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Evidence Based

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Do Parasite Cleanses Really Work?

Written by Dr. Michael Ruscio, DC on August 28, 2024

Written by Dr. Michael Ruscio, DC on August 28, 2024 — Reviewed by Hilary Watts

Separating Fact From Fiction When It Comes to Parasite Cleanses and Healing Your Gut.

• Using Symptoms To Choose the Best Course of Action|
• Good Gut Health is the Best Defense|
• 3 Steps for an Effective Parasite Cleanse|
• Parasite Cleanse: Back to Basics|

If you’ve gotten sick during international travel, you may have been infected by a parasite. Sometimes parasites clear out of the host’s body on their own, and sometimes they stick around and cause long-term problems.

Some parasites are dangerous and deadly, but not every parasite is harmful to all individuals. Research suggests that the health of the gut microbiome plays an essential role in whether or not certain parasites cause infections. That implies that maintaining and improving digestive health is a defensive cornerstone against parasitic infection.

If you suspect you might have an intestinal parasite, tests can tell you what it is and whether it might negatively impact your health. Conventional doctors often prescribe antiparasitic medications—which may come with side effects of their own—to treat the problem. In contrast, more holistically-minded practitioners may suggest a parasite cleanse. My policy is that the best treatment should be guided by the person’s symptoms and their severity.

Typically, zeroing in on parasites with targeted parasite cleanses can miss underlying gut issues that may have made the gut vulnerable to parasites in the first place.

Improving overall gut health with an anti-inflammatory diet, a gut-supportive lifestyle, and probiotics can both prevent and kill gut parasites better than most of the expensive parasite cleanses online.

Let’s separate fact from fiction when it comes to dealing with gut parasites. I’ll go over the 3-step process I use to fortify the gut and immune system against intestinal parasites and kill existing infections.

Using Symptoms To Choose the Best Course of Action

If you’re looking for a parasite test, it’s likely because you’re experiencing persistent, unexplained gut symptoms, such as [1, 2, 3, 4]: 

• Weight loss
• Bloating
• Nausea
• Fever
• Rash
• Vomiting
• Constipation
• Lack of appetite
• Diarrhea
• Cramping
• Stomach pain
• General gut discomfort

Though it’s understandable to want to blame parasites for all of them, some of these symptoms may be attributable to other digestive system issues, like irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO). 

When working with clients who have one or more of these symptoms, I assess how severe their symptoms are first. If not severe, I find it’s best to start with overall gut-healing treatments before suggesting they spend money on parasite testing. This plan of action addresses whole gut health, both preventing parasites and killing any that may be present.

However, if my clients have extreme symptoms (like severe abdominal pain, dehydration from diarrhea, or significant weight loss), I recommend urgent testing. They may be dealing with a severe infection that requires pharmaceutical treatment and holistic gut support. 

Parasite Testing Basics

Parasite tests generally look for protozoan parasites in the gut via a stool sample. Many different integrative and conventional healthcare providers can order and interpret a Gastrointestinal Microbial Assay Plus (GI-MAP™) parasite test. 

GI-MAP™ was one of the first Food and Drug Administration (FDA)-approved tests for gut pathogens. Although Medicare is the only insurance company that covers it, some insurance providers may provide partial reimbursement after purchase.

What’s important is not jumping to conclusions if the results show certain protozoa in your stool—not all of them are bad for human health. You should be concerned and follow up with your provider if you’re positive for:

• Cryptosporidium [1]
• Entamoeba histolytica [2]
• Giardia [3]
• Cyclospora spp. [5]
• Dientamoeba fragilis [6]

These are infectious, can cause debilitating symptoms in most people, and probably require prescription medication for treatment. 

However, if your test shows the following protozoan parasites, you can relax—they’re not generally considered harmful:

• Chilomastix mesnili [7]
• Endolimax nana [8]
• Entamoeba coli [8]
• Entamoeba hartmanii [8]
• Pentatrichomonas hominis [9]

Blastocystis hominis has mixed research behind it, some of which shows harm, and some of which doesn’t. Seek medical advice to be sure about this one, especially if you’re having symptoms [4, 10].

