Introduction to helminthic therapy

    From Helminthic Therapy wiki

    Home>Introduction to helminthic therapy

    Are you a doctor or other medical professional?

    Please first see, Helminthic therapy information for doctors.

    Are you a journalist, or skeptical about this therapy?

    You may find it helpful to start with the History of Helminthic Therapy, which reviews this therapy's development alongside the emerging science.

    Are you considering using this therapy?

    Reading this entire page very carefully, along with the material at the links within the text, will greatly increase the likelihood of a satisfactory outcome.
    Quotein.gif
    Make sure to read the wiki... literally all of the questions are answered there. [1]
    Quotein.gif
    I didn't read the wiki closely enough before starting. So I'm paying the price! [2]

    Do you have worm phobia / an aversion to worms?

    If you are reluctant to try helminthic therapy because of a fear of worms, see, Don’t let worms give you the squirms!

    What is helminthic therapy?

    Helminthic therapy is a "probiotic" self-treatment involving the reintroduction to the digestive tract of a controlled number of specially domesticated, safe, mutualistic helminths (intestinal worms) in the form of microscopic eggs or microscopic larvae.

    Quotein.gif
    We think of these worms as kind of big probiotics. (Dr Paul Giacomin, Australian Institute of Tropical Health and Medicine.) [3]

    People living in developed countries gradually lost contact with this type of organism during the 20th century as a result of the introduction of "systems hygiene" in the form of indoor flush toilets and sewage treatment as well as water purification facilities and food processing plants, plus innovations such as mass-produced shoes, canned food, artificial refrigeration and anthelmintic drugs. [4]

    By reconstituting and enriching the intestinal biome, helminthic therapy counteracts this loss of biodiversity, as well as halting the immune-related disorders that result from it.

    The therapy is being used today by many thousands of individuals to successfully treat and prevent autoimmunity, inflammation and allergy as well as neuropsychiatric and metabolic disorders.

    Since it is not a medical treatment, doctors are not normally involved in its use, although many naturopathic physicians and practitioners of functional medicine recommend their patients to use it.

    In order to experience optimum benefits from helminthic therapy, the self-treater must fully understand how to use it before commencing, and there is a lot to learn, with a choice of four different organisms, each with different characteristics and somewhat different effects. Fortunately for anyone who is new to this therapy, all the information they need is presented on this site, and this page is the main doorway into that information.

    Terminology

    This practice is known variously by the following terms:

    • Helminthic therapy
    • Helminth therapy
    • Helminth replacement therapy
    • Helminth-induced immunomodulation therapy (HINT) [5]
    • Worm therapy
    • Biome restoration
    • Biome reconstitution

    Hovering your cursor over any words or abbreviations that have a faint underlining will reveal a definition. Alternatively, go to the Terminology page.

    Humans need helminths

    The term, “helminthic therapy” may suggest that this might be just another therapeutic option that one can try in the hope of fixing some health issue that has not responded adequately to other forms of treatment, but helminth replacement is actually far more than this.

    Helminths are an essential component of a healthy human biome and provide uniquely effective exercise and training for the immune system, such that continual exposure to helminths is a fundamental necessity for optimal human health.

    The first suggestion that this might be the case emerged in a report published in 1968 by a researcher working in Nigeria who opined that the rarity of autoimmune disease in tropical Africa might be related to the fact that Africans typically host multiple parasites.

 [6]

    Since then, it has become abundantly clear that humankind’s coevolution with helminths over millennia has left the human immune system less able to function optimally without the presence of this type of organism.



    Quotein.gif
    All immunocompetent humans need regular exposure to helminths in order to maintain optimal immune function and avoid risk for inflammation-associated disease. [7]

    It is now known that helminths train the developing immune system in infancy and continue to regulate immunity throughout the rest of life for as long as they remain with their host. The science supporting this view is now extensive, and growing continually.



    Quotein.gif
    Independent lines of evidence, including epidemiologic studies, studies using animal models and clinical observations, point to the idea that we need exposure to helminths in order to avoid biota alteration and immune hypersensitivity. [8]

    The gradual loss of intestinal worms from industrialised societies from the mid-1800s, leading to their virtual eradication during the 20th century, has undoubtedly relieved these populations of the health issues associated with pathogenic helminths, but it has also led to inflammation-associated deficiencies in immune function that have contributed to widespread pandemics of allergy and autoimmune disease, as well as metabolic and neuropsychiatric disorders.

    Quotein.gif
    Exposure to helminths is a necessary component of our biology, and the essentially complete absence of those organisms is an underlying cause of inflammatory disease. Based on this view, we have argued that access to helminths is a basic human need. [9]

    The only rational solution to the loss of these essential, "keystone" organisms is their routine replacement in the form of the non-pathogenic helminth species that have been domesticated and made available commercially in the 21st century for use as "probiotic" supplements. (See Therapeutic helminths.)

