Helminthic therapy and coeliac / celiac disease

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An autoimmune disease is a condition that results from an anomalous response of the adaptive immune system, wherein it mistakenly targets and attacks healthy, functioning parts of the body as if they were foreign organisms.

Coeliac disease (celiac disease in American English) is a long-term autoimmune disorder, primarily affecting the small intestine, in which individuals develop intolerance to the gluten present in foods such as wheat, rye and barley. [1]

This disease can be helped, at least to some extent, by hosting helminths. For example, the presence of helminths can significantly reduce the severity of adverse reactions caused by accidental exposure to gluten while following a gluten-free diet.

The scientific evidence[edit | edit source]

For more papers see Helminthic therapy research

NB. In spite of their double-blind, placebo-controlled design, some “gold standard” helminthic therapy trials may have produced unreliable results due to a lack of adequate consideration of the biology of living helminths and their interactions with their hosts. [2] For more about this, see: Problems with clinical trials using live helminths.

2024 Aug 22 - Prevalence of Helminth Infections in Patients with Celiac Disease

2020 Dec Randomized, Placebo Controlled Trial of Experimental Hookworm Infection for Improving Gluten Tolerance in Celiac Disease -- Full text | PDF

2017 Sep 7 Helminths as an alternative therapy for intestinal diseases -- Full text PDF

2016 Nov 9 Changes in duodenal tissue-associated microbiota following hookworm infection and consecutive gluten challenges in humans with coeliac disease -- Full text | PDF

2015 Sept 18 Experimental hookworm infection and escalating gluten challenges are associated with increased microbial richness in celiac subjects -- Full text | PDF

2015 Feb Experimental hookworm infection and gluten microchallenge promote tolerance in celiac disease -- Full text | PDF (Also reported by EurekAlert [3] and ABC Austrailia. [4])

2013 Mar Changed gluten immunity in celiac disease by Necator americanus provides new insights into autoimmunity

2011 Sept 16 Suppression of inflammatory immune responses in celiac disease by experimental hookworm infection -- Full text | PDF

2011 Mar 8 Effect of hookworm infection on wheat challenge in celiac disease - a randomised double-blinded placebo controlled trial -- Full text | PDF

Clinical Trials and observational studies[edit | edit source]

See Helminthic therapy clinical trials

Media coverage[edit | edit source]

2021 Sept 9 Could Worms Cure Coeliac Disease? - Dr Paul Giacomin, The Sensitive One. (Youtube) (Also see this response to Dr Giacomin's comments.)
2019 Aug 30 Helminths for Celiac Disease, Multiple Sclerosis, and Other Autoimmune Diseases - Mark Davis (Youtube)
2019 Jan 12 (Updated 2021 Apr 19) Using Hookworms To Treat Celiac Disease - Jane Anderson, Verywell Health (via the WayBack Machine)
2019 Jan 9 Parasitic worms could be the solution to asthma, eczema and coeliac disease - Nicky Pellegrino, New Zealand Listener
2017 Feb 8 Coeliac disease study to open in Queensland using hookworms - Felicity Caldwell, Brisbane Times
2017 Feb 8 Crawler cure: hookworms used to alleviate coeliac symptoms - ABC New 24 (Video)
2016 Oct 6 Hookworms to treat coeliac disease? - Includes a linked podcast from Nights, Radio New Zealand
2015 Nov 10 Hookworm larvae to be injected into coeliacs in bid to treat gluten intolerance - ABC News
2015 Apr Can Hookworms Cure Coeliac Disease? - Paul Giacomin, Australasian Science
2010 Feb 18 Hook Worms (and coeliac disease) - Jonica Newby, Catalyst
2009 Oct 22 Worms linked to coeliac relief - Dina Rosendorff, News Online, ABC Australia

The anecdotal evidence[edit | edit source]

Also see Non-coeliac / celiac gluten sensitivity (NCGS) and Gluten ataxia.

These first two reports are more detailed than the quotes that follow them.

