Drug interactions with helminthic therapy

This is the first post in a series on this topic. I will expand this post rather than create many different ones, and may turn it into a page accessible from the main nav.

What drugs should I avoid while on helminthic therapy?

Do antibiotics kill hookworms? Can I continue to take my antihistamines while I am on helminthic therapy? When can I reduce or stop taking my medications? Will smoking marijuana harm my helminths? What about cocaine or ecstasy? Viagra? Pumpkin seeds?

Does prednisone, or methotrexate, or pentasa, or remicade or tysabri interfere with the efficacy of helminthic therapy?

We get asked these questions, and others in the neighbourhood, a lot.

Our first answer is always, correctly, that we are not doctors and that only a doctor can advise you about medication use or changes to medication use in connection with an illness. That you should discuss any changes in medication with your doctor. The doctor ideally that you will have discussed helminthic therapy at length with before going ahead.

But there are a hell of a lot of drugs being prescribed, and almost as many bought OTC, still others like exotic probiotics are often used, too.

So it is clearly impossible to give advice on the basis of direct knowledge in all instances for you to share with your doctor.

But we can advise about those we know, and perhaps more importantly teach you how to assess whether a drug is deserving of more research.

That is the purpose of this post, to give you all the information we have, in a series of updates to this post. As well as to show you how we quickly evaluate something for it’s potential to harm your helminths, and to some extent if a drug requires more investigation for it’s potential to interfere with your ability to get the most out of helminthic therapy.

Besides an interest in knowing what to avoid so you can keep your new friends healthy, both you and your doctor should be keenly aware that if and as you respond positively and your symptoms and disease improve it may be more than advisable to reduce your intake of your medication, the dose, of the drugs you use. In fact in some cases it is obviously dangerous to continue taking medication at the same levels if you improve.

All drugs have the potential to affect, for good or ill it should be said, the course of helminthic therapy and how you respond to it, or to kill helminths.

Given all the possible combinations, and the differences due to genetics or whatever in how different people respond to this or that, as well you can see how complicated this area is.

So the question is not a simple one to answer, and if you do find yourself in that happy position of improving I seriously and strongly advise you to contact us and your doctor. We cannot advise you, but we can advise your doctor through you.

Given this is a huge topic, and that I am incapable of either simple or brief answers, I think the best way to approach this question is break the answer, and perhaps the question up.

Some are so damaging to helminthic therapy’s effectiveness that taking them regularly means you should not bother with helminths, unless you can stop or reduce their intake first.

Antibiotics

Avoid at all costs!

The easiest to identify as having a strong negative impact on the efficacy of helminthic therapy are antibiotics. Simply put if you have to take antibiotics three or four times a year you are very unlikely to attain and maintain any beneficial effects from helmithic therapy long enough to notice them.

Antibiotic use, in my opinion, will one day be identified as one of the largest contributing factors to the explosion in modern, chronic inflammatory diseases, and the largest factor in establishing the hygiene hypothesis in the canon of scientific theory. Consider just this, that the appendix clearly evolved to act as a reservoir for beneficial bacteria and micro organisms in our colons. It worked when we had terrible diarrhoeal illnesses, because as an annex to the colon micro organisms naturally colonised it, and were not scoured away, when as in the case of cholera for instance we violently shed not just our intestinal tract contents but it’s lining.

However there is no nook or cranny in the body where anything is safe from the extraordinarily blunt instruments that are antibiotics.

This is not a selective precision instrument, and when I talk to clients who are most often suffering from IBD in one form or another, but lately someone with asthma, too. where their doctors are telling them they have to go on a course of multiple antibiotics to kill an overgrowth of this or that specific bacteria I think the following:

Why does the doctor believe that exterminating this, and complete classes of antibiotics, is going to result in sustained health, when the illness clearly has arisen out of, if their diagnosis is correct, an imbalance in micro organism populations likely caused in the first place by antibiotic use?

Any bacteria, if such an overgrowth is present, is clearly not some exotic species either. Anything that has managed to enter, and to survive and in this scenario thrive if the doctor is correct, has clearly come from he environment, and is therefore very unlikely to be an exotic organism the patient is unlikely to encounter in the future. Therefore as soon as the antibiotics are stopped it is likely that in a relatively short period of time that same organism will be reintroduced, on a breath of fresh air, or a slice of pizza, or an apple.

Stepping into an environment this organism, or perhaps different ones with the potential for harm if unusually large populations develop, find an environment denuded of competitors. Moreover, any yeasts or other organisms left behind, during what is often proposed as a six or twelve month course of a variety of antibiotics, will face much reduced competition to occupy other niches in the ecosystem formed by our bodies. They will have proliferated to a degree never seen in nature, and occupy areas usually denied to them by competition.

