Helminthic therapy information for doctors

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    Helminthic therapy: the reality

    Today, the global helminthic therapy self-treatment community comprises many thousands of individuals, including a large cohort of PhDs, many MDs and NDs along with other healthcare professionals and several professors of medicine, many of whom are, themselves, self-treating with helminths. For example, this pathologist.

    Upwards of 170 immune-related conditions are being treated, including neuropsychiatric and metabolic disorders, [1] and numerous scientists have expressed support for this form of probiotic therapy. [2]

    Helminthic therapy offers patients a self-administered treatment that is very safe, [3] effective in approximately 75% of cases of immune-related disorder, [4] and available for immediate use from suppliers who have been vetted by the community [5] and rated by their clients. [6]

    Detailed information about all aspects of the therapy can be found in the Helminthic Therapy wiki, [7] while support is available online from knowledgeable and experienced users, [8] along with information from doctors and other health professionals who have personal experience with the therapy. [9]

    Hosting a mutualistic helminth is not a medical treatment, so there is no need for doctors to become involved in its use. All that self-treaters require from their medical practitioners is the continued provision of routine healthcare, while the patient pursues helminthic therapy independently.

    Now that helminthic therapy self-treatment has been developed to the point it has reached today, there is no longer any justification for its disparagement, for attempts to dissuade patients from using it, or for refusal to provide routine medical care to patients who do use it. Primum non nocere (first, do no harm).

    From medical science to citizen science

    Research has revealed that humans need continuing exposure to living intestinal worms in order to enjoy optimum immune function. [10]

    The first helminth product introduced for therapeutic use was Trichuris suis ova (TSO), which was developed around the turn of the century by Prof Joel Weinstock and a biotherapy company. [11]

    Early studies with TSO were very promising. [12][13][14]

    A dozen later studies failed to show any benefit, but these trials all had a critical flaw that was never mentioned in the published reports. The TSO that had been used by Weinstock, et al, had a pH of 2.4, the empirically established optimum formulation. However, for reasons that have never been disclosed, the team responsible for mounting the twelve later trials used TSO at pH 5.0. [15]

    When research into the therapeutic use of living worms stalled following these multiple clinical trial "failures", citizen scientists took up the baton. Their subsequent endeavours saw the introduction for self-treatment of three further mutualistic helminth species: Necator americanus (NA), Trichuris trichiura ova (TTO) and Hymenolepis diminuta cysticercoids (HDC). The full story of how the therapy has developed is presented in The history of helminthic therapy.

    Medical research has now largely switched to seeking helminth-derived proteins for use in drug development, although it is clear that living worms provide a much more comprehensive range of benefits than synthetic single-molecule medicines might be able to do, and they do this without any long term side effects. [16]

    The safety of mutualistic helminths

    The specially selected and domesticated mutualistic organisms used in helminthic therapy present a level of risk significantly lower than that associated with many of the medical treatments currently employed to treat immune-related disorders. [3]

    Although helminthic therapy has been available since 2003, and is being used today by many thousands of individuals, there have only been two reported cases of serious adverse effects associated with the therapy.

    The first case involved a patient who required hospital treatment for Loeffler’s syndrome and hypereosinophilia following inoculation with excessive doses of NA. [17] The level of dosing used in this case has since been found to be unnecessary and is no longer recommended. [18]

    The second case involved a woman who was already terminally ill with lung disease when she began hosting hookworms. She then fell victim to a perfect storm as a result of several factors coalescing during the Covid-19 pandemic. These included a previous accidental and unrecognised infestation with the pathogenic helminth, Strongyloides stercoralis, which proliferated as a result of the administration of prednisone, and hastened her death. [19]

    The role of the global self-treatment community

    Between 2015 and 2021, a team of researchers centered on Duke University reported on three socio-medical investigations into the practices and experience of self-treaters and the observations of their physicians. [4][20][21] The authors of these three studies concluded that:

    1. the disappointing results from the “gold standard”, double-blind, placebo-controlled clinical trials were starkly at odds with numerous other strands of evidence,
    2. the poor trial results were likely due to a lack of appropriate consideration of the biology of the organisms used, and of the nuance of their interaction with their hosts,
    3. helminthic therapy self-treatment has become a readily available and well-established resource used by thousands of individuals,
    4. the self-treatment community has become the primary "laboratory” for helminthic therapy using living organisms,
    5. the community’s “biohacking” endeavours may prove to be critical for public health by addressing the biota alteration that is a fundamental cause of disease in Western society.