Hookworms successful against colitis and celiac disease after medicine fails

From hopelessness to new meaning and purpose: a celiac's 3 year update

“(My husband) had celiac disease (confirmed via endoscopy/biopsy) and was on a starch free diet for ankylosing spondylitis... but now he has a completely unrestricted diet for the first time and has not noticed any ill effects from the gluten or starch... its awesome!” [5], [6]

“I am a 30yo female diagnosed with celiac disease 15 years ago. I have experienced chronic diarrhea and iron deficiency anemia although I eat a gluten free diet (as confirmed by continued lab work). I inoculated with two doses of 15NA 1.5yrs ago. My ferritin before inoculation was 22 (highest I'd ever had is 32). Six months later my ferritin elevated to 56! Additionally stools became much more firm and increased in diameter (previously pencil thin). I did not attempt to eat gluten, but I did start eating at restaurants where cross contamination was more likely (pizza restaurants, and restaurants with shared cooking spaces) and did not get sick. Whether this was due to psychological or physiological effects I'm not sure, but I'm very pleased.” (Via private communication.)

“I have Celiac Disease. My first dose was 30hw when I was 18 in 2009. I re-upped in January 2016 of this year with 30hw and then again 30 more 3 months later… I have an extremely sensitive system and my Celiac Disease is very active. I have sensitivity below 20ppm and symptoms after ingesting gluten include brain fog, short-lived but intense depression (4-8 hours), memory loss, clumsiness, headache, bloating, facial rash, abdominal pain, severe diarrhea. I suffered greatly before hook worms and found that post-inoculation, my response time to gluten changed from 6 hours to 12-18 hours with greatly reduced symptoms. It's the difference between missing a couple days of work vs. being able to manage. I still don't eat out at restaurants unless I Nima test the food or it is a 100% gluten free facility. I don't eat at friends house or have any gluten in my household. The two years where the hook worms probably died and I didn't re-up were horrific - my sickness felt twice as bad as it used to be because I knew my baseline wellness could be so much higher.” [7]

“I first inoculated (6 months ago) with 25 NA. I started HT not to eat gluten again but to know I was not doing as much damage to my body if I should accidentally get a small amount while out. I also didn’t think that being gluten free was helping as much as it should. Since being diagnosed I have eaten super healthy… But despite this, I was sick at least every few weeks, which has been happening my whole life… Well it’s now been 5 months since I’ve been ill. Not so much as a sniffle. My glands aren’t swollen. I saw a functional medicine doctor recently… He ran a lot of tests and when they came back he said that I am the healthiest coeliac he has ever seen… My blood results were all in the normal range besides the Absolute Eosinophils which were 1078 (no surprise).” [8]

The following update was posted 2 years later.

“I have had NA for 3 years. Until recently I didn’t bother trying to reintroduce gluten as I was happy with a GF diet. But 3 weeks ago I started eating a piece of pasta a day. I’m up to 12 pieces daily and I’m not reacting at all. Usually that would have me incredibly ill, vomiting, diarrhea and tons of inflammation…” (Link expired)

“I took 20 worms (NA) about three months to help treat my celiacs disease. A week ago, I started to eat one piece of candy each day that contained a bit of barley. Usually that would have triggered a horrible reaction, but nothing but a little light cramping and swelling for an hour or two after ensued. Each day, the amount and time spent cramping and swelling went down. A week later, I decided to do the real test - eat a full slice of pizza. Normally, this would have caused me to be absolutely and completely sick for at least a week. No reaction. I tried a couple crackers the next day - no reaction. Then a chocolate bar with wheat wafers - no reaction. So there you have it! While I will still be sticking to a gluten free diet, the worms are a reassuring safety net for if I ever do consume gluten by accident, or if I would like to treat myself once in a blue moon. And strangely enough, ever since I have been slowly introducing the gluten, my bowels and stomach have been great! Better than before to be honest.” [9] [10]

