Guidelines for Self-Administering Helminth Therapy with Dr. Nancy O’Hara

Helminth therapy essentially refers to using health-promoting worms in a very similar manner to how we use probiotics.  Healthy helminths may be an important, and missing, part of our gut microbiota communities.  By restoring these to our intestinal tract it may be possible to reduce inflammation, balance the immune system and improve autoimmunity.  Today we speak with Dr. Nancy O’Hara who has been using helminths in her clinical practice for years.

Dr. R’s Fast Facts


  • Started her career working with children with Autism, studied Pediatrics, received masters in public health, spent past 20 years working with children with developmental disorders

What is Helminth Therapy?

  • Essentially – using worms like probiotics
  • Typically not the first place to start in terms of therapy. Strongly considered if no improvement from using other therapies like diet, probiotics, etc.

Why Does It Help?

  • Regulates and may be able to reset the immune system
  • Has anti-inflammatory effects


  • Generally very safe
  • HDC and TSO organisms cannot survive in human host
    • They will not become a long-term resident
    • If someone does have a reaction it is short-lived
  • May occur naturally in the food supply anyways
    • Think of it like a step further than yogurt
  • HDC is limited to the inside of the gut or intraluminal, unlike others that can breach the barrier of the gut

What Conditions Can it Help?

  • Autism, PANDAS (Pediatric Acute-onset Neuropsychiatric Syndrome)
  • Autoimmune conditions
  • IBD
  • IBS
  • Neuropsychiatric conditions
    • Depression, anxiety, chronic fatigue, mental/brain fog, headaches
    • Insomnia


  • Use for 3-4 months, at full dose, then re-evaluate.  Full effect is normally realized by then.
  • Dosing, for HDC which is Dr. O’Hara’s preference
    • Start with 5, then 3 weeks later dose 10, then 3 weeks later dose 20 etc. Then start counting the 3 months when you get to full dose
    • Target dose – 20 top for children, 40 top for adults. Dosed every 3 weeks
    • Increase by 5-10 every 3 weeks
    • Those who have initial reaction
      • Start low and slowly increase, increase more slowly if there is a reaction
      • Slow increase = 5 after 3 weeks.  Fast increase = 10+ after 3 weeks

Side Effects

  • The more severe someone’s illness – the more likely a slight histamine reaction may occur
    • Biltracide for rare severe reaction, only occurs in children, very rare.
  • Short term side effects (most common) irritability, headache
    • Can be treated with ibuprofen and an antihistamine – dose as needed to manage symptoms
  • Other side effects: Abdominal cramps and/or diarrhea
    • Reactions indicate you should use a lower dose
  • Persistent GI cramps may indicate need for antimicrobial therapy


  • Constipation
  • Mast cell over reactivity or histamine intolerance, might be a problem
    • Be cautious here, slow steady dosing
    • May help to take an ibuprofen and an antihistamine before dosing
  • Immunosuppression
    • People on immunosuppressants should proceed with caution

Helminths Vs. FMT

  • Recommend trying helminth therapy before Fecal Matter Transplant therapy
    • Especially when working with children. Helminth therapy is far less invasive
  • FMT can be much more expensive


  • Treat SIBO directly first, then consider HDC if non-responsive cases – about 50% successful

Consultations – Learning More

  • For parents or anyone who wants to learn about Helminths – there are multiple articles, videos, and info at
  • Book: Epidemic of Absence
  • Dr. Baker is willing to guide clinicians
  • Dr. Parker is willing to discuss with practitioners

Helminth Suppliers

DrR Podcast NOHara
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Episode Intro …00:00:39
Defining Helminth Therapy … 00:03:00
Safety & Side Effects … 00:05:20
What Conditions Can it Help … 00:11:50
When Do You Start to See Results … 00:14:14
Histamine Intolerance / Mast Cell … 0016:38
Treatment … 00:18:00
When Should You Try This Therapy … 00:20:34
Helminths Vs. FMT … 00:23:50
Dosing … 00:25:35
(click gray Topics bar above to expand and see full outline/time stamp)
Managing Symptoms … 00:29:04
Contraindications … 00:30:30
Where Can People Find Out More Info … 00:32:04
Any Connection With IBS, IBD, and SIBO … 00:34:00
Episode Wrap-up … 00:38:20

Download Episode  (Right click on link and ‘Save As’)

Guidelines for Self-administering Helminth Therapy with Dr. Nancy O’Hara

Episode Intro

Dr. Michael Ruscio: Welcome to Dr. Ruscio Radio. This is Dr. Ruscio. Today, I am here with Dr. Nancy O’Hara and we are going to be doing part three on helminths.

