NEWSLETTER

Parasites

Please understand that the only time we receive training regarding parasites is when we study tropical diseases during our infectious disease rotation. That is about ten minutes of training.

When a patient is refractory (nothing works) to treatment for systemic candidiasis (yeast), we need to explore the idea that the patient has a parasitic host. Many parasitic based illnesses can be misdiagnosed as peptic ulcer. Amoebic (internal animal parasites) colitis can be misdiagnosed as ulcerative colitis, chronic fatigue syndrome may be secondary to Giardiasis and diabetes mellitus and hypoglycemia could be tapeworm infection.

In April l997, the CDC (Center for Disease Control) stated there are about 100,000 to one million cases of Giardia every year. According to a 1993 press release, the NIAID (National Institute of Allergy and Infectious Diseases) reported that parasites in the United States affects millions.

Malaria, the most virulent of parasitic diseases is on the rise both in the US and abroad, partially due to the fact that mosquitoes have become resistant to DDT and other insecticides.

Researchers have suggested that Endolimax nana may be the cause of Rheumatoid Arthritis. Giardia can live up to six months under the fingernails and is resistant to chlorinated tap water. I think Giardia when my patients have Irritable Bowel Syndrome, think roundworm when dealing with allergies, think pinworm with ADD.

Parasites which can linger in your system for thirty years can mimic a host of diseases - the great masquerader we call it. Parasites, untreated thyroid disease, and Syphillis all manifest so many symptoms - they are the great masqueraders and need to be considered with most chronic degenerative diseases.

How Do Patients Get Parasites?

Foreign travel, of course. For example in St Petersburg, Russia (formerly known as Leningrad), the city's tap water was infested with Giardia lamblia. The CDC warns those traveling to Africa of the danger of bathing or swimming in fresh water, as the water is infested with blood flukes, which cause a disease called schistosomiasis. Many of my patients visit Africa.
According to an article in Parasitology Today, one of the United States greatest parasitic hazards is a highly infectious parasite called Cryptosporidium parvum. This parasite resists chlorine treatment that is in our tap water, as does Giardia lamblia. So who knew that by drinking tap water we are being exposed to Cryptosporidum and Giardia. This information was supplied by the CDC.
Day care centers are a source of Giardia lamblia.
The majority of restaurant workers no longer wear hair nets or gloves when handling food. Often the same person who serves your food takes your money.
Four New York orthodox Jews (where eating pork is forbidden) had sudden mysterious seizures and CT scans showed PORK tapeworm cysts in their brains. The CDC investigation discovered a housekeeper from Central America.
American troops returning from Desert Storm were told not to donate blood due to the incidence of the parasitic disease Leishmaniasis spread by desert sand flies.
65 infectious diseases are transmitted by dogs to humans and 39 by cats. Dogs are known carriers of Giardia lamblia. 89 percent of all house cats sleep with their owners.
Microwave cooking of fish often does not kill anisakid worms. Anisakiasis is a disease resembling Crohn's disease.
In a randomized test of public toilet seats, 61 percent had Trichimonas vaginalis that causes a foul smelling vaginal discharge, burning, and inflammation. Up to 50 percent of all women harbor this parasite. When passed to a man, this can be the cause of nonspecific urethritis. So your Mothers were right. Don't sit on the toilet seat.
Campylobacter jejuni found in chicken causes 4 million illnesses per year according to the CDC. Hence, I only shop at Whole Foods.
Divers can become infected with Giardiasis and Entomoeba histolytica. We have a number of divers in the practice.

Our current lifestyle of eating out, traveling, camping, children in day care, caring for pets, and overutilizing antibiotics increase the likelihood of exposure to parasitic disease here in the US. This is no longer a tropical disease.

Testing and Diagnosis

Very tricky because eggs or cysts are passed at irregular intervals. Some eggs are not found in stool until 60-75 days after initial infection. To diagnose parasites your doctor needs to be suspicious and we are not trained to think about parasites in this country. Parasites that reside in the tissue and blood, such as those causing malaria, filiarsis, and trichinosis, WILL NOT BE FOUND in fecal (stool) samples. Pinworms are rarely seen in stool.

So you could be harboring a parasite and all the tests are NORMAL. I remember a patient as a resident with whom I had a strong suspicion had parasites, but the tests were normal. Stool tests, blood tests, colonoscopy, GI series. Nada, nothing. We had nothing to help this patient because as a resident you are not allowed to think differently. If the tests are normal...

Parasitologists suggest three stool samples on three different days, if negative and symptoms persist, 3-6 more samples should be taken. Experts don't seem to be able to agree whether a purged or unpurged sample is best. A purged sample means the stool was chemically induced. Fleet Phospho Soda is generally used. Note that this is a high sodium substance, and those with high blood pressure may consider Epsom salts 2-3 tablespoons in a glass of warm water.

Antibiotics, enemas (I have had patients who do them daily - you have to ask), barium, bismuth can render an unreliable and often difficult diagnosis.

Once parasites stop shedding, they still reside in you, are are undetectable by testing. Now we really have to think.

