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Mark Garzon, MD National Integrated Health Associates Capital University of Integrative Medicine April 18, 2003 P arasites are any organism that derives its food, nutrition and shelter by living in or on another organism. Parasites are very common in nature with more organisms categorized as parasites as opposed to those that are non-parasites. Humans can be host to over 100 different types of parasites. We often perceive parasites to be a disease of developing nations and, in countries with poor sanitation, this may be true; however, in November 1993 the National Institute of Allergy …over 4 billion people infected and Infectious Disease (NIAID) reported that with parasitic disease parasites in the U.S. affects millions of Americans. The Centers for Disease Control (CDC) estimates that between 100,000 and 1,000,000 cases of Giardia lamblia occur each year. In the Spring of 1993, 100 persons died and 400,000 became seriously ill because of contamination of the water supply in Milwaukee by the parasite, Cryptosporidium. A nationwide survey by the CDC in 1976 estimated that one in every six people, selected at random, had one or more parasites. Circulated worldwide, the Journal of the American Medical Association (JAMA) reported in 1984 that more than one-half of the 8.3 billion people on Earth were infected with parasitic disease. One person can pass millions of G. lamblia cysts each day, and most infections probably result from ingestion of water or food contaminated with human sewage. Open sewers in city streets and contamination of drinking water with this sewage undoubtedly results in many infections. Many cases of "traveler's diarrhea" are caused by Giardia. Even in developed countries potable water can be contaminated with small amounts of sewage, especially when septic systems are built too close to wells. Thus, it is not surprising that G. lamblia is found throughout the world. Every year many people return from camping trips to find that they are suffering Ingestion of one or more cysts may cause disease, as from giardiasis, but the source of these contrasted to most bacterial illnesses where hundreds to thousands of organisms must be consumed to infections remains uncertain. Some produce illness. http://vm.cfsan.fda.gov/~mow/chap22.html authorities believe that Giardia infects a number of animals other than humans, particularly beavers, and that campers contract giardiasis from drinking stream water contaminated with cysts from beavers (hence, "beaver fever"). Other authorities, however, believe that these cases result from streams contaminated with human feces. Although mountain streams may appear to be "sparkling clean," some camper upstream may be using your drinking water as a toilet! Thus, no matter what it looks like, stream water should be treated before drinking. Boiling will kill Giardia cysts, and there are commercially available filters that will remove the cysts from water. http://www.biosci.ohio-state.edu/~parasite/giardia.html Why is there a rise in parasitic infection in non-developing countries? Rise in international travel We are a people on the move. Air travel in just another means of transportation and people who visit other countries are exposed to different organisms. In St. Petersburg, Russia the city’s tap water is infected with Giardia. Visitors to Nepal are routinely stricken with this same parasite. Symptoms are Giardia infection include severe diarrhea, fever, chills, muscle pain, and intestinal bloating. Chronic illness has been known to cause irritable bowel syndrome (IBS) and chronic fatigue. Travelers to China often return with roundworms caused by widespread agricultural use of night soil (human waste). The pulmonary phase of the infection can cause cough, wheezing, and bronchial spasms. The intestinal phase may mimic peptic ulcer. The CDC warns travelers to African countries on the dangers of bathing in fresh water that may be infected with blood flukes (shistosomiasis), which can cause fever and chills, eosinophilia (extensive infiltration of gastric mucosa with eosinophils), abdominal pain and enlargement of the liver and spleen. Water contamination Once the organism, Cryotosporidium parvum, became resistant to chlorine, it easily spread in hospitals, daycare centers, and households. A 1993 report showed contamination of water supplies in one-quarter of fourteen states that were tested. Once seen only in mountain streams and international water supplies, Giardia lamblia may now be in 50% of all American water supplies, according to Dr. Steven Rochlitz. Giardia is not killed by chlorination. Drinking water is further contaminated by rural and urban watersheds through human sewage due to inadequate purification systems. Day Care Centers Giardia outbreaks due to the growth of day care centers for diapered children have resulted in rampant parasitic infections nationwide. The CDC estimates 20,000 new cases yearly. In a CDC survey of various American child day care centers, it found astounding results. In a center in Fulton County, Georgia 25% of all the children were infected with Giardia. In New Haven, Connecticut 50% of the children were infected and in Anaheim, California there was a 43% infection rate. Giardia cysts easily