have been no reports of any adverse effects on the helminth colonies of miswak-chewing self-treaters.

* ❌ [https://en.wikipedia.org/wiki/Morinda_citrifolia Morinda citrifolia], also known as great morinda, Indian mulberry, beach mulberry and cheese fruit). Alcoholic extracts of the tender leaves of ''M. citrifolia'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies [http://www.ncbi.nlm.nih.gov/pubmed/1158424], so the same extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Mugwort Mugwort] (Artemisia vulgaris). Also known as Moxa, Common Wormwood, Traveler's Herb and Felon Herb, and a relative of wormwood (Artemisia Absinthium). While less effective than anthelmintic drugs, mugwort extracts, and especially the essential oils, are at least moderately effective natural anthelmintics against a range of nematodes and some cestodes. The herb can disrupt helminth neuromuscular function and interfere with energy metabolism, potentially leading to helminth paralysis and death, and it is said to make short work of roundworms, pinworms and tapeworms.

*❓ [https://en.wikipedia.org/wiki/Myrciaria_dubia Myrciaria dubia] (Commonly known as camu-camu, camu camu, camocamo, caçari and araçá-d'água.) This plant’s seed extracts have shown antischistosomicidal activity, [https://www.sciencedirect.com/science/article/pii/S0963996920303598?via%3Dihub] but nothing has been reported about possible adverse effects on any of the therapeutic worms.

* ⚡ [https://en.wikipedia.org/wiki/Myrrh Myrrh]. This has antiparasitic effects against various schistosome species and the liver fluke, Fasciola hepatica.

* ❌ [https://en.wikipedia.org/wiki/Neem Neem] (Azadirachta indica). Also known as margosa, nimtree and Indian lilac. Ayurvedic medicine holds that Neem is the best herb for treating worms and other parasites and that a simple decoction of Neem leaves can kill all parasites present in the intestines. Neem extract has also been shown to be [http://www.banglajol.info/index.php/DUJBS/article/view/8836 more effective against rodent helminths] than standard chemotherapy with albendazole or mebendazole.

* ✅ [https://en.wikipedia.org/wiki/Urtica_dioica Nettle, stinging] (Urtica dioica) Stinging nettle was found to have anthelmintic effects in one study [https://benthamopen.com/contents/pdf/TOPHARMCJ/TOPHARMCJ-3-38.pdf] but this was carried out ''in vitro'', using a nettle ''extract'', and in a non-therapeutic worm (the Indian earthworm) so these findings are not directly applicable to humans using human-adapted helminths. There have been no reports of any adverse effect on human helminths after their hosts have drunk nettle tea, and one hookworm host has reported regularly eating nettles without issue. [https://www.facebook.com/groups/htsupport/permalink/1265558373500115/?comment_id=1265700353485917&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Noni Noni] (Morinda citrifolia). See the separate entry for Morinda citrifolia, above. A test tube study [https://pubmed.ncbi.nlm.nih.gov/1158424/] found that noni helps to eliminate the roundworm, Ascaris lumbricoides, but, so far, no one hosting therapeutic helminths has reported using this.

* ❌ [https://en.wikipedia.org/wiki/Olive_leaf Olive leaf extract] (Olea europaea). Known as 'nature's antibiotic', this extract contains a component called oleuropein that is able to degrade pathological microorganisms of all kinds, and inhibit or kill many types of intestinal parasites including flatworms, hookworms, roundworms and tapeworms. Two subjects have reported losing their helminths after taking this.

* ⚡ [https://en.wikipedia.org/wiki/Oregon_grape Oregon grape] (Berberis aquifolium/mahonia aquifolium) contains ⚡'''berberine'''.

* ❌ [https://en.wikipedia.org/wiki/Oroxylum_indicum Oroxylum indicum] (also known as broken bones plant, Indian calosanthes, Indian trumpet flower, kampong, midnight horror and tree of Damocles). The bark extract of O. indicum [http://www.ncbi.nlm.nih.gov/pubmed/26660694 produces concentration-dependent effects against both larval and adult H. diminuta worms] so may also affect other helminths.

* ❌ [https://en.wikipedia.org/wiki/Palmarosa Palmarosa] (Cymbopogon martinii). Also known as Indian geranium, gingergrass and rosha or rosha grass. This may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Passionflower Passion flower] (Passiflora). This will not harm helminths.

