Is Crohn's disease on the rise because we've eliminated hookworm infections?

Crohn's disease is a painful immune disorder that causes people's intestines to swell. Some researchers say that the intestines of Crohn sufferers reject the bacteria normally needed for proper functioning. The prescribed treatments have horrible side effects, including cancer and brain infections.

Some people with Crohn's are electing to be infected with parasitic hookworms instead.

In order to live as a parasite inside the human, the parasite must convince the host's immune system to chill and not try to reject it. With hookworms, they secrete a chemical that distracts the immune system, dampening down its response. Hookworms are common in undeveloped countries, places where inflammatory bowel disease is rare.

In the United States, thanks to advances in modern sanitation techniques, hookworms are rare but immune disorders on the rise.

Is there a connection? There could be. "As we have made things more hygienic," Dr. Terdiman explained, "we may in fact be precipitating an outbreak or an increase in the frequency of these immune disorders."

Worm Therapy is a company that uses hookworms and tapeworms to modulate the immune system. A single dose of hookworms costs $2,399 and tapeworms (used for weight loss, asthma and allergy) cost $1,299.

Patients On Hookworm Therapy Swear By Treatment (Via Seth's Blog)


  1. $2300? Jee$u$, you could spend that much spending a month in any underdeveloped country and get hookworm for *free* while you’re having a nice vacation to boot. “Parasite Rex” by Carl Zimmer has a some fabulous parasite tales, including some stuff on Crohn’s and Colitis. Glad to see this treatment getting some press. Go microbial life forms!

  2. I have a very close friend with Chron’s. In February she had to have her entire large intestine removed, along with ten inches of small intestine. This means she now has a colostomy bag.

    We have been reading about this hookworm therapy for years. I tried to find someone that might work with her on it, and had some resources as a nurse, but turned up nothing. She barely had insurance as it was. Funny enough, the remicade infusions cost her $6K every month, and the insurance would pay for that. That’s just for the meds, not the infusion services, too.

    1. This means she now has a colostomy bag.

      Most people who have a colectomy can have an ileoanal anastomosis, so they don’t need a bag.

      he went to cameroon and wandered around barefoot for a while

      And as a special bonus, you could throw out all your furniture and sleep atop your own scrotum if you get elephantiasis.

  3. this is a very interesting article from a few years ago about someone infecting themselves with hookwork to treat asthma

    he went to cameroon and wandered around barefoot for a while.

    also, the causation (not correlation) implied in the title is unlikely since we pretty much eliminated hookworm a generation ago so it should not still be rising.

    doesn’t mean hookworm might not ‘treat’ the condition.

    1. why don’t hookworm users start a sharing society
      promising to help another person once they have
      received help,perhaps only sending eggs by post
      if hay don feel competent to manufacture the
      rest.perhaps a nominal fee of $100 for expenses
      thus bypassing extortionate prices quoted so far
      perhaps create a how to line,

      come on people don’t be dictated to by money grabbers

  4. Another open secret in medicine. If you’re going to do this, get a medical professional to guide you if at all possible. There is another company offering worms (helminths) called Ovamed.

    Another odd and distasteful but potentially effective treatment along these lines is “HPI”, or Human Probiotic Infusions. Wikipedia has a decent summary of it. For people with critical C.Difficile infection, it has saved lives.

  5. Scientific studies please.

    For a site that has made many posts support James Randi in the past, it’s very surprising to see such a non-skeptical post on BoingBoing. You should know better than the promote snake oil.

  6. $2400 is nothing in terms of Crohn’s. I have Crohn’s Disease and routinely get a chemo-style infusion of Remicade (a mouse-protein based immuno-modulator). It’s about $5000 each dose* and has some pretty “neat” side effects. Lately I got mouse serum sickness from it. Not especially recommended. On the plus side, I can eat solid food and I still have most of my large intestine. I’d totally try hookworms. Sign me up.

    * The $5000 includes the drug, which is somewhere in the neighborhood of $3000 or $3500 as well as a 4-hour stay in the cancer ward, which adds up.

  7. $1300 for a tapeworm? Heck, I’d much rather spend that money on sushi. In fact, I bet I’d get a tapeworm from eating sushi well before I’d spent $1300 on it. So I would actually save money. I can’t afford _not_ to start right now.

  8. read the warnings on that hookworm site.

    i’ll take asthma over:

    “Chronic infection can lead to iron deficiency anemia and hypoproteinemia, causing pallor, dyspnea, weakness, tachycardia, lassitude and peripheral edema. In very heavy infection chronic blood loss may lead to severe anemia, growth retardation, heart failure and anasarca.”

  9. I’m with the doctor on this one. There needs to be more studies done. Figure out how to get around the whole FDA thing, who really are holding back on good studies likely to the benefit of big pharma.

    If it works as well as what the article says, they should go for it. Almost overnight relief? The drugs, with SERIOUS side effects take longer to work…if they work. A good portion of drugs are synthesized from natural things anyways…so why not use the natural things?

    Tiny story. I just quit smoking. I have no cravings. None. I took a look at all the ingredients in various medications, found some commonalities, researched those, and made a tea from them. I quit smoking for about 7 bucks.

    1. I have had chrohn’s for many years. recently I’ve been on Cimzia which is worse than anything else I’ve tried. many years ago I did have a bowel resection, no bag, and every few yeras the flareups are beastly. iwas on Remacaid but have not veins lefts to support treatment.
      Anyway, can you give me more info on your stop smoking concoction I’d like to give ita try. I’m sure it does nothing to help Chrohns. Thanks, with appreciation.

