Helminthic therapy safety

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Considering benefits and risks

Every practice - even the healthiest - has risks. For example, eating healthy food carries the risk of choking, and exercise may result in injury. But the risks of eating a healthy diet and exercising are clearly more than offset by the reduction in the risk of heart disease, cancers, and a very wide range of inflammatory diseases that are associated with these practices. Modern medicine also considers the risks of any drug alongside the risks of not taking the drug. By the same token, when considering the risks of helminthic therapyThe 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 and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy., it is important to weigh those against the risks of not engaging in this practice.

Current scientific understanding of the immune system’s development and function indicates that routine exposure to helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] is probably necessary for proper immune function.[1][2][3] In this view, the loss of helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] in Western society (known as loss of “old friends”, biome depletion, or biota alteration) as a result of necessary sanitation practices has left the ecosystems of our bodies highly susceptible to inflammatory disease. Consistent with this view, socio-medical studies indicate that self-treatmentMedication or treatment of one's own disease or condition without medical assistance. with helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] is effective for many people, probably even most people, in terms of alleviating inflammatory-related diseases.[4][5] These findings are supported by a few clinical trials and numerous studies in animal models.[6][7][8][9]

Many of the risks to human health from biota alteration are readily apparent, with a wide range of allergic and autoimmune conditions attributed to biota alteration[10]. Further, diseases not currently confirmed to be associated with biota alteration, including Parkinson’s disease and a variety of other cognitive problems, may be associated with biota alteration.[4][10][11][12] As described by Parker, “it seems highly likely that self-treatmentMedication or treatment of one's own disease or condition without medical assistance. with helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths], despite its unknown risks, varied and changing practices, and poorly defined outcomes, is more beneficial than harmful to the average practitioner.” Parker further argues that physicians violate the principle of primum non nocere (first, do no harm) when they arbitrarily discourage self-treatmentMedication or treatment of one's own disease or condition without medical assistance. with helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths].

In weighing the risks and benefits of helminthic therapyThe 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 and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy., each individual must keep in mind that to remain helminthAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths]-free is a choice to maintain the body in a state of biota alteration which, based on the modern science described above, is pro-inflammatory and thus at risk.

Known and possible contraindications for the use of helminthic therapyThe 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 and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy.

  • Patients with a serious, life-threatening infection such as HIV/AIDS, or who are severely immunosuppressed. However, this does not include those who are taking immunosuppressive medications to treat autoimmune, inflammatory or allergic diseases. For more on this see Combining helminthic therapy with drug treatments.
  • Patients with severe intestinal strictures. HookwormA 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. larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. can temporarily increase inflammation in the small intestine in the initial stages of colonisation and this might close a very narrow stricture, especially if the guidance on the Hookworm dosing and response page is not followed carefully.
  • Patients whose cardiac arteries are severely narrowed due to atherosclerosis. The temporary increase in inflammation following the initial introduction of helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths], especially hookwormsA 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., may exacerbate this condition, possibly occluding an artery and triggering a heart attack.
  • Patients with bleeding or blood clotting disorders are advised to monitor their clotting times when hosting hookwormsA 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.. For more details see Can hookworms make their hosts' blood too thin?, below.
  • Patients with acute anaemia/anemia. HookwormsA 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. have a potential to slightly lower hemoglobin levels, so it may be advisable to correct any existing anaemia before proceeding with the use of this species. For more details, see the Helminthic therapy and nutritional deficiencies page.
  • Patients with a latent viral infection such as herpes or tuberculosis may experience a temporary exacerbation of their condition following inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation]. For more details, see Helminthic therapy and viral infections.
  • Patients who have had a diagnosis of cancer. Helminth providers may be reluctant to supply anyone in this situation, even if the cancer is in remission, although they may be willing to supply someone with a relatively benign cancer or one that is very easy to treat. See: Helminthic therapy and cancer.

Conditions that require a modified approach to helminth dosing

HelminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] can produce much more severe side effects in people with certain conditions, including the following.

