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Contents 1 Welcome to Open Source Helminthic Therapy 2 Website Mission Statement 3 Helminthic Therapy or Helminth Therapy? 4 What Is Helminth Therapy? 5 Helminth characteristics required for use in therapy 6 Current State of Helminth Therapy

Welcome to Open Source Helminthic Therapy

Dedicated to the idea that Helminthic Therapy (hookworm & whipworm therapy) need not be exotic, expensive or rare.

Helminthic therapy is the use of hookworm, whipworm or other helminths (parasitic worms) to modulate the immune system. It is an experimental therapy that has not been approved by any governmental body for the treatment or prevention of disease. Medical authorities of many countries have however, approved research that has yielded very promising results in the treatment of autoimmune diseases with helminths. Successful studies have encouraged further research, and the field appears to be gaining ground quickly. You may review many of these studies on the Studies and Papers page. We are actively seeking all papers or studies in the medical literature relating to helminthic therapy, so please post links to material that is not listed on the site.

The information on this website is an attempt to aggregate the research, the current providers, and the state of this therapy in general. All medical therapies carry some risk. Untreated autoimmune conditions also carry very serious risks. The current medications for autoimmune disease all carry risks, some of them very serious. In the opinion of the website authors, medical providers in the United States, where this website is based, often do an inadequate job of informing patients of the documented side effects, and risks of the procedures and medications that they provide. This website will do its best to point out risks and benefits of this therapy, but at this point it is up to users of helminth therapy to research the known and possible medical risks.

At this point in time, none of the website authors are doctors, although we actively seek review and critique of the site by the medical community. The whole website is also set up as a wiki and we enthusiastically encourage participation from anyone who wishes to add links or create content on this website. Potential contributors without experience in editing wikis should either jump in and learn (better) or just post material to the forum, which can then be added by others.

Website Mission Statement

• Helminth Therapy appears to be an effective therapy for several autoimmune diseases. This website seeks to document the scientific evidence for the efficacy of Helminth Therapy.

• Helminth Therapy may be simple enough to be practiced by careful and conscientious individuals, specifically individuals directing their own therapy. This website is an experiment in exploring that idea.

• The medical community should be engaged to the greatest extent possible in exploring Helminth Therapy. This does not mean interested individuals need wait until Helminth Therapy becomes fully accepted by the mainstream medical establishment, which may take some time. This website may be viewed as an attempt to aid and further the acceptance of Helminth Therapy by the medical community. This website especially values commentary, information, and opinion, of any type, from medical practitioners.

• Helminths (hookworms and whipworms) have a long history of involvement with humans and helminth's life-cycles and possible detrimental effects in humans are well understood. This pre-established history of human testing makes Helminth Therapy somewhat unique in emerging medical therapies.

• The website is dedicated to best practices in helminth therapy and will not be connected to any one therapy provider or practitioner. This website is also completely dedicated to the open exchange of information and the propagation of helminth therapy.

Helminthic Therapy or Helminth Therapy?

This website will use the term "helminth therapy" and "helminthic therapy" synonymously for the practice of helminthic therapy. In all cases the therapy we refer to is deliberately infecting people with helminths to help moderate other conditions (mostly autoimmune diseases) and not eradicating helminth infections acquired inadvertently. Please note that helminth infections are very easy to terminate, should one wish to, with several good medications.

Please also note that the medical literature sometimes also uses anthelminthic therapy and helminthic therapy synonymously for the eradication of helminth infections.

What Is Helminth Therapy?

Wikipedia pages aren't always the most clearly written or concise documents due to the group dynamic involved, but the wikipedia page helminthic therapy page is a notably well-written collaborative effort and the best general overview of the field we have seen. From the wikipedia page:

Helminthic therapy, a type of immunotherapy, is the treatment of autoimmune diseases and immune disorders by means of deliberate infestation with a helminth or with the ova of a helminth. Helminths are parasitic worms such as hookworms and whipworms. Helminthic therapy is currently being studied as a treatment for several (non-viral) auto-immune diseases including celiac disease, Crohn's disease, multiple sclerosis, asthma, and ulcerative colitis. Autoimmune liver disease has also been demonstrated to be modulated by active helminth infections.

The entire wikipedia page is actually a very nice overview of Helminth Therapy, with many citations from medical literature.

Helminth characteristics required for use in therapy

Also from the wikipedia page:

For use as a therapeutic agent, the specific helminth should meet all the following minimum requirements:

• should not have the potential to cause disease in man at therapeutic doses
• should not be able to reproduce in a host, thus allowing control of dose
• should not be a potential vector for other parasites, viruses, or bacteria
• should not be easily transmissible from the host to other people
• should be compatible with a patient's existing medication
• should have a significant period of residence in the host
• must be easily eradicated from the host, if required

A slightly longer list, from a review of helminth-related research¹
Ideal characteristics for a therapeutic helminth

• Has little or no pathogenic potential
• Does not multiply in the host
• Cannot be directly spread to close contacts
• Produces a self-limited colonisation in humans
• Produces an asymptomatic colonisation in humans
• Does not alter behaviour in patients with depressed immunity
• Is not affected by most commonly used medications
• Can be eradicated with an anti-helminthic drug
• Can be isolated free of other potential pathogens
• Can be isolated or produced in large numbers
• Can be made stable for transport and storage
• Is easy to administer

Both Necator americanus (hookworm) and Trichuris suis (human whipworm) ova meet these requirements. Neither is known to cause any specific disease in man, although allergic reactions have been reported with T. suis, and anemia has been reported in individuals hosting very large numbers of N. americanus. N. americanus, the species of hookworm used therapeutically, takes on average 0.03 ml (less than one drop) of blood per day from the host, so anemia is only observed in malnourished individuals with very large numbers of hookworms; this scenario has traditionally been a problem with children and some adults in developing countries. Neither helminth is known to be a vector for the infection of the host with other parasites, viruses or bacterium.

In addition, neither helminth reproduces in the host; in both cases, the reproductive cycle requires a period outside the host, with both worms requiring several weeks' incubation in moist soil. As a result, the therapeutic dose can be tightly controlled. The complexity of both helminths' life cycles also means that cross-infestation, even with people living in very close proximity to the host, is highly improbable. The main difference between N. americanus and T. suis is residency time: T. suis has a lifespan of only 2–3 weeks in humans, while N. americanus has an average life span of 5 years. Frequency of dose corresponds directly to lifespan. Both helminths have been demonstrated to have beneficial effects when used in conjunction with existing (conventional) therapies. If eradication of helminths from the host is required at any point, both respond to either albendazole or mebendazole.

1 Helminths as governors of immune-mediated inflammation David E. Elliott, Robert W. Summers aand Joel V. Weinstock International Journal for Parasitology 37 (2007) 457–464

Current State of Helminth Therapy

We will again refer the reader to the well-written Wikipedia page for a summary of the efficacy but helminth therapy appears to have efficacy in inducing remission of symptoms in significant numbers of Crohn's disease patients, with few side effects reported. The efficacy of helminthic therapy looks even more promising compared with conventional pharmacuetical therapies which are often expensive and entail significant side effects such as bone loss, liver damage, or significant risks of cancer.

The reader can judge from the Studies page, the extent of past and ongoing research in helminthic therapy. This website will attempt to document completed and ongoing research, as well as current therapy providers.