The rectal mucus test is a string test which recovers a sample of duodenal fluid through the swallowing of a gelatin cap on a string - after 3-4 hours, the string is withdrawn and the mucus is examined microscopically. Rarely done.

Looking at blood tests with a different eye, a patient with parasites will often demonstrate the following:

DECREASED IgA, B12, Protein, Potassium, Iron, Vitamin A
INCREASED IgE, Sedimentation Rate, Alkaline Phosphatase, Eos, or the doctor word Eosinophils (a type of white blood cell)
Further note on an increased eosinophil count is that it is often indicative of roundworm, hookworm, toxocara, pinworms, and strongyloides. Giardia and amoeba do not usually increase the eosinophil count. Are you beginning to see how medicine is a gigantic puzzle, requiring trying one piece, doesn't work, try
another, doesn't work...finally, zing bah, a fit.

X-Rays may be helpful. An MRI of the brain may show brain lesions caused by Tosoplasmosis and Cysticercosis caused by porkworm. As a resident, I thought my patient had porkworm. A CT of the eye may show ocular larva migrans DISPROVING the diagnosis of retinoblastoma. A CT liver may show amebic liver abscess. Pneumocystis carinii and dog heartworm which appears like a coin lesion has been mistaken for lung cancer.

Symptoms Indicating a Parasitic Infection Should Be Considered

Symptoms may take many months and what we may be attributing to old age, stress, or plain old poor health may be a parasite.

Some warning signs include: constipation and or diarrhea, gas and bloating, myalgias (muscle aches and pains), anemia, skin conditions (including acne), nervousness, insomnia, chronic fatigue, immune dysfunction, bowel abnormalities such as bulky stools (patients tell me their stools FILL the toilet), steatorrhea (fat in stool), pruritic dermatitis (itchy skin), leaky gut with resultant new onset food sensitivities, pain, inflammation and obstruction...You get the point. There is a lot of leaching of nutrients here, subclinical malnutrition, resulting in, what at first blush, makes your physician think you are hypochondriacal.

Prevention

The first line of defense is a healthy immune system. As my patients know, 70 percent of your immune system is encased in that 35 foot tube running through the center of you.

Gut reflorestation with probiotics, the good bacteria (found in yogurt), is vital. Yes, eat yogurt. But you would have to eat three trucks of yogurt to obtain the billions of bacteria found in a quality probiotic formula. Whole Foods or a high quality health food store have good probiotics in the refrigerator.

Very few pathogenic microorganisms can survive the hydrochloric acid of a healthy stomach. For prevention, as well as treatment, most of my patients take Betaine HCI with meals. All this Tagamet and little purple pill stuff on TV concerns me.

Parasites thrive on sugar, as does cancer.

Microwaves heat unevenly, thereby allowing parasites to thrive. Eradicating parasites in a conventional oven requires a temperature of 325 degrees.

Most outstanding parasitic hazard is contaminated water. Water filters must be no greater than 3 microns (a micron is equivalent to one millionth of a meter) - Giardia cysts are about 5 microns.

Food handling - 1/2 teaspoon of brand name Clorox to one gallon of water for l5-30 minutes, then rinse in filtered water for 10 minutes.

Treatment

Finally - for physician prescribed medications, refer to the Medical Letter, March, 2000. However, a multidimensional treatment modality (not one pill), often works as well, if not better.

Repeated treatment is often necessary because of the life cycle of parasites.

Treatment involves cleansing the intestine, modifying the diet, recolonizing the intestine with friendly bacteria and eliminating risks to avoid re-infection.

Cleansing is achieved utilizing psyllium seed husk fiber, flaxseed fiber, and bran fiber. These are effective bulking agents to remove accumulated wastes. Take with label instructed amounts of water.

Enemas also cleanse. Enemas are to be done after normal evacuation. The cleanse should be done with filtered water. Some suggestions are apple cider vinegar two tablespoons with one quart of water, or blackstrap molasses one tablespoon with one quart of water (removes encrusted matter from colonic wall, often a reason why parasites are undetectable by testing), or organic coffee enemas.

Dietary modifications are necessary because Vitamin A, Vitamin B12, Iron, etc. are utilized by parasites. Several parasites precipitate secondary to lactose intolerances that often persist after elimination. Giardia can produce gluten (wheat) intolerance. Cold foods cause the intestines to contract, holding in toxins rather than releasing them. Add fresh pineapple, papaya, flax seeds, pumpkin seeds to your diet.

Drug treatment may produce unwanted side effects. Physicians refer to the Medical Letter, March 2000. Some drugs include Flagyl, Paromycin, Ivermectin, TMP/SMZ, Dimethylcarbamazine....The entire family is treated in my practice.

Now that you are totally freaked out about parasites, remember, stress, not having a sense of humor, intolerance, anger, not finding work you love , and someone to love and love you back...cause more distress and disease than any of the treatment protocols on my website. Think about it.

Whew, this easily took hundreds of hours to understand, rethink, reduce to accommodate limited time. For more information, read Guess What Came to Dinner by Ann Louise Gittelman, MS