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Helminthic therapy FAQ

2025-01-16T09:21:26Z

Khalid: /* Isn’t helminthic therapy gross? */

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If you are new to helminthic therapy, it's best to start by reading the [[Introduction to helminthic therapy | '''Introduction to helminthic therapy''']]. While the introduction is not set out in the FAQ format, it is the most comprehensive and up-to-date guide to everything you need to know in order to understand and get started with this therapy. Its contents form a foundation to the rest of the material on this site and include details about the special types of helminth which are used in therapy and the companies that supply them. Reading the introduction carefully, and in full, will help to prevent you wasting time and money and possibly not getting the best from the therapy, if you decide to try it. 

== How do I get started with helminthic therapy? ==

This section is for those who want to cut to the chase.

1. Read the [[Introduction to helminthic therapy | '''Introduction to helminthic therapy''']].

2. Check the [[Helminthic therapy personal stories | '''Helminthic therapy personal stories''']] page for the conditions you would like to treat. Reading these stories will help you decide which helminth species might best meet your needs.

3. Read more about these species on the [[Selecting a therapeutic helminth | '''Selecting a therapeutic helminth''']] page, and note that [[Helminth inoculation#The first inoculation should be with a single species | '''the first inoculation should be with a single species''']].

4. See one, or more, of the following pages, as appropriate.

* [[Self-treating with TSO | '''Self-treating with TSO''']]

* [[Self-treating with HDC | '''Self-treating with HDC''']]

* [[Self-treating with NA | '''Self-treating with NA''']]

* [[Self-treating with TTO | '''Self-treating with TTO''']]

5. Once you have decided which species you would like to start with, check the [[Helminth providers | '''Helminth providers''']] page to find companies that supply this organism and ship to your location.

6. Check out the customer feedback about all the providers on the [[Helminth provider reviews |'''Helminth provider reviews''']] page.

7. If you are hypersensitive or have one of [[Helminthic therapy safety#Conditions that require a modified approach to helminth dosing | '''several particular conditions''']], make sure to start with an appropriately small dose, especially if you are going to be using NA, in which case, see [[Hookworm dosing and response#Hookworm dosing in a nutshell | '''Hookworm dosing in a nutshell''']].

== FAQs for newbies ==

===What is helminthic therapy?===

Helminthic therapy is the reintroduction to the digestive tract of a controlled number of specially domesticated, mutualistic helminths (intestinal worms) in the form of microscopic eggs or larvae to reconstitute a depleted biome to treat and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy.

To learn more, see this introduction to the topic.

* [[Introduction to helminthic therapy | '''Introduction to helminthic therapy''']]

===Is helminthic therapy safe?===

Yes, it is very safe, as can be seen from the details on the following page.
* [[Helminthic therapy safety | '''Helminthic therapy safety''']]

===Is helminthic therapy legal?===

There is no specific law prohibiting self-treatment with helminths, or prohibiting the sale, purchase, possession or growing of helminths for self-treatment, anywhere in the world, and, in practice, very few packages containing helminth eggs or larvae are intercepted in transit.

The only country where a helminth has been formally approved by a national regulator is Thailand. The certificate issued by the Thai FDA approving TSO as a natural medicine translates into English as follows.

{{Quote|indent}}According to the request for classification and export permission of TSO as a medicine for the therapeutic treatment of inflammatory bowel diseases (Crohn`s disease and ulcerative colitis), the food and drug administration committé has discussed the therapy and all manufacturing details. The committé recognized the intended use for the curative treatment of humans and decided TSO to be a drug according to paragraph 4 of the drug law from 1967. The production method shows that TSO is derived from animals as a complete biological organism, remains unchanged and is not mixed with another drug or synthetic solution. Therefore we decided that TSO is classified under the category of natural medicines like herbals, which are exempted from the drug registration requirements according to paragraph 79 of the drug law from 1967. (Director Drug Control, Deputy Director of the FDA Committé) [https://www.facebook.com/groups/htsupport/permalink/1831064423616171/?comment_id=1831253603597253&reply_comment_id=1831711236884823]{{Quote|/indent}}

Elsewhere in the world, there is a range of regulatory responses to the shipping of helminth products.

The Brazilian health inspectorate began impounding TSO shipments in 2023, returning the packages to Tanawisa, who advise that it is no longer worth trying to send TSO to Brazil. [https://www.facebook.com/groups/htsupport/posts/6835303553192208/?comment_id=7020441231345105] Saudi Arabia also block TSO shipments because they ban all pig products.

In the United States, the FDA have issued an [https://www.accessdata.fda.gov/cms_ia/importalert_159.html Import Alert] which states that helminths used as immunomodulators are considered to be biological products as defined in Section 351 of the Public Health Service Act. This alert is the Agency's current guidance to FDA field personnel, and authorises US Customs staff to confiscate packages they identify as containing helminth products.

Australian, New Zealand, German and Norwegian Customs departments have all been known to occasionally impound packages from the [[Helminth providers | '''helminth providers''']], although there are ways to avoid this hurdle, so anyone in these countries should talk to their provider about this.

In spite of the isolated issues mentioned here, most people who are self-treating with helminths are able to receive deliveries from the helminth providers without difficulty. In addition to Western countries, one company has reported that they have also shipped NA successfully to India, Myanmar, most Asian countries and some island nations in South America, adding that Argentina would likely also be a viable destination. [https://www.facebook.com/groups/htsupport/posts/7321256967930195?comment_id=7321828447873047&reply_comment_id=7330118893710669]

===Isn’t helminthic therapy gross?===

Anyone who knows that “helminths” are intestinal worms, but does not yet fully understand helminthic therapy, might think that this involves swallowing worms similar to those found in garden soil, or perhaps something like the images they’ve seen online of scary parasitic mini-monsters.

The truth is that the specially selected organisms used in helminthic therapy are microscopic when taken - effectively just another form of probiotic - and they are never seen by the self-treater at any time during the therapy. So it isn’t in the least bit gross if viewed on a rational level. But even someone with a family member who is using, and enjoying the benefits of this therapy, may not be able to bring themselves to try it.

{{Quote|indent}}No more seasonal allergies (for me). My wife is suffering now big time while I’m perfectly fine. Unfortunately she can’t get over the “icky” aspect of hosting helminths so she continues to suffer. [https://www.facebook.com/groups/htsupport/permalink/3691704464218815/?comment_id=3693240957398499]{{Quote|/indent}}

Until the twentieth century, virtually the entire population of the planet was hosting one helminth or another, and, even today, there are more than 1,700 billion global inhabitants who host at least one species of soil-transmitted helminth.

And worms are by no means the only life form being carried around by humans. Even in hygiene-conscious industrialised countries in the twenty first century, most of the population are unwittingly hosting demodex mites in their eyelashes. Related to spiders, and shaped like a slug with eight stumpy legs, these mites grow up to 0.4 millimetres long, live in human hair follicles and associated sebaceous glands and come out at night for a walkabout around their host's face, where they have sex before slithering back into their foliclular tunnels. [https://en.wikipedia.org/wiki/Demodex]

In spite of its rather unattractive appearance, no one is making a fuss about hosting the Demodex mite, because they don’t know it’s there! And it’s arguably irrational to be repulsed by any other invisible non-pathogenic species, including a helminth, especially when it is mutualistic rather than parasitic, and has the potential to transform its host’s health and possibly even save their life, as is the case with the therapeutic helminths featured on this site. As one helminth self-treater has said:

{{Quote|indent}}Life with creepy crawlies in my gut is better than slow death on biologics. [https://www.facebook.com/groups/htsupport/permalink/1831064423616171/?comment_id=1831721263550487]{{Quote|/indent}}

Education about helminthic therapy may be the best antidote to any feelings of fear and disgust that it causes, so ''gradually'' learning about the therapy by reading this wiki may be helpful. And reading the following piece of research about the "yuk" factor may also help someone with worm phobia to understand their own response.

* [https://www.ncbi.nlm.nih.gov/pubmed/31183857 Scary and nasty beasts: Self-reported fear and disgust of common phobic animals] -- [[Media:Scary and nasty beasts- fear and disgust for common phobic animals.pdf| Full text]]

However, if worm phobia is still an issue, the following page offers a very simple, practical solution for this.

* [[Don’t let worms give you the squirms! | '''Don’t let worms give you the squirms!''']]

===Can the worms hosted by self-treaters infect other people?===

The worms used in helminthic therapy have been carefully selected to be safe, both for the person hosting them and for everyone else. These particular helminth species cannot escape their host and directly infect another individual, because, once they leave their host, they die.

These worms all reproduce by means of eggs which can only develop into a new generation of worms after they have been passed by their host and undergone incubation elsewhere.

HDC reproduction requires a multi-stage process involving both rats and beetles, and the eggs produced by the whipworms, TSO and TTO, require months of incubation before they can transform into infectious organisms. Even the eggs produced by the hookworm, NA, must incubate for at least 4 days in specific conditions before they can become infectious larvae capable of infesting a new host. For more detail, see the following page.

* [[Helminthic therapy safety | '''Helminthic therapy safety''']]

===Why is helminthic therapy necessary?===

Helminthic therapy has only become necessary because humans have adopted many practices (e.g., wearing shoes and using toilets) that interrupt the life cycles of helminths which our forebears had previously hosted for millions of years.

Helminths are now considered to be ''heirloom'' species that have coexisted and co-evolved with humans to the extent that we are now incomplete without them and depend on their presence for the optimal functioning of our immune systems. These mutualistic organisms train the developing immune system in infancy and continue to regulate immune function throughout life for as long as they remain with us. Helminthic therapy is therefore not like a drug treatment, but more a form of replacement therapy - putting back something we have lost but which we actually need.

Although some people with particular genetic profiles don’t develop autoimmune diseases or allergies as a result of being helminth deficient, there is evidence that even they can be susceptible to developing degenerative diseases because they lack the very efficient inflammation control that helminths provide.

* [[Helminthic therapy for well people | '''Helminthic therapy for well people''']]

===How does helminthic therapy work?===

The organisms used in helminthic therapy work as a result of the chemicals that they secrete to protect themselves from being ejected by their host and to keep their host alive for as long as possible.

Over millions of years of coevolution with humans and our primate ancestors, helminths have learned to evade most of what the human immune system can throw at them, and they do this by controlling inflammation. For more detail about how they achieve this effect, see the following page.

* [[The effects of helminths on the immune system | '''The effects of helminths on the immune system''']]

===What are the benefits of hosting helminths?===
Helminthic therapy modulates (normalises) the function of the immune system. This action controls inflammation and reduces autoimmunity and allergies. To see how these effects are achieved, go to the following page.
* [[The effects of helminths on the immune system | '''The effects of helminths on the immune system''']]

Since inflammation is involved in many diseases, its control has many benefits for helminth hosts. Diseases that have been successfully treated by helminthic therapy are listed on the following page.

* [[Helminthic therapy personal stories | '''Helminthic therapy personal stories''']]

In addition to treating existing disease, helminthic therapy can also prevent disease, as can be seen from the details on this page:

* [[Helminthic therapy for well people | '''Helminthic therapy for well people''']]

=== What conditions have been helped by helminthic therapy? ===
Conditions with the largest number of reported successes are Crohn’s disease, allergy, food intolerance and ulcerative colitis. 
Other conditions with a high number of reports of success include multiple sclerosis (MS), eczema, irritable bowel syndrome (IBS), asthma, multiple chemical sensitivity (MCS), food allergy, anxiety, depression, autism, migraine and Sjogren’s syndrome. In all, more than 150 conditions have been reported to have been successfully remediated by helminthic therapy. These are all listed on the following page along with thumbnail comments by the patients or their parents, and, in many cases, with links to their full reports.
* [[Helminthic therapy personal stories | '''Helminthic therapy personal stories''']]

=== How effective is helminthic therapy? ===

Most of the clinical trials set up to investigate the effectiveness of helminthic therapy have produced unreliable results due to poor trial design. (See [[Helminthic therapy research#Problems with clinical trials | '''Problems with clinical trials''']].)

The most useful data have been gathered by socio-medical studies investigating the results obtained by members of the global community of helminthic therapy self-treaters. [http://www.yourwildlife.org/wp-content/uploads/2015/05/galley-proof-v2.pdf] [https://helminthictherapywiki.org/wiki/images/7/77/Practices_and_outcomes_of_self-treatment_with_helminths_based_on_physicians_observations.pdf] [https://helminthictherapywiki.org/wiki/images/a/ad/Socio-medical_studies_of_individuals_self-treating_with_helminths_provide_insight_into_clinical_trial_design_for_assessing_helminth_therapy.pdf]

In the first of these three studies, more than 250 personal experiences of self-treatment with helminths were examined to determine the extent to which this therapy had effectively treated the subjects’ disease(s), and/or produced side effects, and the study authors concluded:

{{Quote|indent}}It is readily apparent from a substantial number of anecdotes that self-treatment with helminths is effective for many people, probably even most people, in terms of alleviating a wide variety of inflammatory-related diseases.{{Quote|/indent}}

The effectiveness of each of the four helminths currently used in therapy was summarised as follows.

