Hookworms: A Cheap Treatment for Autoimmune Diseases?
According to Lawrence, hookworms and whipworms -- parasitic worms, or helminths, that take up residence in the intestine -- induce a subdued inflammatory response more effectively than modern medicines can.
"They persuade the immune system to leave them alone," he said in an interview with DailyFinance, and thereby regulate the immune system, causing these illnesses to go into remission.
Restoring the Natural Equilibrium
After treating more than 180 people, including himself, by infecting them with these tiny creatures, British-born Lawrence is even more convinced of the science. While purposely contracting an infection runs counter to common sense, Lawrence insists that he's only restoring the natural equilibrium. As he sees it, before the introduction of toilets and anti-bacterial soap, the normal state of affairs for the human immune system was fighting off repeated parasitic infestations.
"A variety of intestinal parasites used to be almost universal and throughout a person's life, and that situation prevailed for as long as humans have been humans," says Lawrence. "The ape and any of the proto-humans in the fossil records all were infected with parasites, so our immune system has evolved to account for this immunomodulatory effect on inflammation."
As a result of our modern obsession with super-clean living environments, Lawrence theorizes, our immune systems have gone haywire, giving free rein to all kinds of debilitating and expensive-to-treat diseases.
"When you take those worms out of people, the immune system doesn't develop properly and is unregulated, and the inflammatory response is stronger and misdirected," says Lawrence. "So, by reintroducing the parasites, you restore the situation that our immune systems evolved for."
Lawrence himself suffered from severe allergies for most of his life, with his eyes swelling shut "to the point of pain," he says. Desperate for relief, he tried all kinds of allergy medications. "I was doped to the gills every spring on antihistamines," he says. "I was often asked if I was taking drugs at school because I was so bombed out on antihistamines all the time."
In 2004 he saw a BBC documentary about the relationship between parasites and asthma. Lawrence, then 40 and running his own ad agency, was captivated, and after hours researching parasites on the Internet, he made the decision to use himself as a medical guinea pig.
Hookworm is a common parasite, with about 1.3 billion people worldwide playing host to the toothed creature that's just 5 to 13 millimeters in length. But in America, it's almost impossible to contract. So in 2006 Lawrence traveled to Cameroon, where the country's poverty and abysmal sanitation made it a likely place to contract the worms. "It was a bit of a gamble," he says, "since there weren't any direct studies showing that worms could benefit any disease at that time."
A Memorable Time in Cameroon
Hookworm larvae enter the human body through the skin, so Lawrence visited about 30 outdoor latrine areas in Cameroon, where he confounded the locals by wading through their feces in his bare feet. Although he'd planned his trip very carefully down to this important detail, "when I was confronted with actually taking my shoes off and doing the business, it was so repulsive and so repugnant that if I hadn't told everyone what I was doing, I wouldn't have done it," he says. "I didn't have to step directly into excrement, but I did," he explained, since the larvae also live happily in the soil. "I wasn't going to go all that way and take any chances" of not getting the desired infestation.
Weeks later, Lawrence tested positive for hookworm, and a few months later, when allergy season returned, he realized his asthma had disappeared.
Lawrence began dispensing hookworms through Autoimmune Therapies in 2007 and claims exceptional success in treating various autoimmune diseases for which the medical world has yet to find cures. Lawrence emphasizes that the parasites aren't a cure either, but according to his data, 80% of the ulcerative colitis and Crohn's disease cases he's treated have gone into remission, and his results with MS have been even better. "Everyone with relapsing, remitting multiple sclerosis that we've treated has gone into remission or damn near remission within six months," he says.
$140,000 vs $3,050
These are the kinds of results that drug companies fear, which may explain why more research hasn't been conducted on helminthic therapy. While a five-year course of treatment for MS with Tysabri, made by Biogen Idec (BIIB) and Elan Pharmaceuticals, costs about $140,000, Lawrence charges $3,050 for a treatment. The worms live three to 10 years, and he guarantees infection for three years.
"If you were in business, would you replace a drug that earned you $140,000 over five years with a parasite that might earn you $4,000 that was more effective?" Not only that, explains Lawrence, but the worms aren't patentable, and once they become available through more vendors, the price is likely to fall to a few hundred dollars a dose. "All the drugs that are on the market -- Methotrexate, Tysabri, Humira -- all these drugs would suddenly be worthless," he says. "It's not going to happen, is it?"
The U.S. Food and Drug Administration hasn't made things easy for Lawrence. Last November the FDA came knocking, saying they were going to help him come into compliance. They explained that the creatures would be treated like leaches or maggots, which are still used for medical purposes, and that he had nothing to worry about. One lawyer advised him that the worms could be categorized as probiotics, which are readily available at any health food store. (Indeed, his website describes the treatment as "Immunotherapy using Probiotic Helminthic Therapy.")
These Bugs Are Drugs!
But by the end of that week, the FDA returned with bad news: Lawrence's worms would be classified as pharmaceuticals and he would have to embark on a study to prove efficacy and apply for FDA approval, a long and costly process that could run to millions of dollars. "We didn't have any money, certainly not that kind of money," says Lawrence. "We'd bet the farm on it. We'd re-mortgaged our home and borrowed all the money we could in order to do this."
Lawrence moved his practice to Mexico and the U.K. Whereas he used to visit patients within the U.S. who were too sick to travel, now those desperate for relief fly long distances for a treatment that takes minutes to administer. Lawrence places an adhesive bandage embedded with about 35 hookworm larvae on the skin and waits for them to burrow in. The worms then make their way through the bloodstream to the lungs. The host then coughs them up and swallows them, sending them through the digestive tract to their final home in the wall of the small intestine. Watch the short video below for Lawrence's narration of the procedure.
While some people experience nausea, fatigue and diarrhea for a few days, Lawrence claims that within four to five weeks any side effects disappear, with no permanent damage. Contrast that with Tysabri, the MS drug, which carries a warning that it has a 1 in 1,000 chance of triggering "a rare brain infection that usually causes death or severe disability" -- which cannot be reversed once it sets in.
In contrast, hookworms and whipworms can be eliminated at any time with a course of albendazole, made by GlaxoSmithKline (GSK). Strangely, a more pressing concern is keeping the creatures alive. "They are very sensitive to nitrous oxide," explains Lawrence. "If someone went to the dentist and had nitrous oxide, their disease symptoms would return within about two weeks," which is "a good sign that they've lost their worms."
First-hand experiences with the parasites posted on Helminthic Therapy Forum, a Yahoo! chat group, show that those who've benefited from the treatment feel the risks are well worth it. "My experience with hookworm has been completely positive," writes one woman who had suffered from a debilitating case of irritable bowel syndrome. "The impact on my disease, complete cure, is nothing short of miraculous. It even fixed problems I did not even realize could be affected by hookworm."
Some doctors are, to their surprise, curious about the possibility that this sort of natural treatment might work. Dr. Jonathan Terdiman, a gastroenterologist at UC San Francisco Medical Center who has treated Crohn's disease patients, told CBS Healthwatch: "It's not a therapy that I can officially endorse or condone. But at the same time, there is a growing body of science that suggests that this makes some sense. It's not a crazy idea."
Even if Lawrence could overcome the rigorous FDA requirements and powerful drug-company lobbyists, the hookworm treatment's biggest stumbling block is still the Yuck Factor. The prospect of infecting oneself with worms is a hard sell for most potential patients, making it unlikely that this will become a popular and lucrative treatment. So far, at least, Lawrence says his company is only barely profitable and his worms certainly haven't made him rich. "If I could claim this cured baldness or obesity," he quips, "I'd be a millionaire."