  • fibromyalgia (see Helminthic therapy and fibromyalgia)
  • chronic fatigue syndrome (CFS)
  • myalgic encephalomyelitis (ME)
  • multiple chemical sensitivity (MCSMultiple Chemical Sensitivity is a chronic physical illness affecting people of all ages and backgrounds. It involves allergic-type reactions to very low levels of chemicals in everyday products and often also sensitivity to food, medicines, moulds and electromagnetic fields. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1241652/ A review of a two-phase population study of multiple chemical sensitivities])
  • multiple food intolerance
  • narcolepsy (see Helminthic therapy and narcolepsy)
  • eosinophilic esophagitis / eosinophilic oesophagitis (EoEEosinophilic 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.)
  • eosinophilic gastroenteritis (EG)
  • mast cell disorders (see Helminthic therapy and mast cell disorders)
  • mitochondrial dysfunction

While people with any of these conditions can still self-treat with helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths], they need to:

  • start with very small doses,
  • only add further doses after all side effects from the previous dose have subsided,
  • increase the size of subsequent doses very gradually.

These recommendations are even more important for females with any of the above conditions, since they appear to experience a somewhat increased severity of side effects in comparison with males.

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

TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis has been used experimentally in humans since scientists at Iowa University began to study it in 1995. Since then, it has passed all the evaluations required by the US Food and Drug Administration (FDA), the German Federal Institute for Drugs and Medical Devices (BfArm) and the appropriate medical agencies of Denmark, Switzerland, Austria and the Czech Republic. Gaining these safety approvals was a precondition for securing permission from these agencies to carry out phase 2 trials, which added further confirmation of TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis's safety.

(Although the authors of this paper have made comment on a lack of benefit to subjects, the trial was only designed to assess the safety of TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis and not its efficacy. It would not have been capable of demonstrating any significant benefit because it used a treatment period of only 12 weeks, which is inadequate when assessing the efficacy of a helminthAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths]. It also used a novel TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis formulation with a pH of 5, when it is known that storage of TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis at a pH above 4 may impede its therapeutic effect in humans. [1])

Also see: The question of possible TS persistence.

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

HelminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] such as the human hookwormA 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. (NAthe human hookworm, Necator americanus) and the porcine whipwormA helminth with a tapering whiplike body that lives in the colon. In helminthic therapy, the microscopic eggs of either the human Trichuris trichiura (TTO) or pig Trichuris suis (TSO) are taken in a drink. (TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis) have been tested for adverse side effects in published, controlled clinical trials. Although several animal studies have shown efficacy of HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta in protecting against chemically-induced colitis, [13][14][15][16][17] the therapeutic effect of HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta has not yet been tested in a human trial. However, William Parker and colleagues at Duke University have systematically compiled records of individuals self-treating with helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths].[4][5] Although these sociomedical studies are generally not designed to quantitatively assess the risk of adverse side effects, the Duke team has been able to obtain some semi-quantitative information from physicians who supervise patients self-treating with certain helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths], TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis and HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta in particular. When considering adult self-treaters, the Duke team has noted that adverse side effects from use of HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta are dose dependent and generally mild, involving temporary diarrhea following administration of a dose that is relatively high for a given individual. (Most individuals use therapeutic doses that are below their personal threshold for induction of diarrhea.)

A considerable number of cases of paediatric use of HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta were reported to the Duke team, and the quality and quantity of adverse side effects was different in this population than in the adult population. Most paediatric individuals using helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] in the Duke sociomedical studies were attempting to treat neuropsychiatric disorders (for example, ADHD associated with autism), which heavily biases the available information. Based on physicians’ reports to the Duke team, most individuals with autism experienced a slight but transient increase in hyperactivity following self-treatmentMedication or treatment of one's own disease or condition without medical assistance..[5] This was not considered a reason to discontinue therapy by most individuals, but rather was considered an early indicator that the HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta were having a beneficial effect. (Similar observations were made with TSOthe ova (eggs) of the porcine (pig) whipworm, Trichuris suis use in the paediatric population.)