'''Effectiveness of TSO'''
{{Quote|indent}}According to a provider, “80% of all patients who took TSO have either achieved remission or at least a condition close to remission.” This is consistent with the original information published by Weinstock [https://pubmed.ncbi.nlm.nih.gov/15825065/] [https://pubmed.ncbi.nlm.nih.gov/15591509/], although, as described above, the use of TSO has expanded beyond Weinstock’s studies, which involved only treatment of inflammatory bowel disease. It is noteworthy that suppliers of helminths other than TSO (i.e., competitors of TSO providers) support the effectiveness of TSO as reported by a TSO supplier.{{Quote|/indent}}

'''Effectiveness of NA'''
{{Quote|indent}}There is general agreement among suppliers that healthier individuals respond better to helminthic therapy than do very sick individuals. In general, only about 50% of the “most difficult cases” of allergic disease, often accompanied by “immune syndromes,” or syndromes associated with inflammation, may respond to helminthic therapy with NA. Furthermore, for individuals that are “very sick” with ulcerative colitis and Crohn’s disease, helminthic therapy with NA proves successful in only about 40% and 65% of cases, respectively (source: provider interview). On the other hand, NA is apparently very effective at alleviating seasonal allergies (sources: publically available information and provider interviews, n = 2), consistent with the original report by Turton [https://helminthictherapywiki.org/wiki/images/f/fd/Letter_-_IgE%2C_parasites%2C_and_allergy_%28Turton%29.pdf], with rates of remission reaching 80%. NA is extremely effective at treating relapsing-remitting multiple sclerosis, with a success rate exceeding 90%. The success rate for treating progressive multiple sclerosis is less, at about 50% (source: provider interview).{{Quote|/indent}}

'''Effectiveness of TTO'''
{{Quote|indent}}TTO is effective in “up to 50%” of Crohn’s cases in the large bowel, but it is not as effective as NA. Based on interviews with providers, TTO is probably most effective for ulcerative colitis.{{Quote|/indent}}

'''Effectiveness of HDC'''
{{Quote|indent}}Treatment with HDCs is apparently effective in more than 90% or even 95% of cases, which is slightly better than treatment with other helminths. This increased effectiveness is likely due, at least in part, to the relatively less ill population using the organisms. Whether the helminth itself makes a difference is unknown. It is possible, based on very limited information from survey participants and from provider interviews, that HDCs have more of an impact on neuropsychiatric function than does NA (see Section 4). However, comparisons between the effectiveness of HDCs and other helminths, especially TSO, are very difficult if not impossible to make based on the information available.{{Quote|/indent}}

For a guide to the relative effectiveness of each of the available four helminth species in treating some of the more common medical conditions, see the details in the following table.

* [[Selecting a therapeutic helminth#Considerations when choosing a therapeutic helminth | '''Considerations when choosing a therapeutic helminth''']]

Further evidence for the effectiveness of helminthic therapy generally is presented throughout this wiki, for example on the following page.

* [[Helminthic therapy personal stories | '''Helminthic therapy personal stories''']]

=== How long does helminthic therapy take to effect a cure? ===

Helminthic therapy does not "cure" anything. The replacement of worms in a previously worm-free intestine restores an ancient symbiotic bond developed over millennia between worms and host which optimises immune function. The resulting improvement in immune balance mitigates against chronic inflammation, autoimmune disease and other immunological disorders including allergy and some neuropsychiatric conditions. [http://www.ncbi.nlm.nih.gov/pubmed/21741180] This results in improved health that continues for as long as the worms are present. For examples of these improvements, see the following pages.

* [[Helminthic therapy personal stories |'''Helminthic therapy personal stories''']]

* [[Helminthic therapy for well people | '''Helminthic therapy for well people''']]

=== How long does it take to see benefits? ===

Helminthic therapy is typically very slow to deliver benefits when compared with drugs. For the majority who respond to treatment with hookworms, consistent improvements do not usually materialise until at least 3 months after their first inoculation, with most people only seeing improvement in their condition between 3 and 5 months. Some may only start to improve between 6 and 12 months and a few may even have to wait for as long as 18-24 months. Response to the non-human helminths, TSO and HDC, is usually more rapid.

Once improvements do begin, some people can experience a sudden and dramatic reduction in symptoms while others may respond more gradually over a period of time, possibly three years or more. Improvements during the first 2 years are not always continuous because there can be periods of exacerbation during which symptoms may worsen again, albeit temporarily.

Helminthic therapy is not a one-size-fits-all solution, nor a one dose fix. Dosing needs to be tailored to the unique needs of each individual, and continued indefinitely in the vast majority of cases.

=== How long do the benefits last? ===

There are people who have been able to enjoy many years of relief from their disease(s) after taking only one or two courses of TSO, and this period of remission has been extended in some self-treaters by taking periodic maintenance doses. (For more detail, see this [[Introduction to helminthic therapy#TSO (Trichuris suis ova) | '''page section''']].) But only one case has been reported of someone remaining disease-free for a number of years after completing only one course of therapy with NA [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], and there have not yet been any reports of HDC users having remained disease-free after stopping the treatment. While there may be cases that have not yet been reported, they are likely to be limited in number.

In the majority of cases, users of helminthic therapy need to continue to host worms in order to maintain the benefits. And, when this is done, there is no limit on the length of time that benefits can be enjoyed.

=== Which worm species are used in helminthic therapy? ===

Four species of benign helminth have been domesticated for therapeutic use.

* [[Introduction to helminthic therapy#Therapeutic helminths | '''Therapeutic helminths''']]

* [[Selecting a therapeutic helminth | '''Selecting a therapeutic helminth''']]

=== Which is the best helminth to use? ===

See the following page.

* [[Selecting a therapeutic helminth | '''Selecting a therapeutic helminth''']]

=== How many helminths do you need to take? ===

The number of helminths that need to be inoculated, and how often these doses need to be repeated, is different for each species. There are full details on the following pages.

* [[Self-treating with NA | '''Self-treating with NA''']]

* [[Self-treating with HDC | '''Self-treating with HDC''']]

* [[Self-treating with TSO | '''Self-treating with TSO''']]

* [[Self-treating with TTO | '''Self-treating with TTO''']]

=== Where do you get helminths from? ===

See the details here:

* [[Introduction to helminthic therapy#Obtaining helminths | '''Obtaining helminths''']].

=== How are helminths administered? ===

Three species (TSO, TTO and HDC) are taken orally in a drink, while NA is introduced percutaneously (via the skin). More details on the following page.

* [[Helminth inoculation | '''Helminth inoculation''']]

=== Where, and how long, do helminths live? ===

NA and HDC live in the small intestine. The whipworms (TSO and TTO) live in the large intestine.

NA are reported to survive in humans 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] However, the experience of hookworm self-treaters suggests that they typically only survive for approximately 1-3 years, and sometimes for only a few months, depending on the strength of the individual host’s immune response. For more, see: [[Hookworm dosing and response#Hookworm survival | '''Hookworm survival''']].

TT can survive in humans for more than 2 years, and there have been two reports of them showing up during colonoscopies 7 and 8 years post-inoculation. However, they may die in under a year.

TSO and HDC only survive in humans for 2-3 weeks, and a few people may need to re-dose every week with HDC, suggesting an even shorter lifespan for this species in some hosts. HDC may mature to adulthood in immunosuppressed adults, and colonise a very small percentage of young children, but TSO does not colonise.

More details on the following pages.

* [[Self-treating with NA | '''Self-treating with NA''']]

* [[Self-treating with HDC | '''Self-treating with HDC''']]

* [[Self-treating with TSO | '''Self-treating with TSO''']]

* [[Self-treating with TTO | '''Self-treating with TTO''']]

=== What side effects are experienced by people with helminths? ===

Side effects are usually transient and confined to the first two or three months after the first inoculation. They are also dose-dependent, so can be minimised by conservative dosing.

For more detail about the side effects that are associated with each off the helminth species, see the following pages.

* [[Hookworm side effects | '''Human hookworm (NA) side effects''']]

* [[Self-treating with TTO#Possible TT side effects | '''Human whipworm (TTO) side effects''']]

* [[Self-treating with TSO#Possible side effects and how to avoid them | '''Pig whipworm (TSO) side effects''']]

* [[The HDC experience#Side effects | '''Rat tapeworm (HDC) side effects''']]

=== Can helminths increase inflammation? ===

Once the immune system detects the introdution of helminths, it initially attempts to dislodge and dispatch them by creating inflammation in the gut and opening tight junctions to release a surge of fluid in a coordinated "weep and sweep" response. The extent of this response is dose-dependent, which is why helminthic therapy should always commence with small doses.

The increased inflammation also extends to other tissues throughout the body, as revealed in the results of various blood tests, and reflected in the increase in eosinophil numbers shown in the following graph.

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

This inflammatory response to the initial introduction of worms can give rise to a variety of transitory side effects, seen most notably with hookworms (see [[Hookworm side effects | '''Hookworm side effects''']]) but, provided that dosing is not excessive, these peak at around 50 days after inoculation and gradually reduce between 50 and 100 days.

The inflammatory response to a second dose is typically muted, and is likely to be absent altogether after subsequent doses as a result of worms already in the colony effectively modulating the immune response. For more about this, see [[The effects of helminths on the immune system | '''The effects of helminths on the immune system''']].

=== Can helminthic therapy help with haemochromatosis? ===

All the therapeutic helminths tend to normalise nutrient levels, especially where these had previously been low due to poor absorption or excessive bleeding in disorders such as Crohn's disease or ulcerative colitis. Reducing nutrient levels is not something that they typically do, especially not to the extent that is often required in treating haemochromatosis.

It is possible that NA might help '''''in a very small way''''' with iron overload disorders, but it would likely take a large number of NA to achieve a meaningful reduction in iron load. For example, at least 300 NA would be required to produce a noticeable effect on iron status in an individual on a "normal" First World diet, and this is far more than anyone should attempt to inoculate with. Even where NA does reduce iron levels somewhat, this species takes insufficient blood to be able to halt the organ damage that is caused in haemochromatosis by excess iron.

It is more likely that the Old World Hookworm, Ancylostoma duodenale (AD), would have an impact on haemochromatosis because it is reported to draw nine times more blood than NA. In the 1940s, AD was used successfully to treat 25 patients with polycythemia, which causes an abnormally high number of red cells in the blood, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5190334/] but between 300 and 600 AD were given to each of these patients, and this species is not currently available for therapeutic use.

There is a very small possibility that the human whipworm, Trichuris trichiura (TT) may cause anaemia in the long term, but the type of anaemia in this case is not due to low iron. It is speculated to be due to active suppression of the formation of blood cellular components in the bone marrow, rather than bleeding.

=== Can helminthic therapy help patients with cardiomegaly? ===

Whether or not hosting worms will help a particular individual with cardiomegaly will depend on the cause of this condition in their case.

"Cardiomegaly is not a disease, but rather a condition that can result from a host of other diseases such as obesity or coronary artery disease... The causes of cardiomegaly vary from patient to patient, depending on each case. Many times this condition results from high blood pressure (hypertension) or coronary artery disease." [https://en.wikipedia.org/wiki/Cardiomegaly]

Helminthic therapy might help some people with cardiomegaly if the causes of this condition in their case involve the immune system and inflammation. By reducing systemic inflammation, worms are known to reduce the risk of cardiovascular problems generally. (See, [[Helminthic therapy for well people#Cardiovascular disease | '''Helminthic therapy for well people: Cardiovascular disease.''']])

=== What products and medications can harm therapeutic helminths?===

See the following page.

* [[Helminth care‎ | '''Helminth care‎''']]

== FAQs about NA (the hookworm, Necator americanus) ==

=== How big should a hookworm colony be? ===

It’s pointless to even consider what the exact size of a hookworm colony might be because, firstly, there is no reliable test to determine the number of organisms being hosted, and, secondly, because worms are constantly dying due to unrelenting attrition by the immune system, the extent of which varies widely between different individuals.

All that can be determined about the extent of hookworm colonisation is the number of larvae that a host has introduced via inoculation, and the dates of, or the intervals between, these inoculations.

It is also true that the total number of worms being hosted is not important for the purposes of helminthic therapy. What matters is the length of time that the host has been exposed to worm secretions, the benefits of which develop gradually as the worms and the host’s immune system negotiate their long-term relationship.

So all that is required for successful therapy with hookworms is that the colony is kept refreshed by adding periodic top-up doses, and, for most people, top-up doses don’t need to be very large. It's the regular repetition of dosing that is most important. For more details, see the the following links.

* [[Hookworm dosing and response#Colony size |'''Colony size''']]
* [[Hookworm dosing and response#Dosing in the long term |'''Dosing in the long term''']]

=== I've inoculated with too many hookworms. What should I do? ===

See the following page section.

