2968Re: 6 weeks after rerereinoculation
- Jul 11, 2009Hi Marya, and all other clients of ours. This is very important, so please take the time to read this very lengthy post. It applies to all of you to some extent, but particularly those of you with Crohn's and other intestinal diseases.
Although it is not directly related to prednisone, it does apply to changes in your habits and use of medication once you start to see improvements from helminthic therapy. Whether hookworm or whipworm.
Please make any reduction in drugs like humira or remicade, or diet, or whatever coping mechanisms you have relied upon, gradual. This is not just me being cautious. Read on.
In addition wait until long after you would like and expect to make those reductions or changes. At least 6 months after seeing strong results, so nine months after treatment is complete.
One good reason is that it takes 45 weeks for your immune system to settle in completely to the presence of hookworm, and I would expect whipworm. This is part of the reason that about 5% of those we treat only start to see an improvement after 9 months. So to get the full benefit from helminthic therapy one must wait almost a year.
Don't kid yourself, as sick as you may have been before helminthic therapy those drugs are exerting a very positive effect on your disease, even if the risk of side effects is large.
Prematurely removing the drug from the equation means hookworm or whipworm will have to carry the load alone before their affect is fully felt. Not good, and for more than the obvious reason. There is much more to it than that.
A theory I have long had is that Crohn's, UC and Celiac disease, as well as IBS, are the result of inheriting genes, probably from both parents, that confer advantages on the host in managing helminth populations.
This was important, and still is in the third-world, when we did not have access to ablendazole, and similar. Meaning for most of our evolutionary history. Acquiring a large worm burden, particularly when malnutrition occurs, can be fatal if the subject does not have access to modern drugs (costing five bucks, tops).
Host immune response to intestinal helminth infection results in inflammation in the gut in the short term, before the helminth can exert its immunomodulatory effect. This response is an attempt to drive the parasites towards the exit, the anus, and is the cause of the side effects some experience in the six to eight weeks immediately after treatment. By forcing the worms to detach though inflammation of the intestinal tract feeding is prevented, the helminth is weakened, and the inflammation makes reattachment more difficult, attachment shorter in duration, feeding less frequent and incomplete, etc., etc. The weakened and starving parasite is shuffled off to the wastewater treatment plant. RIP.
Ulcerative Colitis, Crohn's disease, Celiac disease and IBS are inflammatory conditions that affect various parts of the intestinal tract. That recent paper I got so excited about (Parasites represent a major selective force for interleukin genes and shape the genetic predisposition to autoimmune conditions.pdf) asserts that the genes for Crohn's, UC and Celiac disease have been shaped by long term and widespread helminth infection of man.
The two most common intestinal helminthic parasites? Hookworm and whipworm.
Given all that it seems possible, using the conservative language favored by scientists so I don't get called out by someone, that Crohn's, UC and Celiac disease represent the consequence of inheriting genes helpful in managing various helminths. Probably most particularly hookworm and whipworm given their current prevalence and likely historical prevalence, too.
As with Taye-Sachs and the genes protective against tuberculosis, Cystic Fibrosis and the genes protective against Cholera, Sickle-cell Anemia and Malaria, etc., I believe those with Crohn's, and other inflammatory diseases affecting the intestinal tract, carry genes conveying a higher than normal level of immunity to hookworm and whipworm. That UC similarly represents specifically an adaption to whipworm. For Celiac disease and IBS I am less certain of the target parasite. It may be that they are just the consequence of getting some subset, or combination of subsets, of the genes for Crohn's and UC.
Consider UC, riotous inflammation in the colon, where whipworm live exclusively. It seems reasonable to theorize that UC represents inheritance of genes from both parents conferring increased resistance to whipworm on the host.
If that is true, if you have Crohn's or UC and you use either hookworm or whipworm to treat your disease you are at a greater risk of an inflammatory reaction to infection that would result in expulsion of your therapeutic helminths.
And we have seen a higher rate of worm loss in our Crohn's clients, particularly in those who ignore our advice to only gradually reduce their use of anti inflammatory medication, like Remicade and Humira.
Because of the rebound effect.
It is a common observation that, because the body and immune system is a dynamic adaptive system, when sudden changes are made in any use of medication a rebound effect is possible.