  10. I believe it’s the same guy who went to Cameroon who is now selling the hookworms. There’s an American company in California (, run by Jasper Lawrence) who offers the same modality. The Mexican clinic until recently was charging $3900 for hookworms- same as Autoimmune Therapies- I suspect it’s the same people behind both things, and the Mexican clinic just lowered their price.

    As for evidence it works:

    Under the “Evidence” sidebar, they have stuff from the refereed literature as to the efficacy of parasites for other autoimmune diseases as well.

    The whole problem with wallowing in filth in some 3rd world country (or Alabama) to get hookworms is that the dose cannot be adjusted; you might get none, you might get a thousand. Millions of people worldwide are colonized with these parasites, many of whom suffer not at all. But each one consumes about 30 microliters of blood per day; for an infant or a child with large numbers, that’s a very bad thing, and will lead to anemia, growth retardation, and other ill effects. Getting a piece of gauze on your skin with ~25 animals means you won’t get too many or too few. That they are from a host that is (presumably) screened for infectious diseases, and that the eggs are (presumably) washed in solutions to reduce the chances of infection with other maladies (and I’m not certain hookworms are vectors for infectious disease anyway) would add to the cost.

    Really- $2-4,000 is about the cost of one or two colonoscopies, or less (as one has already pointed out) than one injection of Humira or Remicade- both “black box” drugs rife with warnings as to their side effects. Hookworms have their own side effects (in large numbers), but in a controlled dose, the worst effect is a slightly oogie feeling of having worms inside of you- which is nothing in comparison to the devastating side-effects of having Crohn’s, ulcerative colitis, multiple sclerosis, etc.

    I have Crohn’s; I control it through careful dietary adjustment (eliminating dietary sources of amylopectin starch, which is what feeds the organism that causes this disease according to the Ebringer theory of Crohn’s and ankylosing spondylitis). I need no medications, but I must watch every bite of food that I consume. I’d try hookworms if I could afford it.

  11. I’ve said it before: “embrace the filth.”

    Wait a minute. . . is this a joke? Doctor’s name is “Terdiman!”

  12. I read of a study — serious one — on pig worms in Crohn’s patients. They used pig worms because they had a three month survival time in human tracts.

    If I remember correctly, Crohn’s symptoms vanished in most subjects, reduced in others. It all returned after the three months.

    As a person with mild Chrohn’s (that did put me in the hospital once due to massive horrible nasty internal bleeding), I just remembered thinking (as I am now), I’d try that if I got worse.

  13. As many others have said, I’d like to see links to actual studies like what Bat Guano describes before I spread the news on this, though it does sound promising.

    Maybe someone should ask the team to do an article on this.

  14. Is there a good animal model of Chrohn’s disease? That is, can we give it to mice at will? This seems like a plausible treatment modality and deserves research.

  15. 7 bucks? I quit by ceasing to spend huge amounts of money!

    Anyways, yeah, human/commensal organism balances are only just starting to be understood, ironically enough at a time when the richest societies are at a peak of antiseptic hysteria. I’m prepared to believe there is something to this just on the scant evidence so far. Studies ought to be being conducted in countries where big pharma disdains the market as too poor to fleece (and too closely watched to use as disposable test subjects).

    So many disease seems to have over-consumption lifestyles roots, maybe a little of the poverty blooming now in our incipient global economic depression might cure a few. Probably bring back a few other diseases too though, not everything we learnt was silly.

  16. @6, THIS. Yeah, it sounds all alternative medicine and all but when it comes down to it, this reeks of pseudoscience to me.

  17. “So many disease seems to have over-consumption lifestyles roots, maybe a little of the poverty blooming now in our incipient global economic depression might cure a few. Probably bring back a few other diseases too though, not everything we learnt was silly.”

    Not that there’s nothing to the idea that we’re too antiseptic, but that last statement is kind of a huge understatement. I don’t think many people realize just what life was actually like before sanitation, hygeine, etc. were taken seriously. We should probably tone it down on the antibacterial soap, but all that back to nature talk is very misguided.

  18. a challenge: what decade represents the pinnacle in the West of quality of public health? When we were the healthiest? When did modern medicine bestow the most general benefit and when were we not so under-exercised and over-fed that quality of life was there?

    I lean to the fifties perhaps sixties, long before endemic Hep and HIV, smallpox in retreat and most other common serious illnesses under at least some kind of control.

    Go on, think it through, what would you trade for what? Dig through the romanticized memory and weigh horror against benefit.

  19. We always walk around barefoot in the garden, and we pull weeds and tickle roots and all the rest sans gloves. I’ve been counting on the good innoculating benefits of playing in the dirt, and so far we are healthy.

  20. Trimeta> A number of individuals have noted that Johne’s disease in ruminants (mainly dairy cattle, although other non-ruminants such as pigs and chickens have been infected experimentally) is strikingly similar to Crohn’s disease. We know for certain (dead-nuts, absolutely certain- proven with Koch’s postulates and everything) that Johne’s disease is caused by a mycobacterium (Mycobacterium avium ssp. paratuberculosis, or MAP). MAP has been found in humans with Crohn’s, but not *all* individuals with Crohn’s. Moreover, MAP is found in about 15% of people with no sign of gastrointestinal disease, and maybe 1/3 to 2/3 of people with Crohn’s, depending upon the study you read (there are many). There is scant proof that MAP causes Crohn’s, although some mycobacterium-specific antibiotic therapies have shown some efficacy. (These abx may be working on other bacteria that cause the disease, as I mention below.) Unfortunately, these abx are very hard on the body, and must be consumed for at least two years; the disease frequently returns once therapy is discontinued.

