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Episode 63
The Doctor's Farmacy: House Call

Are Parasites Driving Your Autoimmune Or Gut Issues?

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You may be surprised to learn that having a parasite, in and of itself, is not necessarily a bad thing. In fact, our gut microbiome is made up of more than 500 different species of microbes, including various types of bacteria, fungi, parasites, and viruses. Some of them help us, but others are harmful. Parasitic infection can result in an individual experiencing a range of symptoms from digestive issues to muscle ache, joint pain, skin rashes, and more; it can also signal issues with a weakened immune system. In this episode, Dr. Hyman sits down with Dr. George Papanicolaou to discuss how parasites can influence our overall health, and why they sometimes trigger autoimmune disease, gut imbalance, and much more.

George Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital. He is also an Institute for Functional Medicine Practitioner. Upon graduation from his residency he joined the Indian Health Service. He worked on the Navajo reservation for 4 years at the Chinle Comprehensive Medical Facility where he served as the Outpatient Department Coordinator. In 2000, he founded Cornerstone Family Practice in Rowley, MA. He practiced with a philosophy centered on personal relationships and treating the whole person, not just not the disease. He called that philosophy “Whole Life Wellness”. Over time as the healthcare system made it harder for patients to receive this kind of personal care Dr. Papanicolaou decided a change was needed. He began training in Functional Medicine through the Institute of Functional Medicine. In 2015, he established Cornerstone Personal Health – a practice dedicated entirely to Functional Medicine. Dr. Papanicolaou joined The UltraWellness Center in 2017.

This episode is sponsored by Thrive Market and Rupa Health.

Thrive Market is offering all Doctor’s Farmacy listeners an extra 25% off your first purchase and a free gift when you sign up for Thrive Market. Just head over to thrivemarket.com/Hyman.

Rupa Health is a place for Functional Medicine practitioners to access more than 2,000 specialty lab tests from over 20 labs like DUTCH, Vibrant America, Genova, Great Plains, and more. You can check out a free live demo with a Q&A or create an account at RupaHealth.com.

In this conversation, Dr. Hyman and Dr. Papanicolaou discuss:

  • The connection between the immune system and parasitic infection
  • The most common parasites and how you get them
  • Patient cases they have treated
  • When parasites can be helpful
  • Common symptoms of having a parasite
  • Testing and diagnosing for parasites
  • Treating parasites with herbs and pharmaceuticals
  • The possible role of over-sanitization and parasitic infection, autoimmune issues, and other chronic health issues
  • Using parasitic worm therapy (i.e. helminth therapy) to treat autoimmune issues, asthma, allergies, and more

 

I hope you enjoyed this conversation as much as I did. Wishing you health and happiness,
Mark Hyman, MD
Mark Hyman, MD

Guest

 
Alex Gallegos
 
Dr. George Papanicolaou

Dr. Papanicolaou is a graduate of the Philadelphia College of Osteopathic Medicine and is Board Certified in Family Medicine from Abington Memorial Hospital, Abington, Pennsylvania. He is also an Institute for Functional Medicine Certified Practitioner. Dr. Papnicolaou established his own practice: Cornerstone Personal Health dedicated to the Functional Medicine Model. Dr. Hyman invited him to bring his expertise and twenty years of experience to the UltraWellness team. He specializes in treating the root causes of many conditions including Neurodegenerative disorders, ADHD, PANDAS/PANS, gut and hormone health.

Show Notes

  1. Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues
  2. An Epidemic of Absence: A New Way of Understanding Allergies and Autoimmune Diseases
  3. Fixing The Root Cause of Irritable Bowel Syndrome
  4. The Power Of Food To Heal Everything From Autoimmune Disease To Traumatic Brain Injury

Transcript

Dr. George Papanicolaou:
When you see parasites, you should be thinking immune system, and you should be thinking something is amiss in the immune system. But you should also be thinking about the fact that there’s the good side, and that we need to have a diverse microbiome. That includes bacterial diversity. That includes parasitic diversity.

Dr. Mark Hyman:
Welcome to The Doctor’s Farmacy. I’m Dr. Mark Hyman. That’s pharmacy with an F, a place for conversations that matter. If you ever wondered if you had parasites and if they’re affecting your health, this is the podcast you got to listen to, because that’s what we’re going to talk about today on this special episode of Doctor’s Farmacy called House Call with none other than our Dr. George Papanicolaou from the UltraWellness Center, an extraordinary doc, friend, and just a hero of mine, who’s so committed to helping patients, and doing such a good job. I just think we are so blessed to have him here [inaudible 00:01:03]. Welcome back, George.