So, Nancy, welcome to the show today.

Dr. Nancy O’Hara: Thanks for having me.

DrMR: It’s a pleasure. I’m actually really excited to pick your brain. I know that this is an area that you have a lot of experience with and definitely want to jump into some of the details. But before we get there, can you give people a little bit of your background and how you got into this area of practice, specifically?

DrNO: Sure. I started my career as a teacher of children with autism about 35 years ago and I was a really lousy teacher. So I took the easier road and went to medical school. And was doing developmental work and then a general pediatric practice, had my master’s in public health. And then while I was in practice, had a couple of moms of children with autism who said, “If you ever do anything differently, we need somebody to integrate all of our care.”

And about the same time, I had a young man who was four and a half, severe allergies, allergic rhinitis, asthma and autism, not speaking, who got remarkably better with taking dairy out of his diet. It’s a long story and I won’t bore you with all the details. But basically, I told her, ‘Well, that’s hogwash’. And she found my mentor, Dr. Sidney Baker. And said, ‘You got to go talk to him’. And I resisted but at the time I was going through infertility. And the medical community was not serving me well. And so I went to see Sid as a patient. And that changed my life.

So for the past 20 years, I have been working in a consultive fashion with children with neurodevelopmental disorders. Started almost exclusively with children with autism. And now, it’s kids with anxiety, OCD, ADHD, PANS, PANDAS, all types of autoimmune diseases. And it’s all of that—all of those by the way, I think are autoimmune diseases and I think there’s a lot of proof for that—how I got into helminth therapy.

DrMR: Definitely something that I think is up the alley of our listeners. Of course, the audience is very privy to gut-health and also the gut immune/autoimmune connection. So definitely, an area I want to explore a little bit deeper. We’ve covered before what helminths are, essentially the polite or a medical term for a worm.

Defining Helminth Therapy

How would you define helminth therapy and if you could piggyback on top of that, why you think or maybe a couple of the theories as to why that therapy is helpful for people?

DrNO: The way I try to explain it to families is that we are all an ecosystem. And we have depleted our ecosystems of the plethora of germs that we need. And so, as such, we have markedly increased the way that the immune system attacks self. And so in giving something like these HDCs, Hymenolepis diminuta cysticercoid—say that 10 times fast—which is a very safe intervention, we can reset that immune system and help to decrease the autoimmune phenomenon that may be going on in an individual. So it’s not just antibiotics and antibacterial soaps. But it’s wearing shoes using toilets and living indoors more without vitamin D exposure and not living in the dirt, and all the things I’m sure you’ve told all of your listeners for years that have made our systems unable to promote a normal and necessary immune response.

And so what the helminths do is provide something that, evolutionarily, our bodies are used to, that is fairly low cost, that is not a parasite and does not colonize humans. And that helps to increase the anti-inflammatory and decrease the pro-inflammatory cytokines—as I’m sure William Parker told your listeners earlier—within our systems. So what I see is that inflammatory reaction, that inflammation that is their gut disease or that is their autoimmune disease in general—and I have multiple examples—I see that get better in many of the kids when they use this therapy.

Safety & Side Effects

DrMR: So you said something there that takes us to a question I wasn’t planning on asking until a little bit later. But it’s one that I think is really important to ask. And you said “safe.” You said the safe therapy. And one of the things that I am confronting as I’m having this discussion with patients in the clinic is the “eww” factor. And I get it. And I think patients have an understandable but probably more so of a stereotypically formed, preconceived notion that these things may not be safe.

