Graham Le Gros and helminthic therapy

Helminth research at the Malaghan Institute[edit | edit source]

Prof Graham Le Gros had stated that the long-term goal of his research programme at the Malaghan Institute of Medical Research in New Zealand was to develop vaccines against asthma and allergy and to create an anti-hookworm vaccine. [1]

In 2019, Le Gros and his colleagues began a clinical study in which healthy adult volunteers were each given a dose of Necator americanus hookworms (NA) to enable the researchers to investigate the human immune response to this species [2] and to understand its effects on a healthy individual’s gut bacteria composition and function.

In July, 2019, Le Gros gave a series of interviews to the New Zealand media [3] [4] [5] [6] to promote this work, with a further interview being given in September 2020, [7] by which time his team’s remit had been extended to investigating the feasibility of using human hookworms as a medication-free maintenance therapy for ulcerative colitis, [8] with similar trials being planned for perennial rhinitis and eosinophilic esophagitis.

A later page posted on the Malaghan website describes the institute's hookworm programme as, "exploring the therapeutic potential of human hookworms to ultimately find better treatment options for a range of inflammatory and autoimmune diseases, including coeliac, asthma, allergy, MS and IBD". [9]

Smoke and mirrors in Le Gros’ interaction with the media[edit | edit source]

In the four interviews Le Gros gave in 2019, he presented himself as the pioneering investigator of what he proposed could eventually lead to a natural, low cost treatment solution for many inflammatory and allergic diseases, and he claimed that his forthcoming trial was a “world first”. [10]   

However, Le Gros failed to mention that, more than thirty years previously, Prof David Pritchard (Nottingham University) had pioneered the study of the immune response engendered by the human hookworm, Necator americanus, and has been researching the potential for the therapeutic use of this species since the early 2000s. After completing preliminary safety and dose-ranging studies, Pritchard’s team carried out a large Phase II randomised, placebo-controlled trial between 2011 and 2016 to assess the effects of hookworms on disease activity in patients with multiple sclerosis. [11]  

Also not mentioned by Le Gros was that, in 2010, Australian researchers Prof Alex Loukas (James Cook University) and Prof John Croese (The Prince Charles Hospital, Brisbane) began clinical trials using N. americanus in human subjects with coeliac disease, and have continued with this work in the years since. [12] [13] [14] [15] [16] [17] [18]

Research into helminthic therapy self-treatment[edit | edit source]

Not only has all this pioneering science involving the therapeutic use of N. americanus been carried out previously by other researchers, but the practice of helminthic therapy has been continuously developed and refined since 2003 by citizen scientists using this species and three other domesticated, mutualistic helminths: the human whipworm, Trichuris trichiura, the porcine whipworm, Trichuris suis, and the murine tapeworm, Hymenolepis diminuta. The results obtained from all this work by the helminthic therapy citizen science community have been investigated and documented by several researchers.

In 2015, Prof William Parker and his team at Duke University reported their first detailed examination of this community.

Overcoming Evolutionary Mismatch by Self-Treatment with Helminths: Current Practices and Experience (PDF)

A year later, they published this second study.

Practices and outcomes of self-treatment with helminths based on physicians observations (PDF)

Then, in 2020, they published a further paper after revisiting the community.

Socio-medical studies of individuals self-treating with helminths provide insight into clinical trial design for assessing helminth therapy -- Full text | PDF

The helminthic therapy community has also been investigated by academics from disciplines other than medicine. These include Jamie Lorimer, Associate Professor in Human Geography at Oxford University, who has published three papers and a book on topics related to helminthic therapy using hookworms.

Hookworms Make Us Human - The Microbiome, Eco-immunology, and a Probiotic Turn in Western Health Care (PDF)

Parasites, ghosts and mutualists - a relational geography of microbes for global health (PDF)

Gut Buddies - Multispecies Studies and the Microbiome (PDF)

The Probiotic Planet: Using Life to Manage Life

Another scientist who has taken an interest in helminthic therapy citizen science is Stephen Flowers, Professor of Management (Innovation) at the University of Kent, UK. In the following book chapter, he explored the implications of innovation in the context of helminthic therapy and Crohn’s disease, and, although the data that Flowers references had been collected several years previously, in the very early days of the self-treatment movement, his commentary continues to be pertinent.