Dr. George Papanicolaou:
Mark, it is always a pleasure to be here to talk about what we do here at the UltraWellness Center and helping our patients get to the root cause of their conditions, and then helping them get better using treatments that make sense for their biology and their environmental lifestyle.

Dr. Mark Hyman:
Absolutely. All right, let’s say today we’re going to talk about something that seems like a weird topic, which is parasites and worms and stuff that creeps people out. There’s this whole phenomena in the wellness health world of, “Oh, you got parasites, you need a parasite cleanse.”

Dr. George Papanicolaou:
Oh, gosh.

Dr. Mark Hyman:
It’s like a whole thing. You and I have been looking at poop for longer than most people on the earth have been alive. I think we have seen our share of parasites and our share of worms, but I’m not so sure that it’s the cure for everything.

Dr. George Papanicolaou:
No.

Dr. Mark Hyman:
I don’t think it’s as prevalent as people think, although it is common. I do think that it’s a completely underappreciated, underdiagnosed, and undertreated problem for many people with gut issues, with autoimmune diseases, with all sorts of problems that are overlooked. Part of the challenge is, and we’ll talk more about testing and how we find it and so forth, the challenge is that most doctors don’t think of checking for parasites. They might do a stool test. “Oh, you’ve been to India,” or “You were in Mexico. Maybe we should check you for parasites if your stomach’s not right.” But mostly if you come in with an autoimmune disease or some other weird thing or irritable bowel, they’re not really thinking about parasites.

Dr. Mark Hyman:
Then the testing they do is so antiquated. Basically think about it like this. You have a guy looking down a microscope, looking at stuff swimming across this field, and hopefully one of those critters swims by, and he goes, “Oh, I got that one.” Then he identifies it. The problem is a lot of parasites are from the developing world that people get. A lot of people don’t know how to look for it. So if you’re in Texas and someone drives by in a Volvo, you’re like, “Well, what’s that?” Like, I don’t know what that is. But if you’re in Sweden and someone drives by in a Volvo, you’re like, “Oh, it’s a Volvo.”

Dr. Mark Hyman:
So I think we really have to take a step back. We’re going to dive deep into this conversation about why we get parasites, what the symptoms are, and what our approach to diagnosing and treating it is quite different, and how it can affect so many different issues. So how can we get parasites?

Dr. George Papanicolaou:
How can we get parasites?

Dr. Mark Hyman:
Is it a bad thing?

Dr. George Papanicolaou:
I’ll tell you why. Let me tell you why we have parasites. Because God made parasites. God put them on this Earth for a reason. Maybe the fact that our tests have been so antiquated for so long has been a good thing, because I think if we had really good tests all the time, all along, we’d realize that most everybody has parasites. They’re in our gut for a reason. They really become a problem because there are some that are more pathogenic than others. But the real trick and trigger is, and I think why we see more parasitic-based chronic disease, is the immune system. If you have a hampered immune system, if your immune system is suppressed in any way, or is out of balance, you’re going to to start to feel the impact of those parasites.

Dr. George Papanicolaou:
So why do we have them? Because they’re part of the biologic ecosystem that works for plants and animals, and for humans as well. It’s when you get a big dose of a pathogenic organism. You happen to be immune-compromised at that period of time. It gives you that opportunity for that parasite to take hold in your intestine, and now you’re going to have either an acute illness, and most people have experienced parasitic illnesses acute, like Campylobacter, Giardia, Shigella, salmonella.

Dr. Mark Hyman:
Those are bacteria though. Those aren’t parasites.

Dr. George Papanicolaou:
Well yeah, those are bacteria. But your Giardia is your-

Dr. Mark Hyman:
Entamoeba histolytica.

Dr. George Papanicolaou:
Yeah, Entamoeba histolytica, those are two of the major ones.

Dr. Mark Hyman:
Amebiasis.

Dr. George Papanicolaou:
Yeah, Amebiasis, those three. Those are the ones that people have experienced the most. But the diagnosis to get to Giardia, or Entamoeba histolytica, it can take months to years-

Dr. Mark Hyman:
To years.

Dr. George Papanicolaou:
… for somebody to figure out your chronic diarrhea is caused by one of those two or three parasites.

Dr. Mark Hyman:
Yeah, I had a woman who had chronic fatigue, terribly at her bowel, food sensitivity. She was miserable. It was an extremely well-connected wealthy woman who had access to the best medical care. She had Giardia that she picked up somewhere and she was miserable, and no one found it.

Dr. George Papanicolaou:
Well, it’s very hard to find. One of the standard ways that used to be used, and now I think they use capsules to go in and look for it. But they used to go down into the intestine and it’d be almost like fishing for the Giardia and see if they could pull any Giardia out and do biopsies. Very difficult to diagnose, but we have new tests, and we’ll talk about that.

Dr. Mark Hyman:
Yeah, and people get parasites from water, from food. What kind of food and water?

Dr. George Papanicolaou:
Yeah. You get water, food, you can get it from meats, uncooked meats, and you can get it from your pets. So if you have a cat who’s going out, it happens to be an outdoor cat that likes to kill things, they’re going to get parasites from the rodents and the small creatures that they eat. They’re going to bring it back, and if you’re not careful cleaning their litter box, then you’re going to be at risk for getting a parasite with cats. It’s toxoplasmosis. I actually have a patient who has schizophrenia. I just did, because I’m trying to find out a root cause, I did testing, and I tested him for toxoplasmosis antibodies, and he had very high antibodies of toxoplasmosis. There’s a link between toxoplasmosis and mental health disease, particularly schizophrenia.

Dr. Mark Hyman:
Incredible.

Dr. George Papanicolaou:
Right. Even if it’s treated. The inflammation and the antigenic nature of the toxoplasmosis has an ongoing impact on the brain in such a way that it can lead to the symptoms of schizophrenia. So it’s interesting. It was an interesting case.

Dr. Mark Hyman:
Yeah, it’s really interesting. So that brings together a different train of thinking, which is these parasites are in your gut, but they can cause problems that seemingly have nothing to do with your gut. I remember one kid with autism who was really quite sick, but had a lot of gut issues, and a lot of kids with autism have gut issues. We’re like, “Oh, well, we’ll check his stool,” and he had Giardia. We treated that, and literally the kid’s autism dramatically improved, he started talking. I was like, whoa.

Dr. George Papanicolaou:
Yeah.

Dr. Mark Hyman:
So talk about the ways in which these parasites are common, and what are the most common ones we see, and how do we start to think about what they’re doing in the body? Because in a way you could make a devil’s advocate argument and say, well, we all grew up in nature and we weren’t living in a sanitized hygiene world, and we were all exposed to parasites and we all had worms and amoebas and bacteria. Maybe they have a role in our health.

Dr. George Papanicolaou:
Right.

Dr. Mark Hyman:
Are they all bad?

Dr. George Papanicolaou:
They’re not all bad. Since you brought it up, that’s the hygiene hypothesis. The hygiene hypothesis says that industrialized countries where we have sanitized everything, including our food, we have lost some of the important elements of our gut microbiome, particularly parasites. There’s mounting evidence that parasites actually have a important role in modulating in a positive way the immune system. That there are particular parasites, that there’s a balance in your immune system, and there’s an inflammatory side and anti-inflammatory side. The parasites that are in our body actually produce certain proteins and long-chain carbohydrates and fat molecules that will balance out the immune response so that there’s the T-helper cells that are more inflammatory are shut down. So that can limit auto immunity.

Dr. George Papanicolaou:
We know that auto-immune illnesses and auto-immunity is the base of many of our chronic diseases. So there’s more and more evidence that having a healthy microbiome that includes some parasites can be very helpful. I know we’re probably going to talk about this, but it’s called helminth therapy. Although you don’t hear a lot about it, it is becoming-

Dr. Mark Hyman:
It’ a worm.

Dr. George Papanicolaou:
Yeah, helminth is a worm and they’re being used to modulate the immune system. We’ll talk, I have a case that we’ll talk about later in which I’ve used helminth therapy. So that question mark about can parasites, are they good or are they bad? They’re both.

Dr. Mark Hyman:
It depends. There’s really a couple of good books. One is called Missing Microbes, which is about the damage to our microbiome and the lack of the right bugs that keeps us healthy. The other is called The Epidemic of Absence, which is a brilliant book where this guy literally went to South America, Mexico, and was suffering from allergies and asthma and auto-immune issues and treated himself with worms and actually got better. Oh, it was fascinating. But this is such a crazy idea that people are like, wow, treating people with worms. That sounds like we want to get rid of the parasites.

Dr. George Papanicolaou:
Right.

Dr. Mark Hyman:
But it’s a mixed bag, and you have to figure out what’s going on with the patient. So let’s talk about what are, obviously digestive symptoms, right, if you have a parasite, you’re going to have diarrhea. You’re going to have bloating, you’re to have gas, constipation.

Dr. George Papanicolaou:
Cramping.

Dr. Mark Hyman:
Cramping, all that stuff. People understand that.

Dr. George Papanicolaou:
Right. You’re going to have increased appetite. You may feel like you’re never full. You’re going to have muscle ache, joint pain. You’re going to have skin rashes, itching, hives. You’re going to have brain fog, fatigue. In real severe cases, when you have a 35-foot tape worm hanging out in your gut, you could be anemic, significantly anemic. Iron deficiency, it would be an iron deficiency.

Dr. Mark Hyman:
Nutritional deficiencies. I’ve even seen cystic acne caused by parasites. So they’re common. They cause a lot of issues and they can lead to a lot of auto-immune issues you mentioned. There are a lot of bugs in your gut. There’s bacteria, there’s viruses, there’s fungi. There’s parasites, there’s worms. Did I forget anything? [inaudible 00:12:03] or something. I think it’s a complex subject. It’s a look at the ecosystem in a gut. So essentially it’s like, if you’re a functional medicine doctor, it’s like you’re being a rainforest ecologist. There’s all these different directions and all these dynamic connections. But the problem is really common and the diagnosis is often missed. But often when I see parasites, I feel like they really need to be treated.

Dr. George Papanicolaou:
Absolutely.

Dr. Mark Hyman:
So tell me about, how do we go about diagnosing this? What is wrong with traditional diagnosis? How do we start to diagnose this?

Dr. George Papanicolaou:
Just go back to that one comment you made, because I think it’s really profound. I just want to really make it the last statement on this, is that when you see parasites you should be thinking immune system, and you should be thinking something is amiss in the immune system. But you should also be thinking about the fact that there’s the good side and that we need to have a diverse microbiome that includes bacterial diversity, that includes parasitic diversity, because those organisms have evolved with us. They make compounds for us and they educate our immune system. See, if we don’t have parasites and we don’t have bacteria, then our immune system doesn’t know. It doesn’t know what to respond to. So you now have a sterile diet, and without the nutrients that you should have, you’re not eating fresh vegetables, and you’re not eating grass-fed beef. You’re not going to get the full compliment of bacteria, and even parasites that will educate your immune system. What will happen then is your immune system will then over respond. It’s been in isolation all these years. It’s almost has agoraphobia. It’s afraid to go out of the house. It goes out of the house, and all of a sudden it’s at Gillette Stadium and it’s completely having a panic attack. When it does that, it over responds. You get these auto-immune and inflammatory responses that lead to chronic disease.

Dr. George Papanicolaou:
So it’s really important to understand that we need to eat our food from really healthy soil. We need to eat whole food and vegetables that have these organisms on it. Because that’s going to help us have a diverse gut microbiome that has an abundance of good bacteria that helps protect us, and parasites are part of that. So that’s the good side.

Dr. George Papanicolaou:
Now, the bad side. When you do have that problem, we talked about some of the signs and symptoms. How do you get to that diagnosis when that person’s had chronic diarrhea, or they’ve had this itching and this bloating? Now you’re suspecting, okay, they’ve had all this testing done and nobody’s figured it out. See, that is an advantage we have, because we are oftentimes the doctors of last resort. So I get to look at everything that’s been done, and I can say, you know what? They did this and that, but oftentimes in 20 years of practicing conventional medicine I think I had one positive O&P test.

Dr. Mark Hyman:
One, right.

Dr. George Papanicolaou:
GI doctors, chronic diarrhea, let’s do an O&P. So what the O&P is basically is you have somebody in a lab looking under a microscope at multiple slides at somebody’s poop. You have to look at hundreds of slides to capture one-

Dr. Mark Hyman:
Yeah, and then good luck. You might not recognize it, the guys not trained.

Dr. George Papanicolaou:
You’re right about they’re not trained. There are fewer and fewer lab techs. If you and I saw, well, we’ll probably get it. But we wouldn’t recognize smallpox, because we’ve never seen it. So most of the techs these days when they’re trained, it’s all on biochemical assays, and they’re not getting the microscope training and they don’t see them.

Dr. Mark Hyman:
They might not be as common, like some of the bugs might not be as common here. So if you’re in India and you’re a pathologist, you probably see thousands, and you recognize that.

Dr. George Papanicolaou:
Right, so it’s really hard to see. So using an O&P, if somebody comes here-

Dr. Mark Hyman:
Open parasite test.

Dr. George Papanicolaou:
Open parasite test, I’ve had three of them, and I’ve been told I have no open parasites. Well, there’s new technology called quantitative PCR. So what that does, it’s going to look for DNA material of parasites. It’s going to be able to multiply it until you can measure it. That’s what the PCR does, it’s a polymerase chain reaction.

Dr. Mark Hyman:
That’s what we use for COVID, right?

Dr. George Papanicolaou:
Yeah, exactly. For diagnosing the acute phase of COVID. So that test is very effective and it’s part of one of the tests that we do to look at the gut microbiome. I use this one particular lab and they do the quantitative PCR. They’re very, very sensitive and they pick up parasites.

Dr. Mark Hyman:
That’s like 6,000 times more sensitive than looking at poop in the microscope.

Dr. George Papanicolaou:
It is.

Dr. Mark Hyman:
That’s crazy.

Dr. George Papanicolaou:
We have that diagnostic tool.

Dr. Mark Hyman:
So let’s talk about the approach to looking at parasites. We use a special test. We use one we call GI Effects test here. It’s a-

Dr. George Papanicolaou:
GI-MAP.

Dr. Mark Hyman:
GI-MAP.

Dr. George Papanicolaou:
I like the GI-MAP because of its quantitative PCR. It’s very sensitive, almost to sensitive.

Dr. Mark Hyman:
Yeah, it often picks up things that may not be actually-

Dr. George Papanicolaou:
You get that with a lot.

Dr. Mark Hyman:
There’s a difference between sensitivity and specificity in medicine. Sensitivity means if you have it, it will for sure find it. But it can over report it. Specificity means if you have this, it’s for sure there.

Dr. George Papanicolaou:
It’s that. It’s that thing.

Dr. Mark Hyman:
So it might over-diagnose stuff on some of these PCR tests, because you may have a fragment of something, or it passes through, or it may not be a real problem.

Dr. George Papanicolaou:
You use your clinical judgment and what’s going on with the patient, and that’s the cognitive process that we go through all the time. We don’t treat tests. We treat patients. But we use tests so we don’t guess. So that’s how it works.

Dr. Mark Hyman:
Let’s talk about then, how you would really approach dealing with someone with chronic parasite infections. Then I want to get into talking about worms, because parasites and worms are quite different. I normally wouldn’t give someone a parasite, but we sometimes in medicine are now giving people worms to treat them.

Dr. George Papanicolaou:
Yeah, helminth therapy.

Dr. Mark Hyman:
So talk about what is our approach? We do the diagnostic tests. What is our approach to treating a chronic parasitic infection? We find them through these tests where other people don’t find them.

Dr. George Papanicolaou:
We’ve gone through the process. Now, the patient comes in, we’ve clued into the fact that they have a parasite. We did great testing. We did the GI_MAP. We found their parasite. Now what are we going to do? So there are, of course in medicine, there are some drugs that you can use. But they are very potent and they have lots of side effects to them, and you get more diarrhea, you can get more cramping, you can have hepatotoxicity with them. So you got to be really careful. They can be effective, and I’ve used them.

Dr. Mark Hyman:
Flagyl or Alinia.

Dr. George Papanicolaou:
Flagyl, Alinia, Tinidazole. The two things I think about when I’m dealing with a parasite is, if they have a symptomatic parasite then their gut microbiome is significantly disordered and you usually see not only the parasite, but you’re also going to see other markers of disorder. You’re going to see an over-growth of pathogenic bacteria. You’re going to see candida, because those are the markers of a disordered microbiome that will allow a parasite to really take hold and become pathogenic. So I think first off, it’s the five R’s. So I need to get rid of the parasite. We use botanicals. The botanicals that are really helpful are oregano.

Dr. Mark Hyman:
Herbs.

Dr. George Papanicolaou:
Yeah, herbs. We use oregano, we use garlic, we use black walnut, we use-

Dr. Mark Hyman:
Wormwood.

Dr. George Papanicolaou:
Wormwood.

Dr. Mark Hyman:
Berberine. [crosstalk 00:20:43] extract.

Dr. George Papanicolaou:
Berberine. You can use-

Dr. Mark Hyman:
Papaya seeds.

