Why You Shouldn’t Always Treat Parasites

Parasites like Dientamoeba fragilis and Blastocystis hominis are two of the most common causes of digestive problems I see in clinic. From adults to very young kids, these critters can cause some pretty unpleasant symptoms, the most common ones being loose stools and abdominal pain that comes and goes.

I have a really good success rate at clearing both parasites using herbal extracts, enzymes, prebiotics, nutrition and strain specific probiotics BUT I don’t always treat them. Why? Because I know from experience that if someone’s gut is in a very bad state, in order to clear the parasite I’m going to have to give them incredibly strong herbs for long periods of time, causing (in my opinion) more damage in the long run.

I know this may come as a surprise and I can just feel some people’s eyebrows rising in disapproval as I write these words. But hey, I’ve treated my fair share of parasites and gut problems so I feel I’ve earned my right to be controversial.

So here’s my take on parasites and my clinical observations.

Why do some people get symptoms and others don’t?

In recent years more info has come to light that Blastocystis hominis may not always be pathogenic. Apparently this is due to it having various subtypes – so basically some subtypes may be more virulent than others.

There’s only one test I know of in Australia that tests for this. But, as I think the test doesn’t give you any other helpful information I don’t recommend it. At the end of the day, if you have severe symptoms that’s that and you need to work out how to improve those as chronic diarrhea is not something you want in the long run.

So this might be one factor as to why some people suffer more than others. But as I don’t test for subtypes, that’s not a factor that affects my clinical decision to treat.

However, I think that this goes deeper than just a difference in subtypes.

My observations in clinic have led me to believe that, invariably, the people who get better (meaning who clear the parasite the quickest) fit a certain category:

  1. They usually have no co-morbidities. Meaning their only presentation is gut symptoms and specifically just the parasite. How do I know? Because I usually run other tests to rule out Helicobacter pylori infection, Small Intestinal Bacterial Overgrowth, Celiac’s disease, IBD, food intolerances etc.
  2. They are treatment virgins i.e they haven’t come after rounds of antibiotics.
  3. They are COMPLIANT – let’s not underestimate this point. Herbs and supplements only work when taken as prescribed, for the period of time prescribed.
  4. They have an open mind. Many people live in constant fear of the unknown and letting go of control (I will do a post at some point about high histamine traits). So many people I see are not ready to give up old habits and old beliefs in order to get better (for example if I ask someone to come off the GAPS diet and they bite my head off as they’ve read on 20 blogs how it heals the gut – er, scientific evidence please – to this day I still haven’t seen any GAPS diet and intestinal permeability studies cited on PubMed?).
  5. They were already following a reasonably good whole food diet, with a variety of gut friendly foods.
  6. They have a strong vital force. This is a naturopathic term meaning they exude vitality and strength and have a good constitution (as opposed to someone who is constantly fatigued and sick).

Why not just treat everyone. Herbs are gentle, right?

To me, treating every single case of parasites goes against what I’m trying to do in clinic, which is assessing people as individuals and not as a collection of separate pathologies.

So, if someone tells me their digestion has always been poor since childhood,  if they have a family history of digestive issues like IBS, reflux, inflammatory bowel disorders or they had a bucket load of antibiotics throughout their life and were fed formula as a baby and had a SAD (junk) diet throughout childhood – I do NOT rush to treat their parasite straight off the bat.

Why?

Because that person’s gut ecosystem is no doubt already so imbalanced that I’d have to nuke their colon with some full-on herbs and essential oils for many weeks in order to kill the parasite. Herbs are powerful and can be extremely damaging to the gut ecosystem when not used judiciously. Just because it once resembled a plant it doesn’t mean it’s going to be gentle.

I don’t treat people to get a notch on my belt to then claim on forums how well I treat Blastocystis. That’s not why I became a naturopath.

I’m intrigued by every person’s individuality and response to treatment. So for such a person I might start by restoring upper digestive function by providing them with some bitter and liver herbs, assessing their zinc status and introducing a gentle prebiotic fibre such as GOS and see if they tolerate it.

I would assess their diet to see if they’ve perhaps been on some crazy, gut bacteria destroying diet like GAPS and see if there’s any movement we can make towards a more alkalising, fibre-rich diet (grain free initially as most of these people cannot tolerate any grains at first). I would aim to identify food intolerances and remove those foods instead.

I would then move onto a strain-specific probiotic like Saccharomyces boulardii var Biocodex – not available in Australia but is easily available over the net and well tolerated.

I may then add in gentle tannin containing herbs that also have the added effect of being astringent and slowing down transit time like Punica granatum husks – if alcoholic extracts are not tolerated, a simple decoction of pomegranate husks (from the greengrocer) is usually well tolerated.

Does this approach work?

YES.

But it may not suit everyone. We live in a world of black an white questions and answers. We have access to so much information (and mis-information) yet are starved of true wisdom and knowledge. New treatment protocols sweep through facebook groups like wildfire yet sick people are none the wiser. A lot of people want quick fixes and will resort to anything to get better.

I get that. I really do. No one enjoys sitting on the toilet 8 times a day but from my perspective, where I’ve seen so many people on the other side of doing a colonic infusion for antibiotics (this is the most effective way to get rid of resistant blastocystis in the current medical system) I just wish that people tried the gentler approach first. In the last year I have seen so many extremely sick people who just cannot bounce back after 1 or 2 rounds of colonic infusions and the subsequent rounds of oral antibiotics that follow this harsh treatment.

Most of them can just tolerate under 10 foods and even struggle to tolerate probiotics. Some of them have gone onto do several fecal microbial implants (where a healthy poo sample is ‘implanted’ back in the colon) and yet they still struggle with severe food intolerances. When you test their stool through a PCR CSA (most accurate stool analysis currently available) they have all the right species in place yet their symptoms remain. Could it be because the antibiotic infusions have killed some fringe strains that we don’t yet know the significance of? That’s my hunch.

My question is whether these poor people have truly had informed consent before undergoing such harsh procedures. Did anyone tell them beforehand that there would be a strong chance they would feel much worse despite eradicating the parasite? Did anyone mention to them the loss of fringe beneficial bacteria due to the harsh antibiotic therapy? Were they told that just popping a probiotic pill afterwards could not replace all the lost species of beneficial bacteria?

That’s certainly not the feedback I’m getting in clinic.

So to conclude, I would say look after your gut microbiome.

You’ve only got the one and it has to last you a lifetime.

While at present there are no reliable methods of significantly altering the species of bacteria in your gut, you can increase the potential of all the good guys currently inhabiting your digestive tract by feeding them a high fibre diet, keeping your stress levels down (they get stressed too), supplementing with prebiotic fibres daily and avoiding all unnecessary antibiotics – yes, including anti-parasitic ones.