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    The Selling Of Worms As A Treatment For Autism: Wormy Woo
    By Kim Wombles | May 24th 2010 12:53 PM | 133 comments | Print | E-mail | Track Comments
    About Kim

    Instructor of English and psychology and mother to three on the autism spectrum.

    Writer of the site countering.us (where most of these

    ...

    View Kim's Profile
    One of the worst things I see on the internet, as both a parent of children on the spectrum and as scientifically-based, rational person who works hard to instruct my students in critical thinking skills and being able to detect pseudoscience, is the woo that abounds relating to alternative autism treatments.

    The charlatans and snake oil salesmen abound, and one of these individuals, who promises to cure your child of his autism is a chiropractor named Chun Wong who really, really likes the woo. His latest article on his site, dated May 10, is about helminthic therapy for autism, or as I've decided to call it, Wong's wormy wormy woo.

    Wong loves to say there are studies, blah blah: "For example, it has been shown that some Autism symptoms are the result of malfunctioning immune system. Studies are also suggesting that removing helminths from the body is the start to obtaining a malfunctioning immune system. There have also been cases reported in which Autism symptoms decrease significantly when the child is sick or with a fever." What the heck does that have to do with worms, Wong?

    Even Mercola is not inclined to deal with the worms: "Treating MS Without Toxic Drugs, or Parasites."

    Of course, his idea of treating MS is to check your vitamin D, take omega-3, ALA, progesterone, go dairy free, some other woo and, I kid you the frak not: "Resolve past emotional traumas -- Probably the single most important resource for improving MS is finding a solution for the previous emotional traumas in your life. In my experience nearly every MS patient has some unresolved emotional trigger that caused their immune system to become impaired, eventually progressing to MS. Clearly, issues related to this event need to be addressed to resolve the disease."

    It's not just Wong pushing hookworms for autism, though. The New York Metro Chapter of the National Autism Association appears to be, as well: "What we learned is that TSO was available first. It is the Pig whipworm. The way it's administered is that the ova come in a glass jar with saline. This parasite is microscopic so it is not visible to the naked eye and the solution has no taste. As a mom who just started this therapy only weeks ago, I have to say it is up there with one of the easiest things to administer that I have tried." And, hey, if you decide it's not for you, no biggie, you can give your kid the meds to kill the worms. No big whup. Easy to do. Give your kid worms because you're so woo-driven you can't see your head from a hole in the ground.

    The mom writing the piece admits: "I have to admit I did feel a little bit like a crazy person when I did it and when I first gave it to my little guy. However on day 3 when I saw a significant cognitive improvements it was difficult to feel that I was doing anything but really trying to help my son." Ya think?

    This guy wants to give helminth to babies: "What I propose instead is that these benign organisms once identified be given to children as part of their well baby care and beyond as a prophylactic measure." Just as bad, he justifies his high prices: "Before I get into it let me remind everyone that it is our objective to

    popularise this therapy to that it becomes widely available, and in so doing to drive down the price. The only way to accomplish what we want requires a strong and dedicated company focused on nothing else. That in turn requires people work on it full time, the only way we can pay for that is to charge prices which will allow it. Michelle and I do not own a car, or a house, we have no savings or insurance, all our possessions fit in two back packs. We own and have next to nothing. No one here is even comfortably well off. So if you are pissed off about what we charge console yourself with the knowledge that we are broke." This last bit is from a really long, really defensive post. No doubt it will convince his devoted followers to keep ponying up the bucks.

    And they are big bucks, but that's okay, because "No one knows as much as we do about the use of human helminths outside the research centers. If you proceed with therapy you will find that we follow up with clients constantly. This focus on you helps us to tailor therapy to the person and to continuously refine our approach. For instance, if we find you are an exception to a rule, your therapy will be adjusted without additional charge. If additional doses are required for you to see the results you want additional doses are yours for the asking and the cost of shipping."

    How much will it set you back? According to the website, a cool $2900 to $3900 bucks. Holy pig! And yet the AoAers are having a frikking conniption over the porcine virus DNA snips in the rotavirus vaccine. But, I betcha they'd be all in favor of this treatment.

    It's not clear, though, whether they can legally do this. On another Woo Worm site, I found this: "The FDA has ruled that intestinal worms used to regulate the immune system are a drug. Any drug that has not passed the FDA's review process is an experimental and therefore illegal drug in the United States. The FDA allows, via the personal import policy, for patients in which there is no comparable therapy to import a drug started under the direction of a physician in a foreign country for personal use. It should be noted that the FDA reserves the right to change this policy at any time. The personal import policy is not a right or law but rather an enforcement reprioritization. Should they change their mind they can do so without notice."

    The interesting thing, upon further digging, is that the guy charging the fortune for worms, has had to leave the country leaving his kids behind: "We have largely come to terms emotionally with the trauma of having to leave our home in the US. It is hard still of course, and always will be. But it is no longer oppressive or a crisis, we have settled into something approaching a routine." Later he writes, "We have come to a consensus on how to proceed with Autoimmune Therapies, and we made some good decisions early on about some changes to our business model and to how we produce doses. In some ways the FDA decision to classify helminths as a drug have been good for us. It lit a fire under us and has also resulted in much more media attention."

    This guy may beat Wakefield for having a martyr complex: "To have one’s life turned upside down for making sick people well,, sick people mainstream medicine has nothing as effective, safe or cheap to offer, is infuriating." Oh, poor, pitiful martyr.

    Moving on, Autism TSO writes a bunch of nonsense about autism and autoimmune, blah blah, before offering this nugget: "Helminth worms, in particular the porcine whipworm (Trichuris Suis), have been studied as a potential treatment for Crohn’s disease and ulcerative colitis." Of course, since the woo-meisters love to push gastrointestinal issues as the causative factor in autism (thank you Wakefield), their conclusion: "In summary, there is evidence to suggest a possible causal relationship between increased levels of proinflammatory cytokines and symptoms of aggression and agitation in autism. New immunomodulatory treatments for other autoimmune disorders should be investigated as possible treatments for these symptoms. The recent extremely promising results from the use of TSO in the treatment of Crohn’s disease and ulcerative colitis warrant examination as a potential treatment for symptoms of agitation and aggression in individuals with autism."

    The Autism TSO site, of course, links you to a site where you can get some pig worms. Can't ship them here, though.

    Here's another site pushing TSO for autism, with one case study as proof. It, of course, links you to the Ovamed site linked in the paragraph above. Hey, you can always take your kid to Thailand, if you're not fond of Mexico.

    Again, I really have to ask: will AoA leap to the idea of pig worms as a cure all while lambasting the porcine virus DNA in the rotavirus vaccines? Will they give their children worms, worms that can have seriously deleterious effects?

    Real science on helminth infections:

    "However, recent studies have provided evidence indicating the exacerbating effects of helminths on bacterial as well as non-infectious colitis in animal models" (Wang, Cao, Shi, 2008). In other words, maybe (maybe) it is helpful in Crohn's for poorly understood reasons, but it sure as hell can make things a lot worse:

    "Most helminth infections, if left untreated, result in multi-year, chronic inflammatory disorders that will eventually cause disability. The chronic, disabling and disfiguring consequences of helminth infections, together with their high prevalence, make them a global problem of significant medical, educational, and economic impact" (Wang, Cao, Shi, 2008).

    "Protective immunity to helminths depends on T lymphocytes. It is now well established that the CD4+ subset of T cells plays a major role in the generation of the host protective response that expels the worms, and that CD4+ T cells regulate many of the inflammatory and immune parameters that accompany expulsion of the parasites from the gut" (Wang, Cao, Shi, 2008).

    "The major importance of helminth infections includes not only the direct pathogenic effect of the worms as described above, but also the modulation of the host immune system, which may alter the response to other pathogens and antigens and cause additional immunopathology" (Wang, Cao, Shi, 2008). Again, screw things up worse.

    But, hey they're your kids, and it's so terrible, and you can always give the kids pills to kill the pig worms if it doesn't work out, so what's the big deal with going to Mexico to infest your kids with worms and pissing thousands of dollars down the drain?

    What I see when I look out there on the internet, when it comes to not just autism treatments, but treatments for all host of diseases and illnesses, is an abundance of woo. Woo is a highly profitable industry. And yet the folks at AoA decry big Pharma.

    Addendum: Thanks to a friend looking into this (and for passing along the catalyst for this article in the first place), here's a new study comparing rates of helminth infections in the general population to a sample of intellectually disabled children in Norther Iran. If the hypothesis that those using helminthic infection to "treat" autism is that there an absence of these parasites causing the intestinal issues which somehow manifest as autism, then the finding that there is no difference between the general population and the ID population studied would suggest that there is no reason to conclude that helminth infections or lack thereof contribute to cognitive impairment. I don't know why the wackaloons I found once I started looking past Wong thought it would, but there you go... hmmm.

    Comments

    antunes
    Parasites as medicine remind me of how radium cures were popular in the 1920s. A little dose of radium brought a false flush of health and vigor to ill people... as their immune systems kick into a futile radium-induced resist-cancer overdrive, followed shortly by death. Quackery never goes out of style, *sigh*
    When someone suggested bread mold could fight bacterial infections, there were a number like you who simply scoffed and rolled their eyes *sigh*. Please read: http://www.guardian.co.uk/science/2010/may/27/bone-marrow-transplants-me...

    Gerhard Adam
    So what.  Suggesting bread mold fights bacterial infections is irrelevant until there is evidence.  Why do people always assume that every assertion must be greeted with open arms and hailed as a new discovery?  It should be viewed skeptically.  That's why it's so important for anyone making assertions to advance a real argument, and hopefully real data.

    Simply claiming that bread mold fights bacteria should be scoffed at, if not because it may seem implausible, but from the sheer audacity of someone suggesting it and offering no hypothesis or data.

    Of course, I seriously doubt your anecdote is true, since there's no reason to believe that bread mold wouldn't fight off bacteria.  Whether bread mold would be capable of doing so within the human body is a completely different matter. 
    Mundus vult decipi
    http://opensourcehelminththerapy.org/mediawiki2/index.php?title=Studies_... <<-- look through all these papers. They document how helminthic therapy is actually quite effective. There is even a pharmaceutical company conducting official clinical trials in the US under the auspices of FDA with helminthic therapy: http://www.coronadobiosciences.com/products/cndo-201.cfm

    1) No one is saying there is definite proof yet, but there actually is a fair amount of serious research that points to the role of parasites in a whole host of immune and health concerns: http://news.bbc.co.uk/2/hi/health/7856095.stm

    2) Wow, you need to take a history of science class.
    Please learn a bit more about bread mold, as I'll bet you have taken penicillin before: http://en.wikipedia.org/wiki/Penicillin

    Another Bit O' History: British travelers in the 17th century observed "crazy" Turkish women actually infecting their children with diseases to help them fight off the same disease later on, which is why we now have vaccines.

    Gerhard Adam
    Great.  However when someone is selling or offering therapies, then you'd better not be looking for evidence that they're effective.  That's doing it backwards and is quackery.

    Don't know what you read into my comment about bread-mold, but I do know it's role in antibiotics.  My only point was the notion that bread-mold kills bacteria isn't that startling a conclusion.  The scientific issue was whether bread-mold introduced into the human body would be useful to combat bacterial infection.   When looked at in that fashion, then it becomes much more reasonable to understand why there may have been initial skepticism.

    I have no problem with scientific exploration of whatever produces results.  Even ventures that turn out to be blind paths are not a problem.   Not everything will be successful.  I get that.

    HOWEVER ... that also means that no one should be talking about therapies or treatments.

    Mundus vult decipi
    On your own website I discovered this post:
    http://www.science20.com/science_20/blog/kids_need_eat_little_dirt_be_he...

    which led me to this link

    http://www.cnn.com/2011/OPINION/03/02/berezow.germs/

    which discussed helminthic therapy on the bottom of the article :-)

    And this was over a year ago. If I waited until this therapy was FDA approved, I would not have achieved a remission from severe Crohn's disease.

    Here's a list of articles from New York TImes, CNN, Wall Street Journal, Nature, Discover Magazine, Washington Post, The Scientist, Scientific American, Science News and others, describing successes of helminthic therapy:

    http://opensourcehelminththerapy.org/mediawiki2/index.php?title=Media

    Gerhard Adam
    If I waited until this therapy was FDA approved, I would not have achieved a remission from severe Crohn's disease.
    Let's be clear about this.  Whatever you choose to believe, and whatever actions you take on your own behalf is your personal responsibility.  Whether you believe it works or doesn't work, is also up for your subjective interpretation.

    However, if you take a dime from anyone else, or make a recommendation to someone else with nothing more than that, then you're simply a fraud and a crook.  It isn't up to YOU to decide what is acceptable for FDA approval. 

    What you need to be thinking about, and I hope you do it seriously, is to consider that whether something did or didn't work for you ... how you would feel if someone followed your advice and had a negative outcome.  Would you then be willing to step up and take responsibility for that advice?  I suspect not.
    Mundus vult decipi
    And that's why I did my research first. This double-blind study https://docs.google.com/file/d/0B6q9LY6_tfVZYjhjNGEyMjYtNTcyMS00NjVjLWIz...
    establishes the safety of small doses of Necator Americanus in human subjects.
    As a matter of fact I *HAVE* recommended this therapy to people I know personally. Quite a few of them were persuaded by the overwhelming amounts of scientific evidence I presented (please see the 120 PDF files on the google docs link http://goo.gl/CFsY and the other 3 links I posted below). So far *everyone* who started the therapy has seen incredible results with eosinophilic esophagitis, autism, narcolepsy, Crohn's disease and Ulcerative Colitis. This with cases where other medical approaches failed. In each of these case, the doctors of these patients are in the process of writing up and publishing case studies due to such great reductions of symptoms. If you join this forum, you will be able to speak with these people personally: http://www.facebook.com/groups/HelminthicTherapy/

    Gerhard Adam
    This with cases where other medical approaches failed. In each of these case, the doctors of these patients are in the process of writing up and publishing case studies due to such great reductions of symptoms.

    I'm not interested in the patient's anecdotes.  Let's see what the doctors say.  Surely they must be prepared to offer their views [especially since they are writing up unofficial and unsanctioned studies].

    Let's hear from them. 
    This double-blind study https://docs.google.com/file/d/0B6q9LY6_tfVZYjhjNGEyMjYtNTcyMS00NjVjLWIz...
    establishes the safety of small doses of Necator Americanus in human subjects.

    Well, it does sound like you know your salesmanship.  It's fascinating that your "research" consists of a study that doesn't deal with effectiveness of helminthic therapy, but essentially establishing the limits of one's liability for making the recommendation.  Pretty good.

    Mundus vult decipi
    "However when someone is selling or offering therapies, then you'd better not be looking for evidence that they're effective. That's doing it backwards and is quackery."

    Wow, I'm not trying to be a jerk, but what you describe as quackery is literally THE HISTORY OF MEDICINE. REally.

    I'll stop posting wiki links, but please do some research into how every thing from aspirin in the 19th century to Risperdone now have come about. Throughout the ages, medicines have been discovered, used, tested, and only much later to theories come about concerning why or how they work. The truth is, medical science is an oxymoron, it has always been well-educated guessing. And you use the FDA as the bench mark? Fine. Then of course you know that a drug doesn't have to be proved even close to 100% safe or 100% effective (again, see Risperdone). However TSO worms have been proven safe in FDA trials, in fact they're much safer than Risperdone, which again is FDA approved

    I am the creator of the autismtso.com website and the father if a 19 year old son with autism. I thought it might help clarify if summarize what my lengthy, and sometimes boring website says. My son's autism symptoms included extreme self abuse, agitation, anxiety and OCD. 13 years of pharmacological interventions working with a prominent specialist in Autism (who was then Chairman of the dept of Psychiatry at Mount Sinai and Director of the Seaver Center for Autism Research) we were still faced with these symptoms. I noticed that whenever my son had a fever or insect bites the symptoms mentioned above went away. I began doing research and came up with an idea and potential treatment. I presented this to my sons doctor, who helped me obtain and administer TSO. After 8 weeks my son went from having to be physically restrained multiple times a day to not hitting himself at all. His anxiety, agitation and OCD completely vanished. His doctor was as shocked as I was and asked me to present this to a group of doctors and scientists, which I did. They thought this deserved further study. I did not go public with any of this for a full year, as I did not want to be the purveyor of false hope to anyone. For the next year I agreed to work with the team at Mount Sinai to write a grant application to study this. I worked at night and weekends to help out with the grant application. I am not a doctor but was able to contribute and the grant application process, although it took longer than expected, got done. After letting a year go by and setting up the groundwork for a real study, I spent my own money on a website that told my story. I wanted people to know about this line of research and to have a forum where people that wanted information or wanted to share their experiences could go. I have never had, and never will have, any financial relationship with the manufacturer of TSO. I'm just a father with a remarkable story that may stimulate some real science and help others. I have tried to take my son off TSO 3 times since 2008, one time for a full three months. Each time the self abuse, agitation, anxiety and OCD returned. Each time TSO was reintroduced the symptoms went away. If anyone reading your blog cares, Mount Sinai is recruiting for a 10 person study of TSO in autism; info can be found at clinicaltrials.gov.

    kwombles
    With no reasonable explanation for why dosing an individual with intestinal parasites would reduce difficult behaviors in autistic individuals, with no control group, a sample group of individuals over the age of 18 (there's that to be grateful for at least), and exclusion requirements that would preclude those individuals who (according to the whole premise) would potentially benefit the most, this doesn't impress me as particularly good science. For parents to place their adult autistic children in such a study strikes me as singularly lacking in common sense, especially in light of the hysteria on the part of those who believe autism is vaccine injury over the recently discovered porcine virus dna in the rotavirus vaccine.

    In addition, the website (along with the information provided to the clinical trials) would seem to overstate the case that it is of benefit in IBD.

    On the basis of anecdote, ten disabled individuals will be put through a treatment with the potential to cause harm?  Mount Sinai provides this information: "Trichuris Suis Ova (TSO) TSO is a helminth with previously demonstrated benefits from several controlled trials in autoimmune inflammatory bowel disease. In autism, TSO has anecdotal evidence from several individual case studies to support its use to treat self-injury and repetitive behaviors, and we are interested in testing this hypothesis further."