    Quotein.gif
    In some not too distant futurity, there may come a day when we all take ‘helminth supplements’ along with our Omega 3 fatty acids, vitamins, and whatever else goes to make up a modern balanced diet. [10]
    Quotein.gif
    Twenty years from now everybody is going to have a helminth, and no insurance company will begin to cover you if you don’t have your helminths. We’re very confident in the science, that every single human being needs a helminth. It’s part of our biology. [11]

    The rewards of re-worming

    
Socio-medical studies have examined the effects of intentional re-worming and found that the controlled reintroduction of mutualistic helminths is effective in treating a wide range of inflammation-related diseases including allergic disorders and autoimmune conditions as well as digestive and metabolic diseases. Even neuropsychiatric disorders such as depression, anxiety, migraine headaches, ASD, bipolar disorder and Parkinson’s disease have been effectively ameliorated by self-treaters using the available therapeutic helminths.

    For many hundreds of anecdotal reports of success using helminths to treat over 160 different conditions, see the following page.

    

In addition to re-worming being an effective treatment for existing immune-related disorders, there are many benefits to be gained from hosting helminths throughout life. Amongst these are a reduction in risk for a whole raft of conditions which include the degenerative diseases that develop with age.


    A brief history of helminthic therapy

    Following the first appearance, in 1968, of evidence pointing to the importance of helminths for human health, [12] further evidence emerged in the 1970s, including a report of higher levels of allergic disease in urban communities than in rural indigenous areas where levels of helminth colonisation were much higher. [13]

    By 1990, it had become clear from further scientific studies that, while autoimmune, inflammatory and allergic conditions had escalated in developed countries during the twentieth century, they had remained much less common in parts of the world where helminths are still prevalent. (See this distribution graphic prepared at the start of the twenty first century by the late Prof Robert Summers.) It was this realisation that gave rise to the idea of reintroducing helminths into patients who have developed these conditions, in the hope that this intervention might rebalance their immune system and restore their health. The first indication that this may be an effective approach had already appeared in the Lancet in 1976, when a researcher had reported putting his own seasonal allergies into remission by colonising himself with hookworms. [14]

    Researchers began to consider the importance to health of the microbiome, and the theories formed by these pioneers have been refined through several stages, each being given a new title, viz. the Hygiene Hypothesis, the Old Friends' Hypothesis and, more recently, Evolutionary Mismatch Theory and Biome Depletion Theory/ Biota Alteration Theory. By the 2020s, this concept had ceased to be merely a hypothesis, and had become a working paradigm.

    During this process, helminths were identified as being of special significance, and they are now considered to be keystone species of the human multibiome, with profound importance for health. So much so that there are calls for them to be employed not only as a treatment for established disease, but also as a preventative to help eliminate the pandemics of allergic, inflammatory and autoimmune diseases that are today afflicting the populations of developed countries, and possibly also to offer protection against many degenerative diseases such as atherosclerosis, diabetes and cancer.

    Most members of the medical profession remain skeptical about the use of live helminths, while some are overtly hostile, and no mainstream medic will be able to use these organisms in clinical practice until they have been validated in each target disease by randomised clinical trials.

    Unfortunately, where helminths have been the subject of studies, these have often employed methods that were designed to test pharmaceutical products and are unsuitable for the assessment of a natural therapeutic, especially one whose beneficial effects do not become consistent for at least twelve weeks - the typical limit of drug trials - and, in a few cases, have taken as long as two years to materialise. (See Problems with clinical trials using live helminths.) Unsurprisingly, some of these trials have failed to show efficacy, in contrast to the experience being reported by many thousands of individuals who are self-treating with helminths.

    Quotein.gif
    Although self-treatment with helminths cannot be recommended by medical professionals due to a lack of blinded, placebo controlled trials, neither should it be discouraged since the available evidence suggests that it is beneficial in most cases when practiced by knowledgeable individuals. (Parker and Morey, 2015)

    As a consequence of the failure of medical research to provide the type of evidence that would allow the use of helminthic therapy in clinical practice, millions of patients are being forced to continue to suffer the often devastating effects of immunological disorders, along with the frequently serious side effects produced by many of the pharmaceutical therapies currently prescribed to treat them. And this is in spite of the fact that four helminth species have already been identified as suitable and safe for use in therapy and are currently being used successfully for self-treatment by many thousands of individuals.