And I’d like to get your expansion on why you feel these are safe. Briefly, I’ll just provide mine. I think the most foundational reason is, quite simply, these organisms, the HDC specifically and the TSO, also can’t survive in a human host. So they are not going to become a long-term resident. And if anything, if someone does have a reaction, it would be short-lived. I actually did the self-inoculation with HDC. I had a little bit of histamine response. Took an Advil and some over-the-counter antihistamine. And within 30 minutes, the reaction abated—and the reaction was only a bit of irritability—the reaction abated and never came back.

So it seems that the potential side effects are short-lived, fairly mild. And these organisms will not be able to establish residence, so we don’t have any kind of long-term consequence. So those are things that I have offered people. But how do you grapple with that question of getting people past that weird, ‘Okay, this is the helminth and this seems kind of foreign to be doing this’. How do you get them past that?

DrNO: So first of all, I say, ‘Do you drink yogurt? Do you eat cultured foods?’ In a lot of ways, this is just the next step beyond that. Because these HDCs are raised in grain beetles that are normally found in our human food supplies as contaminants in a wide variety of grains. And if you go into my mother’s shelf, they’re probably all still there. But evolutionarily, when we used to dry our grains in large vats, we were eating grain beetles and grain beetle worm eggs all the time. I think this particular form is even safer than TSO in that is intraluminal. It’s limited to the inside of the gut. Unlike other nematodes, hookworms, whipworms that can breach the barrier of the gut, these are intraluminal. So I do think they’re exceedingly safe.

So let me tell you about—and I agree with you 100% about the typical reaction, which is a little bit of a histamine reaction or a Herxheimer’s reaction. And the more severe your immune disease is—for instance, in my children with severe Lyme, the more likely you are to get that Herxheimer’s, die-off histamine reaction. So what I usually do in those cases, I start with less worm eggs and slowly build up. And if there’s any amount of reaction, do exactly what you said, which is taking an antihistamine and ibuprofen. I do not recommend Tylenol for other reasons, but Advil, Motrin, that sort of thing, and an antihistamine either natural or over-the-counter.

Now, there is a very, very small group of only children, not true in adults, but in children, where my level of concern raises just a little bit. And right now, it’s about a risk of one in a thousand, maybe one in ten thousand and that is of infestation. So not infection, not colonization, but where the eggs hatch before they’re excreted. And you can get a little bit of belly pain. And that is easily treated with Biltricide. All of the HDCs are sensitive to that.

And I have not seen that in years. And the reason being is I avoid it in those children that are severely constipated. So they’re not getting things through their guts, so they’re more likely not to poop it out. Are on any immunosuppressive medications from their GI doctor or their rheumatologist or whoever. I also think a little bit more about it in kids that are nonverbal or who already have gut pain because then I may be less likely to be able to tell. But it’s, again, very, very rare. I feel very safe with it. And as you said, very easily treated if there is any problem.

The one case that I saw has been a couple of years now. And since, keeping that group of children—out of the children I recommend it for, I haven’t had a problem. Now as a pediatrician, I don’t treat adults. I don’t really like them either, but—no, just kidding. But in adults, you will never see this. This is only something we see very rarely, as I said, in children.

DrMR: Got you. And if someone was a provider that was trying to address this with herbal agents, do you think something like artemisinin or another kind of broad-spectrum antimicrobial herbal preparation would work in a similar fashion?

DrNO: Because I’ve only seen it severely in this one child, I went straight to Biltricide. But I certainly, in any kids that are having a little bit of belly pain, absolutely would have no hesitation with using Artemisia for those kids.

DrMR: Got you. Got you. Okay. So you definitely feel like it’s safe. And, again, I like the few pointers you laid out there, which is the more severe someone’s illness, the more potential that they really may have some kind of histamine response. So that makes a lot of sense to be on the lookout for that and not necessarily freak out about that but understand that may be part of the immune system recalibrating as you kind of alluded to earlier. And I love the perspective of, and it’s actually something else that I do use in the clinic as analogy to help patients with this, which is if we went back 100 years in time and told the person we were talking to that people in the future are taking capsules of bacteria and swallowing them, they will think that we’re crazy. But it’s now a common practice. So I agree with you, I think this is kind of the evolution of probiotics, in a sense.