* ❓ [https://en.wikipedia.org/wiki/Handroanthus Pau d’arco]. Also known as lapacho, red lapacho or taheebo, pau d'arco is a tea made from the inner bark of Handroanthus impetiginosus (Pink Ipê), which is claimed to have antiparasitic effects. Its main active ingredients are lapachol, quercetin and other flavonoids. Having expectorant properties, it is used as a herbal remedy for colds, flu and smoker's cough. However, lapachol is rather toxic and is more often used topically, for example as as antibacterial or pesticide. There have been no reports from helminthic therapy self-treaters to suggest what effect, if any, drinking pau d'arco might have on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Mentha_pulegium Pennyroyal] (Mentha pulegium). A member of the mint family, also known as European pennyroyal, pennyrile, squaw mint, mosquito plant and pudding grass. This plant has anthelmintic properties. [https://www.ncbi.nlm.nih.gov/pubmed/32002775]


* ⚡ [https://en.wikipedia.org/wiki/Peppermint Peppermint] (Mentha piperita, aka M. balsamea Willd) is used as an ingredient in some antiparasitic preparations. Several helminth hosts have strongly suspected that peppermint oil killed their worms, and one found he could not establish a worm colony at all while taking peppermint oil. Even eating a lot of peppermints caused a return of disease symptoms for one hookworm host. [https://www.facebook.com/groups/htsupport/permalink/948433751879247/?comment_id=948595591863063&comment_tracking=%7B%22tn%22:%22R%22%7D] However, a number of others, who have used peppermint oil as a treatment for IBS, have noticed nothing untoward, and one subject has reported taking peppermint oil continuously without issue. Only the oil has been implicated. Eating ✅''peppermint leaves'', or drinking tea made from them, should not be a problem, as was found by two hookworm hosts who have reported drinking lots of peppermint tea without hurting their worms. [https://www.facebook.com/groups/htsupport/permalink/1986080694781209/?comment_id=1986669308055681&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/posts/7433421123380445/?comment_id=7434211146634776] ''Peppermint extract'' has also been reported not to be a problem for another hookworm host. [https://www.facebook.com/groups/htsupport/permalink/3042115625844372/?comment_id=3048690678520200]

* ❓ [https://en.wikipedia.org/wiki/Phyllanthus_niruri Phyllanthus niruri], also known as gale of the wind, stonebreaker, shatter stone, seed-under-leaf, carry-me-seed, quebra pedra, chanca piedra and chance pierre. This has been used traditionally to treat intestinal worms, and an extract of the plant has shown anthelmintic potential against a type of parasitic flatworm. [https://jffk.unram.ac.id/index.php/sjp/article/view/245] However, there have been no reports so far of any effects on therapeutic helminths.

* ❌ '''Pollia serzogonian'''. Alcoholic extracts of the rhizomes of ⚡''P. serzogonian'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424] so extracts of the rhizomes may also have an adverse effect on other helminths.

* ❌ [http://www.starchild.co.uk/products/6564_3590_quassia-root-chips.aspx Quassia] (Picrasma excelsa) has, anecdotally, been used successfully to treat threadworms and roundworms, as well as giardiasis, especially when used as an enema. It is a favoured botanical anthelmintic because of its low toxicity.

* ✅ [https://en.wikipedia.org/wiki/Rhodiola_rosea Rhodiola rosea]. Two hookworm hosts have reported taking rhodiola without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/995774170478538/?comment_id=996296763759612&comment_tracking=%7B%22tn%22:%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1627189140670368/?comment_id=1627254150663867&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Rosemary Rosemary] has been reported not to be a problem for helminths.

* ❌ [https://en.wikipedia.org/wiki/Salvia_officinalis Sage] (Salvia officinalis) was used traditionally as a treatment for intestinal worms and some forms of sage are still often included as an ingredient in modern proprietary antiparasitic remedies. Also one NA host has reported that drinking sage-containing teas stunned his colony for nearly a month. [https://www.facebook.com/groups/htsupport/posts/3505446409511289/?comment_id=5274927742563138&reply_comment_id=5275387002517212] However, the use of sage leaves as a culinary herb may not pose a problem for helminths, but there has not yet been sufficient feedback to be certain about this. [https://en.wikipedia.org/wiki/Sage_oil Sage oil] is likely to be much more of a problem for helminths, and one helminth provider cautions against the use of any concentrated form of sage.

