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Medicine

Hookworms Successfully Prevent Type 2 Diabetes In Human Trial 126

A two-year human trial conducted by James Cook University (JCU) has concluded, demonstrating positive results using low-dose human hookworm therapy to treat chronic conditions, particularly in relation to type 2 diabetes. New Atlas reports: [O]f the 24 participants who received worms, when offered a dewormer at the end of the second year of the trial, with the option to stay in the study for another 12 months, only one person chose to kill off their gut buddies -- and it was only because they had an impending planned medical procedure. "All trial participants had risk factors for developing cardiovascular disease and type 2 diabetes," said Dr Doris Pierce, from JCU's Australian Institute of Tropical Health and Medicine (AITHM). "The trial delivered some considerable metabolic benefits to the hookworm-treated recipients, particularly those infected with 20 larvae."

In this double-blinded trial, 40 participants aged 27 to 50, with early signs of metabolic diseases, took part. They received either 20 or 40 microscopic larvae of the human hookworm species Necator americanus; another group took a placebo. As an intestinal parasite, the best survival skill is to keep the host healthy, which will provide a long-term stable home with nutrients 'on tap.' In return, these hookworms pay the rent in the form of creating an environment that suppresses inflammation and other adverse conditions that can upset that stable home. While the small, round worms can live for a decade, they don't multiply unless outside the body, and good hygiene means transmission risk is very low.

As for the results, those with 20 hookworms saw a Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) level drop from 3.0 units to 1.8 units within the first year, which restored their insulin resistance to a healthy range. The cohort with 40 hookworms still experienced a drop, from 2.4 to 2.0. Those who received the placebo saw their HOMA-IR levels increase from 2.2 to 2.9 during the same time frame. "These lowered HOMA-IR values indicated that people were experiencing considerable improvements in insulin sensitivity -- results that were both clinically and statistically significant," said Dr Pierce. Those with worms also had higher levels of cytokines, which play a vital role in triggering immune responses.
The study was published in the journal Nature Communications.
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Hookworms Successfully Prevent Type 2 Diabetes In Human Trial

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  • by eneville ( 745111 ) on Wednesday August 23, 2023 @02:17AM (#63789714) Homepage

    The host was eating human plus 20 worms worth of food.

    Would reduction of food intake have the same result?

    • The host was eating human plus 20 worms worth of food.

      That's not the mechanism causing the effect.

      Would reduction of food intake have the same result?

      Eating less and losing weight will help with type-2 diabetes.

      The problem is that people don't stick to it.

      • An adult male who works out moderately need sbout 2000 calories a day.

        The average meal st a restrauant is about 1200 calories.
        Eating out twice a week ( or ordering door dash) ggivesbyou an exyra days worth of food ina week.

        The problem is poetion control. Limit how much you eat and dont clean yourbplate just vecasue you bought it and stabilize your weight over time.

        Fat builds quickly and leaves slowly. The only longer term succeess is done through portion control at every single meal.

        • Re:IOW (Score:4, Informative)

          by Entrope ( 68843 ) on Wednesday August 23, 2023 @08:13AM (#63790320) Homepage

          An adult male who works out moderately need sbout 2000 calories a day.

          The USDA [usda.gov] disagrees with you on this. So does the Mayo Clinic [mayoclinic.org]. Under 40, even physically inactive men need more like 2400 calories per day. Physical activity quickly adds to that.

          Also, your math is awful. When splitting a nominal 2000-calorie diet into three meals, each meal should be about 670 calories. A 1200-calorie meal is not even two nominal meals, much less half a day extra. But most people have one or two meals that are lighter than the most caloric meal of their day, so if that calorie-heavy meal is when they eat out, it's less of an impact.

          Still, people should pay attention to how much they are eating, avoid sugary drinks (even fruit juice), and prefer low-fat foods. It's almost impossible to eat a balanced diet with just vegetables and some fruits, but legumes and high-fiber starches are a good way to add fairly healthy calories.