lodge under fingernails and spread from one child to the next during diaper changes. Giardia also is transmitted through fecal contact with toys, through drinking faucets and through hand-to-mouth contact. The Centers for Disease Control estimates that 20% of parents caring for sick children become infected with Giardia. Immigration Immigrants from the South Pacific, Mexico, South America, Asia and Haiti may be carriers without having any overt symptoms of disease. New immigrants often work in restaurants where food contamination may occur. In 1992 in New York City, CT scans showed pork tapeworm cysts in the brains of four Orthodox Jews, who had never eaten pork. The link among these individuals was a Central American housekeeper who had contaminated the food sources. Armed Forces During the Viet Nam War thousands of returning troops carried parasite-induced diseases. Nearly 54,000 soldiers returning from Operation Desert Storm were told not to donate blood because of the high incidence of the parasitic disease leishmaniasis, spread by desert sand flies. Pets Pets are hosts to numerous parasites and the unexpected spreaders of disease. There are 240 infectious diseases spread by animals to humans: 65 by dogs and 39 by cats. Dogs are known to carry Giardia lamblia picked up by ground water or animal waste. Of all house cats in America, 85% sleep with their owners. Dog and cat roundworm, hookworm, and cat-transmitted toxoplasmosis can become severe in a pregnant woman (see appendix 4) and even lifethreatening if immuno-compromised. Parasites can also be transmitted by raccoons, birds, rodents, and rabbits as well. In one case, a one-year old boy nearly died after contracting microscopic roundworm eggs commonly found in raccoon feces. Processed and Sugary Foods As with any organism, parasites need food. Parasites thrive in a sugar-laden environment. The average American eats approximately 150 pounds of sugar per year. A diet change could cut the food supply to any parasites. Changes in diet, such as avoidance of simple sugars (sucrose and white sugar), are vital. Carbohydrates break down into sugars. Some complex carbohydrates like corn, potatoes, brown rice and whole wheat are quickly absorbed by our bodies in much the same way as simple sugars are. Exotic Foods Raw or undercooked foods have led to an increased incidence of parasites. The usual suspects in this category include sushi, sashimi, steak tar tare, ceviche, and Dutch herring. Pacific red snapper and Pacific salmon are most frequently infested with anisakid worms, a parasite also found in Atlantic haddock. Aniskid larvae will survive undercooking and/or microwave cooking. The illness resulting from these worms is called anisakiasis, a gastrointestinal illness resembling Crohn’s disease; stomach ulcers, and appendicitis. Another culprit is cyclospora. Several outbreaks of illness were reported due to this parasite, the worst of which involved 1,000 persons becoming ill from tainted raspberries imported from Guatemala. Antibiotics and Immunosuppressive Drugs When the gastrointestinal tract is in a healthy balance there is less opportunity for parasitic infections. Antibiotics cause yeast overgrowth, which in turn promotes Trichomonas vaginalis infection, the symptoms of which include foul-smelling vaginal discharge, burning sensation, and inflammation. In some areas of the country Trichomonas is found in 50% of all women. When passed to the male partner it can cause non-specific urethritis. Immuno-compromised, or those undergoing immunosuppressive therapy for cancer or organ transplant, are at far greater risk for life-threatening toxoplasmosis. The Sexual Revolution An increase in the number of sexual partners directly increases the likelihood of Trichomonas vaginalis, Entamoeba histolytica, Giardia lamblia, pinworms, and pork tapeworms. HIV/AIDS Persons infected with HIV/AIDS are very vulnerable to many opportunistic infections. A connection has been demonstrated between AIDS and amebiasis, Pneumocystis carinii, cryptosporidiosis, and strongyloidiasis. In 1985 PBS aired a show on Nova entitled, “Conquest of the Parasites”, in which it documented parasites as the “great neglected diseases”. “Great” because they affect hundreds of millions of people and neglected by the public, physicians, and the political and funding agencies of the world. Hookworm disease affected 900 million people, ending in death for 60,000, but the world’s agencies spend less than $1 million on hookworm research. Warning Signs of Parasite Infection Constipation Some worms can physically obstruct certain organs. Blockage of the common bile duct in the gall bladder and the intestinal tract can make elimination infrequent and difficult. Diarrhea Some parasites, primarily protozoa, produce a prostaglandin that creates a sodium and chloride loss that leads to frequent, watery stools. Gas and Bloating Some parasites live in the upper small intestine, where the inflammation they produce causes both gas and bloating. This problem worsens with the eating of hard-to-digest foods such as beans, raw fruits and raw vegetables. Persistent abdominal distension is a frequent sign of hidden invaders. Irritable Bowel Syndrome Parasites can irritate, inflame and coat the intestinal cell wall, leading to a variety