* ❌ [https://en.wikipedia.org/wiki/Salvadora_persica Salvadora persica] (also known as arak, jhak, pīlu, Salvadora indica, toothbrush tree and mustard tree). Extracts of the root of this plant have been found to have powerful anthelmintic activity in a model worm. [https://www.ncbi.nlm.nih.gov/pubmed/31516352]

* ✅ [https://en.wikipedia.org/wiki/Sambucus_nigra Sambucus nigra], also known as European elderberry, European black elderberry, elder, European elder, elderberry, black elder, and the branded product, Sambucol. Several NA hosts have taken different forms of black elderberry liquid with no harm to their NA. [https://www.facebook.com/groups/htsupport/posts/2546894892033117/] Elderberry is known to stimulate the immune system, so might increase the symptoms of autoimmune diseases [https://www.webmd.com/vitamins-supplements/ingredientmono-434-elderberry.aspx?activeingredientid=434&activeingredientname=elderberry] [https://www.mskcc.org/cancer-care/integrative-medicine/herbs/elderberry-01#references-7] which may give the impression that it has affected a worm colony when it hasn't. Also see the comments [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570536949668921&comment_tracking=%7B%22tn%22%3A%22R0%22%7D here] and [https://www.facebook.com/groups/htsupport/permalink/1570295849693031/?comment_id=1570537809668835&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

* ❌ [https://en.wikipedia.org/wiki/Santonin Santonin] is extracted from the dry buds of the desert plant ''Eurasian wormwood'' ([https://en.wikipedia.org/wiki/Artemisia_cina Artemisia cina]). It acts against most parasites except Echinococcus, and is used to treat roundworms.

* ⚡ [https://en.wikipedia.org/wiki/Saw_palmetto Saw palmetto] (Serenoa repens). Also known simply as Serenoa, or Sabal serrulatum. One individual has reported an inability to maintain a hookworm colony while taking this herb, but had success once the herb was discontinued.

* ✅ [https://en.wikipedia.org/wiki/Shilajit Shilajit] (mumijo). One hookworm host has taken this without any apparent adverse effect on his colony. [https://www.facebook.com/groups/htsupport/permalink/1132613460127941/]

* ❓ [https://en.wikipedia.org/wiki/Ulmus_rubra Slippery elm] (ulmus rubra, also known as ulmus fulva). This is listed on at least one website [http://www.livestrong.com/article/395900-herbal-home-remedy-for-hookworms-in-a-human/] as a herb that may be helpful in treating various types of parasitic worms, including hookworms, but the only report [https://www.facebook.com/groups/htsupport/permalink/796860063703284/?comment_id=796869800368977&offset=0&total_comments=2] so far was from a hookworm host who said that she used a small amount of slippery elm powder on a few occasions without noticeably affecting her worms.

* ❓ [https://en.wikipedia.org/wiki/Soursop Soursop]. This is also called graviola, guyabano and guanábana, and is the fruit of the Annona muricata tree. A. muricata has demonstrated nematicidal activity against several roundworms, including Meloidogyne incognita [https://pubmed.ncbi.nlm.nih.gov/37552644/], Trichinella spiralis [https://pubmed.ncbi.nlm.nih.gov/34515021/] and Haemonchus contortus. [https://pubmed.ncbi.nlm.nih.gov/31455460/] [https://pubmed.ncbi.nlm.nih.gov/23583362/] Since NA are nematodes, there is a possibility of A. muricata also producing an adverse effect on this species, but there have been no reports yet by helminth self-treaters.

* ⚡ [https://en.wikipedia.org/wiki/Southernwood Southernwood] (Artemisia abrotanum) This European flowering plant has demonstrated effects against some helminths. It is also known as old man, boy's love, oldman wormwood, lover's plant, appleringie, garderobe, Our Lord's wood, maid's ruin, garden sagebrush, European sage, sitherwood and lemon plant. Spondias (Spondias mombin or Spondias purpurea var. lutea) This tropical fruit, which is also known as hog plums, Spanish plums, libas in Bikol, golden apples and mombins, may have anthelmintic effects.

