Helminthic therapy and pregnancy

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    Hosting helminths during pregnancy is commonplace, with approximately 44 million pregnancies occurring globally each year in women with helminths. [1]

    De-worming during pregnancy is not advantageous and may be harmful

    Many medics have advocated de-worming pregnant women to prevent a range of supposed health risks, but studies have found that, where good antenatal care is provided, de-worming produces no benefits in respect of anaemia, birth weight, perinatal mortality, infant mortality or infant response to immunisation. [2] [3] [4]

    Deworming did not show consistent benefits for indicators of mortality, anemia, or growth in children younger than five or women of reproductive age. [5]
    … anthelmintic treatment during pregnancy has no benefit for an infant's response to immunisation, or for their health and development… [6]
    ... treatment may impose more costs than benefits, for example, by increasing the risk of infant eczema. Treatment may also have additional unanticipated effects by altering maternal blood glucose regulation, microbiota, or hormonal environment. [7]

    Both mother and child benefit when helminths are hosted during pregnancy

    Prenatal exposure to parasite antigens impacts on the strength and width of postnatal immune responsiveness without generating aberrant inflammatory immune responses. Neonates not exposed to parasite antigens have inappropriately increased or decreased gene expression profiles. [8]

    Current epidemiological findings suggest that prenatal exposure to helminth infection may have an important effect on the development of the foetal immune response and that this might help prevent the emergence of inflammatory conditions such as allergy. [9]

    Studies from Uganda have shown that hookworm colonisation in pregnant women confers protection against infantile atopic eczema, protection that is abrogated by anthelmintic treatment during pregnancy. [10] [11] The presence of helminths at delivery has also been shown to be inversely related to infantile eczema, adding further support to the hypothesis that maternal helminth infection protects against this disease. [12]

    Studies in mice indicate that helminth infection during pregnancy may reduce the susceptibility of the offspring to allergic airway inflammation. [13] [14]

    Helminth infection in the perinatal period protects children from the neurological damage that can accompany bacterial infections, and this protection extends into adulthood. [15]

    Antenatal maternal helminth infections are associated with modestly increased IgA responses to oral infant vaccines. [16]

    Sepsis, a condition that is hard to recognise and treat, is an increasing cause of complications and death among women in the West, and rates of severe and fatal sepsis during labor and delivery are rising sharply, such that sepsis is now the leading cause of direct maternal death in the UK. [17]

    As a helminth infection counterbalances the exacerbated pro-inflammatory immune responses that occur during sepsis, thus improving survival, it is arguable that the presence of a small colony of therapeutic helminths might actually prevent a woman developing sepsis. [18]

    Hyperemesis gravidarum (HG) is a pregnancy complication characterised by severe nausea, vomiting, weight loss, and possibly dehydration, [19] which is considered more severe than morning sickness. [20] In view of the fact that allergy is the most significant condition associated with HG prior to pregnancy [21] - which suggests a possible allergic or autoimmune component - it is possible that women who are hosting helminths might be less likely to develop HG.

    Since helminths control inflammation, commencing helminthic therapy prior to pregnancy might help women who have autoimmune disorders such as colitis to stay healthy during pregnancy, [22] and help to spare their offspring adverse, inflammation-related effects on brain development, some of which can result in autism-like features. [23] [24]

    I am a physician and see absolutely no problem with using HT while pregnant. In fact, I plan to do it myself later this year. (Posted to a Helminthic Therapy support group.)

    Reports by women who hosted small numbers of helminths while pregnant

    One woman who examined all the available evidence on the risks and benefits of hosting helminths during pregnancy came to the following conclusion.

    I got hookworm (and just a couple of whipworms) to help keep my immune system in check during my next pregnancy, since my first kid is on the autism spectrum. From my research it seems safe in low doses and can prevent allergy in offspring, another reason I decided to go for this. Not pregnant yet, just planning.

    And she reported, at a later date,

    I hosted whipworm and hookworm during 2 term pregnancies. The first baby is 2 years old and is free of allergies and autoimmunity, unlike the older sibling who was sick since birth.

    Someone else, who had previously had two children with severe eosinophilic esophagitis-related food intolerances, maintained a hookworm colony throughout her next pregnancy and delivered a healthy, allergy-free baby. (Expired link)

    Other mothers have reported as follows.

    I did 3 NA at second trimester. And another 3 one month after giving birth. Baby is healthy ❤ and breastfeeding continues with no worries. [25]
    I hosted hookworm while pregnant with my second and had no issues. [26]

    Mothers, as well as their babies, can benefit by continuing to host helminths during their pregnancy.