of gastrointestinal symptoms and malabsorption of vital nutrients, particularly fatty substance. The malabsorption leads to bulky stools and excess fat in the feces (steatorrhea). Joint and Muscle Aches and Pains Parasites can migrate and become enclosed in a sac (encyst) in joint fluids, and worms can encyst in the muscles. When this happens, pain becomes evident and is often assumed to be arthritis. Joint and muscle pain and inflammation are also the result of tissue damage caused by the body’s ongoing immune response. Anemia Some intestinal worms attach themselves to the mucosal lining of the intestines and leach nutrients from the human host. If they are present in large enough numbers, they can create enough blood loss to cause a type of iron deficiency. Allergy Parasites can irritate and sometimes perforate the intestinal lining, increasing bowel permeability to large undigested molecules. This can activate the body’s immune response to produce increased levels of eosinophils. The eosinophils can inflame the body tissue, resulting in an allergic reaction. Skin Conditions Intestinal worms can cause hives, rashes, eczema and other allergic-type skin reactions. Protozoa invasion can cause cutaneous ulcers, swelling and sores, papular lesions and dermatitis. Granulomas Granulomas are tumor-like masses that encase destroyed larva or parasitic eggs. They most often develop in the colon or rectal walls, but can also be found in the lungs, liver, peritoneum, and uterus. Anxiety Metabolic wastes and toxic substances form parasites can act as irritants to the central nervous system. Restlessness and anxiety are often the result of parasitic infestation. Insomnia Awakening during the night, particularly between 2 and 4 am are possibly caused by the body’s attempts to eliminate toxic wastes via the liver. Teeth Grinding Bruxism has been observed in cases of parasitic infection. Most notable in sleeping children, this is thought to be a nervous response to a foreign irritant. Chronic Fatigue Tiredness, flu-like complaints, apathy, depression, impaired concentration, and faulty memory may all be symptomatic of malnutrition. In the presence of a parasitic infection, malnutrition results from malabsorption of proteins, carbohydrate, fats and especially vitamins A and B12. Immune Dysfunction Parasites depress immune system functioning by decreasing the secretion of IgA. IgA deficiency results from low levels of or complete absence of immune globulin A, which causes decreased immune function in the mucosal surfaces (e.g., mouth, gastrointestinal tract, and lungs) and results in increased risk for respiratory and gastrointestinal infections. It is associated with autoimmune diseases. The presence of parasites continuously stimulates the immune response and eventually can exhaust it, leaving the body vulnerable to bacterial and viral infections. Diagnosis As with any illness, suspicion and recognition that there may be a problem are the first steps in reaching a diagnosis (see questionnaire, appendix 5). Traditionally, diagnosis is reached through laboratory analysis of stool specimens; however, these tests can be misleading. Some parasites reside in the blood and tissue (malaria, filariasis, trichinosis) and will not be seen in the stool samples. Parasites more prevalent in children, such as pinworm and dogworms (visceral larva milagrans) are rarely seen in the stool. Many parasites do not appear in the stool because they dwell in the gastrointestinal lining (lumen). They strongly adhere to the intestinal mucosa, unless they are pulled out from the lining. Even with parasites, the drive to survive is strong. Parasites do not willingly exit a host that is supplying adequate food and shelter. In some species, for example Entamoeba histolytica, Giardia lamblia, and stronglyloides, the cyst, egg or segment secretion varies from day to day. Most parasitologists suggest examination of three stool samples. Some even recommend up to nine samples, if the first three are negative and clinical symptoms persist. Even with this many samples, the diagnosis may still be missed. Some substances can suppress the shedding of amoebas into stool, but don’t kill the parasites. These substances are barium, bismuth, kaolin, soapsuds enemas, and antibiotics. Broadspectrum antibiotics may prevent the shedding of amoeba for months. Examples of broadspectrum antibiotics currently in use are: Zithromax (azithromycin), Biaxin (clarithromycin), Augmentin (amoxicillin-clavulavate), Cipro (ciprofloxacin), Floxin (ofloxacin), Levaquin (levofloxacin), Zagam (sparfloxacin), and Trovan (trovafloxacin). Here are some of the more accurate methods of testing currently available: Purged Stool Test This is widely considered superior to the random stool tests. This is the test of choice for identifying the presence of Giardia, amoeba, roundworm, threadworm, tapeworm, hookworm, Cryptosporidium, liver flukes, blood flukes, Strongyloides, and blastocystis. Parasites rarely appear before the fourth bowel movement and often as many as twelve are required to yield a positive result. The test begins with 1.5 ounces of Fleet Phospho-Soda on an empty stomach. Care must be taken with hypertensive patients, in which case 2-3 tablespoons of Epsom salts in a large glass of warm water