    Quotein.gif
    What was a costly and sometimes risky venture into the unknown, undertaken by only a few 10 years ago, is rapidly becoming a readily available and well-established resource currently used by thousands of individuals. (Cheng et al, 2015)

    Several of the researchers who have examined the effects of helminths on autoimmune disease admit privately that, were they or a member of their family to succumb to an autoimmune disease, they would not hesitate to use one of the available therapeutic helminths. A few have even said this publicly.

    Quotein.gif
    In developed countries, where we are well nourished, worms are potentially good... If I had Crohn’s disease, ulcerative colitis or multiple sclerosis, I would infect myself without hesitation. (Alex Loukas, Australian Institute of Tropical Health & Medicine, in Life On Us, 2014)

    While citizen scientists continue to refine the therapeutic use of live helminths, the vast majority of medical researchers have their sights set on the creation of drugs employing helminth-derived molecules. However, some researchers have suggested that no worm-derived pharmaceutical will ever match the efficacy of a live worm.

    Quotein.gif
    It is difficult to imagine a single pharmaceutical or even a collection of pharmaceuticals that could recapitulate the vast complexity of the interaction between helminths and the host immune system. While pharmaceuticals are generally directed at one component in the immune apparatus, a single helminth species produces dozens if not more molecules that each target specific components of host immunity. (Bilbo et al, 2011)
    Quotein.gif
    When you give someone a live worm, it’s like giving them the factory that makes the products and letting the factory do what it needs to do… Evolution has already created this thing. (David Elliott, University of Iowa.)

    Helminth-derived pharmaceutical products are still many years away, and if and when they do become available, some, if not all of them, are likely to present adverse side effects, as are seen frequently with other single molecule drugs. In contrast, none of the living helminths that are currently in use therapeutically cause long-term side effects.

    Acceptance of helminthic therapy by the medical establishment is currently hindered by the strong pharmaceutical bias of modern Western medicine, and by an inflexible medical research system that ignores vibrant sources of new knowledge generated by activist patients such as those who have contributed to this wiki and its associated groups and blogs. [15]

    However, in spite of these factors impeding acceptance, helminthic therapy is nevertheless predicted to become an essential part of healthcare in the future.

    Quotein.gif
    Twenty years from now everybody is going to have a helminth, and no insurance company will begin to cover you if you don’t have your helminths ... We’re very confident in the science, that every single human being needs a helminth. It’s part of our biology. (William Parker, 2016)

    For a more detailed examination of the history of this therapy, see the full History of helminthic therapy.

    Helminthic therapy science

    Here is a short selection of scientific papers that provide a good overview of the therapeutic potential of controlled colonisation by benign helminths.

    For a full list of scientific papers and articles from the media documenting the history and development of helminthic therapy from its beginnings up until the present day, see the following pages.

    Helminthic therapy safety

    Helminthic therapy is very safe.

    For details about benefits and risks, known and possible contraindications, and a list of conditions that require a modified approach to helminth dosing, see the following page.

    Therapeutic helminths

    For a helminth to be suitable for use in therapy, it must meet a number of generally agreed criteria. The following list is a composite drawn from several sources, including [16] & [17].

    Criteria for a therapeutic helminth

    1. does not cause disease in humans at therapeutic doses
    2. is not a potential vector for other parasites, viruses, or bacteria
    3. does not cause long-term symptoms in humans at therapeutic doses
    4. does not alter its behaviour in patients with depressed immunity
    5. is not easily transmissible from the host to other people
    6. is not able to reproduce in a host, ensuring dosage control
    7. is easily eradicated from the host if required
    8. is compatible with commonly used medications
    9. is easy to administer
    10. is amenable to production in large numbers
    11. is amenable to storage and transportation

    A more recent Graphical Overview of (Re)formulated Eligibility Criteria for Present and Future Therapeutic Worm Candidates can be found in Figure 1 of this paper.

    There are currently four types of helminth available commercially for use in self-treatment. All of these meet the above criteria.

    1. Pig whipworm, Trichuris suis (TS)
      Introduced for therapy in 2003. Sold as ova (TSO) and taken as a drink.
    2. Human hookworm, Necator americanus (NA or HW)
      Introduced for therapy in 2006. Sold as microscopic larvae which are applied to the skin.
    3. Human whipworm, Trichuris trichiura (TT)
      Introduced for therapy in 2009. Sold as ova (TTO) and taken in a drink.
    4. Rat tapeworm, Hymenolepis diminuta (HD)
      Introduced for therapy in 2011. Sold as cysticercoids (HDC) and taken in a drink.

    Choosing a therapeutic helminth

    See the separate page:

    Helminthic therapy in practice

    Before starting

    Helminthic therapy is contraindicated for people with certain conditions.

