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[P]
For the therapeutic use of benign infectious organisms in the treatment of immunological disease

By luckbeaweirdo in Science
Tue Mar 17, 2009 at 05:50:16 PM EST
Tags: helminthic therapy, hookworm, hygiene hypothesis, old friends hypothesis, epidemiology, multiple sclerosis, crohn's, ulcerative colitis, allergies, asthma (all tags)

Because of my experience going to Cameroon, first written about here in 2006, to infect myself with hookworm to deal with my allergies and asthma, and because of my role as the founder of the world's first company offering infection with human hookworm and whipworm to the public, I was approached by a documentary film maker a while ago. I agreed to be filmed but quickly became unhappy with the direction they were taking. They were more interested in our personal lives and an Oprah-like approach to the story than in the science or the implications for the practice of medicine. To try and persuade them to do a movie I was interested in watching, and that I was willing to continue to participate in filming, I wrote the following, believing that doing so would compel them to take a different approach. Who would not prefer to make the first documentary about something historic? I am still waiting for their response but it occurred to me that what I had written was a nice summation of my perspective on what I have learned since I started down this path and of my thinking about this approach to medicine.


At the core of the concept of the therapeutic use of infectious organisms is the idea that all complex organisms function as ecosystems. Every large multi-celled organism is dependent to a very large degree upon other organisms that use its body as their "home". This dependency is not trivial, we depend upon microbes to function. Not just to function properly, but to function at all.

To help see the human body as an ecosystem, which is a radical departure, it helps to know that 60% of your feces by weight is bacteria. That if you were to eradicate the bacteria living in your intestine you would soon die of malnutrition. That the intestine is the location of, by some estimates, 60% of our immune system. That, strictly speaking, the intestines are the surface of our exterior, a wet, semipermeable skin, in contact with the outside as we push things from the outside through a long thin hole through our bodies. That over 80% of the cells by number in and on (see above) your body right now are not human cells (they are much, much smaller than human cells).

We are a walking rain forest in a sense, and we function like one.

It is estimated that as many as 70% of species are symbionts (parasitic), most of them either have a mutually beneficial relationship with their host or one organism benefits without the other being harmed. Proper immune function is a benefit, so that some organisms currently classified as parasites of man, like most helminths, perhaps should more properly be classified as mutualistic symbionts. Although this might appear to appear to be semantics, it is important because the word "parasite" is freighted with strongly negative, and undeserved in this context, meaning.

The important take-away is that whether or not you are aware of it you depend for your very life on organisms almost universally regarded as repulsive, repugnant and that exist on and within you in enormous numbers.

Nor is the idea of a connection between infectious diseases and autoimmunity a new one. In the mid 1960s scientists made the observation that MS was more common in those who had had very clean childhoods. In 1986 Godfrey published in the Lancet what would become known as the hygiene hypothesis, based on his observation that allergies were less common in later siblings in large families. He reasoned that their increased exposure to infectious organisms throughout their childhoods via their elder, numerous, siblings was the cause.

Since then hundreds of scientific papers have been published looking at this issue and the majority confirm or extend his ideas. The result had been to refine and expand the Hygiene Hypothesis is to produce the Old Friends Hypothesis (OFH).

The OFH suggests that the immune response to infection, particularly by large multi-celled and complex organisms like helminths, is effective in moderating immune response in large measure because we and our immune systems (and by we I mean all large complex organisms) have co-evolved with every organism that has parasitized or infected us long term. Our immune systems depend upon cues provided by infection with bacteria, viruses, protozoa and helminths, to develop and function properly. To be able to properly identify appropriate targets the immune system has to be exposed to them. Since the targets must exist, according to the genetic script of the immune system - they always have existed therefore they must be here, in the absence of those targets the immune system attacks the closest analogs to the organisms we co-evolved with: pollen, dander, food, self.

Having evolved in an environment where we lived in close contact with the soil, as humans and prehumans, our bodies account for the presence of these organisms from an early age. The absence of what were universal effects and cues is the cause, according to the OFH, of many if not all of the "modern" diseases that involve inflammation or immune dysregulation. Our immune systems depends upon regular and continuous exposure to a library of organisms to develop and function properly.

Note: Autoimmunity is often used mistakenly to refer to any immunological disorder. It is a specific type of immunological disorder where the immune system identifies self tissues as foreign and attacks them. Asthma, amongst many, is by this definition not an autoimmune disorder because the body does not attack self tissues. In asthma, and most diseases of immune dysregulation, of which autoimmunity is a minority subgroup, the disease arises out of collateral tissue damage caused when the immune system mistakenly attacks benign pathogens, like cat dander or pollen.

The OFH makes sense because, as is demonstrated in the less developed regions of the world now, our bodies were home to large numbers and varieties of parasites and cohabiting organisms from within a few months of birth to death. This situation prevailed for our genes for as long as parasites and infectious organisms have existed. Much of our genetic material is ancient, predating primates or mammals, so the genetic pressure exerted on our genes by parasites predates the arrival of the particular configuration of genes that constitute homo sapiens.

Many organisms that infect or parasitize us manipulate our immune system, including bacteria. So the collective cumulative evolutionary effect of all these organisms over millions of years, even if the individual effect is mild, must be enormous.

To see the impact and the genetic bargain struck by our genes look to areas of high cholera, tuberculosis and malaria incidence. Where an individual inherits a gene from both parents that protects the bearer from each of these diseases the result is Cystic Fibrosis, Tay-Sachs, or Sickle Cell Anemia respectively. To believe that these are the only genetic consequences of coevolution with disease causing organisms or parasites is prima facie absurd. They are just the most awful and therefor apparent.

Helminthic therapy is a subset of what will one day be called something like Biological Therapy, the therapeutic, or prophylactic, use of benign infectious organisms to combat disease through deliberate and repeated infection. The idea is an obvious consequence of epidemiological observations and laboratory studies demonstrating that asthma, allergies, MS, Crohn's, UC, Lupus, heart disease, depression, etc., are unknown or almost unknown in the third world where people are commonly infected with a variety of parasites including multiple simultaneous active helminth infections. Or, in the case of multiple sclerosis that those acquiring a helminth infection after developing relapsing remitting form of the disease experience something close to remission while hosting helminths. Or that providing pig whipworm ova to thsoe suffering with IBD is as effective as prescribing Humira or Remicade. Nottingham studied Ethiopians infected with hookworm and observed that in those with hookworm asthma was 50% less likely. Many more studies than these have been performed with similar results.

To illustrate these ideas briefly consider that the first case of Crohn's disease was observed in New York City in the early 1930s, very soon after the elimination of helminths in that urban population. Or that in 1967, probably on a wheeze (ahem), an English researcher went to Ghana to look at asthma in that country. Despite staying for months he found not one case.

Consider also that there is a North-South gradient for all these diseases. The further from the equator, and the tropics, one lives the higher the incidence of <insert name of modern disease involving immune dysregulation here>. Besides a north south gradient in disease there is one for income and sanitation (as well as exposure to sunlight).

Or that within industrialized countries those living on farms or on the land experience far lower incidences of <insert name of modern disease involving immune dysregulation here>.

That babies born by Caesarian Section have higher incidences of allergies. That antibiotic use correlates with the incidence of many of these diseases.

If one examines the epidemiology of the modern diseases, like heart disease, that involve inflammation and environmental factors or triggers, even then the effect of eating too many cheeseburgers is not enough alone to explain the increase in heart disease. Some other, as yet unidentified pro-inflammatory factor is at work, which I propose is the damage done to our personal ecosystems by modern living.

That besides manipulating serotonin levels many modern antidepressants have anti-inflammatory properties for brain tissue and that inflammation has been linked to many forms of depression as a possible causative factor.

Neither genetic changes in humans (the time scale is to brief) nor environmental pollutants, nor increases in research looking at these issues are sufficient to explain the increase in these disease according to studies into each possiblity. In a matter of two or four generations we have gone from a point where Crohn's disease essentially did not exist to a point where it affects 1/250 of the population in the US. And all the modern diseases are increasing rapidly, from asthma to ulcerative colitis. Right now it is estimated that 1/85 births results in an autistic child. As recently as the 1960s arguments raged, amongst scientists and doctors although not parents, as to whether autism was a real disease or just the result of poor parenting. Now if you plan on having a child you have better than a 1% chance of having a child on the autistic spectrum. Never mind MS, allergies, asthma, Crohn's, UC, AI liver disease, Hashimoto's thyroiditis, Lupus, RA, JRA, and on and on. Most of these are diseases that were vanishingly rare or that were not observed or described until the 20th century.

Given the trend, if it continues, it is reasonable to think that within a few generations the amount of disability due to these diseases will reach a level catastrophic to our economy as resources are diverted to care for the sick. Never mind the impact on our lives. Forget Social Security, Medicaire and the baby boomers, worry about a population so sick it consumes our annual budget whole.