More troublesome adverse reactions were noted in about 1% of the paediatric population taking HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta and were considered cause for cessation of therapy. Adverse reactions were of two types:[5] firstly, severe gastric pain associated with documented colonisation (adult helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] growing in the gut - see Risk of HD maturation and persistence) and, secondly, worsening of behavioral symptoms. These more troublesome effects were relieved by treatment with anthelminthic drugs. Behaviour usually returned to baseline in these cases within one to three weeks of treatment, based on physician’s reports to the Duke team. Based on available data, Parker estimates that the chance of having a very favourable reaction to HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta compared to a very negative reaction is about 25 to 1 (favouring a very positive reaction) in the paediatric population. However, again, this number is based on experiences of self-treaters with neuropsychiatric disorders and was obtained using a sociomedical study design that is semi-quantitative in nature. In the adult population, the Duke study suggests that the chances of a very negative reaction may be much less than in the paediatric population, but insufficient numbers have been obtained to reach any conclusions. (William Parker, personal communication February 2017 commenting on over 700 cases of self-treatmentMedication or treatment of one's own disease or condition without medical assistance. with HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta.)

Can H. diminutaA murine (rat) tapeworm used in helminthic therapy that generally does not mature in humans and is taken as cysticerci (HDC) in a drink every 2 or 3 weeks. mis-migrate to organs outside the digestive tract?

There are no reports in the scientific literature describing mis-migration in humans by H. diminutaA murine (rat) tapeworm used in helminthic therapy that generally does not mature in humans and is taken as cysticerci (HDC) in a drink every 2 or 3 weeks.. There are numerous articles describing the colonisation of humans by HDCHymenolepis diminuta cysticercoids (Hi-men-o-lep'is dim-a-nu-ta sis-ti-sur-koid) - the larval cysts of the rat tapeworm, Hymenolepis diminuta (see Risk of HD maturation and persistence), but none of these mentions mis-migration.

The safety of NAthe human hookworm, Necator americanus

The safety of controlled infection with NAthe human hookworm, Necator americanus has been confirmed in studies at universities in the UK and Australia.

The Centers for Disease Control and Prevention of the United States Government Department of Health and Human Services have determined that "light" hookwormA 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. infections require no treatment, and the infection levels used in helminthic therapyThe 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 and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy. are all considered to be "light". (In 1991, the World Health Organisation defined a light hookwormA 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. infection as one producing fewer than 1,000 eggs per gram of faeces,[18] and, in 2002, as one producing less than 2,000 epg of faeces.[19])

Therapeutic dosing with NAthe human hookworm, Necator americanus should follow the guidelines established by the helminthic therapyThe 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 and prevent chronic inflammation, autoimmune disease and other immunological disorders including allergy. community and set out on the following page.

The use of larger doses than those recommended can result in side effects, which can be severe and, in one case, caused eosinophilic pneumonia.

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When I started, I took waaay too many hwhookworm, usually referring to the human hookworm, Necator americanus, and too fast. My third dose exceeded my body's tolerance for hwhookworm, usually referring to the human hookworm, Necator americanus and I developed eosinophilic pneumonia which showed no signs of abating after 5 months. My eos got up to 22%. I took albendazole to (mostly) terminate my colony. 6 weeks later, my pneumonia hadn't improved significantly. My symptoms only improved after reinoculating with a small dose of 6 hwhookworm, usually referring to the human hookworm, Necator americanus. After healing from the pneumonia, I had no adverse symptoms.[20]

In another reported case, excessive dosing with hookwormsA 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. appears to have caused organ damage, which fortunately proved to be reversible with anthelminthic treatment.[21]

In spite of the safety of "light" doses of NAthe human hookworm, Necator americanus having been established, there are four questions that occasionally concern those considering self-treatmentMedication or treatment of one's own disease or condition without medical assistance. with this species.

Can hookwormsA 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. act as a vector for pathogens?

The commercial providers of NAthe human hookworm, Necator americanus use an antimicrobial wash to clean their larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state., and ship them in a weak antibiotic solution. Since helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths] are living organisms, it is impossible to sterilise them completely without killing them, but a review of the literature found no reports of NAthe human hookworm, Necator americanus transmitting a secondary infection.

The providers also periodically test their reservoir donors for a range of communicable diseases such as HIV and hepatitis.