    Has it occurred to you that your experiences don't demonstrate the efficacy of TSO (but instead may reflect other changes that led to your conclusion that your son's behaviors worsened with removal and abated with reintroduction) and that the way this study is designed will also not demonstrate the efficacy of TSO? Evaluators know the subjects are getting it and will be subconsciously prepared to see less OCD and SIBs. I know, the way the study is set up, it's only to evaluate the safe amount of TSO in preparation for future studies.

    How hard up would one have to be to put one's child through this much woo?
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    As a researcher, I was privileged to attend a lecture by Joel Weinstock, MD, who is now the Chief of Gastroenterology at Tufts Medical Center, Boston on the topic of using helminths to treat refractory (non-responsive) Crohn's disease & ulcerative colitis. 50% of the patients achieved a lasting remisison. Since Weinstock's research was published in 2005, more research with helminths involving other autoimmue conditions has followed. Currently, there is a study recruiting in Boston for use of helminths in peanut allergy: http://www.thebostonchannel.com/health/23652453/detail.html Another study is recruiting at U Wisconsin for Multiple Sclerosis: http://www.neurology.wisc.edu/publications/07_pubs/Neuro_5.pdf and there is a nice article by respected researcher David Elliott detailing possible additional "applications" for helminthic therapy: http://www.direct-ms.org/pdf/HygienePrinciples/Helminiths%20immune%20reg... I think that considering the paucity of available treatments for autism, seeking an immunological cause is not beyond the pale, and if you don't believe me, go to www.pubmed.gov, the biggest mnedical database in the world, and cut and paste in the Medical Subject Heading I have providedhere: "Autistic Disorder/immunology"[Mesh] See also Judy Chinitz, who has a book out called "We Band of Mothers."

    kwombles
    Thanks for the links. I have problems with how you've framed your argument. First, studies into helminths and autoimmune conditions are not relevant to the whether parents ought to be going out of country to infect their children with worms for autism. Second, the "paucity" of autism treatments is irrelevant to whether worms should be used to treat autistic children.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Human worms are commonly found in people's guts in developing countries, but due modern hygiene practices in our developed world, these worms are very rare here.

    Thus it would appear that it is the developed world as a whole that is performing an uncontrolled experiment by suddenly removing these commensal organisms such as worms from our guts via modern hygiene practices. Whose idea was it to remove these? What are the consequences of removing these commensal organisms? Why was this done without controlled studies to see what the effects of dispensing with these "old friends" are?

    This is the whole theory behind the hygiene hypothesis.

    Hank
    It's kind of a silly assertion.   They have a lot more hepatitis in Asia too, yet in the US we do not, so your assertion is that our no longer having hepatitis might be a cause of more autism?
    That is not exactly the assertion. A lot of these worms may well be commensal: they do no real harm. Unlike hepatitis.

    Commensal gut organisms may secrete anti-inflammatory factors in order to tone down our immune response and thus survive in our gut. We have evolved in their presence, so our immune response may configured to take commensal gut organisms into account. Once these gut organisms are removed, and their anti-inflammatory factors gone, you might expect the immune response to be a little too strong.

    That does not mean that all worms are good for you. Taenia solium (pork tapeworm) for example can lead to dementia.

    My personal bet is on autism having mainly a infectious viral or bacterial fundamental etiology or etiologies; but it may also be possible that lack of "old friend" helminths (or probiotic bacteria) may make autism and other inflammation-linked conditions worse.

    This post is stupid because it engages in positive empiricism. That is to say that just throwing the word "woo" around and associating worms with something scary and dangerous, you have somehow come to the erroneous conclusion that helminths *don't* aid in regulation of one's immune system.

    First of all, there are plenty of studies going on currently regarding efficacy of necator americanus for treatment of allergies. Second, the worms are relatively harmless in controlled quantities and more than 800 million people worldwide are infected with no symptoms. There are plenty of people who have achieved *complete* remission from immune related issues with helminthic therapy, and numerous evidence that killing off the helminths showed a reversal of symptoms.

    Yes there is no conclusive evidence or hard numbers regarding efficacy yet. That doesn't make it woo. It just means it's unproven. And if you consider the potential benefits and compare them to the potential harm (which at worst is mild anemia, which is reversible as well), then it's a no brainer for a lot of people suffering from these immune related issues.

    You will find alot of crackpots and nutcases on the internet, but the advocates of helmenthic therapy are not among them.

    If you had treated us with a modicum of the gravity with which we treat the science of helmenthic therapy, you would have come away with far different conclusions.
    One can not, however, impartially judge something which one is frightened of from the start.

    Science requires having an open mind and a willingness to test assertions. Ideally, we would be able to make studies to prove in favor or against new teratments, and then, with enough data on hand, we can decide if the treatment works or not. Unfortunately medical science is very expensive and hard to conduct.

    I have noticed that a lot of medical science journalism has fallen into a rigid and unscientific position of discounting what they think are icky or unpopular treatments by stating that there are no studies that prove whether they work or not. Although stating the lack of studies should be a qualifier of ignorance, it is often used as evidence against a treatment. This is logically incorrect. Lacking studies doesn't translate into "it is wrong" or "it is pseudo-science." Lack of studies means "we don't know."

    And the proper, scientific stand when the answer is, "we don't know" is to keep an open mind and wait for results, or attempt to get those results to know whether it works or not.

    Yes, even if it grosses you out. We should keep an open mind especially when it comes to medical science. Many treatments are gross, we just don't see it that way because we are used to them. You and I probably think that consuming mold for health reasons would be disgusting, yet we happily take antibiotics when we need them.

    I think you had a good goal when you wrote this piece, and I commend you about it. We do need to fight quackery. But we also must be scientific enough to keep an open mind on new treatments.

    Gerhard Adam
    And the proper, scientific stand when the answer is, "we don't know" is to keep an open mind and wait for results, or attempt to get those results to know whether it works or not.
    Whoa .....

    If you want to maintain that position then:

    (1) don't allow anyone to describe something for which "we don't know" as a therapy.  That is misrepresenting the state of knowledge.

    (2) don't allow anyone to charge money for something for which "we don't know".

    (3) ensure that anyone promoting something "we don't know" assumes full legal liability for the consequences of their recommendations.

    THEN, you have a basis for claiming that we should maintain an open mind.  Of course, that wouldn't be necessary because the evidence can speak for itself. 

    You see the problem isn't open-mindedness.  The problem is that too many people and organizations take the position that "we don't know" is synonymous with "anything goes" and "whatever we can get away with".  It is NOT incumbent upon science to disprove quackery. 


    Mundus vult decipi
    Hi, Gerhard,

    You are really arguing against science keeping an open mind? And that we shouldn't hold judgement on treatments until they have been proven right or wrong through studies? Really?

    I had to control myself from fully pushing this point forward against you. But, by the tone of your answers, it seems that you are having a bad day. Calm down, re-read what I said, understand what I am saying, and then realize how, in your desire to attack, you put yourself in a impossible to defend position on the nature of science.

    I hope you have a better day. God bless you.

    Gerhard Adam
    You are really arguing against science keeping an open mind? And that we shouldn't hold judgement on treatments until they have been proven right or wrong through studies? Really?
    Why do people always assume an "open-mind" is synonymous with "sucker"?

    You cannot judge a treatment until it has been proven right or wrong.  If you do then you're not interested in science, you're interested in salesmanship.

    By what stretch should someone be allowed to claim something as a therapy when there is no evidence that it works?  How can someone claim a treatment or a cure when there is no evidence that it works?  More to the point, how can someone actually charge money for these things, when there is no evidence?  They can do it, because they are pretending that it is true.  They have no inhibitions from taking people's money and raising their hopes, all the while knowing that they have no knowledge as to whether what they're recommending will help, hurt, or do nothing.

    That isn't about science.  It's snake oil.
    Mundus vult decipi
    Gerhard Adam
    Science requires having an open mind and a willingness to test assertions.
    No, it should be a "willingness to test REASONABLE assertions".  Science would get nothing done if every quack claim had to be tested and refuted to satisfy all those too lazy their conduct their own experiments.  The onus is on those making the assertion.  No data, no basis for making an assertion.  It's not complicated.  So the question should be, why all those making assertions feel that it is someone else's problem to provide the tests and data?
    Mundus vult decipi
    Gerhard Adam
    ...modicum of the gravity with which we treat the science of helmenthic therapy.
    Well, good, then you should have no problem in providing links to scientific articles detailing its effectiveness.  I am a bit concerned by your comment about "impartially" judging something.  I thought this was scientific?  Since when does someone have to judge conclusive evidence?  It isn't about opinions.
    Mundus vult decipi
    OK, I will take that challenge. i can provide valid references to back up my claims now as there has been quite a lot of research in the last few years on this topic. Please go to this google docs link and look through the articles from respected medical journals: http://goo.gl/CFsY
    Open each one and at least read the titles and the abstracts.
    Please also look through my website wiki on helminthic therapy. It's most definitely not quackery. http://www.opensourcehelminththerapy.org

    Gerhard Adam
    OK ... here's the problem

    First PDF:
    Genetic Component to Susceptibility to Trichuris trichiura: Evidence from Two Asian Populations

    This has nothing to do with anything, beyond determining the genetic susceptibility of a population to a whip worm infection.  How does this relate to therapy in any way?

    Second PDF:
    Bacteriophage Therapy: Exploiting Smaller Fleas

    How do bacteriophages relate in any way to worms?

    Third PDF:
    Parasites represent a major selective force for interleukin genes and shape the genetic predisposition to autoimmune conditions

    This has nothing to do with therapy, but is merely attempting to demonstrate that parasites have been a selective pressure in shaping certain genetic responses for autoimmune disorders.

    Other titles such as:
    A proof of concept study establishing Necator americanus in Crohn_s patients and reservoir donors.pdf

    Again ... a "proof of concept" is not therapy.

    I didn't see a single paper that indicated any successful implementation of a therapy, nor proposing one.  Instead there are a lot of disconnected articles that may or may not be relevant that say none of what is being alleged.
    Mundus vult decipi
    Sorry, google docs link has a lot of other docs that may not be related. Scroll through the titles of all PDFs - there are over 120. The right ones will jump out at you. Here's a list of the ones you will find useful:
    https://docs.google.com/file/d/0B6q9LY6_tfVZYjY2N2Q3ZjYtOTY3OC00MjQxLTlh... <<-- helps MS
    https://docs.google.com/file/d/0B6q9LY6_tfVZNTZhNGMxYTMtOTFjYS00MThmLWE4... <<-- especially page 554 and 555 under section named "HOOKWORM AND THE HYGIENE HYPOTHESIS".
    https://docs.google.com/file/d/0B6q9LY6_tfVZdWd5Z01FWExSbUNTY1dXOEM0TG92... <<-- a brief overview list of all trials with helminthic therapy on humans on page2

    Gerhard Adam
    Sorry, but YOU do the work if you want to provide evidence.  I asked you for links and you gave me a bunch of unrelated nonsense.

    If you can't be bothered to put something together in support of your "evidence", then don't expect me to do the research for you.

    I have to ask ... where do you see gastrointestinal disorders in the title of this post?    You provided a link that indicates it's "a brief overview list of all trials with helminthic therapy on humans"

    However, that can be misleading, since it is for intestinal disorders and NOT AUTISM!
    Mundus vult decipi
    These are not directly intestinal disorders - these are AUTOIMMUNE disorders where an immune system attacks the digestive system. New evidence is coming to light that shows that autism is also an IMMUNE disorder. Look at this article: http://www.guardian.co.uk/science/2010/may/27/bone-marrow-transplants-me...
    a mental disorder was cured by transplanting an immune system. Stewart Johnson and other people I know successfully treated autism with TSO which is in clinical trials now for AUTOIMMUNE diseases: see this Mount Sinai Presentation on Autism and TSO: http://www.youtube.com/watch?v=r_R_sHV8H9o

    So, I am trying to show that there is credible scientific evidence that points to helminthic therapy as a viable option for treating the symptoms of autism. Instead of flatly denying this, I suggest to review the accumulated evidence!

    Gerhard Adam
    Now you're cobbling together connections that I suspect you aren't remotely qualified to make.

    The Guardian is not a scientific journal, and YouTube is not scientific evidence.

    Unless you have something scientific to offer then you're simply a salesman.  You claim that there are doctors writing up these topics ... well, I don't believe you, but if you can't produce something they've officially written, then by all means.

    Your assertion regarding autism is simply wrong.  You know nothing about it, you know nothing about any linkage, and you're speculating for no better reason than to raise people's hopes for something you can't possibly know works.

    That's pretty bad [hmmm .. I wonder what the odds are that you'll make money somewhere in this deal?]
    Mundus vult decipi
    Great, now you're attacking my credibility by using ad hominem (http://en.wikipedia.org/wiki/Ad_hominem ) logical fallacy claiming that I must make money on this instead of replying on the merits of my arguments. Youtube is not scientific evidence but if you actually bother to click on the link you will see the evidence in the clip which is a scientific presentation in Mount Sinai - a respectable teaching hospital. Why don't your respond to the evidence presented in that report on its merits instead of flatly denying it before even looking into it?
    https://docs.google.com/file/d/0B6q9LY6_tfVZYWMyZmFlYTctMzlmNi00ODQzLTlj...
    is a scientific article in a peer-reviewed journal showing that autism and the hygiene hypothesis are being investigated as very likely related and that autism may very well be an immune disorder closely linked to inflammation. I have collected a LOT of medical studies showing that helminthic therapy is helpful in immune disorders specifically dealing with inflammation by regulating the Th1 and Th2 immune responses and controlling the release of various cytokines.

    Here's the reality:

    1. Replacing helminths, and possibly other microorganisms, may be the only reasonable therapy for a wide range of immune-associated disorders, including allergy, autoimmunity and autism. http://tiny.cc/5vn53

    2. Helminthic Therapy is already transforming the lives of hundreds of extremely sick individuals, as can be seen from the following link, which lists clips from the accounts of some of those who are benefitting. http://tiny.cc/i74ld

    This is not "woo'. This is Wow!

    Many doubted that bread mold could fight bacterial infections or that infecting your child with a disease could actually help them not get sick later, as Turkish women in the 17th century were observed doing. Scoffing and rolling eyes does not make one rational, and more science seems to be supporting the basic premise: http://www.guardian.co.uk/science/2010/may/27/bone-marrow-transplants-me...

    http://online.wsj.com/article/SB1000142405297020479530457722099364155746...

    kwombles
    To the new commentator who is pushing his worm agenda, this article was written two years ago. It concerns using an untested treatment for an unproven hypothesis regarding autism causation.
    Autism is a neurological condition that is in all likelihood set by birth. It is not, despite Wakefield's attempts, a gastrointestinal issue. 

    The use of worms in a vulnerable population without scientific evidence to back up its efficacy and safety is unethical. The very fact that parents have to take their kids out of the country to purchase the worms ought to be a clue.

    I don't care about your anecdotes or your google docs with a listing of unrelated articles.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    I respectfully disagree that the articles are unrelated. New evidence has come to light that autism may be very closely related to immune dysregulation and might be an immune disorder which affects the brain. If you review the articles I posted that are printed in reputable medical journals you will see that there is real evidence of this. If you continue to refuse to even inspect the evidence and respond on the merits, you are being very close-minded and not scientific in your approach.

    Gerhard Adam
    Sorry ... now you've crossed a line.  If you have evidence present it.  If you want to discuss therapies, then you're WAY out of line because you have no evidence that these work.

    Your earlier point about waiting for the FDA illustrates one serious problem, and advocacy of such treatments especially for something that has no such connection is quackery and fraud.  There is nothing to consider regarding open-mindedness.  It's about basic honesty and integrity.

    Anyone that promotes a treatment or therapy, knowing that there is no evidence that it works is dishonest.  Anyone that would also take money for it is despicable.
    Mundus vult decipi
    Gerhard Adam
    The sad part about this, is that whatever merit some of these studies may have will be undermined by someone like you that goes around touting treatment and cures before anyone knows any such thing.

    Your exuberance will undermine the very thing you claim you want to advance.  You don't provide credible information, you provide snippets of data that aren't connected to anything and which NO doctor would sign off on. 

    You truly are clueless, if you think that your paltry experience with Crohn's makes you an expert on parasites and their effects.  Yet, I guess you think it should be "full speed ahead" until someone yells "Iceberg".

    Mundus vult decipi
    https://docs.google.com/file/d/0B6q9LY6_tfVZNTY0ZDNjYmEtZGZhZi00YzdhLWI4...

    <<-- more evidence that helminthic therapy helps with autoimmune diseases. I have already
    ~~~~~~~~~~~~
    peer-reviewed study mentioning helminthic therapy being used for autism:
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092582/?tool=pubmed
    ~~~~~~~~~~

    Stop refusing to examine the evidence presented - this is definitely something that will require further research. It has already been established as safe by double-blind studies. There is no current effective treatment for autism. So that means that people are not losing anything by trying it and anecdotal accounts show that when people do try it, they see amazing results.

    http://opensourcehelminththerapy.org/mediawiki2/images/f/ff/A_Review_of_... <<-- an extensive peer-reviewed article in "Clinical & Developmental Immunology" discussing autism as an immune disorder.

    Anecdote from the web on PANDAS and TSO:
    http://www.latitudes.org/forums/index.php?showtopic=14398

    http://goo.gl/5oBd9
    google search on "helminthic therapy" AND autism
    with a lot of results.

    You respond to my post 14 minutes later which is definitely not enough time for even the smartest people to read the 8 articles I posted, and yet you conclude that I am clueless.

    Why don't you first read each of these articles, examine the evidence presented and respond on the merits before jumping to conclusions and using ad hominem to discredit me?