    People considering self-treatment with helminths sometimes ask if they need to make sure they don’t already have any worms before introducing therapeutic ones. However, this is unnecessary in the vast majority of cases, as can be seen from the details on the Deworming debunked page. Additionally, the use of "parasite cleanses" is rarely a good idea, for the reasons set out in this article.

    In a study carried out in Argentina, 12 MS patients were found to be hosting a variety of helminths. Three had Hymenolepis nana, 3 Trichuris trichiura, 3 Ascaris lumbricoides, 2 Strongyloides stercolaris, and 1 Enterobius vermicularis. Only one of these species is a mutualistic helminth (Trichuris trichiura), yet no patient developed clinical disease associated with any of the helminths during the 4.6 year period that they were followed by the researchers. And there were only 3 reported relapses in MS in the subjects hosting this wide range of mostly non-mutualistic helminth species in comparison with 56 relapses in those without helminths. [18]

    However, any potentially pathogenic helminths that also have the capability to proliferate within a host may do so if the host were to become immunosuppressed, for example due to chemotherapy or HIV, or as a result of taking a corticosteroid drug such as prednisone. This could result in a helminth such as Strongyloides stercolaris multiplying and causing the pathologies associated with this species, including Strongyloides hyperinfection syndrome which has a high mortality rate. Therefore, if someone has previously travelled to an area of the world where pathogenic helminths are endemic, they may wish to take a parasite test before commencing helminthic therapy. This would allow them to avoid the possibility that any future immunosuppression might cause the proliferation of a species that would require termination, causing the collateral loss of any therapeutic helminths that were also being hosted at that time.

    The only reliable test for this purpose is a PCR (polymerase chain reaction) analysis that checks for helminth DNA, and this can be ordered internationally online from Diagnostic Solutions in Atlanta, Georgia, US. The clinician ordering this test should ask specifically for the helminth test.

    Getting started

    This quick start guide will ensure that the prospective helminth host has covered all bases before commencing treatment.

    Further considerations

    Self-treatment with helminths is very individual so, even with guidance, it can take a while to establish the ideal dosing regimen.

    Quotein.gif
    I now realise that the dosage, intervals and maintenance of Helminthic Therapy is ongoing and requires lots of attention, which if I’m being honest I wasn’t expecting.
    Quotein.gif
    Self treatment is hard. I'm still figuring out the right species and number of worms best for me, 5 years into this. For some of us, it's much more complicated than 'take worms, get better.'

    Helminthic therapy is typically very slow to deliver benefits when compared with drugs. For the majority who do respond, significant and consistent improvements do not usually materialise until at least 3 months after the 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.

    Quotein.gif
    18 month update. After hitting the one year mark with no improvement I was starting to get discouraged… Finally, a couple weeks ago, everything changed. I was able to eat regular foods again. [19]
    Quotein.gif
    I was a year and a half into HT and flaring. My GI wouldn't do my colonoscopy because I was so inflamed he thought I would perf. He thought I should be admitted for IV steroids and started on Remicade. (but, at almost 2 years) I have been in complete remission for the past two months and have never felt as good. [20]

    Once improvements do begin to materialise, 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. And approximately 25% of those who try helminthic therapy do not respond at all.

    Helminthic therapy is also 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.

    It is not yet possible to predict exactly who is likely to benefit from helminthic therapy, but statistics compiled from responses to a survey carried out by one provider of NA showed that 70-80% of those who self-treated with this species experienced an improvement in their health. The report of a survey conducted by researchers at Duke University showed that treatment with HDC was effective in more than 90% of cases, although this apparently higher efficacy of HDC in comparison with NA is likely to be at least partly due to the fact that users of HDC tend to be relatively less ill than those who use other therapeutic helminths.

    Helminthic therapy is not always a complete solution on its own, and some self-treaters may need to combine this therapy with lifestyle changes, dietary modification [21] and other treatments, either complementary or pharmaceutical. For example, one self-treater has said:

    Quotein.gif
    My personal efficacy is quite low without entocort. Without it, I need to take the HDC about weekly to get any effect on my sinuses, and the effect still isn't as good as with it.

    There are many examples of both successful and unsuccessful outcomes in the Helminthic therapy personal stories collection, which presents thumbnails and links to more than 900 accounts by people who have used helminthic therapy to treat over 160 different medical conditions.

    There are very few doctors who understand helminthic therapy, let alone have any practical experience with it. A few medics are using HDC in some client groups, especially children with autism (video) and a few doctors may recommend that patients with various autoimmune conditions try TSO. There is also a small but growing number of doctors, especially naturopathic practitioners, who are recommending the use of NA and a few doctors have become sufficiently knowledgeable to be able to advise self-treaters. (See Helminthic therapy practitioners.)