The immune system is extraordinarily complex and because it is a dynamic system that is hard to study is poorly understood. We have not even identified all of its constituent parts, never mind learned completely how they interact with one another or respond to pathogens. The idea that we are going to come up with such an understanding in time to create medical interventions based on drugs is ridiculous. Never mind the price of such drugs or their side effects. The drugs invented so far to treat these "modern" diseases can cost enormous sums annually, up to $500,000, and can cause terrible side effects. Remicade, according to one account I have read, is the most lethal drug on the market when one excludes accidental overdoses. Besides all this many of these drugs only effective for limited periods of time, patients develop antibodies or reactions to the drugs themselves. Drugs are not an effective response, even could we afford it. Besides this we don't have the time to develop enough new drugs to treat all these diseases, even if we had the resources.

What is needed is a simple, natural approach. Do we really want to wait decades to produce very expensive, dangerous drugs when a very effective, simple, natural solution is at hand? Lets stop treating the symptoms and fix the problem: restore the ecosystem formed by our bodies to its natural state by reintroducing missing beneficial organisms.

The use of therapeutic organisms, ones with very low risk profiles, is easy to do, in theory. In practice the medical system is not designed to prevent or cure disease cheaply. A profit driven medical system is exactly that, profit driven. Resources are quite naturally directed at solutions that produce profits. There is far more money in a palliative, for instance, than in a cure.

There is research being carried out to study the impact of parasites on the human immune system and particular diseases, often funded by drug companies, in Australia, the US (multiple locations), the UK (Nottingham, London, Edinburgh) and Japan. The drug companies obviously believe these organisms are producing something that can be used to treat disease.

I believe that the main focus of this research is probably to isolate molecules (like ES-62 derived from helminths) with immune effects that can be packaged and used as drugs. These will almost always be produced, as Humira is, from genetically engineered organisms. Drug companies don't sponsor research to develop therapies to substitute for drugs.

The result will be a very expensive drug that will have to be delivered by injection at a hospital, and very bad side effects will be a likely consequence. If any effective and relatively safe drugs are produced it will take decades.

People with Crohn's, MS, asthma, Lupus, etc., don't have decades. So why not use helminths? The CDC recommends against treating light infections of hookworm and whipworm, so the CDC obviously believes that both are safe. Unlike Remicade, Humira and Tsyabri no one is going to develop multi-focal leuko encephalopathy (brain death) because of using therapeutic helminths.

I propose that instead of spending billions of dollars annually on dangerous drugs that a more natural, safe, cheap and effective approach be used. We can still use the drugs in those cases where organisms don't work. Lets give benign organisms to children as part of their well baby care as a prophylactic measure. There is plenty of evidence that if exposure is continuous through childhood and into early adulthood the benefits are permanent. For older people protocols based on mixes of benign bacteria, protozoa and helminths would largely eliminate or arrest Type I Diabetes and its variants, asthma, allergies, food intolerances, Multiple Sclerosis, Ulcerative Colitis, Autoimmune Liver disease and Crohn's, These are just the diseases that have been studied so far. Lupus and Rheumatoid arthritis both look very promising amongst many, many others.

But of course the use of infectious organisms to treat disease is not a miracle cure, this is not a revival tent meeting. The results of helminthic therapy both in the lab and in our experience while very good, certainly comparable with drugs like Humira, Remicade, Tysabri or Enbrel in terms of the proportion getting better, are no miracle. No therapy is universally successful, none are completely safe. Any time anything is ingested or introduced into the body problems will sometimes occur, although none have to date. Nor are the results uniformly revival-tent worthy, but given what we have seen this approach should be being beaten to death by medical researchers instead of this slow drip of research currently.

This is obvious from looking at the mortality statistics for the United States. Look at how many react badly to just aspirin. So I am not proposing that this approach is without risk, what I am saying is that compared to modern drugs, even OTC ones, it is very safe.

So if its so great why can't you get it from your doctor? Primarily I think because it is a new concept, helminths have only been examined relatively recently. Along with this is that the profit motive is absent, in fact most interested parties, all but patients, would lose out from the use of helminths and other organisms in this way. The drug companies depend upon chronic conditions, and palliative treatments for them, for most of their profits. Cures and vaccines do not produce income streams in the billions. Dosing someone on a monthly basis with an expensive genetically engineered drug most certainly does. Giving someone an infection using un-patenable organisms carried by a billions of people in the third world, where the modern diseases are very rare or unknown, does not.

To understand the potential loss to the drug companies from the adoption of just helminths like hookworm look at asthma drugs. The annual market for such things is enormous and from personal experience the therapeutic results very poor. Take Singulair, a drug I was prescribed and from which I derived no discernible benefit. In 2005 the sales of Singulair were $2,975,000,000.00. Almost $3 Billion dollars! Just imagine what the annual market for antihistamines like Claritin and its generic versions is. Research Claritin's efficacy compared to a placebo for an eye-opener. Now imagine the substitution of hookworm, requiring a single dose on average every five years, for all those drugs. Helminthic therapy does not look like a good deal to the drug industry, it looks like the apocalypse.

Hookworm appears based on our early results to be more effective, far cheaper, and with milder and only transient side effects, than drugs costing two or three orders of magnitude more (100 - 1000 times as expensive).

For that reason it is not in the interest of the drug companies to take the risks associated with pushing for such a huge change in the way medicine is practiced and for the change in public attitudes required for helminthic therapy's adoption. Would you be willing to undertake the public relations task of convincing the world that they should infect themselves with a parasitic worm in exchange for the complete destruction of you business?

Biological therapy is too effective, safe, and cheap in the long run, to not be adopted. The only question about biological therapy is how long will it take and how many millions of people will live lives cut short and ruined before this idea is integrated into the practice of medicine.

Whether or not that is recognized within my lifetime one day the ideas above will form the basis for a new branch of medicine and diseases like Type I diabetes, allergies, Crohn's disease, multiple sclerosis and ulcerative colitis will for the most part be a bad memory, like Polio.

The therapeutic and prophylactic use of infectious organisms to treat disease: Biological Immunotherapy.

References

Helminthic Therapy A site containing the full text of many of the papers cited below.

Parasitic worms and inflammatory diseases

Asthma and current intestinal parasite infection: systematic review and meta-analysis

Helminths and the modulation of mucosal inflammation

Serious events with infliximab in patients with inflammatory bowel disease: a 9-year cohort study in the Netherlands.

Progressive multifocal leucoencephalopathy in the rheumatic diseases: assessing the risks of biological immunosuppressive therapies.

Association between parasite infection and immune responses in multiple sclerosis

Trichuris suis therapy in Crohn's disease

A proof of concept study establishing Necator americanus in Crohn's patients and reservoir donors

Helminths and harmony

Inhibition of Autoimmune Type 1 Diabetes by Gastrointestinal Helminth Infection

The increased prevalence of allergy and the hygiene hypothesis: missing immune deviation, reduced immune suppression, or both?

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Related Links
o Cameroon
o Hygiene Hypothesis
o helminths
o Autoimmuni ty
o Helminthic Therapy
o Parasitic worms and inflammatory diseases
o Asthma and current intestinal parasite infection: systematic review and meta-analysis
o Helminths and the modulation of mucosal inflammation
o Serious events with infliximab in patients with inflammatory bowel disease: a 9-year cohort study in the Netherlands.
o Progressiv e multifocal leucoencephalopathy in the rheumatic diseases: assessing the risks of biological immunosuppressive therapies.
o Associatio n between parasite infection and immune responses in multiple sclerosis
o Trichuris suis therapy in Crohn's disease
o A proof of concept study establishing Necator americanus in Crohn's patients and reservoir donors
o Helminths and harmony
o Inhibition of Autoimmune Type 1 Diabetes by Gastrointestinal Helminth Infection
o The increased prevalence of allergy and the hygiene hypothesis: missing immune deviation, reduced immune suppression, or both?
o Also by luckbeaweirdo


Display: Sort:
For the therapeutic use of benign infectious organisms in the treatment of immunological disease | 82 comments (78 topical, 4 editorial, 0 hidden)
I found this article quite interesting. (2.40 / 5) (#1)
by dakini on Mon Mar 16, 2009 at 04:34:41 AM EST

It was quite long, and at first I thought I would not finish reading it. But after I got into it, I couldn't stop reading until the end. This is a very interesting read and a very informative read.

I believe there are many things we have not learned about the human body and diseases. Being a nurse, I am not one for alternative medicine, but this article was very informative.

I will definitly vote this up when it has gone to vote. +FP from me.

" May your vision be clear, your heart strong, and may you always follow your dreams."

yeah thats what crohns disease is all about (2.25 / 4) (#2)
by circletimessquare on Mon Mar 16, 2009 at 05:39:20 AM EST

its about an immune system evolved to hyperaggressively fight worms for your entire life

but modern life and its complete absence of worms makes the immune system go stir crazy and start attacking the body instead, for some individuals

give such individuals worms, and their rogue immune systems develop some focus and discipline again

hmmm i need focus and discipline

maybe i should put worms in my brain


The tigers of wrath are wiser than the horses of instruction.

goa'uld for the win $ (2.00 / 3) (#10)
by alba on Tue Mar 17, 2009 at 02:16:11 AM EST



[ Parent ]
I thought you already had /nt (1.50 / 2) (#33)
by BJH on Thu Mar 19, 2009 at 01:25:16 PM EST


--
Roses are red, violets are blue.
I'm schizophrenic, and so am I.
-- Oscar Levant

[ Parent ]
interesting, informative, well written (2.50 / 6) (#3)
by Lady 3Jane on Mon Mar 16, 2009 at 07:15:01 AM EST

what the fuck is going on here

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8 This is offensive. Fix your site Rusty you have to -- The Honorable Edwin Lister
8 Please enjoy a male chorus, All of us will become human rifles and bombs!
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It's a plot (none / 1) (#7)
by MotorMachineMercenary on Mon Mar 16, 2009 at 05:41:27 PM EST

before you know it, it'll implant itself into your face and soon you'll be begging for the space marines to kill you.