    Gerhard Adam
    I don't need to read the article when the abstract already indicates it has nothing to do with your claims.
    Mundus vult decipi
    My claim is that autism is an immune disorder. Here's a paper without an abstract that shows it to be an immune disorder: http://opensourcehelminththerapy.org/mediawiki2/images/f/ff/A_Review_of_...
    My claim is that helminthic therapy works well against immune disorders and it's safe. My claim is that since it's a safe possible treatment, it should be tried if no other effective medical treatments exist.

    Stop burying your head in the sand and examine the evidence provided. http://www.amazon.com/Cutting-Edge-Therapies-Autism-2011-2012-Siri/dp/16... - has a chapter on this subject.

    Examine everything I posted here - this is not quackery, especially since people that try it instead of denying it, see actual results.

    kwombles
    Your claim about autism is still unfounded. 
    Your claim about helminth therapy being safe is not backed up by sound scientific studies.

    There is no rationale based on evidence in which helminth therapy should be used with autistic children.

    Cutting Edge Therapies is an alt-med nightmare with no scientific evidence backing it up. Yes, I've read it.

    It is quackery, and anecdotes from people who have subjected themselves to helminth therapy are not convincing evidence, especially given the incredible incentive to believe that treatment is effective. Who, after all, would want to admit they'd injected themselves with parasites and didn't get better?

    You are essentially spamming this article, and it smacks of desperation.

    If the claims that thousands of parents witnessed their children regress into autism after vaccines is insufficient as scientific evidence, why would a handful of desperate individuals claiming worms helped them be any more convincing?
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    http://www.medicalnewstoday.com/articles/244320.php
    What do you know, in April's issue of International Journal of Developmental Neuroscience they tell us that the immune system has been implicated in autistic disorders:

    http://www.sciencedirect.com/science/article/pii/S0736574811001912

    What do you say to that?

    Gerhard Adam
    OMG ..Autism has been cured!!! ... If that's not what you mean, then what's your point?  "Implicated" doesn't mean anything definitive.
    Mundus vult decipi
    Gerhard Adam
    What are you thinking?
    Here's a paper without an abstract that shows it to be an immune disorder:
    This is your idea of demonstrating that autism is an immune disorder?
    While there is a growing cognizance of immunological dysfunction in some ASD children, a great deal of research remains to be done.
    http://opensourcehelminththerapy.org/mediawiki2/images/f/ff/A_Review_of_Autism.pdf
    My claim is that helminthic therapy works well against immune disorders and it's safe.
    ... what method do you use to guarantee safety? 

    You are doing more harm to science than anything.  People like you run off prematurely, or in the wrong direction, announcing discoveries that haven't happened and claiming evidence where none exists.  Then when science provides real data, it's no surprise when the charges of "cover-up" occur or the frustration, in the public's mind, of science constantly changing it's position.  This is one reason why people say things like "it's only a theory". 

    Until the research data is in and confirmed, there is no therapy or treatment.  I don't know how many ways I can say this.  Your point about medical history being based on experimentation and THEN confirmation is irrelevant. 

    If people want to experiment on themselves, then it's ultimately their problem.  They have no grounds for complaint, especially if they follow uninformed opinions and advice.  If they get better, if they get worse, or even if they die .... so what.  It's their choice.  However, let's not pretend that it has anything to do with science.

    Mundus vult decipi
    Your article here is a bunch of "woo".
    You clearly did not do your research before letting your fingers do the walking across your keyboard.

    In 1998, Dr. Sudhir Gupta, of the University of California at Irvine, published a paper in the Journal of Neuroimmunolgy entitled, “Th1- and Th2-like cytokines in CD4+ and CD8+ cells in autism.” This paper states that the “…data suggest that an imbalance of Th1- and Th2-like cytokines in autism may play a role in the pathogenesis of autism.” His work has been replicated many times since.

    What does this mean? Simply put, there are different parts of our immune system. The innate immune system causes an initial inflammatory response when a pathogen is introduced into our bodies. The adaptive immune system forms antibodies over the course of a few days – which, in turn, provides us ongoing immunity if those same pathogens make their way into our bodies at a later time. In autism, there are abnormalities in both these parts of the immune system. Some major immunological insult, sometime very early in life, has seriously disrupted the normal immune balance in children with ASD (autistic spectrum disorders).

    A few of the specific abnormalities found in autism include:

    In an unstimulated state, individuals with autism have higher levels of proinflammtory cytokines (chemical messengers of the immune system) than controls.
    With stimulation of the immune system (i.e. with the introduction of pathogens), individuals with ASD have markedly higher levels of proinflammatory cytokines than controls.
    Specific proinflammatory cytokines that have been found to be high in people on the spectrum include Tumor Necrosis Factor alpha (TNF-alpha) in both the blood and the gut; interferon gamma (IFN-gamma) in both blood and the gut; levels of IL-12 are higher in the blood.
    Individuals with ASD have lower levels than controls of regulatory cytokines (those chemicals that turn off inflammation) like interleukin-10 (IL-10).
    About 60% of our immune system is in the mucus lining of our digestive (and nasal) passages. Many, if not most, children with autistic spectrum disorders have digestive symptoms if not outright gut pathology. One of the greatest bits of wisdom ever shared with me came from Dr. Sidney Baker, co-founder of the Defeat Autism Now! Team of clinicians and researchers. “Inflammation is inflammation.” It may sound so simple but the implications are vast. These chemicals of inflammation are not just affecting how these individuals respond (or don’t respond) to disease-causing microbes; they also affect the health of the digestive system and the function of the brain itself.

    Dr. Martha Herbert, an Assistant Professor of Neurology at Harvard Medical School, a Pediatric Neurologist at the Massachusetts General Hospital in Boston, who is a foremost authority on autism, has stated over and over that the brain is downstream from the digestive system, meaning that if the latter is compromised, the former suffers. It’s also a fact that if the digestive system is compromised, the entire immune system is as well – and vice versa. The brain, the digestive system, the immune system are all one – and inflammation is inflammation.

    Another well-established fact is that individuals with ASD have abnormal gut microbiota. What does this mean? The human body contains about 90 trillion microbes, a number that is nearly 10 times more than the cells in our body. No one really knows what we are meant to have and in what proportions. Certainly, this will have wide variance too, depending on what microbial populations are native to our environment. We do know though that there should be something like 500 different species of bacteria living in our intestines and amongst these should be species like acidophilus. Multiple researchers have now established that individuals with ASDs have not only abnormal amounts of bacteria living in their digestive systems, but also seemingly abnormal kinds as well. It’s a chicken and egg scenario: abnormal gut microbiota leads to abnormal gut conditions compromising the immune system, but the reverse is also true. Abnormal immune functioning will lead to abnormal microbiota.

    Interesting - I saw Dr Sudhir Gupta before I was diagnosed with MS. I have a son with Aspergers, I had no idea that he did this study!

    Rachel

    Gerhard Adam
    ... and you still don't know what the study says.

    Because of Ig/antibody deficiency and autoimmunity in autism, there is a rationale for the therapeutic use of IVIG in autism; however, the results of open-label and uncontrolled studies are conflicting, which may be due to differences in patient age, the presence or absence of Ig/antibody deficiency and/or autoantibodies, and dosing and duration of IVIG treatment. Thus, there is a need for a well-controlled double-blind clinical trial with replacement and immunomodulatory doses of IVIG in ASDs.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883089/
    intravenous immunoglobulin =  IVIG

    Funny story ... no mention of worms.
    Mundus vult decipi
    Gerhard Adam
    So you just decided to lift this article from Judy Chinitz without attribution?  Wow, that's definitely displaying some integrity.

    Mundus vult decipi
    http://books.google.com/books?id=Z2b6RXJxIWcC&pg=PT4&lpg=PT4&dq=%22helmi...

    the 2nd entry in the link above shows a chapter on helminthc therapy titled:
    Cutting-Edge Therapies for Autism 2011-2012
    By Ken Siri, Tony Lyons, Teri Arranga

    Here's the amazon link: http://www.amazon.com/Cutting-Edge-Therapies-Autism-2011-2012-Siri/dp/16...

    Gerhard Adam
    Instead of addressing each individual post let me just do it in one place.

    To Herbert Smith:

    You've got NOTHING!  You've got a bunch of cobbled together pieces of articles, which may have some merit, although in what capacity, to what degree, and in what application isn't at all clear.  In addition, it is the epitome of irresponsibility to even begin to advise people on a course of action that has no proof.  No doctor would recommend it, but you think you can Google the internet and produce a recommendation?  How irresponsible can one be?

    You are absolutely clueless about how dangerous parasites can be and yet you want to send people, equally uninformed as yourself, to Mexico and other countries so that they can intentionally infest themselves, for what YOU are proposing as a cure.

    What you fail to grasp, is that it isn't about finding one or two articles that might offer some connection on which additional research and testing can commence.  You want to recommend reckless pursuits of anecdotal evidence and flimsy linkages.

    Have you no conscience?  Have you never considered the ramifications if someone does something wrong?  Have you never wondered if you might be giving bad advice?  Have you ever considered the possibility that you might be recommending someone to a death sentence [because despite your love affair with parasites, they do kill people]?

    YOU are not a peer-review board.  Regardless of what your opinion is, YOU don't get to decide if something is scientifically proven, no matter how many Google links you provide.  You can criticize the FDA and government [and there's plenty to criticize], but let's also remember why they exist.  It's precisely so that there are rules and guidelines, so that some innocent person doesn't get taken advantage of.  It's to ensure that when people are expecting to obtain some result, that there's data and consensus backing it up.

    There isn't a qualified doctor that would feel comfortable dispensing medical advice to people he's never met, and yet you're getting about as close as possible to exactly that scenario, despite having no qualifications beyond some Google links.  I can't tell if you're crazy, stupid, or both.

    Don't you get it!  Even if everything you said is 100% true, from your experience.  Your experience is no guarantee against negative outcomes.  To blindly push this agenda is about as irresponsible as anyone can get.  Your claim that parasites can be safe, illustrates one huge flaw in your reasoning.  You can't control parasites.
    Mundus vult decipi
    kwombles
    Excellent summation, Gerhard. Thank you.
    And a reminder to Herbert, despite his claims that it's safe:

    "Most helminth infections, if left untreated, result in multi-year, chronic inflammatory disorders that will eventually cause disability. The chronic, disabling and disfiguring consequences of helminth infections, together with their high prevalence, make them a global problem of significant medical, educational, and economic impact" (Wang, Cao, Shi, 2008).
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Kim, you're using straw man logical fallacy: http://en.wikipedia.org/wiki/Straw_man as I am not recommending "most helminth". I am not recomending dangerous helminths. I am recommending small doses of Necator Americanus which does NOT reproduce inside a human host and requires incubation in soil before becoming infectious. It has been proven SAFE by a double-blind peer-reviewed medical study: https://docs.google.com/file/d/0B6q9LY6_tfVZYjhjNGEyMjYtNTcyMS00NjVjLWIz...

    Additionally, this is not just MY experience. There are literally hundreds of people with whom I am in contact that are trying safe doses of helminthic therapy with amazing results. There is scientific evidence which you're not addressing in the posts above. Open your mind and consider the actual scientific evidence instead of knee-jerk emotional rants. Spend a few hours of your time like I did examining carefully everything I posted above - I challenge you to find fault with the studies above proving safety AND efficacy.

    A publicly traded company on NASDAQ (ticker CNDO) is conducting FDA approved human clinical studies for autoimmune diseases right now using helminthic therapy: http://www.coronadobiosciences.com/products/cndo-201.cfm

    I went to Mexico and I was treated by a medical doctor in a fully qualified medical facility - helminthic therapy is administered safely and effectively.

    http://www.ncbi.nlm.nih.gov/pubmed/9627004 clearly shows that Th1 and Th2 immune pathways are adversely affected in autistic children. Articles I posted above conclusively show that helminthic therapy modulates the Th1 and Th2 immune responses. This is NOT quackery - this deserves more study but in the meantime it has been deemed as safe by medical science: https://docs.google.com/file/d/0B6q9LY6_tfVZYjhjNGEyMjYtNTcyMS00NjVjLWIz...

    kwombles
    Herbert,
    Perhaps I haven't been clear.

    Your experience is anecdotal. It is not proof of anything.

    My article concerns the use of helminths for autism. The strawman has been committed by you. 

    I don't care about your personal experiences with helminth therapy. Continuing to post here isn't going to change anything--your experience is anecdotal. Helminth therapy cannot be administered in the United States. There is no evidence that it is safe for autistic individuals nor that it will help them. 

    Anyone pushing that treatment is irresponsible and NOT relying on the scientific evidence.

    Period.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Look, let's be honest. There's nothing you or anyone else can say, Herbert, no evidence would ever be good enough for these guys. They've made their minds up.

    Gerhard Adam
    I am recommending small doses of Necator Americanus which does NOT reproduce inside a human host and requires incubation in soil before becoming infectious.
    For other readers that may not be familiar with it Necator Americanus is hookworm.  Your comments, while true, are disingenuous in their presentation.  You're making it sound as if this is some "special case", when you must certainly realize that that is the normal life cycle for hookworms.


    PATHOGENICITY: Infective larvae penetrate skin and travel via the lymphatics to enter the bloodstream, the lungs and the small intestine; adult parasites attached to the villi of small intestines suck blood causing abdominal discomfort, diarrhea, cramps, anorexia, weight loss; clinical features correspond mainly to the intensity of infection; heavy infection leads to development of iron deficiency and hypochromic microcytic anemia;leading causes of iron-deficiency anemia in children resulting in physical and mental retardation in development; infection causes cutaneous larva migrans - a self-limiting condition characterized by skin eruption; fatality is rare; no evidence of immunity in the infected

    EPIDEMIOLOGY: Widely in tropical and subtropical countries, where improper disposal of human feces is practiced; occurs in South East Asia, South Pacific and East Africa and South America - moisture and temperature conditions favour development of larvae; sporadic cases occurs in southeastern US; prevalence higher in rural areas; universal susceptibility

    HOST RANGE: Humans
    http://www.msdsonline.com/resources/msds-resources/free-safety-data-sheet-index/necator-americanus.aspx

    In 1962, Norman Stoll, the distinguished Rockefeller Institute scientist who helped to establish human parasitology research in North America, described the health impact of hookworm:

    "As it was when I first saw it, so it is now, one of the most evil of infections. Not with dramatic pathology as are filariasis, or schistosomiasis, but with damage silent and insidious. Now that malaria is being pushed back hookworm remains the great infection of mankind. In my view it outranks all other worm infections of man combined…in its production, frequently unrealized, of human misery, debility, and inefficiency in the tropics."
    http://www.metapathogen.com/hookworm/humanhookworms/
    Mundus vult decipi
    Gerhard, your post shows that "Necator Americanus does not reproduce inside a human host and requires incubation in soil before becoming infectious." Isn't that what Herbert said?

    Gerhard Adam
    ... and your point?  Herbert's comment creates the impression that this is new knowledge, or something that is different in this treatment.  He's simply stating what has always been true,  and yet we still manage to have about 740 million people infected with hookworm [around the world].  In other words, hookworms have never reproduced inside human beings.  So, how is stating the hookworm's life cycle some kind of reassurance? 

    I think the problem is that you [and Herbert] don't understand how hookworm gets introduced into humans.  It comes from the soil [which is one reason it has hooks - besides attachment to the intestine] and burrows into the skin.  It then travels through the blood stream to the lungs where it migrates upwards to be swallowed and reintroduced into the digestive system.
    Hookworm is not transmitted from person to person. Infected people can contaminate soil for several years if the right conditions are present. Larvae can survive in dirt for several weeks but do not survive in clay, dry or hard packed soils, or in temperatures that are freezing or higher than 45ºC.
    http://mtherald.com/hookworms-in-humans-symptoms-treatment-life-cycle-prevention/
    Humans acquire hookworm when the infective larval stages (known as third-stage larvae or L3) living in the soil either penetrate through the skin (both N. americanus and A. duodenale) or when they are ingested (for A. duodenale). It has also been reported that N. americanus L3 will invade the buccal epithelium if they enter through the mouth.
    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268732/
    ... and of course
    Roughly 95% of hookworms found in the southern region of the United States are N. americanus. This parasite is found in humans, but can also be found in pigs and dogs.
    http://en.wikipedia.org/wiki/Hookworm
    http://hookwormsindogs.net/
    So. while you may think that you couldn't possibly spread a hookworm infection, or contaminate your soil, can you say the same about your dog?
    Mundus vult decipi
    >>>>... and your point?<<<<
    My point is that what Herbert said was correct, and that you for some reason seemed to contradict him.

    >>>I think the problem is that you [and Herbert] don't understand how hookworm gets introduced into humans<<<
    Actually Herbert and I are well aware of how it works. Simply throwing these obtuse quotes into the debate doesn't change the fact that, as Herbert said, "[worms do] NOT reproduce inside a human host and require incubation in soil before becoming infectious."

    Perhaps you can explain how, as someone infected with 35 hookworm, and also a user of modern Western toilet facilities, I can possibly "spread a hookworm infection".

    [I've no idea what you are saying about my dog. I don't think my dog is infected by hookworm.]

    Interesting tidbit: Toward Responsibility in International Health: Death following Treatment in Rockefeller Hookworm Campaigns, 1914–1934 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2844286/

    Regarding Norman Stoll: The demonstration of a curative immune or self-cure response soon led Stoll to draw analogies between parasitic and bacterial immunology. Consequently, he was quick to try to emulate the successes in vaccination that had been demonstrated by bacteriologists. Stoll's prophylactic investigations began with attempts to induce resistance through the parenteral injection of dried Haemonchus suspended in saline. Preliminary results were extremely positive encouraging Stoll to conclude that `saline worm extracts given subcutaneously have both curative and protective effects against worm infestations'. A year later, however, the results of further investigations led Stoll to play down the protective effects of the administration of dried Haemonchus.

    Well, at least Stoll formed a hypothesis based on some observations, tested it, and found out that he was wrong. That is the scientific method...come up with a theory....test it....prove or disprove your theory, then have others be able to replicate the same results.