Interestingly, once hookwormsA 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. have entered their host, they appear to engender a milieu that is generally less permissive of pathogenic bacteria. This became evident when blood from individuals hosting hookwormsA 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. was shown to have a significantly greater ability to control virulent mycobacterial growth (including that of Mycobacterium tuberculosis) in vitro than blood from subjects without hookwormsA 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.. This benefit, which is possibly mediated by helminthAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths]-induced eosinophilsEosinophils are a specialised type of white blood cell with a variety of both harmful and beneficial functions. Their numbers rise temporarily following inoculation with helminths., was lost following treatment with an anthelminthic drug.[22]

Can hookwormsA 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. mis-migrate to organs outside the digestive tract?

There are no reports in the scientific literature describing mis-migration in humans by NAthe human hookworm, Necator americanus[23] and several authorities have made it clear that NAthe human hookworm, Necator americanus does not mis-migrate in our species.

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Over 700 million people remain infected with hookwormsA 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.... Auto-reinfection, direct person to person infection, aberrant migration, and hypobiosis do not occur.[24]
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Necator americanusThe species of human hookworm used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. migration in humans is predictable, via the lungs (larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state.) to the gastrointestinal tract (adults worms).[25]

Mis-migration can occur with some species of helminth that are not adapted to living in humans, such as the roundworm species[26] of dogs and raccoons, which are well known for migrating to the brain and eyes after entering a species to which they are not adapted.[27] And there may be an increased risk of mis-migration by these and other species in people who are severely immunocompromised, for example someone with HIV/AIDs. However, inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation] with NAthe human hookworm, Necator americanus has been reported to be safe, even in patients who are immune-suppressed.[24]

Do hookwormsA 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. cause tissue damage?

When they feed, mature Necator americanusThe species of human hookworm used in helminthic therapy. Its microscopic larvae are applied periodically to the skin. hookwormsA 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. create a microscopic break in the surface of the mucous membrane lining the intestine which biologists refer to as 'ulcers', and a number of these sites will be produced by each worm as it moves to a new location every few hours. However, it is important to remember that an adult hookwormA 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.’s mouth is a little narrower than its body and that its body is only as thick as a few human hairs, so these 'ulcers' really are tiny and they heal quickly, in part due to the localised first aid administered at their feeding sites by the worms themselves in the form of healing secretions.

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… both helminthAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths]- and host-derived factors contribute to establishing a state of vascular tolerance to limit tissue damage and promote repair.[28]

These 'injuries' caused by hookwormsA 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. are insignificant when compared with the massive operation of planned demolition and reconstruction that is going on throughout the bodies of humans at all times and which, for example, 'destroys' more than 50 billion cells every day[29] and replaces them with new ones. This natural process of tissue breakdown and repair is what keeps humans alive for several decades, but the words that biologists use to describe these processes can cause concern to non-biologists whose viewpoint is inevitably much more subjective.

HookwormA 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. larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. also cause what biologists refer to as tissue 'damage' when they break through the blood capillary walls to enter the alveoli of the lung during their migration from the skin to the intestine, but the resulting holes are microscopic and heal very quickly thanks to repair mechanisms that deal automatically with such events.

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While the migrating larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. of hookwormsA 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. cause mechanical and enzymatic damage to the lung parenchyma and epithelium... there is remarkable repair of pulmonary pathology postmigration.[30]
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The host uses its immune system to regulate the damage caused by the bacteria and the worms.[31]

For more details about this healing process, see the papers from which the following quotes are taken.

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… AMP-activated protein kinase (AMPK), a key driver of cellular energy, regulates type 2 immunity and restricts lung injury following hookwormA 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. infection.[32]
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Here, we analyze some of the studies regarding the role of AAMs in tissue repair during the tissue migration of helminthsAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths].[33]

There is evidence that the migration of hookwormsA 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. through the lungs may have direct beneficial effects for the host, for example by reducing their susceptibility to tuberculosis.

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Studies show that even a transient exposure to hookwormA 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. not only recruits innate cells to the lungs (both eosinophilsEosinophils are a specialised type of white blood cell with a variety of both harmful and beneficial functions. Their numbers rise temporarily following inoculation with helminths. and alternatively activated macrophages), and induces changes in T and B cells, but can also produce long-lived alterations in the pulmonary immune environment that may have a role in enhancing subsequent responses to respiratory pathogens, including M.tb [34]

Do hookwormsA 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. cause excessive blood loss and anaemia/anemia?