* ✅ [https://en.wikipedia.org/wiki/Hypericum_perforatum St. John’s Wort] (Hypericum perforatum). It had been considered conceivable that some of the constituents of hypericum might have an adverse effect on helminths if taken in isolation and in large quantities (e.g., hyperforin, which has demonstrated some antibacterial properties, and hypericin, which has shown both antibacterial and antiviral activity), but there have been no reports of adverse effects on human helminths from any hypericum product in more than a decade.

* ⚡ [https://en.wikipedia.org/wiki/Artemisia_annua Sweet Annie] (Artemisia annua). Also known as sweet wormwood, sweet sagewort and annual wormwood. Both the herb and the pure form of its active ingredient, the sesquiterpene lactone, [https://en.wikipedia.org/wiki/Artemisinin artemisinin], have been used traditionally to treat malaria and intestinal parasites. Artemisinin is a potent anthelmintic and has been shown to be effective against [https://en.wikipedia.org/wiki/Schistosoma schistosomes]. [https://www.ncbi.nlm.nih.gov/pubmed/29727708]

* ❌ [https://en.wikipedia.org/wiki/Tansy Tansy] (Tanacetum vulgare), also known as common tansy, cow bitter, bitter buttons and golden buttons, is highly toxic to intestinal parasites and, for centuries, tansy tea has been prescribed by herbalists to expel worms. One study found that both the crude hydroalcoholic extract of T. Vulgare, and its essential oils, possess significant activity against adult S. mansoni worms, and the activity of the essential oils may be related, at least in part, to monoterpene thujones, which were detected as major constituents of the essential oils. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3929489/]

* ⚡ [https://en.wikipedia.org/wiki/Tea_tree_oil Tea tree oil] (Melaleuca alternifolia) has been claimed to kill intestinal worms, including roundworms, tapeworms and hookworms, and its anthelmintic activity has been investigated. [https://pubmed.ncbi.nlm.nih.gov/33503761/] The use of tea tree products may therefore have adverse effects on therapeutic helminths.

* ❌ [https://en.wikipedia.org/wiki/Tephrosia_purpurea Tephrosia purpurea]. Alcoholic extracts of ⚡''T. purpurea'' have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

* ❌ [https://en.wikipedia.org/wiki/Thymol Thymol]. This is a monoterpene phenol found in [https://en.wikipedia.org/wiki/Thyme%23Medicinal_use oil of thyme] and ''oregano oil'' (see separate reference), as well as ''[https://en.wikipedia.org/wiki/Ajwain ajwain] oil'' and ajwain "seeds" (actually the seed-like fruit from which the oil is extracted). Thymol has antimicrobial and antifungal properties and is said to be highly effective against hookworms. It can also be toxic and has caused fatalities in children.

* ⚡ [https://en.wikipedia.org/wiki/Usnea Usnea] are lichen species with powerful antibiotic and antifungal properties. [http://species.wikimedia.org/wiki/Usnea_florida Usnea florida] extract has been found to have a dose-dependent anthelmintic effect against the nematode worm, [https://en.wikipedia.org/wiki/Trichinella_spiralis Trichinella spiralis].

* ❓ [https://en.wikipedia.org/wiki/Arctostaphylos_uva-ursi Uva-ursi]. (Arctostaphylos uva-ursi). One of several related species referred to as bearberry, uva-ursi contains the glycoside [https://en.wikipedia.org/wiki/Arbutin arbutin], which has antimicrobial properties. There are claims online that uva-ursi is also anthelmintic, but, so far, there have been no reports of its effect on therapeutic helminths.

* ✅ [https://en.wikipedia.org/wiki/Valerian_(herb) Valerian] (Valeriana officinalis). One hookworm host has reported taking valerian tincture without noticing any interaction with her worms. [https://www.facebook.com/groups/htsupport/permalink/1300794123309873/?comment_id=1301681973221088&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Vasaka Vasaka] (Justicia adhatoda). Also known as Malabar Nut, Adulsa, Adhatoda and Vasa. From the same family as Adhatoda zeylanica. The leaves (which contain [https://en.wikipedia.org/wiki/Vasicine vasicine], an alkaloid with significant antimicrobial activity), root, bark, fruit, and flowers are all said to help in removing intestinal parasites.