--
MMM, tenured K5 uberdouchebag
- Herr mirleid


[ Parent ]
A few nits (2.82 / 17) (#5)
by Sgt York on Mon Mar 16, 2009 at 10:11:39 AM EST

A few nits:Well, it started off as a few nits. I thought I would largely agree with you based on the title...but....well, I don't exactly disagree with the idea, just your broadness of application and cursory examination of the complexities of the idea. I also was going to make this editorial, but instead will make it topical.
70% of species are parasites, most of them commensal or symbiotic,
A simple terminology issue: This should read "70% of species are symbionts, most of them commensals or mutuals."

In fact, most of the physiologic gut flora are considered mutuals due to their immune function. Symbionts include parasites, commensals, and mutuals. A parasite is a specific type of symbiont that benefits at the expense of a host. Commensals have no significant impact each other and mutuals benefit each other. Parasite has negative connotations because a "parasite" is a bad thing, by simple definition. If you want to argue that certain helminths are not harmful, then you are arguing that they are not parasites, not that parasites are harmless. Again, just a basic terminology issue.

Nor is the idea of a connection between infectious diseases and autoimmunity a new one
But it is a controversial one. For every study that supports the clean baby hypothesis, there is one that refutes it. I personally am of the opinion that the clean baby hypothesis has merit, but you should be aware that this is not a settled issue. Most likely, pediatric exposure is beneficial in many cases, harmful in others, and makes no difference in others.

Autoimmunity: Usually, the clean baby hypothesis is used to address the larger issue of hypersensitvities. Type I covers things like asthma, allergy, and atopy. Autoimmunity is actually a very broad group of pathologic phenomena that is included in the other 3 hypers. It is "narrow" in that it is always the immune system attacking self, but the mechanism and specifics of that attack are quite varied.

CF: The CF-cholera link is very, very weak. It's a good idea, but there's not a lot of data behind it (at least that I am aware of). I am unaware of the Tay-Sachs/Typhoid link. The sickle cell idea is an old one and is commonly accepted. The genetics back it up, though the mechanism is unclear.

Ethiopians infected with hookworm and observed that in those with hookworm asthma was 50% less likely. There are many more studies than that one.
Be careful about your correlation-causation statements here. There is also a very strong correlation between incidence of asthma and air quality. Overall air quality in the US has increased over the past 40 years, and asthma incidence has increased along with it. But those data alone mean little (if anything).

Helminth specificity: First, it is reasonable to see asthma as an immune defect/injury. It is certainly a pathology. There is a problem in the way the immune system responds; if it is an inherent response (either genetic, epigenetic, or acquired in utero), any immune challenege would be a negative selector for people with that predisposition. To put it simply, given the data presented, one could argue that instead of curing asthma, helminths kill youung people that have asthma or predisposition to become asthmatic. This would lead to the same observations.

Second, you select out one type of infector, when there is no reason to. Someone exposed to helminths has likely been exposed to multiple other parasites and pathogens. A more common (and more physiologically supported) mechanism of the clean baby hypothesis is through prokaryotes. Lack of prokaryotic stimulation causes a maintainence of the "Th2" predisposition of the newborn, leading to asthma. Even beyond that, it could be simply that asthma in a poverty-stricken African environment is much more lethal than in a modern western one, and infectors have no impact on it.

Crohn's: "...nor environmental pollutants..." You don't make this case. You also don't make the case against diet or lifestyle as a cause. These have changed dramatically over the timescale presented. Also, you ignore diagnostic rates. Crohn's was not described until the 1930s, but that does not mean it didn't exist before that. Inflammatory bowel diseases have been known since antiquity. It is a known phenomenon that when a disease is first described, the incidence appears to rise dramatically over the course of decades as the idea is trained into and accepted by more doctors.

Ok...this started as just a few nits, but it built into a lot more. This needs major revamping, from initial misunderstandings of the basic terminology of your proposal to the thought processes involved. This is a huge and complex avenue of active research, and this is an overly simplistic and overly broad glance at it. There are not just books written on this subject, but book sets.

Oh, and on the last line...No, we didn't read it here first. Well, some people may have, but this is an old idea. I remember being taught it in undergrad. Ever hear the marketing term "probiotics"? Look on a container of yogurt sometime. That's exactly what this is, probiotic therapy.

There is a reason for everything. Sometimes, that reason just sucks.

clean baby hypothesis is a joke (2.83 / 6) (#6)
by sholden on Mon Mar 16, 2009 at 05:12:39 PM EST

Seriously I challenge anyone to last more than a day before they let the damn kid eat off the floor.

It progresses:

  • throw it in the bin if it touches the ground.
  • realise you can't afford to do that for too long, so "three second rule here we come".
  • OK, three seconds from when you saw it.
  • the ground doesn't look too dirty.
  • it only bounced off the dog shit.
  • three seconds in the dog shit is OK.
  • that marshmallow you found in the dog shit is crunchy, who cares munch away junior.

--
The world's dullest web page


[ Parent ]
slippery slope fall zzzz (1.50 / 2) (#18)
by tetsuwan on Tue Mar 17, 2009 at 05:00:46 PM EST


Njal's Saga: Just like Romeo & Juliet without the romance
[ Parent ]

Yakult, right? $ (none / 1) (#50)
by carnival of animals on Mon Mar 23, 2009 at 05:12:44 AM EST



[ Parent ]
my apologies and thanks (none / 1) (#68)
by luckbeaweirdo on Tue Mar 24, 2009 at 12:56:51 AM EST

I never properly thanked you for such comprehensive, useful and thoughtful suggestions.

I was selective about what I incorporated of your suggestions, obviously. For a lot of what I did not react to I felt that, while what you said had some merit, I did not need to address the issue as thoroughly as you suggested. That what I had done around the idea was sufficient.

Part of it was length. This is a complex topic and I could have gone into more depth and offered more citations, etc, in many areas. But I had to pick a limit, and for the most part, particularly after I had integrated the rest of your suggestions, I was satisfied with the result.

My ambition is to write a book, and I have no doubt that consciously or not, if I pull it off, much of what you suggest will make it into the manuscript. Whether or not I find a publisher.

My sincere thanks.

Jasper



[ Parent ]
Didn't I read almost this same article by the same (1.25 / 4) (#8)
by yuo on Tue Mar 17, 2009 at 12:31:19 AM EST

author, a million years ago?

I agree with the basic premise, that sick people should be allowed to give themselves any stupid old treatment if they think it would work.

As for biological therapy, hospitals already use sterile leeches and maggots, so it's not like the use of sterile hookworms is beyond reason.

And the CDC's stance that a mild hookworm infection should be left alone is meaningless in your argument. One infection passes in months unless you go trudging around in human shit all day. Where are the studies about the long-term effects of a chronic hookworm infection?

Other than that, the article is full of pseudo-intellectual bullshit. So, we got into this trouble from pre-mammallian evolution? Do a lot of lizards and birds have asthma? Or are you saying that they don't because they get more diseases? What does that have anything to do with your point?

And now, your kind hasn't adapted well to a more sterile environment? And this will affect a catastrophically large portion of the population? This is delusional thinking. Here's the truth: your kind is not well suited to a modern environment, and will die out through a type of artificial selection called prenatal DNA screening, followed by an abortion.

I wish I had thought of pants pants pants pants pants pants pants pants.

I get no response, just a rating, luckbeaweirdo? (none / 1) (#9)
by yuo on Tue Mar 17, 2009 at 01:48:54 AM EST

I presume that you think abortion distasteful, but why then did you place your abortion of logic in the story queue?

I wish I had thought of pants pants pants pants pants pants pants pants.
[ Parent ]

I started to reply... (2.00 / 3) (#15)
by luckbeaweirdo on Tue Mar 17, 2009 at 04:24:53 PM EST

... and then I remembered all the exchanges I had the last time I posted here. Real quality, like the one below about rubbing raw sewage on my cock to cure a disease the person can't spell. So I went for the rating because it seemed like a response less likely to result in long threads of "fuck you, no fuck you, double fuck you" So yeah, a half assed compromise, a rating but no comment.

[ Parent ]
Well, I generally disapprove of 0ing any (none / 1) (#17)
by yuo on Tue Mar 17, 2009 at 04:49:57 PM EST

comment with interesting discussion. I always browse viewing hidden comments, and I often will 3 a comment that I disagree with if I think it was hidden unfairly. I mean, why 0 hide something that you really 1 disagree with?