DrNO: Right. And a lot of us, we’re not in the dirt anymore. We’re not getting that good earth that we need. So we have to get it in other ways.

What Conditions Can It Help

DrMR: Yeah. I agree completely. So you gave a couple of great bits there I want to pick more into, which is troubleshooting potential reactions and contraindications. But before we get into some of those details, zooming us out for a moment, are there conditions that you find this to be more or less helpful for?

DrNO: So I have a lot of children with PANS and PANDAS in my practice. I’m sure you’re familiar with that. For any of the listeners that are not, that’s a pediatric acute-onset neuropsychiatric illness that’s associated with strep, with mycoplasma, with viruses, where they get an acute onset of anxiety, OCD, tics, severe separation issues, and other neurodevelopmental problems. Those children I have seen many improve with this.

I also see children with inflammatory bowel disease, Crohn’s colitis. I use it in my own husband. A few years ago when I met him, he was on multiple medications for his Crohn’s disease. And I said, ‘Let me just do one thing’. And I gave him this. It’s a small vial of water. Tastes like salty water, looks like cloudy water that you take once every—about three weeks. And now he’s off all his meds and continues to take this. So my IBD kids, my PANS/PANDAS kids, my Lyme kids, arthritis kids, so all of those sort of autoimmune diseases.

Some of my children with autism, because I think it is also—autism is an autoimmune disease. Those are all children that get better. I feel so safe about it that in any child that I’m worried about inflammation, which is many in my practice, I will use it. If, though, they don’t have any immune system abnormalities, if they have no inflammation, if they have none of those illnesses and they don’t have anxiety or OCD—so for instance, your ADD kid that doesn’t have anything else, it may not work as well. But I have to say that I think it is such a safe and effective intervention that if I get over the ick factor with families, I will recommend a trial for three to four months before they say yay or nay.

When Do You Start To See Results

DrMR: Okay. So that answers another question, which is, how long until someone typically sees a response? So you say three to four months is a good reevaluation window?

DrNO: Correct. So three to four months at the full dose. So often, for instance, let’s say you or I might take 30 to 40 HDCs, which means there are 30 to 40 eggs within the vial. I would start with five. And then three weeks later give 10. And then three weeks later, give 20. And three weeks later, give 30. And then start counting the three months when I got to 30, before I decided.

Now, having said that, those kids that get the autoimmune histamine reaction right away, even at a low dose, are much more likely to get a positive later. And sometimes what I see is the parents don’t even realize how positive it was until they stop it.

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DrMR: So those who have more of that histamine type reaction that I actually had and I was describing earlier, those are the ones who you found are more likely to have a benefit from this after that window has been reached of about three to four months at full dose?

DrNO: Correct.

Histamine Intolerance / Mast Cell

DrMR: That makes a lot of sense. And so, actually, there are so many directions I want to go here. So I want to follow this thread to another question that I have, which is one that I’ve really been pondering and I’ve been doing a little bit of the experimentation in the clinic with, which is can—and this is mostly in adults, I should clarify. And I know that you’re seeing I’m assuming mostly children. But I’m wondering if you’ve caught some lessons here that maybe applicable to both, because while children and adults are different, they’re also very similar in many ways.

So for those that appear to have signs of histamine intolerance, I’ve read some papers that have suggested, theoretically, that helminths may be able to aid with histamine intolerance and mast cell activation overzealousness, if you will. But I’ve also read some comments that you may want to be cautious. And I believe one of the things that William Parker said may be a contraindication is those with mast cell reactivity. And I know sometimes these things are complicated. The immune system is very complex. But I’m wondering for this kind of sphere of associated symptoms, the histamine intolerance and then the mast cell activation type looking presentations, have you found this to be something that you would say is generally helpful, generally not helpful? Or do you have any other kind of comments or thoughts on that?


