John Scott

I'm still trying my hand at hookworm incubation. This time I set 5 jars going all using the same method, namely small, hermetically sealable jars stuffed with a coffee filter smeared with a small amount of egg infected stool (mine) with about a 1/2 cm of mineral water at the base and left for 9 days. I made sure the filter paper always touched the water and that the stool was moistened well before smearing. To the best of my knowledge, I prepared each jar in exactly the same way. I even weighed the amount of water I used for the jars (27g each).
This time when I put samples under the microscope, four of the jars were barren, and one was an absolute 'A', a single drop from the jar having at least the 25 larvae I usually inoculate with.
I'll keep trying, but right now the theory that this is all about the egg deposition in the stool by the hookworm females appears to hold. If the stool sample hits a vein of deposited eggs, that jar will be successful, otherwise you'll get squat. I inoculate with 25 larvae. When people start out, they use considerably less, suggesting that their incubations will be less successful because there would be fewer hookworms laying eggs in the gut.
It is possible that there is some minor finesse causing jars to fail. Next time, I'll do my absolute best to make sure the jars are prepared as identically as possible.
My celiac disease and ulcerative colitis remain happily in remission, with my next inoculation due mid-January. The only recent weirdness is a new reactivity to mayo. I can eat eggs just fine, and I use oil in cooking, so what's up with that? According to Google (Healthline) - "Although the most common allergen in mayonnaise in egg, it's possible in rare cases to be allergic to some of the other ingredients, including: soybean oil, due to a soy allergy, especially if it's expeller pressed or cold pressed. lemon juice, due to a citrus allergy. vinegar, due to a sulfite allergy."

Last week I set four small jars going, and today I gave them a look. Two of the jars were completely devoid of larvae. The other two were "B-" results, enough for inoculation but would require a fair amount of work collecting the larvae as the observed quantity was low. Think maybe 5% of best jars I've seen so far.
I'm becoming convinced this is truly all about the quantity of eggs in the stool. If the colony is having an off day and not releasing many eggs, resulting incubations will always fare poorly, simple as that. That means incubating will forever be something of a crap shoot, requiring multiple jars and allowances being made for complete failure. However, turn around time being only a week, there should always be enough time for additional incubation attempts before experiencing a hookworm gut die off.

I followed the same technique I used last time that yielded such huge results, but this time basically I got zilch from two small jars. A few corpses and several uninspired zombie looking larvae moping around under my microscope's lens. Not enough to consider spending the time trying to get a harvest for an inoculation.
The only thing different this round was the heat. It's been consistently over 30C in my non-air conditioned apartment this week. Damn global warming!
Since I'm new at this hookworm incubation game, it's quite possible that what I'm seeing is a heat effect. I had planned on inoculating from this batch, but I do have plenty of time for up to three or four more tries before I run out of room. By September I would expect my existing gut buddies to start dying off. I'll use four jars next time. Fingers crossed.

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. 
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.
 
 
 

Hookworms and the three other helminths are used for a variety of immune conditions, not just celiac disease. John Scott just pointed me towards a collection of blogs like mine where people discuss their experiences at length like I do: https://helminthictherapywiki.org/wiki/Helminthic_therapy_blogs?fbclid=IwAR0U6tvguzLaQ0Tl-0gwC-zMPkJrMKIn2tZk018iHiDGuN8L0so01_lbcXA#Blogs
Which begs the question, what is the future for this blog?
What I've done so far is talk about my past, how I got into HT and what the results have been so far. Going forward what I expect to happen is I'll probably make one more order for hookworm larvae in October and then immediately set about getting a microscope and supplies so I can breed my own. It's not so much the money but with a 5-month cycle I'll be hitting weather constraints here in Canada. Larvae don't like temps below 5C. They die. Providers will typically re-send larvae for free but that doesn't necessarily solve the problem if the next batch freezes as well. So I'll be talking about the experience of self-supply, and whenever I learn something new about the HT field I'll talk about it.
Going forward for so long as my colony remains healthy odds are my celiac disease and ulcerative colitis will stay in remission. I don't believe I'll have any reason to venture into trying other helminths as I've had good success just using hookworms alone.