can be substituted. This test is contraindicated in the presence of gastrointestinal obstruction, pregnancy, appendicitis, and debilitation. Bueno-Parrish Test This test involves a rectal mucus swab combined with immunofluorescent stains that identify Giardia and Cryptosporidium. There is a high rate of positive findings using this method, even with a negative purged stool test. In a test case of patients suffering from irritable bowel syndrome, almost 50% were found to have Giardia infection using the Bueno-Parrish Test. String Test There are other methods of discovery if both the purged stool test and the Bueno-Parrish Test have revealed negative results and if Giardia is still strongly suspected. These tests are Enterotest (string test), duodenal aspiration, and duodenojejunal biopsy. The string test is most simple. The patient swallows a gelatin capsule containing a string. One end of the string is attached to the patient’s cheek while the other is attached to the capsule. As 3-4 hours the string is withdrawn through the mouth and mucous examined microscopically. This test is also effective for diagnosing Strongyloides. Blood Tests and Other Laboratory Tests Eosinophil count – Roundworm and hookworm can increase eosinophil count (eosinophilia) by 25%, strongyloides may increase eosinophils by greater than 25%. Toxocara and pinworm may also cause eosinophilia. Giardia and amoeba rarely cause eosinophilia. Many physicians dismiss elevated eosinophils as an indicator of allergy, not realizing primary allergy is parasite itself. Low serum protein and potassium – This can indicate the presence of Strongyloides. Low vitamin B12 – This may indicate the presence of fish tapeworm. Low folic acid, iron, and calcium levels – This may mean Giardia. Low serum iron – This may indicate the presence of hookworm. Elevated alkaline phosphatase – This has been found in cases of amebiasis. Serum antibody tests – This is available for Entamoeba histolytica, Strongyloides; blood, liver, and lung flukes; Toxacara canis, Leishmania, Toxoplasma gondii, malaria, filarial, cysticerci, heartworm, and Trichinella spiralis. Salivary GI tests – There is a saliva test available for detecting Entamoeba histolytica. The saliva tests are also good for testing allergic-type responses to certain foods such gliadin and milk. Urine tests – There are urine tests to detect the presence of blood fluke eggs and microfilariae in filarial infection. Tissue swabs – Perianal swabbing can be used to recover eggs of the pork tapeworm, beef tapeworm, and blood fluke. Regular, household Scotch tape is used to test for pinworm. The female adult worm lays eggs around the perianal area in the early morning hours. Specimens are best obtained at these hours before bathing. Transparent tape pressed against both sides of the anal and perianal area are then transferred to a glass slide for microscopic examination. Cultures – Strongyloides are among the easiest parasites to culture from stool. Intestinal amoeba, roundworm, blood fluke, and Leishmania have also been successfully cultured. Prenatal tests – Toxoplasmosis infection of the fetus can be detected by ultrasound. Toxoplasmosis infection can cause mental retardation and blindness. Some countries require all pregnant women to be tested for toxoplasmosis. Now available, is a blood anti-Toxoplasma antibody test which provides a fast screening test. During her annual Pap smear, a woman can insist of screening for pinworms, Ascaris and filaria (all of which have been found in the vagina). Types of Parasites There are 300 different types of parasites in the United States today. The Centers for Disease Control estimates the number to be much higher, even in the thousands. Parasites are categorized according to their structure, shape, function, and reproductive ability. Categories of Parasites • • • • Nematodes (Nematoda) include roundworms, pinworms, and hookworms. Protozoa are single-celled organisms that include Toxoplasma, Giardia, Cryptosporidium, and amoeba. Tapeworms (Cestoda) Flukes (Trematoda) The most common gastrointestinal parasites are roundworms, pinworms, and tapeworms. Roundworms (Ascaris lumbricoides) are the most common intestinal parasite in the world. About 1 billion persons are currently infected with this organism. This creature is spread directly to humans from soil or from food contaminated with feces. Children are very prone roundworm infection. Although CDC/Division of Parasitic Diseases: roundworms are found worldwide, they are more prevalent http://www.cdc.gov/ncidod/dpd/ in tropical and subtropical areas, especially in Asian countries which practice crop fertilization with “night soil” (raw human sewage). These worms are mobile and can travel up into the liver, heart and lungs; growing up to 35 cm in length. Persons with this infection suffer from malnutrition due to competition for food and the inhibition of absorption of proteins, fats, and carbohydrates. Roundworms are diagnosed when their eggs are found in a stool specimen. Pinworms (Enterobius vermicularis) are the most common of all worms in the United States, most prevalent in children. Pinworm infestation is picked up through contact with contaminated food, water, house dust, as well as human contact. The adult female moves outside the anus