DrNO: Sure. Sure. I think it’s an excellent question. And it’s one that is much more of a mixed bag than most. And what I mean by that is that I do have children with mast cell activation, histamine intolerance and have done very well with this. But I am very, very cautious. And start with even lower dosages as possible. And go up even more slowly. And watch for any signs of over activation. Not just in blood testing but more in history and physical exam. And if I see any of that, then I back off. And I have a few that have not been able to tolerate it. But I have others that this is the only thing that’s really helped them.

So in my clinical experience, I don’t have—okay, you have histamine intolerance but you’re going to do well. You have histamine intolerance but you’re not going to tolerate it. There isn’t a good clinical or lab test indication that tells me that. It’s just, from my experience, I have to start much lower and be more cautious.

DrMR: Got you. Got you. Okay. And that makes a lot of sense. Coming back for just a moment to the conditions that this can help. And please feel free to modify this if you disagree or would modify in any way. But if something has the ability to improve immune status, especially immune status in the gut because that’s such a large part of our immune system, globally, it wouldn’t seem like a stretch to say that this helminth therapy maybe able to help with a wide array of conditions.

And of course, some supports for that, if we look at the association between the gut and different areas of the body, we can tie it to things like depression, insomnia. We can tie it to dermatological issues like atopic dermatitis. We can tie it to inflammatory conditions in the bowel. We can tie it to just a number of things. So, I guess what I’m driving it is, would you agree that the improvements from this can manifest in a wide array of improvements because of the far-reaching impact of the gut?

DrNO: Absolutely. And the other extension of that is, the gut is the first line of defense of our immune system. The gut and how we treat the gut affects our immune system. And so, these HDCs in any gut disorder as well as almost any immune disorder, can be potentially very helpful.

When Should You Try This Therapy

DrMR: I think a question that many people are going to be grappling with, myself included and I’m sure this will apply to both the lay person and the healthcare provider alike, is where do you fit this therapy in? And for me, I’m starting with a lower, varied entry—to use maybe not the best term for it—but easier to start with therapies for whatever reason. It’s a lower ick factor. It’s easier in terms of compliance.  Things like dietary changes, probiotics potentially treating something like SIBO or Candida, things like this are more so our frontline therapies is where I would start.

And then I would reserve this toward the end just because it’s going to be easier. And I would maybe put FMT at the very end of this spectrum. I positioned a referral for helminths before FMT, Fecal Microbiota Transplant, for the audience is where you can essential transplant a healthy donor of microbiota via essentially a stool enema into a sick recipient. And there are some impressive data there. But you’re looking at a few thousand-dollar investment at least.

And so since you can get started with a trial on the HDC or other similar helminths for hundred, maybe a couple of hundred dollars and you can have that at your door in about a week, it just seems like an easier starting point. So I know I kind of give a lot just there. But what would you add to that?

DrNO: You answered the question. But I would absolutely agree. I always start with probiotics, with diet, with anti-inflammatories, with treating dysbiosis and SIBO. Although this is not a parasite, I also want to make sure that this child is not having problems with parasite. I look at the moon cycles. I want to get to know them and their gut a little bit better before I jump right in. Having said that, as a consultant, as not a primary care person, I often have people coming with very severe diseases who have been to many clinicians, who have been down many roads, and they’ve already tried many things.

Then if that’s the case, A, as one of my mentors, Maureen McDonald used to say, ‘You have to go in through a door not a window’. I want to make sure they went in all through the right doors. And you have to make sure the foundation is there of the house before you start building the roof. So even if they have been doing a hundred things, I want to make sure they have a good foundation, that they have a fairly healthy gut, that they’re definitely not constipated.

And then I give them the information. I talk about it. I give them my spiel. I give them, for instance, the biome restoration website to learn more. I give them articles on it. I want them to be informed. And then we bring it up the next time and decide if we’ve taken care of the probiotics, the inflammation, the dysbiosis, the SIBO, if there are any parasites. And then we decide. But absolutely, it’s not a first line even in my kids that are coming after doing countless interventions.

Helminths Vs. FMT

DrMR: I’m assuming you’d recommend this before FMT. Would you and would you share that same kind of thinking that I have, which is, I’m equally open to both of them. It’s just the barrier to entry is so much lower for the helminthes, which is why I would assign it in the hierarchy position before the FMT.