Anyways, my comment was my attempt to keep your story from being posted (I wanted to insert some vitriol into my comment to elicit embarrassment), but it looks like it'll probably go up anyways. I was hoping you'd take it down and rewrite it to fix all of the aforementioned crummy parts. I didn't catch it in the edit queue.

That doesn't make my points less valid, though.

I wish I had thought of pants pants pants pants pants pants pants pants.
[ Parent ]

Pants? (none / 1) (#22)
by luckbeaweirdo on Tue Mar 17, 2009 at 07:34:31 PM EST

In the US or UK sense? If the latter your signature is more revealing perhaps than you intend.

[ Parent ]
EITHER SENSE IS FINE. I'M MORE INTERESTED IN (none / 1) (#25)
by yuo on Tue Mar 17, 2009 at 10:53:31 PM EST

the grammar.

I wish I had thought of pants pants pants pants pants pants pants pants.
[ Parent ]

Thanks for the mention... but depriving me of a (none / 1) (#19)
by sausalito on Tue Mar 17, 2009 at 05:43:19 PM EST

(0) was rather cruel of you.
_____________

GBH - "The whole point is that the App Store acts as a firewall between busy soccer moms and goatse links"
[ Parent ]

ah the guy stomping shit in Cameroun (none / 1) (#14)
by sausalito on Tue Mar 17, 2009 at 01:19:40 PM EST

that was a kla5sic!

Not read this yet but I'll FP based on your track record: hopefully you rubbed raw sewage from Mexico City on your dick to heal your genital psyoriasis or crazy stuff like that.
_____________

GBH - "The whole point is that the App Store acts as a firewall between busy soccer moms and goatse links"

I was delicately tiptoeing (none / 1) (#16)
by luckbeaweirdo on Tue Mar 17, 2009 at 04:26:24 PM EST

And the guy voted me down not up.

[ Parent ]
Some metapersonal considerations (2.00 / 3) (#20)
by k31 on Tue Mar 17, 2009 at 06:46:57 PM EST

I read the previous story relating to this, so I mostly skimmed it this time... it occurs to me that the documentary maker has already decided on a direction, however, and won't change because of this article sent to them. If they can even comprehend it.

It is not that most of the world is stupid, but rather, for most people, one narrow reality is the safe way to think. Forcing people to open up to wider possibilities tends to cause a negative backlash that keeps them more closed and you more removed from your goals.

Even if the documentary is more "Oprah-ish", the target demographic for an alternative healthcore would be biased towards parents, self-suporting people, and so on... people who do watch stuff like Oprah and more importantly, exposure as a humanistic rather than a scientific story would put you closer to mainstream markets.

You might be trying to sell an idea rather than a product, but it is still selling. It's impossible to do that if you don't get people's attention, or make their eyes glaze over.

With words like "helminth".

It was a great story, btw. I've missed such in-depth articles with a high density of information, brimming with passion and backed by extensive research.

Your dollar is you only Word, the wrath of it your only fear. He who has an EAR to hear....

It doesn't matter how you explain it... (2.00 / 3) (#21)
by luckbeaweirdo on Tue Mar 17, 2009 at 07:21:57 PM EST

... people freak the fuck out about it. People with MS who were my friends for instance, the Relapsing remitting variety, that I know I can put into remission EVERY TIME, are completely alienated from me. They have a fucking college education for fuck's sake and they cannot even read the science it repulses them so much. They would literally rather have MS than get worms. Its insane how people react to this.

[ Parent ]
Good point.... (none / 1) (#80)
by k31 on Fri Apr 24, 2009 at 10:04:59 PM EST

I mean, it sounds like a matter of "limited realities"... it is like if, in general, humans carry around so much negative space that they can never grow.

By negative space, I mean, defining what won't work or can't happen, rather than investigating or trying.

The domestication process is highly effective, then, at reducing humans in general, even if it also makes us specifically ideal for... employment by slightly less limited humans, I guess.

Your dollar is you only Word, the wrath of it your only fear. He who has an EAR to hear....
[ Parent ]

a potentially depressing assessment, but yes (none / 1) (#83)
by luckbeaweirdo on Thu Apr 30, 2009 at 01:42:55 AM EST



[ Parent ]
But then again, (none / 1) (#49)
by carnival of animals on Mon Mar 23, 2009 at 05:10:00 AM EST

selling it that way might permanently doom some alternative treatments to the dustbin of cooky ideas, along with 'mediums' who can talk to the dead. Maybe it's better to have your ideas considered by the educated public to be obscure and even suspect science rather than popular probable-BS.

[ Parent ]
Yeah, (none / 1) (#81)
by k31 on Fri Apr 24, 2009 at 10:09:34 PM EST

Perhaps you're right in general, but even if something was BS, if I came across it, I would investigate to make sure it was BS, rather than dismissing it outright.

If I hadn't heard about it, I wouldn't be able to investigate...

I don't really remember exactly how I found k5, but it's cool partly because people actually investigate and experience what they talk about, for the most part... on other sites, like /., it is so much wild speculation and "forward thinking press releases" (i.e. vaporware) that I almost feel covered with snake-oil just by glancing.

... but most people don't even know k5 exists... I think we should have a magazine or something, just to draw attention to the site, not 'cause we need more readers, but because it is another vector to attract good writers.

I forget what my point was. I think I was just thinking aloud. With my fingers. On the keyboard. I gotta stop doing that, maybe... but the electrons seem to happy when I inconvenience them.


Your dollar is you only Word, the wrath of it your only fear. He who has an EAR to hear....
[ Parent ]

Potentially Dangerous (2.40 / 5) (#23)
by the77x42 on Tue Mar 17, 2009 at 09:40:05 PM EST

First of all, I ate dirt a few times as a young child. I don't have any stomach or intestinal problems going on for almost thirty years. I don't, however, advocate feeding my kids dirt as a preventative health measure.

Your previous article was suggesting that people who have certain diseases visit a third world country and romp around in the local's shit houses to suppress those diseases.

This article is suggesting people who have certain diseases attempt getting at the end result of the 'shit' treatment, without mentioning the shit. That is: infect themselves with a worm that we don't really know that much about.

Your first article condoned treatment that would very obviously subject you to a host of other medical problems. Your defence of the end treatment in this article is no less dangerous.

Let me put this into perspective. A girlfriend of mine had Chron's Disease and was in a substantial amount of pain. The extreme changes in diet, as recommended by professionals, did only a small amount to relieve the pain. Enter placebo. After discovering homeopathy, naturopathy, and some additional bullshit called cleansing, she thought she was cured. Well, actually, no, she wasn't, she still had flare ups and the most effective treatment was the original diet change suggested by the hospital. But that still didn't stop her from eating a dozen lemons every other week.

Why?

Because desperate people do desperate things.

This isn't to say that anything she did was dangerous, but it shows that rational people, when reason tells them that something they really want to happen won't, will try unreasonable measures to make it happen. Enter helminthic therapy.

You are advocating treatment that has unknown side effects. It may turn out to be The Cure, but until more research is done, you should not be suggesting that people (who are susceptible to anything that might help) try potentially dangerous treatments.

You suggest that there are documented aversions to over-the-counter drugs, so why should this treatment be so bad? Answer: It's because of the undocumented side effects. You say there have been no recorded side effects, but how many people have been on this treatment compared to the number of people taking over-the-counter drugs?

You suggest that further research would be painfully slow because of the dominance of drug companies. But, please, this is no reason to go ahead and try radical treatments.

There are many people in the world passionate about finding a cure for these diseases; more research will be done on helminthic therapy. Until then, let's not have desperate people jumping at potentially dangerous treatments.

And I'll just stick with my dirt.


"We're not here to educate. We're here to point and laugh." - creature
"You have some pretty stupid ideas." - indubitable ‮

Trolllike? (1.33 / 3) (#26)
by luckbeaweirdo on Wed Mar 18, 2009 at 01:15:07 AM EST

You didn't understand the first article and you don't understand this one, you repeatedly ignore things I have written in both to make your points. Your signature says it all.

[ Parent ]
I think you completely misunderstood me (1.50 / 2) (#31)
by the77x42 on Wed Mar 18, 2009 at 04:57:42 PM EST

I'm not saying that the therapy categorically IS dangerous, I'm saying it could be. Championing something that so little is known about, without a full understanding of the risks involved, is without a doubt, plain wrong. This is especially true in fields like medicine where people tend to believe anything they think might cure them. If you think your worms cure you, that's great, but it could also be a side effect of something much more serious than your original condition.

Go ahead and be defensive. We have long been subject to bogus treatments that are claimed to be verified by sound science, and yours even isn't. All I am saying is be cautious and skeptical. I just don't gamble with my health.


"We're not here to educate. We're here to point and laugh." - creature
"You have some pretty stupid ideas." - indubitable ‮

[ Parent ]

It's worse than that (none / 1) (#34)
by Liar on Thu Mar 19, 2009 at 02:38:55 PM EST

He's also gambling with the health of others.