to lay eggs, then the eggs are transferred from itching anal area to the mouth. Pinworms can quickly transmit to the entire family through the bathtub, toilet and bed clothes. Perianal itching is the most common symptom. A ten-year study of 2,000 cases of pinworm in children linked seemingly unrelated symptoms, i.e. epilepsy, hyperactivity, and vision problems. The treatment for pinworms is the prescription drug, Vermox (chewable). Tapeworms are found in three types of meats -- each a different species, all treated the same. They are the beef tapeworm (Taenia saginata), pork tapeworm (Taenia solium), and fish tapeworm (Diphyllobothrium latum). Despite its size, several feet in length, the beef tapeworm does not produce many symptoms. It thrives on carbohydrates consumed by its host, utilizing the tissue of its host for a source of protein. Thankfully, most beef tapeworms live a solitary life, but that life usually lasts twenty to twenty-five years. The common symptoms of this infection are diarrhea, abdominal cramping, nervousness, nausea, and loss of appetite. The treatment is the prescription drug, Biltricide. The pork tapeworm is similar to the beef tapeworm, but shorter in size. These worms are typically transmitted to their human host through undercooked pork, such as fresh or smoked ham or sausage. These parasites usually produce multiple worms living in the same host. Immature larvae can migrate into the muscles, heart, eyes, and brain. The treatment is the prescription drug, Biltricide. The fish tapeworm is the largest parasite found in humans. Commonly found in Scandinavia, Russia, Japan, Australia, the Great Lakes of North America, Canada, and Alaska, this parasite can be contracted by eating raw or lightly cooked freshwater or migratory fish. The list of fish includes Alaskan salmon, perch, pike, pickerel, and American turbot. The most common symptoms are pain and fullness of the abdomen, nausea, and anorexia. The most debilitating effect of this infection is a B12 deficiency or pernicious anemia. The treatment is the prescription drug, Biltricide. Treatment The goal of any parasitic treatment is to eradicate the parasites and not just relieve the symptoms. People who live together can infect one another when making food for one another or sharing the bathroom. It’s a good idea to treat all household members at the same time. The protocol for treatment of gastrointestinal parasites is as follows: • • • • • Cleansing the intestinal tract Modifying the diet Administering parasitic elimination substances Recolonizing the GI tract with friendly bacteria Avoiding re-infection by eliminating risk factors Cleansing This process is important because parasites often are embedded in the intestinal wall and can be more difficult to treat because of mucus and encrusted matter overlying the worms. Guidelines for a thorough cleanse include: • • • Using products containing psyllium seed husk fiber, flaxseed fiber and bran fiber all of which are gentle and effective bulking agents for removal of accumulated wastes Drinking plenty of water, as water absorption lubricates old fecal matter Irrigating the colon through colon hydrotherapy dislodges and removes toxins in the large intestine Modifying the diet, the goal being to support the host and starve the parasite. A diet high in simple carbohydrates like sugar, white flour and processed foods provides an ideal feeding ground for worms. A diet low in fiber may have initially provided a breeding ground for parasites, slowing down food passage, allowing food to decay and putrefy (producing stagnation in the colon). A good modified diet would include: • 25% good-quality fat, including one to two tablespoons of unprocessed expeller pressed safflower, sesame, flax oil or omega oil blend (Udo’s Choice or Pharmax 3:6:9) • 25% protein, which provides amino acid building blocks for tissue regeneration. Good sources of protein would be well-cooked meat, chicken, fish and eggs. High fiber protein sources such as beans, nuts, seeds, peas, and legumes may produce flatulence and may be more irritating to the GI tract than bulking agents like psyllium, flaxseed, and bran. • Avoidance of foods that produce an alkaline condition (see appendix 6). An overly alkaline condition in the GI tract provides a favorable environment for parasites. Soy products leave an alkaline residue in the GI tract and should be eaten in moderation, i.e. not more than 1-2 servings a week. • Limiting or avoiding dairy products. Some parasites like Giardia and roundworm may precipitate a secondary lactose intolerance that may persist for months after elimination of parasites. • Limiting gluten in diet. Giardia can produce gluten intolerance. All protozoan infection can damage the intestinal villi, so reduce grain intake should be encouraged (gluten-free rice and millet are acceptable). • Avoiding raw fruits and vegetables. Raw fruits and vegetables, plus cold or iced drinks, can cause the intestines to contract, thereby holding in toxins. Cook most fruits and vegetables so that they are more easily digested. • Digestive enzymes. Well-absorbed vitamin and mineral supplementation will be helpful. (A tapeworm is able to absorb up to 75-100% of physiological dose of vitamin B12.) Digestive enzymes with meals are important