Dr. George Papanicolaou:
You can use them individually, and you can use them in combination. There are some great, great combo treatments out there that will cover a host of your parasites, and also treat those biotic or pathogenic organisms. So the first thing I want to do is I want to start them on a therapy that’s going to finally get rid of that organism. So it’s a direct attack on the organism. But then we have to look at the entire-

Dr. Mark Hyman:
Before you do that I want to share a story. I was once giving a talk at Yale, and it was to bunch of doctors and naturopaths. I was talking about the gut and I mentioned a parasite in a particular patient, and this naturopath got up and goes, “I tend to use these drugs. I tend to use drugs more for parasites,” and he starts going on and on about all the herbs and how these herbs work against parasites. A minute later this other guy got up, who was a naturopath as well, but he was an older guy. He was like, “The truth is, I’m a naturopath and I primarily use herbs, but often they don’t work as well as the medications. So you can try herbs, but I wouldn’t be afraid of the medications.” Because this is a short-term thing that goes with the cause.

Dr. George Papanicolaou:
No, absolutely not.

Dr. Mark Hyman:
It’s amazing. Irritable bowel is so prevalent and it’s such a big problem for people, and there’s many causes of it, but sometimes it is a parasite. I had a patient recently who was very famous lady, and she was really struggling with chronic gut issues. We treated a parasite and boom, she was instantly better.

Dr. George Papanicolaou:
So yeah, again, Blastocystis hominis, which is a parasite, and another one called Entamoeba histolytica, they’ve both been implicated in IBS, as triggers for IBS.

Dr. Mark Hyman:
Irritable bowel.

Dr. George Papanicolaou:
If you can’t find a reason for somebody’s IBS, and you should be looking for one, because IBS is just not the diagnosis, there’s a trigger for it, and you haven’t been able to get to the bottom of it, you should be looking for those two parasites.

Dr. Mark Hyman:
Unbelievable.

Dr. George Papanicolaou:
I will start with herbal therapies, and then I will advance to using pharmaceutical agents if necessary. But then I want to make sure the rest of their gut is working. So we look at the digestive processes, and oftentimes why do we have the parasite? Because their digestive processes aren’t working well. They’re not making enough HCL in their stomach because they’re under chronic stress. They might not be producing enough pancreatic enzymes. They may have some issues with their gallbladder that’s limiting and their liver that is limiting their production of bile or release of bile. So we want to make sure they have all their digestive enzymes. We want to make sure that their gut immune system is working well. So we want to create that environment.

Dr. George Papanicolaou:
Besides treating, I’m going to want to make sure that they’re getting the types of foods and supplements in their diet that will support a healthy gut microbiome. Good prebiotic foods, like cruciferous vegetables. I want them to make sure they’re getting things like broccoli, and asparagus, and Brussels sprouts, and dandelions. My dad was Greek and we lived in a suburban community and in the springtime my dad would go around the yard and he’d get all the dandelions and he’d bring them in the house and he’d steamed them up and boil them. He’d mix them up with garlic and oregano and dandelions. What are we doing? We’re giving our gut great prebiotics to feed the good bacteria, and we’re giving natural herbs and botanicals to make sure that we keep a healthy gut microbiome. So dandelions really good. Artichokes really good. Konjac root with glucomannan is really good prebiotic. So I want to not just treat the organism, I want to create a really healthy gut microbiome that has a healthy immune system that will prevent further disease down the road.

Dr. Mark Hyman:
So really it’s about not only killing the bug, because often in traditional medicine we’re like-

Dr. George Papanicolaou:
Just kill it.

Dr. Mark Hyman:
… kill the bug, okay, see you later.

Dr. George Papanicolaou:
Carpet bomb it and let’s move on.

Dr. Mark Hyman:
Forget it. The problem is that most people’s gut don’t get back to normal on their own. I often see this even with celiac patients, they will be told, “Oh, you have celiac, don’t eat gluten,” but they still struggle for years with all kinds of digestive issues that they cannot handle certain foods, or they have bloating or gas. It’s even after they’ve eliminated gluten. So you really have to go through this whole gut restoration program. We talk a lot about on the podcast, but it’s such a key part of functional medicine, this five R program where we get rid of the bad stuff, foods, bugs, whatever. Then we put in the good stuff and help the body repair and heal.