* ❌ [https://en.wikipedia.org/wiki/Vernonia_amygdalina Vernonia amygdalina] Wild Mahale chimpanzees control parasite-related diseases by ingesting the pith of this plant, [https://pubmed.ncbi.nlm.nih.gov/7878093/] and some human tribal communities use concoctions of the plant for the same purpose. [https://en.wikipedia.org/wiki/Vernonia_amygdalina#Medicinal]

* ❌ Vervine ([https://en.wikipedia.org/wiki/Stachytarpheta_jamaicensis Stachytarpheta jamaicensis]) (Also known as, blue porterweed, blue snake weed, bastard vervain, Brazilian tea, Jamaica vervain and light-blue snakeweed. Vervine extract has been shown to inactivate 50% of the larvae of the helminth, Strongyloides stercoralis, in approximately 81.5 hours - not much more than the anthelmintic drug, thiabendazole, which took 74 hours. [https://www.researchgate.net/publication/21072595]

* ✅ Vitaxyn. Alcoholic herbal concoctions with this name, or referred to as "Tancosan", are thought unlikely to be a problem if taken at the recommended dosage and unless they contain some other ingredient that is known to be harmful to helminths. A product called "Tancosan" was taken by one hookworm host for over 2 years without any obvious adverse effect on her worms.

* ✅ [https://en.wikipedia.org/wiki/Vitex_agnus-castus Vitex agnus-castus]. Also known as vitex, chaste tree, chasteberry, Abraham's balm, lilac chastetree and monk's pepper. One hookworm host has taken 1000 mg of dried vitex agnus castus each day for many months without any noticeable ill effect on her worms. [https://www.facebook.com/groups/htsupport/permalink/986939411362014/?comment_id=986984301357525&comment_tracking=%7B%22tn%22:%22R%22%7D]

* ⚡ [https://en.wikipedia.org/wiki/Juglans_cinerea White walnut] (Juglans cinerea). Also known as Butternut. This nut has been used to expel rather than kill worms, although both root bark and leaves have been used in combination with an equal amount of ❌''Mugwort'' to treat worms in children.

* ❌ [https://en.wikipedia.org/wiki/Wild_rue Wild rue] (Peganum harmala). Also known as Esfand, Syrian rue, African rue and harmal. Its powdered seeds were used traditionally to expel tapeworms.

* ❌ [https://en.wikipedia.org/wiki/Stachys_officinalis Wood betony] (Stachys officinalis). Also known as betony, purple betony, bishopwort, or bishop's wort. A tea made from this may kill helminths.

* ✅ [https://en.wikipedia.org/wiki/Woodsorrel Woodsorrel] (Oxalis) has been reported[https://www.facebook.com/groups/htsupport/permalink/544122108977082/] as not being a problem for worm hosts when eaten as a food.

* ❌ [https://en.wikipedia.org/wiki/Dysphania_ambrosioides Wormseed] (Dysphania ambrosioides, formerly Chenopodium ambrosioides). Also known as epazote, goosefoot, Jesuit's Tea, Mexican Tea, Herba Sancti Mariae and paico. Wormseed is a traditional herbal remedy used in the tropics for expelling roundworms, hookworms and tapeworms. The oil, leaves or whole plants can be used, but one study[http://www.ncbi.nlm.nih.gov/pubmed/?term=Studies+on+the+traditional+herbal+anthelmintic+Chenopodium+ambrosioides+L.:+Ethnopharmacological+evaluation+and+clinical+field+trials] found that the powdered herb did not effectively eradicate hookworms, roundworms, or whipworms.

* ❌ [https://en.wikipedia.org/wiki/Artemisia_absinthium Wormwood] (Artemisia Absinthium). Also known as common wormwood, green ginger or grand wormwood, this herb was used traditionally as an anthelmintic. Other members of the genus, artemisia, that were traditionally used as anthelmintics include white wormwood ([https://en.wikipedia.org/wiki/Artemisia_herba-alba Artemisia herba-alba]), Eurasian wormwood (Artemisia cina) commonly known as santonica, Levant wormseed and wormseed, and Russian wormwood (Artemisia vestita) also known as Buer, Chamariya, Drubsha, Ganga Tulsi, Kubsha, Kundiyaa, Kundja and Seski. [https://pubmed.ncbi.nlm.nih.gov/36985759/]

* ✅ [https://en.wikipedia.org/wiki/Yerba_mate Yerba mate] (also known as erva-mate). No adverse reports have appeared so far about the effect of this herb on human helminths, or of the beverage made from it, known as mate, maté, Chimarrão, cimarrón, Tererê or Tereré.