for complete digestion of foods. Administering parasite elimination substances, may mean assaulting the parasite using a combination of substances, including prescription and herbal, plus the device described next. Sputnik is a metal capsule with a battery inside that taken orally. According to the website (http://parasiteremedies.com/) the capsule emits frequencies that are lethal to parasites as it passes through the GI tract. The capsule consists of two hemispheres, which serve as electrodes. It switches itself on as soon as it finds itself in the electrolyte environment of the GI system. The capsule dimensions are 11 X 22.5 mm. The strength of the pulse is 10 mA, the amplitude is 4.5 V, and the frequency is 50 Hertz. Average passage through the body is 24-36 hours. Not every administration of the capsule will produce visual evidence of parasites. The smaller ones will have disintegrated and will not be in evidence. In the case of larger parasites, e.g. tapeworms, the parasites emerge shredded into sections, killed by the current of the capsule and forcibly expelled by the strong peristaltic waves induced in the intestinal tract. Prescription Anti-Parasite Remedies Antihelminthic drugs are available only with a prescription and are available as liquids, tablets or capsules. Some commonly used antihelminthics include: albendazole (Albenza), mebendazole (Vermox), niclosamide (Niclocide), oxamniquine (Vansil), praziquantel (Biltricide), pyrantel (Antiminth), pyantel pamoate (Antiminth) and thiabendazole Helminth: (Mintezol). An intestinal vermiform parasite, primarily nematodes, cestodes, trematodes, and canthocephalans. Regular medical visits are recommended for people affected by parasitic infestations. The physician monitors whether the infection is clearing or not and also keeps track of unwanted side effects. The prescribing physician should be informed if symptoms do not disappear or if they get worse. http://www.principalhealthnews.com/topic/parasitedrugs Herbal remedies and homeopathic remedies have long been used to eliminate parasites. Due to the vast number of illnesses implicating parasites as the cause, a regular natural digestive detoxification program including an anti-parasite formula and colon cleanser to promote proper elimination has been recommended by Suggested Reading various naturopaths. Parasites: The Enemy Within by Hanna Kroeger • • • • • • • • • • • Black Walnut Extract is regularly used for destroying most types of intestinal worms. Various formulated products are available. You may experience diarrhea while using products with black walnut as the body flushes the intestines. Grapefruit Seed Extract is also effective in destroying parasites and may be taken internally and used to wash raw fruits and vegetables before eating. Cayenne, garlic, and turmeric support proper immune system function and help destroy some worms. Aloe Vera Juice may be taken to sooth the system Acidophilus helps restores normal friendly bacteria levels to the intestines. Essential Fatty Acids may help protect the intestinal tract Multivitamin & MultiMineral Complex supports proper nutrition Vitamin B complex may help prevent anemia caused by parasites Bromelain may help to destroy tapeworms Witch Hazel may be used to reduce anal itching Monastery of Herbs, herbal combinations that are very effective against parasite infestation. http://www.herbalremedies.com/cenfordiscon.html Other herbals which are helpful in the elimination of parasites and detoxifying the body are: elecampane root licorice root pink root sage fennel tansy cranberry powder garlic Irish moss peppermint leaves goldenseal cloves oil of oregano alfalfa leaves anise leaves buckthorn bark wormwood thyme male fern Homeopathic remedies: for liver flukes for hookworm/roundworm for pinworm for tapeworm for roundworm Chelidonium Chenopodium Cina Felix mas Santonium Recolonization of the Intestinal Tract Reintroduction of friendly bacteria into the gastrointestinal tract following eradication of parasites helps detoxify noxious substances, maintain proper pH and is a natural antibiotic, protecting against future infection. The use of an excellent-quality probiotic such as Pharmax’s HLC line is highly recommended. Avoiding re-infection by eliminating risk factors is perhaps the culmination of a learned lesson (see appendix 5). Once infected and then cleansed of parasitic hitchhikers, a wise person will take note of how the infected was initially contracted and take precautions to prevent additional infestations. Appendix 1 http://www.biosci.ohio-state.edu/~parasite/lifecycles/giardia_lifecycle.html Appendix 2 Important Supplements Due to the vast number of illnesses implicating parasites as the cause, a regular natural digestive detoxification program including an anti-parasite formula and colon cleanser to promote proper elimination has been recommended by various naturopaths. • • • • • • • • • • • Black Walnut Extract is regularly used for destroying most types of intestinal worms. Various formulated products are available. You may experience diarrhea while using products with Black walnut as the body flushes the intestines. Grapefruit Seed Extract is also effective in destroying parasites and may be taken internally and used to wash raw fruits and vegetables before