DrNO: Absolutely. And I have a slightly different bent, only because in dealing mainly with children, you have to take in the psychological/emotional factors of the FMT. Because it’s being done to them, they’re not making that conscious decision. And this is just—my son took this for years in his cool lime refresher from Starbucks without even knowing it. And if he’s online right now or listens to this podcast, he’ll be really bummed.

But it’s easy to do. It’s once every three weeks. It’s not invasive. So it’s not something that is as problematic, as expensive, or even as financially burdensome.

DrMR: Yeah. That’s a big factor for a lot of people. Yeah. I think if we’re going go somewhere and have it done, the estimates I’ve heard are about $5,000, $6,000, on average. Which is not a huge price if it’s going to have a sizable impact on your health, I get that. But it’s not pennies either. So, yeah.

DrNO: Now, if somebody came in to me with recalcitrant Clostridium and nothing had worked and C. diff, would this be my first line before one FMT? No. I would do FMT first. But if a child’s coming in with autoimmune disease or autism and that’s what they’re considering, I would do this hands down for months before I would even consider FMT.


DrMR: And I’d agree with you there completely. Now, coming back to the dosing, you had said that you start with five units and then three weeks later, 10. And then was it three weeks later 20 or are you going up in increments of five? Or how does that look, just one more time?

DrNO: Great question. It really depends on the child and their response. So let’s say I did five to start and there was no histamine reaction. Then I said go to 10 and there was still no histamine reaction, then I may go to 20 and then to 30 because I want to get going. But if at five there was a histamine reaction, then I may stay at five and dose them with ibuprofen and antihistamine prior to taking the next dose and for the few days after and if they’re okay then without a severe worsening.

So let me give you an example. I had a young woman recently, she’s actually in her 20s who has severe Lyme disease and many co-infections and a tremendous amount of inflammatory and autoimmune response. She was starting therapy, was doing well with the Lyme disease, started this, and the first time she took five, she—all of her symptoms of Lyme came roaring back: Severe brain fogs, severe arthralgias, severe fatigue. So then I backed off even more. I gave her less. And for the few days around it, gave her an antihistamine and ibuprofen. Then she did well, so the next time I went back up to that original dose. And then inched my way up with her. What’s interesting is she was doing really, really well. Minimal brain fog left. All of her other symptoms were gone. And she missed one dose and it was back to the beginning again. But then when she got the dose on time again the next time—she was traveling, lots of different logistical reasons why she missed the dose—her symptoms went away again and she was fine.

So it can be that sensitive in some people. So I base it on my N of one, that individual that I’m treating. But in general, you’re very safe to go up by five, starting with five. In children, I will go up to usually, no more than 20. In adults, usually no more than 40. That’s my comfort level, that’s a very individual clinical experience and just based on thousands and thousands of doses.

Dr. Ruscio Resources

DrMR: Hey, everyone. This is Dr. Ruscio. I quickly wanted to fill you in on the three main resources that are available to you in case you need help or would like to learn more. Of course, I see patients both via telemedicine, via Skype, and also at my physical practice in Walnut Creek, CA.

There is, of course, my book Healthy Gut, Healthy You, which gives you what I think is one of the best self-help protocols for optimizing your gut health and, of course, understanding why your gut is so important and so massively impactful on your overall health.

And then, finally, if you’re a clinician trying to learn more about my functional medicine approach, there is the Future of Functional Medicine Review which is a monthly newsletter which is a training tool to help sharpen clinical skills.

All of the information for all three of these is available at the url, And in case you’re on the go, that link is available in the description on all of your podcast players. Ok. Back to the show.

Managing Symptoms

And regarding managing the symptoms, are you administering just one dose of ibuprofen and an antihistamine or are you using those as directed with—let’s say the antihistamine has got a twice a day dosing and the ibuprofen maybe every four hours. Are you having someone just use that semi per the bottle instructions as needed to help with their symptoms or how are you doing that?

DrNO: So it’s as needed to help with their symptoms up to every six hours with the ibuprofen and twice a day with the antihistamine. But I may increase the dose to ends of the spectrum of what’s okay, 10 milligrams per kilogram in the ibuprofen and a higher dose of a natural antihistamine, for sure.

