Pete Dixon

When I first got into hookworms to treat my several severe GI immune conditions, I was confused and filled with trepidation. Six years later, it all seems pretty simple, but I suppose perhaps everything is like that when you are starting out. 

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The first step is to purchase larvae from a provider listed in the Helminthic Therapy Wiki and when they arrive, slap them on your arm.

Afterwards to save money, if you are into DIY, several months later you can start to incubate to provide your own supply. Hookworms eggs will now be in your stool. A lot of them. The simplest method would be to smear infected poop on a stick and lean it in a bucket with water at the bottom. 

However, we can do a lot better than that. Hookworm larvae pose a threat and uncontrolled exposure would be dangerous. Initial inoculations these days are often recommended to be only 3 or 5 larvae so that the immune system can get used to their presence. You need to know exactly how many you are getting. To ensure control and safety of the incubation process, some refinements to the bucket concept are required.

The simplest and safest idea I've seen is to place a coffee filter smeared with a small amount of poop hung suspended above a small amount of water in a hermetically sealable jar. The filter should touch the water. These jars are tough to break and will keep odor in, as well as prevent the water from evaporating. Placed in the dark, 10 days later there should be 300-1000 L3 larvae sitting in water.

To harvest the larvae, you'll need a microscope to pipette drops from the jar water onto a slide or petri dish. From there you can either transfer larvae into another container for later use or directly wipe them onto a bandage for immediate application.

There are some techniques worth mentioning here. Safety is of utmost concern. The work surface must be covered with a plastic sheet (a garbage bag will do) and paper towel should be laid on it so you can see and deal with any spills. Plastic gloves must be worn, and pants and long sleeves aren't a bad idea (a lab coat would be ideal). I was pretty nervous my first couple of incubations and had some spills.

What I eventually realized is all I needed to was to crack open the jar and remove a mere milliliter or so of water via pipette and create a checkerboard pattern of very small drops on a petri dish. The drops should be about the width of the field of view of the microscope, which in my case is 1/2 a centimeter, or 5mm. Each drop will probably contain 0–3 larvae. If you are starting out, 3 larvae might be all you need. Wipe that drop or drops onto a bandage, apply it, and you are done.

Cleanup would involve pouring bleach into the jar, sealing it, and freezing for several days along with both it and any supplies that might have come into contact with larvae, including the petri dish, the pipette, the paper towels and the garbage bag. A large Ziplock bag is useful for this. Later, the jar's contents can be safely flushed and the other materials doubly bagged and tossed in the trash.

It wouldn't be a bad idea to practice the whole thing end to end a few times just using plain water until you've got the idea down.

Everything you need for incubation and inoculation is available on Amazon or AliExpress. I've skipped some details, like how much water to use in the jar, the amount of stool to use, and how to suspend the filter, pipette size, but those are just details. In this post, I just wanted to give the big picture.

The Helminthic Therapy Wiki has other incubation methods, and you can read about those here. In my experience, charcoal, vermiculite, incubators aren't necessary. Perhaps they lead to greater or more reliable yields for those folks, I don't know.

Before pursuing either inoculation or incubation, joining the Helminthic Therapy Support Group on Facebook is a must. Introduce yourself and mention what conditions you are attempting to treat. There's also a subgroup for those doing incubation. Giving the Wiki a solid read is important for you to understand what you are getting yourself into with Helminthic Therapy.