Suppose this does work and it becomes the next national craze to eliminate asthma. Huzzah! At that point, we've exchanged our first-world asthma problems with a third-world infestation and the challenge will then be to keep that to manageable levels in all individuals. Asthma afflicts the unfortunate few, but now we'll have to change society to manage the infection in everyone.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
you didn't even read the title (1.33 / 3) (#40)
by luckbeaweirdo on Fri Mar 20, 2009 at 08:43:43 PM EST

So of course I assumed your post was in bad faith. "For the therapeutic use of benign infectious organisms in the treatment of immunological disease". BENIGN. You are familiar with the meaning of the word? If you think hookworm are not benign for Americans and Western Europeans then you know nothing about hookworms. I have been reading and researching this topic since 2005, I know what I am talking about.

[ Parent ]
you didn't even read the comment (none / 1) (#42)
by Liar on Sat Mar 21, 2009 at 02:14:09 AM EST

You can't imagine why someone may disagree with the premise that you're dealing in only benign organisms. I've had hookworms and enjoyed the wheezing and the coughing enough to disagree that they're benign.

So, that's why I was replying to someone else. You're a true believer and won't listen to someone contradicting you. I'd be more apt to listen to you if you didn't act like a ass in your first reply to me.

Bad faith, indeed. I've been studying self-delusional pinheads since 1987, and I recognize one when I see one.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
I read it (1.33 / 3) (#44)
by luckbeaweirdo on Sat Mar 21, 2009 at 09:01:28 PM EST

"Suppose this does work and it becomes the next national craze to eliminate asthma. Huzzah! At that point, we've exchanged our first-world asthma problems with a third-world infestation and the challenge will then be to keep that to manageable levels in all individuals. Asthma afflicts the unfortunate few, but now we'll have to change society to manage the infection in everyone. "

Hookworm is not an infectious disease in any society that wears shoes or uses toilets. It was endemic in the US South until those things became common. No adaptation required. Are you just frightened, in an OCD way, that you might catch these as a result of what I am doing? If you are you are worrying about nothing.

If you had read my article or the references you would know this. So you are criticizing me, and calling me names, on the basis of ignorance. Or you are a Troll. Or you are stupid. If you have had hookworms, which I doubt, ask yourself if a temporary cough or wheeze would be a price you would be willing to pay to rid yourself of Crohn's, allergies, Relapsing Remitting Multiple Sclerosis or to guarantee that you would never develop Type I Diabetes.

So, life in a wheel chair or a cough for a few days or weeks?

[ Parent ]

actually, no you didn't read my comment (none / 1) (#46)
by Liar on Sun Mar 22, 2009 at 11:38:04 AM EST

You're only talking about the benefit to an individual. You still are. I'm talking about the cost to the society.

You think my usage of toilets and shoes kept me from a hookworm infection in Kenya? I had both. So did those I interacted with. I still was infected.

You underestimate the effects of shoes and toilets. Food service workers with unclean hands can easily infect patrons. We have enough problems with keeping our food supply safe without loosening standards which creates another vector.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
No, you're both wrong and ignorant on this subject (none / 1) (#54)
by luckbeaweirdo on Mon Mar 23, 2009 at 12:24:28 PM EST

There is no significant risk to society. Hookworm cause harm in only narrow circumstances that are very unlikely in the US: malnutrition and high worm burden. Hookworm are almost impossible to catch if one wears shoes or in a place where toilets are commonly used.

You almost certainly use aspirin or ibuprofen I expect. Approximately 7,000 people die annually in the US from NSAIDs like aspirin and ibuprofen, so what level of risk are you talking about? Or does this have more to do with your emotional reaction to the idea of parasites?

You cannot become infected with Necator Americanus via the oral route. It is thought you can with Ancylostoma Duodenale, although if it happens it is rare. A. Duodenale is the other species of hookworm that infects humans, we use Necator.

If you had read widely on hookworm you would know, as the CDC does, that hookworm are not a health risk in places like the US. You don't have to believe me, but how you can argue with the CDC is beyond me.

If you got infected in Kenya you did so by coming into direct skin contact with feces contaminated soil at least nine days after the infected person defecated. It was almost certainly the rainy season when you were infected because the larvae cannot develop in straight feces, too acidic. You almost certainly walked barefoot at some point, or sat or lay on the ground (they can go through thin fabric) and you got a mild rash somewhere.

Managing hookworm infection safely requires nothing more than regular checkups to look for the very remote possibility of anemia. And in a society like the USA or Europe there is effectively zero risk of infection because of this.

Contrast that with Remicade, which as I state is by at least one estimate I have read the most lethal drug on the market if one excludes overdose. Tsyabri has been linked with a 1/1000 risk of multifocal leucoencephalopathy. Meaning 1 in every 1000 people who take the drug experience brain death.

Those are just a very few of the risks of the modern drugs on the market, all of which were put through the evidence-based medical system. If that level of risk is acceptable to the FDA what is the problem that a slow developing and easily treatable condition like anemia has a very remote chance of developing in someone with hookworm?

[ Parent ]

so your great faith in anecdotal evidence... (1.50 / 2) (#57)
by Linux or FreeBSD on Mon Mar 23, 2009 at 12:57:48 PM EST

doesn't extend to the anecdotes of others? you don't believe him when he says he wore shoes and still got hookworm, but we're supposed to believe you?



[ Parent ]
especially because (none / 1) (#59)
by Liar on Mon Mar 23, 2009 at 03:54:57 PM EST

hookworms don't enter via the feet.

No need for anecdotal evidence.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
Oops, my bad (none / 1) (#61)
by Liar on Mon Mar 23, 2009 at 04:44:39 PM EST

Actually, they can. I must have been thinking of some other parasite.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
of course (none / 1) (#65)
by luckbeaweirdo on Mon Mar 23, 2009 at 11:34:41 PM EST

because you have researched so many you just can't keep them straight.

[ Parent ]
Troll or complete dumbass? (none / 1) (#64)
by luckbeaweirdo on Mon Mar 23, 2009 at 11:33:25 PM EST

They enter through the skin you ignorant dipshit. Feet included (clue: feet have skin). I cannot believe that you are so certain in what you say when you don't know even the most basic things about hookworm. Unbelievable.

On the other hand, why do I continue to post replies to someone who is either a troll or so stupid it is unbelievable?

Troll somewhere else, I am done with this thread.

[ Parent ]

he has no idea how he caught it (none / 1) (#66)
by luckbeaweirdo on Tue Mar 24, 2009 at 12:24:19 AM EST

Neither does his doctor, who probably had one class on parasites twenty years ago. And neither do I. But I at least know how they are caught.

Knowing that one can only acquire hookworm through the skin, except possibly in very rare circumstances, I reasoned that he either removed his shoes for at least a brief time or came into other bare skin contact with feces contaminated soil. He just assumes he ate them, which is vanishingly unlikely. The rainy season is when the vast majority of infections occur, we have yet to hear from him about that (don't bother, I have lost interest). The rain makes for ideal conditions for them to develop and it broadcasts contamination over wide areas without any evidence of feces. An infected individual can pass half a million in a single trip to the WC. All invisible to the naked eye. Feces decays away to nothing within 48 hours in central Africa. You get rainwater sheeting across cement, or grass, or mud, carrying millions of invisible hookworm larvae down slope. You don't even need to take your shoes off under those circumstances. Besides, flip flops are the footwear of choice in the tropics.

He doesn't know how he caught it, or when with any precision. He does not even know which species it was. He likely does not know with certainty that it was hookworm, it could easily have been Stronyloides Stercoralis, or other helminths, the embryos of which all look very, very similar. I have seen lab techs with thirty years experience in places like Belize and Nigeria arguing over what species of embryo they were looking at. Do you think some lab tech who sees parasite ova perhaps once a year in the US can distinguish between them with certainty? If it was Necator that guarantees it was skin. Odds are very, very high that he came into bare skin contact with some contaminated soil, or a leaf, or cement. They can, and do, burrow up through (by some accounts) up to three feet of topsoil in order to come into skin contact with people and remain viable. Ingestion is so rare if it does occur, and still argued about, some college texts do not list it as a possible route for infection with the species it is speculated to be possible for, A. Duodenale. That's right, I have more than one text book on the subject.

If he did catch them by ingestion chances are very good that what he had was roundworm or whipworm. All helminths cause very similar symptoms immediately after infection. Because the impact is actually due to the immune response, not directly caused by the organisms.

Just because you catch a disease and speak to a doctor about it once or twice, a doctor who in my experience probably knows NOTHING about parasites, does not make you an expert. He has no knowledge of hookworm, and if what he is saying originated with his doctor, then neither does his doctor. Many more people in America are convinced they have had parasites than have actually had them. Charlatans like Hulda Clark make a living peddling fear of parasites to credulous idiots and spread misinformation about parasites into the bargain.

Finally, my evidence is not just anecdotal. You may have noticed, and were probably confused about, the links at the bottom of my article with the subhead "References" above them? Those are links to the abstracts of scientific papers supporting my assertions. My statements are not just anecdote, they are supported by scientific evidence. I am not arguing on the basis of anecdote alone, although my observations and the experience of those I have helped all support my assertions. I have science. S-C-I-E-N-C-E

I am done here, this is really my last post in reply to ignorance like this. There have been some good critiques here, yours don't number amongst them.