* ❌ [https://en.wikipedia.org/wiki/Zingiber_zerumbet Zingiber zerumbet]. Alcoholic extracts of the rhizomes of Z. zerumbet have shown ‘good’ anthelmintic activity against the human roundworm, Ascaris lumbricoides, in test tube studies[http://www.ncbi.nlm.nih.gov/pubmed/1158424], so these extracts may also have an adverse effect on other helminths.

{{Columns}}

=== Fungi ===
<blockquote>
* ❓ [https://en.wikipedia.org/wiki/Amanita_muscaria Amanita muscaria] is a psychoactive and poisonous fungus with several known variations, or subspecies. One hookworm host has reported eating "a couple of hats (5-6 max)" on a few occasions without any effect on his NA that he can remember. [https://www.facebook.com/groups/htsupport/posts/2485762264813047/?comment_id=5343576092364969&reply_comment_id=5374046685984576]

* ❌ [https://en.wikipedia.org/wiki/Inonotus_obliquus Chaga mushroom] (Inonotus obliquus). This fungus, which grows singly on birch and other trees, is claimed, in several places online, to be effective against intestinal parasites, and it has been used for this purpose in the traditional folk medicine of Russia and Eastern Europe. One hookworm host thinks that drinking tea made from chaga mushrooms may have caused the failure of several hookworm incubations, [https://www.facebook.com/groups/htsupport/permalink/810579668997990/?comment_id=810664495656174&offset=0&total_comments=8&comment_tracking=%7B%22tn%22:%22R4%22%7D] however, another NA host has taken 200 mg+ daily of the chaga-containing Sacred 7 Mushroom Extract Powder blend (chaga, cordyceps, lion's mane, maitake, reishi, shiitake, & turkey tail) with no apparent ill effect on his NA. [https://www.facebook.com/groups/htsupport/permalink/4610641158991803/?comment_id=4611955338860385&reply_comment_id=4887932381262678]

* ✅ [https://en.wikipedia.org/wiki/Cordyceps Cordyceps] One NA host took 1/4-1/2 teaspoon cordyceps 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ❌ [https://en.wikipedia.org/wiki/Fomitopsis_betulina Fomitopsis betulina]. This edible fungus, which is usually found on birch trees, was previously known as Piptoporus betulinus, and is commonly known as the birch polypore, birch bracket, or razor strop. Wikipedia reports that F. betulina has been widely used in traditional medicines, and a paper referenced in the Wikipedia article suggests that polyporenic acid, found in the fruit body of the fungus, may be poisonous to the human whipworm, Trichuris trichiura (TT). [https://en.wikipedia.org/wiki/Fomitopsis_betulina#Research_on_chemical_constituents] F. betulina also contains toxic resins and an active compound, agaric acid, which are powerful purgatives that can result in strong though short-lived bouts of diarrhoea. [https://sci-hub.hk/10.1016/S0140-6736(05)79939-6]

* ✅ [https://en.wikipedia.org/wiki/Lingzhi_mushroom Lingzhi mushroom] (also known as Reishi). Several self-treaters have taken Reishi mushrooms or their extracts, e.g, [https://www.facebook.com/groups/htsupport/permalink/1301004239955528/?comment_id=1973652139357398], and there have been no reports of any adverse effects on NA or TT. One user says he consumes moderate doses of reishi [https://www.facebook.com/groups/htsupport/permalink/316642988391663/?comment_id=936181859771103] and another has even successfully used Reishi (Reishi Mushroom extract powder, 1000 mg 2x daily) to treat “worm flu”. [https://www.facebook.com/groups/htsupport/permalink/1461731890549428/?comment_id=1461830860539531]

* ✅ [https://en.wikipedia.org/wiki/Hericium_erinaceus Lion’s mane mushroom] (Hericium erinaceus) Also known as yamabushitake (= ‘mountain priest mushroom’), bearded tooth fungus and bearded hedgehog. One NA host took 1/4-1/2 teaspoon lion's mane 5 times a week for months with no ill effect on his helminths. [https://www.facebook.com/groups/htsupport/posts/6943497675706128/?comment_id=6943653899023839]