    Gerhard Adam
    It has been proven SAFE by a double-blind peer-reviewed medical study: https://docs.google.com/file/d/0B6q9LY6_tfVZYjhjNGEyMjYtNTcyMS00NjVjLWIz...
    You have an interesting definition of the word "safe" here.  In the first place, the study covered 12 weeks, after which the parasites were killed after a round of treatments to eliminate the parasite [with a follow-up check after 2 weeks after that].  So, at it's absolute best, you might claim that it was "safe" for that period of time.

    However, that's not the whole story.
    Consenting subjects were then seen on a separate occasion when a drop of water containing either 10, 25, 50, or 100 Necator americanus larvae was administered double-blind under gauze to an area of skin on the non-dominant arm.

    A major concern in exploring the therapeutic potential of hookworm infection in asthma, and in other conditions, is the theoretical risk of pulmonary adverse effects during the lung migration phase. For this reason we excluded all subjects with a history of asthma or with measurable airway hyperresponsiveness from the present study, and monitored FEV, vital capacity, and respiratory symptoms throughout the study.

    None of the three subjects who received 10 larvae reported any respiratory symptoms. Our findings on adverse effects thus demonstrate that of the four doses tested, the 10 larvae dose was the best tolerated.

    However, since the total IgE and eosinophil responses to this dose were also less than with the higher doses, it is likely that this greater tolerability is achieved at the expense of a lesser effect in provoking a potentially beneficial (anti-asthma) host immune response.
    DOSE-RANGING STUDY FOR TRIALS OF THERAPEUTIC INFECTION WITH NECATOR AMERICANUS IN HUMANS
    Consider the number of larvae in the study and then the number of eggs that are produced daily.  It is clear that the assumption of "safety" is in assuming that such a steady production of eggs doesn't actually result in other human infections, pet infections, or self-infection.  During her life span of about one year, a female hookworm will lay about 10,000-30,000 eggs a day during her adult life. Once these eggs are released, they travel with the stool and hatch after a couple days of incubation (under ideal conditions, warm and moist) , the eggs hatch and the larval hookworms continue their development in the soil. Once fully developed, larval hookworms penetrate the skin of the human host and travel through either the blood stream of the lymphatic system to the lungs. Here the hookworm works its way up the respiratory tract where it eventually gets swallowed by the human host and gets into the intestinal tract.
    http://bioweb.uwlax.edu/bio203/s2008/wilson_marc/reproduction.htm
    I went to Mexico and I was treated by a medical doctor in a fully qualified medical facility - helminthic therapy is administered safely and effectively.
    ... and your point is what?  Do you think you represent scientific evidence that is applicable to 300 million people in the U.S.?  Do you think that your experience with Crohn's disease suddenly qualifies you to talk about autism?  Whether anything was even effective, depends on taking your word for it.  What does your doctor say [besides throwing up his hands and saying it's a miracle]?  More importantly, would your doctor advise you to do this [I already know he wouldn't]?
    Mundus vult decipi
    "You've got NOTHING! You've got a bunch of cobbled together pieces of articles, which may have some merit, although in what capacity, to what degree, and in what application isn't at all clear. In addition, it is the epitome of irresponsibility to even begin to advise people on a course of action that has no proof. No doctor would recommend it, but you think you can Google the internet and produce a recommendation? How irresponsible can one be?"

    Mr. Cowboy:

    For someone who purports to be a science blogger, you have a peculiar stance on scientific epistemology. It seems you adhere to a sort of nihilist methodism far beyond that espoused by hard-core methodists like Karl Popper, even. Have you done any reading in the history of science or western intellectual history generally?

    I assume you are not a physician as your logic would obviate MOST of modern medical practice no matter how effective. But let's deal first with just one example that most everyone can relate to. Smoking. Do you consider it proven that quitting smoking makes you less likely to die? If so, why? Are you aware that the case against tobacco smoking is 100% based on epidemiology and laboratory studies on animal models. There has never been a randomized trial to determine if not smoking is safer the smoking. Would you then display horror if I or Mr. Smith were to claim that it is advisable to quite smoking? Would it be the height of irresponsibility ("No doctor would recommend it") for Mr. Smith to advise against smoking before a definitive randomized trial proving that quitting smoking is beneficial is advised? I am not joking when I say that it in fact has never been PROVEN to the standard you are claiming is necessary, that quitting smoking is beneficial. It is "merely" a very strong circumstantial case based on epidemiology and rat studies and quite a bit of common sense. The nascent case for helminthic therapy is different only in degree, not kind, from the case against cigarettes. But in the case of helminthic therapy, I expect that the large trials underway currently for treatment of IBD MS and other disorders of immune regulation will actually provide pretty solid evidence to support the already very compelling case for the hygiene and old friends hypotheses.

    "You are absolutely clueless about how dangerous parasites can be and yet you want to send people, equally uninformed as yourself, to Mexico and other countries so that they can intentionally infest themselves, for what YOU are proposing as a cure."

    It seems rather presumptuous to assert that Mr. Smith is absolutely clueless about how dangerous parasites can be for two reason. 1) You obviously know little about parasitology or immunology as judged by your near-hysterical reaction to the very idea of the hygiene hypothesis on this thread. In fact, it is rapidly becoming a mainstream idea in allergy and immunology, gastroenterology and neurology. Google and pubmed are your friends. You are looing quite foolish by pretending to be alarmed by the idea when there are plenty of medical doctors that find the idea compelling and sound. 2) Mr. Smith has already told you he carefully researched the idea before inoculating himself and putting his disease in remission. At the very least, it is rude to call him a liar by saying he "has no idea", since you have hardly had the time to learn as much about helminths as he has had. Unless you are a both a rancher and a parasitologist and have not told us so yet.....

    "What you fail to grasp, is that it isn't about finding one or two articles that might offer some connection on which additional research and testing can commence. You want to recommend reckless pursuits of anecdotal evidence and flimsy linkages."

    Mr. Smith has in fact found and read hundreds of articles, as have I, that support helminthic therapy. How many have you read in order to rebut his arguments? I'll wait a few months while you go read them all for us... As far as the linkages being flimsy, please let us know you opinion of the work published by Pritchard, Weinstock and Loke as well as Graham Rook and Rick Maizels. Please be specific in your criticisms in explaining why none of these scientists describes the linkages as "flimsy" Tell us why these men are wrong. Be specific.

    "Have you no conscience?"

    That is an interesting thing to ask. Mr. Smith does not earn a dime from his efforts to learn and teach about the promise of HT. I would ask you, Have you no compassion? Do you, sir, have a clue what it is like to shit blood or be hospitalized for asthma or care for a child with an autoimmune disease? Who exactly are you. or for that matter the overlords at Big Pharma funded FDA, to tell Mr. Smith what he can do with his own body, or whether to tell other what he knows and believes? Your attitude is more soviet than scientific, I am afraid.

    Have you never considered the ramifications if someone does something wrong? Have you never wondered if you might be giving bad advice? Have you ever considered the possibility that you might be recommending someone to a death sentence [because despite your love affair with parasites, they do kill people]?

    I am sure Mr. Smith has considered all these things. Have you? You seem to know nothing about parasites other than what you know from cultural prejudice. Otherwise please tell us how a controlled infestation with necatar americanus can kill you. I and Herbert know the biology and life cycle and what happens in an infestation, do you? If so, tell us what you know that we don't.

    "YOU are not a peer-review board. "

    I don't think Mr. Smith has claimed to be a "peer review board". Do you even know what peer review is? I have published a dozen peer-reviewed articles and know the peer review process well. Peer review is a cultural practice that is used in scientific publication. Laws of biology and natural science are not "decided" by some consensus panel. They exist to be discovered using the whole of all the tools available to our culture. Anecdotal reports, personal experience, hypothesis generation and synthesis of knowledge from different disciplines are all part of the cultural practice we call science. To say that only peer reviewed papers represent knowledge and that any claim of efficacy not from a randomized trial is bogus is to trash 90% of all human knowledge and experience. Is there woo? Yes there is, and I am its worst enemy. But lacking a randomized trial being the definition of "woo" is just know-nothing stupid, frankly. Woo is not just unsupported by robust trials, woo is stuff that conflicts with well-established areas of knowledge, is internally inconsistent, is non-falsifiable or just has no support among thinking knowledgeable people. Crystals and homeopathy are woo. Helminthic therapy is not woo. Claiming cigarettes kill is not quackery because there has never been a prospective trial of it.

    "Regardless of what your opinion is, YOU don't get to decide if something is scientifically proven, no matter how many Google links you provide."

    Here is where you are totally wrong. He DOES get to decide, whether he is right or wrong. In fact, he is the only one that can decide. No consensus panel or individual in power can decide what is or is not science. The alternative to Herbert being able to decide is that he must ask someone else. The man in the cowboy hat? a "peer review panel"? How would that work? It quickly becomes obvious that using your system one man could discover a new truth, and it would NOT BE SCIENCE until he was able to convince some arbitrary number of people. Are you really advocating this kind of radical subjectivity? Science is decided by democracy or by fiat of the chosen few? Or is science just a cultural process of persuasion with special and powerfully convincing tools? Please read Dierdre McCLosky for more on this (the rhetoric of economics)

    "You can criticize the FDA and government [and there's plenty to criticize], but let's also remember why they exist. It's precisely so that there are rules and guidelines, so that some innocent person doesn't get taken advantage of. It's to ensure that when people are expecting to obtain some result, that there's data and consensus backing it up."

    The FDA exist ostensibly to "protect" the public, but drug companies now fund the FDA directly through fees and therefore the FDA represents rent-seeking and regulatory capture at its best. FDA approval is a political process and not a scientific one.

    "There isn't a qualified doctor that would feel comfortable dispensing medical advice to people he's never met, and yet you're getting about as close as possible to exactly that scenario, despite having no qualifications beyond some Google links. I can't tell if you're crazy, stupid, or both."

    The adhominem here is not only boring but ineffective. Perhaps Mr. Smith is neither crazy nor stupid. Perhaps Mr. Smith is well, and interested in what made him so. Your anger is only understandable if you are yourself lacking in knowledge of the risks and rewards, or if you are just having a bad day.

    "Don't you get it! Even if everything you said is 100% true, from your experience. Your experience is no guarantee against negative outcomes."

    There is no guarantee against negative outcomes, but sometimes the outcome is guaranteed to be negative if you DO NOTHING. You know not of which you speak, Mr. Cowboy. Mr Smith has not stated there can be no negative outcomes. Any scientist or doctor knows that is not possible with any therapy or NON THERAPY - there can be no guarantee, only informed choices made by free agents.

    "To blindly push this agenda is about as irresponsible as anyone can get. Your claim that parasites can be safe, illustrates one huge flaw in your reasoning. You can't control parasites."

    How can you state so definitively what can be controlled? Necator Americanus is non-self infective and dies a natural death unless you maintain the infestation. With modern sanitation, there is no danger of spread. Please back up your assertions which are hopelessly vague. There are thousands of prokaryotic protozoan and metazoan "parasites" . Some are good some are definitely bad. The ones used in therapy tend to be benign and can be beneficial. Pleat tell us how you know that the parasites used therapeutically "cannot be controlled" and why.

    Gerhard Adam
    Any scientist or doctor knows that is not possible with any therapy or NON THERAPY - there can be no guarantee, only informed choices made by free agents.
    Are you not paying attention to ANYTHING!  What makes you think that someone is acting as a "free agent" and making an "informed choice" when the advice is that it cures autism?  Do you think that just MAYBE some parent will end up taking a kid down into Mexico to infect them with parasites?

    As I said before ... I don't care if you sprinkle hookworms on your breakfast toast.  My problem is that you have no business recommending it as a treatment, nor in giving advice for a condition you know nothing about ... [this is about autism, NOT Crohn's disease].
    There is no guarantee against negative outcomes,
    You're right, assuming that the advice is provided by a qualified authority based on the best available scientific evidence.  Ohhh .. but you don't actually have any of that.  So what you've got is unqualified people, giving half-assed advice, and assuming no responsibility or liability for the consequences of their ideas. 
    He DOES get to decide, whether he is right or wrong. In fact, he is the only one that can decide.
    Only for himself.  Personally I think that if someone were to follow his advice, he should also be held liable for it.  But then, I already know ... none of you advocates will take that position, because despite all your confidence, you aren't actually ready to put your liability on the line for your beliefs.

    The fact that doctors, researchers, and the medical profession are all liable and consequently more cautious about treatments ... you guys can throw caution to the wind, because in the end, you know that you aren't responsible for anything you say, because you have no qualifications to say it.

    As I said ... if adults want to go and bury themselves in animal shit and eat hookworms, I couldn't care less if they think that's a treatment that will help them.  However, the first time someone takes it upon themselves to put someone else through that treatment without their express approval or informed consent [as is the case with autism] then you're being irresponsible.  You don't have to agree, but perhaps one day the idea will dawn on you that maybe ... just maybe, you could be responsible for a bad outcome, because you couldn't discuss science ... you had to go advocating treatments/therapies that you were clueless about.

    Mundus vult decipi
    "Are you not paying attention to ANYTHING! What makes you think that someone is acting as a "free agent" and making an "informed choice" when the advice is that it cures autism?"

    Firstly, stop screaming at everyone and settle down. What gives you the right to prevent people from disseminating information and others from making their own choices? Do you ask your own doctor for permission what to eat? Are you some kind of stalinist? Is your ranch located in North Korea?

    You have set up the dichotomy yourself. Either a parent can make a choice for the child they are responsible for, a suffering child. or you, a guy in a cowboy hat who is not doctor or parasitologist or anything and is admitting by omission that you have not read two words of the corpus of actual science on what we are talking about, whether it is autism or helminths or the immune system, can be their personal supreme soviet and FORBID them seeking a non-FDA approved treatment.

    That is, you think that YOU have a right to control the child's welfare that supersedes the parents. Or which government agency is it that you worship if you are not saying it is you personally?

    Do you apply the same standard to yourself? If you had an unknown inflammatory condition never studied before and never described, would you refuse oral prednisone and say that you will wait until the NIH funds a randomized trial for your unknown condition, in the meantime dying of it, even though prednisone works for basically every inflammatory condition ever discovered so far? Please answer me this time rather than just shouting in your cowboy hat.

    The thing you are missing in perseverating about Autism vs IBD is this: You do not understand how medicine is actually practiced. Medicine itself is a cultural practice based on science. It is not itself science, it is based on science. Any physician like me who has done research and spent time in the academy, as well as practiced helping patients will tell you that the vast majority of medical care is EMPIRIC. The average medical decision is an informed one based on medical knowledge applied to frequently incompletely known or even mysterious ailments. To apply your rigorous standard of needing a randomized trial to apply any therapy would eliminate 90% of all medical care instantly. Is that what you propose?

    Do you know what off-label means? It means the practice of giving drugs for applications which in the judgement of the physician and the PATIENT may help a disease, but THERE IS NO EXPLICIT FDA APPROVAL FOR THAT PARTICULAR DISEASE. This is in fact the majority of medical practice. In the case of surgery there is NO SUCH THING AS FDA APPROVAL. Little surgical practice is supported directly by randomized trials that prove surgical therapies "work".

    Re: Autism/IBD. You are obviously ignorant of the cutting edge research on the gut/brain axis. But if you were to have knowledge of how the immune system works, say, by being a physician like I am and doing a lot of research on it, you would understand that there are thousands of diseases of immune dysregulation and many that are probably not yet described - like species in a rain forest - almost infinite. To understand how to treat diseases that are different phenotypically yet have have common shared mechanisms is to practice scientifically, that is to have a method that makes sense. It will never be possible to have enough patients with each of thousand of diseases and enough money and time to run trials to prove to your standard that each disease is effectively treated by HT or by prednisone, or by anything.

    Your epistemological stalinism would require that we wait a very long time to be able to treat only the commonest diseases, and then everyone else be consigned to suffer and die. And as I pointed out, your stance also would rewire that most medical therapies occurring as we speak come to a grinding halt.

    "Do you think that just MAYBE some parent will end up taking a kid down into Mexico to infect them with parasites?"

    What concern is it of YOURS, personally? Are you concerned that parents right now are feeding their kids hot pockets and juice boxes and giving them diabetes? But since you asked, there are parents that have done so and are reporting very good results and are quite happy with the results. Who are YOU to say anything about it one way or the other? And you do understand the reason the clinic is in mexico is because of medical stalinists like yourself, correct?

    "As I said before ... I don't care if you sprinkle hookworms on your breakfast toast. My problem is that you have no business recommending it as a treatment, nor in giving advice for a condition you know nothing about ... [this is about autism, NOT Crohn's disease]."

    I have yet to see anyone anywhere advocate for, much less force, anyone to do anything. As a physician, I am pretty sure I know more about autism than you do, especially as you have read nothing about it. Re: Crohns' vs autism. Certainly the science is more established for Crohns' but the issue is whether there is scientific reasoning to support the idea that it might help Autism, and further whether the risk to reward ratio is favorable for this disease with no other treatment, and finally whether YOU or some agent of the STATE should have more power over what a parent does than the parent. Tell me again why your view is not Stalinist?

    "You're right, assuming that the advice is provided by a qualified authority based on the best available scientific evidence. Ohhh .. but you don't actually have any of that. "

    How would you know without being a knowledgeable authority yourself? I am an MD with research experience who has read extensively on the topic at hand and the advice to CONSIDER HT for a variety of AI diseases looks reasonable to me. Tell me why you are fit to judge my competence.

    "So what you've got is unqualified people, giving half-assed advice, and assuming no responsibility or liability for the consequences of their ideas."

    Right back at you. You admit to having no expertise in the area, have not had time to read all the literature provided to you, and are now giving half-assed warnings that parents ought to hand over sovereignty over their own suffering children to YOU. You advocate they be prohibited from making their own decisions. You've yet to make a single solitary argument based on SCIENCE about whether it might be reasonable or safe to attempt HT for autism or anything else. The reason is obvious. You have no idea what you are talking about and are only digging in your heels.

    "Personally I think that if someone were to follow his advice, he should also be held liable for it. But then, I already know ... none of you advocates will take that position, because despite all your confidence, you aren't actually ready to put your liability on the line for your beliefs."

    How about you behaving responsibly?