* [[Hookworm dosing and response#Reducing the size of a hookworm colony | '''Reducing the size of a hookworm colony''']]

=== Are tattoos contraindicated if you have hookworms? ===

Since hookworms secrete a small amount of anticoagulant to assist their digestive process, NA self-treaters are sometimes concerned that getting a tattoo could cause excessive blood loss. This is not the case, however, due to the minuscule amount of anticoagulant involved, the fact that its effect is mostly localised at the feeding sites and the small number of worms that are hosted. For more about this, see the following page section.

* [[Helminthic therapy safety#Can hookworms make their hosts' blood too thin? | '''Can hookworms make their hosts' blood too thin?''']]

=== Can NA affect bile production? ===

There are approximately 70 different species of hookworm, some of which may enter the bile ducts of animals, blocking them and consequently reducing, or halting, bile flow. There are also human helminths that are known to do this, including the roundworm, [[Ascaris lumbricoides | '''Ascaris lumbricoides''']]. However, this is not something that NA does in humans. See the following page section.

* [[Helminthic therapy safety#The safety of NA | '''The safety of NA''']]

=== Might a genetic bottleneck weaken the domesticated NA stock? ===

See the following page section.

* [[Self-treating with NA#Is there genetic degradation in laboratory-reared hookworms? | '''Is there genetic degradation in laboratory-reared hookworms?''']]

== FAQs about TT/TTO (the human whipworm, Trichuris trichiura) ==

=== Does the human whipworm, TT/TTO, cause "whipworm disease”? ===

The human whipworm, Trichuris trichiura (TT/TTO), can certainly cause "whipworm disease” if it is hosted in very large numbers, but when this species is used in helminthic therapy, only very small numbers of organisms, or “light” infections, are used. The following quote is from the website of the US Government's Centers for Disease Control and Prevention.

{{Quote|indent}}People infected with whipworm can suffer light or heavy infections. People with light infections usually have no symptoms. People with heavy symptoms can experience frequent, painful passage of stool that contains a mixture of mucus, water, and blood. Rectal prolapse can also occur. Heavy infection in children can lead to severe anemia, growth retardation, and impaired cognitive development. [https://www.cdc.gov/parasites/whipworm/disease.html]{{Quote|/indent}}

If an individual who is hosting TT for therapeutic purposes experiences any side effects at all, these will typically be mild and limited to the first few weeks of treatment. See, [[Self-treating with TTO#Possible TT side effects | '''Possible TT side effects''']].

For more detail about the therapeutic use of TT/TTO, see the following page.

* [[Self-treating with TTO | '''Self-treating with TTO''']]

== FAQs published by the helminth providers ==

The following "Frequently Asked Questions" pages on the websites of the commercial helminth providers are an additional source of answers to questions about the therapy.

* [http://biomerestoration.com/faqs/ Biome Restoration FAQ] (HDC)
* [http://www.symmbio.com/faq/ Symmbio FAQ] (NA and TTO)
* [https://www.yoursymbionts.com/faq YourSymbionts FAQ] (NA and TTO)

== Alternatives to FAQs ==

There are several alternative ways to get answers to questions by drilling into the contents of this site using one or more of the tools at the following link.

* [[Introduction to helminthic therapy#How to drill into the contents of this site | '''How to drill into the contents of this site''']]

Hookworm side effects

2022-03-18T18:15:54Z

Khalid: /* Treating the side effects */

{{Breadcrumb|[[Using_helminths|Using helminths]]}}
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==Side effects overview==

===Side effects following the first dose===

The first inoculation with NA can cause '''''transient''''', dose-dependent side effects during the first 12 weeks.

:A parasite said to its host,  
:‘Though I’m not trying to boast,
: My favourite trick  Is making you sick, 
:So your health will be better than most.’ [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]

In the majority of cases, the earliest that side effects might appear is on or after the 4th day but, occasionally, they may start from day 2 and might include coughing, respiratory symptoms, fatigue, diarrhoea, cramping, gas, nausea or vomiting - symptoms collectively known as [[Worm flu | '''"worm flu"''']].

{{Quote|indent}}It feels SO MUCH like a normal flu. [https://www.facebook.com/groups/htsupport/permalink/2397365493652725/?comment_id=2397368003652474&reply_comment_id=2397369183652356]{{Quote|/indent}}

{{Quote|indent}}I had severe side effects the two first days with 3 NA and had to stay in bed because of high fever and nausea. [https://www.facebook.com/groups/htsupport/posts/4644202185635700/?comment_id=4646180948771157]{{Quote|/indent}}

All the side effects experienced following inoculation are a result of the immune system responding to what it perceives to be an invading alien organism, and trying to get rid of this. The immune response involves an increase in eosinophils that usually begins in weeks 2-3 following inoculation, then rises more rapidly from week 4 and peaks at around weeks 5-8, before dropping back to normal at about 14 weeks. This progression can be seen in the following graph, which also illustrates why higher numbers of larvae produce more severe side effects.

[[file:Eosinophil_count.gif]]

Graphic taken 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]

For more detail about eosinophils in helminthic therapy, see [[Helminthic therapy and eosinophils | '''Helminthic therapy and eosinophils''']].

Since the side effects are dose-dependent, their severity can be minimised by commencing with a small dose. For much more detail about the best approach to hookworm dosing, see [[Hookworm dosing and response | '''Hookworm dosing and response''']].

When the guidance to limit the size of doses is ignored, especially at the commencement of therapy, there is a risk of triggering very challenging side effects, as was discovered by someone who received an excessively large first dose of 20 NA.

{{Quote|indent}}(After) my initial dose… I had 36 hours with symptoms identical to the worst flu I've ever had in my life except I had no fever. That is I had vomiting, diarrhea, and a strange feeling like time was drifting over my head. [https://www.facebook.com/groups/htsupport/permalink/1496030463786237/?comment_id=1497285636994053&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

Even starting with a small number of larvae can be tough for a few people.

{{Quote|indent}}I must say the 1st week (with 5 NA) was hard. [https://www.facebook.com/groups/SclerodermaFM/permalink/3073307496077674/?comment_id=3073854619356295&reply_comment_id=3076031772471913]{{Quote|/indent}}

In addition to the side effects discussed on this page, the disease being treated can also flare during the first 12 weeks.

{{Quote|indent}}Going on 3 weeks since I stuck 5 NA on my arm. In the last few days I’ve been feeling like crap. Headache, ringing ears, bloating, tired. All normal stuff for me but exaggerated. [https://www.facebook.com/groups/htsupport/permalink/3116443291744938/]{{Quote|/indent}}

{{Quote|indent}}Week 8 was like hell for me, too. My arthritis was the worst it has ever been in my life. Now at week 9.5 I feel like things are slowly getting better. [https://www.facebook.com/groups/htsupport/permalink/2691495487573056/?comment_id=2692070590848879]{{Quote|/indent}}

{{Quote|indent}}I did have a flare in neuropsychiatric symptoms (which is the main thing I am trying to treat) around week 10. It cleared up in a week and a half. [https://www.facebook.com/groups/htsupport/permalink/1890842694305010/?comment_id=1891331044256175&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

Although the side effects and/or disease exacerbations tend to follow the graph shown above, self treaters can experience personal peaks at different times.

{{Quote|indent}}I usually have week 3 as my worst. [https://www.facebook.com/groups/htsupport/permalink/2401206293268645/?comment_id=2401362916586316]{{Quote|/indent}}

{{Quote|indent}}Week 8/9 was the worst for me. [https://www.facebook.com/groups/htsupport/permalink/2401206293268645/?comment_id=2413226655399942]{{Quote|/indent}}

{{Quote|indent}}For me it’s week 9. [https://www.facebook.com/groups/htsupport/permalink/2401206293268645/?comment_id=2401218413267433]{{Quote|/indent}}

There may also be a reappearance of old injuries and illnesses (see [[Hookworm side effects#Recapitulation of old injuries, illnesses | this section]], below), but, in most cases, the side effects and exacerbations resolve between 12 and 14 weeks, eventually giving way to the emergence of benefits.

{{Quote|indent}}After inoculation both times I experienced increased chronic fatigue and lasting low energy. It was bumming me out and lasted for weeks. Now it’s passed. I have great energy. Normal bowel movements. Asthma disappeared. Pollen allergies disappeared. Strange headaches that were chronic are gone! Sleep is great. Sexual function is even boosted. [https://www.facebook.com/groups/htsupport/posts/4126676507388273?comment_id=4128779390511318]{{Quote|/indent}}

As well as being dose-dependent, the severity of side effects varies widely between individuals and is to some extent determined by the subject’s disease.

There is no reliable link between the presence or severity of side effects and eventual success with the therapy.

For what to expect in the days, weeks and months after first inoculating with hookworms, including all the ''typical'' side effects, see the following page.

* [[Hookworm timeline | '''The Hookworm Timeline''']]

=== Symptoms experienced after inoculation are not always worm side-effects ===

Symptoms experienced after inoculating with helminths might be assumed to have been caused by the worms, when they may in fact have other origins! A number of people who have been convinced that symptoms they were experiencing were worm-related, have eventually realised that the issue(s) they were having actually had a different cause altogether.

{{Quote|indent}}I killed the worms, thinking it was all them, but it was not until I stopped the LDN that the nighttime retching and daytime nausea went away. Only a very small amount of people taking LDN get gut issues, so I was in denial that it could be that. [https://www.facebook.com/groups/htsupport/permalink/2980446142011321/?comment_id=2980523308670271&reply_comment_id=2980535385335730]{{Quote|/indent}}

{{Quote|indent}}The sleep disturbances I thought were from NA were actually from vitamin D megadoses and klonopin, both of which I took to *prevent* side effects. (whoops!) [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=2995809023808366]{{Quote|/indent}}

{{Quote|indent}}I got rid of my NA... to see if they were contributing to a sudden and consistent drop in energy I've been experiencing. (Yes, this was misguided. Yes, I regret doing this... I was desperate to feel better and this was the nearest thing I had control over.) I find that I am more depressed without them... More NA on the way to restock. [https://www.facebook.com/groups/htsupport/permalink/1715076141881667/?comment_id=3042523755803559]{{Quote|/indent}}

===The 'bounce' - a very enjoyable side effect!===

A much more welcome phenomenon that may be experienced by some new helminth self-treaters is the so-called 'bounce', which can provide a brief period of temporary, yet sometimes profound, symptom relief accompanied by a sudden feeling of unusual wellness, and perhaps also by a strong sense of calm, focus, happiness and lightheartedness. For more details, see the following page.
* [[The helminthic therapy bounce | '''The helminthic therapy 'bounce''''.]]

===Side effects following supplementary doses===

Once there are mature worms living in the gut, these help to modulate the immune response to any new worms that are added. Therefore, when side effects occur following supplementary doses, these usually reduce progressively with each successive dose, and are typically absent in the long term unless overly large doses are added.

{{Quote|indent}}I had very sharp pain the first time. On the second, I am just getting a tightness in the same area. So quite different. [https://www.facebook.com/groups/htsupport/permalink/1489781371077813/?comment_id=1490049997717617&reply_comment_id=1490150091040941&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}The side effects with my first dose were pretty discouraging! They got better with the second dose, and I am glad that I kept going. [https://www.facebook.com/groups/htsupport/permalink/2325589907496951/?comment_id=2338312102891398&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}The first dose (25 NA) was extremely painful to the point I wanted to take anthelmintics to terminate them. The other doses (10, 25, 25) were gradually less painful. [https://www.facebook.com/groups/htsupport/permalink/1489781371077813/?comment_id=1490049997717617&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had a bad reaction of poor energy with my first and second innoculation, first one lasted quite a few weeks, second one less and now its not long at all... days if anything... [https://www.facebook.com/groups/htsupport/permalink/1470403189682298/?comment_id=1472526732803277&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I noticed last time I did 10 NA and again this time I have done another 10 NA, that my hot flushes (hot flashes) that had virtually gone, have come back for I think it was the first 8 weeks or so (on and off). [https://www.facebook.com/groups/htsupport/permalink/2138594556196488/?comment_id=2139005642822046&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

===Side effects that recur following inoculations in the longterm===

There are a '''''few''''' individuals who continue to experience side effects after inoculations in the long term.