          • I'm 175cm and run 20km a week. If I ate 2000kcal a day, I'd gain weight. Your estimates are bullshit.

        • > Eating out twice a week ( or ordering door dash) ggivesbyou an exyra days worth of food ina week.

          Do you really think people are eating out twice a week? LOL. Some people eat out for EVERY MEAL OF THE DAY, ahahahaha.

      • Re:IOW (Score:5, Insightful)

        by wierd_w ( 1375923 ) on Wednesday August 23, 2023 @04:58AM (#63789964)

        Helminths also secrete a cornucopia of bioregulatory hormones (to prevent the host's immune system from going bonkers on them) which have been shown to do a wide amount of positive effects for human health, not limited to such things as moderating inflammatory bowel disease, moderating asthma in extreme sufferers, moderating allergies in extreme sufferers, and a bunch of others.

        the issue, is that "they are parasitic worms" has stuck since the 19th century, when it was vogue as an idea to eradicate all germs, and all parasites.

        Treating them as potentially valuable endosymbionts instead might be therapeutic, which is where helminthic therapy (such as this one) comes into play.

      • "Eating less and losing weight".

        This is true, for those at risk or with type 2 and over weight.

        There are other people where weight and diet are NOT the main factors at play.

    • Re: (Score:2, Flamebait)

      by Joce640k ( 829181 )

      Would reduction of food intake have the same result?

      Yes but that requires accepting some personal responsibility.

    • Re:IOW (Score:5, Informative)

      by Nova ( 272 ) on Wednesday August 23, 2023 @07:33AM (#63790212)

      You might be confusing hookworms with tapeworms. Tapeworms live in the gut and consume food meant for the host. Hookworms are much smaller (7-11mm long for adults and about the width of a human hair IIRC) and attach to the small intestine to consume the host's blood. For this level of infestation (20 worms) the blood loss is negligible and after the initial 3-6 month period they are generally well tolerated.

      To echo another poster, the article summary is incorrect. Hookworms are parasites and their survival skill is not as concerned with "keep[ing] the host healthy" as it is with reducing inflammation in the gut to make the gut environment less dangerous to them. Functionally it works out to be similar with lower worm loads, but it's an important distinction.

      I actually host about 20-30 of this same worm (necator americanus) and have been on "helminthic therapy" as it is called for the last 12 or so years on and off, mainly for IBD (Crohn's disease). I've found it's been very helpful, although it can increase histamine levels when I re-dose every 6-12 months. Wikipedia says the worms last about 3-5 years on average, but the lifespan varies widely by individual and how permissive their immune systems are to the organisms. With me it's about 9-12 months, but there have been case studies where you have 10+ year old worms. I have a friend that had horrible allergies and was on at the "end of the road" with prednisone treatments (due to side effects) and these were a godsend for him too. It's not a miracle treatment though, and one has to be careful about dosing and side effects.

      Doctors in certain states (NY, CA and TX I think?) can prescribe these, but in most states you are on your own, and there are certain online providers that can supply the worms. Most seem to do a pretty good job, but one really needs to do their research.

      A community run wiki for learning more about this therapy is at https://helminthictherapywiki.org/wiki/Helminthic_Therapy_Wiki

    • by keltor ( 99721 ) *
      Per hookworm consumption is around 0.1mL per day which if it were PURE fat would be less than 1 kcal per day, so in this case we'd be talking about less than 18 kcal per day. It's probably much less than 18 per day as they would likely overheat, they are tiny things. A reduction in food intake will of course cure T2DM in around 80% of cases though mostly it just depends on how much beta cell damage there is. Those people will require insulin for life. There's also people who have very high insulin resista
  • Hook me up! Pun intended.
  • Editing? (Score:5, Informative)

    by Barny ( 103770 ) on Wednesday August 23, 2023 @02:28AM (#63789722) Journal

    Irritable Bowel Disease (IBD)

    Inflammatory Bowel Disease is very different from Irritable Bowel Syndrome, and the two should probably not be conflated to this degree. Who edited this article, ChatGPT?