What is a rebound effect? Take the example of the use of antacids. Sudden cessation, particularly after long use, in the use of antacids to treat stomach ulcers, often results in much worse heartburn/stomach acid than before treatment.
The body grows accustomed to, adapts to, the affect of the antacid. The sudden removal of the antacid means the stomach's acid production, increased to compensate for the change in pH caused by the antacid, is at an elevated level. Remove the affects of the antacid on stomach acidity by abruptly stopping taking the drug and suddenly the stomach acidity rapidly increases. It is producing far too much stomach acid because it has adapted to the presence of a drug that lowers stomach acidity. Because although it is a dynamic system it is not capable of making the sudden changes caused by drugs, or their removal from the equation.
It is a very similar concept to the hygiene hypothesis, but over a shorter time span. The body adapts to some change in its environment caused by taking a drug, sudden change represented by not tapering off the drug, just cutting it off, results in a change in conditions that happens in too short a time period for the body to adapt to quickly enough, and we get sick. In this case you get really bad hearburn.
The same phenomena has been observed with anti inflammatory drugs: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T12-4W38RM6-8&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=954703120&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=dc618cae459fc4b5bff551f6dc4f0875. The only interesting thing about the study I chose for you regarding inflammation is that anyone thought that it required investigation. The rebound affect is not drug specific, it is a natural consequence of the nature of our bodies and the use of powerful drugs, or rather of their sudden withdrawal. I really wonder about scientists and doctors sometimes.
Opiate addiction is another example of this. I am sure there are countless others. Ingest or inject opiates and the brain creates more opiate receptors to deal with the new equilibrium of having endorphin-like molecules circulating in larger numbers than the brain is adapted to. It adapts, creates more opiate receptors (it is an adaptive, dynamic system after all) and upon sudden withdrawal of opiates the subject has too many pain receptors for the number of endorphin-like molecules in circulation. Withdrawal symptoms, and another junky, are the result.
What does this mean for us?
It means that if you are a Crohn's, UC, Celiac or IBS patient who has been using powerful anti inflammatory and/or immunomodulatory drugs for any length of time that your bodies inflammatory circuits have compensated (being an adaptive, dynamic system also) for the drug's action to the extent it can. Your immune system is compensating for the suppression of whichever component of inflammation the drug targets by producing more pro-inflammatory cytokines, etc. than it would if you were not taking the drug.
So you suddenly stop taking the drug, you cut if off cold, you just stop. After all, it has been four months since you started on hookworm or whipworm, it has been two months since then of eating and drinking whatever you want. Damn it! You have been sick for fifteen years and you are *so* over taking these toxic chemicals and risking, amongst other things, Progressive Multi-focal Leukoencephalopathy) or lymphoma. You are tired of being terrified of the drugs you use, of going to the hospital for, or administering yourself, these injections of expensive filth.
What the hell does Jasper know anyway? He's just some guy who went to Africa. Anyone could have done that!
Well, your body, as in all the examples cited above, has a rebound reaction. Your immune system does not turn on a dime, it does not adjust to this new environment suddenly. On top of that your inflammatory circuits are special, they are wonderfully adapted to manage helminth populations to protect you against what you now need to be healthy. Your immune system, as part of its increased inflammatory efforts is trying really hard to expel the worms, but the drug has been suppressing those efforts.
Now that you have suddenly stopped taking the drug (6MP, Asacol, Humira, Remicade, whatever, it does not matter which). With the pressure off, stopping the very drug that is effective because it suppresses the action of those very genes concerned with your disease, which remember may be an adaptation that helps control the exact helminths through inflammation that you have also taken to control your disease, suddenly are unleashed. And they are coiled tight.
That rebound inflammatory reaction you unleashed because you were impatient kills your worms. Because the reason you suffer from the disease you have is because your inflammatory circuits evolved to kill exactly the helminth you purchased from us.
So, as we have seen with multiple patients ignoring our advice, the Crohn's client loses his or her worm population mysteriously within a few months of stopping taking their Remicade or Humira.
So, please. Taper your drugs, only start doing so after eight months at a therapeutic level, or five months after achieving a substantial improvement in your symptoms.
Doing so will save you months of being sick and Michelle and I hours in preparing and shipping doses you otherwise would not require.
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