    The helminth providers are another valuable source of information and guidance, although no one company sells or has experience with all four helminth species, so they are unlikely to be able to match the objectivity or breadth of information found in this wiki, which offers a balanced assessment of all 4 available helminth species based on the findings of science and the first-hand experience of self-treaters. It is therefore recommended that, before proceeding with this therapy, each would-be helminth self-treater should make full use of this site and familiarise themselves with as much of its contents as possible.

    Quotein.gif
    The only bumps I have had as a self treater, were when I didn't check the wiki. [22]

    Obtaining helminths

    Newcomers to helminthic therapy will often ask in the support group for personal recommendations about the best place to buy helminths, but purchasing worms for therapy needs to be approached on an individual basis.

    There are four different species of therapeutic helminth available with two different methods of application, widely differing lifespans and somewhat different effects. None of the companies who supply therapeutic helminths sell all the available species, ship to all global destinations, or accept all payment options. And, while most sell individual doses, with discounts for purchasing multiple doses at one time, a few offer long-term contracts. Therefore, details from all of the following three pages will need to be considered in conjunction in order to make the best decisions about which organism(s) will meet each user’s unique needs and circumstances, and where to purchase them.

    Some adventurous would-be hookworm hosts may consider traveling to an area where these worms are endemic, in the hope of acquiring their larvae at zero cost in the same way that the locals do - accidentally, while walking barefoot in open-air latrines. This is a not a good idea, however, for a number of reasons, as is explained here by the only Westerner known to have done this.

    Working with a doctor

    At the present time, helminthic therapy is not approved as a medical treatment anywhere outside Thailand, so mainstream doctors - as opposed to naturopathic doctors (NDs) - face the possibility of losing their medical licence if they become involved In its use. Fortunately, helminthic therapy does not need to be doctor-led because, in practice, it is little different from taking a probiotic supplement, which most people do without involving a doctor.

    One of the purposes of this wiki is to provide everything that the helminth self-treater needs in order to use this therapy safely, but it is essential that would-be self-treaters familiarise themselves fully with all the relevant sections of the site before commencing their treatment.

    While a doctor's involvement is not essential, it can be helpful to have medical support available during the early stages of helminthic therapy. For example, a doctor will be able to prescribe an immunosuppressant drug to ease helminth side effects if these were to become troublesome, or to prescribe an anthelmintic drug if termination of a worm colony became necessary. But exactly how much to involve a physician is a matter for each self-treater to decide for themselves, based on their knowledge of their own practitioner.

    Most doctors are dismissive of helminthic therapy, some are even hostile to its use, and many intensely dislike patients taking matters into their own hands to try what the doctor will likely consider an "experimental" treatment. Fortunately, all that is required from a doctor is that, while the patient is using helminthic therapy, they continue to provide the routine medical care that they would normally provide.

    If a helminthic therapy self-treater decides to tell their doctor what they are doing, the language used can be important because, if a doctor thinks that their permission, approval or cooperation is being sought, they may feel they have no choice but to refuse to become involved in any way. To avoid placing a doctor in a difficult position, they can simply be informed by the patient of their intention to pursue the therapy. This lets the doctor off the hook and gives them the option of ending the relationship if they feel uncomfortable about it.

    Doctors should certainly not disparage this therapy nor try to dissuade their patients from using it, especially if they are not fully conversant with the therapy. Any physician who does arbitrarily discourage self-treatment with helminths, in disregard of all the available research and anecdotal evidence would clearly be violating the Hippocratic principle of primum non nocere (first, do no harm) and, in acting in this way, would arguably be committing medical abuse.

    If a doctor is open to learning about helminthic therapy, they can be given a link to, or a copy of, the concise summary of information on this wiki page: Helminthic therapy information for doctors.

    One patient who shared a few selected scientific papers with her doctor and explained what she’d learned about the therapy reported that, after glancing through the literature, the doctor responded as follows.

    Quotein.gif
    I cannot officially recommend this as treatment, or treat you with this, but, in your case i think this is a great idea. The risks seem minimal. I see no threat to your health, and I’m happy to run any monitoring testing you want. Just let me know. [23]

    Here are comments by other patients who have found their doctors to be supportive of their decision to try helminthic therapy.