eating. Cayenne, garlic, and turmeric support proper immune system function and help destroy some worms. Aloe Vera Juice may be taken to sooth the system Acidophilus helps restores normal friendly bacteria levels to the intestines. Essential Fatty Acids may help protect the intestinal tract Multivitamin & MultiMineral Complex supports proper nutrition Vitamin B complex may help prevent anemia caused by parasites Bromelain may help to destroy tapeworms Witch Hazel may be used to reduce anal itching Monastery of Herbs, herbal combinations that are very effective against parasite infestation http://www.herbalremedies.com/cenfordiscon.html Appendix 3 Intestinal Parasites Screening Rate the symptoms listed below using the symptom scale: 0 = never 1 = seldom 2 = occasionally 3 = frequently 4 = infrequently with severe symptoms 5 = almost always contact with animals anal itch, fissures, rashes family members infected eating meats cooked rare constipation food allergies hives chronic fungal infections eating sugary/starchy junk foods contact with grass, clay skin problems chronic fatigue eating processed meats, ham, etc. bloating, flatulence diarrhea have had parasites before abdominal cramps, pain Appendix 4 Specific Recommendations for Pregnant Women A pregnant woman (or one who contemplates pregnancy) can minimize exposure to Toxoplasma by taking the following measures: • • • • • • • • • Exclude rare or undercooked meat and non-pasteurized dairy products from the diet. Test household cats for antibodies to Toxoplasma. Assuming that a cat is healthy, a positive antibody test indicates that the animal is most probably immune and not excreting oocysts and thus would be an unlikely source of infection. A healthy antibody-negative cat is most probably susceptible to infection and would shed oocysts for one to two weeks after exposure to Toxoplasma. If possible, the cat should be tested before the woman becomes pregnant. Have herself tested for antibodies, preferably before becoming pregnant. A positive test would indicate past infection that will not be transmitted to the fetus. The presence of antibodies also lessens the likelihood that congenital transmission would occur should she be exposed again to the parasite during pregnancy. An antibody-negative woman would thus be at greater risk of transmitting Toxoplasma to the fetus should she become infected during pregnancy. Protect cats from infection (or re-infection) by preventing access to birds, rodents, uncooked meat, and non-pasteurized dairy products. Avoid handling litter boxes. Even if a cat is antibody-positive and hence most likely immune, there exists a potential for reshedding of oocysts (although in much smaller numbers than during the initial infection). For safety, litter boxes should be changed daily or every other day by another person to eliminate any potential for accidental infection. Avoid handling free-roaming cats, because the fur or paws could be contaminated with oocysts, which might be transmitted by hand-to-mouth contact. Any cat allowed indoors should be kept off the bed, pillows, blankets, or other furnishings the woman uses. Avoid handling any cat showing signs of illness. Wear rubber gloves if working with garden soil. Uncooked vegetables, whether grown in a home garden or supplied commercially, should be washed thoroughly before ingestion, in case they have been contaminated by cat feces. Make a habit of vigorously and thoroughly washing hands with soap and water after contact with soil, cats, non-pasteurized dairy products, or uncooked meat or vegetables. http://web.vet.cornell.edu/Public/FHC/toxo.html Appendix 5 Parasite Risk Questionnaire Travel Have you ever been to Mexico, Africa, Israel, China, Russia, Asia, Europe, or Central or South America? Have your traveled to Hawaii, the Caribbean, the Bahamas, or other tropical islands? Do you frequently swim in freshwater lakes, streams, or ponds while abroad? Did you serve overseas while in the military? Were you a prisoner of war in World War II, Korea, or Vietnam? Have you had intestinal problems, unexplained fever, night sweats, or an elevated white blood count during or since traveling abroad? Water Is your water supply from a mountainous area? Do you drink from untested well water? Have you ever drunk water from lakes, streams, or rivers on hiking or camping trips without first boiling or filtering it? Do you use plain tap water to clean you contact lenses> Do you use regular tap water that is unfiltered for colonics or enemas? Can you trace the onset of symptoms (intermittent constipation and diarrhea, night sweats, muscle aches and pains, unexplained eye ulcers) to any of the above? Food Do you regularly eat unpeeled raw fruits or raw vegetables in salads? Do you frequently eat at sushi bars or salad bars; in delicatessens, vegetarian, Mexican, fish, Indian, Armenian, Greek, Pakistani, Ethiopian, Filipino, Korean, Japanese, Chinese, or Thai restaurants; fast food restaurants; or steak houses? Do you use a microwave over for cooking (as opposed to reheating) pork, fish, or beef? Do you prefer fish or meat that is undercooked, i.e. rare or medium rare? Do you frequently eat hot dogs made from pork? Do you eat smoked or pickled foods, e.g. sausage, lox, herring? Do you enjoy raw fishes like