Helminthic Therapy: Could This Be The Secret Treatment For Autoimmunity?
As a functional medicine practitioner, I frequently see patients who suffer from autoimmune disorders — a group of illnesses characterized by an inflammatory response that has gone haywire. Autoimmunity occurs, just as the name suggests, when the immune system starts attacking itself, causing damage to the body’s own tissues instead of focusing on actual threats, like pathogenic microbes and physical injuries.
I do comprehensive lab work on my patients with autoimmune problems and recommend lifestyle and diet changes. But my patients also rely on me to think outside the box. And one of the atypical treatment options that could be of value to autoimmune diseases is called helminthic therapy.
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What is helminthic therapy?
Helminthic therapy involves swallowing a saline solution infused with mutualistic parasites, called helminths. At first, this might seem crazy. I mean, aren’t parasites bad?
Actually, not all parasites are bad! The helminths used in these treatments are called “mutualists,” which means they cooperate with their human host (that’s you!) and are not typically problematic health-wise. So, while this is not an FDA-approved treatment, it is being studied as a potential treatment for a range of autoimmune disorders, such as type 1 diabetes, Crohn’s disease, and multiple sclerosis. The results of these preliminary studies are extremely promising, but we are still waiting for data on long-term patient outcomes.
But wait, why worms?
You’re probably wondering how, out of all the potential treatment options in the world, worms could possibly be the answer to your autoimmune disease. Well, the answer has everything to do with the root cause of autoimmunity.
You see, our world has changed dramatically in a very short period of time and this has caused a mismatch between our genetics and our lifestyles. Factors like poor food quality, environmental toxins, and a sedentary lifestyle have unlocked vulnerabilities in our genes, which led to a lot of chronic inflammation over many years and eventually, the autoimmune epidemic we’ve seen in the past decades.
Another factor that researchers suspect has contributed to autoimmune disease is the oversterilization of our modern world. Our fear of germs has caused us to create an oversanitized, antibiotic-happy world, which has allowed drug-resistant superbugs to grow in strength and number. This has greatly reduced the diversity of our gut microbiomes, which includes trillions of healthy bacteria, healthy yeast (the mycobiome), and yes, mutualistic protozoans and helminths.
Researchers are looking at this decimated microbiome diversity as a factor in the rise of autoimmune conditions (1) since our microbiome plays a major role in the health of our immune system. In fact, this decreased microbial diversity may be one reason why autoimmune diseases are exploding in industrialized nations while there are fewer cases in developing countries, where parasites are more common. (2)
So yes, a lack of parasites in the gut might be an underlying cause of autoimmune disease, which, all of a sudden makes helminth therapy a lot less crazy-sounding, doesn’t it?
How does helminthic therapy work?
Essentially, the worms decrease inflammation in the body. How? Researchers suspect that helminthic infections have the ability to decrease inflammation by suppressing Th1 and Th17 cells and increase in T-regulatory cells (3), which are the cells that help your immune system tell the difference between the body’s own tissues and outside invaders. Human and animal studies have both provided evidence (4) of decreased inflammatory responses from Th1 and Th17 cells and increased T regulatory cells.
Basically, chronic inflammation in the host is not conducive to the helminths’ survival, and they have coevolved with us to keep chronic inflammation in check. So, when you expose the body to helminths on purpose — proper helminthic therapy is administered in a sterile saline solution and swallowed from a cup or vial — a potential result is less inflammation, a more balanced immune system, and fewer autoimmune symptoms. These studies have been done primarily in people with conditions (5) like inflammatory bowel disorders, multiple sclerosis, type I diabetes, rheumatoid arthritis, and immune issues like asthma. More research needs to be done before we can draw conclusions and apply them to other autoimmune-inflammation problems, but so far, there are no major risks for helminthic therapy known in the scientific literature at this point.
Should you try helminthic therapy?
I want to be clear on one thing: Helminthic therapy is a first-line treatment to consider. I would recommend exhausting all other options before trying something experimental like this. That said, as a functional medicine practitioner, part of my job is to educate people on the latest research on emerging natural therapies—like helminthic therapy—so that they have all the options presented to them.
Most of my patients are somewhere on the autoimmune inflammation spectrum and have already tried everything conventional medicine has to offer. They’ve often seen little-to-no benefit from diet changes, herbal and nutrient-based protocols, and other lifestyle changes or experienced unwanted side effects from their treatment. We start with other therapies first to see what headway we can make and then we consider all options.
Helminthic therapy is not FDA-approved in the United States, so doctors cannot administer it outside of a research setting. Although some people self-administer helminthic therapy, as with anything, you should always talk to your doctor.
If you do try this therapy, the worms used in helminth therapy don’t survive to adulthood in humans, so they do not cause infestations and will die in a few weeks. This also means that regular doses are given around every three weeks to maintain results. The ultimate goal is to get the patient to a place where the patient’s immune system is regulated well enough that it is not flaring up and overreacting. Then, the patient can discontinue the therapy.
At first glance, helminthic therapy might seem really “out there.” But after reading this article, it probably doesn’t seem as crazy as you thought. In fact, it appears that there are significantly fewer side effects associated with helminthic therapy than with immune-suppressing pharmaceuticals and steroids, which are often given to people with autoimmune conditions.
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- Weinstock, J. V. (2004). Helminths and harmony. Gut, 53(1), 7–9. https://doi.org/10.1136/gut.53.1.7
- Okada, H., Kuhn, C., Feillet, H., & Bach, J.-F. (2010). The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update. Clinical & Experimental Immunology, 160(1), 1–9. https://doi.org/10.1111/j.1365-2249.2010.04139.x
- Kondělková, K., Vokurková, D., Krejsek, J., Borská, L., Fiala, Z., & Andrýs, C. (2010). Regulatory T cells (Treg) and Their Roles in Immune System with Respect to Immunopathological Disorders. Acta Medica (Hradec Kralove, Czech Republic), 53(2), 73–77. https://doi.org/10.14712/18059694.2016.63
- Smallwood, T. B., Giacomin, P. R., Loukas, A., Mulvenna, J. P., Clark, R. J., & Miles, J. J. (2017). Helminth Immunomodulation in Autoimmune Disease. Frontiers in Immunology, 8. https://doi.org/10.3389/fimmu.2017.00453
- Elliott, D. E., & Weinstock, J. V. (2009). Helminthic therapy: using worms to treat immune-mediated disease. Advances in experimental medicine and biology, 666, 157–166. https://doi.org/10.1007/978-1-4419-1601-3_12
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BY DR. WILL COLE
Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is the host of the popular The Art Of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, The Inflammation Spectrum and the brand new book Gut Feelings: Healing the Shame-Fueled Relationship Between What You Eat and How You Feel.