* ✅ [https://en.wikipedia.org/wiki/Wolfiporia_extensa Wolfiporia extensa] (also known as hoelen, poria, tuckahoe, China root, fu ling and matsuhodo) is a species of fungus in the family Polyporaceae. One hookworm host has reported drinking Fu Ling herb daily (E-Fong brand extract powder) with no issues for his colony. [https://www.facebook.com/groups/htsupport/posts/10041354979253700/?comment_id=10050698938319304]
</blockquote>

== Miscellaneous ==
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* ✅ [https://en.wikipedia.org/wiki/Apitherapy Bee venom therapy] appears to be safe for worms. [https://www.facebook.com/groups/htsupport/permalink/876826799039943/?comment_id=876902382365718&offset=0&total_comments=5&comment_tracking=%7B%22tn%22:%22R2%22%7D]

* ❌ [https://en.wikipedia.org/wiki/Diatomaceous_earth Diatomaceous earth (DE)]. This is made from the fossilized remains of tiny, aquatic organisms called diatoms which are mined from ancient sea beds and ground into a fine powder to produce food grade or medical grade diatomite. The finer grade diatomites are used as an insecticide and are also employed to deworm pets and humans. They are believed to work by dehydrating the organism, although the sharp edges of the particles may also be damaging to tiny creatures. A daily dose of one heaped teaspoon of DE has been claimed to be effective for human worm control, and one hookworm host has reported that three doses, of approximately one teaspoon each, quickly wiped out her colony and caused the return of all the symptoms of her disease. Someone who actually wanted to terminate a hookworm colony has said that small amounts of DE did not do this for her, but that taking 1 tablespoon each day for three days did completely eradicate a hookworm colony. [https://www.facebook.com/groups/htsupport/permalink/3759836894072238/]

* ❓ [https://en.wikipedia.org/wiki/Clay Clay] (bentonite, kaolin, etc.) Some clays have antibacterial properties [https://www.ncbi.nlm.nih.gov/pubmed/26743034] [https://www.sciencedaily.com/releases/2018/08/180821112029.htm] that vary by type, and some have been claimed to be natural parasite preventives that inhibit the reproduction of organisms. One helminth provider at one time advised against the use of clay while hosting worms, but clay is now thought much less likely to harm human hookworms and whipworms than it is tapeworms, and it may in fact not have any adverse effect at all on any type of ''therapeutic'' helminth. Someone has reported taking a "scant soup spoonful" of [https://en.wikipedia.org/wiki/Montmorillonite montmorillonite clay] slurry daily for quite long periods up to 3 or 4 months with no obvious adverse effect on her NA. [https://www.facebook.com/groups/htsupport/posts/5297777343611511/?comment_id=5298086576913921]

* ✅/❌ [https://en.wikipedia.org/wiki/Diarrhea Diarrhoea/diarrhea] While it is possible to lose hookworms to diarrhoea, this is only likely if the diarrhoea is very severe, or if it is severe and prolonged, i.e., lasting for several weeks. There is a description of one individual’s experience of losing a hookworm colon to very severe diarrhoea [https://www.facebook.com/groups/htsupport/permalink/1992639020792043/?comment_id=1993403570715588&comment_tracking=%7B%22tn%22%3A%22R%22%7D here].

:People who get diarrhoea/diarrhea as a side effect following their first inoculation with hookworms do not lose all their worms as a result of this, and hookworms are able to withstand the typical [https://en.wikipedia.org/wiki/Colonoscopy#Preparation colonoscopy prep]. See [[Human helminth care manual#Laxatives | '''Laxatives''']].

:It would seem logical to assume that hookworms might be better able to resist being flushed out after the point at which they attach to the gut wall, which is towards the end of the third week post inoculation.

:While adult hookworms do move around to feed, and are therefore theoretically more likely to be lost if diarrhoea strikes while they are on the move, this is unlikely to lead to any significant loss.

:Human whipworms are unlikely to be dislodged by diarrhoea once these are mature and embedded in the colonic mucosa, but they could could potentially be flushed out before this, especially around 21-22 days post inoculation. After 28 days, human whipworms should not be affected at all by diarrhoea.