And then based on what they did the last time and what they did well on, if I’m doing it preventively, the next time, I’ll start with that dose. And then try to do less and less moving forward.

DrMR: Got you. Okay. And then, again, for the dosing, you’re increasing by essentially five to 10 units every three weeks depending on how big those increases are depends on the history of reactivity. The more reactive they’ve been, the slower your titration upwards is going to be; the less reactive they have been, the faster your titration upwards is going to be; and you’re topping out at about 20 for children and 40 for adults?

DrNO: Correct.

DrMR: Got you. Okay. And that makes perfect sense. And then you’re using things like ibuprofen and antihistamines essentially as needed to manage those reactions. And so it makes complete sense.

And then what I’m just trying to drive out here is sometimes I think people get so wrapped up in the confines of a protocol, they don’t think about the underlying simple principle of how we’re doing this. And so that’s why I’m just trying to get to what maybe the simple principle is to help guide people through this.

DrNO: Right. Right.


DrMR: Coming back to contraindications, constipation is one I’ve heard before. And the mast cell over reactivity, a.k.a. histamine intolerance, a little bit different there in terms of what those things actually mean, but they’re very similar. Anything else that you found to be something that you should proceed with caution if present?

DrNO: Immunosuppression.

DrMR: Immunosuppression.

DrNO: So a child that, for instance, is on intravenous gamma globulin or other therapies for CVID or immunodeficiencies. A child that has bowel disease and is on an immunosuppressive medication, steroids for instance, from their GI doc. Somebody that’s on Humatin or high doses of steroids for their rheumatoid arthritis, I would proceed with caution because their immune systems don’t always act as you expect them to.

And if I have that coupled with a child with autism or a nonverbal child, then this intervention, for me, is off the table.

Where Can People Find Out More Info

DrMR: Got you. Okay. What about if people were looking to obtain some kind of consulting with this. I know this can be a touchy subject because of FDA regulation, so is there somewhere where you can point people who wanted to get more feedback or coaching or what have you with this process?

DrNO: Right. So first of all, for information, I would definitely go to There are multiple articles there. There are some videos there. There’s information from Dr. Parker. If you are a clinician, I know that Dr. Parker is very willing to discuss it with practitioners. There’s also an excellent book just on helminth therapy in general by Moises Velasquez-Manoff, the Epidemic of Absence. That gives good information. I also know that my mentor, Dr. Baker, who learned from Dr. Parker, is very willing to guide clinicians and actually is helping to teach some clinicians how to harvest these in their own clean lab. So certainly, would be willing to work with people on that.

We just did a series of lectures for the Institute for Functional Medicine and the HDCs were discussed there. So if any of the practitioners happen to be members there, some of the information from that conference as well as information within the toolkit would be there. For parents, I would start with biome restoration and the information that is there to become acquainted with and talk to people about it.

Any Connection With IBS, IBD, and SIBO

DrMR: Got you. Got you. Okay. And the other question I wanted to ask, just popped back into my head, which was, the connection to IBS and Small Intestinal Bacterial Overgrowth, if you’ve seen anything or if you have any opinion on that. I know the audience is going to be curious because we talk a lot about both of those. So anything there?

DrNO: Certainly, when a child or an adult has IBS or SIBO, Small Intestinal Bacterial Overgrowth, I like to treat that in other ways first, whether it be herbs, sometimes medications, Saccharomyces boulardii has been one. I’ve had very good success with probiotics. Certainly diet. And try to do as much as I can in those ways.

If I’m still not getting a hit, an improvement, this is next in line for me. I’d say it’s still at best a 50/50 proposition as to whether that group of patients, not the IBD, but the IBS and the SIBO, will get improvement with this.

DrMR: And how would you compare that in the IBD? You say this is about 50/50, how would IBD rate?

DrNO: Much better than that.

DrMR: Got you.