    Moreover, the immunosuppressant drugs used to treat Crohn’s (steroids, TNF inhibitors, azathioprine, etc.) should- in theory- cause MAP to proliferate and go nuts, killing the host. Instead, Johne’s disease eventually kills its host (there is no treatment other than a bolt gun to the head), while Crohn’s disease only kills quite rarely- even with the immunosuppression therapies that are used all the time. Ironically, a related mycobacterium (the one that causes tuberculosis) is an absolute contraindication for any sort of steroid, TNF, or other immunosuppression therapy for Crohn’s.

    So- if Johne’s is the same as Crohn’s, then it’s a lot more cryptic than anyone thinks- and for a disease whose etiology has eluded researchers for over 70 years, that’s pretty remarkable.

    Now, boxers (the dog breed, not the profession) get a disease that is strikingly similar to Crohn’s. They also get spondylosis deformans, a disease that is similar to ankylosing spondylitis- a malady that is related to Crohn’s (the separating factor being human lymphocyte antigen B-27, or HLA B27).

    It seems likely that Crohn’s, ulcerative colitis, and ankylosing spondylitis are “reactive” diseases, in which the immune system forms antibodies to a common bacterium. This is not new; we know rheumatic fever (causing autoimmune disease of the great vessels of the heart, the joints, and the brain) is caused when the body reacts to proteins produced by group B strep. We know that Reiter’s disease (reactive arthritis) leads to autoimmune attack of the knees, the eyes, and the urethra (“can’t see, can’t pee, can’t bend the knee) after apparently unrelated infection by bacteria. Crohn’s is probably the result of antibodies to enzymes produced by bacteria (mainly pullulanase), which are morphologically similar to the body’s own collagen. This goes back to larger issues in the human lymphocyte antigens, which in turn relate to the major histocompatibility complex.

    So- the disease is partly genetic (as above), partly environmental (overconsumption of foods that are broken down by bacteria that produce pullulanase to digest them), and partly bacterial.

    In the meantime, hookworms come along, screw with the T1/T2, and by making the gut a place they can live without being killed by the immune system, cause the immune system to turn a blind eye to these other problems. It’s hardly pseudoscience, and is backed up by peer-reviewed literature.

    1. This is the best summary of the disease and current treatments that I’ve found anywhere. Thank you for taking the time to post.

  21. Tak…that 7 bucks allows me to save all the other money from smoking (or quitting medications). It’s a VERY small investment with a VERY BIG return.

    Personlly, I’m trying to move further and further away from pharmacuticals. Obviously taking them when NEEDED, but not when unneeded. Medication is way over perscribed and miss-prescribed as well. Don’t get me wrong, some of it is needed, but not all.

    Tak, I think your right about the 50’s and 60’s. Anti-biotics were starting to develop more, and it took what…30 years before we got anything that was immune to it (MRSA, VRSA, etc…)

    A test that could ‘easily’ be done is to give the hookworm something (someone) to feed on, and see EXACTLY what is released from the worm, and the body. Develop a medication out of that.

  22. Well, it’s not like I have rusty nails and broken chicken wire lying around. Dirt, grass, stepping stones, rocks… how are you going to get tetanus from those things?

    When we dog/chicken sit, at the bro-in-law’s house, we wear boots. They actually have all sorts of broken metal and mansonry sprawled out over there and its a bit hazardous. Some places you really do have to be careful. But with even a minimal amount of attention, you can create a safe place for your kids to explore their world…

  23. a side-bar on the Ick! factor and health: More than few would reject the idea on any potential benefit from parasite infection, especially worms, because of the Ick! Factor, ie: they are emotionally disgusting. Understandable, but one must not outright dismiss things just for that. I suppose it is seared into primate race-memory that any wriggly shape is a monkey-eating snake so it is hard to dismiss. Consider though, that one of the oldest symbols of healing is the cadesus: the serpent entwined staff of the physician. A symbol some argue derives from one of the earliest medical acts of lifesaving intervention: the slow twisting out of the Guinea Worm from a lesion without the deadly consequence of it breaking off inside. Ick!

    The Ick! Factor causes trouble in other ways. You may have heard of the super-bug, Clostridium difficile. It kills the elderly and infants and seriously inconveniences healthy adults with run-away diarrhoea. Hard to get rid of once established in healthcare settings and unromantic for funding (yes, romance is important, just ask any Noro-virus people). Apparently there is a therapy that can give good results: fecal transplant. Ick! again. Many how have suffered or had a family member suffering have not been told about it. (Any professional leeches and such like feel free to jump in here). As I understand it, the prepare a feces enema to replace the intestinal flora of the victim. Ick! It sound positively medieval but supposedly it works – or can work.

    But ah well, primate wisdom again, better to let people literally shit themselves to death than deal with Ick!

  24. “ileoanal anastomosis, so they don’t need a bag.”

    please tell me there is a standard John Belushi joke they tell in private.

  25. Sorry, but “spontaneous emergence of proglottids from the anal sphincter” means I’ll not be adding any worms to my digestive tract ON PURPOSE, thanks.