[ Parent ]

'science' (none / 1) (#77)
by Linux or FreeBSD on Sun Mar 29, 2009 at 01:10:51 AM EST

are you sure you know what that word means? there's absolutely nothing scientific about what you've done. and have you even read the articles you're citing? ...or did you not get past the abstracts?

let's see, choosing one randomly... from Summers RW, et al.: "Twenty nine patients with active Crohn's disease, defined by a Crohn's disease activity index (CDAI) > or =220 were enrolled in this open label study.", "We therefore conducted a 24 week clinical trial to evaluate the safety and possible efficacy of live T suis therapy in Crohn's disease."

an open fucking label study indicated this one species is safe for ~6 months and possibly an efficacious treatment for chron's disease. well that's certainly wonderful evidence for your claims. hurr. why don't you just conduct a proper study yourself? people will be much more likely to believe you if you have, you know... actual evidence behind your assertions.



[ Parent ]
I don't use aspirin (none / 1) (#60)
by Liar on Mon Mar 23, 2009 at 04:10:29 PM EST

Never really seemed to help. Since it's unlikely in the most extreme for me to ingest aspirin involuntarily or in an uncontrolled situation, you're still missing the point.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
One last time Mr. Troll (none / 1) (#63)
by luckbeaweirdo on Mon Mar 23, 2009 at 11:29:04 PM EST

You cannot catch hookworm from another person in the industrialized world, unless:

You come into skin contact with feces contaminated soil nine days after defecation when it has averaged 30 Centigrade for the preceding nine days, been humid, and rained.

Maybe going barefoot and defecating outdoors is common where you live?



[ Parent ]
ok, mr. dick (none / 1) (#69)
by Liar on Tue Mar 24, 2009 at 01:20:38 AM EST

Right from the beginning, you assumed bad faith. So I never saw the need to take any of this seriously. And the more you press your point, the less apt anyone will be to treat you seriously.

If you're trying to sell an idea, assuming bad faith and then repeating that bad faith from the start is not good salesmanship.

In short, you're a plague of the worst kind. A true believer who refuses to listen to others.


I admit I'm a Liar. That's why you can trust me.
[ Parent ]
You're full of the shit you ate (2.00 / 3) (#45)
by glowing tits on Sun Mar 22, 2009 at 10:39:59 AM EST

Well, medicine isn't only about results that can also come from a bunch of other phoney treatments, including the traditional placebo.

Medicine is in fact a scientific discipline which tries to understand and describe how things work and where treatments are supposed to undergo rigorous validation.

When you advocate shit as treatment, although you may very well be on to something valuable as supported by the publications you mention, you clearly forego the "science" part. But when you remove science from the equation, all that remains is shit.

I would applaud an effort to detect which signalling molecules and which pathways are involved in helminthic immune-modulation of the host and how we can use them to the advantage of patients. You could really do a PhD on that. Instead you chose to do business.

Best of luck...

[ Parent ]

Potentially life changing (1.33 / 3) (#27)
by luckbeaweirdo on Wed Mar 18, 2009 at 04:19:08 AM EST

I got this today: Jasper -- My five year slide into asthma hell is over. The past two years was a bad spiral into over using the emergency inhaler. It was at times almost constant need for albuterol. This stopped in late summer 2008 (along with the US economy and the stock market! -- J . This was three or so months after my May inoculation of 50 or 60 parasites in Santa Cruz. I picked up using the steroid inhaler QVAR, in late august again, (after failing in it's use a year before.) (I gave up the first time after a few staggered weeks of ineffectual results. It made my need to cough worse at times, so I let go early I guess) The funny thing, is Qvar is supposed to take several weeks to get things under control, but my need for athsma emergency inhaler virtually stopped the next day. I kept using Qvar, thinking, why stop a good thing --? After years of being out of control, you don't want to let go of any kind of relief. I went on using this once in the morning and once at night as a preventative through the first of the year. But I kept wondering - wow that's weird. It stopped the first day. That's just not the way the steroid is supposed to work. So after four months of blessed relief, I thought okay, try things without the qvar. Maybe it was a fluke, a timing coincidence -- ? So I have indeed stopped using Qvar for the past three months. And I no longer need the albuterol either. I pretty much breathe fine. Or at least as good (or bad) as I used to breathe ten years ago. This is within certain limits. I am able to walk briskly for an hour. I can moderately and slowly jog for maybe 10 minutes. I can run fast for a few hundred yards. All without severe windpipe constriction, wheeze or need to gasp. I have however noticed a little bit of tightening if I push these limits. I am not complaining, just noting it. If I try more strenuous exertion, real up and down basketball for example, I feel the smart thing is to take a rest at 5 minutes. I can feel a little hint of barely a tiny wheeze. So I have not tried yet to go past this limit yet. But the difference in my life is night and day. I am walking regularly, and cutting firewood, and playing ball with my son, and feeling like I can make it through the day without medical inhalation. Anyway, this is great news, just amazing, and I want to add one more vote to the circumstantial evidence that the hygiene hypothesis is clearly something that can give a chance to everyone. Not for all cases and all things, but better than a life, and eventual death by advair, and qvar and albuterol, etc. Bless big medicine for having these drugs, but bless you more jasper for stepping out in little wads of doo-doo, time and time again. Yours, <Name removed>

[ Parent ]
Damn, sorry I missed the (1.50 / 2) (#24)
by dakini on Tue Mar 17, 2009 at 10:30:33 PM EST

voting, but I certainly wanted to vote +FP for this article. As I stated earlier, this is very informative.

" May your vision be clear, your heart strong, and may you always follow your dreams."
double-blind study or stfu $ (2.25 / 4) (#28)
by th0m on Wed Mar 18, 2009 at 06:50:06 AM EST



fuck me (1.50 / 2) (#32)
by the77x42 on Wed Mar 18, 2009 at 05:00:47 PM EST

I wasted all that time typing something that could be said much easier with an acronym.


"We're not here to educate. We're here to point and laugh." - creature
"You have some pretty stupid ideas." - indubitable ‮

[ Parent ]
Just worked stfu out (1.33 / 3) (#43)
by luckbeaweirdo on Sat Mar 21, 2009 at 08:51:00 PM EST

No one should say or do anything unless they have run a double blind study? If this were a drug that had never been used and we knew nothing about its safety I would agree with you. But the lowest estimate for the number of people hosting hookworm is very well known, 740 million people. It has been studied for over a century and is regarded by people who know (scientists) as benign. It is repeatedly referred to as such in the papers referenced. As I say in the article, the only risk to trying this is financial. So a double blind study is not required.

[ Parent ]
i apologise for evidence-based medicine (2.00 / 3) (#48)
by th0m on Mon Mar 23, 2009 at 05:05:07 AM EST

and how much inconvenience it must cause you

double blind studies are nothing at all to do with safety and everything to do with discovering whether a treatment is effective

here is how we play it: you can have as many ideas as you like, and justify them to yourself with as many references and statistics as you can find, but until those ideas have actually been demonstrated to be true they will not be taken seriously by anybody

sorry about science

[ Parent ]

Proven safe, you mean like with VIOXX or PhenPhen? (1.33 / 3) (#53)
by luckbeaweirdo on Mon Mar 23, 2009 at 12:04:17 PM EST

But I guess I better contact all those people who have gotten better since purchasing hookworm from me and let them know that their MS, Crohn's, allergies, asthma and Sjogren's syndrome is not actually in remission as they think because a scientist hasn't validated their observations yet. That despite the facts about hookworm safety, derived from over a century of research, and the opinion of the CDC that light infections are not worth treating, and that they have been hosting hookworm for over a year without ill effect, that they are in mortal danger?

Who knew evidence and observation was neither until validated in a study conducted by a scientist?

Are you this demanding of evidence and as acquiescent to authority with respect to your own health? Would you really be willing to wait 10-20 years for someone to fully research a harmless alternative that could keep you out of a wheel chair if you had MS?

Somehow I doubt it.



[ Parent ]
you're a tool. (2.00 / 3) (#56)
by Linux or FreeBSD on Mon Mar 23, 2009 at 12:51:04 PM EST

yes, anecdotal evidence is evidence. but it's incredibly poor evidence. maybe those people's diseases really are in remission... but is it because of the hookworms, or because of the placebo effect? you have NO WAY of answering that question. the fact that you're so strenuously objecting to the idea of legitimate studies really hurts your credibility.

and yes, i would indeed wait for double blind, peer reviewed studies by scientists who actually know how to do this shit. you have zero evidence that hookworms are any more effective than a sugar pill. and you have no evidence that hookworms are safe. so the risk/benefit ratio is not in favor of infecting oneself with hookworms, that's for fucking sure.

and here's a clue: "not worth treating" does not equal "safe," idiot.



[ Parent ]
very eloquent (none / 1) (#62)
by luckbeaweirdo on Mon Mar 23, 2009 at 11:25:04 PM EST

Your intellectual rigor and command of English has laid waste to my illusions and revealed my research and reading these five years to be a delusional mirage.