Dr. Mark Hyman:
That’s really an incredible approach, and we’ve seen patient after patient who’ve had amazing, and I’ve come across really crazy things. I’ve seen people with schistosomiasis from Africa, and I’ve seen people with Entamoeba histolytica, and I’ve seen a lot of parasites. Blastocystis is one of the most common ones, and it’s often not to be not a pathogenic ones. So it’s not bad, but it often does cause symptoms. If people have symptoms and they have Blastocytis and irritable bowel I tend to treat it.

Dr. George Papanicolaou:
Absolutely.

Dr. Mark Hyman:
So let’s jump to the final topic, because I think that it’s such an interesting topic, and it has to do with worms. Look, we all co-evolve with living with all these bugs, and we had them, and they live with us. What’s interesting is that in the advent of modern civilization we’ve become over-sanitized, and we’ve lost the contact with the natural world. I think we’ve seen this uptick and allergies and asthma and auto-immune diseases and inflammatory diseases.

Dr. George Papanicolaou:
MS, rheumatoid arthritis, psoriatic arthritis.

Dr. Mark Hyman:
All these diseases, and the question is why? Because when you go to the developing world and you go to a hunter-gatherer culture, they don’t have them.

Dr. George Papanicolaou:
Nope.

Dr. Mark Hyman:
There’s just no allergies, no asthma. I was thinking about it the other day. I grew up every summer spending three months on a ranch with horses, and poop, and outside, and being dirty all the time, and dirt, and sleeping outside, and being excited, and I don’t have a single allergy or anything. I think there’s this whole phenomenon where you see kids who grew up on farms don’t get allergies and auto-immunity.

Dr. George Papanicolaou:
If mothers today saw what you and I were doing when we were kids, mucking around in creeks, holding on the salamanders, feeding, we had a horse farm near us and I would feed the horses apples through the fence and they’re licking my hand. Mother’s today would be freaked.

Dr. Mark Hyman:
Right, exactly. So we’ve over-sanitized ourselves, and there’s a number of books like The Epidemic of Absence you mentioned. It really talks about this, and there’s some really good science behind using worms, re-introducing worms into the body. When you look at the part of the immune system that has us deal with the worms, it’s the same part of the immune system that helps us deal with allergy or asthma, which is fascinating to me, because it’s like, oh, it has nothing better to do because it was supposed to be fighting the worms all the time and keeping everything under control. But if you don’t have the worms to fight, all of a sudden the directing gets turned on you and your body starts dealing with attacking, then become more allergic or auto-immune related.

Dr. George Papanicolaou:
There’s an interesting observation. There’s an observational study that looked at people with immune diseases in Sub-Saharan Africa and in underdeveloped countries. They looked at those in regards to the severity of disease, progression of disease, and response to treatment compared to developed countries like the US, and they compared it along the lines of the load of parasites. They found that the patients in Sub-Saharan Africa, and the hypothesis is that it’s because of the parasites, they have their disease, their rheumatoid arthritis, is less severe. It’s progresses more slowly, and it responds better to therapy versus developed countries where there’s less parasites. We have the operation of the hygiene hypothesis where we just live in too sterile of an environment, that our immune systems just are, like you said, are going to get confused. They’re more likely to have an auto-immune response in response to something that’s coming through the system that they maybe should not even respond to.

Dr. George Papanicolaou:
That’s called immune tolerance. Your body actually has to have immune tolerance. You have to tolerate your own antigens, but you have to tolerate the antigens of other organisms, because if you’re responding to everything that comes through your body, then you’re going to be constantly inflamed. So your immune system has to have a mechanism by which it can appropriately tolerate organisms. In that particular setting, those organisms that are being tolerated may be doing something good for us. So if we’re having immune tolerance for a parasite that isn’t harming us, is getting some benefit, but it’s creating compounds that actually modulate and balance our immune system, that’s a win-win.

Dr. Mark Hyman:
Yeah. I know this sounds completely wacky.

Dr. George Papanicolaou:
It’s true.

Dr. Mark Hyman:
Dr. Hyman and Dr. George are giving patients worms. Are they quacks? Or what’s going on here?