    I also agree that more study is warranted. It seems to me that there are really valid reasons for people to not have parasites.

    What about probiotics specifically for Crohn’s patients? I know that such products exist…and don’t involve hookworms. Does it work for Crohn’s?

    (I know first-hand that probiotics can make a major change for people w/o Crohn’s.)

  26. For those seeking scientific studies on the matter:

    For those thinking infection with tapeworms, or any sort of helminths will do, that is not what the studies or any sort of hygiene-theories propose. Specific nematode species are chosen (Trichuris suis Ova, Trichuris trichiura Ova, and Necator Americanus) for their “safeness” in humans — their inability to reproduce inside the body, their short life-span and their limited growth-potential/consumption-rate.

    Poster #12 – great post!

    @#7 – The development of this treatment is far from snake-oil, pseudoscience and the like. Read up on the evidence at hand before offering these warnings, please. I’ve been investigating this for some while now, as I’d REALLY like to put an end to my ankylosing spondylitis, and other autoimmune diseases.

  27. Dear Wolfie’sMa


    Tetanus cases reported worldwide (1990-2004). Ranging from strongly prevalent (in dark red) to very few cases (in light yellow) (grey, no data).

    Tetanus is a global health problem, as C. tetani spores are ubiquitous. The disease occurs almost exclusively in persons who are unvaccinated or inadequately immunized.[1] Tetanus occurs worldwide but is more common in hot, damp climates with soil rich in organic matter. This is particularly true with manure-treated soils, as the spores are widely distributed in the intestines and feces of many non-human animals such as horses, sheep, cattle, dogs, cats, rats, guinea pigs, and chickens. Spores can be introduced into the body through puncture wounds. In agricultural areas, a significant number of human adults may harbor the organism. The spores can also be found on skin surfaces and in contaminated heroin.[2] Heroin users, particularly those that inject the drug, appear to be at high risk for tetanus.

    Tetanus – particularly the neonatal form – remains a significant public health problem in non-industrialized countries. There are about one million cases of tetanus reported worldwide annually, causing an estimated 300,000 to 500,000 deaths each year.[2]

    In the United States, approximately 100 people become infected with tetanus each year, and there are about five deaths from tetanus each year.[7] Nearly all of the cases in the United States occur in unimmunized individuals or individuals who have allowed their inoculations to lapse,[7] whereas most cases in developing countries are due to the neonatal form of tetanus.

    Tetanus is the only vaccine-preventable disease that is infectious but is not contagious.[2][7]

    [edit] Association with rust

    Tetanus is often associated with rust, especially rusty nails, but this concept is somewhat misleading. Objects that accumulate rust are often found outdoors, or in places that harbor anaerobic bacteria, but the rust itself does not cause tetanus nor does it contain more C. tetani bacteria. The rough surface of rusty metal merely provides a prime habitat for a C. tetani endospore to reside, and the nail affords a means to puncture skin and deliver endospore into the wound. An endospore is a non-metabolising survival structure that begins to metabolise and cause infection once in an adequate environment. Because C. tetani is an anaerobic bacterium, it and its endospores will thrive in an environment that lacks oxygen. Hence, stepping on a nail (rusty or not) may result in a tetanus infection, as the low-oxygen (anaerobic) environment of a puncture wound provides the bacteria with an ideal breeding ground.”

    I have been immunized all my life so I can’t judge odds. A booster every five years or so (I think you get up to ten years coverage from one shot).

  28. My mom’s been suffering from Chron’s for years. The treatment is terrible, and now she can’t even use Remicade, because she had an allergic reaction to it. It’s bad, bad stuff that no one knows about. So, hopefully she’ll see this and reconsider her treatment options.

  29. According to Scott Westerfield’s “Peeps”,* Crohn’s disease was almost unheard of until about a century ago. Then it started out primarily as a rich person’s disease, and slowly trickled down to the middle class and poor, as sanitation improved.**

    No indication of this on Wikipedia, though it does cite a study that showed a statistical correlation between the use of refrigeration and the disease. Refrigeration could be a proxy for clean water, since both are linked to wealth.

    Wikipedia also mentions hookworm treatment, but god only knows how long it’s been there or if it really ought to be. The study it cites had only eight participants.

    * Who needs peer-reviewed research when you’ve got books with vampires?

    ** Westerfield described the modern immune system as a bored security guard with a shotgun, getting itchy to do something.

  30. I have ulcerative colitis and keep it in remission by following the Specific Carbohydrate Diet – which is also supossed to control the bacteria in the intestines. This diet did more for me in three weeks than 5 months of conventional meds.

    There are no studies to support the efficacy of the diet, but the book (Breaking the Viscious Cycle – there are reviews at Amazon) is a much cheaper and more palatable option than hookworms.

  31. got that laying around somewhere, someone with colitis recommended it but I cured myself by stopping caring. Still looks like a very useful text though.

  32. #38> There’s the study by Dr. Leo Galland. Not exactly a peer-reviewed publication, but a long-term study with decent oversight.

    If you go back through the peer-reviewed literature, there are good data from the 1980s where there was work done on carbohydrate restriction (as the SCD is effectively a form of carbohydrate restriction), with about half the studies showing it was way effective, and the other half showing it was about as good as controls.