The fact that hookwormsA 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. create tiny wounds when they feed, and that these continue to bleed briefly after the worms have moved to new feeding sites, has led to concern that NAthe human hookworm, Necator americanus might cause excessive blood loss and consequent anaemia. This notion has arisen partly because NAthe human hookworm, Necator americanus is often confused with the other prevalent human hookwormA 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., Ancylostoma duodenale (ADAncylostoma duodenale. A species of roundworm, aka the Old World hookworm, that is not suitable for use in helminthic therapy. [https://en.wikipedia.org/wiki/Ancylostoma_duodenale Wikipedia:Ancylostoma duodenale]), the 'Old World' hookwormA 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., which causes nine times more blood loss than NAthe human hookworm, Necator americanus.[35] In the case of NAthe human hookworm, Necator americanus, there is arguably a greater risk of anaemia attached to diagnostic blood testing[36] and blood donation than there is from hosting this species of helminthAn intestinal worm which grows large enough to be seen with the naked eye when mature but which is microscopic when administered in helminthic therapy. [https://en.wikipedia.org/wiki/Helminths Wikipedia:Helminths]. The 1.09 liters of blood that is estimated to be drawn each year by a colony of 100 NAthe human hookworm, Necator americanus (a single NAthe human hookworm, Necator americanus can take 30 microliters of blood per day[37]) is significantly less than the 2.88 liters of blood that an adult weighing 100 lbs or more is permitted to donate annually. For more detail, see Helminthic therapy and nutritional deficiencies.

Even the additional bleeding from hookwormA 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. feeding sites that is caused by a host taking a drug or supplement with a blood thinning effect - such as the antimalarial drug, hydroxychloroquine (Plaquenil, etc.) or the herb, ginko biloba - is unlikely to present a problem unless the patient’s clotting time, or INR (International Normalized Ratio) is already significantly raised, or they have a very large worm colony, or an existing predisposition to iron deficiency anaemia. There is therefore no need to avoid products that have a blood thinning effect while hosting hookwormsA 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., unless there is a preexisting issue with clotting, and, even in this case, it is unlikely there would be a problem. Several people who are hosting a therapeutic number of hookwormsA 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. have even been able to maintain INR at a level of 2-3 while also taking potent anticoagulant drugs such as heparin. And hydroxychloroquine (Plaquenil, etc.) does not significantly increase clotting time so should not be a problem if taken while using hookwormsA 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..

Can hookwormsA 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. make their hosts' blood too thin?

The fact that hookwormsA 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. secrete anticoagulants to assist their digestive process can raise concern in the minds of patients with coagulopathy - a condition in which the blood’s ability to form a clot is impaired. However, the amount of anticoagulant produced by NAthe human hookworm, Necator americanus is minute, and its effect is mostly localised to the worms' feeding sites, so it is unlikely to pose any risk to self-treaters who are only hosting a therapeutic number of hookwormsA 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.. Even most of those individuals for whom clotting was a pre-existing issue do not experience any significant change in their clotting time after inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation] with NAthe human hookworm, Necator americanus. Nevertheless, patients with coagulopathy should monitor their clotting time after inoculating with hookwormsA 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. as a precaution to ensure that this remains optimal. Clotting time should also be checked by anyone who experiences any unexplained, spontaneous bruising.

There has only been one report by a hookwormA 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. self-treaterSomeone who treats their own disease or condition without medical assistance. that indicated a decrease in coagulation following inoculationThe introduction of an infectious agent into an organism. [http://helminthictherapywiki.org/wiki/index.php/Helminth_inoculation Helminth inoculation] with NAthe human hookworm, Necator americanus.

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I take a drug that has a blood-thinning side effect (flurbiprofen, a cousin of ibuprofen), so I clot slower than most people, and can't take any other medicine with a blood-thinning effect (e.g., ginko biloba) without getting clotting problems. A few weeks ago (about 4 months after first inoculating with NAthe human hookworm, Necator americanus) I started getting spontaneous bruises that looked just like the ones my mom gets when her coumadin (blood thinner) dose is too high. I immediately started taking a vitamin K2 supplement (which helps clotting among other effects) and that seems to have solved the problem. My belief is that the tiny, local anti-coagulant that all blood feeders secrete (to keep their dinner flowing) was just enough to kick my blood from too thin to way too thin, causing the bruising. (Edited from two posts:[38][39])

Can hookwormsA 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. multiply within a host?

It is not possible for NAthe human hookworm, Necator americanus to multiply within a host because its eggs need to go through a period in soil in order to commence their development into worms. Once they have been deposited into the soil, the eggs will access nutrients from the faeces in which they were passed. Given adequate warmth, shade and moisture, they will then embryonate and, within a couple of days, hatch into larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state.. While remaining in the soil, the larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. will go through two moults over the course of a week before becoming infective. Once these microscopic L3 larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. find a host, they will begin their migration from the host's skin to their small intestine, where the larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. will become adult hookwormsA 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. and reliably remain for the rest of their lives. The progeny of these worms will follow the same very predictable lifecycle as their parents after passing out of their host in faeces. For more detail, see The developmental stages, migration and diet of Necator americanus.

Can hookwormA 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. hosts infect other people?

The use of a flush toilet, and the washing of hands, will remove any risk of a hookwormA 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. host infecting others.

In order for infection to be passed to another person, a hookwormA 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. host would need to defecate in sandy, loamy soil in a warm, humid climate and for another individual to then expose the bare skin on their feet or legs to the ground or low vegetation at the defecation site. Campers who are hosting hookwormsA 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. should therefore avoid disposing of their waste in soil in the open to prevent the risk of their infection being passed to others who might visit the site.

HookwormsA 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. do not thrive in clay soils, or where the ground temperature gets very cold, but, where the conditions are favourable, they can become infectious after just a few days and may continue to be infectious for up to 5 months.

Defecating in a shallow hole in the ground, especially in an area with sandy, loamy soil, will not provide adequate protection against infection transmission because hookwormA 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. larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. can climb four feet through this type of soil. So, to protect other people and animals, any hookwormA 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. host needing to defecate in the wild should dispose of their waste safely by using one of the following methods.

  • Bagging. Mountain climbers carry plastic bags with them to prevent fouling the environment.
  • Boiling. Any hookwormA 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. eggs or larvaeThe active immature form of an insect, or an animal such as a helminth, which develops from an egg and eventually transforms again into its adult state. contained in faeces that are heated in water should be dead before it reaches boiling point, but the faeces should be boiled for at least 5 minutes to make certain.
  • Burning. Cowboys in the American old West are reputed to have burned sun-dried cow pats on their camp fires, so perhaps the same method could be used for the disposal of human waste.

See also

References

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  3. Review series on helminths, immune modulation and the hygiene hypothesis: the broader implications of the hygiene hypothesis.
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  6. (Self-) infections with parasites: re-interpretations for the present.
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  10. 10.0 10.1 Evolutionary biology and anthropology suggest biome reconstitution as a necessary approach toward dealing with immune disorders.
  11. Reconstitution of the human biome as the most reasonable solution for epidemics of allergic and autoimmune diseases.
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  14. Neutralizing anti-IL-10 antibody blocks the protective effect of tapeworm infection in a murine model of chemically induced colitis
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  23. Yahoo Helminthic Therapy forum post 4330
  24. 24.0 24.1 A proof of concept study establishing Necator americanus in Crohn's patients and reservoir donors
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  26. Wikipedia:Ascaris
  27. Yahoo Helminthic Therapy forum post 7254
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  29. Programmed Cell Death and Inflammation: Winter Is Coming
  30. Helminth Modulation of Lung Inflammation
  31. How the parasitic worm has turned
  32. Myeloid-Restricted AMPKα1 Promotes Host Immunity and Protects against IL-12/23p40-Dependent Lung Injury during Hookworm Infection
  33. Role of Macrophages in the Repair Process during the Tissue Migrating and Resident Helminth Infections
  34. [3]
  35. Ancylostoma/Necator
  36. Frequency of blood tests in heart surgery patients may lead to anemia, transfusions
  37. Parasitic infections. Treatment and developmental therapeutics. 1. Necatoriasis
  38. Yahoo Helminthic Therapy forum post 5275
  39. Yahoo Helminthic Therapy forum post 5233
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