The idea of intestinal worms creeping and crawling around inside people tends to get a bad rap, given the fact that, you know, it’s a worm. Inside you. Crawling around. Laying eggs. Multiplying.
It brings to mind deadly, debilitating disease in the developing world; in the developed world, illness, trips to the loo, little kids scratching their bums and not washing their hands, eggs, itchiness, and general unpleasantness. Indeed, a little over 100 years ago, people in the industrialised world were regularly exposed to these little wormies, due to the lack of water treatment plants.
The proper name for intestinal worms are “helminths”, which means ‘parasitic worm’. A parasite is a living thing (that’s the worm) which lives in or on another living thing, called the host (that’s us) and takes nutrients away from the host. Super rude, right?
Wrong! (Stay with me.)
Over the past three decades, an idea first hypothesised by David Strachan in 1989 has been gaining traction. Strachan proposed that improved hygiene was to blame for increased incidences of hay fever.
“Hygiene Theory” or “Old Friends”, as it came to be known, has since been expanded beyond the realms of hay fever and improved hygiene to a more nuanced and complex idea: that the rise in allergies, autoimmune and inflammatory diseases could be linked to the lack of exposure to certain organisms which trained our immune systems to be more tolerant; less “touchy”, less inclined to make you break out in hives because you brushed against something it doesn’t like.
Without that exposure, this theory suggests, our immune systems are hyper-vigilant, ready to strike at the slightest provocation, resulting in higher numbers of allergies, autoimmune diseases and inflammatory diseases.
Enter, the worm. (Literally).
Using worms to treat illness is not a new idea (“Helminthic therapy”). We’ve all seen the movies set in old-timey times, where the doctor comes in and pops a few leeches onto someone’s arm , getting the “bad blood” out (“That’ll fix ‘em right up!”). More recently, they have been hypothesised to help in wound healing and lung disease, but what we are most interested in here at Noshable is their use to treat food allergies, intolerances and sensitivities.
In 1999, researchers Dr Joel Weinstock (chief of Gastroenterology/Hepatolgy at Tufts Medical Center in Boston) and Dr David Elliot discovered that helminths protected mice from getting colitis - inflamation of the lining of the colon, usually caused by inflammatory bowel disease (Crohn’s, Ulcerative Colitis, etc) or an allergic response!
Human trials began a few years later, and in 2005, the results of the trials were published. In the first study, 54 ulcerative colitis patients were tested, some given placebos, others were given pig whipworm eggs. 43% of those given pig whipworm eggs improved, compared with only 17% who received placebos. In the second trial, 29 patients with Crohn’s disease took whipworm eggs every three weeks. By the end of 24 weeks, 79% had reduced disease activity and 72% had gone into remission.
The most commonly used worms for these trials are the human hookworm and the pig whipworm. Clinical trials involving hookworms use a carefully controlled dose of parasite (10–20 eggs/larvae that cannot reproduce in the host, but can live for years). The pig whipworm, on the other hand, can only live for a few weeks in the gut, so trials involving whipworms mean the patients must take doses of whipworm every few weeks.
Over the last decade, human trials have been continuing with mixed but encouraging results and it seems clear that the worms, or a protein they secrete, can be helpful in inhibiting our inflammatory response.
All that being said, much, much more research needs to be done in this field before anything is deemed completely safe to try, especially given that larger trials have not shown anything conclusive yet.
The FDA in the United States currently classifies helminithic therapy as an “Investigational New Drug”, which means the only people currently allowed to distribute the worms are medical practitioners conducting trials. It is a very similar situation in Australia, where currently we are still in the preliminary human trial phase. As I write this, Dr Paul Giacomin is conducting trials in Queensland on patients with coeliac disease and hookworm to see if their symptoms can be improved.
However, some people have decided that they’ve had enough, and can’t wait any longer for human trials to be completed. Thousands of people are crossing international borders to travel to countries where they can buy and ingest worms, to see for themselves if it helps. This is a clear indication of just how seriously a food allergy or intolerance can affect someone. If the symptoms are that bad, day in, day out, and they feel they have exhausted every other possible option, we can begin to understand just why someone would willingly infect themselves with a parasite that has the potential to make them seriously ill.
Here at Noshable however, we'd like to stress to not do anything that might hurt you - if you're feeling down and at the end of your tether, before you resort to eating hookworm eggs, reach out to us and let us know how you're doing. We've probably been where you are now, and we're here to help.