sushi and sashimi, Latin American ceviche, or Dutch green herring? Do you enjoy raw meat dishes like Italian carpaccio, steak tar tare, or Middle Eastern kibbe? At home, do you use the same cutting board for chicken, fish, and meat as you do for vegetables? Do you prepare sushi or sashimi dishes at home? Can you trace the onset of symptoms (weight loss, anemia, bloating, distended belly) to any of the above? Pets Have you recently gotten a puppy? Have you lived with, do you currently live with, or do you frequently handle pets? Do you forget to wash your hands after petting or cleaning up after you animals, and before eating? Does you pet sleep with you in your bed? Do your pets eat from your plates? Do you clean your cat’s litter box? Do you keep your pets in your yard where children play? Can you trace the onset of your symptoms (abdominal pain, high white blood count, distended belly in children, unexplained fever) to any of the above? Workplace Do you work in a hospital? Do you work in a pet shop, zoo, experimental laboratory, or veterinary clinic? Do you work with or around animals? Parasite Risk Questionnaire Do you work in a day care center? Do you garden or work in a yard to which cats and dogs have access? Do work in sanitation? Can you trace the onset of symptoms (gastrointestinal disorders) to any of the above? Sexual Practices Do you engage in oral sex? Do you practice anal intercourse without the use of a condom? Have you had sexual relations with a foreign-born individual? Can you trace the onset of symptoms (persistent reproductive organ problems) to any of the above? Symptoms (symptoms do have to be persistent) Do you have a bluish cast around your lips? Is your abdomen distended no matter what you eat? Are there dark circles around or under your eyes? Do you have a history of allergy? Do you suffer from intermittent diarrhea and constipation, intermittent loose and hard stools, or chronic constipation? Do you have persistent acne, anorexia, anemia, open ileocecal valve, skim eruptions, PMS, bad breath, itching, pale skin, chronic fatigue, food intolerances, sinus congestion, difficulty breathing, edema, bloody stools, ringing in the ears, anal itching, puffy eyes, palpitations, vague abdominal discomfort, or vertigo? Do you grind your teeth? Are you experiencing weight loss or weight gain, loss of appetite, insomnia, depression, moodiness, sugar craving, lethargy, or disorientation? Greater than 40 items checked = High risk for parasite infection Parasite Risk Questionnaire Greater than 30 items checked = Moderate risk for parasite infection Greater than 20 items checked = Some risk for parasite infection No overt symptoms may still mean “dormant” parasite infection. Parasite Risk Questionnaire Children Does your child have dark circles under his eyes? Is your child hyperactive? Has you child been diagnosed with “failure to thrive”? Does your child grind or clench his teeth at night? Does your child constantly pick his nose or scratch his behind? Does your child have the habit of eating dirt? Does your child wet the bed? Is your child restless at night? Does your child cry often for no reason? Does your child tear his hair out? Does your child have a limp that orthopedic treatment has not helped? Does your child have a brassy, staccato-type cough? Does your child have convulsions or an abnormal electroencephalogram (EEG)? Does your child have recurring headaches? Is your child unusually sensitive to light and prone to eyelid twitching, blinking frequently, or squinting? Does your child have unusual tendencies to bleed in the gums, the rectum, or the nose? Infants Does your baby have severe intermittent colic? Does your baby persistently band his head against his crib? Is your baby a chronic crier? Does your baby show a blotchy rash around the perianal area? Appendix 6 Alkaline-Forming Foods (based on consumption of 1 ounce) figs 30.0 pineapple molasses 18.0 coconut olives (green or ripe) 16.0 pomegranate lima beans 12.0 beans, baked soybeans 12.0 nectarines apricots (dried) 9.5 cabbage turnip of beet greens 8.0 cherries spinach 8.0 sauerkraut dandelion greens 8.0 grapefruit mustard greens 8.0 tomatoes raisins 7.0 radish kale 7.0 currents (dried) Swiss chard 5.0 cauliflower almond 3.6 lemon parsnips 3.6 string beans carrot 3.5 peaches beets 3.5 mushrooms dates 3.0 squash celery 2.5 watermelon rutabaga 2.5 grapes endive 2.0 buttermilk cantaloupe 2.0 whole milk lettuce 2.2 millet parsley 2.2 Brazil nuts watercress 2.0 buckwheat apricots (fresh) 2.0 onions potatoes (sweet, white) 2.0 green peas 2.0 2.0 2.0 2.0 1.8 1.8 1.8 1.7 1.7 1.7 1.7 1.7 1.5 1.6 1.6 1.5 1.2 1.0 1.0 1.0 0.7 0.5 0.5 0.5 0.5 0.4 0.3 Acid-Forming Foods (based on consumption of 1 ounce) egg yolk 7.5 bacon herring 5.5 lamb oysters 4.5 duck crab 4.5 whole egg lobster 4.0 spaghetti oatmeal 3.6 organ meats veal 3.5 rice sardines 3.4 bread (wheat or rye) perch 3.3 haddock salmon 3.3 crackers swordfish 3.3 bread (white) most other fish 3.3 most nuts most meats & fowl 3.2 egg whites liver 3.0 dry corn chicken 3.0 cornmeal pork 3.0 Zwieback ham (smoked) 3.0 American cheese macaroni 3.0 natural cheese most grains 3.0 lentils 3.0 3.0 3.0 3.0 3.0 3.0 2.8 2.5 2.5 2.3 2.2 2.0 1.7 1.6 1.6 1.6 1.6 1.5 1.5 Parasite Risk Questionnaire Parasite Risk Questionnaire