Good Gut Health is the Best Defense Against Parasites

When I was in college, I dealt with health issues related to a parasite in my gut, so I know firsthand how much trouble they can cause. But, I still want to caution against focusing entirely on clearing parasites when trying to improve gut symptoms. 

When it comes to getting rid of any harmful protozoan parasites, the most important thing is to improve the health of the gut as a whole. With my clients, my goal is to create a gut environment that supports beneficial microorganisms that make the gut unwelcoming to parasites.

By occupying space and using up nutrients in the gut, a healthy gut microbiome may be the body’s first line of defense against intestinal parasites [11]. Not only do beneficial bacteria and fungi outcompete parasites for resources, they also promote strong intestinal immunity against pathogens that enter the gut [12]. 

A healthy microbiome can also strengthen the cells lining the gut, which have several defenses against parasites. With microbial support, these cells can more effectively [12]: 

• Tell infected self-cells to die, which slows the spread of infection 
• Make proteins that fight parasites
• Help recruit immune cells to fight infection
• Recognize and better react to parasites in the future

Living near intestinal cells, dendritic cells are immune cells that watch out for pathogens [13]. Once dendritic cells encounter foreign invaders, such as parasites, they initiate an immune response and help prevent a similar infection in the future [13, 14]. Dendritic cells may even cooperate with beneficial gut bacteria—including those introduced as probiotics—to reduce inflammation [15].

A harmful intestinal parasite that colonizes the gut can disrupt the microbiome and immune system enough to cause disease [12, 16]. At that point, medical intervention with pharmaceuticals is often necessary to get rid of the parasite. 

The good news is that eating a therapeutic diet and taking probiotics can support the healthy gut microbes during drug treatment. The greater the gut support, the more likely the body will be able to help kill the parasites and reject them more quickly if they return.

3 Steps for an Effective Parasite Cleanse

Sometimes, harmful parasites make it into the gut. To push them out effectively, holistically, and in a way that supports overall gut health, I have my clients follow a step-by-step process depending on their progress with each step. 

Those with mild or moderate symptoms can usually avoid parasite testing and start with Step 1. But people with severe symptoms can benefit from testing to find out what they’re dealing with and whether it makes sense to start with Step 3 (antimicrobials) while they begin healing the gut with step 1. 

Step One: Build The Foundation

For my clients with mild or moderate symptoms, the first step is to lay a solid foundation by getting the gut and immune system functioning well. Incorporating a nutrient-dense, anti-inflammatory diet along with a healthy lifestyle (quality sleep, stress management, and exercise) can boost the microbiome’s ability to keep parasites in check [11, 12, 16]. 

It bears repeating that starting with gut health foundations (diet and lifestyle) and not diving into specific parasite cleanses or botanicals right off the bat can:

• Treat underlying inflammation that may cause parasite-like symptoms 
• Support a healthy intestinal microbiome that can fight symptom-causing pathogens
• Heal the gut environment as a whole to make it less prone to future infections

Whether or not a parasite is present, an anti-inflammatory diet can improve gut health and address other conditions. An anti-inflammatory diet cuts out gluten, dairy, processed foods, added sugars, and other foods that are more likely to trigger the immune system. Those foods can both create inflammation in the system and feed harmful microbes that disrupt the health of the intestinal tract. 

A well-rounded Paleo diet that cuts out common inflammatory foods can form the basis of a parasite cleanse.

Step Two: Add Probiotics

If their symptoms persist after making meaningful changes to their diet and lifestyle, I have my clients add in probiotics following what I call the triple-therapy approach. Though human clinical trials are hard to come by, three randomized controlled trials have demonstrated that probiotics can reduce leaky gut caused by Cryptosporidium [17] and match conventional antiparasitic drugs at treating Giardia [18] and B. hominis [19]. 

In other words, probiotics can both kill certain gut parasites and keep the gut lining resilient in the process. That resilience makes the gut more resistant to both existing and future parasites. 

To boot, unlike most of the “parasite cleanses” out there, probiotics can reduce gut symptoms that don’t result from parasites.

Probiotics seem to outfox parasites by hogging up resources and lightly stimulating the immune system to keep it alert against parasites [20]. Probiotics may also increase the body’s antioxidant power, reduce free radicals, regulate the immune system, and directly kill parasites or prevent them from multiplying [21].