I will write to the authors of all my parasitology texts, to the authors of the referenced science and of the over 100 papers I have on my hard drive, to inform them that a gentleman named Linux or FreeBSD has shattered their life's work with his incisive, perceptive and utterly irresistible logic, incomparably eloquently expressed, to boot. They are all wrong, hookworm in small numbers are not safe. A man enamored of open-source operating systems has changed the history of parasitology.

I kneel before your coruscating intellect.

Please refer me to the texts, the sources of your wisdom on this subject so that I may toil, without any real hope of course, to match your level of erudition.

Read the science

Having been here before with my last article I know reasoning with some as certain in their ignorance as you are is pointless.



[ Parent ]
i missed the part of this reply (2.00 / 3) (#70)
by th0m on Tue Mar 24, 2009 at 03:16:25 AM EST

where you explained how your anecdotal evidence of efficacy is not simply the result of confirmation bias or the placebo effect

i mean you must be supremely confident in the quality of your data otherwise a serious scientist like you would know you were just wasting everyone's time

[ Parent ]

It's not just my observations (none / 1) (#74)
by luckbeaweirdo on Tue Mar 24, 2009 at 06:11:06 PM EST

the science supports it.

For that many people to have experienced the placebo effect so strongly for so isn't possible.

Here is a post by someone with Sjogren's Syndrome, he posted it to a Yahoo group yesterday: link. Are you willing to call his experiences over the course of 18 months with this an illusion? If you are you can discuss it with him. He left his phone number and email address in the post.

You might be right, in a few months or years maybe everyone I have helped will wake up and tell me I was wrong.

But so long as people keep getting better I have to keep doing this.

The results are so striking I believe the effect is real and will continue.

[ Parent ]

god. let me make it real simple: (2.00 / 3) (#72)
by Linux or FreeBSD on Tue Mar 24, 2009 at 08:03:44 AM EST

it's not about all that shit. it's about you having absolutely no evidence that hookworms are superior to placebo.

[ Parent ]
Wait a sec (none / 0) (#51)
by Sgt York on Mon Mar 23, 2009 at 10:27:34 AM EST

First, yes, a double blind should be done. Always. Period. My lab had to do it a few years back when they proposed the use of hypertonic saline in the treatment of CF. Hypertonic saline is really salty water. Inhaled sterile salt water. And it had a double blind trial before use.

Second, hookworm is not benign. Check the CDC factsheet. Some choice bits:

Can a hookworm infection cause any serious health problems?

Yes. The most serious results of hookworm infection are the development of anemia and protein deficiency caused by blood loss. When children are continuously infected by many worms, the loss of iron and protein can retard growth and mental development, sometimes irreversibly. Hookworm infection can also cause tiredness, and difficulty breathing with exertion. Severe disease can cause congestive heart failure.

...

What are the symptoms of hookworm?

Itching and a rash at the site of where skin touched soil and is usually the first sign of infection. These symptoms occur when the larvae penetrate the skin. While a light infection may cause no symptoms, heavy infection can cause anemia, abdominal pain, diarrhea, loss of appetite, and weight loss. Heavy, chronic infections can cause stunted growth and mental development.

A light infection may cause no symptoms, but how do you ensure that everyone has a light infection? The hookworms will try to make it a heavy infection in every case. And even if you do control it to a light infection in every case, that's still just a "may." And a light infection is still contagious.

The argument above is a public health argument, not an efficacy or toxicity argument. If a significant number of people (asthma affects 16.1M people in the US, about 5%) have this as an active untreated infection as you propose, it will spread rapidly and significantly beyond that population. Even if we grant that the treatment is 100% effective in the people treated, those people now infect a large number of otherwise healthy people. You have traded one public health problem (asthma, MS, etc) for another (hookworm infection).

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

Complete rubbish (none / 1) (#52)
by luckbeaweirdo on Mon Mar 23, 2009 at 11:53:02 AM EST

First, anemia is the only potential harm from hookworm, and it kills an estimated 67,000 people a year. But. But, an adult hookworm draws 0.01ml/day of blood so anemia only occurs in individuals who have either enormous numbers of worms or who are malnourished. Hookworm can not auto infect, nor are they infectious to any degree in places like the US or Western Europe. So if I gave you 35 hookworm, 35 is all you would ever have. Since you cannot therefore end up with a large worm burden (hundreds) and are not malnourished your risk of anemia, as for all Westerners, from treatment with hookworm, is ZERO. If it were not there is NO WAY the CDC would recommend doctors not treat light infections with hookworm in their American patients. There is no public health argument until Americans stop wearing shoes, stop using toilets and only then if they live in the American South East where conditions allow the larvae to develop from embryos. But lets say some one does manage to get an infection with 300-400 hookworm, or roughly ten times what is required therapeutically. They may develop anemia if they do not use an iron supplement, but they will do so very slowly. Over months. Since a hookworm infection can be terminated with a single dose of Albendazole completely (price $5), and a slow developing condition like anemia is easy to treat and respond to, what exactly is the risk?

[ Parent ]
Forgive me (1.50 / 2) (#58)
by Sgt York on Mon Mar 23, 2009 at 01:14:25 PM EST

if I take the word of the CDC over yours. They call it a parasite and a health risk, and I agree with them.

Most of your argument hinges on the low incidence of hookworm in the US. However, you are proposing to infect more that 5% of the population, so that argument doesn't work anymore.

Furthermore, the greatest at-risk group with hookworm infection (due to behavior) and morbidity (due to physiology) is children. The highest incidence of asthma is in children. This is a dangerous mix.

When you say "there is NO WAY the CDC would recommend doctors not treat light infections with hookworm in their American patients" you imply that the CDC does recommend that. Are you saying they do? If so, where did you get that?

Treating your asthma with hookworm may be beneficial....for you. Treating a few hundred or a few thousand people scattered around the US may be beneficial....for that few hundred or few thousand people. Treating 16M people across the US may also be good for the people treated, but the scale introduces a new health risk to the population at large. You now have a 5% incidence of hookworm in the population. This will result in other infections. Without universal precautions, the statistics get so high that it's as near a certainty as you can get.

But oh yeah, just among southerners, so that's OK.

"No public health argument"? That kind of simplicity of thought is what is so frightening about your whole analysis. This is a valid avenue of scientific pursuit, but your treatment is so ham-handed and over the top that it truly is dangerous. You are killing a fly with a shotgun. Potentially effective way to get rid of the fly, but not a good idea if the fly is sitting on your kitchen table.

I'm not too concerned about people adopting this. It will likely be met with such resistance you'll never get enough people doing it to make the public health consequences real. However, this kind of behavior hurts legitimate scientists in the field through the association, and that setback is the true casualty here.

Well, at least you feel better.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

CDC and context (1.33 / 3) (#67)
by luckbeaweirdo on Tue Mar 24, 2009 at 12:44:39 AM EST

Hookworm kills an estimated 67,000 people a year, mostly children. Of course it is a health risk and the CDC rightly describe it as such. But it is a matter of context and degree.

In environments where people are malnourished and cannot afford medical care, if there is any available at all, hookworm can kill or cause brain damage in those will large worm burdens and/or malnutrition. Particularly where night soil is used as a fertilizer.

For the poor of the third world it is a scourge, and a disgrace to the rich world. For the lack of a pill costing a dollar or less children die or suffer brain damage from anoxia.

But none of that prevails here, and anemia when it happens (which it won't) is a slow developing condition that is easily treated, either with iron supplementation or infusions, or by elimination. One pill and the worms are all gone the next day.

So no one in America is going to be harmed by hookworm.

With respect to your point about the infection risk to Americans if you read about the hookworm lifecycle you will surely see that no such risk exists.

Skin contact with feces contaminated soil depends on feces being on the ground, itself very rare in the US. And upon bare skin contact with feces contaminate soil. Most Americans are not habitually barefoot, particularly on those rare occasions when they find themselves in an area of open-air latrines.

Does that mean accidental infection is impossible? Of course not. But, again, light infections do not, according to the CDC and my reading of numerous parasitology texts and papers on the subject, represent a health risk.

Your fear stems from your perspective, which is misinformed.

The grateful emails suggest my approach is not ham-handed or over the top. None of my clients has terminated therapy except sometimes when it does not work. I have harmed none, and I have helped many whom modern medicine could not.

But don't worry, you are right in one respect. The world is not beating a path to my door. Yet. When I have helped enough people with MS to go into remission, or Crohn's, or allergies, or asthma, I think I am going to experience a certain popularity.

I do feel a lot better. No prednisone required anymore, no awful allergies or asthma. You must not suffer from any of these diseases, and no, that is no reason to do anything crazy.

But if you read the full text of some of the papers I have you would see that it is not crazy.

If you want to read any of it you know how to find me, I have over a hundred. About 15 are review papers, which are nicely written, and more accessible than studies. I would be happy to send them to you.