Chronic Disease, New Thinking, and Outlaw Innovation: Patients on the Edge in the Knowledge Commons

Numerous other researchers have investigated helminthic therapy, and some of their comments are collected at the following link.

What researchers say about helminthic therapy

Le Gros’ changing views on helminthic therapy self-treatment[edit | edit source]

In his interviews with the press, Le Gros has not only omitted to mention any of the extensive body of work carried out previously by other scientists, or the fact that helminthic therapy has been available as a self-treatment since 2003 and become established as a very successful form of therapy for immune-related disorders, but he and his colleagues have gone out of their way to pour scorn on those individuals who have chosen to follow the extensive scientific evidence (see: Helminthic therapy research) and take advantage of this self-treatment option. When making their claims, Le Gros and other members of the Malaghan team have repeatedly used emotive and disparaging terms, none of which bear any relationship to reality.

There's a whole lot of bootlegged worms, and there are parasite support groups, and so you have people with conditions and they’re just desperate to try something. And they hear that, in one-off cases, that someone feels better once they’ve had a worm. And they’ll just go on the internet and get them. [19]

There's all these urban, backyard bootlegging worm factories around the world. You just go onto Bitcoin, and people are self-diagnosing and they’re working themselves up and giving themselves worms. [20]

At the moment it [hookworms] are just passed from person to person in the most unreliable way, with no clear protocols on how to make a good healthy worm. [21]

They don’t know what they’re buying, they don’t know where they’re coming from, and the dosing and everything is just completely unknown… They’re willy nilly using worms without there being any real evidence yet that they work. [22]

People are buying them [hookworms] on the black market, they don't know what the source is, they don't know the safety of it. Sometimes they're not actually getting human hookworms, they're getting dog hookworms which can make you very sick... [23]

Malaghan staff involved in the institute's hookworm programme have continued to give regular promotional interviews to the New Zealand press, [24] [25] in which they have repeated Le Gros' unfounded claims, especially his bizarre contention that helminthic therapy self treaters are unwittingly being supplied with dog hookworms. This notion is laid to rest here: Could there be dog hookworm larvae in NA doses from providers?

The only researchers outside the Malaghan Institute who share this jaundiced view of self-treatment with helminths are a very small band of parasitologists who include Prof Peter Hotez, an anti-hookworm zealot who, like Le Gros, has spent years seeking to develop a vaccine against this species, which Hotez believes is a scourge and should be condemned to extinction.

Giving people worms belongs in the trash bin. [26]

When Le Gros was interviewed by TVNZ Sunday on 14 November 2021, he appeared to have modified his previously strident views on self-treatment with worms. In response to a direct question as to whether people who self-medicate with hookworms are "wacko," he replied,

No. They're not wacko at all.

And he added,

We've thrown the baby out with the bath water by throwing the parasites away. [27]

The reality of helminthic therapy self-treatment[edit | edit source]

It is clear from the comments made by Le Gros and his colleagues that they lack even the most basic understanding about how helminthic therapy is being practised today. While they have characterised those who self-treat with helminths as desperate, incompetent and reckless renegades, the community in fact comprises thousands of very knowledgeable and responsible individuals with an average level of academic attainment much higher than that found in the general population. A significant number of the community’s members hold higher degrees, including many MDs.

The community is performing a remarkable and invaluable service by sharing their knowledge to enable many others to experience remission from diseases for which the healthcare establishment can only offer pharmaceutical or surgical treatment options, many of which cause long term adverse side effects and some of which can prove fatal. Helminthic therapy has saved many lives, including that of the lady featured on the page, Treating SIBO and metal allergy with helminthic therapy, and the son of the very relieved mother who wrote the following.