    In June of 2016 I decided to try TSO 2500 every 2 weeks, and for the first time, had some real improvement in my (RA-related) inflammation and pain. I got pregnant in September 2016 and from my own research and from talking to Tanawisa, I felt comfortable continuing with the TSO throughout my pregnancy. Because uncontrolled inflammation in a pregnant mother has been proven so detrimental to the health of the child, I decided to bump up my dose of TSO to 2500 every week. Throughout my pregnancy I have had almost no inflammation or joint pain, except for a couple of small flare ups during some stressful events. [27] (This mother also reported, in a different Facebook group, that her baby is healthy.)

    The question of whether to introduce helminths during pregnancy

    Notwithstanding the fact that approximately 44 million pregnancies occur globally each year in women who are hosting helminths, [28] and the many health benefits to be gained by both mother and child as a result of establishing a helminth colony before becoming pregnant, some women are reluctant to commence helminthic therapy for the first time during pregnancy.

    If it were me, I would feel comfortable infecting myself with helminths for the first time before a pregnancy but not during. (Expired link)
    I made the decision not to inoculate during either of my pregnancies - the first because I didn't have an existing colony and I was worried about the heightened immune response triggering heightened immune responses in my child as well as my ability to take any medications to manage the side effects; the second because I already had an existing colony and felt well enough that I was happy to wait. [29]

    If a woman were to start helminthic therapy while pregnant and have a miscarriage, or encounter a problem with the new baby, they, or their healthcare providers, might blame the helminths, and legal action could be taken against whoever supplied them. This has led some helminth providers to decline to supply anyone who is pregnant.

    Since this therapy is so new we do not know the effects on the fetus so we do not treat women who are pregnant. (Worm Therapy)
    Due to the lack of clinical data, anyone who is pregnant would need to wait until after the child is born before beginning the treatment. (Symmbio)

    Another provider recommends supervision by a physician during pregnancy.

    If someone wishes to begin to restore their biome while pregnant, they should do so under a physician’s supervision. (Biome Restoration)

    But one helminth provider who has supplied many thousands of individuals, including many pregnant women, since 1998 without any adverse effects being observed, is confident that their particular organism is safe for use during pregnancy.

    No studies on pregnancy have been performed so far, but TSO (has been) taken since 1998 by many thousands of patients, and many have taken TSO during pregnancy without any problems. Their life cycle also keeps (these organisms) away from any other organs and contact with sensitive areas. They are fully digested in the gut. [30]

    Here are quotes from a few of the many women who have inoculated with probiotic helminths during pregnancy, none of whom have reported anything untoward.

    I inoculated throughout pregnancy and breastfeeding, baby is almost 9 months old and we have no issues. [31]
    I dosed 2 x (with NA) during pregnancy. Prevented me from going over the edge as my stomach was in a special sort of hell since conception. The baby is healthy. My first one had severe milk protein allergies, but so far so good with this baby. I'm doing well as well. (I have Crohn's/colitis.) [32] [33]
    I have UC and continued dosing 100 TTO about every 6 weeks throughout pregnancy. I was actually more afraid to stop dosing than to continue because of being scared of a flare. [34] I use NA too. [35]
    I took a couple of doses of NA during pregnancy because I had to take antibiotics (the same type that seemed to have adversely affected my worm colony in the past) and I decided being wormless was more of a risk to baby than re-dosing after the antibiotics. I was concerned about any initial immune response to the worms (because) I thought there was a good chance my colony had died following the antibiotics. I found a study in mice where they found benefits to the offspring from a first-time infection of the mother during pregnancy. That, together with the multiple studies showing benefits for baby when mum is already hosting, helped me decide to re-dose after each round of antibiotics. My pregnancy went to full term and my daughter is healthy - no signs of allergy or any other problems. [36]

    Note: if a woman wished to terminate a helminth colony during pregnancy, it had been suggested that it would be best to avoid the use of mebendazole. However, a study in 2016 found no association between exposure to mebendazole at any time during pregnancy and negative birth outcomes. [37]

    Helminthic therapy practitioners

    The Helminthic Therapy community includes a number of medical practitioners who are willing to be consulted about the therapy, and these include a registered nurse/midwife, who has many years of experience with the therapy and hosts helminths herself. For her details, see the following page.

    Discussion threads about helminths and pregnancy

    1. Experiences of pregnancy as a current or recent helminth host. Sept 2013. [38]

    2. A doctor’s concern about a hookworm-hosting pregnant patient. Dec 2016. [39]

    See also