DrNO: I’ve had just one little caveat story. I had a young man who also had autism and anxiety who presented with very severe ulcerative colitis. His gastroenterologist wanted to put him on methotrexate as well as very high dose steroids, et cetera, but would not do it until he had been fully vaccinated. And the mom had not fully vaccinated him up until that time. She started vaccinating him, but wanted to do the vaccines not all at once. And I said, while you do that, let’s try the HDCs.

So we put him on that. And he went back in a month to get the information from the doctor. And had gained seven pounds. And his inflammatory markers that had been through the roof, his C-reactive protein, his sed rate, multiple different markers had normalized in one month. And after a few months, his anxiety went way down. So now, several years later, he continues on these every three weeks, has never needed another medication for his inflammatory bowel disease, and is doing very well.

I would say my success rate in IBD in improving their life, improving their stools is well over 75%. And something as remarkable as what he went through, that’s still really remarkable probably 30% to 40%; but moderately remarkable, definitely 60% or more.

DrMR: Great. Okay. So I think we’ve gone through a lot here that hopefully rounds out any of the edges that the audience may have been wondering about or struggling with, where I think we have identified helminths as a therapy to definitely consider, not the first thing to consider. But if you’ve gone through some of the frontline therapies and you haven’t seen the results that you’re looking for, this is definitely a therapy to consider. It shouldn’t be as eww factored as it may be sometimes because it’s fairly safe as we’ve established.

And if you proceed cautiously and slowly through the dosing ramp up and adjust your ramp up speed in correspondence to your reaction and all—if you have reaction—and also use anything, like, ibuprofen and OTC antihistamines to help buffer any reactions, you can do this therapy for about three to four months and evaluate if it can be helpful for you. And I definitely think it’s reasonable from a side effect and safety perspective, also from a cost perspective, and also from a philosophical perspective in terms of this is probably adding something back in that is now missing in our microbiota.

Episode Wrap-Up

So, yeah, I think this has been a great conversation. The final question I want to ask you, Nancy, is where people can connect with you and learn more from you. But before I ask that question, is there anything else that you’d like to leave the audience with on this topic?

DrNO: The main thing is just get over the ick and know that we are all made up of hundreds of trillions of germs, of microbes. And this is just one more that we may not have in our systems that we may need. And finally, if you have a child, your child has constipation, get that constipation treated first before you do anything. I mean, nothing is going to work as well if your child isn’t pooping. It’s not an apple a day that keeps the practitioner away, it’s the poop a day.

And then as far as—and all the rest of the stuff that you said was absolutely very well put. I think my freshman English teacher said to me, “What do you think your biggest problem is?” And I said, “Well, I tend to use too many words to say exactly what I mean.” And I went on and on for five minutes telling her and she finally said, “You mean, you’re too verbose?” So by the way, Michael, thank you for saying it so succinctly and so well.

Connecting with me, I do—unfortunately, for what I do for children with autism and PANDAS have a very long waiting list. But people are more than welcome to go to our website, which is ihealthnow, so the letter I, And there’s lots of information there. We have a neuropractitioner, a naturopath that joined us, who is wonderful and also very, very well informed, and lots of information there. And then also as I said, reaching out to biome restoration and to Dr. Baker. His is listed under primobiotics.

DrMR: Awesome. Awesome. Well, Nancy, I really appreciate taking the time because like I said, we’ve had Parker on, we’ve had Aglietti on, and now, I think, you just give us a nice clinical rounding together of all the information. So super appreciative of you taking the time. And also, thank you for doing the work that you’re doing. I think you’re really pioneering something that will, maybe in 10 years or so, be looked at as much more normal and accepted in a common place. But I’m glad that you’re kind of pushing this forward and doing what you’re doing.

DrNO: I hope so. And thanks for doing what you’re doing. Really appreciate you inviting me.

DrMR: My pleasure, Nancy. Thank you again.

What do you think? I would like to hear your thoughts or experience with this.

Dr. Ruscio is your leading functional and integrative doctor specializing in gut related disorders such as SIBO, leaky gut, Celiac, IBS and in thyroid disorders such as hypothyroid and hyperthyroid. For more information on how to become a patient, please contact our office. Serving the San Francisco bay area and distance patients via phone and Skype.


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