    Shall we sue you if someone dies because they avoided a potentially beneficial therapy due to your know-nothing medical stalinism?

    What a crock. You definitely have no knowledge of law or medicine. What we advocate for is research and awareness. There is no advocacy in favor of, nor professional advice given, in favor of self-treatment with eukaryotic probiotics. Not once has someone been exhorted to do something or talked into it. We do not really view HT so much as advice about medical treatment as much as probiotic restoration of the natural human micro biome. But I am sure I have lost you there unless you have read Dr. Rook.

    "The fact that doctors, researchers, and the medical profession are all liable and consequently more cautious about treatments ... you guys can throw caution to the wind, because in the end, you know that you aren't responsible for anything you say, because you have no qualifications to say it."

    There you go again about "our" qualifications and with your communist chinese attitude towards what one can freely discuss on the internet.

    "As I said ... if adults want to go and bury themselves in animal shit and eat hookworms, I couldn't care less if they think that's a treatment that will help them. However, the first time someone takes it upon themselves to put someone else through that treatment without their express approval or informed consent [as is the case with autism] then you're being irresponsible. You don't have to agree, but perhaps one day the idea will dawn on you that maybe ... just maybe, you could be responsible for a bad outcome, because you couldn't discuss science ... you had to go advocating treatments/therapies that you were clueless about."

    I assure you I am not clueless about any of this. Watch who you call "clueless", cowboy.

    And I again reject your assertion that you have more rights to determine the health and welfare of someone else's child than the parent does. NO ONE specifically advocates for Autism to be treated with HT on the forums. Parents who have done so on their own come and communicate with the rest of us, who have extensive knowledge and interest in the subject.

    Gerhard Adam
    LOL ... now you're just rationalizing a return to snake-oil salesman.  Go for it.  If you think that anonymous posters on the internet have the "right" to disseminate information that qualified professionals don't, then that's what you're advocating.

    I hope you realize that the first time something goes wrong with such treatment, that regardless of whether there's merit to it or not, you will have participated in creating an environment that will be over-regulated and set back years if not decades.  That's what the consequences of irresponsible advocacy produce.

    As I said before, your reference to a few papers doesn't make science.  None of the people that are actively engaged in research would make the claims you're making.  None of the medical professionals would make the claims you're making.  Yet, somehow you want to place yourself on par with them regarding advice.
    NO ONE specifically advocates for Autism to be treated with HT on the forums
    The statement was specifically made here.  If it isn't about autism, then go away because your comments are irrelevant.

    You're so busy advocating for something you don't care if it's applicable or not. 
    There you go again about "our" qualifications and with your communist chinese attitude towards what one can freely discuss on the internet.
    Again ... you aren't discussing.  You're advocating something you know nothing about.  How do I know you don't know anything ... because you haven't published anything.  The people actually working on it, don't advocate as you do.  So the only thing you "might" have is anecdotal information on a completely unrelated condition.  What are you discussing? 
    Watch who you call "clueless", cowboy.
    Yeah, well watch who you call "cowboy", clueless.

    I'm done with you.  You and your other advocates can do whatever you like.  You can tell each other stories and justify, rationalize, ... whatever you choose.  However, don't pretend that what you're doing is remotely scientific. 

    Your argument is a complete red herring.  No one is talking about parents turning their rights over, but that's what you want to propagandize because the alternative isn't acceptable to you.  I'm not telling parents what they can or can't do.  I'm telling parents to be careful of self-proclaimed healers that know better than all the doctors and scientists, because they've "seen the light". 



    Mundus vult decipi
    I support Herbert Smith and the others who support the argument for Helminth Therapy. I too was able to put my crohn's disease (an AUTOIMMUNE disorder) in remission using Helminth Therapy, since 2006, when no other medical treatment worked, and their are many more who can attest to the efficacy of Helminthic Therapy.

    I have used Ovamed's TSO, as well as hookworm and human whipworm from Autoimmune Therapies, all of them have proven effective for me. I have spent many months reading the research and my gastroenterologist, who also has been following the research on Helminth Therapy endorsed the use of it for my autoimmune disorder.

    It appears Gerhard you simply want to be correct; to be right for the sake of being right without actually having done any in-depth research about Helminthic Therapy in relationship to Autoimmune disorders and gut biome dysbiosis.

    Articles like yours are as much quackery in journalism as you proclaim helminth therapy is in medicine. You make scientific journalism look bad and in-turn make yourself look incompetent as a journalist with poor inaccurate reporting and researching.

    kwombles
    What's this article about? Autism and helminth being used to treat it. Not Crohn's. 
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Gerhard Adam
    As Kim said, this isn't about Crohn's disease.  I never discussed whether it was effective or not.  My point is that neither you nor any other poster has any business giving advice to people using untested or unverified therapies.

    If you work with your doctor and he concurs over something, then that's great.  If you want to experiment on yourself, then go for it.  But don't come onto a scientific site with no evidence and then proceed to tell people how everyone from scientists to the FDA are wrong and they should fly to Mexico to infect themselves with hookworm.

    Sorry, but I don't care how potentially legitimate such a treatment might be.  For all I know, perhaps hookworms are the key to achieving immortality.  However, what I do know is that there is no scientific data to presume that hookworm will be effective in treating autism, nor is it something that should be claimed to be a legitimate therapy.

    So, while I'm pleased to hear that your Crohn's is better, it isn't relevant. 
    Mundus vult decipi
    If you were to actually do some scientific research before you wrote your articles, you would actually understand the links between various Autoimmune and gut biome dysbiosis and their effects on diseases such as Autism and other AUTOIMMUNE DISEASES, and their relationship to Helminthic Therapy.

    Clearly you are too lazy and too stuck on being right to bother to actually look at the many research articles available to you. Shame on you, you are a disgrace to solid in-depth journalistic reporting. Hardly worth arguing with the likes of you.

    Back at you and your weak journalistic practices. “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.”

    kwombles
    You know, personal attacks aren't evidence. You obviously don't understand the meaning of the words you're using. "Scientific research" isn't googling until you find a woo-nut site that supports your beliefs.
    Scientific research involves formulating a hypothesis, figuring out how to test it, getting IRB approval, finding subjects, and then conducting the study, analyzing the results, writing it up, and getting it published. 

    You offer no evidence for your claims. Autism is not an autoimmune disease. It is a neurological condition. No conclusive evidence shows that autism is an autoimmune disease.


    Here, start here: http://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-pervasive-developmental-disorders/index.shtml.

    Autism is a group of developmental brain disorders, collectively called autism spectrum disorder (ASD). The term "spectrum" refers to the wide range of symptoms, skills, and levels of impairment, or disability, that children with ASD can have. Some children are mildly impaired by their symptoms, but others are severely disabled. 
    What about treatment?  http://www.nimh.nih.gov/health/publications/a-parents-guide-to-autism-spectrum-disorder/how-is-asd-treated.shtml

    No worms mentioned there.


    You are, by the very nature of your comments, betraying an alt-med, scientifically unbacked view of autism. The top links for autism and helminth are for the people peddling helminths. Postmortem inspection of 11 autistic brains doesn't prove anything about autism--it only tells you what 11 brains looked like. It doesn't explain whether inflammation caused autism or was caused by other factors. It certainly doesn't prove that autism is an autoimmune disorder that can be cured by worms.


    Shame on you for pushing a potentially life-threatening treatment.






    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    OK, so let me try again with scientific evidence.

    1. Claim #1 backed up by scientific evidence: http://www.ncbi.nlm.nih.gov/pubmed/9627004
    Proportions of IFN-gamma+CD4+ T cells and IL-2+CD4+ T cells (Th1), and IFN-gamma+CD8+ and IL-2+CD8+ T cells (TC1) were significantly lower in autistic children as compared to healthy controls. In contrast, IL-4+CD4+ T cells (Th2) and IL-4+CD8+ T cells (TC2) were significantly increased in autism. The proportions of IL-6+ CD4+, IL-6+CD8+ and IL-10+CD4+, IL-10+CD8+ T cells were comparable in autism and control group. These data suggest that an imbalance of Th1- and Th2-like cytokines in autism may play a role in the pathogenesis of autism.

    2. peer reviewed article claiming that helminthic therapy is used for autism: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092582/?tool=pubmed

    3. https://docs.google.com/file/d/0B6q9LY6_tfVZYWI4OGIwYzctNjc3ZS00NDEzLTk5...
    Peer-reviewed scientific article showing how helminthic therapy is modulating Th1 and Th2 immune responses implicated in autism, Crohn's and other autoimmune illnesses.

    4. Here's a list of clinical trials on humans demonstrating the SAFETY (I repeat *safety*) of TSO which is one of the 3 agents used by helminthic therapy. I am going to say this again, TSO has been deemed safe in human subjects in multiple clinical trials: http://www.coronadobiosciences.com/products/cndo-201-published-clinical-...

    5. https://docs.google.com/file/d/0B6q9LY6_tfVZOTE1OTg0NjMtNGM5OS00MDM0LTk0... - Clinical trial establishing safety of TSO.

    6. Multiple sclerosis - an autoimmune disease being treated by TSO: https://docs.google.com/file/d/0B6q9LY6_tfVZYjY2N2Q3ZjYtOTY3OC00MjQxLTlh...

    ~~~~~~~~~~~
    When responding to this post, please respond to each of the 6 points above, point by point. Respond on the merits of safety of helminthic therapy and the links showing that Th1 and Th2 immune responses are involved in autism and helminthic therapy regulating those responses.

    Gerhard Adam
    1.  These data suggest that an imbalance of Th1- and Th2-like cytokines in autism may play a role in the pathogenesis of autism.

    OK ... what is it about the "suggest" that you don't understand?  That isn't proof.  That doesn't mean research shouldn't continue, but you can't draw conclusions from something like this.

    2.  You're joking.  what's actually said is:
    ...infection with helminth parasites has been tried as a therapy in inflammatory bowel disease, and there are case reports relating to other conditions (e.g., autism); however, the impact of infection with parasitic helminths on musculoskeletal diseases has not been extensively studied.

    3.  You're taking a "suggested" possibility and drawing an unwarranted conclusion.  Autism is not Crohn's.

    4.  Again, what's actually said:
    The initial safety and efficacy of TSO in Crohn's disease has been evaluated in two open-label investigator-sponsored clinical trials.
    Autism is NOT Crohn's.  You cannot make any other claims.

    5.  Again.
    This new therapy may offer a unique, safe, and efficacious alternative for Crohn’s disease
    management.

    6. The last is self explanatory.

    You cannot simply take selected studies on unrelated conditions and cobble together solutions presuming that they work, that they work under the same conditions, and utilize the same levels.  Wouldn't it be great if we only had to study one disease and simply extrapolate the results to everything that suits our fancy?

    This is what makes science hard work.  While it may be tempting to take short-cuts, you haven't provided anything except a distraction.  If you went to any doctor and he treated autism with the regimen for Crohn's disease, he would be sued into oblivion [rightfully so].  What are you thinking? 
    Mundus vult decipi
    This article was written 2 years ago; since that time, Mount Sinai School of Medicine has launched a clinical trial to test Trichuris suis ova in adults with autism. It is currently recruiting as I write.

    http://www.clinicaltrials.gov/ct2/show/NCT01040221?term=helminths+autism...

    I say, woohoo! Bravo to all the pioneers who recognize and act on novel ideas and are willing to do the work to test them definitively.

    Ms. Beales:

    I have to think you cannot be serious about the clinical trial you mentioned, it being, by its creators' own admission, incompetently designed. It is, in fact, a methodological joke.

    Here is an excerpt from the description of the clinical trial:

    "To date, many medications have been used in individuals with autism and the history of psychopharmacology of autism is notable for the exaggerated benefit of a variety of treatments. To date, most medication studies in the field have been open-label without use of a placebo control and without systematic behavioral assessments. The current practice of prescribing medications to patients with autism without scientifically demonstrated efficacy underscores the necessity for methodologically rigorous studies to be conducted."

    "We propose a 16 week, open-label trial of TSO to assess the effect on repetitive behaviors, aggression and irritability, and global functioning in adults with autistic disorder."

    So, to remedy the problem of bad data in medical trials due to them being open-label and lacking appropriate controls, they propose an open-label study that lacks appropriate controls? These people speak of "the necessity for methodologically rigorous studies to be conducted," and then propose to do the opposite.

    It's almost as though they want to generate a spurious positive outcome due to expectancy biases...that could be used to claim illusory treatment efficacy...that could be used to leverage further funding. Not that anyone would ever do such a thing. Right?

    James T. Todd, Ph.D.

    Ms. Beales:

    I have to think you cannot be serious about the clinical trial you mentioned, it being, by its creators' own admission, incompetently designed. It is, in fact, a methodological joke.

    Here is an excerpt from the description of the clinical trial:

    "To date, many medications have been used in individuals with autism and the history of psychopharmacology of autism is notable for the exaggerated benefit of a variety of treatments. To date, most medication studies in the field have been open-label without use of a placebo control and without systematic behavioral assessments. The current practice of prescribing medications to patients with autism without scientifically demonstrated efficacy underscores the necessity for methodologically rigorous studies to be conducted."

    "We propose a 16 week, open-label trial of TSO to assess the effect on repetitive behaviors, aggression and irritability, and global functioning in adults with autistic disorder."

    So, to remedy the problem of bad data in medical trials due to them being open-label and lacking appropriate controls, they propose an open-label study that lacks appropriate controls? These people speak of "the necessity for methodologically rigorous studies to be conducted," and then propose to do the opposite.

    It's almost as though they want to generate a spurious positive outcome due to expectancy biases...that could be used to claim illusory treatment efficacy...that could be used to leverage further funding. Not that anyone would ever do such a thing. Right?

    James T. Todd, Ph.D.

    Again, if you actually did your homework, like respectable scientific journalist do, you would know about and understand the relationship between Autoimmune disorders, the intestinal biome, and the "hygiene hypothesis," All of which IS readily available in peer reviewed research articles. Start by reading Weinstock and Summers, and that's just the tip of the iceberg.

    Since Weinstock and Summers began their ground breaking research other researchers support and verify the validity of the "hygiene hypothesis," and the symbiotic relationship between helminths and humans and the modulating effects of helminth on the immune system. If you don't know who these researchers are then you really have no idea what you are talking about. The research is available if only you would take the time to investigate thoroughly.

    Start here: "Scholarly articles for "hygiene hypothesis" weinstock and summers."
    Helminths and harmony - Weinstock - Cited by 64
    Helminths and the IBD hygiene hypothesis - Weinstock - Cited by 59
    Helminths as governors of immune-mediated … - Elliott - Cited by 87

    Try using "Pubmed.," this a "research tool" that would be helpful for you while doing your research!

    Back at you and ... “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.”

    Gerhard Adam
    ... and not ONE of these publications recommends helminthic therapy for autism.  Again, you're simply cobbling together a bunch of unrelated conditions and treatments and simply assuming that what works for one can be readily extrapolated to others.

    It's bullshit and you know it's bullshit.  No one can even establish precisely what autism is, and you're willing to claim not only knowledge of the cause, but of the treatment. 

    Potentially there may be some results in a variety of areas and perhaps even autism.  But making unsubstantiated claims and conflating all manner of unrelated conditions is just disingenuous and sloppy thinking.

    All of your publications regarding Helminths requires unequivocally that autism is strictly an autoimmune disorder.  Find me ONE publication, that is reputable, that is prepared to make that claim.  Without that connection, you've got nothing.

    You may not like it, but evidence doesn't grow on trees, and it isn't collected by making unsubstantiated claims and Google searches. 

    I'm not against studies.  I think they're important and they should certainly be pursued.  However, until they occur and until results are reviewed, it is irresponsible to act as if it's already a foregone conclusion.
    Mundus vult decipi
    The only reason the research appears to YOU to be "cobbled together" is because you do not understand the research. If you took the time and new the research we would not be having this debate.

    If you new the research you would understand that Helminthic Therapy is NOT bull-shit and you would understand the science and the connections between autoimmunity, dysbiosis of the gut microbiota, and autism.

    You are missing out on amazing medical science and research, which would make for a truly great article as opposed to this fluffy article.

    Unfortunately you are unwilling or unable to take the time to learn something in-depth. Clearly you are stuck on proving yourself right instead of admitting you don't understand the research or simply have not bothered to do your due diligence. Back at you- “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.”

    Stick to fields you understand and stay away from science base writing; you are out of your depth.

    Gerhard Adam
    So, now we get to the heart of it.  Again ... only YOU and those that believe as you do can understand the "science".  What you don't understand is that you can't just make up connections between papers and presume what's been settled.

    I answered the supposed "scientific" queries ,and not one of them addressed the issue of autism.  Instead everyone seems intent on arguing that Crohn's disease is a suitable proxy for autism treatment. 

    Even your login name perpetuates the same nonsense.  This isn't about Crohn's.  It's about autism.
    Mundus vult decipi
    Quoting Gerhard Adam: "All of your publications regarding Helminths requires unequivocally that autism is strictly an autoimmune disorder."

    How does that follow? If autism has autoimmune components in its pathophysiology (many diseases do have autoimmune components), then it would be valid to use therapies that treat the autoimmunity, even if it does not address the other components in the disease process.

    On a different point: a single dose of ivermectin, a very safe and very well tolerated drug, will eradicate any helminth infection, so if a helminth experiment does not yield benefits, it is very easy to remove all these worms from the gut, and get back to square one.

    FInally, the words of Dr Daniel Clauw might bring some perspective here. Clauw works on chronic fatigue syndrome and related conditions, and leads a team in the study of these illnesses at the University of Michigan, Georgetown University, the National institutes of Health, and several other academic medical centers.

    Clauw's golden rules to patients with CFS include this advice when trying out tested or untested therapies:

    When trying any therapies (tested or untested), do your own personal research. Make sure the treatment is safe.
    • Only start one new treatment at a time.
    • See if you get better when you are using the treatment.
    • See if you get worse when you stop the treatment.
    • See if you get better again when you re-start the treatment.
    • If the treatment passes this test, then it works for you.
    • If you are still having symptoms, seek out a treatment that is likely to help those symptoms and add it to the above treatment.

    Source: http://www.prohealth.com/library/showarticle.cfm?libid=13108

    Clauw implicitly understands that, for a condition like CFS which is poorly understood and for which there are few if any proven treatments, it makes sense for a patient to experiment with tested and untested therapies.

    There is no reason these rules should not apply to autism, or any other poorly understood condition and for which there are few if any proven treatments.

    In what Clauw says, there is none of the "it's got to be rigorously proven and publicised in peer-reviewed journals before you even think of trying it" stuff that is being said here.

    Many individuals are quite capable of testing therapies on themselves in a controlled and scientific manner. Science is not some elitist activity that only the elect can undertake; it can also be done on a small scale; all it needs is keen observation, a rational mind, and a careful, considered approach. Oh and an enquiring mind too, otherwise you never move forward.

    I myself have CFS plus an anxiety disorder & aversion to sound or stimuli that borders on autistic sometimes. After years of experimentation, trying out all sorts of drugs and supplements, and finding out by trial and which work and which don't, you find a lot of the time there is no process of reason that you can follow to work out which therapies are going to work in advance, you just have to try them.

    kwombles
    http://scientopia.org/blogs/whitecoatunderground/2011/02/10/a-good-idea-gone-horribly-awry/ -- a newer review of the literature by a medical doctor:

    This hypothesis---that autistic behaviors can be modulated by parasitic infection---is not as insane as it sounds.  Rabies increases aggressive behavior in animals, causing them to bite and spread the virus.  The parasite Toxoplasma has been hypothesized to change human behavior. But in the Johnsons' case, an unbroken chain of faulty assumptions led them to try something foolish.
    The basic syllogism is this:
    1. Inflammatory diseases can be treated by a parasite.
    1. Autism is an inflammatory disease.
    1. Autism can be treated by a parasite.
    First, can "inflammatory diseases" really be treated with pork whipworms?  The studies are unimpressive.  The few studies done found some minor statistically significant improvement when whipworm infestation was tested against placebo.   The inflammatory response generated by parasitic infection is a bit of a blunderbuss.  Compare it to something like infliximab, a monoclonal antibody very successfully used in Crohn's disease that targets a specific immune molecule and doesn't involve ingesting worm larvae.
    Many diseases fall under the category of "inflammatory", and inflammation is a complicated process, one that can't be nailed down as something to be turned "on" or "off".  This makes analogies between one inflammatory disease and another problematic.
    Is autism an "inflammatory disease"?   One study cited in The Scientist looked at a very small sample of autistic people, without a control group, and found evidence of inflammation in their neural tissue.   There  is no clinical evidence that autism has an "inflammatory" cause that can be affected by immunomodulation with, say, corticosteroids which are a non-specific immunologic treatment effective in many inflammatory diseases.
    Given that statements one and two are false, number three is ridiculous.

    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    kwombles
    Pubmed doesn't have any studies detailing helminth or hookworms and autism. If it doesn't involve autism, it isn't relevant to this article detailing people using helminths as a therapy for autism. Our children aren't guinea pigs.


    That study the worm-lovers are touting (that I even mentioned in my piece) hasn't been updated since 2009. Guess it didn't go far.

    http://www.mssm.edu/research/centers/seaver-autism-center/research/current-studies  Not even mentioned as one of their current studies.


    Only place helminth even appears at Mount Sinai's site: 
    _http://www.mssm.edu/profiles/wayne-g-shreffler 


    http://clinicaltrials.gov/ct2/show/NCT01040221?term=autism+helminth&rank=1 
    Trichuris Suis Ova Adult Autism Symptom Domains (TSO)
    The recruitment status of this study is unknown because the information has not been verified recently.
    Verified December 2009 by Mount Sinai School of Medicine.   Recruitment status was  Recruiting
    First Received on December 24, 2009.   Last Updated on December 28, 2009   History of Changes
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    One problem that I keep seeing here is the fallacy that autism is one disease. "Autism" is simply a description of psychological symptoms. The DSM is not able to identify the difference in people who have autism from genetic mitochondrial disease, other genetic forms of autism, autoimmune disease, prematurity, etc.

    I am not a big fan of Wakefield, I think he was wrong to go to the media with his conclusions before enough research was done on his hypothesis. However, this does not mean there is not a GI cause of some autisms. Check out the recent research by Ian Lipkin's group on autism and GI microbiota. The GI track is a known site where autoimmune diseases can develop. All the kids I know with ASD, including my own, have either GI symptoms or documented pathology, such as eosinophilic esophagitis. The dendritic cells in the GI track are able to capture antigens and present them to the immune system, and this can lead to autoimmunity. There is a subset of ASD kids who have documented problems with gluten.
    http://www.ncbi.nlm.nih.gov/pubmed/19623831

    And the risk of having a child with autism goes up with the number of first degree family members with autoimmunity.
    http://www.ncbi.nlm.nih.gov/pubmed/10385847

    Here are the conclusions I came to:

    -Worms in small doses are harmless under medical supervision.
    -In people with autism AND other autoimmune disease/severe allergy, worms would be a good therapy to try. At worst it wouldn't work and you are out of some money. Let the people who can afford it waste their money.
    -Worms are way less harmful than other medical treatments for autism/autoimmunity, such as steroids, and have the potential to actually modify the immune system rather than cover up the symptoms of immune dysregulation.

    I agree completely. Humira - an anti-TNF drug for Crohn's has black box warnings and has resulted in death due to side effects. I don't think there is a single documented case ever where a person who got under 30 hookworms had any long-term severe life-threatening health issues. Infection can always be terminated by an anti-helminthic drug. In the case of TSO, all you have to do is stop taking it and it will be eliminated within 2-3 weeks - no anti-helminthic drugs necessary.

    kwombles
    Apparently, some of the worm-supporters really have a hard time understanding the basic principles of ethical behavior relating to medical treatments.
    There are no studies on the use of helminths in the autistic population. The one that was being attempted in 2009 apparently never went anywhere.

    You can't get the worms in the US--you have to leave the country to get the worms. 

    No one committed a fallacy regarding autism being one disease. In fact, I never called autism a disease. I called it a neurological disorder.

    There is no evidence to support the contention that helminth therapy will benefit autistic children. It is irresponsible to take your child out of the country to engage in experimental treatments in attempt to cure autism.

    There is no evidence that the helminths being used by people in an attempt to treat autism are in fact safe.

    Since it is not FDA approved over here, it is highly unlikely an ethical medical doctor in the US is going to supervise this therapy. There are, of course, an abundance of quacks.

    There is far more to be lost here than money, as one poster contends Subjecting one's child to untested treatments, especially ones that require foreign travel is stressful to both the child and the family. Money and time that could have been used on tested therapies is otherwise wasted on wild goose chases.

    The very fact that these posters feel the need to spam a thread with condescension and name calling rather than any actual studies relating to helminth therapy in the treatment of autistic children is very telling, but that's because there are NO studies on this therapy relating to autistic children. In fact, if you google helminth and autism, you get quacks promoting the therapy and no scientific evidence whatsoever.

    As the parent to three children on the spectrum, I find your repeated attempts to push an untested, unproven therapy on families desperate to help their children incredibly offensive. Perhaps you aren't trying to profit off of this, but there are people who are, and you're pushing people towards them. And because you are all essentially anonymous, there is no proof that you wouldn't stand to profit off of families pursuing TSO.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Once TSO is approved by FDA in the USA which may happen sometime in the next 5 years, physicians will be able to use it off-label on autism. Then we will see how effective it's really going to be. If it is as effective as I think it will be (judging by Thelma's and Stewart's experiences) - you just might change your mind.

    kwombles
    What evidence do you have that the FDA is considering approving TSO?
    "*** Hookworms, Whipworms, and their eggs, and larvae used as immunomodulators to treat patients with allergies, asthma, autism, Crohn�s Disease, multiple sclerosis, Sjorgrens Syndrome, and Ulcerative Colitis by deliberate self infestation are considered to be biological products as defined in Section 351 of the Public Health Service Act. Entries have been declared for personal use only and are accompanied by a US Physician's prescription. Currently, there is no new drug application approval or biologics license application for this product and no IND has been filed with CBER. 

    FDA has concerns regarding the product's safety as the Agency does not have information regarding the manufacture, control, and release tests for this product. Specifically, the Agency has no information with regard to testing for adventitious agents, including porcine viruses, at the manufacturing stages and in the final drug product. Additionally, there is concern regarding the potential presence of other contaminants and/or allergens within the oral mixture that patients are being directed to consume. *** "


    http://www.accessdata.fda.gov/cms_ia/importalert_159.html?utm_campaign=Google2&utm_source=fdaSearch&utm_medium=website&utm_term=Trichuris%20suis%20ova&utm_content=1

    http://courses.umass.edu/mic590s/2009/Reading/Crohs2009.pdf:
    "The major hookworm-related injury in humans
    occurs when the adult parasites cause an iron-deficiency
    anemia resulting from intestinal blood loss (Hotez and
    Pritchard 1995; Stoltzfus et al. 1997; Albonjco et al. 1998).
    The chronic anemia associated with moderate to severe
    hookworm infection is a handicap to the affected human
    and limits the individual’s prospects of a better future
    (Joven et al. 2005)."



    Let's give autistic kids hookworms in a foreign country, bring them back home and see how well they fare. Or not. This isn't any better than the parents on autism forums talking about how they are giving their children fecal transplants they prepare at home from the family's own fecal waste. It's the equivalent of Russian roulette carried out by self-righteous, overly-confident, poorly informed parents who, because they read some anecdotes on google, believe they know better than doctors, because after all, doctors are in Big Pharma's sway.








    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    An IND for TSO was already filed:
    http://www.coronadobiosciences.com/products/pipeline.cfm

    Here's the presentation showing the progress of the IND so far:
    http://www.coronadobiosciences.com/pdfs/Coronado%20Biosciences%20Lazard%...

    Gerhard Adam
    ... and where on these links is autism mentioned?  More importantly where are hookworms (N. americanus) mentioned?
    Mundus vult decipi
    kwombles
    No surprise, they aren't. Go figure. 

    They keep providing additional proof that they don't care about autism and helminth therapy--not really. They just want to push their own agenda and hope that Science 2.0 will show up high in the google hits for helminth therapy so that their comments will get read by a wider audience.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    kwombles
    You do recognize that is not evidence that the FDA is considering approving TSO, right? That just gives the company the legal right to use it in clinical trials, which are in the preliminary phase. That absolutely doesn't correlate with an FDA approval in the next five years.  TSO hasn't been studied in more than a hundred or so people, either, so there's no way it's going to get FDA approval before tens of thousands of patients have been given it in clinical trials.
    The one study they are doing isn't even looking at efficacy, only at safety, and it's only examining 36 people. 36 people. 36 people. That's worth repeating a few times to hammer in how insignificant a sample size that is.
    http://www.clinicaltrials.gov/ct2/show/NCT01434693?term=TSO+Crohn%27s&rank=3 
    Safety and Tolerability of Single Doses Oral CNDO 201 Trichuris Suis Ova in Patients With Crohn's Disease
    This study is ongoing, but not recruiting participants.

    First Received on September 13, 2011.   Last Updated on April 13, 2012   History of Changes
    Sponsor:Information provided by (Responsible Party):ClinicalTrials.gov Identifier:
    Coronado Biosciences, Inc.
    Coronado Biosciences, Inc.
    NCT01434693

      Purpose

    This is a sequential dose-escalation (with up to 3 dose levels of TSO, ie, 500, 2500, and 7500 TSO), randomized (within each of 3 periods, with a ratio of 3:1 for TSO to placebo), double-blind, placebo-controlled study to evaluate the safety of a single dose of oral CNDO-201 Trichuris suis ova suspension, as compared to placebo, in patients with Crohn's Disease.



    ConditionInterventionPhase
    Crohn's Disease
    Biological: Trichuris suis ova
    Phase 1


    Study Type:Interventional
    Study Design:Allocation: Randomized
    Endpoint Classification: Safety Study
    Intervention Model: Single Group Assignment
    Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
    Primary Purpose: Treatment
    Official Title:A Sequential Dose-Escalation, Double-Blind, Placebo-Controlled, Phase I Study to Evaluate the Safety and Tolerability of Single Doses of 3 Different Doses of Oral CNDO 201 Trichuris Suis Ova Suspension (Tso) in Patients With Crohn'sDisease

    Resource links provided by NLM:

    Genetics Home Reference related topics: Crohn disease
    MedlinePlus related topics: Crohn's Disease
    U.S. FDA Resources 


    Further study details as provided by Coronado Biosciences, Inc.:

    Primary Outcome Measures:
    • To evaluate, in a sequential dose escalation manner, the safety and tolerability of single doses of 3 doses levels (500, 2500, and 7500 embryonated) oral Trichuris suis ova suspension (TSO), as compared to placebo, in patients with Crohn'sDisease [ Time Frame: 6 mo ] [ Designated as safety issue: Yes ]Comparison of safety and tolerability will be performed across the dose levels by evaluating the post-dose tolerability of TSO in patients with Crohn's Disease via incidence of adverse events with a specific focus on reported gastrointestinal signs and symptoms



    Estimated Enrollment:36
    Study Start Date:November 2011
    Estimated Study Completion Date:May 2012
    Estimated Primary Completion Date:May 2012 (Final data collection date for primary outcome measure)
    ArmsAssigned Interventions
    Experimental: TSO 500Biological: Trichuris suis ovasingle dose

    Experimental: TSO 2500Biological: Trichuris suis ovasingle dose

    Experimental: TSO 7500Biological: Trichuris suis ovasingle dose

    Placebo Comparator: PlaceboBiological: Trichuris suis ovasingle dose






      Eligibility

    Ages Eligible for Study:  18 Years to 55 Years
    Genders Eligible for Study:  Both
    Accepts Healthy Volunteers:  No
    Criteria

    Inclusion Criteria:

    1. Males or females, 18 to 55 years old.
    2. Patient has confirmed diagnosis of Crohn's Disease by established criteria with a minimum disease duration of 3 months.
    3. If patient is using concomitant medications, the dose/regimen is stable and remains stable for the two weeks of close observation following TSO administration. Concomitant medications may include: 1) Oral sulfasalazine, mesalazine (5-ASA), or mesalazine derivative, if receiving it for >6 weeks and if receiving the same dose for at least 4 weeks; 2) Oral prednisone up to 15 mg/day, if receiving it for >4 weeks and if receiving the same dose for at least 2 weeks; and 3) Azathioprine or 6-mercaptopurine if receiving it for >3 months and if receiving the same dose for at least 8 weeks.
    4. Hemoglobin ≥ 12 g/dL at screening.
    5. Normal white blood cell count and normal lymphocyte count at screening.
    6. Platelet count > lower limit of normal at screening.
    7. For females of childbearing potential, negative serum pregnancy test during the screening period, not breastfeeding for study duration, and willingness to use accepted forms of reliable birth control for study duration [including bilateral tubal ligation, use of oral contraceptives, double barrier methods (diaphragm with spermicidal gel or condoms with contraceptive foam), Depo-Provera®, hormonal implants, partner vasectomy, and total abstinence]. Pregnancy tests are not required (indicate "N/A") for males or females not of childbearing potential (post-menopausal with last menstrual period >1 year ago or total hysterectomy).
    8. Patient must have the ability to provide informed consent.

    Exclusion Criteria:

    1. Patient with ulcerative colitis, indeterminate colitis, or ulcerative proctitis.
    2. Bowel surgery in past 6 months.
    3. Resection of more than 50 cm of the ileum.
    4. Ileostomy colostomy.
    5. Septic complications.
    6. Patient who is hospitalized or exhibiting signs of toxicity (sepsis), has significant or multiple strictures, or impending obstruction (as evidenced by abdominal distension, severe abdominal tenderness, fever, nausea, vomiting, or tachycardia) or anticipating a need for blood transfusion for gastrointestinal bleeding or in whom surgical intervention may be imminent.
    7. Patient with gastrointestinal abscess, perforation, active draining fistulae or fistulae that are considered clinically significant or perianal lesions.
    8. Patient with history of colorectal cancer or colorectal dysplasia.
    9. Parenteral or tube feeding.
    10. Patient with evidence of infectious colitis, e.g., Clostridium difficile, Amoebiasis, Giardia lamblia or stools positive for other enteric pathogens, ova or parasites at Screening.
    11. Female patient who is pregnant or breastfeeding or wishing to become pregnant during study participation or unwilling to use birth control.
    12. Patient with serum creatinine ≥ 2.0 mg/dL; blood urea nitrogen >40 mg/dL; alkaline phosphatase > 250 U/L; aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 100 U/L; or total bilirubin >1.5 mg/dL.
    13. Patient with white blood count <5,000 or >15,000/mm3; platelet count <150,000 per μl; or iron or vitamin B12 deficiency. Correction of lab exclusion is allowed provided that medical condition is not deemed to put patient at risk and stability of result is sustained for a minimum of 30 days.
    14. Patient with active hepatitis B virus, hepatitis C virus, liver cirrhosis or portal hypertension, cytomegalovirus, Epstein Barr Virus or herpes simplex virus or is known to be human immunodeficiency virus (HIV) positive.
    15. Patient with primary sclerosing cholangitis.
    16. Patient with active malignancy or treatment with anticancer drugs in the past 5 years.
    17. Patient received cyclosporine, anti-TNF or other immunomodulatory agents other than azathioprine/6-mercaptopurine 12 weeks prior to Screening.
    18. Patient received methotrexate 4 weeks prior to Screening.
    19. Patient received metronidazole 2 weeks prior to Screening.
    20. Patient received non-steroidal anti-inflammatory drugs (NSAIDS) within 2 weeks before Baseline visit for more than 3 consecutive days, except acetylsalicylic acid ≤ 350 mg/d which is allowed.
    21. Patient received antibiotic, antifungal or antiparasitic medication in the last 2 weeks prior to Screening and/or would potentially require this during the study treatment period.
    22. Patient with history of drug or alcohol abuse within 6 months prior to Screening.
    23. Patient with evidence of poor compliance with medical advice and instruction including diet or medication.
    24. Patient is unable or unwilling to swallow study medication suspension.
    25. Patient with a significant medical condition which puts the patient at risk for study participation and/or for any reason is considered by the Investigator to be an unsuitable candidate to receive CNDO-201 TSO or is potentially put at risk by study procedures.
    26. Patients who has participated in another clinical trial within 30 days of Screening for this trial and/or any experimental treatment for this population.