    • Irritable Bowel Disease (IBD)

      Inflammatory Bowel Disease is very different from Irritable Bowel Syndrome, and the two should probably not be conflated to this degree. Who edited this article, ChatGPT?

      Actually ChatGPT was consulted to calculate the chances of the audience even reading TFS, let alone TFA.

      Accuracy requirements were established based on that. Congratulations on being today's outlier. It's not every day you pop up.

  • by protehnica ( 10187841 ) on Wednesday August 23, 2023 @02:30AM (#63789724)

    From a 2012 NYTimes article called "A Messy, Exuberant Case Against Being Too Clean", on the "hygiene hypothesis":

    This hypothesis argues that our modern obsession with eradicating germs has backfired into an explosion of disease, specifically all the “new” diseases that have replaced infections to undermine our health. The modern immune system, the idea holds, is stymied by the sudden absence of its customary microbial targets. With nothing constructive to do, it is crazily spinning its wheels, resulting in soaring rates of food allergies and asthma, arthritis, psoriasis, multiple sclerosis and diabetes, even heart disease and cancer — not to mention alopecia [...]

    A human being, the proponents of the hypothesis argue, is not really an individual. Instead, each person is a “superorganism,” a large creature subsuming many billions of smaller ones, most of them intestinal microbes. Thriving in the colon, these “old friends” that have been with us since time immemorial are as important to our health as a limb or an organ. Altering their numbers, whether with sanitary measures, antibiotics or deworming pills, is analogous to fooling around with the liver or the spleen.

    And that doesn’t just mean that antibiotics may cause ruinous diarrhea. The microbes in the intestine, the hypothesis holds, educate the immune cells that travel all over the body, and any major alteration in the intestine sends some wild and crazy cells out there to wreak havoc unpoliced.

    There's also a Wikipedia article called "Hygiene hypothesis".

    • From what I understand, it's not just insufficient bacteria & microorganisms, it's the wrong kinds. Apparently, people who have dogs or cats that roam in green parks & the countryside have much richer & diverse gut bacteria but also specific kinds of bacteria that we've co-evolved with & that seem to make our bodies healthier.

      I remember one researcher commenting that rates of allergies increase tenfold among populations that move from rural areas to cities & suburbs. So yeah, we need
    • by chill ( 34294 )

      There's also George Carlin's take on germophobia [lingq.com]. And the video version [youtube.com] for those who prefer.

    • Everything but the simple solution that works - no carbs.
      Gotta think about the insulin profits!

  • Sounds good as long as it doesn't take a remotely operated microscopic human-shaped robot with a sword to kill them when necessary.

  • Haven't we been discovering that a few cancers are the result of long term viral or parasitic infection? We can live in equilibrium with these things, but then after a while the damage they are doing and being repaired leads to increased risk of cancer cells forming. Don't catch herpes, don't eat the sushi. You'll be miserable with hayfever and diabetes your whole live, but hey, you won't need to spend your twilight years on chemo and later death!
    • If we know the treatment increases the risk of certain cancers we can do regular screening for them and treat them early.

    • Viruses, due to their life cycle, necessarily increase cancer risk but I'd not guess helminths would. The thought behind helminth therapy is that 'wild-type' humans would have them, and the immune system is 'tuned' for their presence, so you have elevated immune activity in their absence that can manifest as allergies or inflammation.
  • As a McDonald's customer I am pleased to already know the test results.
  • by bradley13 ( 1118935 ) on Wednesday August 23, 2023 @03:47AM (#63789824) Homepage

    TFA doesn't seem to understand the difference between a parasite and a symbiote. Hookworms are parasites, and a serious infection produces serious symptons. The trick in the research was keeping the number of worms relatively low (they reproduce outside the body: you poop out the eggs). They tried 0 (placebo), 20 and 40 worms. The greatest improvement in insulin resistance came from the smaller number of worms. However, the abstract also notes that "adverse events were more frequent in hookworm-treated participants".