{{Quote|indent}}I still get a spike in inflammation when I take a new dose and I do the therapy for about 2 years now. It only is for a few days though and for me it’s a sign of a successful inoculation. [https://www.facebook.com/groups/htsupport/permalink/2182238021832141/?comment_id=2184350624954214&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I have Graves' and I have symptom flares from that when I inoculate. I introduced 10 more NA on March 12th and I've had disease symptoms flaring for the past week (second week of May). I'd expect them to continue for another month or so based on previous experience. [https://www.facebook.com/groups/htsupport/permalink/1658237297565552/?comment_id=1658252197564062&reply_comment_id=1658381660884449&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}I feel dead tired for about 4 to 6 weeks following a hookworm inoculation. The peak of these effects happens at the 6 to 8 week mark. It can be really challenging. [https://www.facebook.com/groups/htsupport/permalink/1929845233738089/?comment_id=1929870023735610&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I usually add 7 NA each time, and I always get side effects. They're not horrible horrible, but they start around week 3 and sometimes last till week 9, peaking between weeks 3 and 5. The nausea is often sporadic, usually lasts for about a week and can be really bad. It almost feels like I’m pregnant! I get lymph node pain in my arm pits and knee pain or joint aches, and a flu-like feeling throughout my body. My extremities (hands, feet and nose) get cold, I get very tired and I sleep more during this time. My heart can also skip beats and I can get breathing issues. This happens to me at every inoculation to the point where my family knows. When I begin complaining, they tell me: Oh, you just took your worms… it will go away. (Via Messenger.){{Quote|/indent}}

{{Quote|indent}}Every time I apply Hookworms, a couple of weeks (sometimes days) later I get a red left (or right, or sometimes both) eye(s). It happens 2-3 weeks after inoculation, without any pain or itch, and persists for a very long time. (Edited from two posts: [https://www.facebook.com/groups/htsupport/permalink/2224946950894581/] [https://www.facebook.com/groups/htsupport/permalink/2224946950894581/?comment_id=2225005914222018&reply_comment_id=2225018647554078&comment_tracking=%7B%22tn%22%3A%22R%22%7D]){{Quote|/indent}}

{{Quote|indent}}I got random skin inflammations and 1 or 2 "puffy eye" each time I upped my dosage. [https://www.facebook.com/groups/htsupport/permalink/1376977685691516/?comment_id=1378003632255588&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}My symptoms always seem to peak right at 8 weeks after a new inoculation with HW. Did 7 last time, and my left eye was swollen nearly shut this morning, plus lots of skin rashes and sores, and unhappy gut. 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. The inoculation before this, I woke up exactly 8 weeks after inoculating, with both eyes swollen shut and the right one streaming gobs of goo. [https://www.facebook.com/groups/htsupport/permalink/1376977685691516/] [https://www.facebook.com/groups/htsupport/permalink/1936169449772334/?comment_id=1936702619719017&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

The author of this last comment has also reported that her response to each inoculation can be quite different, ranging from just a few symptoms to a complete melt down. [https://www.facebook.com/groups/htsupport/permalink/1915345108521435/?comment_id=1915353551853924&comment_tracking=%7B%22tn%22%3A%22R%22%7D] And new symptoms that appear following 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]

===Side effects that persist, even in the longterm===

In a few '''''rare''''' cases, a side effect may persist for a considerable time.

{{Quote|indent}}I inoculated… with 3 NA. I was originally planning to add 5 more after around 12 weeks, but I was also waiting for the effect to "stabilise" and since nothing really changed and I had lots on my mind, I guess I just did not realise how much time has passed (next Thursday it's going to be 24 weeks). Since about a week after the inoculation my regular allergy symptoms have diminished: skin looks much better, don't really have significant red patches, only barely noticeable reddish coloration in some places, much less runny nose, even when I'm dusting (nice!), much less dryness and wounds on head/in hair (great!). But it's not just positives unfortunately. All this time I'm also struggling with a very strong itching all over my body; the kind you usually get in a single place when e.g. you're bitten by a mosquito. It's so bad, that for the last few months I constantly have small wounds and scabs in all sort of places I keep scratching without even thinking. There are moments when it's stronger (usually I think in days after I eat things they don't like, or after drinking etc), and there are moments when it's a bit weaker, but although I hoped it would diminish over time it did not really, or maybe just slightly. I keep taking my antihistamine meds just in case, but I don't really see them doing much (or anything) about the itching. [https://www.facebook.com/groups/htsupport/posts/4525402410849012/]{{Quote|/indent}}

Occasionally, the side effects may persist more or less indefinitely.

{{Quote|indent}}I tend to get flatulence that really never goes away... This is about the 7th or so time I have been inoculated… but I have had the flatulence the entire time. [https://www.facebook.com/groups/htsupport/permalink/3579053868817209/]{{Quote|/indent}}

==Side effects in detail==

===Anaphylaxis===

The chance of an anaphylactic reaction to helminthic therapy is extremely small, but it is possible, especially with ''large'' doses of hookworms. For more detail, see [[Helminthic therapy and anaphylaxis | '''Helminthic therapy and anaphylaxis''']].

===Anxiety===

Helminth doses, including doses of NA, can occasionally produce a temporary increase in anxiety. See [[Helminthic therapy and neuropsychiatric function#Temporarily increased anxiety |'''Temporarily increased anxiety''']].

But, in the longer term, helminths are likely to alleviate anxiety. See [[Helminthic therapy personal stories#Anxiety | '''Helminthic therapy personal stories: Anxiety''']].

===Body odour / body odor, increase in===

This effect may be partly related to an improving sense of smell, which some new hookworm hosts have reported. [https://www.facebook.com/groups/htsupport/permalink/3695934930462435/?comment_id=3696803643708897]

{{Quote|indent}}One really weird thing I've been noticing pretty much since I've innoculated is I'm sweating and actually have BO. I usually don't have any BO at all!{{Quote|/indent}}

{{Quote|indent}}The first weeks after my inoculation my sweat smelled like it did in my twenties. [https://www.facebook.com/groups/htsupport/permalink/3695934930462435/?comment_id=3696626623726599]{{Quote|/indent}}

{{Quote|indent}}Weird thing-My feet have never smelled. Like, it’s a thing. Well I’m sad to report this as an unfortunate side effect of NA - they are no longer so pleasant [https://www.facebook.com/groups/htsupport/permalink/3695934930462435/]{{Quote|/indent}}

===Claustrophobia===

{{Quote|indent}}The week I took my first dose of NA, I had my first-ever experience with claustrophobia. I awoke in the middle of the night, feeling constrained. I got up, went outside, breathed big and deep, and the sensation passed. IIRC, it happened again the next night, but not as severely. It did not repeat itself after that. [https://www.facebook.com/groups/htsupport/permalink/1500750116647605/?comment_id=1524683410920942&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

===Constipation===

{{Quote|indent}}The constipation started a week after inoculation and was suddenly gone on about day 20. [https://www.facebook.com/groups/htsupport/permalink/1983332318389380/?comment_id=2080023232053621&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

===Cravings===

See [[Helminths, appetite and body weight#Cravings | '''here''']] for examples.

===Depression===

Depression can present temporarily following the first inoculation, and is most likely to appear in those with a pre-existing tendency to this condition. See [[Helminthic therapy and neuropsychiatric function#Temporarily increased depression |'''Temporarily increased depression''']].

In the longer term, hosting hookworms can bring about a reduction in depression. See [[Helminthic therapy and neuropsychiatric function#Reduced depression / improved mood |'''Reduced depression / improved mood''']].

===Diarrhoea / diarrhea===

{{Quote|indent}}I was having bad diarrhea every day starting around week three or four. [https://www.facebook.com/groups/htsupport/permalink/960597907329498/?comment_id=960661000656522&comment_tracking=%7B%22tn%22:%22R9%22%7D]{{Quote|/indent}}

One self-treater, who had a longstanding problem with diarrhoea, found that this became even worse for several months after a first dose of 15 NA.

{{Quote|indent}}I had science fiction level diarrhea... took a few months to decrease.{{Quote|/indent}}

===Dizzy spells===

{{Quote|indent}}Well, I finally have decided (39 days in) that my 10 NA are there - just a little slow on the uptake. The last couple of days the gut has become increasingly uncomfortable, with some severe pains and quite a lot of dizzy spells. [https://www.facebook.com/groups/htsupport/permalink/1123870124335608/?comment_id=1124843610904926&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}I'm about 3.5 weeks into 20 NA. It’s my 3rd and highest dose thus far over the last 2 years… Starting around inoculation time, I began getting little head rushes here and there and it has been building up to full dizzy spells. [https://www.facebook.com/groups/htsupport/permalink/3387168258005772/]{{Quote|/indent}}

===Fatigue===

This is particularly likely in someone with M.E./CFS, especially if they start with more than 3 NA. [https://helminthictherapywiki.org/wiki/index.php/Hookworm_dosing_and_response#Even_3-5_larvae_can_cause_significant_side_effects_in_some_people]
{{Quote|indent}}I have CFS and started with 5. This was too much as my fatigue got a lot worse for many weeks. [https://www.facebook.com/groups/htsupport/permalink/3828931347162792/?comment_id=3830599996995927]{{Quote|/indent}}
The following comment was reported at 2 days by a patient with CFS/M.E. who had inoculated with 5 larvae.
{{Quote|indent}}Horrible fatigue today…[https://www.facebook.com/groups/htsupport/permalink/2092455257477085/]{{Quote|/indent}}
This was followed by the further comment at 4.5 weeks.
{{Quote|indent}}Too much fatigue, can't stand any more. This is simply unbearable… [https://www.facebook.com/groups/htsupport/permalink/2135581166497827/?comment_id=2135584446497499&reply_comment_id=2135609303161680&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

===Gas / flatulence===

{{Quote|indent}}Day 4 now, and I have enough gas to power a sail boat on a world trip. 😂 [https://www.facebook.com/groups/htsupport/permalink/2526407367415203/?comment_id=2529148333807773&reply_comment_id=2529672667088673]{{Quote|/indent}}

{{Quote|indent}}Toxic farts!... about 1-2 weeks of strange, otherworldly smells... [https://mysymbiontjourney.wordpress.com/2018/10/24/days-102-116-first-major-result-and-new-friends-join-the-club/] [https://www.facebook.com/groups/htsupport/permalink/1949838038405475/?comment_id=1949870388402240&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}The noxious gas and runs are more common in week 3 for me. [https://www.facebook.com/groups/htsupport/permalink/2026465510742727/?comment_id=2026494907406454&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I think i started noticing gas, diarrhea and ab pain right around week 3. Very gassy, very odorous and painful. It lasted for 2-3 weeks. [https://www.facebook.com/groups/htsupport/permalink/1949838038405475/?comment_id=1951206288268650&reply_comment_id=1952186231503989&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1949838038405475/] [https://www.facebook.com/groups/htsupport/permalink/1969827113073234/?comment_id=1970846426304636&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had odorous and painful gas with bloating and cramps with one of the doses. Peak was between week 6-8. [https://www.facebook.com/groups/htsupport/permalink/1949838038405475/?comment_id=1949902961732316&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I swear my last batch of 20 NA had me competing with an entire dairy herd for methane production. [https://www.facebook.com/groups/htsupport/permalink/2504164162972857/?comment_id=2504329252956348]{{Quote|/indent}}

===GERD / reflux===

 A few subjects have mentioned a transient post-inoculation increase in stomach acid with heartburn/reflux.

{{Quote|indent}}I rarely suffer gastric reflux but usually do a few days post inoculation with NA. [https://www.facebook.com/groups/htsupport/permalink/1419247764797841/?comment_id=1420032944719323&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}My mother inoculated 5HW for dust mite allergy and atopic dermatitis 2 weeks ago. At one week she started having reflux (never had before). [https://www.facebook.com/groups/htsupport/permalink/1426082444114373/]{{Quote|/indent}}

{{Quote|indent}}I've been having nighmarish GERD symptoms since about week 2, accompanied with horrible belching. [https://www.facebook.com/groups/htsupport/permalink/1237238522998767/?comment_id=1353908904665061&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I inoculated with 10 HW at the end of September. I had zero issues and was thinking of doing a second round of ten right away. Then, in the beginning of November I suffered from a massive increase in stomach acid production, which brought on GERD and gastritis type symptoms, along with other GI symptoms characteristic of HW infection. It was really bad for three weeks. (Link expired){{Quote|/indent}}

Two cases of more severe and prolonged manifestations of GERD have been reported.

{{Quote|indent}}Around week 9-10 (after a first dose of 5 NA for adult onset celiac and undifferentiated connective tissue disease) I started having extreme amount of stomach acid, 10 times worse than I had ever experienced and requiring a lot more PPI and H2 blockers to function normally. My abdominal pains also worsened. With my history of GERD, I avoided prednisone and took Claritin for 3 weeks to no avail… I held on until day 139 (week 19) when I gave up and took albendazole. Within the night of the first dose (400mg per day X three days), my stomach acid subsided and got better and better. [https://www.facebook.com/groups/htsupport/permalink/3670873856301876/]{{Quote|/indent}}

{{Quote|indent}}I went pre-worm from having occasional heartburn every few months and sort of avoiding onions, to daily agony with diagnosed gastritis and an ulcer over a 3 month period and needing medication. It showed up around the 6-10 week mark and just got worse and worse. [https://www.facebook.com/groups/htsupport/posts/4211120622277194?comment_id=4211570012232255&reply_comment_id=4212872418768681]{{Quote|/indent}}

This side effect is also sometimes [[Self-treating with TSO#Reflux / nausea / gastritis | experienced by users of TSO]].

===Headache===

{{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}}

===Hives===

See [[#Rashes|'''Rashes and itching distant from the inoculation site''']], below.

===Hypersensitivity===

====Alcohol intolerance====

{{Quote|indent}}(My alcohol intolerance) was severe (vomiting, stomach cramps) and first occurred at the 8 week point after my first innoculation of 35 NA (for skin allergies). I don't drink much anyway, but it happened 3 times over 2 weeks (at which point I avoided alcohol for the next 3 months). I re-inoculated 10 weeks ago but haven't had the problem recur. (Link expired){{Quote|/indent}}

{{Quote|indent}}Both me and my mother experienced alcohol intolerance after doses of 5 NA. We both had cramping and pain - a very strong and immediate response that I discovered as soon as I sipped at a beer 1 month in. (Via private communication.){{Quote|/indent}}

{{Quote|indent}}Inoculated with 5 NA right on 10 weeks ago. At the 8 week mark I developed - literally overnight - quite stunning alcohol intolerance. Same bottle of wine, one night to the next, went from being fine to producing immediate (upon first mouthful) burning pain in the stomach, persisting with severe cramping over an hour, resulting in vomiting and graduating to lower gut cramps and eventually, the next day, diarrhoea. Happened once with wine, then (because I didn't join the dots together and thought it was a reaction to the wine, perhaps allergic in nature) once with a clear gin mixed with soda water about a week later. Last night (2 weeks on) I tolerated a much smaller glass/half a shot mixed with soda water, but started to feel what might have been the onset of those same symptoms so gave it up as a bad job. [https://www.facebook.com/groups/htsupport/permalink/3441587845897146/]{{Quote|/indent}}

A few others have reported abdominal pain after drinking alcohol, including three bouts of almost instant burning pain below the navel at 5 weeks after inoculation with 25 NA [https://www.facebook.com/groups/htsupport/permalink/1276571042398848/?comment_id=1603795249676424&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] and two incidents of mild to severe stomach pain at 4-5 months after inoculating with 20 NA. [https://www.facebook.com/groups/htsupport/permalink/1276571042398848/]

As with other hookworm side effects, this experience does not usually persist indefinitely, although it has done for one individual.

{{Quote|indent}}After 2 years with NA, I am still unable to tolerate alcohol. It’s not an allergy, I just process it differently. I can become quite intoxicated off of one glass of wine, and initially would remain that way for several hours. Although it no longer lasts for hours, I basically still have to pass on alcohol, but obviously NA benefits are worth the trade off. (Edited from 3 posts.) [https://www.facebook.com/groups/htsupport/posts/4069771826412075/?comment_id=4072365886152669]{{Quote|/indent}}

For most who temporarily develop this intolerance, there is much to look forward to once the worms have settled in! See [[Helminthic therapy personal stories#Alcohol intolerance | '''Helminthic Therapy personal stories: Alcohol intolerance''']].

====Caffeine intolerance====

Sensitivity to caffeine may develop, or, if present previously, may increase, during the early stages of hosting NA.

{{Quote|indent}}I was very sensitive to caffeine and alcohol during peak NA side effect period. [https://www.facebook.com/groups/htsupport/permalink/1845731158816164/?comment_id=1846422158747064&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I took a caffeine pill yesterday (200 mg) and all my symptoms immediately came back with a vengeance. I’m at week 5 of my second dose. [https://www.facebook.com/groups/htsupport/permalink/1845731158816164/]{{Quote|/indent}}

This increase in sensitivity typically subsides once the worms have matured, and previous intolerance to caffeine may improve.

{{Quote|indent}}My NA has made me less sensitive to the bad effects of coffee. If I ever drank more than one cup I'd get shivers and feel drunk.😆 I don't feel amazing if I drink 3 cups now, but I'm definitely not shaky or weird anymore. [https://www.facebook.com/groups/htsupport/posts/4177936308928959?comment_id=4179468282109095]{{Quote|/indent}}

====Food intolerance====

A few medical practitioners have noticed an increased rate of chicken and duck egg intolerance appearing in patients after their first inoculation with hookworms. People who normally eat a lot of eggs without issue have noted intensified acute abdominal cramping, especially at the 6 week mark and, in some individuals, this has even persisted for several months, In one case, a patient had extremely severe reactions to egg for a whole year, experiencing incapacitating bouts of abdominal cramping that would last for several hours but then resolve on their own. This reaction did eventually subside, and, by the 2nd year post inoculation, this patient was able to resume eating eggs without any issue. This phenomenon has led some clinicians to recommend patients to avoid eggs following inoculation, especially around the 6th week, to minimize the risk of increased abdominal symptoms that are typical at that period post inoculation. The egg intolerance appears to induce or worsen abdominal cramping acutely after eating, within one hour, and then subside without other incident.

{{Quote|indent}}I was able to eat eggs again after 2.5 years. I don’t eat them every day as I used to, but am now ok eating them several days per week. [https://www.facebook.com/groups/htsupport/permalink/2086465811409363/?comment_id=2086570641398880&reply_comment_id=2086745721381372&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

Self-treaters have reported the following additional transient food intolerances following inoculation.

{{Quote|indent}}Before HT, I was only intolerant to dairy and gluten. With my first inoculation (5 NA) I become intolerant to rice. Now with my second inoculation - beans and probably buckwheat... [https://www.facebook.com/groups/htsupport/permalink/1120928157963138/]{{Quote|/indent}}

{{Quote|indent}}Prior to hookworm I only had problems with gluten and occasionally dairy. But about 3 weeks after inoculation (with 25 larvae) I started reacting to what seemed like almost all foods. And at exactly 12 weeks it dropped off and now, at about 15 weeks, I'm fine with all other foods again. [https://www.facebook.com/groups/htsupport/permalink/1120928157963138/?comment_id=1121126284609992&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I now have 5 NA on board, in week 12. I did fairly well for much of the last 12 weeks, but I did have a few episodes of intense stomach ache in week 8 and 9 after having oatmeal and blueberries with almond milk. The pain was so bad during the second episode that I felt like I was going to throw up and I also got dizzy and passed out for a few seconds. Pretty scary stuff. I experimented with the almond milk and raw almonds a few times after that and each time I got a stomach ache, so I have since backed off almonds and almond products. Also should note I had a similar intense stomach ache with pecans in week 10/11. [https://www.facebook.com/groups/htsupport/posts/4811175975604986/]{{Quote|/indent}}

====Hypersensitivity to contact lenses====

{{Quote|indent}}I became allergic to contacts (after wearing them without issue for almost 30 years) a couple weeks after my second inoculation with NA. It took more than a year to resolve, but I’ve gotten used to glasses again so never really went back. [https://www.facebook.com/groups/htsupport/posts/4338944486161473/?comment_id=4339356609453594]{{Quote|/indent}}

====Increased reaction to insect bites====

{{Quote|indent}}I usually don't react much to mosquito bites at all but for a couple weeks (probably around week 7) I was getting big itchy bumps that seemed to take forever to go away. I'm at 12 and a half weeks now after my first inoculation of five NA and mosquitoes aren't bothering me anymore. [https://www.facebook.com/groups/htsupport/permalink/2237580629631213/?comment_id=2237789106277032&reply_comment_id=2237927382929871&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/2237580629631213/?comment_id=2237789106277032&reply_comment_id=2237931289596147&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}At week 7, have been getting huge bumps from mosquito bites on my legs and back. Tree bites is like 5 cm in diameter, usually i dont react to this. [https://www.facebook.com/groups/htsupport/permalink/2237580629631213/]{{Quote|/indent}}

===Hypotension (reduced blood pressure) / lightheadedness===

Several people have reported a reduction in blood pressure, e.g., as reported [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/messages/11143 here].

A few have described becoming light headed.

{{Quote|indent}}I just inoculated (with 20 NA) and within 5 minutes, I felt the itch! Another 10 minutes and I got light headed, I'm now lying on the couch -- head spinning. [https://www.facebook.com/groups/htsupport/permalink/1470903532965597/]{{Quote|/indent}}

{{Quote|indent}}I’ve been lightheaded for a couple of days, especially when standing up, and I've never had that before... I'm a couple weeks in. [https://www.facebook.com/groups/htsupport/permalink/1022014974521124/]{{Quote|/indent}}

{{Quote|indent}}I, too, have had several low blood pressure events recently. I'm 2½ weeks into hosting 25 NA. I have gone through several phases in my life when I have gotten dizzy due to low blood pressure. [https://www.facebook.com/groups/htsupport/permalink/1022014974521124/?comment_id=1024554070933881&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I’m one month in with 5 NA and for two days I felt lightheaded like if I was going to faint, then it went away and came back a week later. (Via private communication.){{Quote|/indent}}

===Infections, exacerbation of===

====Herpes virus reactivation====

One self-treater with no history of cold sores had a serious outbreak of Herpes type 1 virus a few weeks after his first dose of 5 NA. This was diagnosed as [https://en.wikipedia.org/wiki/Eczema_herpeticum eczema herpeticum], and the individual was hospitalised for 2 days.

====Urinary tract infection (UTI) exacerbation====

{{Quote|indent}}I'm 10 weeks post inoculation (with 10 NA) and my UTI and related symptoms have been through the roof for the last 5 or 6 weeks. [https://www.facebook.com/groups/htsupport/permalink/693651310690827/?comment_id=1804070266315587&comment_tracking=%7B%22tn%22%3A%22R4%22%7D]{{Quote|/indent}}

{{Quote|indent}}In week 4 or 5 after my first inoculation with 3NA, I did notice some incipient UTI symptoms as well as some incipient yeast infection symptoms, but these never became full blown infections. [https://www.facebook.com/groups/htsupport/permalink/693651310690827/?comment_id=1804217276300886&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

Once the initial side effect phase has passed, NA may alleviate UTIs. See [[Helminthic therapy personal stories#Urinary tract infections (UTIs) | '''Helminthic therapy personal stories: Urinary tract infections''']].

===Insomnia / hypersomnia===
See the following separate page section.

* [[Helminthic therapy and sleep#Initial insomnia or hypersomnia | '''Initial insomnia or hypersomnia''']]

===Menstrual issues===

(Also see, [[Helminthic therapy and menstruation | '''Helminthic therapy and menstruation''']].)

{{Quote|indent}}My menstrual cycle has changed and I've been having acne break outs on my face and chest since shortly after my first NA dose. I've had lighter and shorter periods with more spotting, fewer PMS symptoms, and the acne. (Link expired){{Quote|/indent}}

{{Quote|indent}}I am 12 weeks in on first dose with 3NA. I have found that during these past three months, my PMS was worsened to what it was when I was a teenager - namely, irritability (verging on blind rage!) and terrible back pain, so bad I could not stand up straight for a couple of days. [https://www.facebook.com/groups/htsupport/permalink/1834330689956211/?comment_id=1834428259946454&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

===Nausea===

One hookworm host felt so dizzy and nauseous at work, she couldn't drive home until it passed. (Link expired)

{{Quote|indent}}It lasted almost all day for a few days around week 5-6 but then as I got more towards weeks 7-9 it seemed to be 2 to 3x per day. Definitely more intense early on.{{Quote|/indent}}

===Oral symptoms===

{{Quote|indent}}... mouth pain 3 to 4 weeks after innoculating (25 hw). Feels kind of like I burned the roof of my mouth. [https://www.facebook.com/groups/htsupport/permalink/1379333685455916/]{{Quote|/indent}}

{{Quote|indent}}At 6 weeks (post-inoculation with NA) burned like tongue feeling. Not the roof of the mouth. [https://www.facebook.com/groups/htsupport/permalink/1379333685455916/?comment_id=1379457402110211&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had lingua geographica ([https://en.wikipedia.org/wiki/Geographic_tongue geographic tongue]) for the first time in my life after my third dose of NA. It disappeared in a week. No treatment needed. [https://www.facebook.com/groups/htsupport/permalink/1438286506227300/?comment_id=1438391296216821&comment_tracking=%7B%22tn%22%3A%22R%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1438286506227300/?comment_id=1438391296216821&reply_comment_id=1438670439522240&comment_tracking=%7B%22tn%22%3A%22R9%22%7D]{{Quote|/indent}}

Two people have reported a consistent “needing to clear throat” feeling at around 13-16 days. [https://www.facebook.com/groups/htsupport/permalink/1472567586132525/] [https://www.facebook.com/groups/htsupport/permalink/1472567586132525/?comment_id=1472673079455309&comment_tracking=%7B%22tn%22%3A%22R%22%7D]

===Pain===

For more detail about people's experience of aches and pains following inoculation with NA, see this Support group [https://www.facebook.com/groups/htsupport/permalink/1546639358725347/ poll] and this related [https://www.facebook.com/groups/htsupport/permalink/1546638618725421/ thread].

<blockquote>

====Abdominal pain====

{{Quote|indent}}I would get cramps for two days with each dose. I just laid face down with a heating pad on my gut and it helped a lot. [https://www.facebook.com/groups/htsupport/permalink/1600163656706250/?comment_id=1600166230039326&reply_comment_id=1600319756690640&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}For the past week, 15 min after a meal I get intense intestinal pain. This resolves after 4 - 5 hours, only to come back after another meal. The pain is not in the stomach, but in the lower abdomen. I never experienced anything like this before the inoculation. (Reported 5 weeks after inoculating with 5 NA.) [https://www.facebook.com/groups/htsupport/permalink/2303657659690176/]{{Quote|/indent}}

{{Quote|indent}}I'm at week 7 and only took 8 NA. I'm having stomach aches after almost every meal. [https://www.facebook.com/groups/htsupport/permalink/2244097125646230/]{{Quote|/indent}}

{{Quote|indent}}The only abdominal pain I felt around week 6 was for 2 days and it was intense muscle contractions/cramping of my entire abdomen. This was different from GI-distress associated with my IBS, which was more localized/rumbly/gas-pain that came and went. The HT cramping was nearly constant and felt like I was doing a painful crunch/sit-up that engaged my entire core. [https://www.facebook.com/groups/htsupport/permalink/1722742731115008/?comment_id=1724470354275579&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Two mornings in a row (at 6 weeks post inoculation with 20 NA) I have had incredible pain in my abdomen - and I can't exactly pinpoint where it is located… It lasts 30 minutes or so, but during that time it is so bad I can't even describe… The pain resembles the pain I tend to feel as a result of my very painful endometriosis… But I normally only suffer from endometriosis once per month - and certainly not at this time of the month. And certainly not 2 days in a row for 30 minutes at the same time in the morning. I can only come up with the explanation that it must be the worms… The pain is so intense I feel like jumping from a roof at that very moment. [https://www.facebook.com/groups/htsupport/permalink/1738874942835120/]{{Quote|/indent}}

{{Quote|indent}}I had pretty extreme stomach pain at times. But my illness involves stomach pain. Now that I think back and I’m out of the woods I think it was totally worth it! [https://www.facebook.com/groups/htsupport/permalink/1738874942835120/?comment_id=1738951506160797&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I recall experiencing what I would describe as an occasional (not constant) definite, though mild, gnawing sensation in the middle of my belly from about six weeks following inoculation with NA to about five or six months post inoculation. As I was noticing steady improvement in my severe allergy and asthma symptoms, and expected to have some abdominal symptoms with HWT, for me, the gnawing sensation was encouraging, and never a real problem. [https://www.facebook.com/groups/htsupport/permalink/1760894503966497/?comment_id=1770120086377272&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

====Joint pain====

Joint pain may be experienced by a few, especially when this was a problem prior to inoculation.

{{Quote|indent}}My mother inoculated 5HW for dust mite allergy and atopic dermatitis 2 weeks ago. At one week she started having... joint pain (the kind you experience when you have flu, or a fever) and light flu-like fatigue and fever. [https://www.facebook.com/groups/htsupport/permalink/1426082444114373/]{{Quote|/indent}}

{{Quote|indent}}I’ve been on HW and WW for 45 days. The first 18 days were easy. Then, on day 19, I was hit with crushing fatigue for eight days…Throughout, I'd been having some joint pain (and have been for years) but it was bearable, but around day 36 the joint pain became awful -- by far the most unpleasant side-effect of the worms I've had yet -- and I'm used to a certain level of joint pain. This is truly horrible. [https://groups.yahoo.com/neo/groups/helminthictherapy/conversations/messages/10978]{{Quote|/indent}}

{{Quote|indent}}At around the 7 week stage I developed strong and scary neuropathic symptoms in my feet and hands. And joint pain especially in my fingers. [https://www.facebook.com/groups/htsupport/permalink/1231739366882016/?comment_id=1231801796875773&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had painful tingling in my fingers, legs, arms and feet that I described in my journal as "almost like thousands of piranha’s nibbling under my skin." I also noted "a jumpiness that feels cellular". Along with this symptom I also had 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. The symptoms finally started to taper off gradually around week 11. I am now at week 14 and all of these sensations are completely gone. [https://www.facebook.com/groups/htsupport/permalink/1207083356014284/?comment_id=1209858305736789&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]{{Quote|/indent}}

====Neck pain/ache====

{{Quote|indent}}Before taking helminths i suffered from chronic severe neck pain... When i took my first and so far only dose of NA, the neck pain flare up occurred now and then during the initial ten weeks, but it eventually went away. Basically its gone for good as far as i can tell. [https://www.facebook.com/groups/htsupport/permalink/947025325353423/?comment_id=947396378649651&comment_tracking=%7B%22tn%22:%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/947025325353423/?comment_id=948866608502628&comment_tracking=%7B%22tn%22:%22R0%22%7D]{{Quote|/indent}}

{{Quote|indent}}My 10 year old son using 5 HW for dog dander allergies experienced neck ache for a short period on day 4 and 5 after inoculation. [https://www.facebook.com/groups/htsupport/permalink/947025325353423/?comment_id=948905575165398&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

====Pelvic pain====

One female subject reported pelvic discomfort on days 23 and 24 - not so much a pain as a “menstrual feeling”, as though she was about to start a period. [https://www.facebook.com/groups/htsupport/permalink/755884327800858/]

</blockquote>


===Prophetic dreams===

Two self-treaters have had dreams that foretold improvements in their respective conditions.

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… 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. [https://helminthictherapywiki.org/wiki/index.php/Wriggling_out_of_total_food_intolerance,_M.E._and_Crohns_disease?fbclid=IwAR02ISw5vcpiabPAaU1MZfjXcWKPD4y3Qp6jXb-uyVoDeZR0m74gOwwKGOU#Not_just_a_dream]

I had another crazy dream. For some reason I am really active in these dreams. Running and jumping and crawling and things AS has made it difficult to do these past 2 years. [https://www.facebook.com/groups/htsupport/permalink/3655230004532928?comment_id=3692224940833434] (This individual's dreams may have been triggered by TSO rather than NA, as he was hosting both species.)

===Rashes and itching distant from the inoculation site===

(For the rash at the inoculation site and the itching associated with this, see [[The hookworm inoculation rash | '''The hookworm inoculation rash''']].)

Several people have reported transient skin manifestations away from the inoculation site, such as mild rashes, or “weird bumpy hives”, on the neck and face, a "sunburn feeling” (in the absence of any sun exposure), tiny bumps all over the forearms (beyond the rash site), and nocturnal "itch attacks" all over the body, all of which can appear from day 3 onwards but usually resolve by the tenth week.

{{Quote|indent}}Apparently I've traded my usual allergy symptoms for skin dryness/irritation. I inoculated with 3 NA 13 days ago. Around 5-6 days ago I started noticing my usual allergy symptoms reducing (I usually have areas of red itching patches in different parts of my body, now it's less severe), and instead my whole skin is constantly pretty dry. Also it's dry in a bit different way than usually, more like... internally? No flaking like allergy sometimes causes, but it is irritated in some way, scratching it also causes small wounds much easier than usually. [https://www.facebook.com/groups/htsupport/posts/4114243931964864/]{{Quote|/indent}}

{{Quote|indent}}I got full body itch after my first dose of NA. It did pass after a week or two. Subsequent innoculations haven't brought on the full body itch. [https://www.facebook.com/groups/htsupport/permalink/3026919184030683/?comment_id=3027117827344152]{{Quote|/indent}}

One individual experienced a full body rash at about 12 days after inoculation. Describing this as being similar to contact dermatitis (small raised lumps with a tiny water blister), the individual said that he had never experienced anything like this before. [https://www.facebook.com/groups/htsupport/permalink/893278837394739/]

Another subject, whose skin was very itchy and flared before commencing HT as a result of chronic urticaria and severe eczema, reported, at 14 days after an initial dose of 35 hookworms:

{{Quote|indent}}My skin is out of control with itching and inflammation. I look like a toad. My eyelids are swollen and I'm red everywhere on my upper body. Face, neck, arms, hands. All of the same places that are normally affected but now the hives are closer together and connecting. I just can't stop scratching.{{Quote|/indent}}

And yet another subject got a rash across his back following a supplementary inoculation, [https://www.facebook.com/groups/htsupport/permalink/941103435945612/] while someone else had a rash on her chest for several days, a few weeks into her second dose of 40 hookworms. [https://www.facebook.com/groups/htsupport/permalink/941103435945612/?comment_id=942881659101123&comment_tracking=%7B%22tn%22:%22R%22%7D]

Others have had similar experiences up to 10 weeks post inoculation.

{{Quote|indent}}I've never had urticaria before, but I'm getting small skin eruptions - like a white head - that eventually turn into a wide itchy patch and take over a week to go away. I have about 5 or so on my body, mostly around my upper arm and shoulders but also around my knees and ankles. This started about 18 days after introduction of 5 NA hookworms, which were my first. I've never experienced hives like this before, so it isn't a worsening of any existing symptoms. [https://www.facebook.com/groups/htsupport/permalink/1694956050560343/?comment_id=1695399737182641&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]{{Quote|/indent}}

{{Quote|indent}}After about 3 weeks, I had very dramatic skin flare ups (eczema and urticaria -- the conditions I'm treating) mild joint pain, and also tingling in my hands and wrists. [https://www.facebook.com/groups/htsupport/permalink/814067228649234/?comment_id=814111748644782&offset=0&total_comments=11&comment_tracking=%7B%22tn%22:%22R7%22%7D]{{Quote|/indent}}

{{Quote|indent}}I developed hives and rashes a week or two past the 21 day point/molt. My doctor suggested that high eosinophils might be responsible. If I had any sensitivity high eosinophils could cause hives in cases where it wouldn't ordinarily. [https://www.facebook.com/groups/htsupport/permalink/785431908179433/?comment_id=785511978171426&offset=0&total_comments=10]{{Quote|/indent}}

Some have reported developing rashes on their faces.

{{Quote|indent}}I'm always suffering rashes. Never on my cheeks though. That was a very strange one. Not itchy at all and I just knew it had to be the immune response to my new friends. [https://www.facebook.com/groups/htsupport/permalink/785431908179433/?comment_id=785444718178152&offset=0&total_comments=10]{{Quote|/indent}}

{{Quote|indent}}I'm at 5.5 weeks post inoculation and I've been getting a weird rash on my face. It almost looks like my facing is breaking out with pimples, which is weird because I've always had very clear skin with no breakouts. [https://www.facebook.com/groups/htsupport/permalink/785431908179433/]{{Quote|/indent}}

{{Quote|indent}}… a few years ago around Fall/Winter season, I woke with an odd red patch on my face, straddling my upper lip and cheek, just on one side…Flash forward to today, I've been having this same weird redness on my face. Now it's on the other side, and my chin. I determined it's "perioral dermatitis", which is a mystery to dermatologists… So I checked my calendar in 2012 when this first happened. Lo and behold I'd done a 75 hookworm top-off, about 10 weeks before it developed. That's exactly where I'm at in the current hookworm cycle, so I think it's safe to say one of my side effects from NA is perioral dermatitis. [https://www.facebook.com/groups/htsupport/permalink/1140954622627158/]{{Quote|/indent}}

At 7 weeks after inoculation with 50 hookworms, one individual had a rash appear, literally overnight, about 2 inches above his waistline. [https://www.facebook.com/groups/htsupport/permalink/1077380182317936/?comment_id=1117564791632808&comment_tracking=%7B%22tn%22%3A%22R0%22%7D]  

Other experiences include the following.

{{Quote|indent}}I introduced 6 NA 13 days ago. (Applied them to my leg; I still have itchy welts in the area.) Six or seven days later, I developed similar itchy welts on my arms and back. [https://www.facebook.com/groups/htsupport/permalink/1227954537260499/]{{Quote|/indent}}

{{Quote|indent}}My hives got worse when I started HT. Seems to be settled down now though at 2+ years. LDN helped bridge the gap. [https://www.facebook.com/groups/htsupport/permalink/1983242591731686/?comment_id=1983748741681071&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had cold hives all over my face and body when I started NA. Prior I would get mild cold hives in winter. I still get a tiny bit on my hands or arms in very very cold weather, but when initially starting NA it was a lot stronger. Didn't last long, maybe a few weeks or so till it fully settled. [https://www.facebook.com/groups/htsupport/permalink/3914106261978633/?comment_id=3915987855123807]{{Quote|/indent}}

===Reactivation of sites of old bug bites and injections===

Sites where the skin has previously been punctured by 'alien' organisms other than helminths, or where 'alien' material has been introduced, for example via injections, can flare unexpectedly following a helminth inoculation, even years after the introduction of helminths.

{{Quote|indent}}My old leech bites often wake up, swell & itch, shortly after inoculating with NA. [https://www.facebook.com/groups/htsupport/permalink/3385034908219107/?comment_id=3386852408037357&reply_comment_id=3386936151362316]{{Quote|/indent}}

{{Quote|indent}}I had (the site of) an old TB test pop up today. I don't get bug bit, ever, and I was still in my long sleeve nightgown anyway. And the TB tests are so distinctive: location, size, etc. [https://www.facebook.com/groups/htsupport/permalink/3385034908219107/?comment_id=3386852408037357]{{Quote|/indent}}

{{Quote|indent}}I have been using hookworms for about 5 years now and one constant is the return of old bites when eosinophils are on the march. Usually about two weeks after inoculation, all my old inoculation sites will act up and get itchy. I'll get these little mosquito bite-like spots on finger and on top of toes, that itch like hell. It's like the skin "remembers" old inflammation when new NA are getting settled. [https://www.facebook.com/groups/htsupport/posts/4252884758100780/]{{Quote|/indent}}

===Recapitulation of old injuries, illnesses===

A remarkable side effect phenomenon that can appear following helminth inoculation is a "strange, mysterious and magical" reappearance (recurrence, reoccurance, repeat, repetition) of symptoms from old injuries and illnesses.

This was reported by someone who inoculated with '''TSO''' a few weeks after a bout of pneumonia:

{{Quote|indent}}I took my very first dose of TSO three hours ago (for Hashimoto's and psoriatic arthritis) and my lungs are killing me. Out of nowhere. Really bad pain, almost burning sensation. [https://www.facebook.com/groups/htsupport/permalink/1242666762455943/]{{Quote|/indent}}

After taking her fifth fortnightly dose of 30 '''HDC''', one self-treater reported experiencing night terrors for almost 2 weeks, before returning to “sleeping great” again.

{{Quote|indent}}I've started getting night terrors again! I haven't had multiple night terrors in years ever since I discovered magnesium 7-8 years ago. It's like a deep wound that healed and left a scar. [https://www.facebook.com/groups/htsupport/permalink/3226282547427678/?comment_id=3324862274236371] [https://www.facebook.com/groups/htsupport/permalink/3226282547427678/?comment_id=3325467854175813&reply_comment_id=3370345276354737]{{Quote|/indent}}

Someone who followed two doses of 35 '''NA''' with a dose of 45, reported that this larger dose caused a reappearance of pain from past injuries.

{{Quote|indent}}... the finger I broke last year is killing me, my TMJ is flaring, my knee is all screwy (high school thing), another finger someone hit with a cymbal in high school hurts, and the wrist I broke 28 freaking years ago is acting up. [https://www.facebook.com/groups/htsupport/permalink/873265256062764/]{{Quote|/indent}}

Other self-treaters using NA have had similar experiences.

{{Quote|indent}}My first inoculation (5NA) I ended up with weird symptoms I hadn't experienced for YEARS. Full blown reactions. [https://www.facebook.com/groups/htsupport/permalink/1414931745229443/?comment_id=1418396941549590&comment_tracking=%7B%22tn%22%3A%22R1%22%7D]{{Quote|/indent}}

{{Quote|indent}}I had [https://en.wikipedia.org/wiki/Antidepressant_discontinuation_syndrome#Symptoms "brain zaps"] briefly this morning, 32 days into inoculation with 3NA. These are a common side effect of SSRI (antidepressant) withdrawal that I used to get when I lowered my dose or forgot to take a pill that day. It is a very distinctive feeling! (I’ve been off SSRIs for about a decade.) [https://www.facebook.com/groups/htsupport/permalink/1760383044017643/]{{Quote|/indent}}

{{Quote|indent}}The first and second time I dosed with NA, I got scared by some disease symptoms I hadn't seen for maybe 10 years. They dissipated after 12 weeks. Now, on my 3rd dose, I'm not having symptoms from 10 years ago but I'm having symptoms I used to have as a child (from 25-30 years ago). [https://www.facebook.com/groups/htsupport/permalink/1267994686589817/]{{Quote|/indent}}

{{Quote|indent}}... then this morning I started having back spasms - real brief intense spasms that hunch me over, knock my breath out, and then are gone. I've had these super randomly in the past (like 3 spasms a year), but I just had 4 within 20 minutes this morning. [https://www.facebook.com/groups/htsupport/permalink/873265256062764/?comment_id=873604356028854&offset=0&total_comments=10&comment_tracking=%7B%22tn%22:%22R2%22%7D]{{Quote|/indent}}

{{Quote|indent}}One week after my 2nd innocualation of 5 NA, I'm having a return of old pains symptoms. Yesterday, my leg was killing me! Had problems walking....then I remembered, oh yeah....I fell when walking the dog back in March, and bruised the bone. Still have a small bump. Today my jaw is aching! Oh no....I must have cracked "another" molar. But no....in the same spot? It's just an old symptom. Having a cracked molar (hidden by a filling, not visible by xrays) for 3 or 4 months was agony. This worm journey is so interesting! [https://www.facebook.com/groups/htsupport/permalink/1335248503197768/?comment_id=1450211868368097&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I've been on HT for 2+ years, so maybe 9 doses (of NA). This last time, I felt a heavy, aching soreness all up and down my right arm, and a pain near my elbow. I became seriously alarmed that I might be developing some symptoms of MS or Parkinson's or something, because it felt like a strain to lift my arm. Then I remembered breaking my right arm at age 9 after a fall from a fast-moving horse. So strange and mysterious and magical to revisit these cellular body memories through the helminth experience. It went away after a couple of days... [https://www.facebook.com/groups/htsupport/permalink/1267994686589817/?comment_id=1268002879922331&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I developed pemphigoid of pregnancy 27 years ago, resolved with treatment. I developed pemphigoid on my hands 3 years ago, resolved with treatment. Now (after inoculating with NA) I have it again on my face. [https://www.facebook.com/groups/htsupport/permalink/1452396584816292/]{{Quote|/indent}}

{{Quote|indent}}When I was younger… my left ribcage locked up and breathing/moving hurt really bad. (This [https://en.wikipedia.org/wiki/Precordial_catch_syndrome precordial catch syndrome]) would always pass eventually. As my PANS got a bit better as I grew up, these incidents essentially disappeared. After inoculating with 3NA three weeks ago, I have had several "lock-ups" of my left heart area that hurt when I breathe and move but go away in a few minutes, like when I was a kid. [https://www.facebook.com/groups/htsupport/permalink/1746429688746312/?comment_id=1746863272036287&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I've started getting night terrors again! I haven't had multiple night terrors in years ever since I discovered magnesium 7-8 years ago. It's like a deep wound that healed and left a scar. [https://www.facebook.com/groups/htsupport/permalink/3226282547427678/?comment_id=3324862274236371] [https://www.facebook.com/groups/htsupport/permalink/3226282547427678/?comment_id=3325467854175813&reply_comment_id=3370345276354737]{{Quote|/indent}}

Someone else who experienced this phenomenon reported a recapitulation of the pain from ''all'' the injuries, and the symptoms of ''all'' the diseases that he had ever had, including nerve pain from an auto accident 10 years earlier and an Achilles tendon injury at the age of 8. These all began to appear within a week of his first inoculation with NA and lasted around a month, causing pain in seemingly every part of his body.

Like other inoculation side effects, these mysterious reappearances of old illnesses and injuries don't last very long, and are usually gone within 12 weeks, although it is also possible to experience this phenomenon after supplementary doses.

{{Quote|indent}}Wow these things are mysterious! Each successive dose, I seem to go though later periods of my illness. I’m at the most recent one: severe and long lasting reactions to trace gluten. [https://www.facebook.com/groups/htsupport/permalink/1623904804332135/]{{Quote|/indent}}

===Sense of smell, enhancement of===

This "side effect" is sometimes evident from around 5 or 6 weeks post inoculation.

{{Quote|indent}}My latest symptom — at almost six weeks — is heightened sense of smell. I can literally smell the chlorine in tap water, which I don’t drink BTW, and subtle scents in clothes, towels, cloth napkins, etc. I can also taste the subtle differences in water. The spring water at my office tastes different than the filtered water I use at home. If water sits in a glass for any length of time, I can tell exactly which scents it has absorbed. At the moment, I could tell you what my downstairs neighbor is cooking for dinner! It’s incredible. Before, my sense of smell was pretty horrible, honestly. I couldn’t smell much of anything. Right now, I could get a job as a wine taster — if I could get rid of my histamine intolerance! [https://www.facebook.com/groups/htsupport/permalink/1874982289224384/?comment_id=1877405798982033&reply_comment_id=1877420212313925&comment_tracking=%7B%22tn%22%3A%22R2%22%7D]{{Quote|/indent}}

{{Quote|indent}}A couple of days ago I went to an excercise class with a small group of ladies and I could smell the burning oils and the yoga mats and the blankets and the tea they were drinking. It has been decades since I could smell like that (I can’t remember the last time) and the only thing that I’ve done differently is start hosting (NA) about 5 weeks ago so I guess it may be the worms. [https://www.facebook.com/groups/htsupport/permalink/2251898131532796/?comment_id=2253378831384726&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

===Shortness of breath / air hunger===

Shortness of breath has been reported occasionally following the first dose of NA.

{{Quote|indent}}I had my first round of hookworms nearly 3 weeks ago. In the last week I have been having sharp chest pain, shortness of breath and bad depression which I never ever suffer from. [https://www.facebook.com/groups/htsupport/permalink/657619667627325/]{{Quote|/indent}}

{{Quote|indent}}I am in the middle of week 6 with 2 NA. In the past week I've had two big (for me) allergy attacks or possibly mild asthma episodes. I have had this before the worms and it lasted about 10 days, including 2 trips to urgent care and 1 trip to the ER, (where) they gave me nitroglycerin which opened up my breathing and fixed the problem. I also have a minor version of breathing issues/chest tightness at night sometimes, and just sit up in bed for an hour or so and it passes. Benadryl helped last night. [https://www.facebook.com/groups/htsupport/permalink/3620410001348262] (NB. This individual was subsequently diagnosed as having MCAS, and also likely responding to environmental mold exposure, either of which may have been involved in the respiratory problems she described.){{Quote|/indent}}

This side effect has been reported more frequently by hookworm hosts following their second inoculation.

{{Quote|indent}}I’m at about week 8 or 9 of my 2nd inoculation. I took 15 NA and didn't have any symptoms or side effects. All of a sudden in the last 3 days, I have experienced shortness of breath randomly throughout the day, like I can't get enough oxygen or something isn't converting correctly. I can breathe deeply but my body isn't satiated with what I'm bringing in. I don't have other symptoms (and) some parts of the day feel fine. [https://www.facebook.com/groups/htsupport/permalink/2432537526802188/]
{{Quote|/indent}}

{{Quote|indent}}I am in week 4-5 of my second dose of NA and I have been experiencing the same thing over the last few days. It feels like ‘air hunger’ even though I seem to be breathing fine... I’ve had about 6-7 incidences of it over the past 6 days. I did have some occasional symptoms like that many years ago so also wondered if it was the ‘ return of past symptoms’ I have read about.
[https://www.facebook.com/groups/htsupport/permalink/2432537526802188/?comment_id=2433442886711652]{{Quote|/indent}}

{{Quote|indent}}I had my second inoculation of NA 3-4 weeks ago. No noticeable symptoms, but when I lie in bed at night and sometimes in the morning I can't get a full breath into my lungs. [https://www.facebook.com/groups/htsupport/permalink/2477830875606186/] [https://www.facebook.com/groups/htsupport/permalink/2477830875606186/?comment_id=2477904942265446&reply_comment_id=2478179072238033]{{Quote|/indent}}

{{Quote|indent}}This happened to me about 8 weeks into my second inoculation. [https://www.facebook.com/groups/htsupport/permalink/2477830875606186/?comment_id=2478350755554198]{{Quote|/indent}}

{{Quote|indent}}Not sure what to make of this. Have not experienced it until now. Most recent worms were about 3 months ago. Am experiencing the shortness of breath, as you describe it, but I have been Dx’d with two different tick borne diseases. [https://www.facebook.com/groups/htsupport/permalink/2432537526802188/?comment_id=2432688946787046]{{Quote|/indent}}

===SIBO===

Although helminthic therapy can improve SIBO in the longer term, [http://helminthictherapywiki.org/wiki/index.php/Helminthic_therapy_personal_stories#SIBO] there has been one case where each new dose of NA has produced a temporary SIBO flare.