      Contacts and Locations
    Please refer to this study by its ClinicalTrials.gov identifier: NCT01434693

    Locations
    United States, California
    Advanced Clinical Research Institute
    Anaheim, California, United States, 92801
    United States, Florida
    Borland-Groover Clinic
    Jacksonville, Florida, United States, 32256
    Shafran Gastroenterology Center
    Winter Park, Florida, United States, 32789
    United States, Michigan
    Clinical Research Institute of Michigan, LLC
    Chesterfield, Michigan, United States, 48047
    United States, Missouri
    Midwest Center for Clinical Research
    Lee's Summit, Missouri, United States, 64064
    Center for Digestive&Liver Diseases, Inc
    Mexico, Missouri, United States, 65265
    United States, New York
    Long Island Clinical Research Associates, LLP
    Great Neck, New York, United States, 11021
    Sponsors and Collaborators
    Coronado Biosciences, Inc.


      More Information
    No publications provided 

    Responsible Party:Coronado Biosciences, Inc.
    ClinicalTrials.gov Identifier:NCT01434693     History of Changes
    Other Study ID Numbers:CNDO 201-002
    Study First Received:September 13, 2011
    Last Updated:April 13, 2012
    Health Authority:United States: Food and Drug Administration

    Keywords provided by Coronado Biosciences, Inc.:
    T. suis ova
    Crohn's disease


    Additional relevant MeSH terms:
    Crohn Disease
    Inflammatory Bowel Diseases
    Gastroenteritis
    Gastrointestinal Diseases
    Digestive System Diseases
    Intestinal Diseases


    ClinicalTrials.gov processed this record on April 19, 2012






























    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Gerhard Adam
    ... and it still isn't the "safe" hookworm.
    Mundus vult decipi
    Gerhard Adam
    As a common-sense measure, all current providers seem to be testing reservoir hosts for the HIV and hepatitis viruses (ask providers about this!). As stated above, some providers use human feces to incubate hookworm larvae. Although this has not been shown to be problematic, this seems like a needless and fairly easily-eliminated source of risk.
    http://opensourcehelminththerapy.org/mediawiki2/index.php?title=Problems&oldid=428
    This is definitely an interesting consideration for those contemplating a trip to a foreign country to obtain a "therapy". 
    Mundus vult decipi
    Just to broaden this conversation: the idea of using helminths in part stems from the idea that removing natural organisms from the human body may cause harm if those organisms were playing a symbiotic role in the human being, such as modulating the immune system, which helminths may well do.

    Modern hygiene and sanitation habits have removes these helminths, but it is not known whether this removal of helminths from the human body is a good thing or a bad thing in terms of human health, as there is little scientific research on this subject. Modern sanitation has just removed these helminths, and science has not questioned it further.

    Another possible symbiotic organism that was removed from the human body also by modern hygiene practices is the coating of < strong >ammonia oxidizing bacteria (AOB) that covered our entire skin. These natural skin-dwelling bacteria secreted substances that modulate the nitric oxide metabolism in the body. However, due to the soaps used from the 60s onwards, these AOB were all killed off, as In the early 1960's, Whitlock says that < strong >synthetic sulfonated soaps were introduced, which are toxic to these AOB bacteria at ppm levels. Thus in the 1960s, we said goodbye to a probable symbiotic organism we had on our skin throughout our history.

    Dave Whitlock has proposed a hypothesis that the loss of these natural ammonia oxidizing bacteria from our skin since the 1960s underpins the apparent rise in autism. In a nutshell, his theory is that low blood nitric oxide is the cause of autism, and that this low nitric oxide is due to the loss of these AOB which make nitric oxide while on our skin.

    His proposal is to repopulate the skin with these natural ammonia oxidizing bacteria, which he suggests form a necessary part of human metabolism, and that this will treat autism. His tests on himself (he is autistic) he says have shown positive results:

    http://daedalus2u.blogspot.co.uk/2007/03/introduction-to-low-no-cause-of...

    I am sure Gerhard Adam and Kim Wombles will like Whilock, as he is a hardened skeptic against all alternative treatments for autism (apart from his own, of course).

    Personally, I suspect that autism, like CFS, is likely a multifaceted condition, with more than one cause, and more than one metabolic system being dysfunctional — even in the individual. Though it has to be said that Whilock's nitric oxide theory of autism makes interested reading (for those with scientific curiosity).

    Gerhard Adam
    If you have evidence, then there's a basis for scientific discussion.  If it's merely anecdotes and invoking the word "natural" then it's not.  Remember, the bubonic plague is "natural" too.

    There's no question that there is a close symbiosis with microbes and the human body, but to suggest that hookworms are symbiotic is simply ignorant.
    Mundus vult decipi
    kwombles
    I am well acquainted with David Whilock's hypotheses. They are not relevant to the discussion of parents using helminths on their autistic children.
    The problem with people's suspicions and beliefs and thoughts when it comes to conditions of the body is that when they are not based on sound scientific knowledge and research, they are little more than empty opinions; following up on them can put people at tremendous risk. 

    After all, there are parents using nicotine patches on their autistic children because they have a suspicion that the nicotine will act on their children's neurons in such a way as to reduce autistic behaviors. There are parents doing fecal transplants because they believe their children's intestinal flora are out of whack and if they give them fecal enemas with their family's collected feces, they can cure autism. Other parents have put their autistic children on herpes medication because of a suspicion that somehow it's the herpes virus causing the autism.

    Plenty of abuse and harm are being done because of parents' suspicions, beliefs, and opinions about autism.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Gerhard Adam
    Great! ... It's a hypothesis.... so what are you proposing?  Whether it's promising or not is yet to be determined.  Certainly whether it's effective or relevant has yet to be determined.  So, if your only point is to convey information then that's fine.  If you're asserting more than that, then you're out of line.
    Mundus vult decipi
    Quoting Gerhard Adam: "...to suggest that hookworms are symbiotic is simply ignorant".

    Well, depends on the definition you are using of "symbiotic". Wikipedia notes that "the definition of symbiosis is controversial among scientists. Some believe symbiosis should only refer to persistent mutualisms, while others believe it should apply to any types of persistent biological interactions (i.e. mutualistic, commensalistic, or parasitic)."

    And anyway, even mutualism can be more subtle and context-dependent than your black and white approach to science. For example, herpes simplex virus you'd think was an undesirable microbe: it's linked to Alzheimer's disease; however, bizarrely enough, having herpes simplex confers protection from the bubonic plague, in murine models at least. So in the times of bubonic plague, herpes may well have been a highly beneficial mutualistic organism. So mutualism can depend on the context.

    Helminths may be mutualistic if they confer some benefit to their human hosts in some context.

    Two main effects of the immunoregulatory proteins secretes by helminths in the gut is: an up-regualtion of the Th2 branch of the immune system, and an up-regualtion of regulatory T cells. Ref: www.ncbi.nlm.nih.gov/pmc/articles/PMC2706953/

    So these immunoregulatory proteins may help diseases which are deficient in Th2 immune responses, and/or where there is autoimmunity (because increasing regulatory T cells can calm autoimmunity).

    More and more diseases, particularly neurological and psychiatric ones, are being linked to immune dysfunction (with the immune dysfunction itself often linked to hidden chronic infections), so immunoregulatory interventions make sense in theory.

    If you look at chronic fatigue syndrome, a condition not entirely unlike autism, you find people with CFS are experimenting all the time with all sorts of therapies, sometimes leading to improvements (and even cures in some cases), but more often, not helping all that much. Nevertheless, people try.

    I simply cannot understand your views about not trying out treatments until they are proven, published and have competed clinical trials. Caution and skepticism and safety are of course vital considerations in any experimentation; and avoiding snake oil salesmen is important too; but you have such a negative attitude towards taking any simple experimental steps forward yourself, on your own steam.

    Not exactly "The Right Stuff".

    Admittedly, it is slightly different when you are testing things out on your child, rather than yourself. You would certainly want to be extra careful, especially as a child may not be able to adequately articulate any negative effects. When I test drugs and supplements on myself, I am in the driving seat, and can discontinue immediately if I sense any worsening of symptoms.

    Incidentally, I read the report of one person who tried helminth therapy for CFS, but found no improvements, but no ill effects either. This perhaps is not entirely surprising, as CFS patients already have an immune system that is over-active in the Th2 branch, and so boosting Th2 further with helminth therapy is not going to help CFS.

    Helminth therapy, if it does help, is more likely going to work for Th2 diseases, and/or diseases with an autoimmune component.

    Gerhard Adam
    Again ... your point is irrelevant.  Unless it's only to advocate self-experimentation, in which case you're certainly welcome to perform it on yourself.  To advocate it for others is simply idiocy.  If you want others to feel free to experiment, then let them use their own judgment.  They don't need a cheerleader encouraging them to do something that may be totally wrong for them.  No matter what your experience is, you don't know and can't know the situation of someone that may be reading your advice. 
    Wikipedia notes
    Stop the presses.  If it's from Wikipedia, it must be true.
    ...while others believe it should apply to any types of persistent biological interactions (i.e. mutualistic, commensalistic, or parasitic)."
    Which simply renders the term, symbiosis, completely meaningless.  It then means everything and nothing. 

    I view such self-experimentation in the same way lawyers view people that defend themselves.

    "When you defend yourself, you have a fool for a client."
    ...but you have such a negative attitude towards taking any simple experimental steps forward yourself, on your own steam.
    Actually you don't know anything of the sort.  I'm opposed to self-righteous people thinking that what they do is appropriate for everyone.  They have no concept of the role such irresponsible statements can have on others that may not be as knowledgeable or as careful.  Instead they just keep running their mouths, regardless of the consequences they may be setting others up to experience.
    You would certainly want to be extra careful, especially as a child may not be able to adequately articulate any negative effects.
    Sure ... and if someone does something improperly and makes things worse, or even kills their child what are you going to say then?  They weren't careful enough? 

    What you continue to fail to grasp is that the reason for scientific results and clinical testing is to establish the parameters and effectiveness across a broad range of subjects.  Unlike you, responsible researchers can't simply assume that everyone has the same responses or conditions that you have.  As a result, such self-experimentation isn't just worthless to others, it is simply dangerous.  In all likelihood, the "self-experimenter" doesn't keep adequate notes and doesn't have a means by which to assess what else might be happening.  So, to advocate or advise others is the height of irresponsibility.
    Mundus vult decipi
    Gerhard, you seem to get more troll-like as the conversation progresses. Do you have any interest in the scientific content of the discussion?

    Quote: "Which simply renders the term, symbiosis, completely meaningless". Er, no it doesn't.

    As for your comments on self-experimentation: what nonsense! A considerable amount of medical science has been advanced by researchers nobly experimenting on themselves. The Helicobacter pylori cause of stomach ulcers was proven by self-experimentation — just one in a long history of such self-experimentation cases.

    But the silliest argument you present (which you see time and time again from online skeptics) is this whole feigned concern with the safety of alternative treatments, and this argument just does not hold true. The occurrence of fatalities and adverse events in alternative treatments is extremely rare — so rare than when one does happen, it usually makes the national press. Whereas the occurrence of fatalities and adverse events in mainstream medicine is so common each day, that there would not be enough space in the newspapers to print them all.

    I think online skeptics do a good job in pointing out the snake oil salesmen to the unwary, but lots of people have regained their good health purely by trying things out until they find something that works.

    Gerhard Adam
    The Helicobacter pylori cause of stomach ulcers was proven by self-experimentation — just one in a long history of such self-experimentation cases.
    ... and let's be clear that in that case, it was conducted by a man that was a doctor and a professor of microbiology.  Not exactly your everyday "person on the street".  So your point is, again, irrelevant.

    Perhaps you'd care to explain how you acquire your hookworms?  Perhaps you'd care to explain how much it costs for you to receive these "treatments"?  Perhaps you can explain how you screen these parasites to ensure they aren't carrying any disease from the individual they were cultured from?
    Mundus vult decipi
    I have not personally looked into the details of using helminths, as I don't think this experimental therapy is going to help my ME/CFS, which is a condition of underactive Th1 and overactive Th2. The helminths will further boost my Th2 immune response, and that will not help me.

    Though looking at one of the refs given above, it seems that there are a number of helminth providers, charging around $2500 to 3000. That seem expensive, but then I don't know what is involved in cultivating these worms.

    Certainly your point on the worms carrying other diseases would be a major concern, and you'd have to question the providers thoroughly to find out what steps they take to prevent transmitting any disease. Ideally, you would hope the worms could be cultivated in vivo, but perhaps that is not technically feasible.

    But given a safe supply of helminths, I doubt if there is any danger. And a single dose of the very well-tolerated drug ivermectin will eliminate all worms in your system anyway, in case some side effects do arise.

    In general, a lot of medicine is a hit and miss affair, for any condition other than simple, well understood illnesses with a simple Rx.

    Healthy people think that modern medicine is a streamlined, rational, systematized process. But in reality, once you have spent any time living in the underground subculture of the unwell, where an accurate diagnosis is often very hard to find, and patients may spend years going from doctor to doctor until they meet one that seems to be able to put a name to the weird symptoms they have. And finally getting a diagnosis is only the beginning of the problem: then you have to find what treatments, if any, might help, and go through the process of trying them out, to find the ones that work best for you.

    There is a lot of luck to medicine when you are a patient in the system. The main factor that seems to bring success when you are ill with some complex or mystery illness is persistence: seeing as many doctors as you can (and seeking out the genius ones, which are very rare), and if you get a diagnosis, trying as many treatments as you can, until you find what works well for you, with the least side effects.

    Same applies to alternative treatments. Except that most are extremely safe, so why not try them. You have nothing to lose, and everything to gain, if you come across an alternative treatment that you find leads to improvement in symptoms.

    This is why stifling the process of trial and error in alternative treatments by expressing unfounded concerns of safety (which as mentioned is a false argument) is not going to help people who are ill. Or at least, address the safety concerns with an accurate, unexaggerated perspective.

    Gerhard Adam
    ...it seems that there are a number of helminth providers, charging around $2500 to 3000.
    OK ... not in this country, so where would you go?  Since you clearly can't maintain your own ongoing infection, then how often are these "treatments" required?  At what expense? 
    Certainly your point on the worms carrying other diseases would be a major concern, and you'd have to question the providers thoroughly to find out what steps they take to prevent transmitting any disease.
    Yes, and how successful do you think you'll be in a foreign country with no regulation to ensure that you're aren't being told a fairy tale?  I also want to be clear that I'm not accusing Mexican doctors of being unqualified, or unscrupulous.  However, someone would have to be brain-dead to not recognize the fact that this presents an opportunity for unscrupulous individuals to come into the scene, promising lower prices, etc.

    I understand about anti-helminthic drugs, and I don't see that as the problem.  I also don't dispute the fact that people are certainly free to pursue whatever course of "treatment" they think is worthy of consideration.  I am opposed to irresponsible advocacy that gives rise to unethical behaviors and opportunists taking advantage of uninformed people that read about such commentary.  Perhaps you will take the time to research things and determine what's appropriate for yourself to pursue.  Are you prepared to make the same guarantee to someone else?  Is this something that you would encourage or advise someone else to do?  That's where my problem comes in.

    Advocacy for something that isn't legal, hasn't been tested, and doesn't have the oversight to ensure that unscrupulous individuals can't take advantage, is setting someone up for a major disappointment if not problem.  I don't think it's useful to encourage people to self-experiment, spend money they may not have, and then try to do it "under the radar" because some anonymous person on the internet promises them that this is the answer to their problems.
    Mundus vult decipi
    Dr. Todd,

    Thank you for your comments. I personally would find it very odd for a major medical school like Mt. Sinai to involve itself in an endeavor that would cast dispersion on its reputation.

    I write merely to point to some evidence that this theory has been taken seriously by a major academic medical center, and therefore perhaps it might be deserving of reconsideration given the content of this article.

    That the study design itself may be poor is indeed something to think about, but it begs the question posed by the author, which seems to be, "is use of helminthic therapy in autism quackery?" To me, the answer appears to be "perhaps not if a major medical institution has begun to study the issue."

    I appreciate your insightful comments.

    kwombles
    Ms. Beales, you obviously ignored my comment showing that Mount Sinai has removed all information relating to this study from its website and has not updated the government's clinical trial records since 2009. It appears the study was not conducted. Using a logical fallacy of appealing to authority, appealing to Mount Sinai's prestige, proves nothing about the value of the study. After all, alt-med woo has made inroads at most major universities, including Harvard where Martha Herbert is an associate professor.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Ms. Beales:

    The number of hospitals that offer Reiki, Therapeutic Touch, and other forms of "energy medicine" suggests there are plenty that do not have an aversion to embarrassing themselves by an association with pseudoscientific nonsense.

    But it goes beyond that. A hospital in Chicago a few years ago offered million dollars in a settlement for a psychiatrist prescribing Facilitated Communication. I needn't tell you of the false memory/Satanic ritual/Multiple Personality Disorder debacle involving Bennett Braun at Rush-Presbyterian St. Luke's Hospital, also in Chicago, that resulted in a single settlement of over $10 million--plus plenty of other legal problems.

    I do not see Mt. Sinai offering Reiki directly--religious affiliates tend to be shy of paranormal things for theological reasons--but you can apparently get a training rotation that includes it. Of course, sometimes clinical trials are done to establish something as nonsense--although that does not seem to be what was planned at Sinai with the worms. That looked like what I call the "Pilot Dodge" in which a bad experiment is elevated in stature by being called "Pilot" rather than just "Having Nothing Like the Controls It Would Need to Draw a Real Conclusion," and, once done, is followed by more like it that build on the bias-based results as though they were genuine. I would suggest reading Murray Sidman's chapter on "Pilot Studies" in the book Tactics of Scientific Research.