For long time followers of this blog will remember my account of my time at the start of my GI-trouble journey, which largely started in 2005-2008 when I was hit with an abscess, multiple corrective surgeries, ulcerative colitis and celiac disease. This was a particularly bad time in my life. After going gluten-free things got much better, I healed, but I was still left with many food sensitivities, including IBS symptoms and horrible gas.
Since I've been using hookworms, by and large I've been riding a cloud of normalcy. Stools are normal, well-formed, produced at an acceptable frequency and are painless. When my hookworms have died off because of ignorance or carelessness, my old symptoms return and I have to temporarily go back on a restricted gluten-free diet and suffer from low grade colitis symptoms regardless how cleanly I eat. Thirty days after larvae inoculation though, I'm back to good health.
So understanding all this, I've been disappointed recently seeing blood in my stool. I've seen this before. With ulcerative colitis I would regularly turn the bowl red. In fact, I was banned from donating blood for 5 years because of low iron, and it's only been recently that I've restarted donating. I've tracked down the problem to peanuts, both whole and peanut butter. So far as I know, peanuts are my only Achilles heel, though I suspect pistachios might have the same effect. 
I'm mid-cycle with hookworms, so I don't think I'm deficient in hookworm protection. I'm thinking rather I've probably always been vulnerable to peanuts and simply wasn't observant enough to notice. Not great, but this is a still far cry from the old days when any meat would have me screaming in pain and a sandwich would make me projectile vomit and feel like passing out.  
Googling, I found this article: https://pubmed.ncbi.nlm.nih.gov/9428217/. It talks about how peanut lectin interacts with cells in the colon in some individuals. Seems hookworms make my GI tract almost normal, but not 100% normal, and peanuts are simply beyond what hookworms can help with.
After my successful incubation last month, I took the opportunity to use some of the larvae for an early inoculation. I used 18 larvae. Going forward, I'm going to use 10 larvae every 2 months and see how that goes.

I now have all my supplies and my microscope. I ended up buying a better one than I had planned because after doing extensive reading I decided I wanted a dissecting scope, and I justified the extra money by considering it a lifetime investment since I'll be using it for probably the next 20 or so years.
Incubation will begin tomorrow and harvesting will occur 10 days after that. I'm not due for inoculation til April 5th, but there would be little harm in applying 5-10 collected larvae now to see how they fare.
From the Helminthic Therapy Wiki there are a wide variety of techniques that people employ for incubation and even the most practiced appear to experience failures. I have two months to get it right. Once I do succeed, I'll report back with my methods and materials.
I almost forget to mention that all is well gutwise. I'm 1/2 way through my 5-month hookworm cycle and my little symbionts appear to be doing their jobs well. I'm not experiencing any colitis or celiac symptoms whatsoever.

About 10 days ago I was called away out of my city on a family emergency. I had to leave on a Sunday, just before the courier with my hookworms were to arrive. I was frantic because were they to be sent back or lost I might not be able to get more until the spring as larvae often are killed in the cold weather. If that happened, I would soon have to go gluten-free and would experience colitis for months till I could reorder when the weather warmed.
The package was sent internationally but I learned it was carried after the border by Canada Post. I received on Tuesday by first email of a delivery attempt. From my parent's home I called my local post office and discovered that they could hold my package for two weeks before it was sent back. Luckily I got back in 8 days and was able to collect it. If things had turned out differently I might not have gotten back to my city for a month and the larvae would have been lost to me.
Yesterday morning I applied them. I was still distracted so I messed up a bit. The idea is always to take the larvae vial and pour it on the gauze, then use the pipette to use the included saline to rinse the larvae vial to collect any stragglers. I just used the pipette to collect the saline and squirt it on the gauze, so I missed any in the larvae vial. Oh well. I had ordered 25 larvae, more than enough, so if I lost a few it's likely not a big deal.
I left the gauze on my arm for 6 hours and then applied the steroid cream. As usual I had felt the tingling as they buried through the skin. Not painful. Like a tickle if anything. Today the entry site was periodically itchy, something I felt like rubbing every hour or so. No big deal. It's starting to get red now and will probably hit maximum ugliness in 2–3 days before it starts healing.
Aside from cost, the delivery drama of getting larvae gets old. Larvae can be delayed or intercepted by customs. Providers generally resend shipments, but the delay has a real effect if you are following an inoculation schedule. I once went an entire winter gluten-free because a delayed shipment (43 days) caused the larvae to be exposed to cold weather killing them.
Hopefully with my plan to self-supply going forward these delivery concerns are over.
 

It's been suggested that I clarify my claim of being celiac. Something of some importance as I am making the claim that at least for myself using hookworms has improved my life as a celiac, and making that claim on a celiac-oriented site no less.
I have never had a positive biopsy test for celiac disease. There, I've said it.
That said, I maintain that there is very little doubt that I am celiac, and the only reason I don't have that positive test is that I get far, far too sick to be able to do the 6-8 gluten prep pre-biopsy. I'm talking non-stop diarrhea and vomiting for that entire period of the prep - often simultaneous diarrhea and vomiting - all to tell me something I already know. I refused to do that gluten eating prep back in 2008, and I will never do it in the future.
My aunt and cousin on my father side are both certified celiacs with identical celiac symptoms to me, though without my colitis. I also experienced dermatitis herpetiformis (DH) on my temple, though I didn't know that's what it was at the time. My celiac disease activated when I was 42 and a half and carried on till I was 45 when I recognized it was gluten that was making me sick. My up to 11x a day bouts of diarrhea ended the day when I stopped consuming gluten.
Over the next 10 years (2008-2018) I was glutened about 20x, mostly concentrated in the beginning when I was learning the ropes. Surprises like flour being put into packages of pistachios, a generic antihistamine's capsule being made from gluten instead of corn starch like the brand name antihistamine. During those years I did everything I could to avoid gluten exposures, rarely eating out of the home and never knowingly taking chances. My gluten exposures always resulted in violent reactions.
I apologize if anyone feels misled, but for me the evidence is overwhelming that natively I am a highly reactive celiac. To prove that though I would have to kill off my hookworms, wait perhaps another 6 months until their effects on my immune system were totally gone, and then endure 1.5-2 months of torture to prove something I don't need proof of. Ain't gonna happen.
Anyway, for the remaining doubters, I put to you the following: I deliberately infect myself with hookworms. Who in their right mind would do that without good reason?