Step Three: Antimicrobials

If, after steps 1 and 2, my clients’ symptoms persist (or if their symptoms are severe in the first place), it’s time for the third step: Antimicrobials. These may be pharmaceutical or herbal, depending on the client’s situation.

Pharmaceutical Antimicrobials

If my clients and their prescribing doctors think the best course of action is the pharmaceutical route, I strongly encourage them to incorporate the first two steps, above, along with their medication. 

Conventional antiprotozoal medications that a primary care doc or gastroenterologist can prescribe may be very effective against certain parasites, but they may also cause side effects, such as [22]:

• Abdominal cramping
• Bloating
• Loose bowel movements
• Nausea and vomiting
• Dizziness
• Drowsiness and fatigue
• Fever
• Headaches
• Itchy skin (pruritus)
• Rash

The good news is that building foundational health in the gut and immune system (with diet, healthy living, and especially probiotics) can set people up for successful treatment and fewer side effects with conventional drugs [23, 24, 25].

Herbal Antimicrobials

For people with persistent minor symptoms, no parasite test results, or a milder parasite, and who are wary of conventional antiparasitic drugs, herbal antimicrobials may be worth a try. 

There is little research comparing herbal antimicrobials to prescription medications for treating intestinal parasites. I’ve found only two herbs with human clinical studies to back their effectiveness in treating harmful gut parasites. 

One, Holarrhena antidysenterica, is an Indian herb that can effectively eradicate Entamoeba histolytica and the symptoms it causes [26]. The other is oregano oil, which an industry-funded study found may be able to eliminate three generally harmless parasites [27].

Meanwhile, certain herbs have demonstrated antiparasitic properties in animal and cell (petri dish) studies and may one day be researched in human clinical studies. For example,

• Common plants in the U.S. with antiparasitic effects against Entamoeba histolytica include [28]:
  
  • Avocado
  • Ginger
  • Garlic
  • Anise
  • Creosote bush
    
• Plants with general antiparasitic properties:
  
  • Garlic (Allium sativum) [29, 30, 31] 
  • Ginger (Zingiber officinale) [29, 30, 31, 32]
  • Peppermint oil [33] 
  • Asafoetida (Ferula asafoetida; aka hing powder or oil) [34]
  • Tongkat ali (Eurycoma longifolia) [35]
  • Chromolaena odorata (bitter bush or Siam weed) [36]    
  • Uncaria tomentosa (cat’s claw) [36, 37]
  • Yarrow (Achillea millefolium) [38] 
  • Fennel (Nigella sativa) [39]

Despite the limited research, many of these botanicals, including cat’s claw, oregano oil, garlic, fennel, and ginger, are considered safe for short-term use in healthy, non-pregnant people. I tend to have my clients take our Biota Clear antimicrobials, which have strong antiparasitic properties.

If you want to try any herbs on your own, please check in with a botanical-savvy provider to make sure they’re safe for you. Just because they’re herbal doesn’t necessarily mean they’re safe.

Probiotics and Antimicrobials

Whether my clients with parasites are using conventional or herbal antiparasitics, we include probiotics along with antimicrobial treatment. Studies have shown that combining antibiotics  with probiotics makes them stronger against other types of microbial imbalances in the gut, such as Clostridium difficile, SIBO, or H. pylori 25, 40, 41, 42]. 

Probiotics can also help reduce the microbiome damage and uncomfortable side effects (like antibiotic-associated diarrhea) antibiotics can cause [23, 24, 25]. 

Parasite Cleanse: Back to the Basics

As with most of our content, the topic of parasite cleanses comes back to gut health. A healthy gut forms the foundation of our resilience against parasitic infections. 

Whether or not gut symptoms stem from parasites, taking the steps to support gut health boosts the immune system, fortifies the cells in the gut lining and supports the helpful microbes. When the gut microbiome is strong and healthy, there’s no room for harmful parasites to thrive.

So, instead of entrusting your health to a Tiktoker’s detox home remedy, I encourage you to follow the science and seek the clinical experience of someone you trust. If you’d like help tailoring your diet, lifestyle, and supplements to deal with parasites or generally support your health, please reach out to the Ruscio Institute for Functional Health and schedule a time to talk with one of our practitioners.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment.