Helminthic therapy and anaphylaxis

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Anaphylaxis is a potentially fatal allergic reaction that can progress rapidly. It typically causes more than one of the following: an itchy rash, throat closing due to swelling that can obstruct or stop breathing, severe tongue swelling that can also interfere with or stop breathing, shortness of breath, vomiting, lightheadedness, loss of consciousness, low blood pressure, medical shock.

Can helminths cause anaphylaxis?

Certain helminth species have been reported in the medical literature to provoke anaphylactic reactions [1], but others can provide protection against anaphylaxis.

Although therapeutic helminths have been available for self-treatment since 2003, and the number of individuals using helminthic therapy was estimated in 2015 to be between 6,000 and 7,000 (PDF link) there have been no reports of treatment with any of the therapeutic organisms that are currently in use (TSO, TTO, NA and HDC) having caused a severe anaphylactic reaction.

There have, however, been three reports of inoculation with large doses of NA hookworms causing moderate anaphylactic reactions, but none of these required emergency treatment.

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

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

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

The scientific evidence

• 2025 Aug 12 Anisakis simplex excretion/secretion antigens abolish the anaphylactic response in allergic mice -- Full text

• 2012 Mar 14 Derived Products of Helminth in the Treatment of Inflammation, Allergic Reactions and Anaphylaxis (Book chapter of Allergic Diseases - Highlights in the Clinic, Mechanisms and Treatment)

• 2007 Apr Modulation of anaphylaxis by helminth-derived products in animal models

• 2004 Nov 15 Helminth infection protects mice from anaphylaxis via IL-10-producing B cells -- Full text | PDF

• 2002 Sep 15 An enteric helminth infection protects against an allergic response to dietary antigen -- Full text | PDF

The anecdotal evidence

The first report is more detailed than the quotes that follow it.

Hookworms treat anaphylaxis and salicylate intolerance in a 5-year-old

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

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

(Our son) hasn’t had an anaphylactic episode in over two years. He is 8yo and he has had about seven anaphylactic episodes, so two years without one is stunning. We are over here living a basically normal life. His progress compared to other children who have his disease (EoE, IgE-mediated allergies and all the symptoms of MCAS) is unheard of, and I credit it to the helminths. He missed more than half of kindergarten and first grade, but only missed five days of school in second grade.” [8]

Our 5yo daughter has anaphylaxis to peanut, egg and milk and also salicylate intolerance. Since starting low dose helminths in August 2012 we are now seeing a good reduction in her salicylate intolerance, she is eating a lot more foods that are high in salicylates, also her stomach aches have gone and so has her eczema. We tried many different alternative therapies and nothing has worked until now. We are very pleased." (Reported to a closed group, Mar 2013)

I’ve had hookworms for 5½ years. I've never achieved full remission of my food allergies, but my list has gone from 30 things I could eat to ~20 things I can't eat (and zero instances of anaphylaxis in 5 years, go team!). I started reintroducing foods around 3 months but still had negative reactions. After a year things were a lot better, 18 months things were relatively great with most of my problem foods.” [9]

A number of people have reported that, while hosing helminths, their reactions to insect stings or bites have been greatly reduced. This effect may be of value to anyone who is prone to developing anaphylaxis after close encounters with insects.

I was stung by a wasp last fall and had no reaction. In the past, I would have needed at least an epi pen. So this therapy may have saved my life!" [10]

I got stung by 7 wasps yesterday. Hands, neck, shoulder. It did hurt. It swelled up immediately like it usually does but… 30 minutes later there were almost no traces left! The inflammatory response was very limited and only for a short time. 24 hours later I can barely tell where I was stung. This is not the first time I got stung. But it IS the first time with such a small reaction... I have been taking TSO every 2 weeks since November 2020 (for 8-9 months). [11]

I noticed also very small reaction to mosquito bites this year with wormies on board! [12]

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

In the case of the non-human worms, HDC and TSO, which need to be re-dosed frequently, there may be a reduction in the level of protection if a dose is forgotten or delayed. Several people who are using HDC have reported a return of disease symptoms due to issues with supply, or simply due to forgetting to take a dose on time. [13] Obviously, a failure to adequately maintain one's helminth colony will increase the chance of an anaphylactic reaction and the risk of fatality.

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

How to obtain and use these organisms, as well as what to expect from the treatment, is all explained in detail elsewhere on this site. The best place to begin is here: Introduction to helminthic therapy.

See also

• Helminthic therapy and allergy

• Helminthic therapy and food intolerance

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 or prevent chronic inflammation, autoimmune disease and other immune-related disorders, including allergy.

An intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. Wikipedia:Helminths

An intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. Wikipedia:Helminths

Medication or treatment of one's own disease or condition without medical assistance.

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 or prevent chronic inflammation, autoimmune disease and other immune-related disorders, including allergy.

the ova (eggs) of the porcine (pig) whipworm, Trichuris suis

the ova (eggs) of the human whipworm, Trichuris trichiura

the human hookworm, Necator americanus

Hymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta

The introduction of an infectious agent into an organism. Helminth inoculation

A helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.

A helminth that lives in the small intestine. Necator americanus (NA) is the only hookworm species used in helminthic therapy. Its microscopic larvae are applied periodically to the skin.

Mast cell activation syndrome, also referred to as mast cell activation disorder (MCAD). An immunological condition. Wikipedia:Mast cell activation syndrome

Eosinophilic esophagitis is an allergic inflammatory condition of the esophagus. Symptoms are difficulty swallowing, food impaction and heartburn. The disease was first described in children but also occurs in adults. It is not well understood, but food allergy may play a significant role.

a change which is a result or consequence of an action or other cause.

the human whipworm, Trichuris trichiura

Someone who treats their own disease or condition without medical assistance.