* ✅ [https://en.wikipedia.org/wiki/Fasting Fasting]. This [https://www.facebook.com/groups/htsupport/permalink/812582472131043/?comment_id=813100818745875&offset=0&total_comments=3&comment_tracking=%7B%22tn%22:%22R%22%7D will not harm human helminths] because they feed from their host’s blood (hookworms), or from their intestinal tissue (whipworms). Fasting is also unlikely to have any detrimental effect on the rat tapeworm, Hymenolepis diminuta (HDC), even though this species normally lives on carbohydrates consumed by their host. HDC can apparently also live off glycoproteins secreted in the gut.

* ✅ [https://en.wikipedia.org/wiki/Fever Fever]. Running a fever for several days will not harm helminths.

* ✅ [https://en.wikipedia.org/wiki/Hyperbaric_oxygen Hyperbaric oxygen]. This is safe for use alongside helminthic therapy. [https://www.facebook.com/groups/htsupport/permalink/1281704005218885/?comment_id=1284905411565411&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/678894952216125/permalink/2543377009101234/?comment_id=2543517345753867] [https://www.facebook.com/groups/htsupport/posts/4319514804771108?comment_id=4320113668044555]

* ✅ [https://en.wikipedia.org/wiki/Infrared_sauna Infrared sauna]. Two hookworm hosts used an infrared sauna regularly for over 15 years without any adverse effect on their colonies. [https://www.facebook.com/groups/htsupport/permalink/2106930399362904/?comment_id=2107487372640540&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ✅ [https://en.wikipedia.org/wiki/Ketosis Ketosis] is a metabolic state in which most of the body's energy supply comes from ketone bodies in the blood. This state is often induced deliberately by fasting or the adoption of a low-carbohydrate diet as a intervention in various medical conditions. One commenter has suggested that ketosis should not be harmful to helminths because, like fungi, they have mitochondria so can metabolise fat and therefore utilise ketones as a food source, unlike bacteria and viruses which require carbohydrates to survive. [https://www.facebook.com/groups/htsupport/permalink/1077988932257061/?comment_id=1078025565586731&comment_tracking=%7B%22tn%22:%22R0%22%7D] For more on keptogenic diets, see [http://perfecthealthdiet.com/2011/02/ketogenic-diets-i-ways-to-make-a-diet-ketogenic/ here].

* ❓ [http://rifevideos.com/index.html Rife machines]. These devices are claimed to be capable of killing or "devitalizing" worms when set to 2,400 Hz. Therefore, assuming that they are able to do what is claimed (and this is a [https://en.wikipedia.org/wiki/Royal_Rife contentious issue]) it would seem sensible to avoid this particular frequency if using these machines.

* ✅ [https://en.wikipedia.org/wiki/Spermidine Spermidine]. When fed to worms, this simple polyamine (found in large quantities in human sperm and grapefruit) significantly prolonged their lifespan. [http://www.rsc.org/chemistryworld/News/2009/October/04100901.asp]

* ✅ Steam. Saunas, hot tubs and hot baths do not harm helminths because the body's core temperature remains relatively constant while the skin sweats.

* ✅ [https://en.wikipedia.org/wiki/Wim_Hof Wim Hof] breathing techniques. Someone who hosts hookworms and has done these exercises on and off for about a year has reported having no issues as a result of combining the two treatments. [https://www.facebook.com/groups/htsupport/permalink/1417893248266626/?comment_id=1417961461593138&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

* ❓ [https://en.wikipedia.org/wiki/Zeolite Zeolite] Zeolites are microporous, aluminosilicate minerals that are used widely in water purification systems. One hookworm host has reported taking 1 zeolite tablet daily for a week with no adverse affect on her colony. [https://www.facebook.com/groups/htsupport/permalink/2129639990425278/?comment_id=2168119789910631]

{{Columns}}

== Additional scientific studies ==

* 2011 Mar 1 [https://hdl.handle.net/1843/BUOS-8G3LVD Avaliação dos efeitos de fármacos imunomoduladores na infecção de Hamsters, Mesocricetus auratus, POR Ancylostoma ceylanicum (Evaluation of the effects of immunomodulatory drugs on the infection of hamsters, Mesocricetus auratus, by Ancylostoma ceylanicum) (Loss, 1911)] (Thesis, Minas Gerais, Portuguese)