    Quotein.gif
    I told my GP and he was totally fine. He even agreed to allow me a test for anemia down the line. (Link expired)
    Quotein.gif
    My neurologist is totally on board and thinks I am brave for doing it. (Link expired)
    Quotein.gif
    I was very nervous to be upfront with my doctor, but when I did, I felt much better, and my doctor never dissuaded me to stop treatment. He screens me annually in a metabolic panel just to be sure. [24]
    Quotein.gif
    I told my specialist. He said don't stop if it's working. [25]

    But some doctors are completely closed to even learning about this therapy. When an extensively published and award-winning toxicologist presented the head of adult allergy and asthma at his local university with papers about helminthic therapy, she refused to consider them and promptly fired him as a patient. [26]

    Another self-treater whose doctor was not supportive found it necessary to locate a new one when he needed a prescription for prednisone to help ease the initial side effects after inoculating with too many hookworms. He did this by identifying all the most alternative and “hippie-looking” doctors in his area and emailing them. While most of them declined to help him, two agreed, and the one he selected carried out before-and-after blood tests and was willing to prescribe whatever he needed.

    One self-treater takes a very proactive approach when introducing the subject with a doctor.

    Quotein.gif
    My drs are all well trained in what I will tolerate from them. I basically say this is the deal and I need your help monitoring general health for everything but biome. This works for 99% [27]

    For further help with talking to a doctor about helminthic therapy, see the following resources.

    Doctors as helminthic therapists

    Some naturopathic doctors (NDs), may recommend helminthic therapy and be willing to become involved in its use, and a few may act as an intermediary in the supply of helminths to their patients. However, even some NDs can be poorly informed about helminthic therapy, and those whose understanding of it is limited can sometimes give their patients incorrect advice. For example, one patient was told by an ND that worms won’t work in someone who has SIBO, which is not the case. See Helminthic therapy and small intestinal bacterial overgrowth (SIBO).

    Doctors who do offer helminthic therapy to their patients often do not treat a sufficiently large number of individuals to have encountered some of the outliers with conditions that require a modified approach to helminth dosing, especially the extremely hypersensitive and those who are helminth permissive, i.e., their immune systems allow much longer helminth persistence. Some NDs may also favour the use of a fixed dosing protocol which they have personally determined as being best for most patients, rather than employing an individualised dose-finding approach in each case, starting with a very small number of worms as recommended in this wiki.

    This latter factor can be a particular issue in the case of therapy with the hookworm, NA. The range of physician-determined dosing protocols for introducing NA varies widely, from the addition of a single larva every week or fortnight, to starting with a single dose of between 25 and 35 larvae. If a patient encounters adverse effects as a result of dosing that proves to be too much for them, an overseeing physician will obviously be able to prescribe immune suppressant drugs and/or anthelmintics, but this eventuality is arguably best avoided in the first place by following a very gentle introductory protocol that establishes the unique dosing needs of each individual. See Hookworm dosing and response.

    If a doctor offers to supply helminths, their prices should be checked against those of the online helminth providers, who will likely be considerably cheaper. Some doctors have claimed that the worms they supply are more gentle, “stronger”, more effective, or even safer, than those available online, but none of these claims is true. See Doctors as providers. The only possible difference between the worms available from doctors and online helminth providers is seen in the "fresh" and "commercially prepared" versions of HDC, and, in this case, correct dosing with commercially prepared HDC fully compensates for their slightly reduced effect in comparison with fresh HDC. See Dosing with HDC.

    For a list of doctors who are experienced in the use of helminthic therapy and who offer remote consultations via telephone and Skype, see the following page.

    Combining helminthic therapy with drug treatments

    No incompatibility issues have been reported as a result of combining NA, TTO or TSO with any immunosuppressive medication, such as the following examples mentioned by helminth self-treaters.

    Cyclosporin; synthetic corticosteroids including prednisone and its active metabolite, prednisolone; the thiopurines, azathioprine and mercaptopurine/6-MP (purinethol); the TNF inhibitors, infliximab (Remicade), adalimumab (Humira), certolizumab pegol (Cimzia) and golimumab (Simponi); humanized antibody drugs, e.g., omalizumab (Xolair); humanized monoclonal antibody drugs such as natalizumab (Tysabri); and recombinant fusion protein drugs such as etanercept (Enbrel).

    The detail sheet for some immunosuppressant drugs - for example dupilumab (Dupixent) and tezepelumab (Tezspire) - may advise that helminth infections should be treated before commencing use of the drug. This advice is to prevent immunosuppression by the drug from supporting the proliferation of pathogenic helminths, but this is not an issue for users of NA, TTO or TSO because these species cannot proliferate within a host. (For example, see, Can hookworms multiply within a host?.) However, it may not be advisable for anyone to take HDCs who is immunocompromised as a result of treatment with major immune-suppressive drugs, or due to HIV/AIDS or a genetic condition. [28]

    It can actually be an advantage to be taking an immunosuppressive drug in the early stages of helminthic therapy using NA, TTO or TSO because the drugs reduce, and often completely prevent, the transient side effects sometimes caused by the introduction of helminths, especially NA.