My son, who is 15, is on the autism spectrum, is gay, overweight, fatigued, depressed, and has PANDAS/POTS and OCD, along with mast cell and allergy issues. The list is long! He started using helminths to treat the PANDAS. The first dose was 5 NA in November 2019, then a second dose of 5 in May 2020. He has always struggled with being awkward and different, and had difficulty expressing what he was feeling, but I didn’t realise just how severely depressed he had become. When he told me how much he had hated himself for so long, it broke my heart. His anxiety was off the charts. He said he was suicidal. Fortunately, a month on helminths has cleared his brain. He wakes up early now, and has lost 15 lbs. It’s like night and day, like a switch turned off and his inflammation is gone, and I am so thankful for this. I wish I had given NA to him 5 years ago. He's doing so great on them. Helminths have literally saved his life. [28]

Below are further facts that give the lie to Le Gros’ opinions about the helminthic therapy self-treatment community.

In the absence of interest from mainstream medicine, the citizen scientists in the self-treatment community have not only pioneered the practice of helminth replacement therapy but also created the world’s largest database of information on the subject, the Helminthic Therapy wiki. This website lists all the relevant research to date - some 900 papers - and features 900 accounts of success and failure by individuals who are treating one or more of over 160 different medical conditions. Were Le Gros to read this wiki, he would learn much that would be of value to him in his own research into this subject, including, for example, why the 30 NA larvae that he gave to subjects in his first hookworm trial can be too large a number to be given as a single dose to a hookworm-naive subject. [29] He would also learn that this species only lives for as little as 2-3 months in some people (see Hookworm lifespan) - not the 10 years that he claims - and why, therefore, a 12-month trial with NA should involve the use of several smaller doses given at shorter intervals. He would also discover that hookworms are not as robust as he believes them to be, and are in fact susceptible to a number of substances, including some foods. [30]

There are many medical doctors who are using helminths to treat themselves. For example, a pathologist in New Zealand

There are yet more medics who are using helminths to treat members of their own families, and there is an increasing number of doctors who recommend helminthic therapy self-treatment to their patients, and advise them to obtain their organisms from the community’s well established helminth providers, the quality of service offered by which is kept under review via customer feedback. The “backyard bootlegging worm factories” imagined by Le Gros have no chance to flourish in this environment.

There is a steadily growing number of doctors with experience in the use of helminthic therapy, and some of these offer online consultations to anyone who feels the need of professional guidance.

There is a very active Facebook group where self-treaters can receive free advice and support from more experienced members while learning how to use helminths to treat their own particular conditions.

Researchers who, unlike Le Gros, have actually carried out rigorous investigations into the activities of the community of helminthic therapy self-treaters, and published their findings, have concluded that this community had, by 2020, become the primary "laboratory" for this therapy. They also stated their opinion that, since helminthic therapy addresses a fundamental cause of disease in Western society, "this particular biohacking endeavour may in fact be critical for public health." [31]

Potential consequences of Le Gros’ comments to the media[edit | edit source]

Sadly, the comments made to the press by Le Gros and his colleagues will have been read or heard by many thousands of individuals, some of whom might have benefitted from this therapy, had they not been dissuaded by these scientsts' pejorative and factually incorrect remarks. Some of those individuals, who are desperately ill and may have exhausted all other available treatment options, will consequently face unnecessary suffering and possibly even an untimely death.

It is untenable to rebuke patients for self-treatment with helminths when such treatment may in fact be their best course of action… (Cheng et al) (PDF)

Although self-treatment with helminths cannot be recommended by medical professionals due to a lack of blinded, placebo controlled trials, neither should it be discouraged since the available evidence suggests that it is beneficial in most cases when practiced by knowledgeable individuals. (Parker and Morey)

In spite of what Le Gros appears to believe, self-treatment with helminths is not something to be regulated, or controlled, by the medical establishment. Helminths are the heirlooms of all humankind, not the sole preserve of medical researchers or clinicians. As an essential component of a healthy human biome, helminths are necessary for optimal immune function. Access to them is therefore a basic human right. [32]

Although Le Gros would have people wait for him to complete his research, there is absolutely no need for anyone to delay availing themselves of the remarkable healing potential offered by helminth replacement. This therapy is already known to improve health in approximately 75% of users with immune-related disorders, [33] it is recommended by doctors who understand its use, [34] the details of its application are already established, [35] appropriate helminths can be purchased from reputable providers, [36] and support for self-treaters is readily available. [37]