Dr. George Papanicolaou:
You know what? I will bring in a patient and she will sit here and tell you that she is a believer in helminth therapy, because she had severe psoriatic arthritis and we worked on everything. Her goal was to be able to either come off of, or greatly reduce her need for, her immunosuppressive Humira. When she came to see, aches and pains in all of her joints, tired, fatigued, really having difficulties. I did all of the things that we do and we’ve talked about on this podcast in functional medicine. But one thing I brought up, I put her on a lot of things that can impact your immune system. Helminth therapy. So I started her on helminth therapy a year and a half ago when she was in the worst, well, she was actually getting better from her pain, but she could not get beyond two and a half weeks without needing the next Humira. Started on helminth therapy, helping her to get to that goal. She’s now, she can go every six weeks before she needs a Humira shot. That started once she started the helminth therapy. So she’s getting parasites, she’s getting helminths, she’s getting these worms. She takes them in capsules. We get them from a really high-level company, and it really does work.

Dr. Mark Hyman:
It does. I would say I’ve been shocked, and I use it very selectively. I have patients who are really struggling, and the usual functional medicine stuff doesn’t work. I think that I’ve been shocked at some of the things I’ve seen. I had this one kid who was on the autistic spectrum, but he was also extremely allergic. He had really high levels of IgE, which is the antibody against allergens when you have allergies, like asthma or allergies. I’m like, I told them, I said, “Look, I don’t know if it’s going to work. I think the risk is very low. We use rat tapeworms, which sounds gross, but they don’t actually take up residence. They don’t actually cause any real problems long-term, they just pass through. But they can help regulate immunity on the way in if you want to try them.” She’s like, “Sure.” Was it really a miracle? This kid not only had reduction of all his symptoms and allergies and everything, but his IgE levels, which normally should be under a hundred, were a thousand. It came down to normal on this therapy. I’ve had other people that have auto-immune diseases, autistic kids-

Dr. George Papanicolaou:
That’s amazing.

Dr. Mark Hyman:
It’s really quite striking. So there’s something to it. You have to pick the right patient.

Dr. George Papanicolaou:
Absolutely.

Dr. Mark Hyman:
We’ll figure it out. But …

Dr. George Papanicolaou:
I just think that in functional medicine, the idea is that it’s not like we just decided, “Oh, you know what, there’s nothing else to do. I heard about witch doctors in Africa using helminths. I think I’ll try that.” There’s a lot of research. I think we pride ourselves here at the UltraWellness Center in getting to the root cause, but really combing the literature for real data that says and helps us find new therapies that are going to be beneficial. So we do that and there is a lot of studies that support helminth therapy in reducing the severity of symptoms and response to medication in people with rheumatoid arthritis, psoriatic arthritis, MS, and asthma.

Dr. Mark Hyman:
Pretty amazing, right?

Dr. George Papanicolaou:
Yeah, it is.

Dr. Mark Hyman:
This is actually in the mainstream medical literature.

Dr. George Papanicolaou:
Yeah, it’s mainstream. It’s mainstream literature.

Dr. Mark Hyman:
Yet, doctor’s are really not doing it. We’re a little on the leading edge here at the UltraWellness Center, and we’re really focusing on what’s going to work for the patients. We use criteria as like, is there scientific evidence? Yes. Is it safe? Yes. Does it have bad side effects? Hopefully not. Is it reasonably priced? Okay. If it meets those things, if we find a great therapy, but it’s a million dollars a dose, we’re probably not going to use it.

Dr. George Papanicolaou:
And it’s invasive.

Dr. Mark Hyman:
Or it doesn’t work. So we really try things that are potentially helpful, and we work with our patients in ways that I think are pretty unique and inspiring, and that allows us to really see remarkable miracles where we often don’t. So if you’re listening to this podcast and you’ve struggled with gut issues, if you have auto-immune issues, if you have allergies, if you have cystic acne, if you have who knows what, you got to start with the gut. You might have a parasite, you might have a worm. You might need to get treated with a worm or get rid of a worm. That’s part of the finesse of medicine.

Dr. George Papanicolaou:
That’s great. We’re either going to get rid of one or give you one.

Dr. Mark Hyman:
Exactly. We figure out how to do that, and that’s really the personalization approach. So if you’ve been listening to this podcast and you struggle with gut or health issues and you want to share how you succeeded in getting rid of your worms or parasites, or what you’ve learned, we’d love to learn from you and share with everybody. Subscribe wherever you get your podcasts. If you know anybody with problems that you think they would benefit, please share this podcast with them. I think they might get something of it. Hopefully, we’ll see you next time on The Doctor’s Farmacy.
Speaker 1:
Hey, everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their Find A Practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.

If you are looking for personalized medical support, we highly recommend contacting Dr. Hyman’s UltraWellness Center in Lenox, Massachusetts today.

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