“I was diagnosed (celiac) almost exactly 5 years ago and sadly saw little improvement over that time. I progressively became sensitive to more and more foods, first dairy, then soy, and just recently I lost eggs. My symptoms are mostly neurological; brain fog, personality changes, memory loss, unbelievable depression and anxiety, peripheral nerve damage, and my eyesight has taken a hit as well… Week 8 now (after inoculating with 5 NA) and all I can say is "wow". The last few days have seen a huge improvement in my energy levels and mood. I find myself smiling constantly! The brain fog has started to lift, I can have much better conversations and my memory is improving too. I don't feel like a zombie anymore!” [11] [12]

“Test results are back! 6 months in and I have been consuming a small amount of gluten. Coeliac markers came back virtually exactly the same as my strict gluten era. 😁 My GP was very impressed with my results!!!” [13]

“My experience so far with 10NA 7 months old and 25NA now 3 months, great results with possible cross contamination. I no longer ask questions when eating out about food preparation, I'm still eating gluten-free but no longer worry about if there is cross contamination. Some of my favourite Chinese sauces I used to cook with before Celiac disease have now appeared back into my cupboard and I have no hesitation using them.” [14]

“My gluten reaction was extreme even to tiny amounts of gluten. The second last time I was glutened it was from an antihistamine capsule. The branded version was GF but the generic wasn't. I was on the toilet for 2-3 hours with my system's obvious goal of emptying my entire GI tract ASAP... I inoculated myself with NA hookworm larvae on July 30th, 2018. I finally got the courage to try a tiny amount of gluten 4 days ago (Dec 20th, 2018). I didn't have a reaction so the next day I tripled the dose, and then tripled it again. Still nothing. I was so encouraged I had an entire whole wheat English muffin. No reaction to that either. That day I ended up eating 4! And I was totally fine. So far as I'm concerned I'm now on an unrestricted diet.” [15] [16]

“I inoculated with 10 NA a year and a half ago and had about 14 months of amazing relief. I have celiac and am incredibly sensitive to cross contamination. I used to have severe gastrointestinal issues after getting glutened and would be knocked out physically for a couple days. I then would have body pain and lethargy for at least a week. With 10 NA, I had zero gastro symptoms when glutened. I just got really tired (and) I could push through if needed, particularly for work. But if I was able to sleep, I would sleep for 4 hours or so, then have a few hours of grogginess. A bit of a queasy stomach, but barely. This felt miraculous to me compared to before. I never intentionally tried gluten, but I know of a few instances where I took chances and was cross-contaminated. I ate out several times, which I could never do previously. Huge quality of life improvement.” [17] [18]

☹️ “I have had loose bowels, diarrhoea and chronic fatigue all my adult life. I was diagnosed with coeliac disease in July 2016 but experienced no improvement with a gluten free diet. I dosed with 25 hookworm larvae in October 2016, then 40 in Jun 2017 and 12 in Jan 2018. I had reactions each time, all in line with what you'd expect from the wiki. I definitely (still had hookworms at) 24 months, as I continued testing for a fair while after dosing. I didn't experience any improvement in my symptoms in the short or long term. I have found that the only way to improve my health is by targeting the symptoms (loperamide, amitriptyline, cholestyramine, clay, calcium carbonate) and reducing my fibre intake to almost zero.” [19]

“I had an accidental brush with gluten on the weekend just passed. For the first time in almost 10 years I had no immediate reaction; moreover no dread of being ill for the next few weeks and then some. Now that’s a hugely triumphant moment for me. So very happy with my life, feeling blessed. I am diagnosed Coeliac. I’ve also had lymphocytic colitis and gastritis over the past 5 years, all confirmed through biopsy by my gastroenterologist. Helminthic therapy was recommended to me after my last bout of gastritis after all other avenues had been thoroughly exhausted. I started with just 2 HDC, and now (at 7 months) I take 10 HDCs fortnightly.” [20]

“I have celiac. If I get even a tiny amount, I’m in severe pain, knock out within minutes and stay asleep for hours. The pain in my joints lasts for months. I’ve been terrified to try even after several years of NA. I accidentally got some in a chocolate bar that had been safe before, but I didn’t reread the ingredients before eating. I only had slight stiffness and it only lasted a few days. Definite difference!” [21]