[ Parent ]

why do you believe (none / 1) (#71)
by th0m on Tue Mar 24, 2009 at 03:19:40 AM EST

that the primary consideration in deciding whether to apply a proposed therapy is whether or not that treatment is harmless?

i mean this has obviously got into your head at some point and you're refusing to let go of it to the extent that you're deaf to all other (more significant) concerns like whether the treatment actually works

[ Parent ]

what I believe (1.33 / 3) (#76)
by luckbeaweirdo on Tue Mar 24, 2009 at 06:25:06 PM EST

Is that safety is the primary consideration in evaluating any therapy. Do no harm is a primary requirement of the Hippocratic oath. I would not have done this if I thought I could have harmed anyone. I don't and I haven't.

I believe that it is effective

I believe that it is cheaper than alternatives

I believe that it is safe.

You believe something else, and we are not going to agree, so lets call it a day.

[ Parent ]

Both human hookworm (1.50 / 2) (#73)
by Sgt York on Tue Mar 24, 2009 at 09:38:02 AM EST

species are at least mildly zoonotic. They infect both dogs and cats (probably other species, too). The viability can be somewhat decreased, but it is by no means eliminated. The larvae can develop in the soil for about half the year in most of the US; the optimal temp range is 20-30C. Assuming this is not a health risk because of the theory and should-be's of current pathology and epidemiology is narrow-minded and short-sighted. You are talking about the introduction of a species. When was the last time that worked out well? Has it ever? I thought we learned that lesson already.

The cliche line from Jurassic Park, "Life finds a way" is actually an old saying in bio labs. And the fact that it's a cliche doesn't make it any less true. Living things do strange, unexpected things that in retrospect you should have expected. If there is a chance, any chance, they can do something at some point, they will undergo selection and that chance will expand as long as the selection is kept up. They will just get better and better at it as time goes by; that's how selection works. And we're not talking speciation type selection, just strains. Amplification and selection of extant diversity. Under moderate selection, we're talking tens of generations, not thousands.

As more humans infected with hookworm come in contact with dogs and cats, the more commonality will be selected for. This is not a wild guess, this is simple Darwinism. It will happen unless you actively and constantly prevent it. Even then, it will only happen more slowly. No one is a vigilant as an organism trying to survive or expand its niche.

And I've read just about the whole body on the clean baby set; not just the hookworm data. I did my thesis on the Dutch Hypothesis. I know asthma, atopy, and COPD inside and out. I've actively worked in this field, at the bench, as my career since 1997. I'm not exactly the world's leading expert, and my focus has moved more to the COPD side of things, but I'd wager I'm at least as familiar with the literature as you. In fact, you may have a few of my papers in your library (they are a bit mechanistic, though, and may not be what you're looking for).

You really need to expand your research to include things beyond something as brute force as a helminth infection. There are much, much better options. For example, the helminth antigen concept is quite sound. We just have to get it right.

Our advantage is finesse. Use it.

There is a reason for everything. Sometimes, that reason just sucks.
[ Parent ]

I accept (none / 1) (#75)
by luckbeaweirdo on Tue Mar 24, 2009 at 06:22:03 PM EST

I would like to read your papers, I enjoy ones on mechanism, and so does my partner.

jasper at autoimmune therapies D o-t comma.

I think your fears of unintended consequences to the reintroduction of hookworm are unfounded. They used to be endemic in the southeast US. But that was before footwear was common, sewers existed and anti helminthics were available.

Finesse would be nice and injections with ground up helminth do appear to provide some benefit. But, I think your reservations about this approach are unfounded, that the benefits far out weigh the risk and that the risks are identifiable and easily manageable.

Finally, if I succeed in popularizing it I will not be involved any longer in pushing it forward. It will be taken over by people whose methods you will be more comfortable with. It needs a GSK to come in with scale to succeed. But I think that is a very long time away given that this is not in the interests of those companies in a position to pursue this.

I am doing what I can to push this forward so that sick people have access to an option that works, now.

I have enjoyed our exchanges, but I think our differences come down to a difference of opinion about the risks. We are looking at the same information and drawing different conclusions, that isn't going to change.

I admit my attitude is colored by my experience getting better, and particularly by my experience with modern medicine failing me. I feel strongly that to be trapped in a failing body is amongst the worst experiences one can have and that an option like this should be available. Because I believe it is safe and no risk to the general population.

Please send me some science and I will send you some in exchange.

Pleased to meet you.

[ Parent ]

HOLY SHIT IT'S A RAPTOR (none / 1) (#78)
by Empedocles on Wed Apr 01, 2009 at 07:54:51 PM EST



---
And I think it's gonna be a long long time
'Till touch down brings me 'round again to find
I'm not the man they think I am at home

[ Parent ]
Don't we have American shit that can do the job... (3.00 / 3) (#30)
by anaesthetica on Wed Mar 18, 2009 at 12:31:46 PM EST

...anymore? Why are we outsourcing our hookworm shit production to third world countries when Mexican-Americans can't find an honest days work here at home? I bet domestic hookworm shit would be twice as good as that foreign hookworm shit made in sweatshop conditions by preteen girls without labor standards or environmental regulations.

—I'm the little engine that didn't.
k5: our trolls go to eleven
[A]S FAR AS A PERSON'S ACTIONS ARE CONCERNED, IT IS NOT TRUE THAT NOTHING BUT GOOD COMES FROM GOOD AND NOTHING BUT EVIL COMES FROM EVIL, BUT RATHER QUITE FREQUENTLY THE OPPOSITE IS THE CASE. ANYONE WHO DOES NOT REALIZE THIS IS IN FACT A MERE CHILD IN POLITICAL MATTERS. max weber, politics as a vocation


100% American (none / 1) (#41)
by luckbeaweirdo on Fri Mar 20, 2009 at 08:49:15 PM EST

and proud of it. Of course, as soon as the Asians enter the market I will be in Washington looking for handouts, so it isn't all great.

[ Parent ]
This was great, and two comments (none / 1) (#35)
by JackStraw on Thu Mar 19, 2009 at 09:56:53 PM EST

Editorial comment: I think you should have started this out (a) admitting that this is bizarre stuff, and then (b) very very succinctly summarizing your best statistics and sources in one reasonable-length paragraph, and then saying "continue below to learn more". Imagine how potent that first paragraph would be if you combined every bit of personal experience and experimental evidence you could find, into one paragraph... that might have convinced me to read more carefully. You're asking a lot of a reader to read this whole goddamned thing to figure out if it should be taken seriously...

Question: You seem to care a lot about microorganisms in our digestive tract, so I ask you this question which has plagued me for a long time: Why the Hell can we not (as humans) digest cellulose without housing bacteria in our digestive tract? Or, for that matter, any other mammal? Or insect? It's the most abundant source of consummable food on earth, and I can't think of any evolutionary trait which would be more strongly selected.

I've found a couple of hypothesis (and don't want to inhibit answers by talking about them), but nothing too convincing... would love to hear anybody's opinions.
-The bus came by, I got on... that's when it all began.

I have no idea, but... (1.50 / 2) (#38)
by luckbeaweirdo on Fri Mar 20, 2009 at 08:32:11 PM EST

... if we do rely on microbes to digest it then we don't need to evolve the capability ourselves. There is no selection pressure in favor of that characteristic if the bacteria are universal and providing the service.

[ Parent ]
It's too late, (none / 1) (#47)
by carnival of animals on Mon Mar 23, 2009 at 05:03:15 AM EST

but I agree with the editorial comment. I read the whole article anyway though, because it was interesting and persuasive, and I think I remember reading about your trip to Cameroon.

[ Parent ]
Good idea but too late for here (none / 1) (#55)
by luckbeaweirdo on Mon Mar 23, 2009 at 12:29:58 PM EST

that is a good idea and I may rewrite this using that approach. If I did I could publish it elsewhere. Thanks for the tip.

[ Parent ]
it's obvious (none / 1) (#36)
by bride of spidy on Fri Mar 20, 2009 at 06:49:30 AM EST

he didn't want the documentary taping his lavish house that he built selling shit from africa.


I wish... (none / 1) (#37)
by luckbeaweirdo on Fri Mar 20, 2009 at 08:29:31 PM EST

I drive a 1971 F100 when its running that looks like a truck owned by someone running a meth lab. Classic its not.

[ Parent ]
The advice below is too (none / 1) (#39)
by luckbeaweirdo on Fri Mar 20, 2009 at 08:32:51 PM EST

rub it on your cock, not to eat it.

Say what? (none / 1) (#79)
by Kaifan on Tue Apr 21, 2009 at 03:21:25 PM EST

Before we all go skipping through dogshit barefoot, are you suggesting a long-term (if not continuous) parasitic infection to suppress degenerative disease? This is a new one.
Sex Toys
Essentially... (none / 1) (#82)
by luckbeaweirdo on Thu Apr 30, 2009 at 01:41:38 AM EST

yes. See the hygiene hypothesis, helminthic therapy, hookworm, whipworm for search terms. Mate those terms with your disease name and prepare to be amazed. If it involves chronic inflammation or immune dysregulation/autoimmunity you have a good shot of getting a result with the right organism. But the potential is broad, for instance infection with almost any helminth will likely prevent the development of type I diabetes in any at risk individual.

[ Parent ]
For the therapeutic use of benign infectious organisms in the treatment of immunological disease | 82 comments (78 topical, 4 editorial, 0 hidden)
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