    Interestingly, Atkins showed his diet worked in about 85% of his Crohn’s patients, but there was no formal study. However, Dr. Wolfgang Lutz puts forth a simple rule: no more than 72 grams/day of carbohydrates. With this, he was able to put about 93-94% of his patients into remission at three years out (!). This also worked for ulcerative colitis, although the time frame was much longer- up to six years. Highly recommended reading: “Life Without Bread.”

    Lutz, Atkins, and Gottschall seem to work off the same program: restricting those carbohydrates that make the disease worse. The work by Ebringer (implicating the bacterial protein pullulanase, which is used to break down polymeric carbohydrates) kind of caps it all off, quite neatly.

  33. This isn’t snake oil. Strange concept, perhaps, but worms are currently being studied for various autoimmune diseases around the world. They are studying hookworms at the University of Nottingham for allergies, asthma, Crohn’s, and soon to be an MS Trial:

    They’ve studied hookworms and celiac disease in Australia:

    There was a double-blind, placebo trial with TSO (pig whipworms) and Crohn’s and UC in 2004 with good results:

    You can now buy TSO from this site:

    but it’s very expensive, and one must drink the ova indefinitely.

    There is currently a trial using TSO for MS at the University of Wisconsin:

    So my point is, it isn’t some quack idea, it’s mainstream medicine testing the hygiene hypothesis, by putting the organisms that are part of our natural microbiome, back into the human gut.

    Recent articles in the NY Times on worms and the hygiene hypothesis:

    and on hookworms specifically:

    What the CBS news piece left out is there is a transient inflammatory reaction to the larvae the first time, and some of us experienced temporary worsening of our condition. But reinfections cause much less, if any negative response, and the positive effects come much quicker. I should know, as I was the woman interviewed for the piece and have been experimenting with hookworms for Crohn’s since 2007.

    For more information on what it was like for me to try hookworms for Crohn’s, see:

    It’s been more effective than Remicade, Humira, 6MP, prednisone, xifaxin, flagyl, the 5ASA’s, and the SCD, which is saying a lot. VSL#3 (the probiotic recommended by most gastroentrologists) costs $500 a month and isn’t covered by insurance unless you’ve lost your colon. It also is more effective for UC and less so in Crohn’s.

    The hygiene hypothesis is gaining momentum, but if you’re going to wait until the studies are completed and the hookworms are available from your doctor, you’ll probably be waiting a long time. They want to make a drug derivative of the worm, but what they are doing is very complex. For those of us with Crohn’s disease, waiting means losing more intestines, taking drugs that come with significant cancer risks, and not being able to eat common foods. Crohn’s disease is a nightmare, and for many of us, the drugs don’t work.

    I am enjoying my 10 hookworms and pizza and beer (for the first time in over a decade), thank you very much! Remicade made me far more squeamish than 10 measly hookworms, especially as I nearly died from neutropenia caused by 6MP.

    Debora Wade

  34. I received hookworm therapy from Autoimmune Therapies for an autoimmune condition about twelve months ago. It saved my life. For those who are interested here are some links:

    The Wikipedia article on it:

    Here is the link for the company which supplies it. You can easily contact the owner, Jasper Lawrence, through this site.

    About the therapy:

    The science behind it:

    Here is the on-line discussion group where you can read about people’s experiences with it, and, if you wish, you can sign up and ask questions. It goes back about a year, with several thousand entries by now. If you click on Most Recent Messages (View All) you can read the archives.
    Jasper moderates the group.

    Here are a few refereed Journal articles from Pub Med:

    Parasitol Res. 2009 Jan;104(2):217-21. Epub 2008 Dec 3. Links

    An update on the use of helminths to treat Crohn’s and other autoimmunune diseases.Reddy A, Fried B.

    Gut. 2005 Jan;54(1):87-90. Links

    Trichuris suis therapy in Crohn’s disease.Summers RW, Elliott DE, Urban JF Jr, Thompson R, Weinstock JV.

    James A Clifton Center for Digestive Diseases, Department of Internal Medicine, University of Iowa Roy J and Lucille A Carver College of Medicine, 200 Hawkins Drive, Iowa City, IA 52242, USA.$=relatedarticles&logdbfrom=pubmed

    Acta Gastroenterol Belg. 2006 Oct-Dec;69(4):418-22.Links

    Intestinal helminths: a clue explaining the low incidence of inflammatory bowel diseases in Subsaharan Africa? Potential benefits and hazards of helminth therapy.Fiasse R, Latinne D.

    Department of Gastroenterology, University Hospital St-Luc, Université catholique de Louvain, Brussels, Belgium.$=relatedreviews&logdbfrom=pubmed

  35. @Trimeta (16ish)

    There is no good animal model of humans, period. If a studies are to be done, they need to be done with human volunteers; otherwise, the results will really be close to useless.

    The reliance of medicine and pharmacology on animal models is outdated, cruel and simply dangerous. We have the money and the technology to do far better than torturing mice and calling it science.

  36. @Apreche (#7)

    Ironically, I did a presentation about Crohn’s disease and helminths (a generic term for parasitic worms) about a month ago. A link to papers about the subject:

    I read 9 of the 10 papers on that first page of links. There have been clinical trials in England, using Pig Whipworm to treat both Crohn’s Disease and Ulcerative Colitis. In both cases there was improvement, more so in the Crohn’s Disease patients. Patients on immunosuppressants responded better to the treatment.