“I have had 2 or 3 previous endoscopies with confirmed celiac, plus positive lab tests. The last endoscopy, (carried out after starting helminthic therapy [with TSO]) the pathologist suggested my previous dx's were in error. I don't believe it. Anyway, now I can eat gluten without issues.” [22]

“I have (had) celiac and after ~18 months (with NA) I could eat gluten again. I don’t even really pay attention to my diet anymore.” [23]

“I went gluten free in the early 80's and most of my gut symptoms resolved soon after. My doctor believed I had celiac disease based upon history but I was not interested in eating enough wheat to get a true diagnosis. Gluten free can be difficult when eating out and I periodically got ambushed. If these cross contamination exposures happened very often, symptoms came back. However, I have had helminths (NA) for about a decade, and a couple big exposures in the last few years did not cause symptoms. A guest staying with us had regular bread in a package that looked a lot like my gluten free bread. I ate several pieces this bread and had no problems. I also discovered that my favorite mexican restaurant's green chile sauce was not thickened with cornstarch but actually thickened with flour. I probably ate this sauce every month and maybe more often. And, where I used to have problems from cross contamination, I don't have them now when I actually eat wheat. That said, I'm not interested in experimenting.” [24]

"I had my celiac disease go into full remission from hosting 25 Necator americanus. Gluten reactivity was sky-high, but now I’m free to eat anything I like, and I rarely even burp. Both my fridge and freezer are stuffed with gluten and my favorite bed-time snack is mini shredded wheat. It's all a dream come true for this former highly reactive celiac. It's rare now that I have a meal without some gluten in it. No reactions at all, and bowel movement frequency has decreased. Only 1-2 perfectly formed bowel movements per day now. Things couldn't be going better. My meat-triggered ulcerative colitis is also entirely absent." (Edited from two posts: [25], [26])

"I have a celiac diagnosis. I now can eat gluten. I still mainly eat gluten-free, but I no longer worry about eating gluten. No reaction. Been doing NA for a couple of years." [27]

"I have been treating coeliac disease with NA for over 4 years now for cross contamination purposes. When I eat out I just order GF and don’t worry what it’s cooked with or in." [28]

"I have hosted hookworm for over 6 years, to treat celiac. It has changed my life for the better, allowing me to eat out and at friends’ homes (always gluten free) without getting severely ill if I accidentally get a very small amount of cross contaminated food." [29]

"Medical science says it's impossible but my sister and I have perfect endoscopies now and we've been eating wheat for a while... Both of us were diagnosed (celiac) by endoscopy and by labs." [30]

"a gentleman have celiac disease and something called ankylosing spondylitis (...) so this patient notice that if he eat gluten he would have digestive problems and he would go into an ankylosing spondylitis flare that eventually had to increase so he not only was eating a zero gluten diet but he was eating a zero grain diet that was low in carbohydrates of all kinds even non green carbohydrates even while on this low carbohydrate no grain gluten-free diet he would have two or three or four flares of ankylosing spondylitis per year that would leave him in bed unable to work his job as a carpenter or do much of any other things for a couple of weeks at a time so this is a big drain on his quality of life we gave him an initial dose of 10 Necator americanus larvae and then another redose just like in the study started gradually reintroducing gluten we didn't weigh out micrograms like they did in the study but he would just have a crumb of this a little bit of that and started gradually gradually introducing reducing the doses. I followed him for about three years after that it's been about five years since I treated him and for that entire three-year period he found his quality life getting better and better and it has been years since he's had an inkling spondylitis flare and he can consume gluten now if he wants you he doesn't go crazy with it all the time but if he feels like having a sandwich or drinking a beer he does with apparently no consequences his inflammatory markers didn't go up for the time I followed him and his symptoms well he just had zero flares of a digestive disturbance or his back pain or lack of mobility. (Mark Davis ND, auto transcription, youtube)

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Selecting a helminth species to treat coeliac / celiac disease[edit | edit source]

To identify the best helminth species to treat coeliac / celiac disease see this list.

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