https://doi.org/10.1093/ibd/izad110 
Published June 15, 2023 in the journal of Inflammatory Bowel Diseases, this study is expressly for ulcerative colitis, but because the focus was on safety and tolerance of hookworms as a treatment, the results should apply for any of the myriad conditions people use hookworms to treat. It's a pilot study paving the way for future full-scale randomized controlled trials regarding efficacy.
The study used 30 Necator americanus larvae. The self-treating community has moved away from the practice of using such a large initial larvae number because of the tendency to create a phenomenon we call worm flu, so what discomfort the study participants experienced would be expected to be less when treating in a home setting.
I think it's great this level of research is being carried out. It's a sign of real interest in proving out the results the community of helminth self-treaters see in their daily lives. For now though what have presented here is evidence that using hookworms is practical (feasible, safe, and well-tolerated), and that's a good start.
 

I've had plenty of gluten goodness sitting in my freezer for a month now and the siren call from them was too much for me to bear. A donut and a Crustini sacrificed themselves for science last night. Aside from a little gas I've had no reaction - just feeling fine. So that it's it, 30 days and I'm back in remission.
I apologize for the dramatics but as all celiacs know, risking a gluten exposure is not for the faint of heart. Back in the day I've had some hella violent reactions where I became quite violently ill for hours or days at a time. And even though I've been working with hookworms since 2018 I'm still learning the rules.
This is what I know now, for me:
I'm a guy who demonstrates all the symptoms of celiac disease and has close celiac confirmed relatives (my father's sister and her son). I also have medically diagnosed and treated ulcerative colitis. Back in 2005-2008 my life was absolute hell when I was still consuming gluten and the meat and nuts that would trigger the colitis attacks. It was so bad I contemplated suicide as I had no quality of life.
With a perfect diet I was much better but still always vulnerable to gluten exposure and the colitis persisted, albeit at a much lower level. Fish and eggs were ok, but all other meat products were off the menu. By 2018 the number of safe foods that I believed wouldn't cause a reaction was about 12. I survived on rice, potatoes, sardines, eggs and fruit.
Using hookworms appears to remove all food restrictions barring a milk intolerance which I expect is not immune-related. From date of application of the hookworm larvae on my arm it takes 30 days for my immune system to be returned to a normal, healthy status. That number might be as early as 25 days but it's not worth risking getting sick to find out the true lower bound. 30 days works.
Protection from symptoms appears to last 5 and a half to 6 months before the hookworms either are killed off or age out, making reinoculation a regular requirement. My last inoculation was May 31st from an order date of May 22nd. Allowing for delivery of ~10 days that would make my next reorder date in 5 months to be Oct 22nd, 2023.
Inoculating more frequently would be sensible but there is also the issue of cost. Each batch of larvae ordered with tracking costs more than $200 a pop, which for me is not insignificant. There's also the matter of cold potentially killing the larvae in transit. Plenty of people who pursue Helminthic Therapy incubate hookworms sourced from the eggs that appear in the stool. Increasingly I'm thinking that might be the path I'll be taking. That would require a microscope, some supplies and trial and error. The user group does offer video instruction and other support on how to do it. Something to keep me occupied next winter.
Again, for those interested in getting started with hookworms to treat celiac disease and other immune related conditions, The Helminthic Therapy Wiki (Google it) and the Helminthic Therapy Support Group on Facebook are your primary sources.
Thanks for reading.
 
 
 

Not much to report. My GI issues have all cleared up, but that's probably because I've gone gluten-free for the month of June. My entry wound has almost entirely healed. Aside from a touch of redness it should be 100% in a couple of days. That steroid cream made a huge difference, not in pain or discomfort really but certainly in aesthetics. Previously the entry wound was ugly enough to scare children.
The way the life cycle of the hookworms works after about a week the larvae drill through the lungs and crawl up the trachea to the larynx where they get swallowed down to the gut. Quite the journey if you think about it. From my reading their goal is the top of the jejunum, the top segment of the small intestine. They stay there attached to the wall of the intestine for the rest of their days, drinking about a drop of blood each per day. It takes about a month until they reach maturity, and that'll be the point where I'd feel comfortable doing a gluten test.
It's been interesting going gluten-free again. For me a gluten-free diet is sort of like riding a bike, you don't forget all the rules and precautions. I don't think I'd get critically ill from gluten what with some of the old guard likely still there and perhaps some contribution from the newbies, but a risking a day of diarrhea over a sandwich doesn't seem like a good deal. I can wait.