    Crohn’s disease is a Th1 inflammation (T-helper cell type 1). Normally the body has numerous types of inflammation, but in Crohn’s Disease, the body seems to start having nothing but Th1 reactions to normal gut flora. (What triggers this is not clear.) Usually the varied inflammation reactions inhibit each other. Th1 has the ability to sustain itself and re-trigger the Th1 reaction. It results in chronic inflammation.

    Helminths trigger Th2 reactions. Th2 reactions inhibit Th1 reactions. By infecting a Crohn’s patient with parasitic worms, it gives their immune system a reason to trigger a massive Th2 reaction which inhibits the Th1 inflammation reaction, decreasing or even stopping the chronic inflammation of Crohn’s Disease.

    They used Pig Whipworm in the human trials because it can’t reproduce in humans. The worms live 2-4 weeks (not months) in humans, then they die and a person has to be reinfected. The initial trial was one dose of 2400 ova, and people had a decrease in symptoms for about 3 weeks. The second trial was a 24 week open label study where 29 patients were given 2400 ova every 3 weeks. By week 12, 70% of patients had a noticeable decrease in symptoms, and ~50% of those patients were in remission. By the end of 24 weeks, 90% of patients had a reduction in symptoms and 70% were in remission.

    In another paper I found reference to an unofficial letter from one of the doctors doing the study: apparently some of the patients opted to continue taking the ova, and 4 years down the road, they were still in full remission.

    The reason that they didn’t use hookworms is because there’s a life cycle where the hookworms tunnel through the body, and depending on what they hit, that can be Bad (TM). On the other hand, Human Hookworm should be self perpetuating, so you wouldn’t need to ingest ova every 3 or 4 weeks.

    For more information you can also search Google Scholar for the “hygiene theory of disease”.

  37. I don’t understand the point of this post. Boingboing is not a science or medical blog, so why is such speculative stuff being posted here? Is there any study here that attributes the rise in such things as Crohn’s disease to lack of hookworms specifically, over the many other possible causes?

    I actually think this is irresponsible. This is how misinformation gets started.

    1. Boingboing is not a science or medical blog, so why is such speculative stuff being posted here?

      Because it’s interesting. If you’re making health treatment decisions based on what you read on BB, um, stop.

  38. My wife learned about these clinical trials shortly after undergoing major abdominal surgery for Ulcerative Colitis. Her mother died of complications from Chron’s disease. Anyone familiar with these diseases would understand why someone would gladly accept an intestinal parasite if it meant controlling the other symptoms.

    The studies I’ve read seem sound enough to make it worth a shot. At least there is some sound scientific theory at work here, unlike most quack remedies.

  39. #44>If what I understand about N. americanus is correct, it’s not that it’s self-perpetuating, but that they are long-lived. Their numbers do not multiply in the host- the eggs require a complex life cycle in which the eggs hatch out in organic matter (dirt or sandy soil), and cross the skin barrier at the L3 stage. Without re-infection, their numbers do not increase, unlike many other parasites.

  40. Lots of good material in the comments here. One slant I do contest, though, is the idea that putting the worms in “gives the security guard something to do”. Given that many parasites have evolved mechanisms to tone down (or at least affect) the immune systems of their hosts, sometimes to the point of even controlling their brains (see Carl Zimmer’s excellent book, Parasite Rex, for examples), I strongly suspect that what the worms are doing is just that, fiddling with the knobs on the human immune system (one of IgE flavours? Man that stuff is complicated). And if the pharmaceutical researchers can figure out how they’re doing it, we could tune the immune system ourselves, without feeding hungry worms (whose self-interest doesn’t really align with ours, especially on their way out of our bodies to disperse…)

  41. Funny, here in Uganda, a friend of mine just got back from a week of treatment for hookworm infection. My sister in law has Crohns and while I feel terribly for her and everyone with the illness, I can also say I would wish it no one to have a hookworm infection.

    Writhing masses visible from the exterior of your skin? Yum yum.

  42. Ha, keep in mind I am laying in bed right now recovering from the treatment for Bilharzia right now. Ahh, life in Africa.

  43. As someone with Crohn’s who has used helminths (worms), maybe I can clear up a few things-
    1) They work. I was skeptical but had few other options (drug allergies.) As part of a clinical trial, I got one dose per month – a capful of clear liquid that I was told to mix with gatorade. Without fail, my Crohn’s would disappear, literally overnight. No more wrenching gut, no more bloody diarrhea, no more fistulas. It may be hard to appreciate if you don’t have Crohn’s but this was without a doubt the closest thing to magic I’ve experienced in my adult life.

    2) They don’t hang around indefinitely – mine were 1 month, max. From what I remember, this was related to the worms being from pig intestines, and unable to reproduce in the human gut. It was definitely confirmed in my experience — like clockwork, around the 3rd week after I’d taken the worms, my Crohn’s symptoms would start to come back, getting progressively worse until I took the next dose, at which point – boom – no more Crohn’s.

    I had 2 amazing crohn’s-free years, before the study shut down. I now spend a crazy amount to get helminths from Europe, which I take whenever the Crohn’s gets particularly bad so as to stay out of the hospital. For whatever reason though, these helminths don’t work quite as well as the ones from the (U. of Iowa) study (still get massive improvement, but minor symptoms remain.) As far as I’m concerned, it borders on criminal that Crohn’s patients are being subjected to surgery after surgery when a cure like this exists (fat chance of it getting FDA approved- no drug company’s gonna shell out the millions needed for multiple trials for something as un-patentable as a worm.)