How does the doctor know that some in situ micro organism, able to proliferate beyond their usual bounds by these antibiotics, does not by overgrowth in number or location transform from being a benign organism to one that now causes pathology?

As well I have never seen any science offered to show that an overgrowth, by a species of bacteria that has never been tested for in any case like this I have been involved in, of the bacteria identified by the doctor as the culprit is the actual cause. Might it not as rationally then be a result not of the overgrowth of that species, if it is actually such an overgrowth, but rather a decline in some other species that has been suppressed first by an antibiotic and later by this overgrowth of competitive organisms?

Think of it, there is only so much room for bacteria and yeasts in our bodies, and if one or three hundred is killed off by AB use, then other species rapidly proliferate to fill the niche left empty. Is it then a certainty that the illness was caused by the overgrowth directly, or as a secondary effect of the decimation of one or more other species. A decimation that conceivably, again is the doctors who do no tests are right of course, caused by AB use, but institutionalised by the growth of one or more other species?

This line of reasoning of course ignores one important point I have avoided but that I have to address.

Who was it who said something like “Continuing to do the same thing despite failing each time is the very definition of stupidity?

“We gave you lots of ABs, and it has made you sick, so to make you well we are going to give you lots more.”

“That will be $500.00, and the pills are another $2,000.00.”

ABs should only ever be used when a culture has been taken and the bacteria causing the disease identified so that the right ABs, in the right quantities can be used, and only then if ABs are the only way to ensure death, disfigurement, or disablity do not result. The truth is most ABs are over or incorrectly prescribed, often to shut up some ignoramous with a viral disease or allergy that is not amenable to treatment with ABs, or that would resolve without treatment (this is true for the vast majority of prescriptions that are for bacterial infections) in a few days or weeks. Which by the way would have the added benefit of allowing your immune system to actually go through the whole process of figting and beating an infection.

For those of you who are curious why ABs are so bad, what the mechanism might be for the damage they do, that point illustrates one likely one. By stopping the process of infection fighting part way through, or by preventing it entirely, the immune system never in those who avail themselves of antibiotics regularly able to develop or “learn” correct procedures and habit.

In addition the impact of ABs on the balance of micro organisms throughout the body, but primarily of course in the intestines where a majority of our immune systems and of micro organisms is located, is a profound and a much longer lasting effect it has been found than was long assumed.

Because bacteria keep us alive in very direct and well documented ways, it is safe to assume they have other effects, likely I think it is reasonable, falling along a spectrum of impacts from the trivial and amusing, to the remarkably subtle but powerful and profound.

It is these populations, of micro organisms who have lived in, on and around us for generations of our genes stretching back to when the carriers of those genes walked on four legs.

One thing about evolution that I think is lost or missed by most is that the unit of life is not the organism (human), not the organ (skin), nor the tissue (eyelid), ne’er the cell (eosinphil). It is the gene, and our genes for the most part are not “human”, they are not freshly minted when our species evolved. Fully 96+% of our genes come from Chimpanzees, but only a few percent of their genes distinguishes them from their predecessor on the evolutionary tree, and so on. Our genes are chimpanzee, dog, whale, rodent, worm, and sponge, etc.

Genes that have been interacting in extraordinary and powerful ways with millions of species of bacteria for hundreds of millions of years.

This is what your doctor proposes you wipe out with a course of antibiotics, so consider the potential negative impacts the next time they are offered, or you think of asking.

Yes, the folks who told us that the appendix was a vestigial organ of no benefit and left over from one of our ancestral ruminants (I cannot believe I was actually taught that) got it wrong when they just assumed bacteria were not important to human health, and when they thought the impact of ABs might last a few weeks, or at most months. No, the impact lasts years, and years.

Beyond that, and the corollary principle that you should minimise their use to the greatest degree possible, is the fact that antibiotic use is so detrimental to the beneficial effects derived from helminthic therapy that if you have to use them regularly there is no point in even trying helminthic therapy. Regular users of antibiotics will never see any significant sustained benefits from helminthic therapy.

Beyond that, if you must, absolutely have to use them, do so knowing that you will lose efficacy for up to eight weeks, and that though you can shorten that time of efficacy loss substantially with a small supplemental dose of helminths, obviously easier with Whipworm, you may experience a reduced level of efficacy for many months after their use.

I will be updating this post periodically with other classes of drugs, this is as is often the case a much larger project than can be accomplished in one sitting.

I will round out this post on antibiotics (ABs), and then move on to antihistamines and then local anaesthetics.

Jasper Lawrence

Antihistamines and interactions with Helminthic Therapy (October 28th, 2014)

Local anaesthetics and interactions with Helminthic Therapy (November 4th, 2014)