    Reading between the lines, all patients were seriously overweight (hence, the risk for type-2 diabetes). One of the positive outcomes for some patients was weight loss. Unclear is the extent to which that weight loss may have resulted from those "adverse events", which included "nausea, vomiting, ..., stomach cramps and abdominal pain".

    Color me unconvinced...

    • by Malc ( 1751 )

      Apparently the adverse affects aren't that bad:

      [O]f the 24 participants who received worms, when offered a dewormer at the end of the second year of the trial, with the option to stay in the study for another 12 months, only one person chose to kill off their gut buddies -- and it was only because they had an impending planned medical procedure.

    • Reading between the lines, all patients were seriously overweight (hence, the risk for type-2 diabetes). One of the positive outcomes for some patients was weight loss.

      Well yeah it wouldn't make sense to take perfectly healthy people for this study, it would produce meaningless results.

      Also correlation is important too. Many treatments for various human ailments do not exhibit direct causation, so yeah we all know weightloss reduces the risk of diabetes, so even if the hookworms caused weightloss instead having a direct impact on diabeties it ultimately is irrelevant if the disease was averted and the treatment didn't have ill effects.

      And don't reply with "they should jus

    • TFA doesn't seem to understand the difference between a parasite and a symbiote.

      It doesn't sound like a perfect solution yet, but it does make one wonder if selective breeding of the things could bring it up to a symbiotic level. How many adverse side effects have to be eliminated?

      Now I want to watch Stargate again.

    • by e3m4n ( 947977 )
      this sounds like the old Richard Simmons Tape-worm Diet back in the 80s. Dont we give our dogs pills to specifically NOT get works which eventually infect the heart?
  • the human hookworm species Necator americanus

    Was it so hard to call it Killer US asshole in plain English?

  • Comment removed based on user account deletion
  • Back in the 1800s [atlasobscura.com], people already deliberately infected themselves with parasites to lose weight.

    tl;dr: Turned out it wasn't that great an idea.

    • Back in the 1800s [atlasobscura.com], people already deliberately infected themselves with parasites to lose weight.

      tl;dr: Turned out it wasn't that great an idea.

      The stuff you linked doesn't contain any reasons for why it wasn't such a great idea, other than "ZOMG, gross!" sentiment.

  • "good hygiene means transmission risk is very low"

    I see people shit and not wash their hands all the time.

    • Re: (Score:3, Insightful)

      Do you get shit on your hands when you go to the bathroom? I never understood this. Do people not use toilet paper? As a chemist, I wash my hands BEFORE going to the bathroom to keep my dick and arse safe and clean.
  • Anything but diet and exercise, right?
    • Anything but diet and exercise, right?

      You also need to treat the often present underlying psychological issues that result in overeating in extremely obese people. People can lose weight, but if the root causes, beyond diet and lack of exercise, are not addressed they'll simply gain it back.

  • Your responsibility also includes keeping your providers up to date.

  • by ZipNada ( 10152669 ) on Wednesday August 23, 2023 @09:35AM (#63790492)

    "Parasitic helminths have infected humans throughout their evolutionary history."

    " Through such coevolution, normal human immune development and function is likely to have become dependent upon the presence of immunomodulatory helminths"

    https://elifesciences.org/arti... [elifesciences.org]

  • James Cook University changes its name to James Undercooked University.
  • I seem to remember this episode [wikipedia.org] on TV...
  • This sort of thing is also an (experimental) treatment, or immunotherapy, for certain types of autoimmune disorders. One of the hypotheses being that the parasites help re-train the immune system. Helminthic therapy [wikipedia.org]

  • Call me skeptic. With 40 participants it's interesting enough to try a larger study, but the sample size is way too low to draw many conclusions.

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