    Finally, if this treatment just isn’t gross enough for you, you could always read up on fecal flora replacement [I shudder just typing the words…]

  44. “Finally, if this treatment just isn’t gross enough for you, you could always read up on fecal flora replacement [I shudder just typing the words…]”

    Or you could read up on the symptoms of Crohn’s disease. Let me just mention a few: bloody diarrhea 10-20X a day. Fistulas, which are abnormal connections that grow between your bowel and either the bladder, the butt, or the vagina. So you are basically shitting out of your skin. Strictures, which means the longterm inflammation makes your intestines grow scar tissue so thick that you have a diameter of a pencil tip instead of a normal intestine. Swallow one orange seed by mistake and you need immediage surgery! Some people get so they cannot eat at all; necessitating TPN, which is total parental nutrition fed into your main vein. Can you imagine not eating anything for years? How would you like to pass cafes and restaurants watching everyone else eat while you go home and hook up your bag?

    Children are getting their colons removed every day because of this disease. So they will either have a j-pouch (where they pull the last section of your small intestine down into a little colon, which means you will forever go to the bathroom a minimum of 6X a day.) Or they get colectomies, which is shitting into a bag connected to your side, and if they have Crohn’s, the disease goes on to attack what’s left of the small intestine. It never goes away.

    Comments like “I’d rather have asthma then the side effects of hookworms” do not take into account the immense suffering that some of us experience for decades because of this disease.

    If a few worms can alleviate the suffering of millions, we should be rushing in droves to the medical industry and demanding immediate research and infection. I for one am most grossed out by the failure of the medical industry in exploring this therapy further, so people with these diseases can finally get relief.

  45. The comments are far better than the original post–at least many of the authors of the comments have bothered to check their facts.

    I, too, have Crohn’s and that first paragraph was a doozy. Crohn’s doesn’t “cause people’s intestines to swell.” It can cause major blockages (among other things) due to one’s body attacking one’s intestines. Furthermore, this sentence is just silly: “The prescribed treatments have horrible side effects, including cancer and brain infections.” Um, which treatments would those be? I’ve been on a few, and I research them to death. I don’t know of any that cause brain infections. I’m on immunosuppresives now, and there are next to no discernable side effects. Steroids are prescribed for tough cases and can be a bummer, but they’re prescribed for a variety of autoimmune disorders. Sure, injected Remicade is serious stuff–but the majority of Crohn’s patients aren’t on it, we’re kept in remission (or close) with much milder, happier drugs.

    Believe me, I’d love to not depend so much on pharmaceuticals, and I’ve tried all manner of diets and alternative therapies. The fact is, we just don’t know what causes Crohn’s (here’s another good theory that I’m sure Mark will love because it blames corporate milk:

    Also, as to hookworms definitively working: sounds like another Crohn’s mystery: antibiotics. We Crohn’s patients all know that antibiotics can make us feel great for a bit, but the disease always returns. The fact is, until we know for sure what causes Crohn’s, we won’t be able to cure it.

    @Deborawade: I’m sorry you have it so bad. That sucks. But FYI for the rest of you out there who are just learning about this disease: I’ve had Crohn’s (and a surgery!) and swallow seeds all the time. Not all of us have it so bad.

  46. Swelling is part of the inflammation reaction and Crohn’s is a disease of inflammation. Tysabri causes progressive multifocal leukoencephalopathy. All the anti-TNF’s significantly skew lifetime cancer profiles. The fact is, you need to do better research.

  47. $2,399 is nothing! Compare it to the $10,600 in debt I now owe to the hospital that had to perform an emergency surgery on me due to my Crohn’s Disease. Crohn’s sucks! Check out my story at
    Crohn’s End.

  48. Considering people have pounds of bacteria in their gut that provide benefits, why would people have a problem with larger organisms that have lived in humans throughout evolution?

  49. I probably represent the mildest end of the spectrum of Crohn’s; it went into symptomless remission when I started taking Asacol (mesalamine) 10 years ago and has stayed that way. No noticeable side effects from the drug. I do take a high dosage, and it’s expensive enough to put me in the Medicare doughnut hole for about half the year.

    I’d love to experiment with nondrug therapy, but I’m scared to go off the Asacol lest I have a flareup that would do further damage to my guts (which have scarring from the initial attacks). And since I have no symptoms on the Asacol, I wouldn’t be able to tell if any other therapy was doing any good unless I went off the drug.

  50. I would just like to add that the general consensus from the above reading indicates that hookworms are not the answer, and that the pig intestinal worms seem to be the best…

    mainly the part about the wriggling to the skins surface and the tunneling part…ewww…definately the “ick” factor

  51. I wanted to add my 2 cents:

    Everytime I take probiotics (this is a very general term; make sure you test different kinds as they don’t all work for everyone, I have a few favorites like the Travel Vita-Vim Probiotic by Jamieson) or do a good cleanse (again, general meaning; find the right one for you; for me, it’s the “Purge Parasitis KIT” by New Roots Herbal), I feel great, and all the symptoms vanish…but soon return after being off of the probiotics, or the cleanse for a varied amount of time.

    I find that cleanse lasts quite long as I tend to avoid breads, cereals, etc. after being on it, and lean more towards meats, veggies, and fruit.