    People who are already taking a daily dose of prednisone when they begin helminthic therapy experience little or no side effects after inoculation, and those who have used this drug on a short-term basis specifically to reduce side effects have found that 5 or 10 mg per day is usually sufficient for this purpose.

    Quotein.gif
    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. [29]
    Quotein.gif
    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 (after tapering off).[30]
    Quotein.gif
    5-10 mg/day completely alleviated my GI symptoms after my first inoculation. [31]

    If prednisone is used specifically to relieve side effects, the prescribing doctor will determine a taper to wean their patient off the drug and, if the symptoms return, they may be willing to defer the taper.

    Immunosuppressive drugs can help human helminths become established by reducing intestinal inflammation, so anyone who is already on one of these drugs should resist the temptation to stop taking them too soon after introducing NA or TTO. As the majority of those who respond to this therapy don’t see significant or consistent benefits until at least 3 months after their first inoculation, it would arguably be unwise to stop taking an immunosuppressant drug before this. In fact, many users have found it best to continue with the drug treatment beyond this point because some people only start to improve between 6 and 9 months, some only after 9 months, and a few not until between 18 and 24 months.

    One individual with IBD-related arthritis found that reducing prednisone too soon caused her joints to ache and stiffen, so she continued to take azathioprine (Imuran) on its own after stopping prednisone, and this provided an intermediate step which allowed her to wean herself off drugs altogether, a process that took between 8 months and a year. [32]

    Even helminth hosts who see early benefits can continue to experience periodic exacerbations or flares of their disease for up to 18 months, and a few may need to continue to take medication alongside helminthic therapy in the longterm.

    Quotein.gif
    I have had success only while taking TSO plus Humira. Humira alone does not make my Crohn's improve. Same with TSO. The combination seems to put me in clinical remission. [33]
    Quotein.gif
    I've had UC for 18 years, mostly mild to moderate. I take 25-50mg azathioprine daily and 250 TTO every 12 weeks. This treatment has kept me in complete clinical and endoscopic remission for 5 years, with no diet restrictions of any kind. (Edited from this post)

    Another self-treater who has kept his ulcerative colitis in remission for many years by combining TTO and NA, also takes 6.75g per day of Balsalazide (Colazal). He says that he probably doesn’t need the drug now, but that it’s cheap and has no side effects so he continues to take it. (Details from private communication.)

    In view of this wide variation in experience, each individual must decide, in consultation with their physician, how long into their therapy to continue with an immunosuppressive drug before beginning, very slowly, to taper the dose. However, one supplier of human helminths (NA and TT) has been very specific about this and advised waiting until at least five months have elapsed after achieving a substantial improvement in symptoms.

    This is particularly important for subjects with Crohn’s disease, or one of the other intestinal diseases, because they tend to have a vigorous immune response to helminths, so suddenly stopping a drug that has been keeping this response in check may result in a flare and, potentially, a loss of worms in the case of NA or TTO.

    A few drugs are harmful to helminths, and those that can adversely affect NA and TT are listed in the Human Helminth Care Manual. These drugs include some oral and injected antibiotics, the effects of which can be such that there may be little point in using NA, or possibly TT, if there is a need to take antibiotics regularly, or on a longterm basis. Those drugs that are incompatible with TSO are listed here, and those that are best avoided by users of HDC are shown here: Caring for HDC.

    Documenting one's helminthic therapy experience

    Unlike pharmaceutical treatments, helminthic therapy is a journey that unfolds over a number of months and, to a lesser extent, over the first two or three years. Recalling the details of one’s experience can be important for informing choices about dosing, which needs to be optimised in the early stages of treatment and may require further adjustment over time. Since memory about these details can fade quickly, it’s important to record the size and dates of doses, along with details of any physical and/or symptomatic changes that occur along the way.

    Some people have found a log app useful for this, possibly combined with a disease activity index to take periodic snapshots of progress during treatment, for example with Crohn's disease, [34] Ulcerative Colitis, [35] Rheumatoid Arthritis, [36] Ankylosing Spondylitis [37] or Lupus (SLE). [38]

    Considering the cost of helminthic therapy

    At first sight, helminthic therapy may appear to be expensive, especially to those who live in countries with free health care, but a number of factors need to be taken into consideration, including the following.

    1. Compared with other treatments used for the conditions that helminthic therapy treats, it is extremely cost-effective. For example, TSO is only 1/5th of the cost of Remicade, and the other helminths are even cheaper than this.

