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Necator Americanus (Hookworm)
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Science vs. "Voodoo"
There are several topics in the field of "Natural Medicine" that are fraught with what I believe are misconceptions, half-truths, and pure fantasy. One of these is the concept of parasite infection.
First of all, what are parasites? Parasites are organisms that live within another (host) organism and produce adverse health effects. Parasites can range in size from microscopic, single-celled to the less common worms that can grow many feet long. Symptoms and health effects from parasites can be quite varied. Most obvious are the gastrointestinal symptoms like diarrhea, nausea, vomiting, cramps, bloating, constipation, colitis, lactose intolerance, and loss of appetite. Other symptoms and conditions can include fatigue, weight loss, anemia, arthritis, rashes, hives, cough, muscle pains, malabsorption, and much more. Other organs that can be infected by parasites include the liver, gallbladder, bladder, lung, brain, and other tissues. I had a patient who had a history of several decades of monthly respiratory infections, which cleared up once we identified and treated infection with a worm known as Strongyloides.
Now, when it comes to parasites, I believe that parasite infections are real. I don't think that is controversial. What is controversial is the prevalence of parasite infections. I have spoken to quite a few people who believe that everyone has parasites. I believe it is important to look at that simple word "has". Let's concede that everyone may have a small number of protozoa passing through his or her gastrointestinal tract on a regular basis. Is that a problem? Does it necessitate or deserve treatment?
What are protozoa? They are one type of parasite. Protozoa are single celled organisms (microscopic), just like bacteria. It is sobering to realize that we each have about 100 trillion bacteria within our intestinal tracts. These weigh several pounds in total. Bowel movements are actually about half composed of bacteria. Common types of intestinal bacteria are easily detectable by laboratory analysis of a stool specimen.
Parasites, on the other hand, are less abundant and more difficult to identify from a stool specimen. Laboratories typically will analyze a stool specimen under the microscope, looking for parasites. Sometimes this method will fail to identify a parasitic infection that is actual present. This has been a source of frustration, which has led to other methods of identifying parasites.
However, just because parasites are difficult to identify is not reason to conclude that everyone should just do a "parasite cleanse". I recently had a conversation with a woman who had been diagnosed with parasites. I asked her how the parasite was identified. She told me that she had been to a spa in Florida and was diagnosed by looking at her blood under a microscope- a test called darkfield microscopy. She was informed that 95% of New Yorkers have parasites, so she was not alone. This is all nonsense, including the method of diagnosis.
I have heard of other unscientific methods of identifying parasitic infections. The things people believe just amaze me. Parasite infections should be identified by laboratory testing.
So, what is the "gold standard" for scientific parasite identification? It is a laboratory test performed on a stool specimen. However, it does not involve visually looking for the parasite under a microscope. It is cutting-edge, although not "over the edge". It is a technique that is not yet common, but should be easily appreciated by any gastroenterologist to be grounded in science. To this point, there is only one laboratory I know of that is offering this test (see left panel).
Enough suspense; what is this test. It is a technique called PCR (poymerase chain reaction) with hybridization of DNA. In other words, the lab is not looking for a whole parasitic organism, it is just looking for its DNA. This method involves breaking down and copying the DNA, which allows for accurate identification when only a small amount of DNA is present. The sensitivity of this test is amazing. The presence of parasites is determined with the smallest trace of DNA. The sensitivity of this test is up to 5000 times greater than other detection methods.
The reason I said any gastroenterologist should be able to appreciate the validity of this method (although they may not be aware it is commercially available) is because it is grounded in science. This PCR technique is utilized in research settings. PCR is also used in PAP smears and in testing for gonorrhea.
I have been using this parasite test since it became available; I believe it is 5 or 6 years now. Prior to using this test, I used other laboratories, which employed the traditional (microscope) detection methods. When I switched to the mew technique, the number of cases of parasites identified in my patients went up dramatically. In particular, the presence of worm infections skyrocketed. This test is so sensitive that it does identify types of harmless single-celled organisms, which are probably just passing through the digestive tract in contaminated food.
Now, even with this super-sensitive PCR technique, most people I test do not have parasite infections. I would guess that about 15% of the patients I have tested had parasite infections. I strongly believe that most people do not have parasite infections.
Does it make sense that everyone should do a "parasite cleanse"? Why treat something that doesn't exist?
That brings us to "the how" of parasite treatment. A parasite cleanse usually involves some combination of herbs. Some products are of good quality, others less so. It is difficult for the average consumer to make that distinction. Even the best of natural products is only partially effective: they sometimes work but not always. Medications are stronger and more likely to be effective but carry a greater risk of side effects. Even the natural treatments may cause symptoms and, rarely, liver toxicity. So, parasite "cleansing" or treatment should not be taken lightly.
Even if you have some or many of the symptoms associated with parasite infection there is no guarantee that you have a parasite. Yeast, bacteria, and viral infections may produce these symptoms. Food sensitivity reactions (especially gluten) may be the actual culprit in many cases of these symptoms. Stress can be another big factor. Don't assume it is parasites! I recommend only treating a parasite infection that is identified with lab testing. It is usually a good idea to test again after treatment to make sure that the infection is gone. |