  52. There are some interesting comments here about worms (I feel the “ick” factor just saying it). Some of your comments need to be read by others with caution:

    [quote] dbarak | May 26, 2009 10:00 AM | Reply

    “If I want worms, I’ll eat our cats’ droppings. ; )”

    Cat droppings would be carrying the wrong worms, and could seriously hurt you (mainly because they are carnivores and we’re not).

    [quote] mralistair | May 26, 2009 9:26 AM | Reply

    “this is a very interesting article from a few years ago about someone infecting themselves with hookwork to treat asthma”

    [quote] nathanmaas | May 26, 2009 1:05 PM | Reply


    Excellent link, after speaking with my GP about current treatments, the hookworm treatment is already out! This is because hookworms multiply and can cause bowel perforations.
    The pig whipworm (pigs intestinal tract is the closest to humans because they are omnivores like us) works much better as they don’t thrive in our tract, but will survive for 3-4 weeks according to the link above. They also have no side effects!
    Now, before some of you start stomping around in pig doo doo, and making out with pigs, watch out for that H1N1 :P
    There are many universities doing studies on this, and there are also 3rd party clinics that offer the whipworm treatment.
    From different sources (one in this forum) the whipworm treatment gives you 3-4 weeks of remission (sometimes complete!).
    Good luck to all of you, I’m heading to the local university to get some worm lovin’ ;)

  53. Yes this cost is a considerable amount, but nothing compared to the Chrons Disease treatment of increasing popularity known as Humira. This treatment comes in the form of syringe injections or in a pen injection form, similar to the epi-pen. This treatment, for a months supply which is 4 pens, costs about 3,200. If this “hookworm” treatment is as effective or anywhere near, I would not hesitate to implement this treatment in place of the 3,200 dollar drug.

  54. I followed the link in #3, interesting article. Many of those who commented on that article were obsessed with the idea that the writer was going to be endangering the rest of us by contaminating us with his weird parasite, despite the facts that a) it would be extremely unlikely that anyone could catch it from him since it would require his shitting in soggy warm ground that people would then walk barefoot in, plus they would have to stay there a long time or come back repeatedly to get a more than a few tiny worms since the ones they get cant multiply internally.
    b)the hookworm itself is not even usually a health problem–causes few problems after the initial coughing attack, and most people who have it have no symptoms. c) If you know you have it you can easily get rid of it with over-the-counter meds, plus the infestation is self-limiting–(even if you don’t know you have it) since they eventually get old and die and are gone, unless you go stand in some more shit and get it again.
    But the most glaring omission in any of the author’s reasonable replies to these paranoid worm-phobic worriers is that a similarly non-lethal parasitic worm (human pinworms) is completely common here, endemic to humans, and probably a large percentage of us have a few of them at any given moment and possibly 90% of us are going to have at least one bad infestation of them at some time in our lives. Bad meaning in enough numbers that we are continually reinfecting ourselves and those around us, and are feeling a lot of uncomfortable anal itchiness. Pinworms also reproduce outside the body, but don’t require muddy soil. They just come out (that’s what itches) and lay their eggs on your skin, the tiny eggs if not washed off get spread around, and hand-to-mouth injested by yourself or someone else and it all starts again. Human pinworms or rather their eggs are everywhere. The worms are inside many of us. You may have a few inside you right now. They have NOT been eliminated by modern sanitation. You certainly cut down on your exposure and on re-infecting yourself if you wash your hands after going to the bathroom, but you will inevitably get some now and then. They have a big “ick” factor, but like lice, carry no known diseases, do very little damage and are very common. So why are people worried about someone having a similar parasite that is very UNLIKELY to spread to anyone else in this country? They should be freaking out about the pinworms that are all around (and inside) us. Parents usually know something about pinworms since young children often do get “bad” infestations. (Children are very hand-to-mouth, not to mention hand-to-butt–when they get it they SPREAD it, especially back into themselves where it builds up into a mega-infestation). But these same parents also think that when they don’t see the mega-infestations their family is pinworm-free. No such luck! The little cooties are totally endemic and have probably evolved with us for millenia. Like human hookworms in other areas of the globe… Some parasites are big problems, others are quite benign. And apparently may even be helpful, like the smaller organisms we all have in our guts and other places performing all kinds of important functions we may not want to know about…
    (ps, resubmitting since my initial post didn’t appear, my apologies if I’m double-posting)

  55. So, is there any one trying to identify, isolate, replicate and then do trials on the chemical alleged to be emitted by the hookworm which dampens down the immune system? Why ingest the worm with all the possible problems if the immune dampening effects can be achieved using a purified chemical treatment?

  56. So… when is some enterprising person going to figure out what chemical is secreted by the worms, and manufacture that as a pill?

  57. Hi, I also suffer from Crohn’s and I am interested in specifically how you control your diet. I was recently diagnosed and have found no doctors to be helpful with the nutritional aspect of the disease.

  58. I would urge anyone with Crohn’s, particularly the newly diagnosed to consult a doctor about Low Dose Naltrexone. This is a cheap drug which has been arond for years with little of the side-effects of existing Crohn’s treatments and many people find it works to put them into remission, including myself. Just google LDN or Low Dose Naltrexone, the worst that can happen is it has no effect. The best is you will achieve remission.

  59. I have achieved a full remission from Crohn’s after trying helminthic therapy. I received 35 hookworms in April and I got whipworms in August. I got rid of food allergies and seasonal allergies as well. You can find a lot of research papers on this subject at under the Studies section

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