    In any case, many seemingly and otherwise reputable institutions find themselves promoting nonsense, like MIT with facilitated communication last summer and Reiki in dozens of hospitals. Some institutionalize it, like the Stanford Research Institute's sponsorship of Targ and Puthoff's "research" into telepathy or Syracuse with Facilitated Communication. The problem isn't being embarrassed about it later as is the case with SRI. (You won't find much about it on SRI's extensive website.) The problem is failing to be embarrassed while it is happening.

    James T. Todd, Ph.D.

    Ms. Wombles, your statement about Mt. Sinai School of Medicine having no links to a TSO trial in autism is inaccurate. Here is a link from Mount Sinai School of Medicine about the TSO trial:

    http://www.mssm.edu/research/clinical-trials/08-0977

    As I stated previously, I make no claim about the study design itself. I merely point out that the issue *is* being studied under affiliation with Mt. Sinai School of Medicine.

    kwombles
    Same one I posted in a comment above, from 2009. At the time I did a search of the Mount Sinai website, no hits came up.  It's been "recruiting" for three years. It's not going anywhere.
    http://clinicaltrials.gov/ct2/show/NCT01040221?term=Trichuris+Suis+Ova+Treatment+of+Adult+Autism+Symptom+Domains&rank=1 

    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    Ms. Wombles, clearly you are very against helminthic therapy as a potential intervention for autism spectrum disorders. I truly doubt I will have any capacity to pursuade you otherwise, but I would like to leave you with this thought, and I appreciate your professionalism in responses. It's excellent to be skeptical. In fact, I highly recommend it as a general practice.

    A recent editorial that appeared in the esteemed New England Journal of Medicine identifies a gene mutation called SHANK 3 in autistic spectrum disorders. This gene is known to contribute to gut mucosal abnormalities. Here is a message I posted on this as Co-Moderator of the Helminthic Therapy Forum:

    http://health.groups.yahoo.com/group/helminthictherapy/message/7438

    The editorial is an interesting read, and puts a focus on autism that has not been clearly elucidated previously except perhaps as parental reports of GI issues in ASD children, and by concerned clinicians who pick this finding up in exams.

    Wolff et al. published a recent paper in mice (yes, I know the limitations of mice studies!) that helminths directly affect gut mucosa:

    http://health.groups.yahoo.com/group/helminthictherapy/message/8692

    They arrived at this study to try to understand why a patient with ulcerative colitis (UC) who self-inoculated with a species of helminth called Trichuris trichiura achieved full remission from his disease. The patient approached their research team at NYU to be studied as a case report. They, in turn, tried to understand what the "mechanism of action" was that drove the positive response.

    I for one have eye-witnessed a complete ulcerative proctitis remission in my spouse, who remitted with this treatment after 34 years of serious disability. So I admit to bias.

    I think it's prudent to keep an open mind about new possibilities, but I grant you, not so open that your brains fall out! But I have spent 14 years studying helminthic therapy, and I think there's enough evidence here to consider the possibility that at least some of the gut issues in ASD patients might benefit from an intervention like helminths.

    I wish you the best in your quest for health.

    kwombles
    No, I'm against the use of untested, unproven, illegal in the United States "treatments" being used on vulnerable populations like autistic children. Huge difference.
    With all due respect, unless you are a licensed health professional or scientist who has studied helminth therapy under the purview  of IRB boards, your experience and "evidence" is nothing more than anecdote and google-U. And people who make medical decisions based on yahoo forums are definitely getting what they paid for.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    This is why clinical trials are so important, Ms. Wombles, and why I have spent some of my time on your blog, to attempt to bring awareness that an effort is being made to study the issue in a controlled, ethically acceptable method.

    My paper on helminthic therapy was presented at Computational Biology, Genomics and Chemoinformatics, BCBGC-08, Orlando, Florida, USA. William Loging, PhD, of Pfizer was my session moderator.

    Best regards.

    kwombles
    Again, one clinical trial from 2009 still recruiting in 2012 would seem to clearly indicate it's not being studied in "a controlled, ethically acceptable method." 
    Parents who use this to treat their autistic children are gambling with their children's health and well-being on the half-baked idea that autism is a gastrointestinal issue rather than a neurological issue. No reputable autism researchers or experts support the idea that autism originates in the gastrointestinal tract, while an abundance of evidence supports the hypothesis that the various autisms are a result of differences in the brain.
    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    I think Kim Wormbles is jumping on the diving board of conclusions a little too early. Or perhaps she hates the similarity of her last name to worms?

    I first learned about the hygiene hypothesis in pharmacy school in 1990. It is based on the observation that there are less allergies/asthma/autoimmune diseases in 3rd world countries compared to the developed world. I believe that is true of autism too.

    http://heather-ozmun.suite101.com/parasites-a-mutually-beneficial-coexis...

    I have multiple sclerosis. Based on an observation, they are currently studying helminths as a treatment for MS.
    http://www.ncbi.nlm.nih.gov/pubmed/18655096
    http://evmedreview.com/?p=92
    http://msj.sagepub.com/content/early/2011/03/02/1352458511398054.abstract

    As a personal observation, my MS was in remission when we lived in Indonesia, where parasites are rampant.

    It has been observed that there is a higher incidence of autism in families with autoimmune diseases. My son has Aspergers. There is speculation that an autoimmune reaction could lead to autism. If parasites dampen the immune response, and they find that autism is linked to autoimmunity, why would they not study helminths as a treatment for autism?

    There is also an observation that autistic kids have 'gut pathology'. Parasites alter the gut environment. The gut is so connected to the brain that some people refer to it as' the second brain'. 90% of serotonin, a neurotransmitter, is found in the gut.

    We have only declared war on the worms in the last 100 years. Is it that hard to believe that our immune systems and parasites co-evolved? Parasites dampen the immune system, that is how they survive in their hosts. I think that some very interesting research will reveal that helminths can be a good thing.

    I plan on getting some hookworms sometime in the future. I expect that minimum, my allergies and asthma will improve. Worst case, I can take some mebendizole to get rid of the worms. I do have a problem with them 'commercializing' them and selling them for outrageous prices. Think I will go walk around barefoot in Indonesia again!

    kwombles
    As a rule, I am disinclined to give any real weight to the words of any one who feels the need to begin her "argument" with a personal attack. Looks like your biases showing through, if you had an emotional reaction sufficiently negative to feel the need to be hostile in your opening statement. I think readers can determine where the "closed mind" is in this situation.
    This article, written two years ago, has nothing to do with helminth therapy or research on helminth therapy for conditions other than autism. It is specifically targeted at charlatans who are preying on the desperate, misguided parents of autistic kids who think that taking their children to third world countries to have their children infected with helminths under the implausible belief that worms introduced to the GI tract will somehow influence a neurological condition.

    I'd rather rely on the bulk of scientific research concerning autism being a neurological disorder with specific changes in the brain and use therapies that are not only plausible but already studied and recommended than use my children as guinea pigs because I've relied on my ability to be a google scholar to come up with the idea that my children have autism because of their GI tract. Research does not back up your "theory."

    “Nothing in the world is more dangerous than a sincere ignorance and conscientious stupidity.” --MLK, Jr.
    As I said, I have MS and my oldest son has Aspergers. He has had some GI problems which I won't go into here.

    Autism and gut pathology:

    http://journals.lww.com/jpgn/Fulltext/2002/05001/The_Gut_Brain_Axis_in_C...
    http://integrativehealthconnection.com/wp-content/uploads/2011/11/Intest...
    http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2036.2002.01206.x/full

    A summary of some studies on autism and gi pathology: http://legacy.autism.com/medical/research/advances/autism-gastro.htm

    Parasites alter gut pathology and dampen the immune system. A large part of our immune system resides in our guts. So I think this area of interest warrants more study. It is way too early to say whether helminths will help autoimmune diseases and/or autism. But I think we should keep an open mind. Humans have been living with parasites for a much longer time than we have been living without them. How do we know what effect taking them out of our environment will have on us? Our immune system evolved to protect us from bacteria/viruses/parasites. Now that we have wiped out parasites and many dangerous viral and bacterial diseases, why would we assume that our immune systems would function normally?

    Rachel

    I should mention that I'm a pharmacist, and seriously considering this for my MS. More people in this world live with helminths than without. If anything, I can take some Vermox and get rid of the worms. I think helminths are a heck of a lot SAFER and cheaper than the $3500/month injection I take for my MS.

    Even drugs that have been approved by the FDA can have unforseen lethal consequences. Just read about Tysabri, the most effective treatment for MS. Tysabri has been rigorously studied, withdrawn from the market, and re-released because so many MS patients benefited from it. So just because something is FDA approved in this country doesn't mean that it is harmless.

    I bet if you look at deaths from parasites in a 3rd world country, compared to deaths from FDA approved drugs in our country, the parasites would come out ahead.

    Rachel

    Ms. Kelley:

    You are a pharmacist? A bona-fide one? With real pharmacy training?

    This is an astonishing revelation. I would not have assumed that someone who entered a conversation with an insult, then concluded with such an alarmingly inaccurate statement about worldwide parasite deaths, could be any kind of legitimate professional.

    This is what you said: "I bet if you look at deaths from parasites in a 3rd world country, compared to deaths from FDA approved drugs in our country, the parasites would come out ahead."

    Incredible. You are so grossly misinformed about the dangers of parasites across the world that you should immediately stop working in your profession. You cannot possibly be giving good advice. Indeed, if you believe what you said, how can you ethically continue to work as a pharmacist? As for the parasites, malaria alone kills over 500,000 people per year, and the toll from various others adds up to millions. This is not to mention the suffering caused to millions more by non-lethal parasites, including intestinal parasites, mostly across developing and undeveloped parts of the world--where when you suffer, you really suffer.

    I dunno. Maybe you'll hairsplit and say you really meant only one single third-world country compared to the U.S. Ok. Let's try an experiment. Let's see how quickly we hear the word "Yes" when we ask the UN ambassador from Bangladesh if he will trade all of his parasites for all of our drugs.

    James T. Todd, Ph.D.

    I was not considering malaria, I was just thinking hookworm and TSO which is what is being debated here. I don't recall purposeful self infection with malaria being mentioned here.

    I attended a conference while living in Indonesia. The epidemiologist estimated that 1/10 of all money being spent on food went into feeding the parasites in Indonesian school children. Most Indonesians live on $3/day and are already malnourished (with or without parasites). I don't think deliberate infection with hookworm, or drinking TSO eggs in a person eating a healthy Western diet can be compared to somebody in a 3rd world country who walks around barefoot in areas with poor sanitation and no access to medical care.

    There is something to the hygiene hypothesis, like it or not.

    Rachel

    Gerhard Adam
    There is something to the hygiene hypothesis, like it or not.
    Well, like it or not, we usually expect evidence and not anecdotes.
    Mundus vult decipi
    Somebody has to be the guinea pig in these worm studies. I am in no way suggesting subjecting autistic children to helminth therapy without informed consent. But just so you know that there are legitimate studies for other medical conditions go to clinicaltrials.gov

    Rank Status Study
    1 Recruiting Helminth-induced Immunomodulation Therapy (HINT) in Relapsing-remitting Multiple Sclerosis
    Condition: Relapsing Remitting Multiple Sclerosis
    Intervention: Biological: Helminth ova
    2 Recruiting Activation and Function of Eosinophils in Conditions With Blood or Tissue Eosinophilia
    Conditions: Asthma; Eosinophilia; Helminthiasis; Hypersensitivity; Parasitic Disease
    Intervention:
    3 Not yet recruiting Trichuris Suis Ova (TSO)in Recurrent Remittent Multiple Sclerosis and Clinically Isolated Syndrome
    Condition: Multiple Sclerosis
    Intervention: Drug: Trichuris suis ova
    4 Not yet recruiting Worms for Immune Regulation of Multiple Sclerosis
    Condition: Multiple Sclerosis, Relapsing-Remitting
    Interventions: Biological: Hookworm larvae; Biological: Placebo
    5 Completed Trichuris Suis Ova Therapy for Relapsing Multiple Sclerosis - a Safety Study
    Condition: Relapsing Multiple Sclerosis
    Intervention: Biological: Trichuris suis ova

    There are studies for Crohn's disease, UC, celiac, asthma:

    2 Recruiting Trichuris Suis Ova (TSO) Suspension Versus Placebo in Active Crohn's Disease
    Condition: Crohn´s Disease
    Interventions: Drug: Low dose TSO; Drug: Medium dose TSO; Drug: High dose TSO; Drug: Placebo
    3 Not yet recruiting Efficacy and Safety of 2 Different Doses of Trichuris Suis Ova (TSO) as Compared to Placebo
    Condition: Crohn's Disease
    Intervention: Biological: Trichuris suis ova (TSO)

    5 Active, not recruiting Safety and Tolerability of Single Doses Oral CNDO 201 Trichuris Suis Ova in Patients With Crohn's Disease
    Condition: Crohn's Disease
    Intervention: Biological: Trichuris suis ova
    6 Recruiting Trichuris Suis Ova in Peanut and Tree Nut Allergy
    Condition: Food Allergy
    Intervention: Drug: Trichuris suis ova (TSO)
    7 Recruiting Mucosal Immunity of Ulcerative Colitis Patients Undergoing Therapy With Trichuris Suis Ova
    Condition: Ulcerative Colitis
    Intervention: Drug: Trichuris suis ova

    1 Unknown † Inoculating Celiac Disease Patients With the Human Hookworm Necator Americanus: Evaluating Immunity and Gluten-sensitivity
    Condition: Celiac Disease
    Interventions: Biological: Necator americanus; Other: Sham inoculation
    5 Completed Randomised Placebo Controlled Study of Effects of Therapeutic Hookworm Infection in Asthma
    Condition: Asthma
    Intervention: Procedure: Infection with hookworm larvae
    6 Completed Randomised Controlled Clinical Trials of the Effect of Therapeutic Hookworm Infection in Allergic Rhinoconjunctivitis
    Conditions: Rhinitis, Allergic, Perennial; Hayfever; Allergy
    Intervention: Procedure: Infection with hookworm larvae

    So I know the ICK factor is HUGE, but would you rather deliberately self infect yourself with helminths or take a really expensive drug developed by big pharma that mimics a helminth infection and probably has worse side effects? I have been following Mr Johnson and his reports of his autistic son's success with TSO. If I had a profoundly autistic child, I would consider this if nothing else helped. I also don't think it a coincidence that moms with autoimmune diseases have a higher incidence of autistic children so I do believe there is an autoimmunity autism connection. I just don't think you can condemn the research before it has even started.

    Rachel

    Gerhard Adam
    I just don't think you can condemn the research before it has even started.
    Oh of course not.  Unlike vaccines, where the research is routinely discounted as being a conspiracy to advance autism.  Instead, we'll go to something that has no data at all.  That should work.

    What you fail to grasp is that the lack of scientific data makes recommendations for helminth therapy grossly irresponsible and quackery.  No one is disputing that it might have legitimate treatment claims, when it is properly researched and the appropriate applications are examined.  However to rush headlong into something for which you know absolutely nothing, is silly.  You talk about "informed consent".  Informed about what?  That no one knows what it will do?

    Is this somehow supposed to be arbitrarily good because it's "natural"?  I can guarantee that if this were being proposed by one of the pharmaceutical companies, you'd be one of the first ones in line screaming about how dare they suggest therapies that haven't been tested.  However, when it is left to you and your pseudoscientific cronies ... then it's an obvious therapy.  Go figure.

    Your anti-science bias is showing.
    Mundus vult decipi
    Informed consent is the process of learning the key facts about a clinical trial before deciding whether or not to participate. Risks and potential benefits are explained in the informed consent document. When somebody participates in the first human trial for a new drug, how do you really give 'informed' consent?

    I have not recommended this therapy to anybody and I'm not promoting it. I'm simply saying that it needs more study. The hygiene hypothesis is something that I have followed for the last 20 years. As somebody with severe asthma/allergies/MS who takes 7 prescription medications, I am not rushing into it headlong, perhaps I don't want to wait another 10 years for it to become approved.

    Is non natural or man made ever better than natural? No, I'm not an earth muffin, but with some bad side effects from man-made drugs, I'm willing to explore this. Anti-science would be not having an open mind.

    Autism, asthma, inflammation, and the hygiene hypothesis: http://www.grc.nia.nih.gov/branches/rrb/dna/pubs/aaihh.pdf

    I do take issue with worm purveyors if they are actually claiming that they can cure autism and are actively recruiting people. Obviously helminth therapy has not been proven safe or effective, and they cannot legally make these claims. I don't think anybody can say that helminths WON'T help autism, no studies have been done, and maybe they should be.

    Gross but true: medical grade leeches (which I had to keep in the pharmacy) and maggots are starting to be used to treat wounds that won't heal. http://www.medpagetoday.com/ProductAlert/DevicesandVaccines/1618 I'm sure FDA regulated medical grade helminths are just around the corner.

    Rachel

    Quackery is not a label automatically applied to methods that are labeled "natural," or alternative," or nonstandard. Judgments about individual methods should be based on whether or not there is scientific evidence of effectiveness.
    Stephen Barrett, M.D. from Quackwatch.com

    I don't think there is evidence of effectiveness or ineffectiveness at this point.

    Is this somehow supposed to be arbitrarily good because it's "natural"? I can guarantee that if this were being proposed by one of the pharmaceutical companies, you'd be one of the first ones in line screaming about how dare they suggest therapies that haven't been tested. However, when it is left to you and your pseudoscientific cronies ... then it's an obvious therapy. Go figure.

    Your statement doesn't make a lot of sense. You don't think a drug company will find a way to patent and market helminth therapy if it is found to be effective? You don't think drug companies are NOT currently researching helminth therapy? Please refer to the studies above on clinicaltrials.gov. BTW, I have no pseudoscientific cronies, it is an individual opinion/decision.

    I don't see any debate about the merit of studies being conducted, I just see biased judgement and a closed mind.