{{Quote|indent}}I may be a special case, as for me NA always trigger a bout of SIBO. I usually have to do a fully ketogenic diet for a few weeks, then it settles down. [https://www.facebook.com/groups/htsupport/permalink/1499383136784303/?comment_id=1499564203432863&comment_tracking=%7B%22tn%22%3A%22R%22%7D] (Also see [https://www.facebook.com/groups/htsupport/permalink/1509328469123103/?comment_id=1509673985755218&comment_tracking=%7B%22tn%22%3A%22R3%22%7D] and [https://www.facebook.com/groups/htsupport/permalink/1509328469123103/?comment_id=1509673985755218&reply_comment_id=1510093365713280&comment_tracking=%7B%22tn%22%3A%22R%22%7D]){{Quote|/indent}}

===Sleep issues===

Some self-treaters have reported temporary insomnia, while a few others have experienced hypersomnia. For more details, see [[Helminthic therapy and sleep | '''Helminthic therapy and sleep''']].

===Thirst===

{{Quote|indent}}I am into the 2nd week of my second inoculation (5 NA again). Have been feeling insanely thirsty all day. And then I looked at my notes from last time and I had the exact same thing for a week back then. [https://www.facebook.com/groups/htsupport/permalink/2555376637851609/?comment_id=2836684726387464]{{Quote|/indent}}

===Throat constriction===

{{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}}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. [https://helminthictherapywiki.org/wiki/index.php/Hook_me_up!_Treating_autoimmune_disease_with_hookworms]{{Quote|/indent}}

{{Quote|indent}}My throat closed while eating several times (5 weeks in) after different innoculations of around 25. The first time it was quite alarming - I thought I was having an unprecedented allergic reaction. It resolves itself in a week or two, and does not happen every time I get more worms. I have been dosing for 3 years. [https://www.facebook.com/groups/htsupport/permalink/1131267180262569/?comment_id=1133169820072305&reply_comment_id=1592757977446818&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Goddamn my throat closed up this morning, didn't expect that on 5 worms (NA) and not 70 days in! I've never experienced anything like it before. Luckily it only lasted a few seconds.{{Quote|/indent}}

===Tinnitus===

See: [[Helminthic therapy and tinnitus | '''Helminthic therapy and tinnitus''']].

===Twitching===

{{Quote|indent}}I've noticed I get twitching when my inflammation is reducing from the helminths (NA). I also had mad eye twitching when I did a course of FMT, which leads me to believe it's related to the gut. The twitching is all over... sometimes rather severe to the point I can see my arm muscle moving.[https://www.facebook.com/groups/htsupport/posts/4011873232201935/] [https://www.facebook.com/groups/htsupport/posts/4011873232201935?comment_id=4012568308799094&reply_comment_id=4013727998683125]{{Quote|/indent}}

{{Quote|indent}}I get a few facial twitches in the first days after my (NA) inoculations - only few twitches, then they disappear. [https://www.facebook.com/groups/htsupport/posts/4011873232201935/?comment_id=4012433235479268] [https://www.facebook.com/groups/htsupport/posts/4011873232201935?comment_id=4012568308799094&reply_comment_id=4012650738790851]{{Quote|/indent}}

{{Quote|indent}}I also get twitching on eyelids and more premature ventricular contractions after inoculating (with NA). Weird neurological symptoms in general, but they are always mild and self-limiting. [https://www.facebook.com/groups/htsupport/posts/4011873232201935/?comment_id=4012578782131380]{{Quote|/indent}}

One hookworm host has reported that she gets twitches and ticks when she's in need of a new dose of NA. Once she has added a fresh dose, they go away immediately. [https://www.facebook.com/groups/htsupport/posts/4011873232201935?comment_id=4014012608654664]

==Treating the side effects==

=== Prednisone ===

If necessary, inoculation side effects can be quelled completely by taking [https://en.wikipedia.org/wiki/Prednisone prednisone/prednisolone]. Those who are already taking 5 mg, or more, of this drug per day for a preexisting condition will usually not notice any inoculation side effects, to the extent that they may be convinced the inoculation was unsuccessful.

{{Quote|indent}}… we've found that a half-pill (5 or 10 mg?) of Prednisone per day is enough to kill any of those symptoms from dosing. [https://www.facebook.com/groups/htsupport/permalink/1016630521726236/?comment_id=1016974145025207&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}I was having bad diarrhea every day from worm flu starting around week three or four. 5mg of prednisone per day helped a lot (I'm 135 pounds). I am in week 7 now and stopped taking prednisone a few days ago (tapered off even though idk if you need to with 5mg) and feel really good. [https://www.facebook.com/groups/htsupport/permalink/960597907329498/?comment_id=960661000656522&comment_tracking=%7B%22tn%22:%22R9%22%7D]{{Quote|/indent}}

{{Quote|indent}}5-10 mg/day completely alleviated my GI symptoms after my first inoculation... Generally, I prefer non-pharma approaches to managing my health but was really thankful for prednisone mitigate the side effects of my first dose of NA. It made the difference between whether or not I could get off of the couch and function throughout the day. [https://www.facebook.com/groups/htsupport/permalink/977396905649598/?comment_id=978535158869106&comment_tracking=%7B%22tn%22:%22R1%22%7D] (This quote includes additional details from an expired link.){{Quote|/indent}}

A short course of prednisone immediately following inoculation can be particularly helpful for anyone with an intestinal stricture. The drug will obviate the possibility of localised inflammation making a stricture worse. Prednisone may also be appropriate if diarrhoea or fatigue persist for more than a few days, and it could be continued for a week, with a doctor's approval, followed by a taper agreed by the doctor.

Anyone who is worried about inoculation side effects could ask their doctor for a prescription for prednisone and keep this to hand for use in suppressing the side effects if these were to become troublesome. As it should only be needed for a short time, there would be no long term adverse consequences of taking this drug.

=== Other steroid preparations ===

All the side effects are related to inflammation, so anything that reduces inflammation could potentially help.

{{Quote|indent}}I decided to try taking hydrocortisone with my NA this time, to avoid the usual loose bowels in the first week. I took 8mg on day 2 then quickly tapered to 4, 3, 2mg over the next 3 days. Magic. No gut issues at all. [https://www.facebook.com/groups/htsupport/permalink/3508883289167601/]{{Quote|/indent}}

Even the small amount of immunosuppression provided by a steroid nasal spray can be useful for this purpose.

{{Quote|indent}}I am on week 4 of 3NA and seeing some side effects. [https://en.wikipedia.org/wiki/Fluticasone_propionate Flonase] (the sensitive kind), which I take in the spring for allergies, seems to be helping a bit. [https://www.facebook.com/groups/htsupport/permalink/1761224033933544/?comment_id=1761277187261562&reply_comment_id=1762775553778392&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

=== Antihistamines ===

The side effect mechanism is very similar to allergies, so antihistamines can help and many self-treaters have reported good results with this type of drug.

{{Quote|indent}}Allergy medication helped me more than anything else because it calmed down my reaction. [https://www.facebook.com/groups/htsupport/permalink/1248358258553460/?comment_id=1248404615215491&comment_tracking=%7B%22tn%22%3A%22R8%22%7D]{{Quote|/indent}}

{{Quote|indent}}Taking daily Claritin seemed to all but eliminate the side effects of my last dose of 5NA. [https://www.facebook.com/groups/htsupport/permalink/2336171929772082/?comment_id=2338295286226413&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}[https://en.wikipedia.org/wiki/Fexofenadine Fexofenadine] tempers the (epigastric) pain almost the entire day. [https://www.facebook.com/groups/htsupport/permalink/1057160664339888/?comment_id=1058455910877030&comment_tracking=%7B%22tn%22:%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Taking [https://en.wikipedia.org/wiki/Benadryl Benadryl] (antihistamine which, in the US, contains diphenhydramine) has helped a lot and keeps the (stomach) pain away for the most part. I take it several times a day. [https://www.facebook.com/groups/htsupport/permalink/1381206295268655/?comment_id=1381812371874714&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

However, only worm-safe antihistamines should be used, and these are listed in the [[Human helminth care manual | '''Human helminth care manual''']].

In addition to using the [https://en.wikipedia.org/wiki/H1_antagonist H1-antihistamines] such as fexofenadine and diphenhydramine, there have been reports that [https://en.wikipedia.org/wiki/Antihistamine#H2-antihistamines H2-antihistamines] such as [https://en.wikipedia.org/wiki/Ranitidine ranitidine] can also help [https://www.facebook.com/groups/htsupport/permalink/1527187794003837/?comment_id=1527200144002602&comment_tracking=%7B%22tn%22%3A%22R0%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1375917779130840/?comment_id=1375920815797203&comment_tracking=%7B%22tn%22%3A%22R1%22%7D] [https://www.facebook.com/groups/htsupport/permalink/1527187794003837/?comment_id=1527200144002602&reply_comment_id=1527241793998437&comment_tracking=%7B%22tn%22%3A%22R%22%7D].

=== Vitamin D3 ===

Vitamin D3 has also proved to be effective for this purpose. The blogger who made the first of the following comments used [https://www.amazon.com/Ortho-Molecular-Vitamin-Capsule-Blister/dp/B008KZD6EO/ref=sr_1_6_a_it?ie=UTF8&qid=1531236581&sr=8-6&keywords=vitamin%20d%2050%2C000 Orthomolecular Products Vitamin D3 50,000 IU - 15 Capsule Blister Pack].

{{Quote|indent}}I took one pill (50,000IU vitamin D3) last Saturday and by Sunday night the nearly constant cramping had ceased! [http://doingtheworm.blogspot.com/2018/05/day-55-support-from-your-community.html]{{Quote|/indent}}

{{Quote|indent}}Without vitamin D, I get only side effects from HW. With vitamin D I get more benefits than side effects... I just take one dose about 60k IU every 2 weeks. [https://www.facebook.com/groups/htsupport/permalink/2005401089515836/?comment_id=2005422022847076&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

{{Quote|indent}}Vitamin D is helpful for side effects. I take 50,000 IU once or twice a week when I’m feeling NA side effects. [https://www.facebook.com/groups/htsupport/permalink/2011561408899804/?comment_id=2011672238888721&reply_comment_id=2011958108860134&comment_tracking=%7B%22tn%22%3A%22R%22%7D]{{Quote|/indent}}

=== A microdose of TSO ===

{{Quote|indent}}Retreated with NA 3 days ago. I took a small dose of TSO (83 ova - 0.5ml from a bottle of 2,500) beforehand. So far it does seem to have helped. Normally the day after treating with NA I get a strong worm flu and feel poorly for 2-3 days. The day after treating with the NA/TSO combo, I felt “normal." [https://www.facebook.com/groups/htsupport/posts/4040337509355507/]{{Quote|/indent}}

=== Low-dose naltrexone (LDN) ===

[https://en.wikipedia.org/wiki/Low-dose_naltrexone Low-dose naltrexone (LDN)] looks promising as another means of offsetting symptoms during this side-effect phase, and is [[Helminthic therapy and low-dose naltrexone (LDN) |'''fully compatible with helminthic therapy''']].

=== CBD oil ===

CBD oil (50-100mg daily) has been reported to help reduce hookworm side effects. [https://www.facebook.com/groups/htsupport/permalink/3491864257536171/?comment_id=3493902483999015]

=== Homeopathy ===

For a list of homeopathic remedies that have been used successfully to treat itching, nausea, gas, diarrhoea, exhaustion, cough and sore throat, see [[Helminthic therapy and homeopathy#Homeopathic remedies used to relieve side effects following the introduction of NA | '''Homeopathic remedies used to relieve side effects following the introduction of NA''']].

=== Loperamide ===

Diarrhoea usually responds well to a standard diarrhoea relief preparation such as [https://en.wikipedia.org/wiki/Loperamide loperamide].

=== Paracetamol (acetaminophen) ===

In theory, ibuprofen should work well, as it is an anti-inflammatory but, in practice, it may make things worse. Like Naprosen and other NSAIDs, ibuprofen is notorious for being hard on the stomach and gut. Paracetamol (acetaminophen) might be better.

=== Probiotics ===

The Lactobacillus plantarum 299v strain has been reported to help ease gastrointestinal side effects. [https://www.facebook.com/groups/htsupport/permalink/2618338774888728/?comment_id=2621316721257600]

=== Colony reduction ===

In cases of severe side effects caused by inoculating with too many larvae, it may be necessary to terminate the hookworm infection and start over with a smaller number of larvae, or at least to cull part of the colony. See [[Hookworm dosing and response#Reducing the size of a hookworm colony | '''Reducing the size of a hookworm colony''']].

'''NB. None of the above is medical advice, and drugs like prednisone are prescription-only medications that should only be used with the guidance of a doctor.''' Please see the [[Wiki:General_disclaimer|'''Disclaimer''']] page.

== Preventing side effects ==

==See also==

* [[Hookworm dosing and response | '''Hookworm dosing and response''']]
* [[The hookworm inoculation rash | '''The hookworm inoculation rash''']]
* [[Hookworm timeline | '''The Hookworm Timeline''']]
* [[The helminthic therapy bounce | '''The helminthic therapy bounce''']]
* [https://www.facebook.com/groups/htsupport/permalink/1539235739465709/?hc_location=ufi Helminthic Therapy Side Effects poll.]