    Quotein.gif
    What we ended up paying for 3-years worked out to be cheaper than any hospital bill we would ever get. [39]
    Quotein.gif
    It may sound like a lot, but it can save money in the long run. I have been on HWs for about a year and I have decreased my medication, stopped my twice monthly IV therapy that cost $145/bag, and reduced my visits to the doctor. In addition I feel better and my quality of life has improved tremendously, for which there is no price tag.
    Quotein.gif
    It’s actually quite affordable. Definitely less expensive than all of the supplements & medications that I took prior. [40]
    Quotein.gif
    It is still early after my 4th inoculation but I'm seeing amazing benefits. Gone are the days of terrible IBS-D and the improvement in life quality is tremendous. All that for about 400 usd per year. I never spent my money better in my life. [41]

    2. There is a good chance that helminthic therapy users will be able to earn more after treatment than they could before.

    Quotein.gif
    Since taking helminth therapy I am able to work, full time and then some, allowing me to make money to support myself and have a meaningful life of contribution and giving, instead of going broke, being a burden and dependent on charity. For those who think Helminthic therapy is expensive I suggest you recalculate the cost of your health care bills and the value of quality of life. I am grateful for helminthic therapy and for those who make it possible. It has literally saved my life! (From someone with Crohn’s disease.)
    Quotein.gif
    Coming up to 3 year anniversary of starting Helminthic therapy. Overall things very good. No significant relapses. Holding down very well paid job and loving it. (From someone with Multiple Sclerosis.)

    3. People who smoke, and many others with a variety of interests and hobbies, often pay out far more than the cost of helminths just to provide themselves with pleasure and entertainment.

    4. Please look carefully at the details for each of the companies on the Helminth providers page. There is considerable variation in what is on offer, and discounts and payment plans may be available to those who ask. You may be able to work out something more manageable if you talk to each of the providers who are offering the species of helminth that you want and are able to ship to your location.

    If you are still unhappy with the cost of helminths, you can grow your own NA, HDC or TTO. Incubating the first two of these species is well within the ability of most people if they follow the detailed instructions on the Helminth incubation page, but a single first dose will need to be purchased from a provider to start the process.

    DIY helminth incubation

    Three of the four species of helminth that are used in therapy are suitable for DIY incubation at home. See Helminth incubation. However, if you intend to incubate hookworms, it is recommended that you obtain your starter dose from an established provider because this will obviate the risk of acquiring a different and possibly harmful species of worm, or some other unwanted infection, from another self-treater. See Hookworm incubation issues for more about these risks.

    How to drill into the contents of this site

    • The Home page shows the site’s main sections.
    • The Index to Topics lists every subject covered on the site.
    • The List of Pages includes the title of every page on the site.
    • The Sitemap provides a schematic of the site's contents.
    • The Search tool available at the top right of every page on the site offers the best way to find specific details. Type a keyword into the search box - e.g., the name of a disease - and hit "Return". This will bring up a list of all the references to that keyword in the wiki, and clicking on any of the items listed will take you to another wiki page where you can use the search function on your device (Control+F on a PC, or Command+F on a Mac) to locate each mention of your keyword on that page.

    Online support

    See the separate page:

    Further information

    Enquirers who use a search engine to locate information about helminthic therapy will be presented, first, with sites that favour mainstream, mainly pharmaceutical approaches to healthcare and deprecate natural and alternative approaches such as helminthic therapy. This is because of Google’s active censorship of the details returned by its searches.

    Prominant among the sites ranked most highly by Google are the larger general health information websites, which carry pages about helminthic therapy. Unfortunately, these pages have invariably been written, and reviewed, by staff members who have no personal experience of helminthic therapy, so have turned for information to the evidence presented by the authors of clinical trials, which, in the case of this particular therapy, are mostly seriously flawed, as is explained here: Problems with clinical trials using live helminths.

    An example of this is the article on the Healthline website entitled, Helminthic Treatment for Crohn's Disease. This speaks of worm eggs being “injected” into patients, and of helminths causing dangerous side effects over time, including anaemia, protein deficiency and stunted growth. However, none of these claims are true in the case of the four species of mutualistic helminth being used in small numbers in helminthic therapy, as can be seen from the following wiki pages.

    Editors of this wiki have made several attempts to have the errors in the Healthline article corrected, but no one has ever responded to any communication about the article, a situation that is typical for most of the large health information websites, many of which have been acquired by pharmaceutical companies and are controlled by these companies' employees or representatives.

    In view of these issues with online health sites, anyone who is seeking information about helminthic therapy is urged to use this wiki as their primary source. It is the definitive database of information about all aspects of the therapy and its primary sources are the personal expereince of helmnth self-treaters and the best of the available science. And it is updated daily by volunteer citizen scientists who are directly involved in pioneering its use.